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This file contains materials relating to the Council of State Governments, the Meals - on - Wheels program, Older Americans Month, the American Association of Retired Persons, the National Retired Teachers Association, Grady Means, and Decker Anstrom.
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1523514
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Aging - General (1)
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1523514
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Aging - General (1)
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This file contains materials relating to the Council of State Governments, the Meals - on - Wheels program, Older Americans Month, the American Association of Retired Persons, the National Retired Teachers Association, Grady Means, and Decker Anstrom.
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collections
Sarah C. Massengale Files (Ford Administration)
Sarah Massengale's Health, Social Security and Welfare Files
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Legislation
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Presidential messages
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1976-11-30
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11
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1976
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The original documents are located in Box 2, folder "Aging - General (1)" of the Sarah C.
Massengale Files 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United States of America her copyrights in all of her husband's unpublished writings in National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.
THE WHITE HOUSE
WASHINGTON Date 11/15
TO: Sarah massingale
FROM: BOBBIE GREENE KILBERG
For Your Information
For Your Comments / Recommendations
Per Your Request
Per Our Conversation
REMARKS:
FORD LIBRARY & GERALD
557 Seventh Street
Brooklyn, N.Y. 11215
November 9, 1976
President Gerald R. Ford
The White House
1600 Pennsylvania Avenue
Washington, D.C.
Dear Mr. President:
The enclosed was given in at the Mayor's Office yesterday and the
accompanying letter sent to the Daily News today.
I believe that had the true plight of our elderly been given priority over
"contract language" funding would have been approved. The mention of
401.6 million being the "highest level in history" in the Memorandum from
Senator Church's Committee should have been made to envision that this,
the first time in 199 years, spread over that same 199 years would not have
apppeared to be so large. The plight of our elderly would not have been
what it was revealed to be by Government appointed COmmittees and Commissions
had appropriations been made at a much earlier date than the Bicentennial
year.
Its sad that it took Government representation to be appointed to such
as the Commissions/Committees before the initial steps could be taken to
rectify that which took 1999 years to unveil.
Trusting that brighter days are ahead for our elderly and, the Nation.
FORD LIBRARY & GERALD
Respectfully yours
Rhona Smith
Rhona Smith
ENCL: 2
557 Seventh Street
Brooklyn, N.Y. 11215
November 7, 1976
The Editor
The Daily News
220 East 42nd. Street
New York, N.Y. 10017
GERALD FORD LIBRARY
Sir:
The enclosed is in gratitude for the Headline afforded our elderly in your
October 30 th. edition of your Newspaper which read "War Declared On Vultures
Who Prey on Elderly.
Withput doubt you very possibly can see where anapology may be due the Nation's
President due to the fact as the enclosed example shows that funding could
not be jastified for "transportation" while our elderly lay rotting and the
Nation or its REpresentatives could not be informed as the enclosed will attest.
The like of this in truth was yet to be revealed by then yet-to-be-appointed
Committees and Commissions such as the Commission on Living Costs, the
Moreland Act Commission, The Subcommitte on Long-Term Care and the various
Committees select and otherwise on the U.S. Senate level together with
those which followed suit on the Congressional, State Senate and, Assembly
levels and the most important voices of all our elderly at "PUBLIC HEARINGS."
The enclosed should be ample enough evidence that a public apology to The
President is in order when the true need for funding the vardous programs
in New York City remained buried such as did the plight of our incarcerated
dehydrated, emaciated, exanguinated moribund elderly. It remained for
Representatives alone to enter into that field, a totally alien one to the
United States as Government DOcumenlation verifies today. This after 199 years
as the 1975 Session of the Legislature will verify when the first laws were
entered on the books of these United States for the protections of the elderly.
Need one say more. Government, and not, "agencies" took the initiative and as
DC
>/
11
2
the most recent volume "FRAUD AND ABUSE AMONG PRACTITIONERS PARTICIPATING IN
THE MEDICAID PROGRAM" A STAFF REPORT PREPARED FOR THE SUBCOMMITTEE ON LONG-TERM
CARE OF THE SPECIAL COMMITTE ON AGING UNITED STATES SENATE an acceptable voice
on behalf of the Nation should attest.
In truth the voice of the people was locked out. The only voice that could be
heard like that of Robert Kennedy's on Willowbrook was that of Government. It
should be Obvious that only Government acceptable voices could be and weree
heard. Then, and not until then, coudd the true plight of our elderly be
readied to come to light. And your Newspaper helped in the coverage of the
1976 unveilings. Truly, the greatest gift the Nation could possibly receive
in its Bicentennial.
Respectfully yours
Rhona Smith
DELIVERED TO MAYOR'S OFFICE NOVEMBER 9, 1976 for First Deputy
Mayor.
THE DAY THAT SENIOR CENTRES CAME INTO BEING IS THE DAY THAT "WAR WAS DECLARED"
ON THOSE WHO PREY ON THE ELDERLY.
THE PLIGHT OF OUR HOMEROOM/BEDBOUND ELDERLY, LIKE&THAT OF THE INCARCERATED ELDERL
NEEDS SOMETHING LIKE THE COMMISSION ON LIVING COSTS/THE MORELAND ACT COMMISSION/
THE SUBCOMMITTEE ON LONG-TERM CARE BEFORE THE VOICE OF THE DEHYDRATING, EXANGUINAT-
ING ELDERLY IS HEARD. IT NEEDS FORTHWITH A ROBERT KENNEDY OF WILLOWBROOK.
THE ENCLOSURE SHOULD ATTEST TO THE TRUTH, OR SOME OF IT, WHY NEW YORK DID NOT AND
COULD NOT GET ASSISTANCE. IF THIS HAPPENED THROUGHOUT ALL EXISTING AGENCIES
IT IS POSSIBLE TO CONCEIVE OF NEW YORK BEING ABORTED FROM THE UNION. SOME SENSE
OF VALUES! SEEKING FOR TRANSPORTATION FOR OUR ELDERIA WHEN IT WAS YET TO BE
VERIFIED BY VERIFIABLE AUTHORITY SUCH AS WAS DISCLOSED BY THE VARIOUS COMMITTEES/
COMMISSIONS ET AL. NO MAN AND NO NATION COULD ELICIT THAT SUCH INSTANT ASSISTANCE
WAS OF SUCH AN IMMINENT NATURE FROM THE SOLE VOICE FOR OUR ELDERLY so HOW COULD
ANY CITY MUCH LESS NEW YORK EXPECT THE NECESSARY ASSISTANCE?
THE MOST RECENT GOVERNMENT ISSUE FROM THE SUBCOMMITTEE ON LONG-TERM CARE SHOULD
BE MORE THAN AMPLE EVIDENCE TO SUPPORT THAT WHICH IS A MUST.
OF COURSE ONE MUST TAKE INTO CONSIDERATION THE MOST RECENT ALBATROSS
THE PRIVACY ACT OF 1974. WITHOUT THIS ALL IS AT A STANDSTILL.
THE HOTLINE PERSONNEL ATI 1-800- 42-9871 CAN ATTEST TO THIS. AND THE STRANGULATING
EFFECT IT HAS HAD ON ITS EFFORTS TO GAIN ASSISTANCE FOROUR ELDERLY.
MUST OR SHOULD THE CITY EMBARK ON THAT WHICH IS NECESSARY TO PROTECT ITS ELDERLY
RESIDENTS BY CREATING A HOTLINE SOMEWHERE IN CITY HALL LEST THE SAME CATASTROPHY
AS TOOK PLACE AT THE WHITE HOUSE CONFERENCE ON AGING BE REPEATED? 'TWOULD SEEM so,
NOW THAT IT HAS COME to LIGHT THAT ANYTHING CALLED INTO THE PRESENT "HOTLINE FOR
THE AGED" CAN COME TO BE REGARDED AS "HEARSAY" AS OF LAST WEEK!!!!!
IT IS REGRETTABLE THAT THE CITY HAS BEEN HELD INCOMMUNICADO AND WAS NOT INFORMED
BEFORE OCTOBER 30TH. 1976 THAT THE CREATION OF SENIOR CENTRES ARE THE LIVING
TESTIMONY TO PREVENTION OF SLAUGHTER OF OUR ELDERLY AND THE CONDUIT TO CUT OFF
AN ONGOING SUPPLY TO THAT ATROCITY OF ALL ATROCITIES
A MODERN-DAY AUSCHWITZ. NEW YORK EITHER UNKNOWINGLY OR UNWITTINGLY REMEMBERED AS
WE ARE WONT TO BE REMINDED AND ONE CAN NOTPOSSIBLY CONCEIVE OF THE MAYOR OF THE
CITY BEING HELD IN SUCH A STATE OF INCOMMENICADO. BUT THE OID ADAGE COMES TO
MIND "THE FIRST SHALL BE LAST AND THE LAST SHALL BE FIRST" WHICH IS IN TRUTH WHAT
HAPPENED AS NEW YORK LED THE WAY INTO THAT UNKNOWN ABOMINABLE EXISTENCE (IF THAT
IT CAN BE CALLED) OF ELDERLY HUMAN BEINGS"REBIDING" WITHIN THE CONFINES OF A
CITY WHOSE PORTALS ARE ADORNED WITH SUCH WORDS AS "GIVE ME YOUR TIRED ETC."
WELL, "AGENCIES" "PROGRAMS" OR WHATEVER WERE GIVEN SUCH ASTHETIRED AND THE WEARY
AND THE END RESULT WAS DEHYDRATION/EXANGUINATION/STARVATION UNTO DEATH OR A
COMBINATION OF ALL. THAT IS UP TO THE JUSTICE SYSTEM TO DECIDE A SYSTEM WHICH
HANDED DONUME "RULINGS" ON INSTITUTIONS BEFORE CURRENT INVESTIGATIONS WERE COMPLETE!
ENVISIONED/APPOINTED/FUND-APPROPRIATED OR WHATEVER!
EXCERPTED FROM 1971 WHITE HOUSE CONFERENCE ON AGING
TOWARD A NATIONAL POLICY ON AGING
FINAL REPORT VOLUME 1 PAGE 83
HOW COULD ONYONE IN OFFICIALDOM KNOW? THE ORACLE HAD SPOKEN. WONDERED! AND WHILE THE
so ROTTED INCOGNITO THE CITY WONDERED AND WONDERED AND
ELDERLY BUT TRUE NOW THAT SUCH VOICES AS THE APPOINTED COMMITTEES AND THANKS COMMISSIONS BE
SAD, HAVE HAD THEIR SAY AND EACH CAN SAY IN UNISON :VENI, VIDI, VICI. PROGRAMS.
THE FOUNDATIONS MUST BE LAID BEFORE INITIATING ANY NEW
TO GOD.
trators in that poll, admitted they had never heard
they will pay a 22½ percent increase in rent.
of an ombudsman. When briefed, two-thirds of
This year's Social Security increase has been
this latter group wanted a state education om-
turned over to the landlords.
budsman immediately.
A massive Federal rent subsidy program must
be endorsed by this White House Conference and
passed by Congress.
Alice M. Brophy,
Director,
In New York City's half-fare transit program
New York City Office for the Aging
for the elderly over 600,000 older New Yorkers
New York, New York
signed up for their passes, 50 percent "get around
more," and 67 percent plan their day to trável
New York City has the largest concentration
in nonrush hours when the fare is reduced. This
of elderly in the country. One million residents,
program means physical mobility and income
5 percent of Americans over 65, live in our five
supplementation.
boroughs. 25 percent of the Nation's elderly live
below the poverty level, 50 percent of our elderly
But New York City is at the breaking point.
FORD
subsist at that level. Most elderly own their homes
The program costs 15 million dollars a year of
is
mortgage free; 70 percent of our city's elderly
city tax levy monies. There must be Federal sub-
are renters without assets. They are poorer today
sidies for operating expenses of mass transit pro-
GERALD
LIBRARY
because they have been poor all their lives.
grams for senior citizens.
Fifty percent of New York City's poverty
Ronald H. Wilson
stricken elderly spend more than 35 percent of
Asbury Methodist Home for the Aged, Inc.
their income on rent. The Federal Government
Gaithersburg, Maryland
has admitted to its responsibility for tenants in
public housing who now pay no more than 25
The American Protestant Hospital Association
percent of their income for rent.
urges all White House Conference on the Aging
But our elderly live in the older rent-controlled
Delegates to actively support efforts being made to
housing of the city without subsidy. This year
obtain tax exemptions for all nonprofit homes for
the aging.
HEALTH.
SDUCA
DEPAR ARTMENT DEPARTMENT
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
U.S.A.
WASHINGTON, D.C. 20201
OFFICE OF THE SECRETARY
Office of Human Development
Administration on Aging
October 28, 1976
NOTE TO SARAH MASSENGALE:
All
I thought you might be interested in the
attached National Journal article on "Senior
Power" if you'd missed it.
Decker Nake Anstrom
Assistant to the Commissioner
Attachment
FORD LIBRARY s GERALD
LOBBYING REPORT
There's a New Kick in the Step
FORD
of the Senior Citizen Lobbies
LIBRARY
The over-65 group represents a ready-made political force that is gaining power
and recognition for the needs of senior citizens.
BY LINDA E. DEMKOVICH
izations: the National Council of Senior
Problems: Probably the single most
Citizens (NCSC), which traces its be-
important issue confronting those over
On Nov. 2, more than 60 million voters
ginnings to organized labor and the so-
65 is the lack of an adequate income.
are expected to turn out at the polls
cial activism of the 1960s; and the
For most people, retirement automati-
to choose the next President. Of that
American Association of Retired Per-
cally means a reduction in income,
number, approximately one voter in six
sons (AARP), which caters to the needs
sometimes by as much as half, and re-
will be over the age of 65, the invisible
of retired professionals. (Affiliated with
liance on private pension or social se-
line that confers automatic status as a
the AARP and served by the same staff
curity benefits. For others, principally
"senior citizen."
is the National Retired Teachers Asso-
those not eligible to draw social securi-
Considering that those in the 65-and-
ciation.)
ty, it means turning to the Supplemental
over age bracket account for only slight-
Taken together, the two groups pur-
Security Income (SSI) program set up
ly more than 10 per cent of the total
port to represent nearly 14 million per-
in 1974 to aid the needy aged, blind
U.S. population, the elderly would ap-
sons over the age of 55. (The council
and disabled.
pear to have a claim as a political force
says its membership exceeds 3.5 mil-
According to a special survey, The
that isto be reckoned with. But in spite
lion, while the association has 9.5 mil-
Myth and Reality of Aging in America,
of gains in recent years, their potential
lion dues-paying members, in addition
released in January by Louis Harris
has yet to be fully realized.
to the 500,000 members of the affiliated
and Associates Inc., 23 per cent of the
For one thing, it is now recognized
teachers group.)
population over the age of 65 have an-
that older persons generally do not for-
Although both the council and the
nual incomes of $3,000 or less, com-
sake lifetime voting habits simply to re-
association are nonprofit organizations
pared with 6 per cent of the 18-64 age
flect their newly acquired status as
and thus prohibited from employing
group. The median household income
senior citizens. With the two possible
lobbyists, their memberships, acting at
for those over 65 is $4,800 a year, Har-
exceptions of social security and medi-
the behest of the two national offices,
ris found, compared to $12,400 for the
care, there have been few single issues
represent a sizable lobbying force.
18-64 segment of the population.
to unite older voters in the manner of
Both organizations have flaws, both
Rivaling income as the number one
the labor or farm vote, for example.
have experienced failures. But there is
issue is the problem of rising health care
Second, larger numbers of the over-
little doubt that without their efforts,
costs. In spite of medicare, enacted in
65 generation live at or below the pover-
many federal programs and policies for
1965 in response to groups lobbying for
ty level or are in ill health or both.
the elderly would have been allowed to
a government-sponsored insurance sys-
Consequently, it makes it more diffi-
lapse. Their watchdog role has been a
tem, the elderly were forced to pay an
cult to build a powerful political base
useful one.
average of $392 out of pocket for health
there.
Other organizations, both private and
care expenditues in 1975. That repre-
Finally, it has only been in the past
governmental, have figured importantly-
sents an increase of 65 per cent in the
decade-and more accurately in the
in representing the interests of the
10 years since medicare took effect.
past five years, since the White House
elderly. The National Council on the
There is a vast array of other prob-
Conference on Aging in 1971-that
Aging Inc., for example, representing
lems that beset the elderly that have yet
the voice of the nation's elderly has
professionals in the field of gerontology,
to be addressed fully: housing, trans-
begun to be heard and noted in the po-
has filled much of the gap in research
portation, crime, dwindling job oppor-
litical process. (For background on
and training, where the membership
tunities and health-related concerns
issues prior to the 1971 conference, see
groups have little expertise. Similarly,
such as care facilities and nutrition.
Vol. 3. No. 39. P. 1966.)
the Senate Special Committee on Aging,
And then there are the unique social
Advocates: A large share of the credit
in existence since 1961, and the Health,
and psychological problems-the sense
for alerting federal policy makers to the
Education and Welfare Department's
of isolation often stemming from in-
special problems of the elderly and for
Administration on Aging have played
firmity or insufficient income. for exam-
transforming senior citizens into a more
key roles within the federal government.
ple, or the reality of death-that be-
astute and active lobbying force must
(For a complete list of organizations, see
come all the more critical with advanc-
go to the two largest membership organ-
box. P. 1387.)
ing age.
1382 NATIONAL JOURNAL 10/2/76
Trends: In the past, the interest groups regulatory structure. The association,
Citizens. Before he was elected to that
have focused much of their attention in particular, has been devoting more
position, Cruikshank was director of the
and
resources
at
the
national
level
of
its
time
on
efforts
to
AFI
CIO's
social
security
department
until the rast year or two IS the rederal acm 01 the National 1 ounen 01 Senior learning that you can I go into a com-
10/2/76 NATIONAL JOURNAL 1383
AMERICAN ASSOCIATION
A
H
OF HOMES FOR THE AGING
The national association of Nonprofit Homes
David C. Crowley, ACSW
Executive Vice-President
October 26, 1976
Ms. Sarah Massengale
Executive Board
The White House
Monsignor Charles J. Fahey
1600 Pennsylvania Avenue
President
Washington, D.C. 20500
Syracuse, New York
Ronald R. Ramstead
President-Elect
Dear Ms. Massengale:
Norwalk, California
Howard B. Bram
As you requested, I am sending you information on our associa-
Vice-President
tion. The American Association of Homes for the Aging represents
Beachwood, Ohio
1400 nonprofit housing, homes, and health-related facilities
J. Scott Houston
serving over 200,000 elderly persons throughout the United States.
Vice-President
Atlanta, Georgia
Because a large number of our members have nursing units (or are
Richard A. Short
free-standing nursing homes), I am particularly interested in the
Immediate Past President
President's promise to expand nursing homes and make them more
High Point, North Carolina
readily available.
Reverend Jerry D. Smart
Secretary
Cincinnati, Ohio
You may recall that my purpose in calling you was to learn
Jacob Reingold
whether a policy statement on this issue, other than the short
Treasurer
remarks made by the President in Miami, was available. I hope you
Bronx, New York
will keep my interest in mind, and let me know when and in what
John A. Jackson
manner the President will implement his promise.
Los Angeles, California
Lawrence E. Larson
New York, New York
Sincerely,
Reverend Everett B. Luther
Phoenix, Arizona
Mother Joseph Mary
Lais Wasser
Trumbull, Connecticut
Lois Wasser
Reverend Guy B. McClure
Editor
Blair, Nebraska
Washington Report
Reverend Albert L. Schartner
Dillsburg, Pennsylvania
FORD LIBRARY & 078839
Gene D. Todd
Great Falls, Montana
LW/mt
Melvyn Weissman
Kansas City, Missouri
Enclosures
1050 17th St., N.W., Suite 770, Washington, D.C. 20036 (202) 296-5960
AMERICAN ASSOCIATION OF HOMES FOR THE AGING
AAHA
The national organization of NONPROFIT HOMES
374 National Press Building, 14th & F Streets, N.W., Washington, D. C. 20045 Telephone (202) 347-2000
THE AMERICAN ASSOCIATION OF HOMES FOR THE AGING
The American Association of Homes for the Aging (AAHA) represents nonprofit housing,
homes for the aging, and health-related facilities serving the elderly throughout the
United States. It was founded in 1961 under the auspices of the National Council on the
Aging through a grant from the Ford Foundation.
AAHA's member homes vary widely in primary purpose, but they are joined by a shared belief
that the community, whether through civic, religious, fraternal, or other sponsorship,
has a responsibility for seeing to the delivery of needed services for the elderly.
Included in the membership are homes that provide skilled nursing services; homes offer-
ing personal care services, such as help with bathing and eating; residentially oriented
facilities with such services as centralized dining and laundry; and specialized housing
which may offer no services, but instead simply provide barrier-free living environments
for the elderly. Some homes are multi-level and provide more than one type of living
style in a single location.
Over 200,000 older Americans live in AAHA member homes. An additional number of elderly
living independently in communities benefit from noninstitutional services provided by
an increasing number of these homes, such as meals on wheels and other nutrition programs,
and adult day care.
Most AAHA member homes are sponsored by religious or fraternal organizations. Others are
sponsored by government agencies, civic groups, and unions. Altogether, 1400 homes and
200 professionals and students make up the membership of the association which is head-
quartered in Washington, D. C.
For Further Information
Contact: Lois Wasser
(202) 347-2000
GCRALD FORD LIBRARY
3/16/76
An
Invitation
to
NON
PROFIT
HOMES
AND
FACILITIES
FOR THE
ELDERLY
LIBRARY GERALD FORDI
AAHA,
a national
organization,
meets the needs
of its members
because it is
directed
by its members.
AAHA,
A non-profit association
created to meet the needs
of residents and management
of non-profit facilities for
the elderly, invites membership
of interested organizations
or individuals.
AAHA
AAHA —
Its Purposes
The inalienable rights of the residents of
facilities for the elderly: self-determi-
Headquartered in Washington, but
nation, privacy, personal dignity, fulfilling
responsive to its members throughout
social roles, good medical and physical care.
the country, AAHA helps non-profit
member homes meet the needs of
their residents in many ways:
AAHA represents the interests of its
members in position papers presented
to influential government agencies,
committees, and individuals.
AAHA informs its members of
governmental regulations, interprets
their importance, suggests ways to
implement them.
AAHA conducts accredited workshops,
seminars, and conferences covering
new developments in the long term
care and housing field. In most cases,
local and state agencies allow sub-
stantial credits for these courses
towards annual licensure
requirements.
AAHA serves its members on an in-
dividual basis. The staff at its
Washington headquarters is always
available to answer questions, fill
requests, help in every way possible.
implications. Copies of relevant new
AAHA -
regulations are sent to members and
then are followed by interpretations of
Its Information
the meaning of the acts and suggested
methods of abiding by the regulations.
Services
Announcements: Special conferences,
seminars, legislative workshops and
Recognizing the need for its members
other meetings are described in detail,
to keep up to date on current in-
giving members ample information on
formation and pending developments,
programs they may wish to attend.
AAHA regularly publishes reports,
newsletters, magazines and other
AAHA Journal: A bi monthly
materials.
publication for long term care
providers is available on a subscription
AAHA "Washington Report": At least
basis. This timely publication includes
twice a month, this informative
by-lined articles by recognized experts
bulletin notifies members of current
on many subjects of great interest to
and pending legislation, suggests how
administrators and specialists in the
to comply with changes.
field of aging.
AAHA News Scene: An attractive,
FROM
THE
photograph-filled, timely magazine,
/
SECTOR
the AAHA News Scene covers news-
LegaL Deces
he
AAHA
News Scene
making people and events, including
MAIN
by-lined articles by leaders in the field
of care of the aging.
H.R. 13870
ANANNA REPORT
19
12% ANNUNFEREN MEET
The
IDENTITY
Washington
Report
AAHA Executive Memo: Published
when special issues warrant, this
CANUARY 107%
memo is prepared by the Executive
BULLETIN
I
Vice President. Basically a progress
report on the Association, it also covers
special concerns, new projects, and
federal register
The Social Components
other information worthy of notice.
13.16. 1973
AAHA Legal News: Prepared monthly
for attorneys and other legally oriented
members, the Legal News includes
information on legislation, case
histories, methods of handling liability
problems, etc.
Action Bulletin: When questions or
problems requiring immediate action
of the members arise, the Action
Bulletin is rushed to all members.
AAHA members are kept current on
Special Mailings: In-depth coverage of
the latest developments with regular,
new regulations, their significance and
interesting, informative publications.
AAHA — and
AAHA -
The Government
Member Meetings
When important policies affecting non-
AAHA conducts in-depth conferences,
profit facilities for the aging are being
seminars and workshops in different
- or should be - considered, AAHA
areas of the country, many of them
prepares position papers representing
accredited by respective states,
the interests and concerns of its
allowing those who attend to accumulate
members. Because of our earned
credits required for annual licensure.
credibility, federal officials respect
these well-researched documents and
Annual Meeting and Conference: Held
refer to them in studying the
each year in different cities, the
possibilities of proposed legislation.
meetings with panels and speakers
cover federal regulations, housing and
State and federal officials regularly
environment, recruitment and training
turn to AAHA for information that will
of long term care personnel, medical,
be helpful in providing for optimal care
physical, professional development
and protection for the elderly.
institutes and more. High-level
government officials and top
In addition, AAHA notifies its mem-
professional and educational leaders in
bers of all changes in governmental
the field attend the conferences as speakers
policy and regulations, interprets the
and delegates. The all day conferences also
meaning of such developments and
include breakfasts, luncheon meetings,
clearly spells out the steps necessary
banquets and receptions.
to comply with regulations and to take
advantage of all possible govern-
Legislative Workshop: Each spring, a
mental services available to facilities
two-day national Legislative Workshop
and their residents.
is held in the nation's capital. When
appropriate, additional regional
workshops are held on issues of
specific member interest or concern.
7
AAHA represents the interests of its
Meetings, conferences and seminars keep members
members to the government, and, in
up to date on continuing changes in their field.
addition, interprets government policy
LICENSURE CREDIT IS ROUTINELY
to its members.
APPLIED FOR IN THE CASE OF ALL
AAHA TRAINING ACTIVITIES.
AAHA —
Information: Washington personnel
will be glad to answer members'
inquiries on governmental policy,
Its Benefits
resources for equipment or supplies,
housing, tax forms, and similar
technical assistance.
Headquartered in Washington, AAHA
is, in effect, a branch office of every
Convenience: AAHA invites members
member.
to visit its office when they are in the
area, and offers them all possible
Membership in AAHA provides many
courtesies.
important advantages:
Referrals: Although AAHA does not
Credibility: Potential residents and
make specific recommendations, all
their families recognize membership
inquiries as to suitable homes in any
in AAHA as an indication of a home's
area of the country are answered with
stature in the field, its professionalism,
lists of local member homes. In ad-
knowledge and interest in a resident's
dition, AAHA frequently serves as a
care. Qualified personnel are also
clearing house for personnel inquiries,
attracted to member homes for similar
although there is no formal em-
reasons.
ployment referral service at this time.
A Staff of knowledgeable, efficient,
interested people in the Washington
office is always available to offer mem-
bers its professional expertise.
AAHA —
2. ASSOCIATE MEMBERS
Qualifying individuals and
organizations receiving all the
Its Members
benefits of membership except voting
rights include:
Thousands of non-profit homes are
a. Individuals: accountants,
sponsored by churches, synagogues,
architects, attorneys, medical
fraternal groups, unions, and govern-
doctors, psychologists, nurses,
ment agencies. Because they share so
members of the Board of
many problems in offering their
Homes / Facilities, others.
residents the best in medical, physical
(Note: Full time employees of
and social care, many have joined
Homes and Facilities may not
forces in AAHA to promote their in-
join as individual members
terests and those of their residents.
unless the facility itself is a
member.)
AAHA offers two categories of
b. State Associations of non-profit
membership to assist various groups of
Homes for the Aging.
professionals interested in improving
c. National Organizations
the care of the elderly in non-profit
d. State and Local Organizations
homes:
or Agencies
e. Business Firms or Suppliers
f. Legal Section: Attorneys and
1. VOTING MEMBERS
others dealing directly with
Member homes and facilities:
the legal problems of member
Non-profit, voluntary and
homes.
governmental institutions caring
for the aging which meet licen-
sure standards or operate under
Totally responsive to the views of its
community sanction where
members, AAHA's policies are developed
licensure does not exist. These
by the elected House of Delegates and
members alone have voting rights
put into action under the direction of
in the association.
the elected Executive Board.
Action Committees
Much of AAHA's great work comes
from the dedicated involvement of
members on upwards of eighteen
action committees.
Members are invited to serve and
provide a wide variety of expertise on
such issues as federal regulations,
educational endeavors, research,
resident's rights, environment, facility
planning and design, etc.
Thus AAHA's activities, goals, and
directions are truly guided by the
members themselves.
AAHA
AAHA
AMERICAN ASSOCIATION OF
HOMES FOR THE AGING
374 National Press Building
14th & F Streets, N.W.,
Washington, D.C. 20045
(202) 347-2000
David C. Crowley, ACSW
Executive Vice President
HEALTH
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
DEPART
OFFICE OF THE SECRETARY
USA
WASHINGTON, D.C. 20201
Office of Human Development
Administration on Aging
AUG 27 1976
MEMORANDUM FOR THE HONORABLE SARAH MASSENGALE
FORDO & LIBRARY GERALD
Subject: Possible Items To Be Included in Speech
by President to NCOA Annual Meeting
The following are some items that conceivably could be included
by the President in a speech to NCOA's Annual meeting in
Chicago, scheduled for September 28-30. Ideas which have not
previously been endorsed by OMB are asterisked.
1. Income Protection
a. Continue to control inflation
Emphasize how President Ford has cut inflation,
which seriously affects older persons, in half.
Reiterate stance that major attention will continue
to be given to controlling and reducing inflation.
We could use language on this that is in the
Special Message.
b. Maintain the integrity of the Social Security system.
Reiterate Special Message proposal to increase payroll
taxes to stabilize the system's funding.
Strongly underline the President's de-coupling
proposal, which the Congress has yet to take action
on, and emphasize how this will protect long-term
financing of the system. We could again use part
of the Special Message language.
*c. Pledge to request as part of the FY 1978 budget a full
cost of living increase in Social Security benerits.
Note that this is consistent with President's commitment
to insure that older persons do not suffer from
inflation. Though this is a new proposal, it was
followed in the FY 1977 budget request. There is
language in the Special Message on the 1977 initiative.
Page 2 - Honorable Sarah Massengale
*d. Propose to eliminate the loss in earnings that occurs
under Social Security when a person remarries.
Under current law if two beneficiaries remarry their
benefits as a couple are less than what they received
as individuals. This situation has caused older
persons to live together without being married, which
tends to be a source of great embarrassment to the
older people, or else leads older couples who do choose
to remarry to live on lower incomes. As of October 1975,
Social Security estimated that the cost of an amendment
to correct this situation would have been $120 million
for calendar 1977. The long range cost projection
for the amendment would be 0.01% of the taxable payroll.
This is a very emotional issue which could be extremely
popular by underlining how this would help preserve
the dignity and freedom of choice of older persons.
It also can be used as an illustration of how the
President wants to reinforce the family, by eliminating
a penalty older people now pay for remarrying.
*e. Liberalize the retirement earnings test for Social Security.
Currently an older person loses $1 in benefits for
every $2 earned above $2,760. This figure does increase
to account for increases in the cost of living. It is
argued that this extremely low figure serves as a
disincentive for older persons to remain in the labor
force, and that it would be wise public policy to
increase this figure to at least $4,000.
This proposal is advocated almost universally by
persons in the field of aging.
Primarily, it is attractive because it eliminates an
incentive for older persons to quit working, and would
therefore serve to keep people involved in the life
of their community.
FORD LIBRARY y GERALD
Page 3 - Honorable Sarah Massengale
*f. Property tax relief
Senator Beall has recently introduced a bill that
incorporates a proposal Secretary Schultz made in 1973
to provide property tax relief for the elderly.
The proposal calls for a refundable tax credit,
up to $500, for real property taxes, paid by persons
65 and older, if the person's tax exceeds 5% of the
household's adjusted gross income. The credit would begin
to be phased out at $15,000 and phase out completely
at $25,000. The Treasury Department has recently
estimated this proposal would cost $750 million.
It's major strength is that it would underline the
nation's commitment to enable older persons 2/3 of whom
own their own homes, to remain in their own homes.
2. Health Care
a. Repeat the President's catastrophic coverage proposal.
Language on this is in the Special Message.
If at all possible, I would strongly urge that
increased cost-sharing for older persons be reduced
to a level where the income would be just enough to
cover the cost of the insurance program.
b. Eliminate Medicaid fraud and nursing home abuse.
HEW's efforts in these areas could be identified.
The President could emphasize in strong terms that
fraud and abuse of the nation's older people, especially
these vulnerable older people in nursing homes, will
not be tolerated.
C. Support for the nursing home ombudsman program.
Language in the Special Message could be used to
underline support for this effort.
Page 4 - Honorable Sarah Massengale
3. Maintain Independence
a. Reemphasize the President's support for the national
network on aging.
Many of the persons in the audience are working every
day with Title III and Title VII programs. Therefore
the President should identify himself very forcefully
with the network. Again, there is language in the
Special Message that can be used.
*b. Support Title V -- Senior Centers
The Administration has never requested funds for this
program. $5 million was appropriated for the
transition quarter; $20 million is currently in the
HEW/Labor 1977 bill that is in conference.
NCOA is the one organization that has been at the
forefront of the senior center movement. A positive
sign of interest by the President would be very, very
well received. This sign could be in the form of a
statement that he is glad funds are in the 1977 bill;
he will request funds in 78.
The thrust could be in terms of providing "one-stop"
service centers for older persons, located in their
own neighborhoods.
*c. Tax incentives for children who have their parents live
with them.
It clearly costs money and takes time for children to
support their parents in their home. Too often,
therefore, the "easy way out" of placing older persons
in nursing homes is taken. The psychological costs and the
cost to the Federal treasury of this decision is enormous.
By offering tax incentives this trend could perhaps be
turned around. The value of a multi-generational family
unit could be protected; unnecessary institutionalization
could be reduced; and Federal outlays could be reduced,
assuming the net tax incentives would be less than the
cost of supporting persons in nursing homes (it seems
reasonable to assume that at the very least these costs
could be equal).
Page 5 - Honorable Sarah Massengale
4. Crime
*a. Mandate that LEAA plans provide for programs to
protect the elderly.
Older people in a 1975 Harris poll identified
fear of crime as their major problem. Legislation
currently in conference extending LEAA mandates
State LEAA plans to provide for programs to protect
the elderly. The President could embrace this
legislation, and indicate he will instruct LEAA
to enforce it vigorously. The President's tough
stance on crime could be re-emphasized and his
determination that the most vulnerable in society
will not be victimized by criminals strongly stated.
*b. Initiate Justice Department effort to combat fraud against
the elderly.
Older persons have been identified as being particularly
vulnerable to confidence games and fraud, whether on
stock schemes, land sales, etc. The Justice Department
could be instructed to study this problem and report
to the President, with recommendations for action.
5. Housing
a. Support for Section 202 program
This program will be funded at a $750 million level
in FY 1977, and support the construction of 30,000
units for the elderly and handicapped. It's very
popular in the field of aging. The President could
associate himself with it, in view of him signing the
FY 1977 appropriations bill for the program.
*b. Insure that social services be provided in publicly-
subsidized housing for the elderly.
A major problem has been insuring that needed social
services are available to older persons residing in
publicly-subsized housing. The basic problem
results from a simple lack of adequate services in
many communities. However, the problem could be
alleviated to some extent if sponsors of such housing
were required, in order to have an application for
Page 6 - Honorable Sarah Massengale
construction approved, to demonstrate how they
were going to insure that services would be available.
This could perhaps be done by requiring the appropriate
Area Agency on Aging to sign-off on the application
with such an assurance before HUD would act on the
application. Some thinking needs to be done about what
action would be taken if no services were available,
though -- should an application nto be approved in such
a situation? If so, would this tend to penalize
low-income areas?
6. Involvement of Older Persons
a. Emphasize commitment that older people be involved in
the labor force.
Language from the President's signing of the Older
American's Month Proclamation could be used very
well for this purpose.
b. Support for Action volunteer programs.
Underline continuing support for these programs, i.e.
Foster Grandparent, RSVP, Senior Companions.
*c. Call for public schools to open their doors to older persons.
AoA and the Office of Education have a working agreement
in this area. Two themes could be noted: (1) utilizing
existing facilities and resources; and (2) bringing
together the young and the old. Several specific ideas
could be underlined, including encouraging school lunch
rooms to serve older people, and encouraging schools
to utilize older people as teacher aides and resource
people in the schools.
The notion of involving older people in their neighborhood,
and of the neighborhood taking advantage of the wisdom
and skills of older people -- with no additional cost
to the Federal treasury -- can be a very appealing one.
The President could call on local school boards to take
this initiative.
Page 7 - Honorable Sarah Massengale
7. Older Persons and the Arts and Humanities
*a. Direct National Endowment for the Arts and Humanities
to give attention to involving older persons.
The President, noting the varied skills and talents
of older persons, could direct the Endowments, within
existing budgets, to give special attention to designing
projects that will encourage the involvement of older
persons in the arts and humanities.
This could emphasize the meaningful way older people
can enrich our national life.
These obviously represent a wide range of ideas that can be woven
into a Presidental address. Some entail additional Federal
expenditures, and I recognize that it may be difficult to obtain
clearance for those. They can be defended though, and I hope they
will be pursued. As a minimum, however, I would hope we could
get clearance for the non-cost items. It is extremely important that
the President have something new to say before the NCOA meeting if
he is to address them.
I look forward to talking with you about these ideas after Labor Day.
I will be happy to help you in any way I can to flesh out the ideas
and develop the speech if the President accepts NCOA's invitation to
address their meeting.
Arthur S. Flemming
Commissioner on Aging
FORD & LIBRARY 076830
HEALTH
NOTIV
L'I
DEPARTMENT OF HEALTH. EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
USA
WASHINGTON, D.C. 20201
Office of Human Development
Administration on Aging
AUG 27 1976
MEMORANDUM FOR THE HONORABLE SARAH MASSENGALE
Subject: Possible Items To Be Included in Speech
by President to NCOA Annual Meeting
The following are some items that conceivably could be included
by the President in a speech to NCOA's Annual meeting in
Chicago, scheduled for September 28-30. Ideas which have not
previously been endorsed by OMB are asterisked.
1. Income Protection
a. Continue to control inflation
Emphasize how President Ford has cut inflation,
which seriously affects older persons, in half.
Reiterate stance that major attention will continue
to be given to controlling and reducing inflation.
We could use language on this that is in the
Special Message.
b. Maintain the integrity of the Social Security system.
Reiterate Special Message proposal to increase payroll
taxes to stabilize the system's funding.
Strongly underline the President's de-coupling
proposal, which the Congress has yet to take action
on, and emphasize how this will protect long-term
financing of the system. We could again use part
of the Special Message language.
*c. Pledge to request as part of the FY 1978 budget a full
cost of living increase in Social Security benerits.
Note that this is consistent with President's commitment
to insure that older persons do not suffer from
inflation. Though this is a new proposal, it was
followed in the FY 1977 budget request. There is
FORD LIBRARY y 028870
language in the Special Message on the 1977 initiative.
Page 2 - Honorable Sarah Massengale
*d. Propose to eliminate the loss in earnings that occurs
under Social Security when a person remarries.
Under current law if two beneficiaries remarry their
benefits as a couple are less than what they received
as individuals. This situation has caused older
persons to live together without being married, which
tends to be a source of great embarrassment to the
older people, or else leads older couples who do choose
to remarry to live on lower incomes. As of October 1975,
Social Security estimated that the cost of an amendment
to correct this situation would have been $120 million
for calendar 1977. The long range cost projection
for the amendment would be 0.01% of the taxable payroll.
This is a very emotional issue which could be extremely
popular by underlining how this would help preserve
the dignity and freedom of choice of older persons.
It also can be used as an illustration of how the
President wants to reinforce the family, by eliminating
a penalty older people now pay for remarrying.
*e. Liberalize the retirement earnings test for Social Security.
Currently an older person loses $1 in benefits for
every $2 earned above $2,760. This figure does increase
to account for increases in the cost of living. It is
argued that this extremely low figure serves as a
disincentive for older persons to remain in the labor
force, and that it would be wise public policy to
increase this figure to at least $4,000.
This proposal is advocated almost universally by
persons in the field of aging.
Primarily, it is attractive because it eliminates an
incentive for older persons to quit working, and would
therefore serve to keep people involved in the life
of their community.
Page 3 - Honorable Sarah Massengale
*f. Property tax relief
Senator Beall has recently introduced a bill that
incorporates a proposal Secretary Schultz made in 1973
to provide property tax relief for the elderly.
The proposal calls for a refundable tax credit,
up to $500, for real property taxes, paid by persons
65 and older, if the person's tax exceeds 5% of the
household's adjusted gross income. The credit would begin
to be phased out at $15,000 and phase out completely
at $25,000. The Treasury Department has recently
estimated this proposal would cost $750 million.
It's major strength is that it would underline the
nation's commitment to enable older persons 2/3 of whom
own their own homes, to remain in their own homes.
2. Health Care
a. Repeat the President's catastrophic coverage proposal.
Language on this is in the Special Message.
If at all possible, I would strongly urge that
increased cost-sharing for older persons be reduced
to a level where the income would be just enough to
cover the cost of the insurance program.
b. Eliminate Medicaid fraud and nursing home abuse.
HEW's efforts in these areas could be identified.
The President could emphasize in strong terms that
fraud and abuse of the nation's older people, especially
these vulnerable older people in nursing homes, will
not be tolerated.
C. Support for the nursing home ombudsman program.
Language in the Special Message could be used to
underline support for this effort.
Page 4 - Honorable Sarah Massengale
3. Maintain Independence
a. Reemphasize the President's support for the national
network on aging.
Many of the persons in the audience are working every
day with Title III and Title VII programs. Therefore
the President should identify himself very forcefully
with the network. Again, there is language in the
Special Message that can be used.
*b. Support Title V -- Senior Centers
The Administration has never requested funds for this
program. $5 million was appropriated for the
transition quarter; $20 million is currently in the
HEW/Labor 1977 bill that is in conference.
NCOA is the one organization that has been at the
forefront of the senior center movement. A positive
sign of interest by the President would be very, very
well received. This sign could be in the form of a
statement that he is glad funds are in the 1977 bill;
he will request funds in 78.
The thrust could be in terms of providing "one-stop"
service centers for older persons, located in their
own neighborhoods.
*c. Tax incentives for children who have their parents live
with them.
It clearly costs money and takes time for children to
support their parents in their home. Too often,
therefore, the "easy way out" of placing older persons
in nursing homes is taken. The psychological costs and the
cost to the Federal treasury of this decision is enormous.
By offering tax incentives this trend could perhaps be
turned around. The value of a multi-generational family
unit could be protected; unnecessary institutionalization
could be reduced; and Federal outlays could be reduced,
assuming the net tax incentives would be less than the
cost of supporting persons in nursing homes (it seems
reasonable to assume that at the very least these costs
could be equal).
FORD LIBRARY &
Page 5 - Honorable Sarah Massengale
4. Crime
*a. Mandate that LEAA plans provide for programs to
protect the elderly.
Older people in a 1975 Harris poll identified
fear of crime as their major problem. Legislation
currently in conference extending LEAA mandates
State LEAA plans to provide for programs to protect
the elderly. The President could embrace this
legislation, and indicate he will instruct LEAA
to enforce it vigorously. The President's tough
stance on crime could be re-emphasized and his
determination that the most vulnerable in society
will not be victimized by criminals strongly stated.
*b. Initiate Justice Department effort to combat fraud against
the elderly.
Older persons have been identified as being particularly
vulnerable to confidence games and fraud, whether on
stock schemes, land sales, etc. The Justice Department
could be instructed to study this problem and report
to the President, with recommendations for action.
5. Housing
a. Support for Section 202 program
This program will be funded at a $750 million level
in FY 1977, and support the construction of 30,000
units for the elderly and handicapped. It's very
popular in the field of aging. The President could
associate himself with it, in view of him signing the
FY 1977 appropriations bill for the program.
*b. Insure that social services be provided in publicly-
subsidized housing for the elderly.
A major problem has been insuring that needed social
services are available to older persons residing in
publicly-subsized housing. The basic problem
results from a simple lack of adequate services in
many communities. However, the problem could be
alleviated to some extent if sponsors of such housing
were required, in order to have an application for
FORD LIBRARY &
Page 6 - Honorable Sarah Massengale
construction approved, to demonstrate how they
were going to insure that services would be available.
This could perhaps be done by requiring the appropriate
Area Agency on Aging to sign-off on the application
with such an assurance before HUD would act on the
application. Some thinking needs to be done about what
action would be taken if no services were available,
though -- should an application nto be approved in such
a situation? If so, would this tend to penalize
low-income areas?
6. Involvement of Older Persons
a. Emphasize commitment that older people be involved in
the labor force.
Language from the President's signing of the Older
American's Month Proclamation could be used very
well for this purpose.
b. Support for Action volunteer programs.
Underline continuing support for these programs, i.e.
Foster Grandparent, RSVP, Senior Companions.
*c. Call for public schools to open their doors to older persons.
AoA and the Office of Education have a working agreement
in this area. Two themes could be noted: (1) utilizing
existing facilities and resources; and (2) bringing
together the young and the old. Several specific ideas
could be underlined, including encouraging school lunch
rooms to serve older people, and encouraging schools
to utilize older people as teacher aides and resource
people in the schools.
The notion of involving older people in their neighborhood,
and of the neighborhood taking advantage of the wisdom
and skills of older people -- with no additional cost
to the Federal treasury -- can be a very appealing one.
The President could call on local school boards to take
this initiative.
Page 7 - Honorable Sarah Massengale
7. Older Persons and the Arts and Humanities
*a. Direct National Endowment for the Arts and Humanities
to give attention to involving older persons.
The President, noting the varied skills and talents
of older persons, could direct the Endowments, within
existing budgets, to give special attention to designing
projects that will encourage the involvement of older
persons in the arts and humanities.
This could emphasize the meaningful way older people
can enrich our national life.
These obviously represent a wide range of ideas that can be woven
into a Presidental address. Some entail additional Federal
expenditures, and I recognize that it may be difficult to obtain
clearance for those. They can be defended though, and I hope they
will be pursued. As a minimum, however, I would hope we could
get clearance for the non-cost items. It is extremely important that
the President have something new to say before the NCOA meeting if
he is to address them.
I look forward to talking with you about these ideas after Labor Day.
I will be happy to help you in any way I can to flesh out the ideas
and develop the speech if the President accepts NCOA's invitation to
address their meeting.
Arthur S. Flemming
Commissioner on Aging
The
Council of
= FORD LIBE LIBERTY
fee
COUNCIL
State
STATE GOVERNMENTS
to
Governments
THEM
THE OLDER
AMERICANS
Issues in State Services
The Council of State Governments
The Council is a joint agency of all the state
governments - created, supported and directed by
The Older Americans
them. It conducts research on state programs and
problems; maintains an information service available to
Issues in States' Services
state agencies, officials and legislators; issues a variety
of publications; assists in state-federal liaison; promotes
regional and state-local cooperation and provides staff
for affiliated organizations.
HEADQUARTERS OFFICE
Iron Works Pike, Lexington, Kentucky 40511
This project was supported, in part, by a grant, number 90-A-414/01, from the
Model Projects in Aging Program, Administration on Aging, Office of Human
EASTERN OFFICE
Development, U.S. Department of Health, Education, and Welfare.
1500 Broadway, 18th Floor, New York, New York 10036
MIDWESTERN OFFICE
203 North Wabash Avenue, Chicago, Illinois 60601
SOUTHERN OFFICE
3384 Peachtree Road, N.E., Atlanta, Georgia 30326
WESTERN OFFICE
85 Post Street, San Francisco, California 94104
WASHINGTON OFFICE
1150 Seventeenth Street, N.W., Washington, D.C. 20036
THE COUNCIL OF
STATE GOVERNMENTS
THE COUNCIL OF STATE GOVERNMENTS
Lexington, Kentucky
Published August 1976 by
Contents
The Council of State Governments
Iron Works Pike, Lexington, Kentucky 40511
Foreword
Printed in the United States of America
V
Introduction
1
Survey Results
2
Establishment of Advisory Committee
5
1. Integrating Services for the Elderly at the Community Level
7
A Community Support System for the Aging
8
Planning
8
Service Requirements
12
Case Manager-Broker-An Intermediary System
14
Organizational and Financial Structure
17
Coordination at Various Levels
18
Manpower
19
Legislation
21
2. A Review and Analysis of State Tax Policy for the Elderly
22
State Tax Relief Programs
23
Development of Tax Relief Legislation
26
3. Providing Transportation for the Elderly
33
An Innovative Program
33
Brief Overview of the TRIP Project
34
Role of the West Virginia Department of Welfare
35
Regional Planning and Development Councils and
Mass Transportation Authorities
36
Planning
39
Funding
41
Problems and Progress
44
Conclusion
45
4. Suggested State Legislation
46
Public Guardian Act
47
Multiservice Senior Center and Community Care
Program Development Act
55
Hearing Aid Dealers Regulation Act
60
Health Care Facility, Safety, and Security Act
77
Life Care and Payments Contracts Act
84
Synopses of Other Proposed Legislation
91
RM-584
Price: $4.50
References
94
Foreword
Americans 65 years of age or older are estimated to make up 10 percent of
the population. By the end of the century, it is projected that they will constitute
20 percent. A stereotype of the elderly as individuals in failing health and
incompetent is a gross error. The majority of our senior citizens are healthy and
vital persons who desire to be active. Yet, one half of them are forced into
retirement at 65. How to utilize this wasted talent and honor our commitment to
provide support for them when needed are questions that challenge state
governments now and will continue to do so in the years to come.
This publication, a sequel to the Council's earlier study On Growing Old,
analyzes contemporary problems and presents some legislative measures to serve
older Americans. It was prepared under the direction of Bill Main, Project
Director for the Council of State Governments on suggested state legislation for
the elderly. Legislators and advocates alike should find this report a useful tool in
addressing the problems confronted by our senior citizens.
Brevard Crihfield
Lexington, Kentucky
Executive Director
August 1976
The Council of State Governments
V
Introduction
The problems that come with growing old in America have become
increasingly acute with the trend toward urbanization and the associated decline
of the extended family. The responsibility for assuring the well-being of the
elderly has increasingly shifted to government.
Except for provisions to aged veterans, the first major federal program for
the elderly was the Social Security Act of 1935. The object of this program was to
provide a minimum income to the elderly through Old Age Assistance and Old
Age Survivors Insurance. These measures were not perceived as sufficient to
provide an adequate income independent of other resources. It was anticipated
that they would supplement savings, private pension plans, and family
contributions. However, for many elderly persons these other resources do not
exist.
The Social Security program has expanded over four decades. Most
significantly, the additions of Titles XVIII and XIX (Medicare and Medicaid)
extended health insurance to the aged and needy. Medicaid and Supplementary
Security Income (SSI) programs brought the States in as partners in the
management of Social Security.
The Older Americans Act of 1965 provided more substantive governmental
intervention in the problems which affect the aged. This act created the
Administration on Aging (AoA), provided financial support for state and
community programs (Title III), grants for research and development (Title IV),
and grants for training personnel in the field of aging (Title V).
Major amendments to the Older Americans Act in 1973 upgraded the AoA
from Social and Rehabilitative Services to the Office of Human Development
attached directly to the Office of the Secretary, the Department of Health,
Education, and Welfare. New emphasis was directed to state planning and,
especially, the concept of area agencies for the aging. Under Title VII of the act, a
new nutritional program was initiated in 1972 and funded in 1973 to provide
meals for the low-income elderly at strategically located senior centers. A
secondary benefit of this program is that isolation would be reduced by bringing
the elderly in contact with their peers.
These federal efforts have made incremental strides toward serving the needs
of the elderly. During the past decade a proliferation of state activities has served
to actualize federal intervention and to address a myriad of problems unaffected
or made more complex by federal action.
Brevard Crihfield, Executive Director of the Council of State Governments,
was a participant in the 1971 White House Conference on Aging. Largely
3
2
quantity of electricity. In Ohio, legislation was introduced in 1975 to create
through his commitment to the problems of the elderly, the Council sought and
lifeline electric and gas rates for all of its residents.
obtained a grant from the AoA for the development and implementation of state
Also in 1975, legislation was introduced in Iowa to establish a utility services
legislation for the aging.
stamp program through which an eligible senior citizen may purchase gas or
The initial process employed by the project was to survey the States for
electric utility services with coupons issued at a minimal charge. In New Jersey,
recent developments in state provisions for the elderly, particularly legislative
legislation was introduced preventing discontinuance of utility services to senior
action. Letters soliciting information about these developments were sent to the
citizens or disabled persons, if the local board of health certifies to the utility,
legislative staff office and the office on aging of each of the 50 States. Responses
within a seven-day period after receipt of a notice of intention to discontinue by
were received from 43 States.
the utility, that such discontinuance will endanger the health or safety of any
Survey Results
senior citizen or disabled person.
Categories were delineated and survey results were summarized as follows.
Care Facilities
State Units on Aging
Connecticut, Maryland, Ohio, Virginia, and Wisconsin were among the
States in which legislation containing a nursing home patients' bill of rights was
Massachusetts and Illinois are two of the States in which recent legislation
introduced or enacted in 1975 or 1976. Legislation regulating foster homes for
established department-level state units on aging. The Massachusetts legislation
adults was introduced recently in South Carolina. California, Massachusetts,
established the Department of Elder Affairs, operated under the supervision and
New Jersey, and South Carolina were among the States in which recent
control of the Secretary of Elder Affairs appointed by the Governor. This
legislation was introduced or enacted creating the position of nursing home
department is the principal agency in Massachusetts to mobilize the human,
ombudsman as part of various state agencies.
physical, and financial resources available to plan, develop, and implement
innovative programs for the elderly, including a home care program for the
Protective Services
elderly in communities throughout Massachusetts. The Secretary may appoint,
Several States, including Alabama, Hawaii, Kentucky, Nevada, Tennessee,
from time to time, citizen advisory committees. Also, an elder service corps, to be
and Virginia, introduced protective services legislation during 1975 and 1976 to
composed of men and women 60 years of age and older, was created to assist in
meeting the needs of the State's elderly population and to offer the elderly
provide a variety of preventive, supportive, and sometimes surrogate services to
adults with some infirmity or incapacity in order to facilitate their safety and
opportunities for service.
welfare. Several issues are typically dealt with in these statutes, the most
The Illinois legislation established the Department on Aging, headed by the
director of the Department on Aging who is required to be a senior citizen with
important of which are (1) the designation of the agency or agencies empowered
sufficient experience to provide services to the aging. The department has broad
to deliver the protective services, their responsibilities, and the scope of their
powers to make provisions for meeting the needs of Illinois' elderly citizens. A
power, including whether or not protective placement is allowed under the act
Council on Aging was also established in the legislation, composed of a majority
and, if so, procedures related to protective placement; (2) the complaint
of elderly persons to review and comment on actions by the Department on
procedure where there is abuse, neglect, exploitation, or other reason for
Aging and to prepare an annual report evaluating the level and quality of all
intervention for protective services purposes; and (3) the procedures relating to
programs, services, and facilities provided to the elderly by state agencies.
emergency intervention.
Finally, a Technical Advisory Committee on Aging was also established,
Housing
composed of state officials. The committee serves as a liaison between state
agencies to facilitate planning and the effective delivery of all programs and
Kentucky, Maine, and Wisconsin were among the States in which legislation
services for the aging.
was introduced or enacted recently to make public buildings accessible to the
physically handicapped. In Florida, an Elderly Housing Authority Act was
Public Utilities
introduced in 1975 to allow localities to create housing authorities to facilitate the
In California, legislation was enacted in 1975 to provide all residents with
construction and expansion of housing facilities that serve the elderly, including
special rates on a lifeline quantity of gas and electricity. Such rates and quantities
health care facilities which are operated by nonprofit corporations. In New
are to be established by the Public Utilities Commission. In Maine, 1975
Jersey, a Retirement Community Full Disclosure Act was enacted in an attempt
legislation called for the Public Utilities Commission to establish demonstration
to protect retirement community consumers by providing a comprehensive
projects for providing elderly residential consumers with special rates on a lifeline
scheme of regulation of retirement communities.
5
4
Age Discrimination
Health Care
In Ohio, legislation was introduced in 1975 to eliminate age discrimination
In California, legislation was enacted in 1975 establishing a pilot project in
for persons 18 and over in the extension of credit, employment, housing, and the
preventive health care in three counties. In 1974, legislation was enacted
procurement of burial lots. In New York, legislation was enacted in 1974
requiring the Office on Aging to provide flu vaccine at minimal costs to all
prohibiting the refusal to issue or renew an automobile insurance policy solely on
persons 65 years or older. In Rhode Island, a comprehensive health care bill was
the basis of advanced age. In Colorado and Florida, age discrimination in
introduced in 1974, one provision of which was to require the State to pay for the
employment legislation was also introduced in 1975 which set no upper limit on
catastrophic costs of eligible health services for eligible persons. In Florida,
the age of the persons to be protected. In Montana, legislation was recently
legislation was introduced in 1975 to regulate home health services.
enacted to prohibit age discrimination in the extension of credit, employment,
apprenticeship programs, and the admission practices of any educational
Employment
institution, with no upper limit on the age of the persons to be protected.
In Arizona, California, and Maryland, legislation was introduced in 1975
providing for part-time employment for certain senior citizens. The California
Establishment of Advisory Committee
legislation directed the State Office on Aging to establish programs through
An Advisory Committee was selected representing state legislative and
specified entities and agencies in community service work. The Maryland
executive officials, administrators of aging programs, and independent
legislation established permanent part-time employment in the state merit
organizations which serve the interests of the elderly. The committee included:
system. Arizona legislation provides for part-time employment by counties for
community service work, utilizing state funds.
Mr. Albert J. Abrams
Mr. David H. Marlin, Director
Secretary of the Senate
Legal Research and Services
Pharmaceutical Assistance
State of New York
for the Elderly
Arkansas, California, Connecticut, Kentucky, Oregon, and Wisconsin were
Mr. Cyril F. Brickfield, Legal Counsel
Ms. Mary Brugger Murphy
among the States in which legislation was introduced in 1975 or 1976 to permit
National Retired Teachers Association
National Association of Counties
the substitution of generic equivalents for brand name drugs in certain situations.
American Association of Retired Persons
Senator William D. Palmer
In Maine and New Jersey, legislation was introduced in 1974 and 1975 providing
Ms. Alice M. Brophy, Commissioner
State of lowa
for state financial assistance to low-income elderly persons in the purchase of
Department for the Aging
State of New York
The Honorable David H. Pryor
drugs. In Connecticut, legislation was introduced in 1975 which mandated the
Governor of Arkansas
posting of prescription drug prices.
The Honorable Julian M. Carroll
Governor of Kentucky
Mr. Robert B. Robinson, Director
Education
Division of Service for the Aging
Mr. Elias Cohen
Colorado Commission on the Aging
In Arkansas, California, Hawaii, New York, South Carolina, and
Department of Community Medicine
Tennessee, legislation was introduced in 1974 and 1975 to allow elderly persons
University of Pennsylvania
Ms. Margaret S. Seeley
U.S. Conference of Mayors
to attend courses in state-supported institutions of higher learning without
Dr. Louise Gerrard, Executive Director
paying tuition. In Florida, legislation was introduced in 1975 establishing a
West Virginia Commission on Aging
Dr. John Shier, Executive Director
statewide education program for the elderly.
Lake Michigan Area Agency on
Representative Barry Kutun
Aging, Inc.
Mandatory Retirement
State of Florida
State of Wisconsin
Legislation which sought to prohibit mandatory retirement at age 65 in the
Representative Richard P. Lindsay
Senator Wilfrid J. Ullrich
public and private sectors was introduced in New York in 1976. Florida and
State of Utah
State of Indiana
California were among the States where legislation was introduced in 1975 to
The committee met for the first time on September 27, 1975, at the Sheraton-
prohibit mandatory retirement at age 65 among some or all public employees. In
Virginia, legislation was introduced in 1976 which set up an Employees
Park Hotel in Washington, D.C. At that meeting they reviewed the interim
Retirement Review Board to hear requests for continued employment past age 65
results of the survey and defined the areas of highest priority for state action.
by state employees, teachers, and part-time employees working pursuant to an
These areas were health, economic support, housing, transportation, protective
order of the board under the legislation.
services, tax exemptions, and crime against the elderly.
6
The project staff convened four regional forums in October and November
of 1975. These meetings, in Boston, Atlanta, San Francisco, and Chicago,
1. Integrating Services for the Elderly at the
included legislators, administrators of state and local aging programs, and a
Community Level
variety of other interested citizens. Using the Advisory Committee priorities as
an outline, the staff developed a list of 53 specific issues for legislation and six
topics for policy analysis. The Advisory Committee screened the list and it was
determined that suggested legislation should be prepared in 17 areas and policy
analysis in three. The state survey had provided a considerable file of statutes,
and four collections of model statutes had been submitted to the project. This
It has been estimated by health care professionals and aging group
resource was searched for statutes that with minimal revision could be matched
spokesmen that between 25 and 80 percent of nursing home residents could have
with the 17 areas for needed legislation. Where necessary, statutes were drafted
remained in their homes if they had available to them a service providing for
by a legislative draftsman, Fred Karp. Through an agreement with David Marlin
periodic visits by a clinician or some minimal assistance in housekeeping or
of the Legislative Research and Services for the Elderly (LRSE), two statutes
maintenance. In many cases the need would only be for a brief period of illness.
recently drafted by Professor John Regan of the University of Maryland Law
The range of estimates cited above leaves much to speculation. If the accuracy of
School for LRSE were included in the package submitted to the Committee on
either the smaller figure is assumed or the number most frequently quoted-40
Suggested State Legislation of the Council of State Governments. Five statutes
percent-we would still be concerned about a considerable overutilization of
in the package were adopted by that committee for publication in the 1977 annual
nursing home beds. There is general agreement among authorities consulted that
volume of Suggested State Legislation. These statutes are included in Chapter 4.
services, or service capacities, exist in sufficient quantity to meet the need. The
In addition, the staff, with assistance from consultants, has prepared papers
foremost barrier is maldistribution and fragmentation. Maldistribution refers
on three areas where a legislative proposal was deemed inadequate or untimely to
not only to inpatient and ambulatory care configurations of health professionals,
respond to needs identified during the project. These constitute the first three
but also to resources such as senior citizens who are presently idle but who could
chapters of this report.
be effectively organized to provide services to others.
The materials included in this publication were determined by the process of
The concept of integrated services in the community to support independent
needs assessment described. The wisdom and experience of elected officials and
living is a priority among organizations which represent and serve older
other professionals, as well as lay citizens young and old, have been consulted. It
Americans. The National Council on Aging has created a program unit, the
is the hope of the Council of State Governments that we have assembled an array
National Voluntary Organizations for Independent Living for the Aging
of tools for serving the needs of older Americans.
(NVOILA), whose purpose is to further independent living for the elderly in their
own homes or in other noninstitutional settings through coordinated community
effort. NVOILA has a membership of 157 national voluntary organizations and
is supported by a Title III National Model Project grant from the AoA. Their
goal is to deliver services to older persons suffering handicaps in functional
capability so they may take care of themselves and not be unnecessarily
institutionalized. This includes bringing individuals to community services and
services to individuals in their homes.
Several States have made integration of services a priority in their aging
programs. Legislation to promote community-based, multiservice agencies has
passed in Florida, Illinois, Maryland, Massachusetts, and Washington.
Kentucky is currently planning a pilot program to be called Project in
Independent Living. The Washington legislation is the most comprehensive in
range of services mandated but, as of this writing, it is too early to report on the
implementation of that program. The Governor's office in Pennsylvania reached
an agreement with the Philadelphia Corporation for Aging to provide these
services in the Philadelphia area on a contract basis.
7
8
9
While there is agreement on the end to be attained, the best medium for
and in providing for each individual the full extent of required assistance
providing those services has yet to be resolved. Chapter 4, devoted to suggested
available. It is partly a problem of communication, partly one of coordination,
state legislation, includes a multiservice center statute based on the Florida act.
and partly one of development of resources.
This is a service agency approach. A broker agency approach similar to the
There have been concerted efforts to plan cohesively for the aging in recent
Philadelphia Corporation for Aging has also received much attention. Dr. Dale
years, but the effectiveness of such efforts is still far from optimum. This is caused
Farabee, a psychiatrist and former Commissioner of Health Services in
partly by the fragmented and self-orbiting approaches to service delivery of the
Kentucky, now a private consultant to health and mental health agencies in
principal systems for the elderly-the social and health services-and by the
several States, designed a model for community services that blends the best
"worlds-apart" reality perspectives of private industry, voluntary nonprofit
features of several approaches presently being implemented. The discussion that
agencies, and the public sector.
follows is a summary of Dr. Farabee's proposal.
Obviously, then, a new effort towards a more unified planning approach
must be seriously undertaken. At the federal, state, and local levels, a
A Community Support System for the Aging
coordinated or even a unified system for planning must be engendered-through
In building and utilizing a continuum of services to meet social, health,
consortiums, or coalitions, or through the authority of a governmental agency
mental health, housing, and environmental needs of the elderly through
empowered to disburse funds, if voluntary efforts cannot be effected.
community-based systems, all supportive and related services must be
Federal, state, and local responsibilities, possibilities, and current resources
encompassed. There is need to create a circle of services for the elderly that is
must each be clearly defined for coordination, development, financing, and
community based and uses any variety of support systems and providers-that of
delivery of services, if continuity of both planning and service delivery is to be
the public sector, both state and local; nonprofit agencies; for-profit firms; and
accomplished.
voluntary, church-related, neighborhood, and mutual support groups.
There are no easy solutions to the building of a community support system
Implementation of this support system should make use of all potential
to maximize the potential of the elderly and to facilitate as high an attainment of
assistance, utilizing everyone from adolescents to the elderly themselves.
physical and mental health and a quality of life as is possible for each individual.
Historically, natural and planned systems of community support have been
Certainly, however, it is possible to begin with a planning process that is
available to individuals and have been successfully used. For example, we know
cognizant of other concerted efforts and with a realistic assessment of individual
from actual statistics that the primary supportive resource for dependent, elderly
needs, moving from there to an organization focused on coordination and
facilitation for the individual.
persons living at home with family today is an adult child, supplemented at times
by other family members and, perhaps, neighbors; but family mobility, working
To have any hope of accomplishing this task, communities, regardless of
wives, and the like, may adversely affect this.
how urban or rural their geopolitical structure, will be forced to carefully assess
In the past, such neighborhood family support was supplemented by
their demography and resources with much more detail than ever before. Full
organizations such as the Ladies Aid Society and by other religious-oriented
consideration of private, proprietary, and voluntary nonprofit roles and
support groups. The potential of the voluntary support groups is not diminishing
resources must be made as an objective overview of the assigned geography (or
but actually growing, as one can note in the development of mutual-help
service area) is undertaken.
associations made up of persons who have suffered through serious illnesses and
If aging populations are carefully located and mapped for proximity to local
in the burgeoning of organizations such as Widow to Widow, Parents Without
resources, if due consideration for ethnic and cultural attitudes and backgrounds
Partners and, historically, in the highly successful Alcoholics Anonymous and
is made, if proper projection is made of health services availability and
related groups. These supporters offer practical information and guidance to the
utilization, if urban and rural transportation problems are visualized, and if the
person in need often more effectively than the professional helper, but they may
literally hundreds of other planning factors are recognized and answered, the
need tangible incentives to enhance their effectiveness.
community can dramatically visualize its problem profile.
In development of such a profile, it is becoming increasingly evident that
Planning
assessments of individuals must take into account their capabilities-the level of
To meet the multiple needs of the elderly as this segment of the population
functioning of the individual-rather than labeling and batching the problems of
mushrooms, multiple supports and varieties of assistance and funding are
the individuals. Resources to maximize individual capability, as well as to
required and they must be organized in such a way as to facilitate rapid
alleviate problems growing out of dysfunction of specific capabilities, can more
communications, sequenced action, and effective tracking of clients.
readily develop from functional rather than diagnostic evaluation.
The problem is in bringing to bear all services-local, state, and voluntary-
Ideally, planning should be a step-by-step process moving from (1)
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11
assessment, to (2) development and identification of program models, to (3)
from the federal level with requirements for coordination and integration of
seeking approaches to and developing financial support for the plan. In the
planning efforts built in.
urgency of the here and now and the zooming problems of the aging, it may not
Health planning and Title XX planning have already gathered much data, as
be possible to proceed at a measured, ordered gait.
have community mental health, alcohol and drugs, and LEAA, to name but a
At a minimum, however, development of a comprehensive community
few. Any new planning efforts on the part of aging proponents should be
support system for the elderly calls for broad-scale needs assessment and
developed through the state aging program authority and progress to the
identification of current resources and gaps. This includes development of
regional or community level only after all available plans submitted for other
profiles of the aging individual's capabilities, related in turn to social-cultural-
federal acts or program requirements have been carefully analyzed. The final
geographic-economic factors, as well as determination of resource availability
requirement for formalization of a community support system for the aged will
and accessibility-including social, health, mental health, housing,
nonetheless require an analysis of factors which reaches more deeply into the
transportation, legal, employment, education, and personal enrichment services
sociological structure of the community than has been required by most such
and programs. A necessary component of assessment is to survey the utilization
plans.
of, and attitudes towards, existing services from the viewpoint of the consumer
In 1974 there were 21.8 million men and women 65 years of age and over in
and the societal institutions of the community (e.g., schools, judiciary, law
this country. Projections indicate that we should expect that number to rise to 31
enforcement, church, government).
million persons in the year 2000. These are sizable numbers that take on greater
While such assessments are being conducted-and this process should
meaning when placed into context with the fact that the 65 and over population
involve citizens, working professionals of various disciplines, and trained
has escalated by 3.3 million persons since the enactment of the Medicare
planners and sociologists-it should be simultaneously possible to examine
legislation in 1965.
carefully the identified existing resources and to study various national and
The present elderly population can be divided into those who are presently
international program models for the immediate and long-range future. The
receiving help, those who need help, and those who are basically healthy. There
entire survey process, properly executed, is in itself a valuabl educational, public
are approximately 4 to 5 percent of the aging in institutions and skilled nursing
awareness instrument, as well as an indispensable step in building the community
homes. There are approximately 95 percent in the community; this figure
support program for the elderly.
includes those in boarding and intermediate care homes.
One may expect, furthermore, that such intensive survey/planning efforts
A study by E. Shanas in the Journal of Gerontology in 1971 indicated that 14
will turn up a vast array of people, situations, helpers, providers, and other
percent of those 65 and over living at home are what are called "functionally
resources capable and willing to assist in solving the dilemmas of aging.
impaired." That is, they are in need of some assistance to cope with normal
In States where regionalization has been accomplished as a planning tool,
demands of living. Of the 14 percent so identified in Shanas' study, only 2 percent
such an undertaking will be markedly simplified, and will be more easily
were bedfast. Six percent, however, were considered too ill to go out, and 6
accomplished. Regionalization is highly controversial in some States, but the
percent more could go out, but only with assistance from others. Adding those
accomplishments of the States that have implemented it tend to give credibility to
who are functionally impaired to those who are in nursing homes and
the concept-at least for use as a state planning tool.
institutions, indicates that there are about 20 percent of our elderly population
To implement such a community or regional planning task, it will be
who need significant amounts of help.
necessary for the existing capability of the Administration on Aging to be
This is a percentage significantly high enough to warrant the focusing of
committed, either directly or through its area organizations, to the intensification
attention on meeting the problems of assisting the vulnerable or disadvantaged
of such planning and survey efforts. Senior citizen services planning committees
elderly, with a reminder that this population is based on 1971 figures, with a
can be formed and funded to carry out the function, or to subcontract for it.
steadily increasing aging population since that time particularly in the over-75
Where they are in place, area aging councils may be able to take such
population. On the other side of the ledger, however, there are about 81 percent,
responsibility for their communities.
according to the 1971 figures, who are relatively mobile and free from disabling
Patterns for such planning, however, should not be generated haphazardly,
infirmities, a fact which raises the possibility that forced retirement systems are
as many communities have been surveyed or planned into total frustration over
costing our society dearly in lost income and pension payments, not to mention
the past few years as first one federal or state plan after another has required
the hastening of the onset of infirmity and depression in the 65 and over age
planning at the community level. For that reason, it is important that a formal
group.
mechanism for interfacing planning be mandated for programs receiving any
At least 8 percent of the population at home will, however, require a heavy
federal support. The basic formats for information gathering should emanate
input of services to cope just with their health problems-the 2 percent bedfast
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13
and 6 percent too ill to leave the home. The other 6 percent, as they grow more
of meals to the home; or in areas where the resources and transportation are
infirm, will eventually need increased health, social, and living supports in their
available, community dining at senior citizen, recreation, or day care centers, or
daily life.
through special care arrangements with restaurants to provide discount prices to
elderly citizens are some of the alternatives.
Service Requirements
In addition to such basic services, numerous other human services are
What are the services required for a comprehensive system of community
possible and needed if the elderly are to be supported in the community and free
support? Many of them are now being offered, but their very profusion and
of institutionalization. These include:
fragmentation create instant confusion for the individual, family member, or
advocate seeking to locate helping services for the elderly person.
1. Homemaker services (home care aides). These persons houseclean, shop,
The 1971 White House Conference on Aging identified and categorized
prepare meals, and provide help with personal care such as bathing and hair
problems and needs of the elderly. These included education, employment,
washing.
social isolation, economic poverty, housing, transportation, health, nutrition,
2. Chore service. This is for heavier home services, including shoveling
and spiritual well-being.
snow, yard work, washing windows, and the like.
It is obvious that some of these problems are basic existence concerns-
3. Transportation. This is basic for the delivery of most services.
money to live on, medical care, and food. Many, however, are more directed to
Arrangement can be made through the public or private sector for public bus
quality of life-a way to face the inevitability of encroaching age and death
services, shuttle busses, vans, taxicab services, or neighborhood support system
without dying each day, a little at a time. It is an essential part of the service or
members-either paid or volunteer-to drive their own or the recipients' cars.
care requirements of the elderly that an adequate, visible quality of life be
4. Vocational counseling and training. This is for those who are able to
work.
produced for them.
Services that should be in place for a viable system of resources for the
5. Employment services. This is for those who can still be productive and
elderly include:
offers a two-way possibility, for some of those over 65 can deliver services to the
1. Physical diagnostic and medical treatment services. Acute inpatient and
elderly and be paid for it, such as handymen for chore services, home aides, foster
ambulatory services.
grandparents, and the like.
2. Specialized and extended health services. Skilled nursing and
6. Recreation and leisure-time activities. Transportation is basic to this.
intermediate care, and a variety of mental health, drug and alcohol abuse
7. Legal and financial services. Assist the elderly in dealing with public
treatment, and rehabilitation services.
agencies for taxes, wills, property problems, and insurance.
3. Health maintenance services. These are basically outreach and follow-up
8. Special education services.
visits by health care personnel-such as registered nurses, aides, and clinical
9. Telephone assurance services. The daily telephone call can be arranged
social workers working in consultation with physicians to provide screening,
through volunteer or agency auspices.
health counseling, education, and direct therapies to patients in their homes-or
10. Friendly visitor and "sitter" services. This can relieve the social isolation
in such community settings as senior citizen centers, intermediate care homes,
and can ease the family burden where the aged person lives with family. Can be
commercial or volunteer service.
local mental health or health centers, or clinics. Decentralized clinics can offer
cancer and diabetes detection, blood pressure checks, flu vaccine, and the like.
11. Aesthetic and cultural development. This can spark motivation through
4. Blood bank services.
library services, reading services to the homebound, and educational television.
5. Medication. This can involve both supervision in taking medication and
12. Opportunities for volunteer services.
assistance in taking medication (such as insulin shots), and the opportunity to
13. Supervised living arrangements. This can take the form of foster homes
obtain medications at the lowest possible prices through a variety of community
or live-in arrangements.
pharmacy arrangements.
14. Protective services. These include legal, financial, health, and social
services.
6. Day care. Here medications can be checked, special treatments and
medications administered, group and individual therapy, problem solving and
With such an array of potential assistance, plus numerous others not listed,
counseling provided, along with numerous recreational and supportive services.
it is easy to visualize the confusion and crosscurrents generated by the various
7. Nutrition. For those able to function alone or living with families,
vectors of influence. It is important that plans for systematic employment of
instruction in nutrition can be provided, if wanted. For those who cannot prepare
services take into account the areas of need identified by the White House
meals, access to home care aides who can prepare meals in the home; or delivery
Conference on Aging and that appropriate capabilities be developed, if not
14
15
available, in the community or by access to such services in other geopolitical
service areas nearby.
Unified Community Support through a Local Intermediary
Many of these services are becoming available to SSI and other Title XX
Case Management Agency
beneficiaries through state plans which are now concentrating on self-sufficiency,
and there is no doubt that many of the most indigent elderly will receive more
STATE
significant assistance. However, the issue remains as to how the remainder of the
22 million Americans 65 and over will find ways of realizing their rightful
opportunities.
The axis of the service problem revolves around the facilitation of services
for the individual. Coordination of effort to produce more effective and efficient
Option A
Option C
Option B
results is the most elusive of all our goals. Federal aging authorities cannot now
compel it. State authorities can control only that aspect of service delivery which
falls within their legal purview. Voluntary agencies are wary of state, local, or
SUBSTATE OFFICE
other controls. Thus, all continue with strong concern for the problems but with
(MULTICOUNTY OR CITY-METROPOLITAN)
few solutions. Therefore, it is suggested that a mechanism out of the "agency
competitor" model may well be able to resolve the problem.
Prepayment
Postpayment
Medicare-Medicaid
LOCAL INTERMEDIARY AGENCY
SSA Title XX
Categorical grants
(20,000 to 75,000 population)
Formula grants
Case Manager-Broker-An Intermediary System
SSI
Aging program
A direct case management "brokerage" concept is proposed, decentralized
titles-demonstrations
into various community locales to act as a catalyst for planning, securing, and
Advocacy
orchestrating the various elements of the community support system into a valid
Linkages
and meaningful program of assistance for the elderly patient/client/resident.
Program development-Monitoring
BROKERAGE
Such a brokerage system would operate in close coordination with-but
SERVICE CONTRACTS SERVICE PURCHASE FEE SERVICE
organizationally independent of-existing agencies.
Those clients needing services of any kind-ranging from occasional
Public
transportation to regular home delivery of meals and daily home health
Quasi-public
Voluntary
Voluntary
Private
agencies
agencies
services-would be registered into a confidential, programmed system of
nonprofit agencies
church-related
vendors
voluntary registration aggressively pursued through a casefinding process.
agencies
Stored records will contain information basic to obtaining a sequence of
services consistent with a mutually planned effort for stabilization or
improvement in the status of the elderly individual. Such services could be
buffer or cushion for the client against any possible unresponsiveness of agencies
obtained from a variety of public and private agencies and practitioners.
or practitioners.
Innovations, more conducive to a personally tailored services package, would be
While primarily performing linkage and advisory services, the case
encouraged.
manager-broker would also serve as a pivot for promotion of planning and
The community-based broker will purchase services from health, social
development on the community level. The case management system's purchase-
services, and other systems as required to carry out the "case plan." The case
of-service approach, bridging the individual client's access to all components of
manager would be the constant, providing regular contact with the client and
service in the public and private sectors, will provide a constant interface between
offering the client participation in the selection process of services determined to
the individual's need and the spectrum of possible resources to respond to the
be useful or essential by the services plan. The broker would also assure contact
needs. This will place the case manager in a unique position to identify gaps in
and coordination with local and state governmental agencies dealing with
services, facilities, and personnel-and to catalyze development of new services.
problems of the senior citizen.
A planned intermediary system would provide regular data input by the
The case manager-broker, as the focal point of an intermediary system
community case managers indicating deficiencies as well as services provided.
between the individual and the full spectrum of community services, will act as a
This could be fed into a statewide computer system to be used for planning
purposes with protection of individual identities. Additionally, the case
16
17
managers would serve as resource persons for area and community planning
situation. All efforts would have to conform to the planning objective of the
bodies.
community as set forth by the state authority for aging programs.
The case load of each case manager would depend on geographic and
With effective case planning, management, information, and referral
population factors. As the intent is for the case manager to develop an ongoing
services available within a coordinative hub, the "circle of support services"
personal relationship with the client as the client's advocate and service
begins to function. The service continuum circles the individual in the
facilitator, the case manager will provide continuity for the client in all situations.
community with support services which can be compared to vectors (entities
If it is necessary for the client to leave the community for a time for placement in a
which have direction as well as magnitude). The ideal support system would
residential facility out of the designated geographic area, the case manager would
apply such vectors of assistance to the individual to achieve either stabilization or
maintain a tracking relationship with the client, placing into effect a continuity of
directed movement in the social milieu, depending upon individual need.
concern and follow-up.
Critical to the development of true habilitative results with the client is a
The proposed system would, hopefully, provide a bridge between the private
goal-oriented service plan, formulated after assessment of the individual's
sector marketplace and public sector delivery system and the latter's capacity to
strengths and deficits is complete.
purchase needed services. It allows for full participation of the private
Each individual client should be assessed for the value system which has
practitioner in publicly funded programs for the delivery of services and should
been most important in his life experience, whether positive or negative in terms
serve to narrow gaps between them.
of social mores. Motivations which are most likely to yield results, should be
Another indirect benefit of such a personalized approach to connecting the
identified and, to the extent possible, reinforced with community assistance.
elderly population to services would be the preventive, early intervention, case-
When these vectors of service are applied in a systematic manner, the individual
finding aspects of the program. The case manager would become the entry point
can be moved toward a capitalization of his own opportunities to pursue a life
into service systems and would be reaching out through a network of contacts to
style to the best of his ability.
find those in need of services.
Organizational and Financial Structure
Furthermore, the case management system would be available to all those
over 65, regardless of income level, with payment by the client on an ability-to-
The ability to disburse funds to purchase services according to the need of
pay scale, or through a prepayment insurance system. The service availability to
each client should provide a more equitable level of services for the elderly.
all will provide the assistance, now missing, to those who may not be classified as
Present legislation and regulations could be amended as needed to enable direct
indigent, but who are not capable of complete self-subsistence, and to those
allocations of federal funds to be made to authorized programs providing
unable to sort out the needed services from the community matrix.
functional coordinative case management services and to allow them to purchase
A case management concept is relatively easy to finance since both contract
other services directly from public and private vendors. Multisource financing
and indirect multisource funding from federal, state, local, and voluntary
should be provided and pre- or post-payment insurance options studied as
services can be accepted and utilized. Purchase of services by the broker agency,
another possible means of financing or partial financing.
as with vocational rehabilitation, commands instant attention from provider
Payment of a small monthly fee upon reaching the age of 65, as proposed in a
agencies but does not negate utilization by clients of their eligibilities for
number of long-term case bills and health insurance bills now before Congress,
reimbursement to pay for services received in other agencies. By acting as a
can, additionally, provide a ready mechanism of identifying or preregistering
service plan developer, utilizing other agencies as diagnostic authorities and
those 65 and over who may eventually require some forms of community
functioning more as a traffic director in some cases, the broker avoids the image
support. This, therefore, may serve as one access into a programmed system of
of the competitive agency. In metropolitan areas, local case managers would
voluntary registration.
cover small areas, with a decentralized approach over them. In rural areas, the
Multisource financing may be necessary, even if the long-term care bills, or
geographic spread could be proportionally greater. Restriction of the geographic
portions of bills, presently in Congress should pass, (e.g., Medicare Long-Term
area served, with concomitant control of location of service delivery and vendor
Care Amendments, Barber Conable, H.R. 2268; J. Glenn Beal, Jr., S. 2702; and
payment through federal regulations, will avoid overwhelming case loads and
the Kennedy-Mills and Kennedy Health Security Bills). They direct their interest
lack of intimate knowledge of the locale. The case management organization,
to long-term care, and eligibility requirements may force discrimination against
using direct cash purchases within a mix of referrals to existing services, can
some elderly persons who have need of community support services.
establish a vital role in the development of organized case planning for the
In planning for and organization of a community support system, the
elderly. This is particularly true in establishing health and related social service
federal government must place highest priority on the solidifying of linkages
activities designed to prevent regression and stimulate movement of the client's
among planning and service systems in regulations issued for federally financed
18
19
programs. It would also be beneficial to mandate specific liaison among agencies
National
through designation of specific positions for liaison within these agencies.
On the national level, legislation may be necessary to establish the
Coordination at Various Levels
appropriate action. Two possible options are suggested. One, a continuation of
the authorities vested in the Administration on Aging. The other would be
Community
establishment of a Special Action Office in the executive branch, preferably as
Organizationally, there should be established a separate intermediary
part of the President's office.
In the first option, the AoA should be given specific authorization to
system which would be operated independent of existing agencies and systems.
Strong linkages would provide for interdiction with the other systems, as would
distribute-through single state authorities-"purchase of service" funds, either
the ability of the intermediary to purchase services from other agencies and
to area aging agencies, where these have already been established in multicounty
state regions (there are 489 nationwide) or to new, independent, nonprofit,
systems.
regional, citizen-led corporations in subareas of the States. These agencies could
Such an agency could be operated and organized in several optional ways,
be multicounty in scope in rural areas, or citywide in authority with decentralized
depending upon the suitability of organization to specific communities and
entry points where population is great. Funds would be authorized and disbursed
States. The local intermediary agency could be established (1) as a nonprofit
with the usual controls to these agencies to purchase services for elderly clients,
corporation, contracting with the state or federal government, meeting
directly, as identified in the Service Requirements Section. With AoA a division
guidelines but independently establishing administrative policies; (2) as an
would oversee, catalyze establishment, and monitor the system.
autonomously operating section or subsidiary corporation of an existing
If the second, but preferable, option were taken, a special office, to be known
voluntary agency with specific safeguards to prevent control by the previously
as CHAP (Community Habilitation for Aging Persons) or OCAP (Office for
existing board and staff; (3) by a for-profit vendor group, contracting to carry out
Coordination of Aging Programs), would be established as part of the
the intermediary function as in 1 and 2 above; or (4) as a separate local office of
President's office. This office would have managerial and budget powers to
the state authority for aging or similar organization, with employees operating
coordinate plans for federal aging programs and to review and modify
under state merit system and administrative authority with a local advisory
board of citizens and consumers.
implementation plans and budget requests of federal departments or agencies as
they may pertain to aging. This power would give clout to the office, authorized
The functions and responsibilities of such a community intermediary system
to see to it that a full-scale coordinated program becomes an actuality.
and its employees have been described. Personnel, in addition to the case
Allocations of resources would be made by the director of this program, but
managers-brokers, would include record clerks and supervisors, case
he would not be allowed to transfer funds between agencies. The office would,
reviewers/monitors, accounting and secretarial staff, and volunteers.
however, be provided with special funds to make direct allocations, through
Regional
single state authorities, to the regional-state-operated or autonomous-
agencies for the purchase of services for the elderly from private vendors and
The locally based case management field staff would be assisted and
practitioners, both for-profit and nonprofit, and from public agencies. There
monitored by a regional office which would encompass a number of counties. In
would be no interference in internal administration and operations of other
large metropolitan areas, however, the regional office would operate as an
federal agencies by the special office, but stress would be placed on effective
areawide support office for coordination of decentralized case management
cooperation and forward movement.
services. The state authority would establish a regional office to provide a
The national-level office would be the center for support of the case
technical assistance and monitoring function, even though the community
management system throughout the Nation. It would provide the same services
intermediary agency is independently contracting with the State.
nationally to the States, and in turn the States would provide the local
State
programs-education, training, technical assistance, monitoring, planning, and
program consultation. It would coordinate with other agencies within the federal
A state office would be established to provide coordination, support,
government and place emphasis upon educational and training opportunities for
training, program consultation, technical assistance, and monitoring for the
the national system of case managers.
regional offices and to supplement regional office efforts in carrying out
assistance to the local level. The state office could be organized in a number of
Manpower
ways: (1) as a separate agency, (2) as part of the Governor's office, (3) as a division
Demands for and on manpower in the human services field are both
of the aging authority of the State, or (4) as a division of an umbrella agency.
overwhelming and complex. Professionally trained personnel are not available,
20
21
even in small numbers, everywhere they are needed. Demand has overtaken the
Colleges and universities should be encouraged to expand curricula in
supply-at least in distribution of professionally trained persons-with some
geriatrics. While the AoA and other groups concerned with the elderly have
rural areas, for example, without even one medical doctor. Thus, many of those
directed much attention to this, it should be a high priority for all planning
genuinely concerned with the need to offer services on a broad and equitable scale
groups concerned with appropriate care and included in all training programs in
are becoming interested in the use of a variety of paraprofessionals and assistants
health, mental health, and social services, at a minimum.
and in development of a generic front-line worker-one with broad, but less
intensive training than those in the traditional disciplines of medicine, nursing,
Legislation
social work, and psychology. Some colleges, particularly community or junior
Development of a cohesive community support system for the elderly must
colleges, have developed two-year courses along these lines and allied health
hinge, at least partly, on development of comprehensive, omnibus legislation on
programs are growing. Case managers with such backgrounds, provided with
the state level, and on such expansions and amendments of legislation on the
ongoing programs of continuing education and in-service training, may well be
national level as are needed to fully sanction the support provisions
used as the front-line workers in a case management intermediary system. They
recommended here.
would free highly trained professionals of much of the daily, time-consuming
On the state level, a comprehensive omnibus package of legislation-which
minutiae of linking individuals to needed services offered by colleagues and
would encompass a variety of rights, assurances, and services for the elderly-is
agencies, and would facilitate their delivery of services in special areas of
needed. Organizationally, the state-level office should ideally be only one or, at
expertise.
most, two steps removed from the Governor-as it is in many States. It should be
In addition to utilization of less extensively trained professionals, the
authorized by legislation to enter into contracts with area agencies-either state
volunteer offers considerable potential for development. Use of volunteers
operated or independent-to provide or purchase a full spectrum of services for
should be encouraged and promoted. Organized programs for recruitment and
its charges (although limits can be written in), and should be enabled to send state
ongoing training of volunteers should enable them to serve as alter egos to case
funds to the area agencies to purchase direct services for the elderly and to
managers and to enhance their invaluable service capabilities to the elderly.
perform brokerage and case management services for each person. These funds
Financial incentives to family members and family surrogates to continue
could be funnelled, via formula grants, from the federal government through the
and solidify their natural support systems for relatives who need help is provided
state agency.
in some European countries with considerable success. It is offered here as a
Since the brokerage capability would be available to all, regardless of
suggestion for study, with the goal of maintaining individuals in the community
income level, those with small, but nonindigent-level incomes would be supplied
to the maximum extent possible.
with services they have needed but have not been able to obtain.
It may be that the availability of continuing contact with a case manager-
Enabling state legislation should be enacted for authorization of
broker, who could find and obtain available community ancillary support for
autonomous, nonprofit corporations, as preferable to state-operated agencies, to
families who need it, would be sufficient incentive in itself to maintain and further
act as case manager-brokers for the elderly.
develop the informal, natural support systems of families, friends, and voluntary
Case managers would certify services for the elderly to third-party payors
organizations, so important historically and in the future, if the elderly person is
for reimbursement to providers on a fee-for-service basis, as well as certifying
to have a greater chance of remaining independent of residential placement.
vendors and practitioners to receive direct payment if the services are provided
There is another overriding priority in the development of appropriate
under a service plan for the client.
manpower to implement community support systems for the aged-the
There are already models of state laws which can generate ideas for
reeducation of large numbers of existing professionals in the service delivery
comprehensive legislation on rights and services for the elderly. A number of
system for the elderly. Traditional professional orientations in providing services
suggested laws fit into community support legislative requirements-including
have been shown to handicap programs that have been designed as delivery
those for protective services, licensure and inspection of community facilities, age
change models, such as community mental health centers. Continuing education
discrimination in employment, and energy lifeline legislation concerning rates
and training programs should emphasize alternative ways to deliver services and
and discontinuance of utility services to the elderly.
should provide structured experiential training to alleviate negativism and
The intermediary case management agencies at the state level, as the
stereotyped attitudes towards services for the elderly-and towards that
advocate for individuals, could serve as the catalysts and coordinators for
population itself-on the part of many charged with helping them. Development
comprehensive legislative packages protecting and enhancing the rights of the
of more positive approaches and attitudes should begin on the secondary and
elderly to the historic equal opportunity promised by the Founding Fathers of
higher education levels.
this Nation.
23
2. A Review and Analysis of State Tax
State Tax Relief Programs
Policy for the Elderly
Tax relief for the elderly has become an increasingly important concern of
Governors, state legislators, and the administrators of state human service
programs. As part of the Council of State Governments' 1975-76 Project on
Aging, it was decided to single out the tax relief issue for special study.
The study was intended to analyze key elements of tax relief programs and to
The problems of the elderly discussed in this publication are very frequently
suggest approaches and cost-estimating methods which can assist state
traceable to economic circumstances. It has been contended that all the real
legislators who desire to productively engage in this complex issue. This report
problems of the aging as a population group that make them distinct from other
provides an initial strategic assessment of the tax relief situation from the
age cohorts are due to limited financial resources and limited financial prospects.
viewpoint of the legislator or Governor who, while responsive to the economic
There have been a variety of governmental interventions in the economic
needs of older people, is mindful of the growing importance of cost control and
plight of the elderly such as direct income supplements, reduction in fees for
program performance.
transportation and recreation, and efforts to control costs in areas which vitally
Ideally, state legislation aimed at providing financial benefits to citizens
affect the elderly such as health care. Tax relief is one form of government action
should strike a balance between social equity and government cost-effectiveness.
to ameliorate the economic problems so frequently attendant on growing old.
Undue stress on either element tends to create undesirable results as the
More than 30 States have made provision for property tax relief for some or
legislation is implemented. As a practical matter, it is difficult to achieve an
all elderly citizens. The homestead exemption making property of residence tax
appropriate balance. The intent of this report is to provide a few stepping-stones
free up to a specific dollar value is the most common statute. Wisconsin provides,
which can make the legislator's or Governor's task easier as he strives for
in addition to a homestead exemption, a comparable tax exemption for renters.
balanced legislation in the area of tax relief for the elderly.
Michigan has repealed its homestead exemption for the elderly and replaced it
with a provision for crediting property tax against state income tax. The
The Setting
Michigan Office of Services for the Aging reports that this change will result in a
The process of growing old gives rise to a variety of circumstances which
significant increase in tax relief for older homeowners. At least two other States
reduce a person's potential for individual growth and social interaction-for
are studying repeal of homestead exemptions in favor of alternate forms of tax
example: health problems, lack of meaningful work, and diminished opportunity
relief for the elderly.
for satisfying leisure activities. The kind and degree of personal or social
The circuit-breaker approach is the second most utilized means of granting
diminishment associated with aging is different for each person, and is
property tax relief. This approach provides a ceiling on property taxes when the
complicated by social bias towards older people. Whatever the nature of each
tax levy reaches a predetermined percentage of income.
person's situation, however, the vast majority of older Americans have
Because of the variance in approaches taken by the States, the Council of
traditionally shared a common problem-an inadequate and insecure income.
State Governments' project did not attempt to identify a particular statute as
In recent years, much has been accomplished by the federal and state
suggested legislation. It was felt that a more productive activity would be a
governments to alleviate the financial problems of older Americans. For
straightforward analysis of approaches. The discussion that follows provides
example, the Social Security program has expanded in scope and benefits, as
guidance regarding the design and administration of tax relief programs.
have other federal retirement programs. With the establishment of the
Mr. Roy Dixon, a private consultant in community development, was asked
Supplemental Security Income (SSI) program, a federally guaranteed income is
to propose a methodology that would enable legislators, administrators, or
now available to all those who were dependent on diverse state welfare programs.
merely interested citizens who might not be schooled in revenue systems to
Through these mechanisms, almost all older Americans are now assured of at
understand the implications of tax relief proposals. Mr. Dixon constructed cost
least a minimum standard income. In addition, medical care and social services
estimation models, complete with sample calculations for three States. The
are provided both in cash and in kind by government. Although most of these
potential cost in deferred revenue of a tax relief plan in any State can be
programs are beset by administrative difficulties (and their increased benefits
calculated relatively easily and accurately from the basic data supplied. This
largely offset by inflation), they nevertheless have provided the basis for a secure
methodology and data is in a companion publication, State Tax Relief for the
income for elderly citizens. Therefore, the current economic issue for most
Elderly: Determining the Costs.
elderly persons is not the security of their income but rather its adequacy.
State government, in recent years, has become increasingly the institution
22
concerned with adequacy. Examples of this concern are: welfare payments
24
25
supplementing the basic federal payments through Social Security and SSI, and
In States where the lien approach has been tried, there has been a strong
additional net income in the form of tax relief. In the past 10 years or so, there has
tendency for older people to refuse to participate. In addition, this approach does
been a dramatic increase in state government interest in types of tax relief other
not benefit renters and it does not provide progressive relief for lower-income
than the income tax exemption or credit. Of particular interest have been the
families.
property tax and sales and use tax.
Circuit-Breaker
Property Tax
As its name implies, the circuit-breaker is designed to protect the income of
the older family from property tax overload while maintaining the principle that
Usually, the annual property tax levied on the assessed value of an older
elderly homeowners and renters should participate to some degree in the taxation
person's home constitutes a financial burden. This annual tax can easily amount
flow in their communities.
to several hundred dollars, and its payment can be devastating to the meager
Although somewhat more complex than the preceding types of tax relief
budget of the low-income older person (particularly because payment, in most
programs, this program adjusts both to property tax levels and to the incomes of
cases, cannot be spread over the course of a year). Most States now have some
homeowners. In addition, it can be readily applied to renters. Since it targets
form of property tax relief program for the elderly. However, there is great
relief according to financial need, it is both more controllable and less costly than
variation in the types of programs and their benefits. The major program types
the previously described types of programs. The concept arose in the late 1960s
are described below.
and since that time has become one of the most popular state programs for
providing relief.
Homestead Exemption
Basic circuit-breakers are limited to elderly homeowners, usually 65 years
This approach, which is relatively easy to administer, exempts from taxation
and older. Expanded circuit-breakers include renters and sometimes disabled
a portion (or all) of the assessed value (or the actual tax bill) of the principal
persons of any age. For renters, a percentage of rent is set as the property tax
residence of the older family or person. Eligibility is usually established by the age
equivalent. Circuit-breakers are further characterized as threshold or sliding
of the head of household (60, 62, or 65) and sometimes is accrued in steps (for
scale. The threshold approach defines acceptable tax burden as some fixed
example, a higher exemption at age 75 than at age 65). Either the local taxing
percentage of household income (different percentages for different income
district, the state government, or both are involved in establishing eligibility and
levels). Tax above this percentage of income is considered excessive and qualifies
defraying the taxes lost because of the exemption.
for relief. The sliding scale approach does not establish a threshold but rather sets
Some criticisms of this approach have been that it is too costly and, because
a fixed percentage of property tax (usually a different percentage for each income
of its insensitivity to income levels, does not provide relief where it is most
class) as eligible for relief. The percentage customarily declines with increasing
needed. It may also give rise to a tendency among local property assessors to
income.
arbitrarily peg the assessed value of an older person's home to the current
For both approaches, an upper dollar limit is established for relief, and this
homestead exemption level-thus causing a further loss in local or state tax
is the most that will be paid to the owner or renter no matter how much his
revenue. Finally, the homestead exemption does not usually apply to older
eligible tax or rent equivalent. It is also often the practice to reduce this limit by a
people who rent homes and who are, on the average, more in need of income
percentage of income above some basic income level. Relief may be provided via
assistance than homeowners.
reduced tax bill, state income tax credit or refund, or by direct cash grants
(rebates). Usually, both state government and the local taxing authority are
Property Tax Lien
involved in program administration, and the State may or may not refund tax
This approach assumes that the property itself should bear the cost of
losses to the community in the case of the direct tax reduction approach.
property tax relief provided to the elderly owner. Once tax relief has been
Sales and Use Tax
granted, a lien is applied to the property by the taxing authority for additional tax
amounts which would otherwise be payable during the lifetime of the owner. The
Any one (or a combination) of three approaches is usually chosen in this
lien becomes payable within a year or two after the death of the owner (or upon
type of tax relief:
his sale of the property). Whatever the equity merits of this approach, it is
Elimination of tax on necessities (food, medicine, medical appliances,
resented by older people because of the nearly universal desire to leave an
fuel, electricity, transportation),
unencumbered estate to the heirs. Under this type of law, the inherited property
Income tax credits, or
must usually be sold to obtain funds to pay off the accumulated lien.
Cash rebates.
26
27
Such forms of tax relief can be applied in relation to age alone or a
develop and test administrative procedures. The initial program can be
combination of income and age. In either case, the lower-income older person
augmented in subsequent years.
tends to receive the higher percentage benefit.
In States which already have substantial tax relief programs, the priority
need may be to fill gaps in the program spectrum. For example, a State which has
Summary
a circuit-breaker program for elderly homeowners may wish to add a similar
State Legislatures can provide tax relief for the elderly in a variety of ways.
program for renters; or, a State which has a homestead exemption may wish to
Whatever the approach under consideration, one must study not only the costs
augment this with circuit-breakers to provide additional relief for the elderly
compared to the benefits, but also the underlying intent of the legislation. It
poor.
should be made clear in the planning process, for example, whether it will be the
State's policy to provide automatic benefits regardless of income or whether
Cost v. Impact-"How Much Is Enough?"
benefits will be directly correlated with income.
Once tentative priorities have been assigned to potential tax relief goals, it is
Automatic age-related tax relief assumes, in essence, that a person has
useful to attempt to establish approximate dollar amounts for such words as
earned benefits as a result of living past his 65th year. Income-adjusted tax relief
"limited assistance" and "substantial assistance." For example, Figure 1 below
assumes that poor older people are just like poor people of any age, only more so.
shows gross national relationships between income and general state sales taxes
In general, income-adjusted relief programs are less costly than automatic relief
in 1972. Although the statistics are not current, there is a clear indication that a
programs because they involve fewer beneficiaries.
linear relationship exists between income and percentage of income paid as sales
As previously noted, the issue at hand seems to be the adequacy of personal
tax.
income. From this viewpoint, only tax relief programs that are aimed primarily
Figure 2 on page 28 indicates that the tax percentage/ income relationship is
at achieving some measure of equity of total taxation in relationship to total
very different in the case of the property tax. Although there is wide variation
income would seem to suffice. In any case, determination of desired results
among regions of the Nation in actual percentage by income class, the general
should be the first step in considering any kind of tax relief-thus, it is the first
relationship is identical. For incomes of approximately $7,000 and over (1971
item considered in this report.
data) there is a very gradual, linear decrease in percentage of income paid as
property tax. However, for incomes under $7,000, the property tax percentage
Development of Tax Relief Legislation
increases exponentially with decreasing income. The information upon which
When developing tax relief legislation it is essential to consider the question:
Figure 2 is based is not current, nor does it reflect the more recent impact of
What are the goals of the legislation? In the area of tax relief for the elderly, it is
circuit-breaker legislation.
crucial that the answers be as complete and specific as possible, since it is difficult
Notwithstanding, it is clear that nationally the relative impact of property
to reduce the scope and benefits of such programs once they are implemented.
taxation is much higher for the low-income homeowner than for the middle-
Some alternative tax relief goals might be:
upper-income levels. Presumably, the same relationship is true for the pass-
1. Substantial or limited assistance for all older people, regardless of
through effects of property tax on renters by income.
income;
In general, it is easy to see that the tax relief goal of equalizing the percentage
2. Substantial or limited assistance for low-income older people;
Figure 1
3. Assistance for older people who are homeowners only;
General State Sales Tax Burden by Family Income, 1972*
4. Assistance for older people who are renters only; and
3-
5. Assistance for older people regardless of residential status.
Since each of these goals can be considered as valid and worthwhile, the
assignment of priorities may hinge on time and cost-as well as political
(Percentage of
income paid
in taxes)
2
feasibility. For example, in a State which currently has little in the way of tax
relief benefits for the elderly, limited assistance regardless of income may be the
most politically feasible goal and may be relatively inexpensive as the first
I
building block in a long-range program effort. Thus, in such a case it might be
1
2
3
4
5
6
7
8
9
10
assigned the highest priority for current legislation, regardless of the fact that it
(Income in thousands of dollars)
might not be considered a sufficiently generous approach. The important thing
*Source: Advisory Commission on Intergovernmental Relations,
here is to provide a basic assistance mechanism both as a first step and as a way to
Federal-State-Local Finances: Significant Features of Fiscal Federalism,
1973-1974 edition (Washington, D.C., 1974).
28
29
Figure 3
Figure 2
Comparison of Theoretical Income-Property Tax Relationship and Actual Income-
Property Tax Burden by Income and Region
Property Tax Relationship with a Circuit-Breaker in Iowa, 1974*
One-Housing-Unit Homeowner Properties, 1971*
18
32-
16
Legend:
14
30
Legend:
(Percentage of income
= Theoretical
28
paid in taxes)
12-
=
Actual
10
8
26
6-
=
North East
4-
24
=
West
2-
22
....
=
North Central
=
South
20
1
2
3
4
5
6
7
8
9
10
(Percentage of income paid in taxes)
(In thousands of dollars)
18
*Source: Project staff calculations.
16
In designing proposed legislation, the legislator or Governor needs a place to
14
start. Figure 2 provides an approximate guide to the property tax/income
relationship in each region, but it is based on relatively old data and in no case can
12
the averages for a region be assumed to be the same as for a given place within the
10
region.
Fortunately, the property tax relief cost-estimating models found in the
8
companion volume can be used both to predict the cost of a given tax relief
6
formula and to identify the current percentage relationship between property tax
and income in a State. Using an appropriate model, the legislator or Governor
4-
can first determine the existing average property tax as a percentage of income
2-
for various income levels. He can then plot this information on a chart-in the
same manner as the regional data is plotted in Figure 2.
For example, in 1974 in Iowa, the theoretical relationship between income
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
and property tax (or tax equivalent) for the 65 and over population without that
(Income in thousands of dollars)
State's circuit-breaker program is shown in Figure 3 above, and is compared to
*Source: C. Lowell Harriss, Property Taxation in Government
the actual relationship between income and net tax under the circuit-breaker
Finance (New York, N.Y.: Tax Foundation, 1974).
program. With lowa's circuit-breaker, average tax as a percentage of income
actually decreases for incomes less than $7,000. In another State, it might be
desirable to maintain the average tax percentage at the same level through the
of income paid as tax can be much more costly to the State in the case of the
lower-income categories; or, it might be fiscally prudent to simply reduce the rate
property tax than in the case of the sales tax-because the sales tax is much more
of increase below $7,000 as a first step. In any case, the actual tax/income
nearly equalized already. However, it is difficult to argue with the idea that, in
relationship can be estimated using the techniques described in this paper and
theory, the percentage of income paid in taxes should, over time, become the
modifying the appropriate regional curve in Figure 2 based on the data for the
same for each income bracket. The entire thrust of tax reform over the past two
specific State. Then the desired income curve for the elderly can be plotted in
decades has been the achievement of tax progressivity (that is, equal distribution
relationship to the regional curve as the basis for approximate cost estimation.
of the tax load).
This approach permits the legislator or Governor to establish a desired
Thus, the Legislature faces the complex task of providing an increased
impact for tax relief, to test the feasibility of that desired impact by estimating its
measure of tax equality while ensuring that tax relief legislation does not create
cost, and to modify the desired impact until an appropriate balance between
undue burdens on the state or local treasury.
average benefit and total cost is achieved.
30
31
Administration
is, of course, the method used in the case of income tax relief. Unfortunately, this
The effectiveness as well as the cost of a tax relief measure can vary
kind of convenience is not usually available for other kinds of tax relief for two
considerably according to the way in which it is administered. Presently, there are
reasons. First, most property and sales tax relief programs are based on total
four key administrative aspects of tax relief programs to be considered during the
income, including sources (such as Social Security and tax-free interest) which
design of legislation:
are not normally reported for state income tax purposes. Second, the incomes of
Publicity and promotion,
many of the poorer eligible people are below the legal minimum for filing a state
Establishing eligibility,
income tax return. Additional eligibility establishment options include the
Verification of claims, and
following.
Cash flow.
1. Utilization of Local Tax Assessment Offices. Some States require that
Publicity and Promotion
potential eligibles establish their eligibility with the local tax assessment office.
This approach has the advantage of using existing staff. However, unless this
Participation in a tax relief program is greatly affected by the quality of the
approach is coupled with a workable claimant checking and auditing procedure,
public information campaign mounted to make people aware of the program. A
it is likely to result in significant underreporting of income and overpayment of
vigorous publicity effort can make the difference between a 60 percent
benefits.
participation rate (as in the case of Connecticut) and a 95 percent participation
2. Combination with Another (Nonincome) Tax Relief Program. Other
rate (as in the case of Idaho). The following kinds of activities should be stressed
States combine the application processes for two or more tax relief programs.
if the objective is to achieve high participation rates:
Illinois, for example, uses the same form to qualify potential eligibles for both
Regular media coverage,
property and sales tax relief (the property tax relief program was first
Liaison with organized groups of older people,
incorporated). This approach has the advantage of significant cost and effort
Information-sharing activities with agencies which also serve older people
reduction (over the use of a separate process for each program). It also increases
(welfare, social services, social security, agricultural extension, state and
the participation rate for each program involved in the process. (Illinois routinely
areawide agencies on aging, food stamps, housing), and
notifies people who apply for one kind of tax relief that they may be eligible for
Mail notification to potential eligibles (through local tax offices and other
the other as well.)
agencies which routinely contact the eligible population by mail).
3. Establishment of a New Eligibility Process. Finally, if no other approach
Experience in the States studied indicates that both a general publicity
is available, it may be necessary to set up a new eligibility establishment process.
campaign (for example, media coverage and liaison with organizations) and
Even if this is unavoidable, steps should be taken to ensure maximum
specific attempts to locate and contact eligibles (information sharing, mail
administrative efficiency. For example, one recent proposal for relief of taxes on
notification) are required.
electricity and natural gas service for older people named the State's Public
In addition, it would be advisable to ascertain what type of factors would
Utilities Commission as the lead agency for program administration.
discourage individual participation. Such factors, if present in a given State, may
Administratively, it would have been more efficient to have the Department of
represent obstacles to be overcome in the public information campaign. For
Revenue as the lead agency since it was equipped to establish eligibility and also
example, a former property tax relief law in Connecticut required that a lien be
process claims for other tax-related matters. However, because the Public
placed on property in return for tax relief granted to the elderly owner. As was
Utilities Commission was the overall policymaker in the utilities area, it was
previously noted, this is an unpopular approach. Although this law no longer
delegated this lead responsibility.
exists in Connecticut, many older people remember when it did, and feel that the
current property tax circuit-breaker program also contains the lien requirement.
Verification of Claims
This is believed to be a significant factor in Connecticut's relatively low
Whatever the approach to establishing eligibility, it must be directly coupled
participation rate (along with a relatively low level of general publicity).
with a workable mechanism for verifying claims. The potential for exaggerated
Establishing Eligibility
claims and underreported income will be substantial unless it is known that the
administering agency has the capability and capacity to routinely audit claims.
Sound administrative practice places an emphasis on simplicity in the
Thus, while it may be tempting to reduce administrative costs by not requiring a
establishment of eligibility. The easiest administrative approach is to
high-quality auditing mechanism, the lack of such a mechanism will usually
"piggyback" application for tax relief eligibility on some other tax program. For
increase program cost disproportionately to the cost of maintaining at "least a
example, state income tax returns may be used as the basis for qualification. This
spot-check auditing procedure. It will probably never be necessary to audit each
32
return-or even a large percentage of returns. Normally, a 1-10 audit ratio will be
3. Providing Transportation for the Elderly
ample. However, the program should also make use of any available cross-check
mechanisms.
For example, the income reported by property and sales tax relief claimants
should be routinely compared to the adjusted gross income reported for state
income tax purposes. This should not be difficult and could be rather effective.
The combined eligibility application approach used in Illinois facilitates
In all of the regional forums which were instrumental in establishing the
cross-checks between two types of tax relief programs.
agenda of this project, the need of a great many elderly for transportation was
Finally, it should be noted that claims for property tax relief by renters are
high on the list of priority issues.
difficult to verify. The rent paid can only be corroborated by the landlord-who
The isolation of the aged with impairment of mobility has effects that are
might be tempted to increase the rent if he knew that a tenant had applied for
more far-reaching than the obvious social and psychological ones. In the absence
rent-related benefits.
of outreach programs, the availability of a great many benefits such as health
care, nutrition, counseling, and legal assistance depends on the capability of the
Cash Flow
elderly individual to travel to a center or agency. There are some splendid
A well-administered tax relief program should provide for cash flow relief as
examples of programs which reach into the homes of the elderly such as "meals
well as tax relief. Unlike other types of taxes which are paid on an "as-incurred"
on wheels" but, regrettably, these services do not reach the majority of the needy
basis, property taxes are usually paid once each year. This can work an extreme
aged. This is particularly true for those who live in the rural areas of America.
hardship on the elderly person whose income is small monthly payments. In
One step that has been taken by nearly one half of the States is to make
many States, the current year receipt for paid property taxes must be presented to
available public school buses for programs for the aged. In most States this
establish eligibility for relief. Thus, the older person has to pay a relatively large
requires permissive legislation. In the States that have taken such action,
sum of money to the tax collector, and then wait a considerable period of time
immediate implementation of transportation programs using the buses has not
before receiving his relief check.
necessarily followed. One restraint is the unsuitability of most school buses for
In some States, the relief is provided by a direct reduction of the property tax
transporting impaired individuals, child or adult. A second restraint lies in the
bill. This approach reduces cash flow burdens on the elderly taxpayer. So does
fact that vehicles alone do not make a transportation system. The challenge of
the current Illinois approach, where the claimant may use his previous year's tax
economically planning routes and schedules to meet a variety of needs requires
bill as the claim basis for the current year.
inventiveness and expertise in public transportation.
New programs in several States bear observation. Oregon has undertaken
Summary
several different demonstration projects. At this writing, however, the State
Effective program administration involves many other considerations than
which has pioneered in transportation planning for the rural elderly is West
those mentioned in this section. The points emphasized above, however, are the
Virginia. The following study of West Virginia's Transportation Remuneration
strategic elements in administration of tax relief programs and will, when
Incentive Program (TRIP) was conducted by Fred Karp of the Council's Aging
properly developed in the overall context of good administrative practice,
Project staff. Assistance was provided by Dr. Louise Gerrard, Executive
substantially increase the probability for administrative efficacy. The growing
Director of the West Virginia Commission on Aging; Commissioner Thomas
network of state and areawide agencies on aging, sponsored by the
Tinder of the Department of Welfare; Grace Strain, Executive Director of TRIP;
Administration on Aging, should be considered an important and needed part of
Roy Payton, Assistant Commissioner of Operations, Department of Welfare;
any tax relief program administration process.
and Transportation Development Specialists Audley Wolfe and Okey
Gillenwater.
An Innovative Program
This chapter primarily focuses on the technical and policy aspects of TRIP,
the innovative transportation project currently being implemented in West
Virginia. TRIP has utilized funds from four federal agencies as well as from West
Virginia's state and local governments in its implementation. Broadly, its goals
33
34
35
are to stimulate lasting positive changes in the delivery of transportation services
responsive, fixed-route/fixed-schedule. modified fixed-route, and volunteer.
to all of West Virginia's citizens with special provisions for the low-income
The second phase of the TRIP system will offer a delivery system of the modified
elderly and handicapped, and to demonstrate to other States the methods and
fixed-route type. The TRIP Development Plan points out that
utility of implementing the program.
Some general characteristics of West Virginia serve to emphasize the
the transportation systems planned include the use of regularly scheduled
importance of both the improved service and demonstration aspects of the TRIP
buses operating on the primary road network to bring people to major
project. The TRIP Development Plan states:
health services, food shopping centers and social services. Smaller feeder
vehicles will cover the secondary roads bringing people from the hollows
The 1970 census shows that 61 percent of West Virginia's population
and remote areas to a primary route where a transfer will be made to the
live in rural areas and only 12.7 percent live in central cities. Sixty percent of
primary route bus. The feeder vehicles will respond to specific prearranged
the State's 55 counties are at least 75 percent rural and only 15 counties have
requests, providing a home pickup or drop-off.
population densities greater than 100 persons per square mile.
Significantly, the more rural counties have a larger percentage of their
Four prototype demonstration projects are also planned within this
population age 60 and over.
demonstration project which were also described by the TRIP Development
Plan. They include:
The TRIP project will operate statewide when it is fully implemented.
Increased knowledge of and solutions to transportation problems of the rural
combining passenger and mail delivery on selected rural routes.
Long
elderly will be one important outcome of this project.
distance trips for specialist medical services in a vehicle designed for that
State provisions for transportation which specifically benefit the elderly are
purpose.
Transportation services from a common fleet of vehicles using
for the most part in an experimental stage. To merely suggest model legislation in
automated fare collection and billing
(and) special mobile units to bring
this publication would have been of limited use to its readers. However, within
health, social, food, educational, and other needed services directly to the
this chapter reference is made to state legislation being used by West Virginia to
people in rural areas.
implement the TRIP project.
This chapter describes past, present, and projected future aspects of the
Role of the West Virginia Department of Welfare
TRIP project in an attempt to shed light on the issues that other States typically
The West Virginia Department of Welfare administers the TRIP project.
have to deal with in implementing similar projects.
Although TRIP is not a welfare project, the Department of Welfare is the most
appropriate state agency to administer it because of its knowledge of the needs of
Brief Overview of the TRIP Project
many of the persons to benefit from the TRIP project, because of its experience
There are two primary phases to the TRIP project. The first phase, which
and technology which enable it to process TRIP application forms and handle
has been operative since June 1974, involves subsidies to low-income elderly and
mass issuance of the authorization cards and transit tickets, and because West
handicapped persons for transportation authorized by the West Virginia
Virginia has no department of transportation. In order to develop continuing
Department of Welfare. This is accomplished through reduced rates for books of
state and regional plans for the TRIP project at the state level, and to develop
transportation tickets issued monthly by the Department of Welfare to these two
administrative and technical competence among the existing staff, the
classes. The system is similar to the federal Food Stamp Program in its operation.
Department of Welfare has had to employ a private consultant firm beginning
The second phase of the TRIP project, yet to be implemented in a significant
one month after the initial formal planning took place for the project in 1973.
manner, will provide greater access to public transportation for all of West
That firm's connection with the Department of Welfare is now being phased out.
Virginia's citizens by making operative 215 new specially equipped vehicles
Also during the initial formal planning of the project and during the
throughout the State. Elderly persons in rural areas without adequate access to
implementation of the ticket subsidy phase of the TRIP project, an advisory
transportation will particularly benefit from this phase of the project. At least
council consisting of 24 individuals representing users, providers, low-income
one vehicle in each of the participating transportation regions in West Virginia
senior citizens, and state agencies from all parts of West Virginia was utilized by
will be equipped with an "electro-hydraulic lift system" for wheelchair
the Department of Welfare. A similar advisory council is being regrouped to aid
passengers.
in the implementation of TRIP's new provider phase.
In an analysis of delivery systems of transportation for the elderly, an April
The Department of Welfare has 27 local offices throughout the State which
1975 Institute of Public Administration publication, Transportation for Older
perform outreach operations for the ticket subsidy phase of the project,
Americans, A State of the Art Report, specified four types of systems: demand-
determine eligibility for ticket subsidies, and authorize and distribute TRIP
36
37
tickets. Each office has a TRIP supervisor, accountable to the local office area
mechanism through which to funnel public funds. (2) The body should be
administrator, and a varying number of TRIP workers. Information gained from
responsive to local situations, yet provide some economies of scale where
TRIP applications and authorization cards turned in monthly to obtain TRIP
possible. (3) The body should have some assurance of continuity.
tickets is put into computer terminals at each local office and stored in a central
computer in the state office of the Department of Welfare. Also, case records are
Transportation authorities were chosen as the proper mechanism to
kept on file in the local office. This information can be used for the evaluation
function as the administrative bodies in West Virginia's regions established in the
and outreach aspects of the TRIP project. The Department of Welfare, the
legislation. The Regional Planning and Development Act is found in Chapter 8,
private consultant firm, and the Office of Research and Development at West
Article 25, of the West Virginia code and the Urban Mass Transportation
Virginia University all have been involved in the ongoing evaluation of the TRIP
Authority Act is found in Chapter 8, Article 27, of the West Virginia code.
project. Grants from the federal Urban Mass Transportation Administration
The stated purpose of the Regional Planning and Development Act is
and the Administration on Aging fund the evaluations.
The Governor of West Virginia is an ardent supporter of the TRIP project
to delegate to the governor, the responsibility for planning and
and is at the head of the program organization at the state level. Next in authority
development in order to (1) achieve the objectives and policies necessary for
to the Governor is the commissioner of the Department of Welfare, followed by
the orderly growth and development of the State; (2) facilitate
intergovernmental cooperation; and (3) designate regions and provide for
the Deputy Commissioner of Operations of the Department of Welfare who
the creation of regional planning and development councils.
serves with the same degree of authority as the Deputy Commissioner of
Administration in the Department of Welfare. The Assistant Commissioner of
Objective (3) is most pertinent to this chapter. The regional planning and
Operations is the highest state official directly involved with the daily activities of
development councils have at least 51 percent of their voting members from local
the TRIP project. Also in the state office is the executive director of the TRIP
governmental entities within the region. Each county is represented by the
project, Grace Strain, who is one of the two administrative personnel who
president of the county court or his designee and each municipality is represented
supervised the TRIP operations during its first year. The State TRIP staff has
by the mayor or his designee. Up to 49 percent of the voting members of the
been expanded since April 1975 to handle the increasing complexity of
councils are persons representing principal community or regional interests and
implementing the TRIP project. There are presently three transportation
are selected by the local governmental regional council members. Each regional
planners and four transportation development specialists as well as the Assistant
council selects an executive committee to perform administrative duties
Commissioner of Operations and the executive director of the TRIP project
prescribed by the regional council in its bylaws. Also, the regional council
working on the project at the state level.
appoints a director who, in turn, appoints a staff, subject to the regional council's
The state office of the Department of Welfare provides administrative and
personnel rules.
technical assistance to its local offices. In addition, the state office has worked
For the implementation of TRIP's new provider phase, the most important
with West Virginia's regional planning and development councils and already
powers of the regional councils, as stated in the act, are the powers to:
existing and newly created transportation authorities in attempting to implement
the new provider phase of the TRIP project. These councils and transportation
(1) Continuously engage in comprehensive planning and development
authorities will be discussed in the next section. Also, providers of transportation
processes and prepare, and from time to time revise, amend, extend or add
in West Virginia are authorized by the state office of the Department of Welfare
to, a plan or plans for the development of the region consistent with any
to participate in TRIP's ticket subsidy phase and are regularly reimbursed
state comprehensive planning and development objectives and reflecting
through it for the dollar amount of tickets they collect.
plans and programs of the participating governmental units The plan or
plans shall embody the policy recommendations of the regional council,
Regional Planning and Development Councils and
and may include but shall not be limited to
recommendations for
Mass Transportation Authorities
transportation networks in the region
(2) Prepare and publish studies of
the region's resources, both natural and human with respect to existing and
According to the first TRIP Annual Report, published in July 1975,
emerging problems of
transportation
and any other matters which
are relevant to regional planning. (3) Collect, process and analyze the social
the following criteria were among those applied in deciding what means
and economic statistics for the region which are necessary to planning
West Virginia would use to initiate transportation services under the new
studies.
(4) Cooperate with, and provide, upon request, planning and
provider phase of the TRIP project: (1) The overall administrative body
technical assistance to municipalities, counties and planning and
should be public in nature to provide public accountability and provide a
development agencies within the region, and coordinate regional planning
38
39
authority (is required to) make careful and comprehensive surveys and
with the planning activities and plans of the State and of the municipalities
studies of the existing conditions and probable future changes of such
and counties within the region, as well as neighboring areas, including those
conditions within its service area.
prior to the adoption of a
in adjoining States, and the programs of federal departments and agencies.
comprehensive plan, the authority
(is required to) submit its tentative
(5)
stimulate public interest and participation in the orderly, integrated
plan to the governing bodies of the participating governments and hold a
development of the region. (6) Perform development on a regional basis as
public hearing in the service area on the plan.
necessary to undertake, complete or accomplish the goals and purposes of
comprehensive planning in the region.
The provisions of the Urban Mass Transportation Authority Act utilize the
Also, all state departments and agencies are required to cooperate with the
operations of the regional councils, the Department of Welfare, and the
regional councils and to "make available for the studies conducted by such
transportation authorities to develop and implement the TRIP project's new
councils, reports, data and other informational and technical assistance within
provider phase. Before an operational plan is developed for a transportation
financial and personnel limitations." This requirement provides a basis for
authority, which becomes the basis for a contract for the implementation of
cooperation between the Department of Welfare and the regional councils.
TRIP's new provider phase between it and the state office of the Department of
The participating governments of the regional council finance the council
Welfare, all three of the entities named have potential input into the plan.
Transportation authorities can provide by resolution for the issuance of
based on their population and according to a formula adopted by the council.
West Virginia has separate statutory provisions for interstate planning
revenue bonds "for the purpose of paying all or any part of the cost of acquiring,
constructing, or improving a system or systems
commissions, each of which, under the Regional Planning and Development
or for any other purpose or
project authorizd by the (act)." In the discretion of the authority, any bonds
Act, is empowered to act as the planning and development council for the West
issued under the act may be secured by a trust indenture. The authority is
Virginia counties within the jurisdiction of the commission.
Generally, West Virginia's regional planning and development councils
required to establish a sinking fund for the payment of the bonds and the interest
have been involved in the planning and initial development of the TRIP new
thereon, and the payment of the charges of banking institutions or trust
provider phase, including facilitation of the use of transportation authorities,
companies for making payments of such bonds and interest, to be funded
according to the provisions of the act and under a resolution by the authority.
and it is anticipated that the already existing or newly created transportation
authorities will be the primary implementers of the TRIP new provider phase and
The fact that the TRIP project is not expected to generate any revenue provides
an argument for authorizing transportation authorities to issue general
assume the greater burden of subsequent development.
The Urban Mass Transportation Authority Act provides a legislative basis
obligation bonds in order to make financing by bond issuance under the TRIP
for transportation authorities, which will implement the new provider phase of
project feasible.
the TRIP project. Four new transportation authorities have been created in rural
Some recent West Virginia legislation removed the transportation
regions. The creation of transportation authorities for the TRIP project in rural
authorities from the jurisdiction of the West Virginia Public Service Commission
rather than urban regions under this act is an issue currently being dealt with in
so that the setting of fees, rates, and schedules for provider vehicles under the
the West Virginia Attorney General's office.
TRIP project need be made only subject to a public hearing, without time-
consuming scrutiny by the commission. However, it is likely that providers under
As stated in the act, authorities are
the TRIP ticket subsidy phase, including new providers, still will have to meet
certain Public Service Commission standards.
created upon the adoption, by the governing body of each participating
government, acting individually, of an appropriate ordinance or order.
Finally, each authority is exempt from most state and local taxes, and
The management and control of any authority, its operations, business
revenue bonds and other evidences of indebtedness issued pursuant to the act,
and affairs are lodged in a board from five to fifteen members, appointed by
and the interest thereon, are exempt from taxation, except inheritance and
the governing bodies of the participating governments.
transfer taxes.
Meetings are usually held quarterly and governments participating in the
Planning
authority normally pay $500 per member annually. The authority is required to,
A vast amount of planning on a continuing basis has been undertaken to
implement the TRIP system. Broadly, in planning for transportation
as soon as practical after its organization,
prepare a comprehensive
development in a State, both technical and policy issues must be dealt with.
plan with respect to a program for a unified or officially coordinated
In addition to the West Virginia Department of Welfare, its advisory
(transportation) system
In the preparation of a comprehensive plan, an
council, the private consultant firm, the regional planning and development
40
41
councils, transportation authorities, federal agencies, and other state and local
(for the system) to become operational, and a timetable via which these
entities, many elderly persons working throughout West Virginia have been
activities (can) occur. Where appropriate, a set of routes, schedules, and
involved in the development of the TRIP project. These persons have assisted
layout for the feeder operations (is also included).
individuals in making TRIP applications for the ticket subsidy phase and have
The Transit Development Program, published in December 1975,
submitted petitions and letters supporting the need for and use of the project.
represents the next major planning effort on a statewide basis for the TRIP
A brief discussion of information provided by three planning documents
project, after the TRIP Development Plan. It makes a five-year projection for the
provides some insight into the breadth of the TRIP planning process.
growth of the TRIP project and was prepared by the Department of Welfare with
The TRIP Development Plan, published in May 1974, was the first major
assistance from the private consultant firm, pursuant to the requirements of the
compilation of how the project was to be developed and implemented. It was
federal Urban Mass Transportation Administration (a major funder of the
prepared by the private consultant firm after being submitted to the then-existing
project).
Office of Economic Opportunity (the first major funder of the project) as two
The broad objective of the Transit Development Program, as stated in its
documents, and reviewed by a federal interagency committee.
introduction, was "to delineate state, local and federal responsibility for
The objectives to be met by the TRIP Development Plan, as stated in the
improving transit services in West Virginia." Some specific aspects of it, also
TRIP Annual Report, were
stated in its introduction, are: "(1) an evaluation of existing transit conditions in
West Virginia, (2) a schedule of improvements, (3) a priority schedule and cost
to establish an administrative plan for TRIP covering all aspects of the
estimate for the improvements, (4) a plan for monitoring the program, and (5) a
ticket system and administration of TRIP, to gather basic data on the
plan for financing the improvements."
transportation needs of the TRIP eligible group, to identify existing and
required resources to meet those needs, and to then formulate plans for
Funding
statewide implementation of the required transportation with particular
attention to establishing transportation in areas of the State where it (was)
The past, present, and possible future funding of the TRIP project provides
insufficient.
useful information to other States having to deal with this important aspect of the
program.
The methodology for achieving these objectives was summarized at the
In the TRIP Development Plan, the TRIP budget for the initial federal
beginning of the TRIP Development Plan:
funding period from 1974 through 1977 was projected at $23.1 million.
Combined with user payments of approximately $9.8 million, the total program
(The development plan was) the result of intensive research which
cost for the initial funding period was to be $32.9 million. Funds were thought to
included statewide data collection, interviews, and specially conducted
be required primarily for the bonus value of the TRIP tickets, adequate
surveys. All the counties in the State were divided into five geographical
development of providers, and administrative and technical support. During the
categories depending on their proximity to urban centers or transportation
initial federal funding period, state, local, federal, and user contributions were to
attractors. Median counties in each category were selected as assessment
increase as the program grew. Of the federal share, projected to be approximately
areas for in-depth study and surveying. The results were then extrapolated
twice the state share, the Economic Opportunity Act of 1964 (as amended), the
on a statewide basis. An additional survey was conducted on board a rural
Urban Mass Transportation Act of 1964 (as amended), the Federal-Aid Highway
bus system.
Act of 1973, and the Older Americans Act of 1965 (as amended) offered the
funding authorities for the TRIP project.
Whereas the TRIP Development Plan offered the state perspective on the
The April 1975 Institute of Public Administration's Transportation for
TRIP project, sketch plans, which are preliminary to the operational plans which
Older Americans, A State of the Art Report is the source for the information
form the bases for the contracts which must be entered into by the newly formed
about federal funding discussed in this section.
or already existing transportation authorities, offer regional perspectives on the
Under Title 2 of the Economic Opportunity Act of 1964, as amended, federal
TRIP project. Sketch plans have been prepared primarily by the Department of
funding was available at the onset of the TRIP project to provide approximately
Welfare, assisted by the regional planning and development councils. According
$4 million during the first part of its initial federal funding period. Section 212(b)
to the TRIP Annual Report, they contain
of the act, in defining the powers and functions of Community Action Agencies,
gave them the power of
basic background on TRIP transportation activities, organizational
guidelines on transportation authorities, activities which must transpire
initiating the sponsoring (of) projects responsive to the needs of the poor
42
43
which are not otherwise being met, with particular emphasis on providing
Under the Older Americans Act of 1965, as amended, Titles 3, 7, and 9
central or common services that can be drawn upon by a variety of related
contain several provisions for transportation for the elderly. Section 308, under
programs, developing new approaches or new types of services that can be
Title 3, relates to model projects and provides the primary basis for federal
incorporated into other programs, and filling gaps pending the expansion
funding under the act. Under this section, the Commissioner on Aging has
or modification of these programs.
the authority to make grants to or contracts with public or nonprofit
Other sections of Title 2 also had applicability to the TRIP project. The
agencies or organizations for paying all or part of the cost of developing
funding under Title 2 was used to support the original planning for the project
and operating statewide, regional, metropolitan area, county, city or
leading to the TRIP Development Plan and to provide West Virginia's
community model projects which will expand or improve social services or
Community Action Agencies with 17 new buses which now operate under the
otherwise promote the well-being of older persons.
TRIP ticket subsidy phase.
Under the Urban Mass Transportation Act of 1964, as amended, Sections 3,
The brief descriptions of these federal funding mechanisms for
5, 6, and 9 have all been utilized to provide limited funding for certain aspects of
transportation for the elderly offer the reader not only substantive information
the TRIP project. Basically, Section 3 offers capital grants to meet
about their nature but hopefully show the resourcefulness necessary to fund a
transportation problems in urban areas. Under Section 3, "both grants and loans
project like the TRIP project.
are available to States or local public agencies within a State, and funds may be
The Transit Development Program makes a five-year funding projection for
used for purchase of land as well as vehicles and supporting facilities." Section 5
the project, separating federal from nonfederal expenditures, and discusses the
relates to capital and operating assistance formula grants. Section 5 established
role of state and local governments in future funding. According to that
"an $11.3 billion, six-year urban mass transit program and an additional $500
document, for capital improvements through 1980, "$10.9 million will be
million program for rural mass transit capital assistance over the same period."
required to implement the entire program. Of this total, approximately $8.9
Section 6 "authorizes a broad range of research, development and demonstration
million is expected from federal sources." Also, "it is anticipated that $17.5
projects in urban mass transportation." Section 9 "authorizes direct grants for
million will be required to operate transit services over the next five years
The
technical studies."
federal funding should amount to $8.7 million while local (state and local
Section 16(b)(2) of the Urban Mass Transportation Act of 1964, as
government) funds are expected to amount to $8.8 million."
amended, "provides for capital assistance grants and loans to private nonprofit
The following objectives are suggested for use in devising a state formula for
corporations and associations for the specific purpose of assisting them in
funding, through 1980, in the Transit Development Program:
providing transportation services meeting the special needs of elderly and
1. The formula should correct what are felt to be deficiencies in federal
handicapped persons." The TRIP project has not utilized this provision.
funding allocation.
Section 147 of the Federal-Aid Highway Act of 1973, as amended,
2. The formula should provide some incentive for service improvement by
authorizes a Rural Public Transportation Demonstration Program. This section
local authorities.
is the principal authority under which federal funds are being sought from
3. The formula should enable local persons to determine best use of outside
agencies within the U.S. Department of Transportation for the TRIP project.
assistance.
Approximately $5.8 million has been sought for the TRIP project by West
4. The formula should recognize variation among the communities' ability
Virginia through its Department of Highways for the initial federal funding
to raise revenue.
period. So far, $1.2 million has been contributed. Under Section 147,
The generating of state and local revenue to support the TRIP project can
take many forms. Insofar as taxation as a source of revenue, the Transit
funds are available for demonstration projects for public mass
Development Program states:
transportation in rural areas. Applicants for these funds must be either
public agencies or public purpose (nonprofit) agencies or corporations,
In general, a tax from the general fund of a government is preferable to
preferably with state or areawide responsibilities. Grants may be awarded
an earmarked tax
since the optional level of public investment in transit
for the purpose of developing transportation sub-systems for the elderly
service may be more or less than the amount of revenue created by the
and handicapped which link to the general public transportation
earmarked tax. However, an earmarked tax does have the advantage of a
demonstrations.
Funds under the program could be used for both
stable supply of revenue not subject to annual budget review.
operating and capital costs; however, amendments in 1974 have limited
operating costs to one-third.
44
45
Problems and Progress
authority by the Department of Welfare to contract directly with an existing
Fragmentation in the West Virginia state government of agencies which
transportation system for the operation of the new vehicles under the TRIP new
relate to the state transportation system has been a major problem in state
provider phase, thereby bypassing the transportation authority concept.
transportation planning. West Virginia has no state department of
The variations in the single transportation authority plan demonstrate the
transportation. The TRIP Annual Report stated that, "currently, the
flexibility used in implementing TRIP's second phase, as certain problems and
Department of Welfare, the Office of Federal-State Relations, the Department
conditions in the regions became apparent.
of Highways and the Public Service Commission all have an integral, albeit
uncoordinated function in the state transportation system."
Conclusion
Some problems generated by this fragmentation are lack of coordination of
Several issues will be confronted by any State wishing to implement new or
state resources for transportation, imbalance in state transportation priorities,
to expand already existing transportation services for the transportation
lack of expertise in certain transportation areas, and loss of possible federal
disadvantaged, particularly for its isolated and low-income elderly citizens. It is
transportation subsidies.
hoped that this discussion of some of the most important aspects of West
After nearly one year of operation of the TRIP project, the following
Virginia's Transportation Remuneration Incentive Program has provided useful
problems were cited in the TRIP Annual Report relating to the ticket system
information for future resolution of these issues.
which is a part of the TRIP ticket subsidy phase:
1. Prediction of utilization of tickets has been difficult and exceedingly
optimistic.
2. The marketing of the program by TRIP field staff has been inadequate.
3. The availability of tickets only through welfare offices may have deterred
some potential users.
4. Some state agencies wish to purchase tickets on behalf of their clients but
as yet are unable to do so.
5. Purchase of tickets requires certified checks, money orders, or cash.
Eligible persons are not likely to have certified checks, and cash should not be
sent through the mail.
6. In determining the eligibility of individuals, total household income, not
income of eligibles, is used.
7. The lack of transportation availability in certain areas has deterred ticket
use.
Since the TRIP Annual Report, steps have been taken to remedy these
problems. The major remedy for problem 7 will be the implementation of TRIP's
new provider phase. The unwillingness of governments in some regions to
participate in TRIP's new provider phase, as manifested in regional council
action, delays in federal funding, and minor impediments in the TRIP
Management-Information System used for ongoing evaluation and with existing
providers in TRIP's ticket subsidy phase have been the source of other problems
in the implementation of the TRIP project.
Presently (May 1976), 38 TRIP vehicles are ready to be utilized in Regions 6
and 10. In Region 10, which includes Wheeling, West Virginia, a labor dispute
involving existing transit systems has slowed up implementation of TRIP's new
provider phase. In that region, a newly formed transportation authority plans to
utilize the services of an already existing transportation authority, to manage the
operation of the new vehicles. In Region 6, which is headquartered in Fairmont,
West Virginia, the regional planning and development council has been given
47
4. Suggested State Legislation
Public Guardian Act
The proposed Office of Public Guardian provides free or low-cost guardian and
conservator services for two classes of individuals. First, the public guardian would
be available to serve as guardian or conservator for those persons who have no
friends or relatives able and willing to serve as guardian or conservator within the
The primary objective of the Council of State Governments' Project on
jurisdiction of the court. Second, the public guardian would be available to persons
Aging was to develop a body of suggested state statutes for the elderly. Through a
whose income or wealth is inadequate to provide the requisite compensation to a
process of needs assessment and identification of appropriate legislation to
private guardian or conservator. Although public guardians are currently provided
respond to areas of need, the project produced 17 statutes which were submitted
in several States, none has such a wide range of powers as the public guardian under
to the Subcommittee on Scope and Agenda of the Committee on Suggested State
this proposal. The proposed public guardian is designed to serve a greater number
Legislation. The Subcommittee approved 10 statutes for consideration by the full
of people than does a public guardian under any current statute. A third distinction
Committee. The five statutes which were adopted by the Committee for
is that the proposed public guardian will be available at little or no cost to most
publication in the 1977 Suggested State Legislation are reprinted here in their full
individuals served.
draft form. Also included are brief synopses of the 12 statutes which were
Four alternative systems for incorporating the Office of Public Guardian into
proposed but not adopted by the Committee.
state or local government are offered for selection at the option of the States. In each
case the powers of the public guardian are nearly identical with those of a private
guardian or conservator as provided by the Uniform Probate Code. The methods of
paying for the services of public and private guardians and conservators differ.
A private guardian or conservator is paid out of the ward's or protected person's
assets. Assuming that an individual's income or estate is large enough for a profit-
making institution to be willing to serve as guardian or conservator, the income or
estate may still be eaten away by administrative expenses. In contrast, the services of
a public guardian would be provided at public expense unless the court determined
that the income or the estate of the individual was large enough to bear the costs of
the administration of the protective service.
The services of the proposed public guardian are available to anyone who would
qualify for a private guardian or conservator, although it is anticipated that a public
guardian will be appointed primarily when no one else is available and willing to
serve. While traditional kinds of private guardians and conservators, such as
spouses, trusted friends, and corporate trustees, generally should be appointed
ahead of the public guardian, for many persons a public guardian may be the only
guardian or conservator available. (Most of the above comments are taken
verbatim from A Handbook of Model State Statutes, published in 1971, and
sponsored by the National Council of Senior Citizens.)
This draft act was dei
Governments.
The Public Guardian Act was drafted by
John Regan, Univ.of Maryland law school,
and Georgia M. Springer Legal Research
and Services for the Elderly.
Suggested Legislation
(Title, enacting clause, etc.)
46
1
Section 1. [Short Title.] This act may be cited as the [State] Public
2 Guardian Act.
48
49
1
Section 2. [Definitions.] As used in this act:
45 protective services to elderly infirm, protected, or incapacitated persons
2
(1) "Conservator" means a person appointed by a court to manage
46 and their spouses and to serve as conservators or guardians of the person
3 the estate of a protected person.
47 for elderly protected or incapacitated persons upon appointment by a court.
4
(2) "Court" means the court or branch having jurisdiction in matters
48
(15) "Public guardian" means the Office of Public Guardian.
5 relating to the affairs of decedents, in this State known as [
T.
49
(16) "Ward" means a person for whom a guardian has been appointed.
6
(3) "Department" means the [state agency responsible for communi-
7 ty-based services to the elderly].
8
(4) "Elderly" means a person 60 years of age or over who is a resi-
1
Section 3. [Establishment of Office.]
9 dent of the State.
Alternative A
10
(5) "Emergency" means an elderly person living in conditions
2 (a) The Office of Public Guardian for elderly persons is established
11 which present a substantial risk of death or immediate and serious
3 within [each court of this State which has original jurisdiction in guardian-
12 physical harm to himself or others.
4 ship and conservatorship hearings].
(6) "Emergency services" means protective services furnished to an
5
13
(b) The [chief judge; presiding judge] of each court which has an Office
14 elderly person in an emergency pursuant to the provisions of the
6 of Public Guardian shall appoint a public guardian who shall serve for
15 [State Protective Services Act].
7 good behavior and may be removed only by the [county board of super-
16
(7) "Guardian" means a person who has qualified as a guardian of
8 visors].
9
17 an incapacitated person pursuant to testamentary or court appointment,
(c) If in the discretion of the [chief judge; presiding judge] the needs
18 but excludes one who is merely a guardian ad litem.
10 of the jurisdiction do not require a full-time public guardian, the [chief
19
(8) "Incapacitated person" means
11 judge; presiding judge] may appoint to the position an individual other
Alternative A
12 than a public official or judge on a part-time basis with appropriate
20 a person impaired by reason of mental illness, mental deficiency, physi-
13 compensation.
14
21 cal illness or disability, advanced age, chronic use of drugs, chronic
(d) The chief administrative judge of the State shall issue regulations
22 intoxication, or other causes (except minority) to the extent that he lacks
15 governing the administration of the various offices of public guardians
23 sufficient understanding or capacity to make or communicate responsible
16 throughout the State.
24 decisions concerning his person.
17 (e) The compensation for the position of public guardian shall be fixed
Alternative B
18 [in the same manner as the compensation for other nonelective positions
25 a person for whom a guardian has been appointed by the court.
19 within the court where the office is located].
26
(9) "Infirm person" means a person who, because of physical or
Alternative B
27 mental disability, is substantially impaired in his ability to provide ade-
20
(a) The Office of Public Guardian for elderly persons is established in
28 quately for his own care or custody.
21 the executive branch of the government of [State].
29
(10) "Interested person" means any adult relative or friend of an
22
(b) The head of the office shall be the public guardian, appointed by
30 elderly person, or any official or representative of a protective services
23 the Governor of the State, upon consultation with appropriate agencies
31 agency or of any public or nonprofit private agency, corporation, board,
24 and individuals concerned with elderly persons, for a term of [five]
32 or organization eligible for designation as a Protective Services Agency.
25 years from the time of appointment.
33
(11) "Protected person" means a person for whom a conservator has
26
(c) The compensation for the public guardian shall be as provided in
34 been appointed or other protective order has been made.
27 the budget.
35
(12) "Protective placement" means the transfer of an elderly person
Alternative C
36 from independent living arrangements to a hospital, nursing home, or
28
(a) The Office of Public Guardian for elderly persons is established
37 domiciliary or residential care facility, or from one institution to another,
29 within the [state office on aging; the state department of social services;
38 for a period anticipated to last longer than six days.
30 the state department of health and mental hygiene].
39
(13) "Protective services" means the services furnished by a Pro-
31
(b) Upon consultation with appropriate agencies and individuals
40 tective Services Agency or its delegate, as described in the [State
32 concerned with elderly persons, the Governor shall appoint the public
41 Protective Services Act].
33 guardian, who shall hold office for a term of [five] years from the time
42
(14) "Protective Services Agency" means a public or nonprofit
34 of appointment.
43 private agency, corporation, board, or organization authorized by the
35
(c) The compensation for the position of public guardian shall be as
44 department pursuant to the [State Protective Services Act] to furnish
36 provided in the budget.
50
51
Alternative D
30 responsibility for the proper performance of these delegated functions.
37 (a) Each county within the State shall establish the Office of Public
31
(h) The public guardian:
38 Guardian for elderly persons.
32
(1) May formulate and adopt procedures necessary to promote the
40 39 cerned with elderly persons, the county [board of supervisors; council]
(b) Upon consultation with appropriate agencies and individuals con-
33 efficient conduct of the work and general administration of his office,
34 its professional staff, and other employees.
41 shall appoint the public guardian, who shall hold office for a term of
35
(2) Shall establish and maintain working relationships with other
42 [five] years from the time of appointment.
36 governmental bodies and public and private agencies, institutions, and
43 44 position of public guardian, the county [board of supervisors; council]
(c) If the needs of the county do not require that a person hold only the
37 organizations, to assure the most effective conservatorship or guardian-
38 ship program for each elderly person.
45 may appoint an individual as guardian on a part-time basis, with ap-
39
(3) May contract for services necessary to carry out the duties of
46 propriate compensation.
40 his office.
47
(d) The Attorney General of the State shall issue regulations governing
41
(4) May accept the services of volunteer workers or consultants at
48 the administration of the various offices of public guardians through
42 no compensation or at nominal or token compensation and reimburse
49 the State.
43 them for their proper and necessary expenses.
50
(e) The compensation for the position of public guardian shall be fixed
44
(5) Shall keep and maintain proper financial and statistical records
51 by the county [board of supervisors; council].
45 concerning all cases in which the public guardian provides conservator-
46 ship or guardianship services, or petitions a court to appoint a guardian,
1
Section 4. [Powers and Duties.]
47 issue an emergency order for protective services, or order protective
2
(a) The public guardian may serve as conservator or guardian, after
48 placement.
3 appointment by a court pursuant to the provisions of the [conservator-
4 ship or guardianship law of the State].
1
Section 5. [Persons Eligible for Services; Petition by Elderly Person.]
5
(b) The public guardian shall have the same powers and duties as a
2 (a) An elderly person residing in the State is eligible for the services
6 private conservator or guardian, except as otherwise limited by law or
3 of the public guardian.
7 court order.
4
(b) An elderly person may petition the court to have the public guardian
8
(c) The public guardian may petition the court to have himself or
5 appointed as his conservator or guardian with the powers and duties
9 another appointed as conservator or guardian, to issue an emergency
6 ordinarily conferred by law on conservators and guardians or for certain
10 order for protective services pursuant to the [State Protective Services
7 limited purposes described in the petition which are consistent with the
11 Act], and to order protective placement pursuant to the [State Protective
8 conservatorship and guardianship laws of this State. If the petition
12 Services Act].
9 requests that only limited powers be granted, the court shall incorporate
13 (d) The public guardian, on his own motion or at the request of the
10 this limitation into its order of appointment. The filing of a petition is
14 court, may intervene at any time in any conservatorship or guardianship
11 not the basis for any inference concerning the competence of the elderly
15 proceeding involving an elderly person by appropriate motion to the court,
12 person, or for any loss of civil rights or benefits.
16 if he or the court deems intervention to be justified because an appoint-
17 ed conservator or guardian is not fulfilling his duties, the estate is subject
1
18 to disproportionate waste due to the costs of the guardianship or con-
Section 6. [Allocation of Costs.]
19 servatorship, or the best interests of the incapacitated or protected person
2 (a) If a public guardian is appointed conservator or guardian for an
3 elderly person, the administrative costs of his services and the costs
20 require intervention.
21
(e) The public guardian pursuant to the [State Protective Services
4 incurred in the appointment procedure shall not be charged against the
22 Act] may petition the court to enjoin interference by any person with the
5 income or the estate of the incapacitated person, unless the court deter-
6 mines at any time that the person is financially able to pay all or part of
23 provision of protective services.
7 the costs.
24
(f) The public guardian may employ subordinates necessary for the
8
25 proper performance of his duties, to the extent authorized in the budget
(b) The ability of the income or estate of the incapacitated or protected
9 person to pay for administrative costs of a public guardian or costs
26 for his office.
(g) The public guardian may delegate to members of his staff his
10 incurred in the appointment procedure shall be measured according to
27
28 powers and duties as conservator or guardian and other powers and
11 the person's financial ability to engage and compensate a private guardian.
29 duties created by this act, although the public guardian retains ultimate
12 This ability is a variable dependent on the nature, extent, and liquidity
13 of assets; the disposable net income of the person; the nature of the
52
53
14 conservatorship or guardianship; the type, duration, and complexity of
30
(e) The incapacitated or protected person has the right to counsel
15 the services required; and any other foreseeable expenses.
31 whether or not he is present at the hearing, unless he intelligently and
16 (c) The public guardian shall investigate the financial status of a
32 voluntarily waives the right. If the person is indigent or lacks the capacity
17 person who requests the appointment of the public guardian as his
33 to waive counsel, the court shall appoint counsel. If the person is indigent,
18 guardian or for whom a court is considering the appointment of the
34 the State shall pay reasonable attorney's fees, i.e., compensation
19 public guardian. In connection with the investigation, the public guardian
35 customarily charged by attorneys in the State for comparable services.
20 may require the elderly person to execute and deliver written requests or
36 (f) The incapacitated or protected person has the right to trial by jury
21 authorizations necessary under applicable law to provide the public
37 upon request by the person or his counsel.
22 guardian with access to records of public or private sources, otherwise
38 (g) The incapacitated or protected person has the right, at his own
23 confidential, needed to evaluate eligibility. The public guardian may
39 expense or, if indigent, at the expense of the State, to secure an inde-
24 obtain information from any public record office of the State or of any
40 pendent medical or psychological examination relevant to the issues
25 subdivision or agency thereof upon request and without payment of any
41 involved in this hearing, and to present a report of this independent
26 fees ordinarily required by law.
42 evaluation or the evaluator's personal testimony as evidence at the
27 (d) The reasonable value of the services rendered without cost to an
43 hearing.
28 incapacitated or protected person shall be allowed as a claim against
44 (h) The incapacitated or protected person may present evidence and
29 the estate upon the death of the person.
45 cross-examine witnesses.
46 (i) The duties of counsel representing an incapacitated or protected
1
Section 7. [Term of Appointment; Accounting; Review of Appoint-
47 person at this hearing shall include: a personal interview with the person;
2 ment; Hearing Procedure.]
48 counseling the person with respect to his rights; and arranging for an
3
(a) The initial appointment by a court of the public guardian as con-
49 independent medical and/or psychological examination of the person, as
4 servator or guardian shall be for a term of one year. Successive appoint-
50 provided in subsection (g) above.
5 ments for a one-year term may be made by the court upon findings that
6 (1) the person is still in need of a conservator or guardian; (2) the ap-
7 propriate circumstances in Section 5 of this act still exist; and (3) the
1
Section 8. [Termination.] The public guardian may be discharged as
8 inventory, account, and plan of the public guardian submitted in accord
2 conservator or guardian by a court upon petition of the incapacitated or
9 with subsection (b) below are satisfactory.
3 protected person or any interested person or upon the court's own motion,
10
(b) No later than [30] days prior to the expiration of his term as con-
4 if it appears that the services of the public guardian are no longer
11 servator or guardian, the public guardian shall file with the court an
5 necessary.
12 inventory and account in accord with the provisions of [the conservator-
13 ship or guardianship law of the State], which shall be subject to examina-
14 tion pursuant to the provisions of [the conservatorship or guardianship
1
Section 9. [Succession to Position of Public Guardian; Vacancies.]
15 law of the State]. At the same time he shall file a statement setting forth
2 (a) A person appointed to the position of public guardian succeeds
16 facts which indicate (1) the present personal status of the incapacitated
3 immediately to all rights, duties, responsibilities, and powers of the
17 person; (2) the public guardian's plan for preserving and maintaining
4 preceding public guardian.
18 the future well-being of the person; and (3) the need for the continuance
5 (b) If the position of public guardian is vacant, subordinate personnel
19 or discontinuance of the conservatorship or guardianship, or for any
6 employed under Section 4 of this act shall continue to act as if the posi-
20 alteration of the powers of the public guardian.
7 tion of public guardian were filled.
21 (c) The court shall hold a hearing for the purpose of making the
8 (c) If the position of public guardian is vacant, the court may act
22 findings set forth in subsection (a) above concerning renewal of the appoint-
9 temporarily as public guardian until the position is filled.
23 ment of the public guardian.
10 (d) If the position of public guardian becomes vacant, a successor in
24
(d) The incapacitated or protected person shall be present at the hear-
11 office must be appointed within [45] days.
25 ing unless he has knowingly and voluntarily waived the right to be present
26 or he is physically or mentally incapable of being present. Waiver may
1
Section 10. [Court Costs.] In any proceeding for appointment of a
27 not be presumed from non-appearance but shall be determined on the
2 public guardian, or in any proceeding involving the estate of a protected
28 basis of factual information supplied to the court by counsel or a visitor
3 or incapacitated person for whom a public guardian has been appointed
29 appointed by the court.
4 conservator or guardian, the court may waive any court costs or filing fees.
54
55
1
Section 11. [Bond Required.]
Multiservice Senior Center and Community Care
2
(a) Upon taking office, a public guardian shall file with the clerk of the
Program Development Act
3 court in which he is to serve a general bond in the amount of [$
]
4 payable to the State or to the people of the county in which the court is
One of the major concerns expressed by the elderly and their advocates at the
5 seated and issued by a surety company approved by the [chief judge; pre-
Council of State Governments' regional forums was over those circumstances which
6 siding judge] of the court. The bond shall be purchased with the [general
compel senior citizens to enter custodial environments. Frequently those
7 funds of the State or county] and be conditioned upon the public guardian's
circumstances are the lack of available alternative resources for care even where
8 faithful performance of his duties as conservator or guardian.
only minor and temporary infirmities are involved. It has been suggested that a
9
(b) The general bond and oath of a public guardian is in lieu of the
minimum of 40 percent of nursing home patients could and would stay in the
10 bond and oath required of a private conservator or guardian.
familiar environment of their home if they could obtain health services and other
supportive services on an outreach basis from a central agency. This statute is drawn
1
Section 12. [Severability.] [Insert severability clause.]
from a Florida enactment aimed at creating such agencies. Other States, including
Maryland, Massachusetts, and Pennsylvania, have taken initiatives, either
1
Section 13. [Repeal.] [Insert repealer clause.]
administrative or legislative, to achieve this same end.
This draft act was developed as part of the Aging Project of the Council of State
1
Section 14. [Effective Date.] [Insert effective date.]
Governments.
Suggested Legislation
(Title, enacting clause, etc.)
1
Section 1. [Short Title.] This act may be cited as the [State] Multi-
2 service Senior Center and Community Care Program Development Act.
1
Section 2. [Definitions.] As used in this act:
2
(1) "Elderly person" means a person [65] years of age or older.
3
(2) "Functionally impaired person" means a person who, because
4 of physical or mental disability, requires help from others in order to
5 cope with the normal demands of daily living.
6
(3) "Center" means a multiservice senior center facility where
7 elderly persons are provided with medical, social, supportive, and
8 rehabilitative services in a centralized and comprehensive fashion. The
9 center will also provide community care services to those who are unable
10 to come to the center.
11
(4) "Community care" means a community-coordinated program
12 administered from a center which provides coordinated home delivery
13 of selected services to functionally impaired or other elderly persons.
14
(5) "Health services" means preventive medical services, diagnostic
15 and treatment services, emergency health services, and counseling
16 services on health matters which are provided on a daily basis at a center
17 by at least one licensed physician or by a registered nurse or other quali-
18 fied health professional under a licensed physician's supervision.
19
(6) "Employment services" means a program established to locate
20 employment opportunities for elderly persons on a full-time or part-
56
57
21 time basis.
1
Section 4. [Location.]
22
(7) "Information and referral services" means the use of a list of all
2 (a) The department shall establish or cause to be established multi-
23 services available in a community for elderly persons by a staff member of
3 service senior centers with community care components in each county
24 a center to assist individuals in identifying the type of assistance needed,
4 or appropriate political subdivision of the State as appropriate and feasi-
25 to place individuals in contact with appropriate services, and to follow up
5 ble to the extent that federal, state, and local funding is available. The
26 to determine whether services have been received and identified needs met.
6 department shall promulgate procedures whereby interested counties,
27
(8) "Health maintenance services" means those routine health
7 municipalities, or local organizations may make application to participate
28 services necessary to help confined elderly people maintain an appropri-
8 in the program. These procedures shall provide that elderly persons or
29 ate standard of personal health. These services are provided by licensed
9 representatives of organizations composed of elderly persons shall be
30 physicians, registered nurses, or other qualified health service personnel.
10 assured of maximum feasible participation in the planning of these
31
(9) "Homemaking and chore services" means those routine house-
11 programs. Where an area agency has been designated, that agency will
32 hold services necessary to help functionally impaired older persons meet
12 be given the option of establishing the center for its existing service area.
33 the normal demands of daily living. These services include light house-
13 (b) Centers shall be centrally located and easily accessible to public
34 keeping and laundering, meal preparation, personal and food shopping,
14 transportation, if any is available in the particular locality. Provision
35 check cashing and bill paying, friendly visiting, minor household repairs,
15 shall be made for transporting persons wanting to gain access to the
36 and yard chores.
16 centers who are unable to do so because of financial inability or physical
37
(10) "Mobile meals" means hot or cold nourishing meals prepared
17 impairment. Centers shall be designed to provide ease of access and use
38 under the supervision of a dietitian and delivered on a regular schedule
18 considering the infirmities of frail and handicapped elderly persons;
39 to functionally impaired elderly persons living at home. This service will
19 special safety features shall be provided in as unobtrusive a fashion
40 include a system for determining nutritional needs of participants.
20 as possible.
41
(11) "Transportation service" means door-to-door vehicular transpor-
42 tation for functionally impaired or other elderly persons living at home.
1
Section 5. [Services.]
43
[(12) "Legal services" means the provision of legal advice and
2 (a) Services provided within the center shall include at least the fol-
44 assistance by an attorney licensed to practice in [State] or by a paralegal
3 lowing:
45 or legal assistant acting under the supervision of an attorney.]
4
(1) Health services.
46
(13) "Counseling service" means the provision of information and
5
(2) Employment services.
47 advice by persons of professional or paraprofessional competence to
6
(3) Counseling services.
48 enable elderly clients to make decisions on personal matters, including
7
(4) Information and referral services.
49 income, health, housing, transportation, and family, personal, and social
8
[(5) Legal services.]
50 relationships.
9 (b) Community care services provided from the center directly to the
51
(14) "Area agency" means the single agency designated by the office
10 home from the center shall include at least the following:
52 on aging to be responsible for the program described in rules adopted
11
(1) Health maintenance services.
53 pursuant to U.S.C. Section 3024, et seq., of the Older Americans Act of
12
(2) Homemaking and chore services.
54 1965, in a designated geographical area of the State.
13
(3) Mobile meals services.
55
(15) "Department" means the [State Department of Elder Affairs].
14
(4) Transportation services.
15 (c) Services in addition to those described in subsections (a) and (b),
1 Section 3. [Program Goals.] The goals of this act are to:
16 including social and recreational services, adult education courses, tele-
2
(1) Identify acceptable and economically feasible ways to provide
17 phone reassurance, escort services, and housing assistance, may be in-
3 coordinated medical, supportive, and rehabilitative services to elderly
18 corporated into the center's programs as appropriate and to the extent
4 persons.
19 that resources are available.
5
(2) Encourage elderly persons to maintain physical, social, and
6 emotional well-being and to live dignified and reasonably independent
7 lives in their own homes.
1 Section 6. [Administration.]
8
2 (a) Services may be furnished by public agencies or private organiza-
(3) Diminish the rate of inappropriate entry and placement of
3 tions, but the total system of providing services within and outside the
9 functionally impaired elderly persons in nursing homes and related health
4 center shall be coordinated by means of a single, centralized management
10 care facilities.
5 unit which operates within the center and is established. staffed. and
59
58
6 equipped for this purpose.
2 shall manage, plan, oversee, and implement, where appropriate, serv- this
7 (b) The department may contract for any portion or all of the services
3 ices for elderly persons as provided in this act. In order to effect
8 required by the center, and the contracts may be made with any other
4 the department or the duly authorized local agency may accept
9 state agency, unit of the state education system, county agency, or private
5 purpose, gifts and grants of any nature and enter into contracts for the purchase
10 corporation in order to accomplish the purposes of this act.
6 of services.
11 (c) This act contemplates significant contribution of volunteer personal
12 services; therefore, the department shall contract for the necessary
1
Section 11. [Severability.] [Insert severability clause.]
13 insurance coverage to protect all volunteers from the normal risks of
14 personal liability while they are acting within the scope of their volun-
1 Section 12. [Repeal.] [Insert repealer clause.]
15 teer assignments for the community care for the elderly program in which
16 they are participating.
1
Section 13. [Effective Date.] [Insert effective date.]
17 (d) Once established, each of the centers shall receive state funds con-
18 tinuously for a period of at least two years, at which time the [secretary
19 of the department] shall make a report to [the Governor, the Speaker of
20 the House of Representatives and to the President of the Senate] sum-
21 marizing the results of programs offered by the center. This report shall
22 include an evaluation of the extent to which these programs achieved the
23 purposes expressed in Section 3. The report shall also include the infor-
24 mation and data necessary for an accurate analysis of the costs and
25 benefits associated with the establishment and operation of senior centers
26 with community care components. The report should include a complete
27 description of the programs that were established and may also include
28 further information and discussion as the department deems appropriate
29 and advisable.
1 Section 7. [Client Eligibility.]
2 (a) Services provided under this act are available to all persons [65]
3 years of age or older, except if funds earmarked for particular component
4 programs have other legally established client eligibility guidelines.
5 (b) It is the policy of this act to encourage voluntary contributions to
6 the center by clients for services received from the center, but no eligi-
7 ble client shall be refused services because of an inability or unwillingness
8 to make a contribution.
1
Section 8. [Discrimination Prohibited.] Centers established pursuant
2 to this act are open to all residents of the area being served without
3 regard to race, religion, color, sex, or creed.
1
Section 9. [Construction.]
2 (a) The provisions of this act shall be liberally construed in order that
3 the purposes of the act may be effectively accomplished.
4
(b) No provision of this act is intended to prevent the establishment of
5 senior multiservice centers under guidelines different from those de-
6 scribed in this act from funds other than those appropriated under this act.
1
Section 10. [Program Supervision by Department.] The department
60
61
Hearing Aid Dealers Regulation Act
23 to, hearing aid evaluation and recommendation, auditory training, and
24 speech reading.
Elderly persons are often the victims of unethical practices in the sale of hearing
aids. This act, drafted by the Retired Professional Action Group, offers broad
25 26 been issued a certificate of registration by the department, which autho-
(6) "Hearing aid dealer" or "registrant" means a person who has
consumer protection in the sale of hearing aids. It may be used in whole or in part to
27 rizes him to engage in the business of fitting and selling hearing aids.
upgrade current laws regulating the sale of hearing aids, or as a basis for legislation
29 28 to the individual, taking audiograms, making ear molds, and advising
(7) "Fitting" includes the physical acts of adjusting the hearing aid
where no law regulating the sale of hearing aids presently exists in a State. Some
outstanding features of this act include the requirements of an evaluation and
30 the individual with respect to hearing aids, audiogram interpretation,
written recommendation by a medical ear specialist or an audiologist prior to the
31 and assisting in the selection of a suitable hearing aid for the sole purpose
sale of a hearing aid, a trial period during which the purchaser can return an
32 of the sale of a hearing aid.
improperly fitted, defective, or unsuitable aid, and a training period and
33 34 or transfer of the right to possession of a hearing aid by lease, bailment,
(8) "Sale" or "selling" includes any transfer of title to a hearing aid
examination for all hearing aid dealers.
This draft act was developed as part of the Aging Project of the Council of State
35 loan, or any other contract, together with pricing, delivery, and guaran-
Governments.
36 teeing of the hearing aid. Wholesale transactions and gifts by public or
37 charitable organizations are not included.
38 39 on the human body represented as aiding or compensating for impaired
(9) "Hearing aid" means any electronic instrument or device worn
Suggested Legislation
40 human hearing, together with any parts, attachments, or accessories of
41 the instrument or device, except batteries and cords.
(Title, enacting clause, etc.)
42
(10) "Trainee temporary certificate of registration" means the
43 certificate which is issued by the department to a qualified person,
1
Section 1. [Short Title.] This act may be cited as the [State] Hearing
44 authorizing the person to engage in the training program prescribed by
2 Aid Dealers Act.
45 this act and to perform, under the supervision of a registrant, acts involved
46 in the fitting and selling of hearing aids.
1
Section 2. [Definitions.] As used in this act:
47 48 but who undertakes to do so through successful completion, under the
(11) "Trainee" means a person who does not qualify as a registrant,
2
(1) "Department" means the [state department of health], which is
3 charged with responsibility for administration of this act and, as the con-
49 direct and personal supervision and instruction of a registrant, of the
4 text requires, the term means the chief officer of that department and the
50 training program prescribed in this act.
5 authorized delegates of the chief officer.
6
(2) "Council" means the advisory council to the department.
1
Section 3. [Powers and Duties of the Department.] The powers and
7
(3) "Otolaryngologist" means a physician licensed in this State who
2 duties of the department under this act are to:
8 specializes in ear, nose, and throat, and is a diplomate or eligible for
3
(1) Establish an administrative subdivision within the department
9 qualification by the American Board of Otolaryngology as an otolaryn-
4 to assist in carrying out the provisions of this act.
10 gologist.
5
(2) Employ and fix the compensation of persons needed to assist
11
(4) "Otologist" means a physician licensed in this State who spe-
6 the department in carrying out the provisions of this act.
12 cializes in the ear, and is a diplomate or eligible for qualification by
7
(3) Authorize all disbursements necessary to carry out the pro-
13 the American Board of Otolaryngology as an otolaryngologist.
8 visions of this act and receive and account for all fees.
14
(5) "Audiologist" means an individual who is eligible for the Ameri-
9
(4) Approve examinations of applicants for certificates of registra-
15 can Speech and Hearing Association certificate of clinical competence
10 tion. The examination shall be prepared by an examining committee
16 in audiology, which means the application of principles, methods, and
11 with the advice of the department and the council. The examining com-
17 procedures of measurement, testing, evaluation, prediction, consultation,
12 mittee shall consist of an otologist or otolaryngologist, an audiologist, and
18 counseling, instruction, habilitation, or rehabilitation related to hearing
13 a hearing aid dealer who holds a certificate of registration under this act.
19 and disorders of hearing for the purpose of evaluating, identifying, pre-
14 The three persons need not be members of the council. If they are not
20 venting, ameliorating, or modifying these disorders and conditions in
15 members of the council, they shall be appointed for the purpose of
21 individuals or groups of individuals. For the purpose of this subsection
16 carrying out this provision.
22 the words "habilitation" and "rehabilitation" include, but are not limited
17
(5) Administer and grade, with the assistance of the examining
62
63
18 committee, qualifying written, oral, and practical examinations to test the
7 under this act, shall hold valid certificates of registration issued under
20 19 knowledge and proficiency of applicants for certificates of registration.
8 this act. One member shall be an audiologist with at least three years'
(6) Designate the time and place for examining applicants for
21 certificates of registration.
9 experience at the time of appointment in audiological practice. One
22
10 member shall be an otolaryngologist or otologist. One member shall be
23 aid education for renewal of certificates.
(7) Establish annual minimum requirements of continuing hearing
11 a physician engaged in general practice. One member shall be a consumer
24
12 hearing aid user. One member shall be a representative of a government
(8) Promulgate, with the advice of the council, rules and regulations
13 or nongovernment consumer protection agency. One member shall be a
25 consistent with the laws of this State which are deemed necessary to
14 representative of the [state department of education]. One member shall
26 carry out the provisions of this act and publish and enforce the rules
27 and regulations.
15 be the chief officer of the department or his delegate. The members of the
28
16 council shall be appointed by the department, and the first appointments
(9) Purchase and maintain, rent, or acquire audiometric equipment
17 shall be made within 60 days after the effective date of this act. In making
30 29 and facilities necessary to carry out the examination of applicants.
18 the appointments, the department shall consider nominations made by
(10) Conduct investigations into the business and ethical back-
19 any state or voluntary agency or private citizen. The terms of office of
31 ground of any person who makes application for a certificate of registra-
20 members of the council shall be three years. Any vacancy on the council
32 tion or a trainee temporary certificate of registration in order to determine
21 shall be filled for the remainder of the unexpired term with a person
33 the applicant's qualifications.
34
22 having the same qualifications as the former council member.
35 rary certificates of registration.
(11) Issue and renew certificates of registration and trainee tempo-
23 (b) Members of the council shall receive no compensation, but each is
36
24 entitled to reimbursement for actual expenses incurred in the perfor-
(12) Investigate alleged irregularities and complaints related to
25 mance of duties under this act, payable from the fund established by
37 the fitting and selling of hearing aids and conduct public hearings re-
26 Section 11 of this act.
39 department with the advice of the council.
38 garding any irregularities and complaints as deemed necessary by the
27
(c) The council shall:
40
28
(1) Meet within 30 days after appointments are complete and elect
(13) Suspend or revoke certificates of registration and temporary
29 a chairman and a vice chairman from its own members. Each officer
42 41 trainee certificates of registration with the advice of the council.
(14) Require the periodic inspection and calibration of audiometric
30 shall hold office for one year.
43 testing equipment of each registrant, and carry out the periodic inspec-
31
(2) Hold a meeting twice each year and other meetings at times and
44 tion of facilities of persons who sell hearing aids to determine that
32 places which the department, chairman, or a quorum of the council's
45 minimal procedures and equipment are used.
33 members directs.
46
47 deems proper.
(15) Delegate ministerial duties to the council as the department
34
(3) Recommend to the department examination procedures for
35 applicants, minimum requirements for the testing of equipment, minimal
48
(16) Record council proceedings and maintain a register of
36 procedures necessary in fitting and selling of hearing aids, public hearings
49 whose certificates have been suspended or revoked. The books persons and
37 in accordance with Section 3(12), a code of ethics to assure improvement
50 records concerning the council proceedings shall be prima facie evidence
38 of services and procedures to be followed by registrants, and specialized
51 of all matters reported therein.
39 educational courses for persons wishing to become hearing aid dealers.
52
40 The council shall be guided by relevant rules and regulations adopted and
53 records pertaining to this act.
(17) Make available for public inspection all the department's
41 promulgated by the Federal Trade Commission.
54
42
(18) Furnish, upon the oral or written request of any person, a
(4) Make a report each year to the department and to the Governor
55 list of persons registered under the provisions of this act.
43 of its official acts during the preceding year.
44
(5) Hear the charges, defenses, and evidence in hearings conducted
45 for alleged violations of any of the provisions of this act or any of the
1
Section 4. [Advisory Council Established; Powers and Duties.]
46 regulations issued pursuant to this act.
2 (a) There is created an advisory council to the department regarding
3 hearing aid dealers consisting of nine members, who are residents of this
1
Section 5. [Oath of Members of Council.] Immediately upon appoint-
4 5 State. Five members are a quorum. Two members shall be hearing aid
2 ment and before entering upon the duties of office, each member of the
3 council shall take the constitutional oath of office and file it with the
6 in dealers with at least three years' experience at the time of appointment
fitting and selling hearing aids and, except for those initially appointed
4 [department of state], which shall issue to the member a certificate of
5 appointment.
65
64
1
Section 6. [Certificate of Registration or Trainee Certificate of Regis-
8 of a registrant who is a member of the council or examining committee
2 tration Required.] Beginning [ ] days after the effective date of
9 be delayed no longer than the third examination given by the department
3 this act, it is unlawful for any person in this State to engage in the busi-
10 so that arrangements are made under which no member will participate
4 ness of fitting and selling hearing aids, or in any way advertise or repre-
11 in the preparation, administration, or grading of an examination taken by
5 sent that he practices the fitting and selling of hearing aids, unless the
12 that member.
6 person holds a certificate of registration, or a trainee temporary certificate
7 of registration issued by the department.
14 13 fails to take or pass the first examination required by this section, the
(b) If any person who received a certificate of registration by experience
15 certificate of registration of the person will be automatically revoked,
1
Section 7. [Exemptions.]
16 and the department shall advise the person that he may apply for a
2
(a) Nothing in this act prohibits a corporation, partnership, trust,
17 trainee temporary certificate and undertake further training under Stage
3 association, or other similar organization from engaging in the business
18 III of the trainee apprenticeship course prescribed by this act in Section
4 of fitting and selling hearing aids without a certificate of registration,
19 9. If this situation occurs, the trainee must work under the supervision
5 if all fitting and selling of hearing aids are conducted by registrants.
20 of a sponsor registrant.
6 The organization shall file annually with the department a list of hearing
21 (c) Each applicant for a certificate of registration or a trainee temporary
7 aid dealers directly or indirectly employed by it. The organization also
22 certificate of registration shall be at least 18 years of age and not under
8 shall file with the department a statement on a form approved by the
23 disability of minority, be of good moral character, have the educational
9 department that it submits itself to the rules and regulations of the
24 equivalent of successful completion of a four-year course in an accredited
10 department and the provisions of this act which the department deems
25 high school, and have an established business address in this State. The
11 applicable to the organization. The organization engaging in the business
26 applicant shall submit to the department a sworn application on a form
12 of fitting and selling hearing aids at retail shall maintain a place of
27 approved by the department, accompanied by the prescribed fee.
13 business in this State which is an actual, established physical location
28 29 tion or license to fit or sell hearing aids in another State and is qualified
(d) Any person who holds a currently effective certificate of registra-
14 from which the organization conducts its business and where applicable
15 books and records are maintained.
30 under subsection (c) of this section may make sworn application to the
16
(b) This act does not apply to a person engaged in the practice of
31 department to take the qualifying examination without any trainee
17 fitting and recommending hearing aids, if the practice is part of the
32 period. Upon passing the examination, the person shall receive a certifi-
18 academic curriculum of an accredited institution of higher education, or
33 cate of registration. If the person fails to pass the examination, the
19 part of a program conducted by a charitable institution or nonprofit
34 procedure shall be as provided in subsection (b) of this section.
20 organization supported primarily by voluntary contributions, or part of
35 (e) Any person who meets the requirements of subsection (c) of this
21 a program of a governmental agency, provided that the organization
36 section and who desires to become a registrant by successfully complet-
22 does not sell hearing aids.
37 ing the training program outlined in Section 9 of this act may submit a
23 (c) This act does not apply to any physician licensed to practice medi-
38 sworn application to the department for a trainee temporary certificate
24 cine in this State who does not sell hearing aids.
39 of registration. Previous experience is not required for a trainee certifi-
FORD
25
(d) This act does not apply to any audiologist practicing audiology
40 cate. Upon receipt of the certificate, the trainee becomes subject to all
26 in this State who does not sell hearing aids.
41 the provisions of this act and regulations issued under it, and under
27
(e) This act does not apply to any dealer who sells hearing aids only
42 the supervision and instruction of a registrant shall undertake the train-
28 upon the prescription or recommendation of a medical ear specialist or
43 ing program described in Section 9 of this act. The application shall be
29 an audiologist, if the dealer does not engage in testing or fitting for the
44 accompanied by a sworn statement from the registrant who will be the
30 purpose of selling a hearing aid.
45 applicant's supervising sponsor that the sponsor accepts responsibility
46 for all acts of the applicant relating to fitting and selling of hearing aids
1
Section 8. [Qualifications of Applicants for Registration.]
47 during the training period, and that during at least Stages I and II of
2
(a) Any person engaged in the fitting and selling of hearing aids from
48 the training program the applicant will receive training and supervision
3 an established place of business at a permanent address in this State for
49 in the same office occupied by the registrant.
4 a period of not less than two years prior to the effective date of this act,
5 upon sworn application to the department, is entitled to a certificate of
6 registration. The registrant shall be required to take the first qualifying
I
Section 9. [Trainee Apprenticeship Course.]
7 examination given by the department, provided that the first examination
2
(a) Stage I-The trainee must work for three months under the direct
66
67
3 and personal supervision of, and in the same office as, the sponsor regis-
1
Section 10. [Examination and Registration Fees.]
4 trant. During this stage, the trainee is not allowed to do any testing,
2 (a) Every initial application submitted to the department shall be
5 fitting, or selling.
3 accompanied by a fee of [$ ] to cover costs of investigation and
6 (b) Stage II-This training stage lasts for six months, during which the
4 verification. No part of this fee may be refunded.
7 trainee may do testing for the proper selection and fitting of hearing aids
5
(b) The annual certificate of registration fee is [$
I.
8 and make ear impressions. During this period the trainee must work
6 (c) The annual trainee temporary certificate of registration fee is
9 under the direct and personal supervision of, and in the same office as,
7
[$
T.
10 the sponsor registrant. During this stage, the trainee may not make
8 (d) The annual renewal fee for every certificate or temporary certifi-
11 final testing or final fitting.
9 cate of registration is [$
I.
12 (c) Stage III-This training stage lasts for three months or until the
10 (e) The fee for each examination is [$
T.
13 time the next examination thereafter is given, whichever is longer. During
11 (f) The delinquency fee on renewals is [$ ]. If any certificate or
14 this time the trainee may engage in all of the activities of a registrant,
12 temporary certificate of registration is issued after January 1 in any
15 but must work under the supervision of the sponsor registrant.
13 year, the annual fee shall be reduced in an equitable manner as provided
16 (d) The three stages described above must be completed with no time
14 by regulations promulgated by the department.
17 lapse between stages except as authorized by the department for justi-
18 fiable cause shown by the trainee, or sponsor, or both. A trainee who
1 Section 11. [Disposition of Fees.] All fees collected under the pro-
19 desires to change sponsors shall furnish the department with a sworn
2 visions of this act shall be paid to the department. The department shall
20 request, giving reasons for the request, accompanied by a sworn state-
3 deposit the funds with the [state treasurer], to the credit of the Hearing
21 ment from the new sponsor with the undertakings required by Section 8(e)
4 Aids and Devices Trust Fund, which is established. The costs of adminis-
22 of this act, and accompanied by the trainee's temporary certificate of
5 tration of this act shall be paid from the moneys collected under this act.
23 registration. If the transfer is approved, the certificate will be revali-
24 dated without charge. If a sponsor desires to terminate responsibilities
1 Section 12. [Examination.]
25 undertaken with regard to a trainee, he shall give the trainee 10 days'
2 (a) An applicant must make a grade of 70 percent or more in each
26 written notice, giving reasons, and notify the department accordingly
3 area, subject, or technique specified in this section to qualify for a
27 by registered or certified mail.
4 certificate of registration. The oral, written, and practical examination
28 (e) Upon completion of the three stages described in this section, the
5 shall be prescribed by the department in accordance with Section 3(4)
29 trainee shall take the qualifying examination given by the department
6 and shall be given at least twice a year, or as often as necessary to
30 and upon passing that examination shall receive a certificate of regis-
7 process applications received. A person wishing to take the examination
31 tration.
8 shall notify the department of his intention and the department shall
32 (f) If a trainee who holds a trainee temporary certificate of registration
9 supply the person with an application on a form prescribed by the
33 takes and fails to pass the qualifying examination, he must work under
10 department. The applicant shall execute the application and send it to
34 the provisions of Stage III of the trainee apprenticeship period until the
11 the department together with the examination fee. If the department
35 next examination.
12 finds that the applicant is eligible to take the examination, it shall notify
36 (g) No trainee may perform any hearing health services for a customer
13 the applicant in advance of the time and place for the examination. If
37 without the customer being informed that the services are being performed
14 the application is rejected, the application fee shall be refunded. If the
38 by a trainee rather than by a registrant. The notice shall be given verbally
15 application is approved and the applicant does not take the examination,
39 by the trainee or by the registrant sponsor, and a trainee identification
16 the fee shall not be refunded. No person will be permitted to take the
40 badge must be worn disclosing the status of the trainee. In each case,
17 examination more than three times.
41 records shall be kept showing the particular services performed by the
18 (b) All applicants taking the examination at the same time shall be
42 trainee.
19 given the same written, oral, and practical examination. The examina-
43 (h) When a course in fitting and selling of hearing aids, approved by
20 tion must be such that, in order to pass, the applicant must establish
44 the department and the council, is established in this State as provided
21 knowledge and proficiency in each of the following areas, subjects,
45 in Section 23, satisfactory completion of the course qualifies the student
22 and techniques:
46 to take the examination required by this act without complying with the
23
(1) Tests of knowledge in the following areas as they pertain to the
47 requirements of the trainee apprenticeship course provided in this section.
24 fitting of hearing aids:
25
(i) Basic physics of sound.
68
69
26
(ii) The human hearing mechanism, including the science of hear-
12 in the fitting or selling of hearing aids.
27 ing and the causes and rehabilitation of abnormal hearing disorders.
13
(5) Violation of any of the provisions of this act, or any of the pro-
28
(iii) Structure and functions of hearing aids.
14 visions of any rules or regulations promulgated pursuant to this act.
29
(iv) Basic psychology relating to the hearing impaired.
15
(6) Selling a hearing aid to any person unless within the preceding
30
(v) Availability of social service resources and other special re-
16 three months the person has been examined by an otolaryngologist or
31 sources for the hearing impaired.
17 an otologist, and a written recommendation for a hearing aid has been
32
(vi) Knowledge of the provisions of this act, with emphasis on
18 made by the physician or by an audiologist eligible for certification by
33 criminal provisions and the grounds on which a certificate of registration
19 the American Speech and Hearing Association to whom the person has
34 may be suspended or revoked.
20 been referred by the physician. This does not apply to replacement of
35
(2) Tests of proficiency in the following techniques as they pertain
21 an identical hearing aid within one year of its purchase.
36 to the fitting of hearing aids:
22
(7) Departing from the medical or audiological recommendations
37
(i) Pure tone audiometry, including air conduction testing and
23 obtained pursuant to subsection (6) without consultation and written
38 bone conduction testing.
24 approval from the physician or the audiologist involved.
39
(ii) Recorded speech audiometry, including speech reception
40 threshold testing and speech discrimination testing.
1 Section 15. [Unethical Conduct Defined.] Unethical conduct includes:
41
(iii) Theory and practice of masking methodology.
2
(1) Obtaining any fee or making or attempting to make any sale of
42
(iv) Recording and evaluation of audiograms and speech audi-
3 any hearing aid by fraud or misrepresentation.
43 ometry to determine hearing aid candidacy.
4
(2) Employing, directly or indirectly, any suspended or unregistered
44
(v) Selection and adaption of hearing aids and testing of hearing
5 person to perform any work requiring a certificate of registration or a
45 aids.
6 temporary certificate of registration.
46
(vi) Basic repair and maintenance of hearing aids.
7
(3) Using, causing, or promoting the use of any advertising matter,
47
(vii) Taking earmold impressions.
8 promotional literature, testimonial, guarantee, warranty, label, brand,
48
(viii) Other skills as required for the fitting of hearing aids.
9 insignia, or any other representation however disseminated or published
49
(c) The examination shall be revised annually by the examining com-
10 which is misleading, deceitful, or untruthful.
50 mittee so that it includes current and significant information which
11
(4) Advertising a particular model, type, or kind of hearing aid if
51 pertains to the categories in this section. No examination of any estab-
12 the offer is not a bona fide effort to sell the product so offered as adver-
52 lished association of hearing aid dealers or manufacturers may be used
13 tised and at the advertised price. Among actions or procedures which
53 exclusively to replace this examination.
14 will be considered in determining whether this type of advertisement
15 has been made are the following:
1
Section 13. [Certificate of Registration.] Upon passing the examination,
16
(i) The creation, through the initial offer of advertisement, of a
2 the department shall issue to the applicant a certificate of registration
17 false impression of the product offered in any material respect.
3 under the seal of the department. The certificate of registration shall be
18
(ii) The refusal to show, demonstrate, or sell the product offered
4 prominently displayed at all times in the registrant's place of business.
19 in accordance with the terms of the offer.
20
(iii) The disparagement, by actions or words, of the product
21 offered; the guarantee; the credit terms; the availability of service,
1
Section 14. [Grounds for Suspension, Revocation, or Refusal to Issue
22 repairs, or parts; or any other disparagement in connection with the
2 or Renew Certificate of Registration or Trainee Temporary Certificate
23 product's sale or service.
3 of Registration.] The department may suspend, revoke, or refuse to renew
24
(iv) The showing, demonstrating and, in the event of sale, the
4 any certificate issued under this act, for any of the following reasons:
25 delivery of a product which is unusable or impractical for the purpose
5
(1) Conviction of a felony or misdemeanor involving moral turpitude.
26 represented or implied in the offer.
6
(2) Willfully making a false statement to the department in an appli-
27
(v) The refusal, in the event of sale of the product offered, to
7 cation for a certificate or for the renewal of any certificate or with respect
28 deliver the product to the buyer within 30 days.
8 to any matter within the scope of the department's power and duties
29
(vi) The failure to have access to a quantity of the advertised
9 under this act.
30 product at the advertised price sufficient to meet reasonably anticipated
10
(3) Altering any certificate with fraudulent intent.
31 demands.
11
(4) Unethical conduct as defined in Section 15 or gross malpractice
32
(5) Representing that the services or advice of a person licensed to
70
71
33 practice medicine or of a person certified as an audiologist will be used
79 another in a professional capacity, as an inducement to influence the
34 or made available in the selection, fitting, adjustment, maintenance, or
80 person, or to have the person influence others, to purchase or contract to
35 repair of hearing aids when that is not true; or using or incorporating in
81 purchase any product sold or offered for sale by the registrant or to
36 any title or designation the words "doctor," "clinic," "clinical audiolo-
82 influence any person to refrain from dealing in the products of competitors.
37 gist," "audiologist," "state-licensed clinic," "state-registered," "state-
83
(16) Violation of any relevant rules and regulations adopted and
38 certified," "state-approved," or any other term, abbreviation, or symbol,
84 promulgated by the Federal Trade Commission.
39 or wearing any costume which would give the false impression that one
85
(17) Other acts or omission as the department determines by regula-
40 is being treated medically or audiologically or that the registrant's serv-
86 tions to be unethical conduct.
41 ices have been recommended by the State.
42
(6) Canvassing from house to house or by telephone, either in person
1 Section 16. [Trial Period: Receipt to be Furnished Purchasers of
43 or by agents, for the purpose of selling a hearing aid, without prior
2 Hearing Aids.] Every registrant who sells a hearing aid shall provide
44 request from the prospective customer.
3 for a trial period of the instrument by the purchaser, and deliver to the
45
(7) Selling a hearing aid to a person under the age of 18 years or to
4 purchaser a receipt which contains all of the following information:
46 a person in a mental institution, hospital, nursing home, convalescent
5
(1) The name, address, and signature of the purchaser.
47 home, or like institution, unless there is present in addition to the regis-
6
(2) The name, address of the regular place of business, the number
48 trant an adult person who is not a business associate of the registrant.
7 of the certificate of registration, and the signature of the registrant.
49
(8) Permitting another to use one's certificate of registration or
8
(3) The make, model, serial number, purchase price, and the date
50 temporary certificate of registration.
9 the manufacturer first produced the same model.
51
(9) Representing, advertising, or implying that the hearing aid repair
10
(4) Whether the hearing aid sold is new, used, or rebuilt.
52 is guaranteed, without a clear and concise disclosure of the identity of
11
(5) If the hearing aid is (or has been represented to be) guaranteed,
53 the guarantor, the nature and extent of the guarantee, and any conditions
12 a clear and precise statement of:
54 or limitations imposed.
13
(i) The identity of the guarantor and the manner in which the
55
(10) Failure to supervise a trainee as required by Sections 8 and 9 of
14 guarantor will perform under the guarantee (such as total or partial
56 this act or to accept responsibility for the actions of a trainee relating to
15 refund, repair, or exchange).
57 the fitting and selling of hearing aids.
16
(ii) The nature and extent of the guarantee.
58
(11) Using any advertisement or other representation which has the
17
(iii) Any material conditions or limitations in the guarantee which
59 effect of misleading or deceiving purchasers or prospective purchasers
18 are imposed by the guarantor.
60 in the belief that any hearing aid or device, or part or accessory thereof,
19
(iv) The fact that the guarantee is offered only by the registrant, if
61 is a new invention or involves a new mechanical or scientific principle
20 a guarantee made by the registrant is not backed up by the manufacturer.
62 when that is not the fact.
21
(6) The complete terms of the sale, including the terms of the trial
63
(12) Representing, directly or by implication, that a hearing aid
22 period, an itemized account showing individually the goods and services
64 utilizing bone conduction has certain specified features, such as the
23 and the individual prices for them, that go to make up the total amount
65 absence of anything in the ear or leading to the ear, or the like, without
24 charged the purchaser.
66 disclosing clearly that the instrument operates on the bone conduction
25
(7) The name and address of the department, with a statement that
67 principle, and that in many cases of hearing loss this type of instrument
26 complaints which may arise with respect to the transaction may be sub-
68 may not be suitable.
27 mitted to it.
69
(13) Stating or implying that the use of any hearing aid will restore
28
(8) In type no smaller than the largest type contained in the receipt,
70 hearing to normal, or preserve hearing, or prevent or retard progression
29 the following statement:
71 of a hearing impairment, or any other false or misleading or medically or
30 The purchaser was advised at the outset of relations with the undersigned
72 audiologically unsupportable claims regarding the efficacy or benefits
31 hearing aid dealer that any examination or representation made by the
73 of a hearing aid.
32 dealer in connection with the fitting and selling of the hearing aid de-
74
(14) Representing or implying that a hearing aid is or will be
33 scribed in this receipt is not an examination, diagnosis, or prescription by
75 "custom-made," "made to order," "prescription made," or in any other
34 a person licensed to practice medicine, audiology, or otolaryngology
76 sense especially fabricated for an individual when that is not the case.
35 in this State.
77
(15) Directly or indirectly giving or offering to give, or permitting or
36
(9) A copy of the written recommendation and findings of the
78 causing to be given, money or anything of value to any person who advises
37 otolaryngologist, otologist, or audiologist who examined the purchaser
72
73
38 and issued clearance for a hearing aid, showing the type and degree of
39 for department inspection shall include:
39 hearing disability involved (such as conductive, sensorineural, or mixed
40
(A) Copy of each receipt executed in connection with the fitting
40 hearing loss).
41 and sale of each hearing aid.
41
(10) A statement precisely setting forth all representations made by
42
(B) A complete record of tests, test results, and services.
42 the hearing aid dealer about the dealer's tests, test results, and recom-
43
(C) Customer's case history.
43 mendations, and about the special benefits of the hearing aid purchased,
44
(D) Any correspondence specifically related to the customer or
44 together with written materials supporting the claims or representations.
45 hearing aid or aids sold to the customer.
1
Section 17. [Minimal Equipment and Procedures.] The following mini-
1
Section 18. [Renewal of Certificate of Registration or Trainee Tempo-
2 mal equipment and procedures as prescribed by the department, with
2 rary Certificate of Registration.]
3 the advice of the council, shall be used in connection with the fitting and
3 (a) Every certificate shall expire on December 31 of the year in which
4 sale of hearing aids:
4 it is issued. On or before October 1 of each year, the department shall
5
(1) Minimal equipment includes:
5 mail to each registrant or trainee an application for renewal of the
6
(i) Access to a selection of hearing aid models and hearing aid
6 certificate. The application shall be completed by the registrant or trainee
7 supplies and services complete enough to accommodate the various needs
7 and sent to the department, accompanied by the annual renewal fee.
8 of hearing aid users, as an adequate stock of hearing aids, including an
8 Every application shall request a record of the current educational
9 appropriate selection of receivers and accessories, and access to facilities
9 material the applicant has studied and the educational classes the
10 for making ear molds and any other supplies required by the department.
10 applicant has attended in the hearing health field since last receiving a
11
(ii) Satisfactory facilities for the personal comfort of customers.
11 certificate of registration or a trainee temporary certificate of registra-
12
(iii) A sound-treated testing room.
12 tion. Upon approval of the application by the department, the department
13
(iv) Pure tone audiometer which shall meet the American National
13 shall send the applicant a renewed certificate issued under the seal of
14 Standards Institute specifications for diagnostic audiometers and which
14 the department.
15 shall be calibrated and recorded at intervals established by the rules
15 (b) In the case of an application for renewal of a trainee temporary
16 and regulations of the department.
16 certificate of registration, the sponsor registrant shall sign a statement
17
(v) Speech audiometer for determining the most comfortable
17 reporting the progress being made by the trainee. No trainee temporary
18 listening level and speech discrimination.
18 certificate of registration shall be renewed for any person who has had
19
(2) Minimal procedures include:
19 the opportunity to take three consecutive examinations.
20
(i) Pure tone audiometric testing by air and bone conduction to
20 (c) A certificate which has not been renewed by January 1 of any year
21 determine the degrees and types of hearing deficiency, and masking
21 shall be automatically suspended after a 30-day grace period until the
22 as required.
22 registrant or trainee pays the regular fee plus a delinquency fee of [$
]
23
(ii) Appropriate testing to determine speech discrimination, speech
23 for each month or fraction of a month that the person failed to register,
24 reception threshold, most comfortable sound tolerance level, and selec-
24 provided, that after a period of three months the certificate shall be
25 tion of the best ear for maximum hearing aid benefit. Selection of an
25 automatically cancelled.
26 instrument that will best compensate for the degree of loss and tolerance
27 level and provide a frequency amplification curve that will give the best
1 Section 19. [Procedurè for Handling Complaints and Denial, Suspen-
28 speech discrimination possible.
2 sion, or Revocation of Certificates of Registration or Trainee Temporary
29
(iii) Final fitting of the hearing aid ensuring physical and opera-
3 Certificates of Registration; Public Hearings.]
30 tional comfort.
4 (a) Any person who wishes to make a complaint against a registrant or
31
(iv) Keeping a complete retail price list showing all hearing aid
5 a trainee or an applicant for a certificate of registration under this act
32 models for all prospective customers to examine.
6 shall put the complaint in writing and file it with the department within
33
(v) Keeping records on every customer to whom the registrant
7 one year from the date of the action (or failure to act) upon which the
34 renders services or to whom he sells a hearing aid. The records shall be
8 complaint is based. If the department finds, after an investigation it
35 preserved for at least seven years after the sale of the hearing aid to the
9 deems appropriate, and after advice of the council, that the charges in
36 customer. If other hearing aids are subsequently sold to that customer,
10 the complaint and the circumstances justify a public hearing to determine
37 cumulative records must be maintained for at least seven years after the
11 whether or not a certificate of registration or a trainee temporary
38 latest sale of an aid to that customer. The records which must be available
12 certificate of registration shall be denied, suspended, or revoked, it shall
74
75
13 take action.
1
Section 20. [Attorney General and County Prosecuting Attorneys.]
14
(b) The initial procedures to be followed are:
2 The Attorney General of this State and all county prosecuting attorneys
15
(1) No certificate may be denied, revoked, or suspended except after
3 shall assist the department in the enforcement of this act.
16 written notice by registered mail to the applicant or registrant or trainee,
17 setting forth the particular reasons for the proposed action, furnishing
1
Section 21. [Penalties.] Violation of any of the provisions of this act,
18 a copy of the complaint, and explaining the right to a public hearing if
2 or of any of the regulations promulgated pursuant to this act, is a mis-
19 demanded by the applicant or registrant or trainee.
3 demeanor, punishable upon conviction by a fine of not more than [$500],
20
(2) Any applicant or registrant who desires a hearing within 20 days
4 or imprisonment for not more than [90] days, or both.
21 after service of notice shall request the hearing in writing and send it
22 to the department by registered mail.
1
Section 22. [Action to Enjoin Violations of Act; Bond Not Required.]
23
(3) If an applicant or registrant or trainee requests a hearing, the
2 (a) Upon violation of any of the provisions of this act, or of any of the
24 department shall fix a date, time, and place for the hearing and notify
3 rules and regulations promulgated by the department pursuant to this
25 the applicant or registrant or trainee accordingly. The notice shall be
4 act, any judge of a court of record in any county where the violation
26 either personal notice or notice by registered mail, and shall be served at
5 occurs may restrain and enjoin any person or his agents or representa-
27 least 30 days before the date set for the hearing.
6 tives from further violating any of the provisions. The injunctive relief
28
(4) If no request for a hearing is made, the department shall immedi-
7 may be granted upon the application of the department and shall not be
29 ately deny, revoke, or suspend the certificate.
8 barred by reason of any administrative or penal proceedings had or pend-
30
(c) For the purpose of the hearing, the department may require the
9 ing involving the same charges. No bond is required when injunctive
31 production of books, papers, and other documents, and issue subpoenas
10 relief is sought.
32 to compel witnesses to appear. Witnesses are entitled to the same per
11 (b) Nothing contained in this section precludes any other person from
33 diem and mileage allowances as witnesses in the county courts of record
12 obtaining injunctive relief or damages on account of a violation of this act.
34 in this State, payable out of the Hearing Aids and Devices Trust Fund,
35 established by Section 11 of this act. The customary rules of evidence
1
Section 23. [Establishment of Academic Courses in the Fitting, Selling,
36 used in court proceedings are not applicable to the hearing.
2 and Servicing of Hearing Aids.]
37 (d) If the department determines from the evidence and proofs sub-
3 (a) The [state department of education], with the advice and assistance
38 mitted that the accused has been guilty of violating any of the provisions
4 of the department and the advisory council, shall establish within educa-
39 of this act, or any of the regulations promulgated by the department
5 tional institutions, financed in whole or in part with public funds of this
40 pursuant to this act, the department, within 30 days after the hearing,
6 State, formal courses of instruction to enable eligible students to become
41 shall issue an order refusing to issue or renew, or revoking or suspending
7 qualified hearing aid dealers and fitters. Minimum enrollment require-
42 (as the case may be), the certificate. The order shall include the findings
8 ments shall be good moral character and the educational equivalent of
43 of fact and the conclusions of law made by the council. A copy of the
9 successful completion of a four-year course in an accredited high school.
44 order shall be sent to the accused by registered mail. The records of the
10 (b) The course shall consist of a minimum of the equivalent of [30
45 department shall reflect the action taken by the department on the
11 semester hours], as computed by accredited colleges and universities
46 charges and the department shall preserve a record of the proceedings
12 in this State. The semester hours shall be devoted to classroom instruc-
47 in a manner similar to that used by courts of record in the State.
13 tion and practical application as the [state department of education] and
48 (e) The final order of the department in the proceedings for denial,
14 the department find most effective.
49 suspension, or revocation of a certificate are subject to appeal to, and
15 (c) Insofar as feasible, the [state department of education] shall pro-
50 review by, an appropriate court of record in the county where the accused
16 vide for the utilization of present faculty members teaching audiology,
51 resides, or in which the accused's principal place of business is located.
17 physics, and physiology, and may permit employment of additional full-
52 (f) The department shall send a copy of the complaint and a copy of the
18 or part-time instructors as necessary to carry out the purposes of this
53 department's final order to the Attorney General for purposes of informa-
19 section.
54 tion in the event the accused pursues a court appeal, and for consideration
20 (d) One year after instruction is commenced under this section, the
55 as to whether the violations are flagrant enough to justify prosecution.
21 [state department of education] may modify the number of semester
56 (g) Insofar as applicable, the provisions of the [State Administrative
22 hours and subjects of instruction required for successful completion of
57 Procedures Act] shall govern the hearing and appeal set forth in this
23 the course to reach the number of hours and subjects necessary for an
58 section.
24 associate in arts degree, or its equivalent.
76
77
25
(e) Successful completion of the course provided herein shall qualify
Health Care Facility, Safety, and Security Act
26 the student to take the examination required by this act without comply-
27 ing with the requirements of the trainee apprenticeship course described
This act has as its goal the enforcement of health, safety, and security standards in
28 in Section 9.
skilled and intermediate nursing homes and in residential care facilities. The basic
29
(f) The [state department of education] and the department may
enforcement mechanism is the "citation system," whereby a representative of the
30 promulgate rules and regulations, not contrary to the laws of this State,
department of health, upon inspection initiated by complaint or in fulfillment of the
31 necessary to carry out the purposes of this section.
requirement for periodic inspections, can issue one of two classes of citations,
depending on the seriousness of the violation. The licensee of the facility has a time
1
Section 24. [Severability.] [Insert severability clause.]
period in which to correct the condition or conditions leading to the violation and, if
he does not do so, an initial fine is levied and an extra fine is levied for each day the
1
Section 25. [Repeal.] [Insert repealer clause.]
violation continues after that. This act also requires public posting of notices of
uncorrected violations and other means to make public those violations of health,
1
Section 26. [Effective Date.] [Insert effective date.]
safety, and security standards by the health care facility. This act is modeled after a
California statute.
This draft act was developed as part of the Aging Project of the Council of State
Governments.
GERALD
LIBRARY
Suggested Legislation
(Title, enacting clause, etc.)
1
Section 1. [Short Title.] This act may be cited as the [State] Health
2 Care Facility, Safety, and Security Act.
1
Section 2. [Definitions.] As used in this act:
2
(1) "Health care facility" means any skilled or intermediate nursing
3 home as defined by the [applicable state law] and any residential facility
4 providing services and care to persons with some degree of physical or
5 mental impairment, below the skilled or intermediate nursing care level.
6 Hospitals are not included in this definition.
7
(2) "Licensee" means the holder of a license issued for a health
8 care facility.
9
(3) "Department" means the [state department of health], which is
10 charged with responsibility for administration of this act and, as the
11 context requires, the term means the chief officer of the department or
12 the duly authorized delegate or delegates of the chief officer.
1
Section 3. [Request for Inspection.] Any person may request an in-
2 spection of any health care facility in accordance with the provisions
3 of this act by giving notice to the department of an alleged violation of
4 applicable requirements of state law. A notice shall be in writing signed
5 by the complainant and set forth the matters complained of, with reasona-
6 ble particularity. The substance of the complaint shall be provided to the
7 licensee no earlier than at the commencement of the inspection. Neither
8 the substance of the complaint provided the licensee nor any copy of the
79
78
6 Section 11, it shall, not later than one day after the date of inspection,
9 complaint or record published, released, or otherwise made available to
7 issue a citation to the licensee. The citation shall be served upon the
10 the licensee may disclose the name of the complainant or other person
8 licensee personally or by registered mail in a manner which will assure
11 mentioned in the complaint, except the name or names of any duly
12 authorized officer, employee, or agent of the department conducting the
9 adequate notice. A copy of the citation also shall be sent to the com-
13 investigation or inspection pursuant to this act, unless the complainant
10 plainant. Each citation shall be in writing and describe with particularity
11 the nature of the violation, including a reference to the statutory pro-
14 specifically requests the release of his name or the matter results in a
12 vision, standard, rule, or regulation alleged to have been violated. The
15 judicial proceeding.
13 citation shall fix the earliest feasible time for the elimination of the
1
Section 4. [Preliminary Review; Inspection.] Upon receipt of a com-
14 condition constituting the violation, where appropriate.
2 plaint, the department may assign an inspector to make a preliminary
1
3 review of the complaint and notify the complainant of the name of the
Section 8. [Classification of Violations.] Citations issued pursuant to
2 this act shall be classified according to the nature of the violation and
4 inspector. Unless the department determines that the complaint is
3 indicate the classification on the face thereof, as follows:
5 willfully intended to harass a licensee or is without any reasonable basis,
4
(1) Class A violations are violations which the department deter-
6 it shall make an onsite inspection within [10] working days of the
5 mines present an imminent danger to the residents or guests of the
7 receipt of the complaint. In either event, the complainant shall be
6 health care facility or a substantial probability that death or serious
8 promptly informed of the department's proposed course of action. Upon
7 physical harm would result therefrom. A physical condition or one or
9 the request of either the complainant or the department, the complainant
8 more practices, means, methods, or operations in use in a health care
10 or his representative, or both, may be allowed to accompany the inspector
9 facility may constitute a violation. The condition or practice constituting
11 to the site of the alleged violations during his tour of the facility, unless
10 a Class A violation shall be abated or eliminated immediately, unless a
12 the inspector determines that the privacy of any resident would be vio-
11 fixed period of time, as determined by the department, is required for
13 lated thereby.
12 correction. A Class A violation is subject to a fine in an amount not less
1
13 than [$1,000] and not exceeding [$5,000] for each and every violation.
Section 5. [Procedures; Penalty for Advance Notice.]
14
(2) Class B violations are violations which the department deter-
2
(a) Any authorized officer, employee, or agent of the department may
15 mines have a direct or immediate relationship to the health, safety, or
3 enter and inspect any health care facility at any time, including, but not
4 limited to, interviewing residents and reviewing records, to enforce any
16 security of health care facility residents, other than Class A violations.
17 A Class B violation is subject to a fine in an amount of not less than
5 provision of this act. Inspections conducted pursuant to complaints filed
6 with the department shall be conducted in a manner which will assure
18 [$50] and not exceeding [$250] for each and every violation. A citation
19 for a Class B violation shall specify the time within which the violation
7 maximum effectiveness. No advance notice may be given of any inspec-
8 tion conducted pursuant to this act unless previously and specifically
20 is required to be corrected. If a Class B violation is corrected within the
9 authorized by the department or required by federal law.
21 time specified, no fine shall be imposed.
10 (b) Any public employee giving advance notice in violation of this
11 section shall be suspended from all duties without pay for a period
1
Section 9. [Subsequent Penalties.] If a licensee has failed to correct a
12 determined by the department.
2 violation within the time specified in the citation, the department shall
3 assess the licensee a fine of [$50] for each day the deficiency continues
1
Section 6. [General Inspections.] The department, in addition to any
2 inspections conducted pursuant to complaints filed pursuant to this act,
4 beyond the date specified for correction.
3 shall conduct at least two general inspections, and as many additional
1
Section 10. [Regulations.] After consultation with industry, profes-
4 inspections as necessary in every calendar year of all health care facili-
2 sional, and consumer groups affected thereby, not later than three months
5 ties in the State without providing notice of the inspections.
3 after the effective date of this act, the department shall publish proposed
1
Section 7. [Issuance of Citations.] If upon inspection or investigation
4 regulations setting forth the criteria and, if feasible, the specific acts that
5 constitute Class A and Class B violations under this act. Not later than
2 the department determines that a health care facility is in violation of
6 six months after the effective date of this act, the department shall adopt
3 any statutory provision or rule or regulation relating to the operation
4 or maintenance of the facility, except with respect to violations deter-
7 and promulgate regulations setting forth criteria and, if feasible, specific
5 mined to have only a minimal relationship to safety or health pursuant to
8 acts constituting Class A and Class B violations.
80
81
1
Section 11. [Notice of Violation.] The department shall prescribe
43 dar over all other cases except those to which equal or superior prece-
2 procedures for the issuance of a notice of violation with respect to viola-
44 dence is specifically granted by law. The times for responsive pleadings
3 tions having only a minimal relationship to safety or health.
45 and for hearings in the proceedings shall be set by the judge of the court
46 with the object of securing a decision at the earliest possible time.
1
Section 12. [Contesting Citations; Court Procedures.]
2
(a) If a licensee desires to contest a citation or the proposed assessment
1
Section 13. [Posting; Availability of Citations.]
3 of a fine therefor, within four business days after service of the citation
2
(a) Each citation for a Class A violation specified in Section 8(1) which
4 he shall notify the department in writing of his request for an informal
3 is issued pursuant to this section and is final, or a copy or copies thereof,
5 conference with the designee of the department for the county in which
4 shall be prominently posted, as prescribed in regulations issued by the
6 the cited health care facility is located. The designee, within four business
5 department, until the violation is corrected to the satisfaction of the
7 days from the receipt of the request, shall hold an informal conference,
6 department, up to a maximum of 120 days. The citation or copy shall be
8 at the conclusion of which he may affirm, modify, or dismiss the citation
7 posted in a place or places in plain view of the residents in the health
9 or proposed assessment of a fine. If the designee modifies or dismisses
8 care facility, persons visiting those residents, and persons who inquire
10 the citation or proposed assessment of a fine, he shall state with particu-
9 about placement in the facility.
11 larity in writing his reasons for the action, and immediately transmit a
10 (b) Each citation for Class A and Class B violations specified in
12 copy thereof to each party to the original complaint. If the licensee
11 Section 8(1) and (2) which is issued pursuant to this section and is final,
13 desires to contest a decision made after the informal conference, he shall
12 or a copy or copies thereof, shall be retained by the licensee at the facility
14 inform the department in writing within four business days after he re-
13 cited until the violation is corrected to the satisfaction of the department.
15 ceives the decision by the department's designee. If the licensee fails to
14 Each citation shall be made promptly available by the licensee for in-
16 notify the department in writing that he intends to contest the citation or
15 spection or examination by any member of the public who so requests.
17 the proposed assessment of a fine therefor or the decision made by a
16 In addition, every licensee shall post in a place or places in plain view
18 designee after an informal conference within the time specified in this
17 of the residents in the health care facility, persons visiting those residents,
19 subsection, the citation or the proposed assessment of a fine or the deci-
18 and persons who inquire about placement in the facility, a prominent
20 sion by a designee after an informal conference shall be deemed a final
19 notice informing the persons that copies of all final uncorrected violations
21 order of the department and not be subject to further administrative
20 issued by the department to the facility will be made promptly available
22 review.
21 by the licensee for inspection by any person who so requests.
23
(b) A licensee, in lieu of contesting a citation pursuant to this section,
24 may transmit to the department the minimum amount specified by law
1
Section 14. [Injunctions; Civil Damages.] Unless the department has
25 for each violation within four business days after the issuance of the
2 taken action and the violations have been corrected to its satisfaction,
26 citation.
3 any licensee who commits a Class A or Class B violation may be enjoined
27
(c) If a licensee notifies the department that he intends to contest a
4 from permitting the violation to continue or sued for civil damages within
28 citation, the department shall immediately notify the Attorney General.
5 a court of competent jurisdiction. Actions for injunction or civil damages,
29 Upon notification, the Attorney General shall promptly take all appropri-
6 or both, may be prosecuted by the Attorney General in the name of the
30 ate action to enforce the citation and recover the fine prescribed thereon,
7 people of the State of [ ] upon his own complaint or upon the com-
31 and take other action he deems appropriate, in the [appropriate court]
8 plaint of any board, officer, person, corporation, or association, or by
32 of the county in which the health care facility is located.
9 any person acting for the interests of himself, the residents of the health
33
(d) In assessing the fine for each count of violation, the court shall
10 care facility, or members of the general public. The remedies specified in
34 consider the nature of the violation and the seriousness of the effect of
11 this section are in addition to any other remedy provided by law.
35 the violation upon the effectuation of the purposes and provisions of
36 this act.
1
Section 15. [Misdemeanors for Certain Acts.] It is a misdemeanor for
37
(e) The fine authorized by this act shall be trebled for a second or sub-
2 any person to do any of the following:
38 sequent violation occurring within any 12-month period, if a citation was
3
(1) Willfully prevent, interfere with, or attempt to impede in any
39 issued for the previous violation occurring within that period and a fine
4 way the work of any duly authorized representative of the department in
40 was assessed therefor.
5 the lawful enforcement of any provision of this act.
41 (f) Actions brought under the provisions of this act shall be set for
6
(2) Willfully prevent or attempt to prevent the representative from
42 trial at the earliest possible date and take precedence on the court calen-
7 examining any relevant books or records in the conduct of his official
82
83
8 duties under this act.
1
Section 19. [Annual Reports.] The department shall annually prepare
9
(3) Willfully prevent or interfere with the representative in preserv-
2 and make available in all offices of the [facilities licensing section] a
10 ing evidence of any violation of any of the provisions of this act or of the
3 report listing all licensees by name and address, indicating the number of
11 rules and regulations promulgated under this act.
4 citations and the nature of each citation issued to each licensee during
5 the previous 12-month period and the status of any action taken pursuant
1
Section 16. [No Retaliation or Discrimination; Violations of Medical
6 to each citation, including fines assessed, and the nature and status of
2 Personnel.]
7 action taken with respect to each uncorrected violation for which a cita-
3
(a) No licensee may discriminate or retaliate in any manner against a
8 tion is outstanding.
4 resident or employee in its health care facility on the basis or for the
5 reason that the resident or employee or any other person has initiated or
1 Section 20. [Training for Inspectors.] The department shall provide for
6 participated in any proceeding specified in this act. A licensee who vio-
2 ongoing training for inspectors charged with implementation of this
7 lates this section is subject to a fine of not more than [$500], to be
3 act in investigative techniques and standards relating to the quality of
8 assessed by the department and collected in the manner provided in
4 care provided by health care facilities.
9 Section 14.
10 (b) Any attempt to expel a resident from a health care facility, or any
1
Section 21. [Review of Effectiveness; Recommendations.] On or before
11 type of discriminatory treatment of a resident by whom, or upon whose
2
[
], the department shall review the effectiveness of the enforcement
12 behalf, a complaint has been submitted to the department or any pro-
3 of the provisions of this act in maintaining the quality of care provided by
13 ceeding instituted under or related to this act within 120 days of the
4 health care facilities and submit a report thereon to the Legislature to-
14 filing of the complaint or the institution of the action, shall raise a
5 gether with any recommendations of the department for additional
15 rebuttable presumption that the action was taken by the licensee in
6 legislation which it deems necessary to improve the enforcement of the
16 retaliation for the filing of the complaint.
7 provisions of this act or to enhance the quality of care provided by the
17 (c) No licensee may be cited for any violation caused by any person
8 facilities.
18 licensed pursuant to the [state statutes licensing medical personnel] if
19 the person is independent of and not connected with the licensee and the
1
Section 22. [Public Record; Public Inspection.] Any writing received,
20 licensee shows that he has exercised reasonable care and diligence in
2 owned, used, or retained by the department in connection with the
21 notifying the persons of their duty to the residents in the licensee's
3 provisions of this act is public record. However, the names of any persons
22 health care facility.
4 contained in the records, except the names of duly authorized officers,
5 employees, or agents of the department conducting an investigation of
1 Section 17. [Individual Causes of Action.] The remedies provided by
6 inspection in response to a complaint filed pursuant to this act, shall not
2 this act are cumulative and shall not be construed as restricting any
7 be open to public inspection and copies of the records provided for public
3 remedy, provisional or otherwise, provided by law for the benefit of any
8 inspection shall have the names deleted.
4 party, and no judgment under this act precludes any party from obtaining
5 additional relief based upon the same facts.
1
Section 23. [Severability.] [Insert severability clause.]
1 Section 18. [Notification to and Referral by Public Agencies.] The
1
Section 24. [Repeal.] [Insert repealer clause.]
2 department, on or before [February 1] of each year, shall notify all
3 public agencies which refer residents to health care facilities of all the
1
Section 25. [Effective Date.] [Insert effective date.]
4 health care facilities in the area found upon inspection within the previous
5 12-month period to be without Class A or Class B violations. Public
6 agencies shall give priority to these health care facilities in referring
7 publicly assisted residents. No public agency may refer residents to health
8 care facilities with any uncorrected Class A violations or five or more
9 uncorrected Class B violations, except those health care facilities which
10 the department may exempt because of a lack of facilities of the same
11 type in the area sufficient to satisfy the demand for services provided by
12 this type of facility.
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85
Life Care and Payments Contracts Act
15 (a)(1) may be allocated to the transferor in weekly, biweekly, or monthly
16 installments. The amount of each installment and the time period over
A home is often an elderly person's only financial asset. This act allows the
17 which the total number of installments will be paid shall be computed
transfer of this asset or other property by the elderly person to a person or
18 by the person, association, or corporation making the payments, based
organization in exchange for the provision of either care in an institution or periodic
19 on the transferor's equity and life expectancy as determined from mor-
support payments while he remains in his home. A number of safeguards are
20 tality or actuarial tables approved by the [appropriate state agency]. An
included in this act to ensure honesty and fair dealing. The person or organization
21 agreement for life care payments is not effective until the [appropriate
providing the payments or care must procure a certificate of authority from the
22 state agency] has determined that the computation is accurate and valid
appropriate state agency. Before an applicant can obtain a certificate, it may be
23 and that the amount of the payments is adequate and fair.
required to file a bond with the agency. The agreement itself must be approved by
24
(d) If the transferor is living when the total number of life care install-
the agency before it or any transaction completed in connection with it becomes
25 ment payments is exhausted, he may continue to reside on the transferred
valid. Certificate holders must also maintain specified reserves. This act states the
26 property until he dies or voluntarily changes his residence. After his
provisions which must be included in every agreement for life care or payments, a
27 death or voluntary change of residence, the person, association, or
copy of which must be furnished to each party. If an elderly person for some reason
28 corporation which made the payments may take possession of the property.
is discharged from an institution providing life care, the certificate holder must
29 (e) Life care pursuant to an agreement under subsection (a)(2) may
either provide alternative care or refund an appropriate portion of the value of the
30 include provision of reasonable cash payments to the transferor or his
assets transferred. The grounds and the procedures for suspending or revoking a
31 nominee for personal and incidental expenses.
certificate are also established.
This act and the preceding introduction are taken from A Handbook of Model
1
Section 3. [Issuance of Certificate of Authority; Standards.]
State Statutes, published in 1971, developed under the auspices of the Legislative
2 (a) The [appropriate state agency] shall issue to a person, association,
Research Center of the University of Michigan Law School, and sponsored by the
3 or corporation a certificate of authority to enter into agreements for life
National Council of Senior Citizens.
4 care payments or for life care if:
5
(1) The person, association, or corporation has complied with all
6 provisions of this act.
7
(2) The person, association, or corporation has submitted written
Suggested Legislation
8 statements detailing the care, services, or payments which will be pro-
9 vided to or purchased for transferors.
(Title, enacting clause, etc.)
10
(3) The person, association, or corporation submits a written state-
11 ment specifying the costs of providing life care, services, or payments.
1
Section 1. [Short Title.] This act may be cited as the [State] Life Care
12
(4) The person, association, or corporation has submitted all other
2 and Payments Contracts Act.
13 information and complied with all other requirements deemed necessary
14 by the [appropriate state agency].
1
Section 2. [Life Care Agreements; Transfers; Payments.]
15 (b) The [appropriate state agency] shall refuse to issue a certificate of
2 (a) Any person, association, or corporation which holds a certificate
16 authority to any applicant who has failed to comply with any provision
3 of authority issued by the [appropriate state agency] may receive trans-
17 of this act.
4 fers of property from persons [60] years of age or older as consideration
5 for the agreement of the person, association, or corporation:
1
Section 4. [Surety Bond: Applicant for Certificate of Authority.]
6
(1) To provide care payments to the transferor for life or for a period
2
(a) Before issuing a certificate of authority, the [appropriate state
7 of [two] years or more; or
3 agency], if necessary, may require an applicant for a certificate to file
8
(2) To provide or purchase care for the transferor for life or for a
4 with the [appropriate state agency], and maintain in effect, during the
9 period of [two] years or more, but only if the care provided or purchased
5 period that the certificate is in force, a bond:
10 meets the standards of the [appropriate state agency].
6
(1) Executed by a surety approved by the [appropriate state agency].
11 (b) Transfer of property under this act shall include the transfer of
7
(2) In an amount satisfactory to the [appropriate state agency].
12 rights as a joint tenant with right of survivorship and of rights as a
8
(3) Conditioned upon the applicant's faithful performance of all
13 tenant in common.
9 obligations which he undertakes pursuant to the certificate of authority.
14
(c) Life care payments pursuant to an agreement under subsection
10
(4) To and for the use and benefit of all persons injured or aggrieved
87
86
15
(2) Investments in certificates issued by building and loan associa-
11 by the failure of the applicant to perform his obligations.
16 tions which are members of the Federal Deposit Insurance Corporation,
12
(b) Any person injured or aggrieved by the failure of the certificate
17 to the extent that the certificates are insured by that corporation.
13 holder to faithfully perform his obligations undertaken pursuant to the
18
(3) Notes receivable secured by first deeds of trust and first mortgages.
14 certificate may bring suit on the bond in his own name.
19
(4) Bonds and stocks selected from an approved list, as determined
20 by the [appropriate state agency]. If stocks, bonds, and securities that
1
Section 5. [Surety Bond: Agent or Employee with Access to Funds.]
21 are not on the approved list are part of the reserves, and if they are to be
2 Before issuing a certificate of authority, the [appropriate state agency]
22 retained as part of the reserves, it is not necessary that those unapproved
3 shall require that any agent or employee of the applicant, who in the course
23 stocks, bonds, and securities be disposed of immediately, but they shall
4 of his agency or employment has access to any substantial amount of
24 be disposed of in accordance with regulations of the [appropriate state
5 funds, furnish and maintain in effect during the period that the certificate
25 agency] and disposal shall be accomplished in a gradual manner so as to
6 of authority is in force, a surety bond in form and amount the [appropriate
26 avoid loss to certificate holders. Securities which, although not on the
7 state agency] deems necessary to protect all persons from loss of the funds.
27 approved list, should be retained in the reserve for reasons acceptable to
28 the [appropriate state agency] may be retained with the specific approval
1
Section 6. [Transferor's Lien; Recording; Release; Appeal; Judicial
29 of the [appropriate state agency].
2 Review.] If necessary to secure the performance of all obligations of the
30
(5) Real estate used to provide care and housing for transferors under
3 certificate holder to transferors, the [appropriate state agency] may
31 life care contracts, or equities therein, owned by the certificate holder,
4 record with the recorder of any [county] a notice of lien on behalf of the
32 to the extent of [40] percent of the net value thereof. Appraisals shall be
5 transferors. From the time of the recording, there exists a lien on all real
33 made by two appraisers approved by the [appropriate state agency].
6 property of the certificate holder, not exempt from execution, either
34
(6) Furniture and equipment situated in property used to provide
7 owned by him at the time or which he may afterward acquire before the
35 care and housing for holders of life care contracts, to the extent of [30]
8 release of the lien, and located within the [county] where the notice is
36 percent of the net value thereof. Appraisals shall be made by two apprais-
9 recorded. The [appropriate state agency] shall file a release of the lien
37 ers approved by the [appropriate state agency].
10 upon proof of complete performance of all obligations to transferors, or
38
(7) Real estate or equities therein owned by the certificate holder
11 upon the filing of a bond meeting the conditions set forth in this act. The
39 as an investment, the rents from which are used to discharge obligations
12 [appropriate state agency] may file a release of the lien if it deems the
40 to the transferors or to reinvest as a part of the reserves.
13 lien no longer necessary to secure the performance of all obligations of
41
(8) At least [25] percent of the reserve necessary to maintain all care
14 the certificate holder to the transferors. The certificate holder may appeal
42 agreements must consist of bonds, stocks, commercial and savings
15 to the [appropriate state agency] from a refusal of a request for release
43 accounts, and building and loan certificates.
16 of the lien. The decision of the board is subject to court review pursuant
44
(d) For purposes of computing the reserve, the liens required under
17 to the [State Administrative Procedures Act], upon petition of the cer-
45 Section 6 shall not be deducted from the value of real or personal property.
18 tificate holder filed within [30] days of service of the decision.
1
Section 8. [Agreements as Preferred Claims on Liquidation.] In the
1
Section 7. [Reserve Requirements.]
2 event of liquidation, all care agreements executed by a certificate holder
2
(a) A certificate holder shall maintain reserves covering obligations
3 shall be deemed a preferred claim against all assets owned by the certifi-
3 assumed under all agreements entered into and maintained. Reserves
4 cate holder.
4 shall be in an amount not less than the sum computed in accordance with
5 the standard of valuation based upon a modern and up-to-date table of
1
Section 9. [Filing Copy of Agreement; Statute of Frauds; Approval of
6 mortality selected by the [appropriate state agency]. The interest assump-
2 Terms.]
7 tion for that computation shall be determined by the [appropriate state
3
(a) The [appropriate state agency] may require the filing with it of a
8 agency].
4 copy of any agreement entered into between the certificate holder and
9 (b) Failure to maintain reserves as provided in this section shall be
5 transferor, by every person or organization holding a certificate of
10 deemed a breach of all agreements to furnish care.
6 authority to receive transfers under this act. All agreements entered into
11
(c) Reserves shall consist of the following:
7 between the certificate holder and the transferor shall be in writing and
12
(1) Deposits in commercial and savings accounts with banks which
8 contain all information required under Section 10.
13 are members of the Federal Deposit Insurance Corporation, to the extent
9
(b) The [appropriate state agency] shall require that any forms used by
14 that the deposits are insured by that corporation.
89
88
10 the certificate holder in concluding an agreement with any transferor be
8 agreements of a certificate holder.
11 filed with and approved by the [appropriate state agency] prior to their
12 use by the certificate holder.
1 Section 14. [Annual Audit.]
2 (a) In lieu of making a detailed financial investigation, the [appropri-
1
Section 10. [Contents of Agreement.] A care agreement executed be-
3 ate state agency] may accept an annual audit of the records of the
2 tween a transferor and a certificate holder shall:
4 organization or person, made by a certified public accountant or public
3
(1) Show the value of all property transferred, including donations,
5 accountant, which includes a certification, if such is the case, that the
4 subscriptions, fees, and any other amounts paid or payable by or on
6 organization or person is maintaining reserves in accordance with the
5 behalf of the transferor.
7 requirements of Section 7.
6 7 holder to the transferor, including, in detail, all items which the transferor
(2) Show all services which are to be provided by the certificate
8 (b) Each certificate holder shall have an annual audit made of its
9 financial affairs by a certified public accountant or a public accountant,
8 will receive-as board, room, medical care, clothing, burial and inciden-
10 which audit shall include full details on per capita costs of operation and
9 tals-and whether the items will be provided for a designated time period
11 on the matter of reserves. A copy of the audit shall be filed with the
10 or for life, and the estimated monthly cost to the certificate holder of
12 [appropriate state agency]. Funds and property received as advanced
11 providing the care.
13 payments for maintenance of the transferors shall be reported separately
12
(3) Be accompanied by a financial statement showing all facts perti-
14 from membership fees, donations, or other funds available for capital
13 nent to the financial condition of the certificate holder.
15 expansion.
14
(4) Be furnished, together with the financial statement, to the
15 transferor.
1
Section 15. [Application for Certificate of Authority; Duration.] An
16
(5) Include the statutory rights of both parties.
2 applicant for a certificate of authority shall submit a formal application
17
(6) Include any other information or provisions deemed necessary by
3 to the [appropriate state agency] in conformance with regulations issued
18 the [appropriate state agency].
4 by the [appropriate state agency]. When issued, the certificate remains in
5 force until suspended or revoked by the [appropriate state agency] in
Section 11. [Contract Approval.] Neither an agreement for life care or
6 accordance with Section 16.
1
2 life care payments or for care or payments over a period of [two] years or
3 more nor any transfer of property pursuant to that agreement is valid
1
Section 16. [Suspension or Revocation of Certificate of Authority;
4 unless the agreement is approved by the [appropriate state agency].
2 Grounds; Appeal.]
3 (a) A certificate of authority may be suspended or revoked for cause
1 Section 12. [Dismissal or Discharge of Transferor; Alternative Care;
4 by the [appropriate state agency]. Grounds for suspension or revocation
2 Refund.] If the agreement for care permits dismissal or discharge of the
5 include violation of the provisions of this act, violations of rules or regu-
3 transferor from the institution providing care prior to the expiration of
6 lations issued by the [appropriate state agency] pursuant to this act,
4 the agreement, with or without cause, the certificate holder, at the
7 and any fraudulent or misrepresentative practice.
5 transferor's election, must:
8 (b) A certificate holder whose certificate of authority is suspended or
6
(1) Provide an alternative care program approved by the [appropri-
9 revoked may appeal to the [appropriate state agency]. The proceedings
7 ate state agency], or
10 shall be conducted in accordance with the [State Administrative Pro-
8
(2) Refund to the transferor a sum equal to the amount of the
11 cedures Act].
9 projected cost to the certificate holder of maintaining the transferor in
12 (c) Final decision of the [appropriate state agency] may be appealed
10 the institution for the remaining period of the agreement.
13 to the [appropriate court].
1
Section 13. [Rules and Regulations; Inspections.]
I Section 17. [Sufficiency of Reserves.] For the failure of any certificate
2 (a) The [appropriate state agency] may make any rules and regulations
2 holder to establish and maintain reserves as provided in this act, the
3 for the governing of the dealings and operations of certificate holders
3 [appropriate state agency] shall revoke the certificate of authority.
4 necessary to protect the rights of transferors.
5 (b) The [appropriate state agency], by a duly authorized representa-
1
Section 18. [Nontransferability of Certificate; Change of Terms or
6 tive, may inspect and examine any institution, home, place, books and
2 Place of Performance.] No certificate of authority is transferable. Neither
7 records, or the performance of any service required pursuant to the
3 the terms of the agreement nor the place of performance specified in any
90
91
4 agreement shall be changed without the written consent of the [appropri-
5 ate state agency], except in circumstances where a transferor is removed
Synopses of Other Proposed Legislation
6 from a life care facility for medical treatment.
Generic Drug Substitution Act
1
Section 19. [Sale of Home by Certificate Holder; Approval.] A holder
This statute, based on an Oregon law, would permit pharmacists to
2 of a certificate of authority, who has life care residents in an institution
substitute a less expensive prescription drug for one prescribed by a physician,
3 and who wishes to sell or transfer ownership of the institution to another
and would require the difference in price to be passed on to the consumer. The
4 party, shall first obtain approval from the [appropriate state agency].
drug substituted would be therapeutically equivalent by professional standards.
If a physician determined that a patient's condition required a specific brand
1
Section 20. [Penalties for Violations.] Any person, association, or
name drug, he would so instruct the pharmacist in writing or by telephone. This
2 corporation which maintains, enters into, or as manager or officer or in
act is distinct from legislation in some other States which have adopted
3 any other administrative capacity assists in maintaining or entering into
substitution laws in that it requires a positive action on the part of the physician
4 any agreement providing for transfer of property, conditioned upon an
to bar substitution and does not empower a formulary board to designate drugs
5 agreement to furnish life care or life care payments to the transferor
which are susceptible to substitution.
6 or his legal representative, without first having secured a certificate of
7 authority therefor in writing, or which refuses to permit or interferes
Prescription Drug Price Posting Act
8 with the inspection authorized by this act, is guilty of a misdemeanor and
This statute, taken from a publication by NRTA-AARP on Model State
9 is punishable by fine not in excess of [$500], or by imprisonment not in
Legislation, would require the posting by each pharmacy in the State of the
10 excess of [90] days, or both.
current selling price of the 100 most commonly prescribed prescription drugs.
The appropriate state agency would be responsible for preparing a list of the
1 Section 21. [Advertisements, etc.; Soliciting Life Care Contracts; Re-
drugs to be posted, including their usual strength and amount prescribed, and for
2 quirements; Penalties for Violations.]
distributing the list.
3 (a) Any report, circular, public announcement, certificate, financial
4 statement, or other printed matter or advertising material which is de-
Health Care Facility Bill of Rights
5 signed for or used to solicit or induce persons to enter into any agreement
This statute, based partly on a Maryland law and federal regulations, would
6 providing for the transfer of property, conditioned upon an agreement to
7 furnish life care or life care payments, or care or payments for a period of
establish several rights for patients in skilled and intermediate nursing homes and
8 more than [two] years, and which lists or refers to the name of any
for residents in residential care facilities. Typically, state statutes regulating these
9 individual or organization as being interested in or connected with the
facilities lack adequate declaration of these rights. Provisions are made to inform
10 person, association, or corporation to perform the contract, shall clearly
all patients and residents of their rights and public and private remedies are
11 state the extent of financial responsibility assumed by that individual
established to enforce this law. One of the most important rights is the right to
12 or organization for the person, association, or corporation and the ful-
present grievances and to recommend changes in the policies of and the services
provided by the facility without fear of reprisal at council meetings to be held at
13 fillment of its contracts.
14 (b) Any person, association, or corporation that issues, delivers, or
regular intervals in the facility. Also, a provision is made for staff training.
15 publishes, or as manager or officer or in any other administrative capacity
Health Care Facility Ombudsman Committee Act
16 assists in the issuance, delivery, or publication of any printed matter or
17 advertising material which does not conform to the requirements of this
This statute, modeled after a Florida law, would create state and regional
18 section is guilty of a misdemeanor and is punishable by fine not in excess
ombudsman committees, appointed by the Governor and composed of private
19 of [$500], or by imprisonment not in excess of [90] days, or both.
citizens with professional expertise. The committees would aid the State in the
enforcement of laws relating to health care facilities, including skilled and
1
Section 22. [Severability.] [Insert severability clause.]
intermediate nursing homes and residential care facilities, and would generally
work to improve the lot of residents in these facilities. One major responsibility of
1
Section 23. [Repeal.] [Insert repealer clause.]
the ombudsman committee at the regional level would be to investigate
complaints against health care facilities, pursuant to guidelines developed by the
1
Section 24. [Effective Date.] [Insert effective date.]
state ombudsman committee, and to set target dates for the taking of appropriate
remedial action by the facility, to make public the complaint, or to refer the
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93
complaint to the state ombudsman committee. That committee could then take
further action against the facility, short of imposing any civil or criminal
Senior Citizens' Community Workers Act
penalties. The state ombudsman committee would also be responsible for
This statute, based on a California law, would provide publicly funded
preparing and distributing an annual report, and discussing the problems of
employment for persons 55 years of age or older who are unemployed or retired,
health care facility residents and making recommendations for improving their
and with little prospect of being employed, in such capacities as "community
care and treatment.
resource aides," "employment aides," and "teachers' aides." The state agency for
aging is authorized to enter into agreements with public agencies and nonprofit,
Residential Care Facility Act
tax-exempt private organizations to effect those purposes.
This statute, based partly on Pennsylvania and Florida laws, would require
the licensing of and adherence to certain standards by residential care facilities
Energy Lifeline Act
which provide a lesser degree of care for their residents than skilled and
This statute, based on Maryland and New Jersey laws, would require the
intermediate nursing care. Public and private remedies are established to enforce
appropriate state agency to set maximum rates for what it deems to be the
this law. What have traditionally been called personal care homes are included in
minimum amount of gas and electricity necessary to form a "lifeline" to older
the definition of residential care facility. However, homes that offer adults only
citizens. Older citizens below certain income levels would pay the lifeline rates.
room and board are only required to register with the enforcing agency
There are also provisions to protect these persons from having their electric or
designated by the statute.
gas service cut off when such action would endanger their health and safety.
State Relocation Assistance Act
Age Discrimination in Employment Act
This statute would authorize local governments to establish relocation
This statute would prohibit age discrimination in employment by certain
assistance plans to aid persons displaced by nonfederally assisted public and
employers, where age is not a bona fide occupational requirement and other good
private activities, and for whom no adequate relocation assistance is available in
cause to differentiate between employees or potential employees does not exist. A
most jurisdictions. Elderly persons comprise a major portion of this group.
civil action in a court of competent jurisdiction is the designated enforcement
Relocation assistance services would be provided by a relocation assistance
mechanism.
agency, pursuant to the relocation plan, and would include counseling, receiving
Adult Protective Services Act
and making relocation assistance payments, and providing satisfactory
relocation housing for displaced persons in need of these services.
This statute, drafted under the sponsorship of Legal Research and Services
for the Elderly, would provide the authority for a State to develop, organize, and
Elderly Housing Authority Act
supervise a state system of protective services and would outline the guidelines
This statute, based on a Florida law, would provide a mechanism whereby
and criteria for the design and operation of a protective services system. Broadly,
localities could create an elderly housing authority to facilitate the construction
protective services are defined in the statute as "services furnished by a protective
and expansion of housing facilities that serve the elderly (including health care
services agency or its delegate to an elderly infirm, incapacitated, or protected
facilities) and which are operated by nonprofit corporations. The authority could
person (for whom a protective order has been made), with the person's consent or
enter into construction contracts, issue bonds and notes, and do other things to
appropriate legal authority, in order to assist the person in performing the
effect the purposes of the act.
activities of daily living, and thereby maintain independent living arrangements
and avoid hazardous living conditions."
The Retirement Community Disclosure Act
This statute would supplement state laws relating to civil commitment and
This statute, based on a New Jersey law, would provide a comprehensive
guardianship proceedings. It would authorize courts to issue orders, after
scheme of regulation of retirement communities, similar to but on a smaller scale
making specific fundings and following designated procedures, for protective
than state and federal regulation of corporations. Retirement community is
placement in institutions, other than mental hospitals, and for the furnishing of
defined as "any complex or proposed complex of more than 10 units, whether
involuntary protective services without always having to appoint a guardian or
contained in one or more buildings or whether constructed on separate lots,
conservator. These appointments often lead to unrealistic restrictions on the
offered for sale or lease as part of a common promotional plan, where such
freedom of elderly persons.
community is advertised or represented as a retirement community or as a
community primarily for retirees or elderly persons, or where there is a minimum
age limit tending to attract persons who are nearing retirement age."
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94
Zubrow, Reueben A., et al. Colorado Predictive Income Tax Model, Phase I Report. Denver, Colo.:
References
Colorado Legislative Council, Research Publication No. 204, 1974.
Yung-Ping, Chen. "Preferential Treatment of the Aged in Income and Property Taxation,"
American Journal of Economics and Sociology, vol. 25, no. 1, January 1966.
Providing Transportation for the Elderly
Institute of Public Administration. Transportation for Older Americans, A State of the Art Report.
Integrating Services for the Elderly at the Community Level
Distributed by the National Technical Information Service. April 1975.
RRC International, Inc. State of West Virginia Development Plan, The Transportation
Annual Report to the President-1975. Federal Council on the Aging. Washington, D.C., 1975.
Remuneration Incentive Program (TRIP Development Plan). May 1974.
Bell, William G. "Community Care for the Elderly: An Alternative to Institutionalization."
West Virginia Department of Welfare and RRC International, Inc. State of West Virginia Annual
Gerontologist, Autumn 1973, pp. 349-53.
Report, The Transportation Remuneration Incentive Program (TRIP Annual Report). July
Brehm, Henry P. "The Future of U.S. Health Care Delivery for the Elderly." Conference on Support
1975.
of the Aged: Policy Options and Research Needs. Elkridge, Md., April 1976.
West Virginia Department of Welfare and RRC International, Inc. State of West Virginia, Transit
Farabee and Associates. "Background Issue Paper." Washington, D.C.: White House Conference for
Development Program. December 1975.
the Handicapped, 1976.
Kahana, Eva, and Coe, Rodney M. Alternatives in Long-Term Care: A Handbook for Researchers,
Planners and Providers. New York, N.Y.: Spectrum Publications, Inc., 1975, p. 511.
McPheeters, H. L. and King, J. B. Plans for Teaching Mental Health Workers: Community College
Curriculum Objectives. Atlanta, Georgia: Southern Regional Education Board, 1971.
Shanas, E. "Measuring the Home Health Needs of the Aged in Five Countries." Journal of
Gerontology, 1971, pp. 26, 37-40.
Simon, Alexander. Keynote Address at Western Resources Conference in San Francisco, California,
December 5-6, 1975. Washington, D.C.: National In
A Review and Analysis of State Tax Policy for the Elderly
Advisory Commission on Intergovernmental Relations. Federal-State-Local Finances: Significant
Features of Fiscal Federalism. 1973-1974 edition. Washington, D.C., 1974.
Property Tax Circuit Breakers: Current Status and Policy Issues. Washington, D.C.,
1975.
Bureau of the Census. Estimates of the Population of the States by Age-July 1, 1973 and 1974.
Current Population Reports, Series P-25, no. 539. Washington, D.C.
Housing of Senior Citizens. 1970 Census of Housing, HC(7)-2. Washington, D.C.,
1973.
State and Local Ratio Studies and Property Assessment. Series GSS, no. 72.
Washington, D.C., 1975.
Butler, Robert. Why Survive? New York, N.Y.: Harper & Row, 1975.
Greenfield, Margaret. Property Tax Exemptions for Senior Citizens. Berkeley, Calif.: Institute of
Government Studies, University of California, 1966.
Harriss, C. Lowell. Property Taxation in Government Finance. New York, N.Y.: Tax Foundation,
1974.
Kreps, Juanita. Employment, Income and Retirement Problems of the Aged. Durham, N.C.: Duke
University Press, 1963.
Lindholm, Richard W. Property Taxation, USA. Madison, Wisc.: University of Wisconsin Press,
1967.
Quindry, Kenneth E., and Currence, Mary G. State and Local Revenue Potential, 1974. Atlanta, Ga.:
Southern Regional Education Board, 1976.
Tax Foundation. State and Local Sales Taxes. Research Publication No. 23. New York, N.Y., 1970.
State Tax Studies. Research Publication No. 13. New York, N.Y., 1967.
Tax Credits-Pas Experience and Current Issues. Research Publication No. 21.
New York, N.Y., 1969.
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Monthly Labor Review, vol. 98, no. 10. Washington, D.C., October 1975.
*
*
ACTION MEMORANDUM
WASHINGTON
LOG NO.:
Date:
June 15, 1976
Time:
Lynn may
FOR ACTION:
CC (for information):
Shril
Phil Buchen
Alan Greenspan
F44
Jim Cannon
Jack Marsh
Max Friedersdorf
Bill Seidman
FROM THE STAFF SECRETARY
DUE: Date:
Thursday, June 17
Time:
Noon
SUBJECT:
Paul H. O'Neill's memorandum
6/15/76 re Housing for the Elderly
Rescission
ACTION REQUESTED:
For Necessary Action
X For Your Recommendations
Prepare Agenda and Brief
Draft Reply
X For Your Comments
Draft Remarks
REMARKS:
FORD i LIBRARY 9ERALD
I concur with Secretary Hills. Rescission would
antagonize a very powerful and highly vocal constituency.
June
PLEASE ATTACH THIS COPY TO MATERIAL SUBMITTED.
If you have any questions or if you anticipate a
delay in submitting the required material, please
Jim Connor
telephone the Staff Secretary immediately.
For the President
Earal
Congressional Record
United States
of America
PROCEEDINGS AND DEBATES OF THE 94th CONGRESS, SECOND SESSION
Vol. 122
WASHINGTON, THURSDAY, JUNE 17, 1976
No. It
Senate
By Mr. McGOVERN (for himself, Mr.
It is, therefore, disappointing that in
PERCY, Mr KENNEDY, and Mr. DOLE)
S. 3585. A bill to amend the Older Ameri-
our efforts to feed America's hungry, we
cans Act of 1965 to provide a national Meals-
have failed to reach the 3 to 4 million
on-Wheels Program for the elderly, and for
shut-in elderly, who, due to their physi-
other purposes. Referred to the Committee
cal limitations, are confined to their
on Labor and Public Welfare.
homes and remain largely outside the
scope of current feeding programs. It is
NATIONAL MEALS-ON-WHEELS ACT OF 1976
time to remedy this tragic situation.
Mr. McGOVERN. Mr. President, I am
A survey of title VII project directors
pleased to be introducing today the Na-
under the Older Americans Act recently
tional Meals-on-Wheels Act of 1976.
released by this committee highlighted
My interest in the plight of the Na-
the director's belief that a separate feed-
tion's homebound elderly dates back to
ing program, operated through and in
a hearing the Committee on Nutrition
conjunction with title VII, is essential
and Human Needs held in my home State
if we are to extend our agricultural boun-
of South Dakota on March 18, 1974. At
ties to the homebound elderly.
that time the committee heard witnesses,
While persons of all ages share a com-
many of them long-time friends of mine,
mon need for adequate nutrition, achiev-
describe the successes of the title VII
ing a balanced diet is particularly diffi-
çongregate program. But they asked why
cult for the aged. As old age approaches,
something was not being done for those
metabolic changes require a reduction in
senior citizens who were physically un-
caloric intake while necessary levels for
able to make it to the nutrition site. To-
protein, vitamins, and minerals remain
day we can begin to answer that ques-
the same.
tion by doing something for the home-
For the homebound elderly. this is an
bound elderly-our most dependent citi-
impossible task. These persons cannot
zens.
leave their homes to shop; find it difficult
We have as a matter of national con-
to prepare food; and lack the incentives
science and integrity pledged ourselves
that companionship provides. Quite sim-
to the elimination of hunger in Amer-
ply, in their isolation and loneliness, good
ica. We should not take this commit-
health is a less compelling pursuit than
ment lightly, nor can we in good faith
it is for those of us who are more mo-
now abandon our goal, because the days
bile.
of unlimited prosperity seem to have
Whether the cause is low income, nu-
ended. The fullest measure of a society
tritional ignorance, lack of motivation,
is not gained during times of great
poor health, or a wide range of other
wealth; we reveal our true character only
common afflictions, numerous experts tell
when commitment requires sacrifice.
us that, even in the general elderly pop-
When the Constitution declared it the
ulation, millions are malnourished. For
responsibility of the Federal Government
the homebound, these diet problems are
to provide for the general welfare, it did
even more severe and the incidence of
not add an exemption for those persons
malnutrition is higher.
who are disadvantaged or poor; nor did
The result has been a disturbingly high
it delegate this responsibility to the
level of anemia, mental depression. sub-
States. The Federal Government, having
clinical pellagra and protein deficiency.
assumed major responsibility for the
as well as higher rates of illness and
proper functioning of the economy, can-
longer, less complete convalescence.
not then ignore the plight of those who
In response to these unique nutrition-
do not enjoy the benefits of economic
al problems of the aged. the Congress
growth.
in 1972 established a nutrition program
This responsibility and commitment
for the elderly. title VII of the Older
are real and apply to all groups and to
Americans Act. Last year this program
each individual.
provided approximately 240.000 hot
meals and various supportive services
In particular, we have a duty to pro-
each weekday in a congregate setting.
vide for the welfare of 042 senior citi-
Title VII is. by philosophy and struc-
zens who have over the course of their
ture. committed to providing an environ-
lives contributed so much to this country.
ment where the lonely and withdrawn
2
senior citizen can meet with friends and
It should be noted that these figures
enjoy their company as well as a nutri-
are extremely conservative estimates.
tious hot meal. This idea makes as much
They are associated only with a first
"good sense" today as it did when en-
year savings of nursing home costs based
acted in 1972. It deserves our continuing
on an $80 million meals-on-wheels pro-
support.
gram. They do not include the cost sav-
Unfortunately. however. the congre-
ings expected from reductions in the
gate meal philosophy, when combined
frequency and duration of hospitaliza-
with severe budgetary limitations, vir-
tion due to nutrition-related illnesses;
tually excludes the homebound elderly.
nor do they project the potential savings
These 3 to 4 million Americans by the
of an expanded meals-on-wheels pro-
nature of their condition, cannot real-
gram reaching larger numbers of the
istically attend the congregate meal site.
homebound elderly.
Yet. last year only 13 percent of title
It is true that a substantial portion of
VII meals were delivered to homes, a fig-
the freed funds would probably go to ex-
ure roughly equal to 30,000 of the 240,000
panding service needs. But it is at least
meals served.
clear that we can take action which will
Under the current congregate ap-
insure a more efficient use of public
proach, feeding the estimated needv
funds in this area, while minimizing the
homebound would require a title VII pro-
excessive institutionalization of our
gram expansion in the area of 1,700 per-
homebound elderly.
cent. Attempting to meet the need of the
Up to this time, the Federal Govern-
homebound elderly under the present de-
ment has largely left the task of feeding
sign of title VII without a separate and
the homebound to chance. While local
additional commitment is obviously im-
meals-on-wheels organizations have done
practical and highly unlikely.
a tremendous job with their limited re-
The evidence clearly indicates that for
sources, they cannot without Federal as-
these several million persons, a home-
sistance tackle more than a small por-
delivered, nutritious meal often makes
tion of the need.
the difference between additional years
The bill which I am introducing today
in their own homes or institutionaliza-
along with Senators PERCY and KEN-
tion in costly nursing homes. When a
NEDY, starts us in the right direction.
senior can no longer shop or prepare
Title VII of the Older Americans Act,
meals, when hunger becomes a daily ex-
the elderly nutrition program, would be
perience, there is currently no alterna-
amended to provide new and additional
tive available other than a nursing home
funds specifically for home-delivered
or hospital.
meals: $80 million for fiscal year 1977,
A meals-on-wheels program would,
$100 million for fiscal year 1978.
therefore, reduce spending in the health
These moneys would be distributed to
care sector. Expenditures for nursing
the States in accordance with the cur-
homes last year reached $9 billion, an
rent title VII formula; that is, each State
increase of over 20 percent from 1974.
receives an amount based on the number
In fact. these expenditures have grown
of persons 60 years and over in that
steadily and substantially in the past 9
State as compared to the number of such
years, with the Government paying a
persons in all States. Each State agency
major and increasing share. In 1975,
responsible for administering these funds
public outlays were over $5 billion, 60
would make grants in cash or in kind to
percent of which was paid by the Fed-
title VII projects or to local meals-on-
eral Government.
wheels organizations for the purpose of
These costs are much higher than they
providing home-delivered meals. Any
need be. Studies carried out by geron-
organization receiving funds under this
tologists in numerous localities have
act may not use more than 20 percent of
consistently shown that from 10 to 40
their funds for administrative purposes.
percent of nursing home residents are
Preexisting community meals-on-
not in need of institutional care; many
wheels organizations with demonstrated
are there simply because they cannot
success in home delivery of meals must
cook for themselves. Yet because of the
be given priority in awarding grants.
limited choice of services, and in many
These small, local programs, staffed al-
cases the lack of home-delivered meals,
most entirely with community volun-
the aged are often forced to seek an
teers, maintain lower costs than could a
institution even though it may not be
Federal program and creat feeling of
appropriate to their needs.
warmth and sensitivity for the elderly
The cost of a nursing home is gen-
which cannot be matched merely by Fed-
erally over $20 per day, while a home-
eral money.
delivered meal costs under $2. In a few
This preference. however, should also
months. staff of this committee will con-
be given with the understanding that
clude a year-long analysis which we be-
not all such groups are capable of quality
lieve will demonstrate. among other
and efficient operations.
things. that an investment of $80 mil-
Among the criteria which should be
lion to provide from 125.000 to 175,000
used in such determinations are cost per
home-delivered meals per day will re-
meal. administrative and personnel ex-
due nursing home expenditures from
penses. startup and equipment costs.
to $400 million.
3
quality of meals served and others which
conduct community outreach. using
the Commissioner deems advisable.
techniques similar to those used in par-
The title VII project and the meals-on-
ticipant outreach, to attract and use a
wheels group should work closely to-
substantial pool of volunteers. In addi-
gether for referral and other purposes.
tion, projects or local organizations
When an elderly person in the congre-
could use funds available under this act.
gate program becomes disabled or other-
when appropriate, to compensate volun-
wise limited in mobility, that person
teers for transportation expenses in-
should be referred to the contracting
curred in the delivery of meals to the
meals-on-wheels group. By the same
homebound participant.
token, when a temporarily disabled per-
Complementing the above provisions,
son regains mobility, that person should
the bill would establish a demonstration
be referred back to the congregate pro-
project to study the National Aeronautics
gram and home-delivered service should
and Space Administration Meal Systems
cease.
for the Elderly. This system, developed
It is not intended that persons who
in cooperation with the LBJ School of
are capable of participating in the con-
Public Affairs at Austin, Tex., and United
gregate program receive home-delivered
Action for the Elderly, mails or delivers
meals. Each potential participant should
a package of seven complete, shelf-stable,
be screened prior to being served under
freeze-dried or canned meals to home-
this act. This screening may be accom-
bound elderly on a weekly basis. Prepa-
plished automatically by referrals from
ration of these meals by the elderly re-
physicians, visiting nurses, or the con-
quires only facilities sufficient to boil
gregate program or may be undertaken
water. In the past year, the NASA-LBJ
by staff or volunteers of the nutrition
project has been tested successfully on
project.
over 120 elderly participants in Texas.
Local projects may choose to serve one
It is important to note that this sys-
or more meals a day, so long as partici-
tem is not intended to replace either the
pants receive no less than one-third of
regular congregate or home-delivered
the recommended dietary allowances 5 or
meal programs. Personal contact with
more days per week. Local projects may
the elderly is an important feature of
elect to provide meals on weekends. If
these programs and should not be dis-
they do, these weekend meals must pro-
placed. Rather, this system is designed
vide no less than 25 percent of the RDA.
to provide meal service only to those per-
This requirement may be met by supple-
sons who are beyond the reasonable reach
mental foods such as a snack, cold meal,
of any current meal service. The NASA
special commercial adult formula or any
Meal System can effectively serve those
combinations thereof. It should be noted
persons who are geographically isolated,
that these figures represent the minimum
live in an area where no program exists,
standards and in no sense preclude the
or are on waiting lists of programs with
option of providing higher levels of nu-
limited caseloads.
tritional support.
The pilot project would be conducted
An information and referral system
in portions of three States, chosen to pro-
would be established for homebound re-
vide an appropriate mix of rural and
cipients to insure maximum coordina-
urban environments. Each demonstra-
tion of additional community services.
tion project will include a medical evalu-
Each meal delivery route must have at
ation to assess, at minimal inconvenience
least one volunteer or staff member who
to the participants, the health benefits
has been trained to observe conditions
of nutritional support for the elderly.
in the homes of participants which
At the conclusion of the demonstration
would seem to necessitate the service of
project, the Commissioner shall report
one or more additional community agen-
the results to Congress, together with
cies. If such conditions exist, the volun-
recommendations for legislation which
teer or staff member would report these
he deems appropriate.
conditions to a volunteer or staff member
All other title VII requirements for
in the project's central office whose re-
sanitation, eligibility, participant con-
sponsibilities would include contacting
tributions, and so forth, would be appli-
the appropriate community agency.
cable to this act, excepting section
Within a reasonable period of time. a
706A(6).
followup check of that agency's action
Despite the cost effectiveness of meals-
should be made and noted in partici-
on-wheels, there are many who will say
pants' files.
that we cannot now afford to begin such
In addition, each project would offer an
efforts. In fact, we can no longer afford
information service to participants. in-
the extravagance of ignoring them.
cluding an easy-to-read flier or poster,
If spending a dollar today to feed a
which would list names, addresses. and
senior citizen will reduce expenditures by
phone numbers of community agencies
$5 next year in health support services.
and emergency services for purposes of
then we are compelled to do SO by the
information and referral; no greater
concerns of our budget as well as the
than 1 percent of funds available under
dictates of our conscience. The unwilling-
this act may be used.
ness to provide adequate medical care for
Each project receiving funds under
the aged is tragic, but the unwillingness
this act would be strongly encouraged to
to spend even modest amounts to keep
- 4 -
them healthy is even less defensible.
for the purpose of providing home delivered
I ask unanimous consent that the Na-
meals pursuant to section (1)
tional Meals-on-Wheels Act of 1976. to-
Provided, That not more than 20 per centum
gether with an analysis of the bill. be
of such funds shall be used for administra-
printed in the RECORD.
tive expenses and supportive services. Sums
There being no objection, the bill and
appropriated pursuant to this section to
analysis were ordered to be printed in
carry out the provisions of this Title shall
remain available for such purposes until
the RECORD, as follows:
expended."
S. 3585
NATIONAL AERONAUTICS AND SPACE ADMINISTRA-
Be it enacted by the Senate and House
TION MEALS SYSTEM FOR THE ELDERLY DEM-
of Representatives of the United States of
ONSTRATION PROJECTS
America in Congress assembled, That this
"SEC. 710. (a) The Commissioner shall con-
Act may be cited as the "National Meals-on-
duct a demonstration project involving at
Wheels Act of 1976."
least 3 States to determine the feasibility
SEC. 2. Section 706(a) (1) of the Older
of using the meals system designed by the
Americans Act of 1965 is amended by insert-
National Aeronautics and Space Administra-
ing "(A)" immediately after "(1)", by in-
tion for the elderly as a component of or as
serting after the semicolon the words "and,
a substitute for regular nutrition projects
or", and by adding after such section the
assisted under this Act particularly in areas
following new subparagraph:
where normal delivery services under such a
"(B) to establish a project (referred to
nutrition project are not feasible or prac-
herein as a 'nutrition project') for the
ticable or are too costly. Each such demon-
elderly, blind, and disabled which, five or
stration project shall include a medical
more days per week, provides at least one
evaluation.
home-delivered meal which assures a mini-
"(b) The Commissioner shall report to the
mum of one-third the daily recommended
Congress on the results of the demonstration
dietary allowances as established by the Food
projects authorized by this section together
and Nutrition Board of the National Acad-
with such recommendations including rec-
emy of Sciences-National Research Council:
ommendations for legislation as he deems
Provided, That any nutrition project which
appropriate.
elects to serve such meals more than 5
"(c) There are authorized to be appropri-
days a week must assure, at a minimum, an
ated for the fiscal year 1977 such sums as
amount of commercially available ready-for-
may be necessary to carry out the provisions
use nutritionally balanced liquid product or
of this section.".
light snack, or both, which provide at least
25 per cent of such recommended dietary
EXPLANATION OF THE NATIONAL MEALS-ON-
allowances for each day in which no home-
WHEELS ACT OF 1976
delivered mail is provided. Preference, where
feasible, should be given to the use of orga-
The following is a brief description of the
nizations, such as meals-on-wheels groups,
bill's major provisions.
which have demonstrated an ability to oper-
1. Title VII of the Older Americans Act,
ate such services efficiently and reason-
the Elderly Nutrition Program, would be
ably;"
amended to provide separate authority for
home-delivered meals to the homebound
SEC. 3. Section 706(a) of the Older Ameri-
cans Act of 1965 is amended by striking out
elderly, an extremely vulnerable group not
"and" at the end of paragraph (10), by re-
now being reached.
designating paragraph (11), and all refer-
2. The number of meals served each day
ences thereto, as paragraph (13), and by in-
to the homebound would remain a local
serting immediately after paragraph (10) the
project option, so long as participants are
following new paragraphs:
provided no less than one-third of the
"(11) to operate an information and re-
Recommended Dietary Allowances on five or
ferral system for homebound individuals re-
more days per week. Projects may elect to
ceiving meals under this title by-
serve meals on weekends. This requirement
may be met by delivering on Friday supple-
"(A) training the delivery personnel so
mental foods such as a snack, cold meal, or
that such personnel may make informed
special adult formula. If they do, these week-
judgments about the additional service needs
end meals might provide no less than 25
of meal recipients; and
per cent of the R.D.A.
"(B) reporting the additional service needs
3. An information and referral system
to agencies, groups, or individuals who might
would be established for the homebound re-
be of assistance in meeting such needs;
cipients. to insure maximum coordination
(12) to seek and utilize volunteer per-
of additional community services. Food de-
sonnel for the provision of home-delivered
meals to the maximum extent possible and
livery personnel will be trained to make in-
to compensate such personnel when appro-
formed judgments about the additional
priate for transportation expenses incurred
service needs of the elderly recipients and
in the delivery of such meals; and".
report these needs to the appropriate agen-
SEC. 4. (a) (1) Section 708 of the Older
cies, groups or individuals.
Americans Act of 1965 is amended by insert-
4. Each project would be encouraged to
ing "(a)" after the section designation.
attract and utilize qualified community vol-.
(2) Section 708(a) of such Act (as redes-
unteers to deliver this nutrition service. In
ignated by paragraph (1) of this subsection)
addition, projects may compensate volun-
is amended by inserting "and paragraph (1)
teers, when appropriate, for transportation
(B), (11) and (12) of section 706(a) after
expenses incurred in the delivery of meals
"section 707(c)" in the parenthetical.
to homebound participants.
(b) Section 703 of such Act is amended
5. Preference in awarding grants for the
by adding at the end thereof the following
homebound nutrition program must be given
new subsection:
to pre-existing community Meals-on-Wheels
"(b) In addition to the sums authorized
organizations, which have demonstrated an
by subsection (a). there are authorized to
ability to successfully deliver meals to the
be appropriated $80,000.000 for the fiscal year
homebound.
1977. and $100,000.000 for the fiscal year 1978
- 5 -
6. The Act also establishes a demonstra-
meal daily. many elderly persons live
tion program to study the NASA Meals Sys-
alone, and through meals-on-wheels they
tem for the Elderly. This system, on a weekly
basis, mails or delivers a package of com-
have contact with other persons, thus
plete, shelf stable meals (such as freeze-dried
breaking the monotony of solitary exist-
or canned) to homebound elderly. The pro-
ence. Doctors tell me they see a marked
gram is designed to reach those elderly who
improvement in a person's health after
cannot be served by the current delivery
one reestablishes contact with other
system. The pilot project would be con-
persons.
ducted in portions of three states.
One of the key points to this legisla-
At the end of the year-long project, the
Commissioner shall report to Congress on
tion is that it is preventative health care
the results of the demonstration projects
treatment. Experience reveals that one
together with such recommendations as he
nutritious meal a day allows homebound
deems appropriate.
citizens to live in their own homes in-
7. There are authorized to be appropriated
stead of moving to a nursing home. One
$80 million in FY 1977 and $100 million in
daily meal is but a fraction of the cost
FY 1978 for the purposes of providing home-
of providing nursing home care. When
delivered meals and supportive services for
this program begins operation, I antici-
the homebound. No more than 20 per cent of
these funds may be used for administrative
pate Federal savings to result from de-
and supportive services costs. Any unspent
creased costs of institutionalization of
funds must be carried over to be expended
senior citizens.
during the following fiscal year.
When listening this morning to testi-
mony before the Select Committee on
Mr. DOLE. Mr. President, the Sen-
ator from Kansas is pleased to join
Nutrition and Human Needs, I was im-
the Senator from South Dakota in intro-
pressed by the unexpected rewards re-
ducing this important legislation. This
ceived by participants in the meals-on-
bill amends the Older Americans Act of
wheels program. New self-esteem, a re-
1965 to provide for the establishment of
juvenation of spirit, and a more positive
a national meals-on-wheels program.
outlook on life are side benefits the shut-
Presently, meals-on-wheels is a local
ins have experienced. A sense of accom-
operation, manned by volunteers who
plishment, satisfaction gained from a
deliver one hot meal daily to homebound
worthwhile project, and a new under-
senior citizens. In addition to expanding
standing of elderly citizens and their
the existing program, the bill introduced
difficulties are side benefits gained from
today will also allow disabled persons of
volunteers delivering the meals.
any age to participate in the program. I
I am especially hopeful that this pro-
specifically requested that this provision
gram will retain its present character-
be included in Senator McGOVERN'S bill.
istics of a community-oriented service
The meals-on-wheels program is one
project, and that the personal elements
of kindness and concern will be main-
of the most popular of our nutrition
tained.
programs. Elderly citizens like it not
only because they receive one nutritious
aging
FOR IMMEDIATE RELEASE
MAY 26, 1976
OFFICE OF THE WHITE HOUSE PRESS SECRETARY
(Columbus, Ohio)
THE WHITE HOUSE
REMARKS OF THE PRESIDENT
AT THE
OHIO GOVERNORS' CONFERENCE ON AGING
THE STATE FAIRGROUNDS
BERALD FORD LIBRARY
4:24 P.M. EDT
Jim, distinguished members of the Ohio delegation--
and let me personally introduce each and every one of them
to you because they are old and very dear friends of mine.
They are strong supporters of what all of you are interested
in. Would you please stand up and remain standing while I
introduce the others, Andy Devine, Bill Harsha, Chuck Mosher,
Bud Brown, Chalmers Wiley, Tennyson Guyer, and Tom Kindness.
They are great people, they have been invaluable
in their aid and assistance to me, and I thank each and
every one of them. Of course, we have on the platform here
a man who spoke from the heart to you just a few moments
ago and who has been a tremendous asset to me as a member
of my Cabinet, Earl Butz. Earl, come on, get up again.
Then it is great to be in the City of Columbus
and Tom Moody, it is nice to see you, your great, great
Mayor here in the City of Columbus. May I also thank the
Walnut Ridge Band -- great music. You play that Victors
very well.
In 1952, Winston Churchill, then a mere 77
years old, had been called into the service of his country
for a second term as Prime Minister of Great Britain, and
smiling somewhat impishly he told the British Commons,
and I quote, "Everyone has his day, and some days last
longer than others."
Today, I welcome this great opportunity to be
a part of your annual Governors' Conference, and I congratulate
Jim Rhodes for undertaking it back in 1968, a conference
concerned with the many, many Americans whose days have
lasted longer than others.
MORE
Page 2
The careers of Winston Churchill, as well as
others who rose to prominence in later years, reminds
all of us -- if we need to be reminded -- that advancing
years need not mean a retreat from active, even future
enjoyable life, nor should advancing years be the certain
barrier of poor health, meager income or social isolation.
The ancient philosophers taught us that the measure
of a civilization's advancement and greatness can be found
in its proper treatment of the elderly.
Let me say that here in Ohio you have demon-
strated your concern in a very solid and a very practical
way.
This conference is but just one example of your
ongoing commitment. I congratulate Jim and all those
associated with him for initiating it in 1968 and continuing
it in his term at the present time.
You all know, and so do those of us from outside
of Ohio, that this State has pioneered in providing senior
citizens' centers that offer a very broad range of
services to the elderly.
The two golden age villages constructed by
your State provide a model alternative to institutional
care at a very reasonable cost.
Now let me thank and commend Jim Rhodes for my
participation in the Golden Buckeye program, which was
begun some three months ago.
I am told that in the very short span of 90
days 178,000 Ohioans have signed up and now it is 178,001.
(Laughter)
Obviously, I am very proud of the fact that the
Federal Government was able to make a contribution to
the Golden Buckeye program, making it a reality by providing
to the Governor's office for use as he saw fit -- through
the comprehensive education and training legislaton --
and I have been so impressed with the program as a whole.
MORE
Page 3
When I get back to Washington, we are going to
take a real good look to see if we can't, on a national
scale, implement something comparable to this. We have
to, of course, see what the law says, what the money is,
but the concept is good and we are going to do our best
to expand it beyond the borders of the State of Ohio.
For more than 40 years, through the vehicle of
Social Security and other programs, the Federal Government
has made a firm commitment of support for older citizens
of our society. I pledge to you that I will continue without
hesitation, reservation, to uphold that commitment.
In recent years there has been some very dramatic
progress to meet the needs of America's older generation. I
want to do better and, with your help and with the help
of a responsible Congress, I will, and we will. And this
is something that all of us owe to this great generation of
Americans, those at the present and those that are to follow.
And as President of the United States, I will do everything
possible in my power to help our Nation demonstrate its deep,
deep concern for the dignity, for the well-being of our older
generations.
The Social Security program, the largest of its
kind in the world, will pay almost $83 billion to more than
32 million Americans in this next fiscal year. This is
more -- and I emphasize more -- than a $10 billion increase
over the current year. And, of course, I suspect many of
you know -- but I want to reemphasize it to show my commit-
ment -- in my budget for the next fiscal year, which begins
October 1, 1976, I am recommending that the full cost of
living increase in Social Security benefits be paid in
that year.
As you also know, however, there are problems
facing our Social Security system. Next year, unless my
reforms are adopted, the Social Security Trust Fund will run
a deficit of nearly $3-1/2 billion, and the next 12 months
after that, if we don't follow a responsible course as I
have proposed, the deficit will be $4 billion in a 12-month
period.
But let me assure you very emphatically, my
Administration intends to preserve the integrity and the
solvency of the Social Security for your benefit and that of
all working Americans now as well as in the future. As long
as I am President, we are going to keep our Social Security
protection and every other retirement program strong, sound
and certain.
In addition to the Social Security program, we are
continuing our commitment to benefit programs for more than
3 million railroad, military and Federal Government employees.
MORE
GERALDA FORD
Page 4
After many, many years of sacrifice and hard work,
these Americans have contributed much to our great Nation.
They have earned our respect as well as our admiration.
They have earned more than the prospect of poverty in their
retirement years.
In my budget, the Supplemental Security Income
program, or SSI, will pay almost $6 billion in Federal benefits
to more than 5 million disabled and disadvantaged older
Americans in 1977, 140,000 of them right here in the great
State of Ohio.
In the field of health care, the Federal Medicare
program, in 1976, will provide more than $17 billion for the
health care of 24 million older and disabled Americans,
1,200,000 again right here in the great State of Ohio.
Now, there are some flaws in this program, which
actually help raise the cost of your medical care and which
fail, unfortunately, to provide or to protect you adequately
against the economic burdens of a prolonged illness. I have
proposed major improvements in the Medicare program to make
it serve you better. One of the most important improvements
would provide for the payment of all but a very small fraction
of the catastrophic costs of complex or extended care as
well as treatment.
I don't have to tell you that medical treatment is
very, very expensive these days. If you have to stay in a
hospital or in a nursing home or under a doctor's care for
a very long, long time, it puts an incredible strain on your
lifetime savings or on your peace of mind, and that strain is
felt by your loved ones just as well as yourself. All of us
know cases -- a friend, a neighbor, a part of your family --
in which someone has been stricken with an illness that lingers
on and on and on. We know of the pain, we know of the heartache
associated with a prolonged and expensive illness. We know
that being sick and bedridden for an extended period of time
is bad enough without having a person's income and life savings
dwindling as the medical bills keep piling up.
This must not continue and I, as President, will
not permit it to continue and, therefore, I recommended what
I think is a good program to solve the problem. There is no
reason that older Americans should have to go broke just
to get well or stay well in the United States of America.
Under my proposal, the individual's contribution to Medicare
would go up very slightly, but consider what the increase would
provide to you and to the other 24 million who would be covered.
Nobody eligible for Medicare would have to pay more than $500
per year for hospital or nursing home care or more than $250
a year for a physician's services. Medicare would pay the
rest, whether it is $1,000, $10,000 or $50,000.
MORE
Page 5
That is good protection, and I think it is a
good program, and I hope you will support it. This proposal
provides the full protection so vitally needed by older
Americans and, if the Congress passes it, the ruinous
economic burden of catastrophic illness is one thing
America's older citizens will never have to worry about
again.
Another of my programs would consolidate 16
Federal health programs, including Medicare, into a single
$10 billion block grant program to the States. If we
can consolidate these programs, we can make them far
more humane and far more effective.
We can improve the services that they provide
to you and millions like you, and we can get those services
to more people who really need them. Programs of this
kind, despite some abuses, do a tremendous amount of good.
They provide food services and health care for many of
our older citizens. For some of our elderly neighbors,
they provide the means for life itself.
MORE
GERALD FORD VIBRABY
Page 6
I know it is all too easy to say that the
Federal Government is too big, that this program and that
program ought to be cut out of the Federal budget, tossed
back to the States to cope with it if their taxpayers
will permit it.
Jim Rhodes knows and I think most of you know
it .is not that simple. I know it and anyone who has
thought it out knows it very, very well. The programs --
if I can put it this way -- the problems and the challenges
discussed at this conference will center on the needs of
Ohio's older citizens. They are often very, very special
needs.
But, the elderly of our nation are also vitally
affected by the problems and concerns that face all of the
215 million Americans. Perhaps the greatest of these are
the problems of inflation. During 1974, August 9 to be
precise, when I became President, inflation was ranging
at an annual rate of 12 percent or higher, eating away at
everybody's buying power, but absolutely devouring the
livelihood of people on fixed incomes.
Americans living on fixed incomes could see
their purchasing power eroding with each visit to the
supermarket. I knew that something had to be done
to bring the situation under control as quickly and as
effectively as possible. I knew that deficit spending
by the Federal Government was a major contributor to
inflation, that slowing the growth of Federal spending was
essential to solve the problem. In short, I believe our
Government should spend less and our Government should tax
less.
I am proud to say to each and every one of you,
I am proud of the sound and steady policies of my Admin-
istration that have succeeded. In the last four months --
from January through the month of April -- the rate of
inflation on an annual basis is less than 3 percent, and
that is a 75 percent reduction from what it was when I
became President.
It is a victory for all Americans because
inflation is no respecter of age. The old as well as
the young suffer. What I want -- and I think all of us
want, young or old, black or white, rich or poor -- is
to live in dignity, to live in security and to live in
peace.
If we continue making the progress America has
made in the last 12 months, we will see that goal achieved.
If I had to sum up the record of my Administration in
just a very few words, it would be peace, prosperity and
trust.
MORE
Page 7
Today, America is at peace. There are no
American boys fighting anywhere on the face of the earth,
and I intend to keep it that way. I will continue my
policies of cutting your taxes, expanding the private
economy, reducing bureaucracy and useless regulation and
restraining Federal spending.
My policies have brought us from the depths of
a recession to a sustained recovery, and will insure
that runaway inflation never again robs us or our
loved ones of the rewards of honest work and lifetime
savings.
Finally, I want to finish the most important
job -- the restoration of trust in the Presidency itself.
As your President, I will promise no more than I can
deliver and I will deliver everything that I promise.
I need your support to insure peace, prosperity
and trust for the future, the good, secure, fulfilling
future that we owe to our children and to our grandchildren.
Americans have always wanted a life to be better for our
children than what it was for us because life for us
has been better than it was for our parents.
Now, what do I see for this great country of
ours in the future? I see a strong and confident America,
secure in a strength. that cannot alone be counted in
megatons, a nation rejoicing in riches or blessings that
cannot be eroded by inflation or by taxation.
I see an America where life is valued for its
quality as well as for its comfort, where the
individual is inviolate in his constitutional right,
where the Government serves and the people rule.
Thank you very, very much.
END
(AT 4:44 P.M. EDT)
FOR IMMEDIATE RELEASE
MAY 26, 1976
OFFICE OF THE WHITE HOUSE PRESS SECRETARY
(Columbus, Ohio)
THE WHITE HOUSE
REMARKS OF THE PRESIDENT
AT THE
file
OHIO GOVERNORS' CONFERENCE ON AGING
THE STATE FAIRGROUNDS
4:24 P.M. EDT
Jim, distinguished members of the Ohio delegation--
and let me personally introduce each and every one of them
to you because they are old and very dear friends of mine.
They are strong supporters of what all of you are interested
in. Would you please stand up and remain standing while I
introduce the others, Andy Devine, Bill Harsha, Chuck Mosher,
Bud Brown, Chalmers Wiley, Tennyson Guyer, and Tom Kindness.
They are great people, they have been invaluable
in their aid and assistance to me, and I thank each and
every one of them. Of course, we have on the platform here
a man who spoke from the heart to you just a few moments
ago and who has been a tremendous asset to me as a member
of my Cabinet, Earl Butz. Earl, come on, get up again.
Then it is great to be in the City of Columbus
and Tom Moody, it is nice to see you, your great, great
Mayor here in the City of Columbus. May I also thank the
Walnut Ridge Band -- great music. You play that Victors
very well.
In 1952, Winston Churchill, then a mere 77
years old, had been called into the service of his country
for a second term as Prime Minister of Great Britain, and
smiling somewhat impishly he told the British Commons,
and I quote, "Everyone has his day, and some days last
longer than others."
Today, I welcome this great opportunity to be
a part of your annual Governors' Conference, and I congratulate
Jim Rhodes for undertaking it back in 1968, a conference
concerned with the many, many Americans whose days have
lasted longer than others.
MORE
GERALD FORD LIBRARY
Page 2
The careers of Winston Churchill, as well as
others who rose to prominence in later years, reminds
all of us -- if we need to be reminded -- that advancing
years need not mean a retreat from active, even future
enjoyable life, nor should advancing years be the certain
barrier of poor health, meager income or social isolation.
The ancient philosophers taught us that the measure
of a civilization's advancement and greatness can be found
in its proper treatment of the elderly.
Let me say that here in Ohio you have demon-
strated your concern in a very solid and a very practical
way.
This conference is but just one example of your
ongoing commitment. I congratulate Jim and all those
associated with him for initiating it in 1968 and continuing
it in his term at the present time.
You all know, and so do those of us from outside
of Ohio, that this State has pioneered in providing senior
citizens' centers that offer a very broad range of
services to the elderly.
The two golden age villages constructed by
your State provide a model alternative to institutional
care at a very reasonable cost.
Now let me thank and commend Jim Rhodes for my
participation in the Golden Buckeye program, which was
begun some three months ago,
I am told that in the very short span of 90
days 178,000 Ohioans have signed up and now it is 178,001.
(Laughter)
Obviously, I am very proud of the fact that the
Federal Government was able to make a contribution to
the Golden Buckeye program, making it a reality by providing
to the Governor's office for use as he saw fit -- through
the comprehensive education and training legislaton --
and I have been so impressed with the program as a whole.
MORE
GERALD FORD LIBRARY
Page 3
When I get back to Washington, we are going to
take a real good look to see if we can't, on a national
scale, implement something comparable to this. We have
to, of course, see what the law says, what the money is,
but the concept is good and we are going to do our best
to expand it beyond the borders of the State of Ohio.
For more than 40 years, through the vehicle of
Social Security and other programs, the Federal Government
has made a firm commitment of support for older citizens
of our society. I pledge to you that I will continue without
hesitation, reservation, to uphold that commitment.
In recent years there has been some very dramatic
progress to meet the needs of America's older generation. I
want to do better and, with your help and with the help
of a responsible Congress, I will, and we will. And this
is something that all of us owe to this great generation of
Americans, those at the present and those that are to follow.
And as President of the United States, I will do everything
possible in my power to help our Nation demonstrate its deep,
deep concern for the dignity, for the well-being of our older
generations.
The Social Security program, the largest of its
kind in the world, will pay almost $83 billion to more than
32 million Americans in this next fiscal year. This is
more -- and I emphasize more -- than a $10 billion increase
over the current year. And, of course, I suspect many of
you know -- but I want to reemphasize it to show my commit-
ment -- in my budget for the next fiscal year, which begins
October 1, 1976, I am recommending that the full cost of
living increase in Social Security benefits be paid in
that year.
As you also know, however, there are problems
facing our Social Security system. Next year, unless my
reforms are adopted, the Social Security Trust Fund will run
a deficit of nearly $3-1/2 billion, and the next 12 months
after that, if we don't follow a responsible course as I
have proposed, the deficit will be $4 billion in a 12-month
period.
But let me assure you very emphatically, my
Administration intends to preserve the integrity and the
solvency of the Social Security for your benefit and that of
all working Americans now as well as in the future. As long
as I am President, we are going to keep our Social Security
protection and every other retirement program strong, sound
and certain.
In addition to the Social Security program, we are
continuing our commitment to benefit programs for more than
3 million railroad, military and Federal Government employees.
MORE
Page 4
After many, many years of sacrifice and hard work,
these Americans have contributed much to our great Nation.
They have earned our respect as well as our admiration.
They have earned more than the prospect of poverty in their
retirement years.
In my budget, the Supplemental Security Income
program, or SSI, will pay almost $6 billion in Federal benefits
to more than 5 million disabled and disadvantaged older
Americans in 1977, 140,000 of them right here in the great
State of Ohio.
In the field of health care, the Federal Medicare
program, in 1976, will provide more than $17 billion for the
health care of 24 million older and disabled Americans,
1,200,000 again right here in the great State of Ohio.
Now, there are some flaws in this program, which
actually help raise the cost of your medical care and which
fail, unfortunately, to provide or to protect you adequately
against the economic burdens of a prolonged illness. I have
proposed major improvements in the Medicare program to make
it serve you better. One of the most important improvements
would provide for the payment of all but a very small fraction
of the catastrophic costs of complex or extended care as
well as treatment.
I don't have to tell you that medical treatment is
very, very expensive these days. If you have to stay in a
hospital or in a nursing home or under a doctor's care for
a very long, long time, it puts an incredible strain on your
lifetime savings or on your peace of mind, and that strain is
felt by your loved ones just as well as yourself. All of us
know cases -- a friend, a neighbor, a part of your family --
in which someone has been stricken with an illness that lingers
on and on and on. We know of the pain, we know of the heartache
associated with a prolonged and expensive illness. We know
that being sick and bedridden for an extended period of time
is bad enough without having a person's income and life savings
dwindling as the medical bills keep piling up.
This must not continue and I, as President, will
not permit it to continue and, therefore, I recommended what
I think is a good program to solve the problem. There is no
reason that older Americans should have to go broke just
to get well or stay well in the United States of America.
Under my proposal, the individual's contribution to Medicare
would go up very slightly, but consider what the increase would
provide to you and to the other 24 million who would be covered.
Nobody eligible for Medicare would have to pay more than $500
per year for hospital or nursing home care or more than $250
a year for a physician's services. Medicare would pay the
rest, whether it is $1,000, $10,000 or $50,000.
MORE
Page 5
That is good protection, and I think it is a
good program, and I hope you will support it. This proposal
provides the full protection so vitally needed by older
Americans and, if the Congress passes it, the ruinous
economic burden of catastrophic illness is one thing
America's older citizens will never have to worry about
again.
Another of my programs would consolidate 16
Federal health programs, including Medicare, into a single
$10 billion block grant program to the States. If we
can consolidate these programs, we can make them far
more humane and far more effective.
We can improve the services that they provide
to you and millions like you, and we can get those services
to more people who really need them. Programs of this
kind, despite some abuses, do a tremendous amount of good.
They provide food services and health care for many of
our older citizens. For some of our elderly neighbors,
they provide the means for life itself.
MORE
DEPART OF HEALTH EDUCATION: AND
free
HEW
NEWS
aging
USA
U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
FOR RELEASE- A.M.s, May 1
National Institutes of Health
Jane E. Shure (301) 496-9121
Dr. Robert N. Butler, psychiatrist and gerontologist, has been
appointed the first Director of the National Institute on Aging, (NIA).
The announcement was made today by Dr. Donald S. Fredrickson, Director
of the National Institutes of Health.
NIA was established by Public Law 93-296 in 1974 to conduct and provide
support for biomedical and behavioral research and training related to
the aging process and to the diseases and other special problems and needs
of the aged. The goal of all Institute efforts is to contribute to the
enhancement of the quality of life by extending the healthy middle years.
NIA's research programs range from basic studies of the aging process at
the level of the tiny molecular building blocks of life to the broad
age-related changes that occur over long periods of time such as the
FORD i LIBRARY GERALD
decline in the body's ability to respond to disease.
Before becoming Institute Director, Dr. Butler was in private practice
in Washington, D. C. as a psychiatrist and psychoanalyst. He has also
worked with and for the elderly for more than 20 years and is the author
and co-author of several books on aging including Aging and Mental Health
(with Myrna I. Lewis), Human Aging (co-author) and Why Survive? Being Old
in America.
-2-
In addition to his private practice, Dr. Butler has been an active
participant in community and public affairs. He has also served as a
psychiatrist and gerontologist at the Washington School of Psychiatry
and has been on the faculty of the Howard and George Washington Schools
of Medicine as well as the Washington Psychoanalytic Institute.
Dr. Butler also served as consultant to the U. S. Senate Special
Committee on Aging, to the National Institutes of Health, the National
Institute of Mental Health, the Langley Porter Neuropsychiatric
Institute of the University of California, and the consumer-oriented
Center for Law and Social Policy.
A native of New York, the 49 year-old Dr. Butler received his
undergraduate and medical training at Columbia University. He served in
the U. S. Public Health Service and was stationed at the National
Institutes of Health from 1955 to 1962. During this time, he collaborated
with scientific investigators of other disciplines in major comprehensive
studies of the normal process of aging. This work resulted in the
book, Human Aging, which questioned many traditional stereotypes
and myths concerning the aged such as the inevitability of "senility,"
the inability of the elderly to change and the extent of age-connected
physiological decline.
In the psychiatric field, Dr. Butler's work on reminiscence led to
his theory of the "life review" which has been a stimulus to many other studies
in the United States and abroad and has formed one basis for psychotherapy
for older people. He also introduced the widely adopted term "ageism"
in his delineation of the pervasive individual and institutionalized
prejudices and discrimination against the elderly.
-3-
Dr. Butler is a member of the editorial boards of several gerontological
publications and also is a member of the Boards of Trustees of the Group
for the Advancement of Psychiatry, National Council on the Aging, National
Caucus on the Black Aged, and the Washington School of Psychiatry. He
was named one of the "Washingtonians of the Year" by the Washingtonian
magazine.
###
FORD LIBRARY & 9ERALD
Note to the Editors:
The National Institute on Aging (NIA) is one of eleven Institutes and
four Divisions of the National Institutes of Health, the main medical
research agency of the Federal government.
As a part of the NIH, the NIA conducts research in its laboratories
at the Gerontology Research Center (GRC) in Baltimore, Maryland and
supports through a program of grants and contracts research in universities,
hospitals and research institutions in this country and abroad on the
biomedical, social, and behavioral aspects of the aging process and on
the diseases and other special problems and needs of the aged. In
addition, NIA supports the training of young, promising researchers.
Examples of areas of interest at GRC include studies:
*to describe in quantative terms the behavioral changes that take
place with age to try to determine the basic mechanism of these changes
and to develop techniques to eliminate or modify them;
*to learn about the aging process in man; and
*to investigate aging at the molecular level;
Also the Institute is supporting research in areas such as connective
tissue aging, societal aspects of aging, cognitive and intellectual changes
with age, hormonal changes with age, and other social and psychological
aspects of aging.
MAJOR LAWS SIGNED BY PRESIDENT FORD
THAT BENEFIT OLDER AMERICANS
FORD is LIBRARY
Older Americans Act Amendments of 1975 (P.L. 94-135)
These amendments extend the Title III Community Service
Program, Title IV Research and Training Programs, Title V Senior
Center Program, Title VII Nutrition Program, and Title IX
Employment Program for three years. They also enact the Age
Discrimination Act, which prohibits unreasonable discrimination
on the basis of age. Also extends for one year Action volunteer
programs for older persons. (Signed Nov. 28, 1975)
Employee Retirement Income Security Act (P.L. 93-406)
The nation's first comprehensive pension reform legislation;
it will protect an estimated 26 million worker's investments and
provides tax incentives for workers to save who are not covered
by private pension plans. (Signed Sept. 2, 1974)
Housing and Community Development Act of 1974 (P.L. 93-383)
Provides Community Development Block Grants to communities
for the development of decent housing and a suitable environment.
Senior centers and housing for older persons, in addition to
important social services, may be funded by communities with
Community Development funds. Also re-authorized the Section 202
housing program for the elderly and handicapped. (Signed Aug. 22, 1974)
Medicaid Eligibility Protection Act (P.L. 94-48)
Made permanent protection against the loss of Medicaid
eligibility because of the 1972 Social Security benefit increase.
(Signed July 1, 1975)
Equal Credit Opportunity Act Amendments of 1975 (P.L. 94-239)
Prohibits discrimination on the basis of age in extending
credit. (Signed March 3, 1976)
Social Services Amendments of 1974 (P.L. 93-647)
Amended Social Security Act, establishing new Title XX, to
provide $2.5 billion annually to the States for the provision of
social services. (Signed Jan. 4, 1975)
-2-
National Health Planning and Resources Development Act of 1974
(P.L. 93-641)
Amends the Public Health Service Act to assure the development
of a national health policy and of effective State and area
health planning and resource development programs. (Signed Jan. 4, 1976)
National Mass Transportation Act of 1974 (P.L. 93-503)
Establishes an $11.3 billion, six year urban mass transit program,
in addition to authorizing $500 million a year for non-urbanized
areas. The law requires recipients of funds to charge no more than
half-fare for the elderly and handicapped during off-peak hours.
(Signed Nov. 26, 1974)
Tax Reduction Act of 1975 (P.L. 94-12)
Provides a special $50 payment to each recipient of Social
Security, Railroad Retirement, or SSI; refunded a portion of 1974
taxes; increased the minimum standard deduction and percentage
standard deduction; provided a tax credit of $30 for each taxpayer,
spouse, and dependent; liberalizes rules for claiming deductions
for caring for a child or older relative. (Signed March 29, 1975)
Swine Influenza Immunization (P.L. 94-266)
Made available $135,064,000 for a nationwide influenza program.
Made available an additional $1.728 billion for manpower
assistance under the Comprehensive Employment and Training Act
program of 1974, and $55.9 million to carry out Title IX of the
Older Americans Act. (Signed April 15, 1976)
Veterans and Survivors Pension Adjustment Act of 1974 (P.L. 93-527)
Increases and liberalizes benefits for veterans and their
survivors. (Signed Dec. 21, 1974)
Federal-Aid Highway Amendments of 1974 (P.L. 93-643)
Amended Federal-Aid to Highway Act to provide that any project
receiving assistance under the Act shall be planned, designed,
constructed and operated to allow effective utilization by the elderly
and handicapped. (Signed Jan. 4, 1975)
-3-
Headstart, Economic Opportunity and Community Partnership Act
of 1974 (P.L. 93-644)
Extends programs under the Economic Opportunity Act through
FY 1977, including the Senior Opportunity Service (SOS) program.
(Signed Jan. 4, 1975)
Rehabilitation Act Amendments of 1974 (P.L. 93-516)
Provides for particular emphasis to be placed on special
projects and demonstrations for older blind individuals. (Signed
Dec. 7, 1974)
FY 1975 Labor-HEW Appropriations Act (P.L. 93-517)
Appropriates funds for FY 1975 for most Labor and HEW programs,
including Titles III and IV of the Older Americans Act. (Signed
Dec. 7, 1974)
Supplemental Labor-HEW Appropriations Act, 1975 (P.L. 93-554)
Appropriates funds for several Labor-HEW programs, including
Title VII of the Older Americans Act, for FY 1975. (Signed Dec. 27, 1974)
FORD & LIBRARY GERALD
BILLS VETOED BY PRESIDENT FORD THAT WOULD
HAVE BENEFITTED OLDER AMERICANS
Health Revenue Sharing and Services Act of 1974 (H.R. 14214) -
Vetoed December 21, 1974; Sustained.
Would have authorized funds for a variety of health services,
provided for startup funds for home health services, and established
a Commission on Mental Health and Illness of the Elderly.
Vetoed because of excessive appropriation levels.
Health Revenue Sharing and Health Services Act of 1975 (S.66) -
Vetoed July 26, 1975; Over-ridden July 29, 1975.
Authorizes funds for a variety of health services, provides
funds for startup of home health services, and establishes a
Commission on Mental Health and Illness of the Elderly.
Vetoed because of excessive appropriation levels.
Emergency Employment Appropriations Act, 1975 (H.R. 4481) - Vetoed
May 28, 1975; Sustained June 4, 1975.
Would have appropriated emergency employment funds, including
$30 million for the Title IX Senior Community Service Employment
Program.
Vetoed because it would exacerbate budgetary and economic
pressures; accelerative influences of the bill would come much too
late to give impetus to economic recovery.
FY 1976 Labor-HEW Appropriations Bill (H.R. 8069) - Vetoed Dec. 19, 1975;
Over-ridden Jan. 27, 1976
Appropriated funds for most Labor-HEW programs, including the
Title VII Nutrition Program.
Vetoed because it would authorize excessive authorization levels,
and because it would increase permanent Federal employment by
8000 people.
-2-
Railroad Retirement Act (H.R. 15301) - Vetoed October 15, 1974;
Over-ridden October 16, 1974. (P.L. 93-445)
Provided for restructuring the Railroad Retirement Benefit
Program to reflect a basic social security covered employment
and railroad service, and a pension based on a formula
applicable only to railroad service.
Provided for elimination of dual benefit rights for future
beneficiaries.
Vetoed because it would authorize excessive appropriation
levels.
MAJOR LAWS SIGNED BY PRESIDENT FORD
THAT BENEFIT OLDER AMERICANS
Older Americans Act Amendments of 1975 (P.L. 94-135)
These amendments extend the Title III Community Service
Program, Title IV Research and Training Programs, Title V Senior
Center Program, Title VII Nutrition Program, and Title IX
Employment Program for three years. They also enact the Age
Discrimination Act, which prohibits unreasonable discrimination
on the basis of age. Also extends for one year Action volunteer
programs for older persons. (Signed Nov. 28, 1975)
Employee Retirement Income Security Act (P.L. 93-406)
The nation's first comprehensive pension reform legislation;
it will protect an estimated 26 million worker's investments and
provides tax incentives for workers to save who are not covered
by private pension plans. (Signed Sept. 2, 1974)
Housing and Community Development Act of 1974 (P.L. 93-383)
Provides Community Development Block Grants to communities
for the development of decent housing and a suitable environment.
Senior centers and housing for older persons, in addition to
important social services, may be funded by communities with
Community Development funds. Also re-authorized the Section 202
housing program for the elderly and handicapped. (Signed Aug. 22, 1974)
Medicaid Eligibility Protection Act (P.L. 94-48)
Made permanent protection against the loss of Medicaid
eligibility because of the 1972 Social Security benefit increase.
(Signed July 1, 1975)
Equal Credit Opportunity Act Amendments of 1975 (P.L. 94-239)
FORD & LIBRARY 938870
Prohibits discrimination on the basis of age in extending
credit. (Signed March 3, 1976)
Social Services Amendments of 1974 (P.L. 93-647)
Amended Social Security Act, establishing new Title XX, to
provide $2.5 billion annually to the States for the provision of
social services. (Signed Jan. 4, 1975)
-2-
National Health Planning and Resources Development Act of 1974
(P.L. 93-641)
Amends the Public Health Service Act to assure the development
of a national health policy and of effective State and area
health planning and resource development programs. (Signed Jan. 4, 1976)
National Mass Transportation Act of 1974 (P.L. 93-503)
Establishes an $11.3 billion, six year urban mass transit program,
in addition to authorizing $500 million a year for non-urbanized
areas. The law requires recipients of funds to charge no more than
half-fare for the elderly and handicapped during off-peak hours.
(Signed Nov. 26, 1974)
Tax Reduction Act of 1975 (P.L. 94-12)
Provides a special $50 payment to each recipient of Social
Security, Railroad Retirement, or SSI; refunded a portion of 1974
taxes; increased the minimum standard deduction and percentage
standard deduction; provided a tax credit of $30 for each taxpayer,
spouse, and dependent; liberalizes rules for claiming deductions
for caring for a child or older relative. (Signed March 29, 1975)
Swine Influenza Immunization (P.L. 94-266)
Made available $135,064,000 for a nationwide influenza program.
Made available an additional $1.728 billion for manpower
assistance under the Comprehensive Employment and Training Act
program of 1974, and $55.9 million to carry out Title IX of the
Older Americans Act. (Signed April 15, 1976)
Veterans and Survivors Pension Adjustment Act of 1974 (P.L. 93-527)
Increases and liberalizes benefits for veterans and their
survivors. (Signed Dec. 21, 1974)
Federal-Aid Highway Amendments of 1974 (P.L. 93-643)
Amended Federal-Aid to Highway Act to provide that any project
receiving assistance under the Act shall be planned, designed,
constructed and operated to allow effective utilization by the elderly
and handicapped. (Signed Jan. 4, 1975)
-3-
Headstart, Economic Opportunity and Community Partnership Act
of 1974 (P.L. 93-644)
Extends programs under the Economic Opportunity Act through
FY 1977, including the Senior Opportunity Service (SOS) program.
(Signed Jan. 4, 1975)
Rehabilitation Act Amendments of 1974 (P.L. 93-516)
Provides for particular emphasis to be placed on special
projects and demonstrations for older blind individuals. (Signed
Dec. 7, 1974)
FY 1975 Labor-HEW Appropriations Act (P.L. 93-517)
Appropriates funds for FY 1975 for most Labor and HEW programs,
including Titles III and IV of the Older Americans Act. (Signed
Dec. 7, 1974)
Supplemental Labor-HEW Appropriations Act, 1975 (P.L. 93-554)
Appropriates funds for several Labor-HEW programs, including
Title VII of the Older Americans Act, for FY 1975. (Signed Dec. 27, 1974)
BILLS VETOED BY PRESIDENT FORD THAT WOULD
HAVE BENEFITTED OLDER AMERICANS
Health Revenue Sharing and Services Act of 1974 (H.R. 14214) -
Vetoed December 21, 1974; Sustained.
Would have authorized funds for a variety of health services,
provided for startup funds for home health services, and established
a Commission on Mental Health and Illness of the Elderly.
Vetoed because of excessive appropriation levels.
Health Revenue Sharing and Health Services Act of 1975 (S.66) -
Vetoed July 26, 1975; Over-ridden July 29, 1975.
Authorizes funds for a variety of health services, provides
funds for startup of home health services, and establishes a
Commission on Mental Health and Illness of the Elderly.
Vetoed because of excessive appropriation levels.
Emergency Employment Appropriations Act, 1975 (H.R. 4481) - Vetoed
May 28, 1975; Sustained June 4, 1975.
Would have appropriated emergency employment funds, including
$30 million for the Title IX Senior Community Service Employment
Program.
Vetoed because it would exacerbate budgetary and economic
pressures; accelerative influences of the bill would come much too
late to give impetus to economic recovery.
FY 1976 Labor-HEW Appropriations Bill (H.R. 8069) - Vetoed Dec. 19, 1975;
Over-ridden Jan. 27, 1976
Appropriated funds for most Labor-HEW programs, including the
Title VII Nutrition Program.
Vetoed because it would authorize excessive authorization levels,
and because it would increase permanent Federal employment by
8000 people.
FORD & LIBRARY GERALD
-2-
o
Railroad Retirement Act (H.R. 15301) - Vetoed October 15, 1974;
Over-ridden October 16, 1974. (P.L. 93-445)
Provided for restructuring the Railroad Retirement Benefit
Program to reflect a basic social security covered employment
and railroad service, and a pension based on a formula
applicable only to railroad service.
Provided for elimination of dual benefit rights for future
beneficiaries.
Vetoed because it would authorize excessive appropriation
levels.
26 Part I- Mon., April 26, 1976 + Los Angeles Times
Washington Plans Special Services Program for Elderly
OLYMPIA, Wash. (P)-Thanks to a
"This is landmark from my per-
having to go into nursing homes."
October. The program will involve
$7.5 million experiment, about 100,-
spective as a physician," said state of-
Gov. Dan Evans, an early suppor-
100,000 Washington residents 65 and
000 senior citizens will be getting
fice director Dr. Roy Schindelheim.
ter of the idea, this week signed leg-
older, Schindelheim said.
free legal advice, death counseling
"It's landmark in terms of trying to
islation creating the program and ap-
hot meals their
protect
from
dotori
The project which also will offer
& FORD LIBRARY
20
placed in jobs (about 38 percent of
all individuals placed), some 238,-
000 received employment counsel-
ing and 222,000 were tested to
determine aptitudes, interests, and
yhebl3
achievement levels.
JOB CORPS-Established by the
Economic Opportunity Act of 1964,
Bureau of Apprenticeship and
Job Corps is now included as Title
Training (there are 150 of them) or
the office of the State Apprentice-
OLDER MEANS
Senior
citizens
SMARTER
with a
reasonable
educational background
"do not lose their mar-
bles" with age. Just the
opposite--claims Gisela
19
R -
pent 4/21
send copy to
grady Means pls
and file "aging"
NOTE.-DO NOT USE THIS ROUTE SLIP TO
SHOW FORMAL CLEARANCES OR APPROVALS
DATE 4/16
AGENCY BLDG. ROOM
TO: Sarah Massengale
APPROVAL
REVIEW
PER CONVERSATION
SIGNATURE
NOTE AND SEE ME
AS REQUESTED
COMMENT
NOTE AND RETURN
NECESSARY ACTION
FOR YOUR INFORMATION
PREPARE REPLY FOR SIGNATURE OF
REMARKS:
(Fold here for return)
To
From
PHONE
56111 John BUILDING Weiner, N ESW ROOM
5614
FORM HEW-30 REV. 11/56 ROUTE SLIP
*GPO : 1975 O-590-173
HEALTH
INFORMATION L}] CATION
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
USA
WASHINGTON, D.C. 20201
Department of Human Development
Administration on Aging
GERALD FORD LIBRARY
PROGRAM INSTRUCTION
AoA-PI-76-14
March 27, 1976
TO
: STATE AGENCIES ADMINISTERING PLANS UNDER TITLES III
AND VII OF THE OLDER AMERICANS ACT OF 1965, AS AMENDED
INFO FOR : Area Agencies on Aging and Nutrition Projects.
SUBJECT
: Release of Additional FY 1976 Funds for the Title VII
Nutrition Program.
PURPOSE
: The purpose of this Program Instruction is to authorize
State Agencies on Aging to obligate and expend additional
funds for the Title VII Nutrition Program for the elderly
and to increase the authorized annual operating level to
$187,500,000.
CONTENT : The FY 1976 Labor-HEW Appropriations Bill became Public
Law 94-206. This bill provided $125,000,000 in appropriated
funds for FY 1976, plus $31,250,000 for the July-September, 1976
transition period for the Title VII, Nutrition Program
for the Elderly. In addition, Congress increased the
Title VII annual operating level for FY 1976 to $187,500,000.
This represents an increase of $37,500,000 over the authorized
operating level of $150,000,000 previously issued by PI-76-4,
dated September 22, 1975.
Attachment A, Column 1 of this Program Instruction sets
forth the revised operating level for each State for FY 1976
based on the new operating level of $187,500,000.
This Program Instruction officially releases additional
FY 1976 funds in the amount of $37,500,000. This amount
plus the $50,400,000 in FY 1976 appropriations released
by PI-76-4 provides $87,900,000 in appropriated funds for
FY 1976 now available for funding the FY 1976 Nutrition
Program under Title VII. (See Attachment A, Column 3.)
This $87,900,000 together with the $99,600,000 of FY 1975
funds released to the States by PI-75-21 now authorizes a
total of $187,500,000 in appropriated funds available for
obligation to reach the $187,500,000 operating level in
FY 1976. The release of the $37,500,000 for use in FY 1976
may result in some States carrying over for future use
significant dollar balances.
-2-
States are prohibited from utilizing these funds in
such a manner as to increase for future years their
operating levels above their formula share of
$187,500,000. A violation of this prohibition could
lead to a State being required at some point in the
future to reduce the levels of its operating programs.
Attached is a chart which explains how the Fiscal Year
appropriations are distributed to support the $187,500,000
operating level. (See Attachment B before reading further.)
You will note that the FY 1976 operating level of $187,500,000
is supported by the FY 1975 appropriation of $99,600,000
forward funded for use in FY 1976 and $87,900,000 of the
FY 1976 appropriation. The July-September 1976 transition
period operating level of $46,875,000 will be supported by
$37,100,000 of the FY 1976 appropriation forward funded into
the transition quarter and $9,775,000 of the July-September,
1976 transition period appropriation. This will leave
$21,475,000 of the July-September 1976 transition period
appropriated funds to be forward funded for use in FY 1977.
The President's original budget request for $24,900,000
in the July-September 1976 transition period and $88,000,000
for FY 1977 were predicated on phasing out forward funding
in FY 1977. These sums would have provided dollar for dollar
support of the then $150,000,000 operating level with
appropriated funds through September 30, 1977. It is still
the intention of the Administration to eliminate forward
funding by the end of FY 1977 and to convert to an annual
funding mode for the Title VII - Nutrition Program in FY 1978.
Program Instruction 76-4 allocated $50,400,000 of FY 1976
funds for use in FY 1976. This Program Instruction releases
an additional $37,500,000 of FY 1976 funds for use in FY 1976.
The remaining $37,100,000 of FY 1976 appropriations and the
July-September 1976 transition period funds of $9,775,000
will be released for use in the July-September, 1976 transition
period prior to July 1, 1976. The remaining $21,475,000
will be released for use in FY 1977 prior to October 1, 1976.
THIS IS AN OFFICIAL AWARD DOCUMENT. The FY 1976 funds
authorized by Attachment A under Column 3 are available
FORD
for obligation and expenditure by State Agencies as of
this date. State Agencies should note that Fiscal Year
1975 funds must be reported on the Financial Status
GERALD
LIBRARY
Report (Form 601T) against the FY 1975 appropriations and
-3-
Fiscal Year 1976 funds must be reported against the FY 1976
appropriations on all fiscal reports regardless of the
year in which they are expended.
FY 1976 funds allotted to the States will be available
for obligation by the States through September 30, 1977.
The July-September 1976 transition period funds will also
be available for obligation by the States through
September 30, 1977.
The reallotment process for FY 1976 and the July-September,
1976 transition period funds for Title VII will take place
during the July-September, 1976 transition period.
PROGRAM GUIDANCE
The law and regulations set forth that preference shall
be given to projects serving primarily low-income individuals,
and that to the extent feasible, grants will be awarded to
projects operated by and serving the needs of minority
individuals at least in proportion to their numbers of the
eligible individuals in the State. This large increase
in operating level for the program gives each State an
opporturnity to improve its performance in serving low-income
and minority persons through the Title VII program.
State Agencies, therefore, must assure that the elderly
living in all geographic areas of the State having high
concentrations or proportions of low-income or minority
older persons have ready access to a Title VII project
before projects are initiated in other geographic areas.
Similarly, expansion of existing projects should be based
on outreach activities designed to make sure that low
income and minority older persons within the project area,
who are often times isolated and cut off from society, know about
the program and have been given an opportunity to participate
in it.
No "later than May 1 States should file, after consultation
with State Advisory Councils, with the Director of the
Regional Offices on Aging, a statement relative to their
plans for the utilization of these additional funds. The
Administration on Aging will not act formally on these plans
but will regard them as a part of the monitoring and assess-
ment process and will use them as a basis for raising
-4-
and discussing issues with the States. States should
follow similar procedures with Area Agencies and Nutrition
Project Agencies including a requirement of consultation
with appropriate Area and Nutrition Project Advisory
Councils.
INQUIRIES : State Agencies should address inquiries to Directors,
Office of Aging, Regional HEW Office.
Area Agencies on Aging should address inquiries to
their grantor (State Agency on Aging or Area Agency on Aging).
Title VII Nutrition Projects should address inquiries
to their grantor (State Agency on Aging or Area Agency
on Aging).
Cutt
Arthur S. Flemming
Commissioner on Aging
Attachments A and B
FORD i LIBRARY
ATTACHMENT-A
REVISED OPERATING LEVEL AND AUTHORIZED FUNDING LEVEL FOR THE TITLE VII NUTRITION
PROGRAM FOR FISCAL YEAR 1976 UNDER THE OLDER AMERICANS ACT OF 1965, AS AMENDED.
THE $87,025,000 IN COLUMN 3 IS AVAILABLE NOW FOR OBLIGATION. THIS IS AN OFFICIAL
AWARD OF FUNDS. (Note: The Allotment Table in PI-76-14 supersedes the Allotment
Table in PI-76-4)
Revised
Authorized
Authorized
Operating
FY-75 Funds for
FY-76 Funds for
Level
use in FY-76
use in FY-76
(PI-76-14)
(PI-75-21) 1/
(PI-76-14)
1/
Column 1
Column 2
Column 3
Total 56 "States"
$185,625,000
$98,600,000
$87,025,000
Alabama
2,971,296
1,566,030
1,405,266
Alaska
928,125
493,000
435,125
Arizona
1,720,227
836,260
883,967
Arkansas
2,079,313
1,102,485
976,828
California
16,160,931
8,453,431
7,707,500
Colorado
1,678,630
883,241
795,389
Connecticut
2,573,105
1,356,182
1,216,923
Delaware
928,125
493,000
435,125
District of Columbia
928,125
493,000
435,125
Florida
9,625,386
4,729,411
4,895,975
Georgia
3,423,918
1,800,935
1,622,983
Hawaii
928,125
493,000
435,125
Idaho
928,125
493,000
435,125
Illinois
9,232,285
5,020,693
4,211,592
Indiana
4,202,679
2,255,083
1,947,596
Iowa
2,785,559
1,519,049
1,266,510
Kansas
2,180,823
1,174,523
1,006,300
Kentucky
2,903,623
1,547,238
1,356,385
Louisiana
2,755,763
1,472,068
1,283,695
Maine
965,139
516,790
448,349
Maryland
2,790,045
1,472,068
1,317,977
Massachusetts
5,258,489
2,840,779
2,417,710
Michigan
6,540,992
3,507,908
3,033,084
Minnesota
3,364,077
1,810,331
1,553,746
Mississippi
1,957,921
1,042,976
914,945
Missouri
4,622,853
2,505,648
2,117,205
Montana
928,125
493,000
435,125
Nebraska
1,473,723
801,808
671,915
Nevada
928,125
493,000
435,125
New Hampshire
928,125
493,000
435,125
New Jersey
6,199,314
3,304,324
2,894,990
New Mexico
928,125
493,000
435,125
New York
16,291,650
8,951,428
7,340,222
North Carolina
3,946,332
2,051,500
1,894,832
North Daketa
928,125
493,000
435,125
Ohio
8,493,377
4,569,677
3,923,700
Oklahoma
2,589,498
1,378,107
1,211,391
Oregon
2,035,758
1,064,901
970,857
Pennsylvania
11,013,262
5,900,802
5,112,460
Rhode Island
928,125
493,000
435,125
South Carolina
1,852,762
964,674
888,088
South Dakota
928,125
493,000
435,125
Tennessee
3,477,673
1,835,387
1,642,286
Texas
9,100,516
4,760,732
4,339,784
Utah
928,125
493,000
435,125
Vermont
928,125
493,000
435,125
Virginia
3,429,062
1,788,407
1,640,655
Washington
2,833,831
1,497,125
1,336,706
West Virginia
1,685,910
905,165
780,745
Wisconsin
3,999,623
2,136,065
1,863,558
Wyoming
928,125
493,000
435,125
American Samoa
464,062
246,500
217,562
Guam
464,062
246,500
217,562
Puerto Rico
1,631,532
895,769
735,763
Trust Territory
464,062
246,500
217,562
Virgin Islands
464,062
246,500
217,562
1/ $1,000,000 of FY 1975 funds and $875,000 of the'FY 1976 funds have been retained for
Federal program evaluation.
Administration on Aging
13.635
Office of Human Development
DEPARTMENT OF HEALTH, EDUCATION
AND WELFARE
MARCH, 1976
ATTACHMENT B
LIBRARY
ADMINISTRATION ON AGING
TITLE VII - NUTRITION PROGRAM FOR THE ELDERLY
FORD
APPROPRIATIONS IN SUPPORT OF THE OPERATING LEVEL
&
07V830
FY 74
FY 75
FY 76
July-Sept.
Operating level
100,000,000
150,000,000 1/
187,500,000
46,875,000
Appropriations
1973
100,000,000
100,000,000
1974
99,600,000
99,600,000
1975
125,000,000
25,400,000
99,600,000
1976
125,000,000
87,900,000
37,100,000
01
J-S, 76 31,250,000
9,775,000
21,475,000
1/ The FY 1975 authorized operating level was $150,000,000. However, $125,000,000 was allotted to the
States to reach the annualized $150,000,000 operating level by June 30, 1975.
2/ Amount available for use in FY 1977 (Forward Funding).
Wi, of Life of Old People
Curbed by Fear of Crime
By PAUL DELANEY
Special to The New York Times
CHICAGO, April 11-Silver-
kids at the alley. And we don't
haired and handsome at age
go to Wednesday night prayer
80, Eugene Hocker can now
meetings unless one of the
look back and laugh without
younger fellows picks us up."
bitterness to three years ago
The Hockers are typical of
when he was beaten and
America's urban elderly,
robbed half a block from home.
though maybe a little better
It was a mugging that left
off than a good many who
him walking with a stiff left
remain behind locked doors,
leg aided by a cane. It also
too terrified to venture out
altered the life style of the re-
day or night.
tired chauffeur and his wife,
It seems to them that the
Ida, also 80.
city and America's youth-or-
"Mama and I stopped going
iented society have turned vi-
out at night by ourselves," he
olently against them, leaving
remarked during an interview
them easy prey to attacks that
at their West Side home. "We
result in deep psychological
still go to the senior citizens
scars at the least and death
center every Tuesday, but
for many of them.
that's in the daytime. We
Police officials and experts
go to church every Sunday
on the elderly consider them
that we can."
to be the most vulnerable C
"But we don't walk in the
1
city dwellers, the victims of
neighborhood like we used to,"
he continued. "I don't walk
Continued on Page 22, Column 3
through the alley anymore-I
The New York Times/Gary Settle
Comic stri artists in person: Auctions! NCS
e West Side of Chicago. Mr. Hocker, who was beaten and robbeo
was robbed by a bunch of
Convention Apr. 16-19 Hotel Commodore.-Adv.
said "We don't walk in the neighborhood like we used to."
n home.
terrorized them that one, Ellen
"This is the only answer.
i's going
Breslin, 85, died of a heart at-
You have to build a de-fence,
nued. "I
tack.
Get it, de-fence," chuckled the
se young
In Chicago, a police lieuten-
5-foot 4-inch, 120-pound insur-
They're
ant, Pauf Blaney, reported that
ance representative who has
kill me
home-invasion gangs were a
lost three bouts with muggers.
ut I try
major menace to the elderly.
"This is our family home.
best I
Last summer, the police broke
We've lived here since 1896
up one such gang that had
when by father built it," he
homes
killed several elderly people on
said. "Many others who had
elderly
the North Side.
homes around here ran away
Dixon,
And not too far away, Freder-
instead of putting up a fence.
inside
ick von Harten, 81, fights his
They're going to have to put
in New
private war against crime: He
up fences around homes not
a group
has constructed a 9-foot, bun-
only in St. Louis, but all over
into the
ker-like fence around his 10-
the country. This is a situation
erly sis-
room home, to the consterna-
that has come up in modern
X and so
tion of some of his neighbors.
times."
INSURANCE EDUCATION SECTIONS
HEALTH.
fill
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
agung
USA
WASHINGTON, D.C. 20201
Office of Human Development
OFFICE OF THE SECRETARY
Administration on Aging
April 6, 1976
MEMORANDUM FOR HONORABLE SARAH MASSENGALE
Attached for your information is a copy of the
draft Administration on Aging-Law Enforcement
Assistance Administration Interagency Agreement
relative to reducing victimization of older
persons.
Dr. Flemming discussed this with Dr. Cavanaugh
Tuesday afternoon. We hope that the final agree-
ment will be signed Friday.
Decker Nake Anstrom
Assistant to the Commissioner
Attachment
FORD LIBRARY & BERALD
STATEMENT OF UNDERSTANDING
CONCERNING THE NECESSITY OF ADDRESSING
THE PROBLEMS OF CRIME AND THE OLDER PERSON
BETWEEN THE
ADMINISTRATION ON AGING, OFFICE OF HUMAN DEVELOPMENT, DEPARTMENT OF HEALTH,
EDUCATION AND WELFARE
AND
LAW ENFORCEMENT ASSISTANCE ADMINISTRATION, DEPARTMENT OF JUSTICE
BACKGROUND
There is a growing recognition that there is a distinctiveness about
crimes against older persons, and that, when considered broadly in terms
of the physical, economic, social and psychological impact, these crimes
warrant treatment as a special category.
The case for singling our older persons as victims of crime from the
general population for special attention may be summarized as follows:
1. There is a high incidence of reduced or low income among older persons.
Thus, the impact of any loss of economic resources is relatively
greater.
GERALO FORD LIBRARY
2. Older people are more likely to be victimized repeatedly often the
same crime and the same offender.
3. Older people are more likely to live alone. Social isolation increases
vulnerability to crime.
4. Older people often have diminished physical strength and stamina; when
this is the case, they are less able to defend themselves or to escape
from threatening situations.
5. Older people are more likely to suffer from physical ailments such as
loss of hearing or sight, arthritis and circulatory problems which
- 2 -
increase their vulnerability.
6. Older people are more easily hurt should they try to defend themselves.
For example, bones are more easily broken, and recovery is more
difficult.
7. Potential criminals are more likely to seek out an elderly target
(whose aged status is easily visible.)
8. There is a greater likelihood that older people will live in high
crime neighborhoods as a result of diminished income and of being
rooted in central cities.
9. The dates of receipt by mail of monthly pension and benefit checks
(and hence the dates when older people are most likely to have cash
on their persons or in their dwelling) are widely known.
10. Dependency on walking or on public transportation is more likely
among older people who, for physical, financial or other reasons, are
less likely to drive or own a private automobile.
11. There is evidence that some older people are particularly susceptible
to fraud and confidence games.
12. The highest rate of the crime of personal larceny with contact (theft
of purse, wallet or cash directly from the person of the victim,
including attempted purse snatching) is among older persons.
3 -
13. Awareness of their increased vulnerability to criminal behavior has
a chilling effect upon the freedom of movement of older Americans.
Fear of criminal victimization causes self-imposed "house arrest"
among older people, who may refuse to venture out of doors. Even in
those situations where the fear of being victimized may be somewhat
exaggerated or unwarrented by local conditions, the effect on the older
persons is just as severe as when the fears are justified.
14. Because of a loss of status and a decreased sense of personal efficacy
older people may be less likely to process complaints through the
criminal justice system and to draw upon available community resources
for protection and redress.
OBJECTIVES
In recognition of the unique and critical problems associated with crimes
against older persons the Law Enforcement Assistance Administration and the
Administration on Aging, Office of Human Development, Department of Health,
Education and Welfare agree to work cooperatively to achieve the following
objectives:
1. To expand the base of knowledge about the actual extent of criminal
victimization of older persons, the factors relating to such
FORD & LIBRARY 9ERALD
victimization and the constraints imposed upon older persons due to
fear of actual or presumed danger of victimization.
2. To increase the level of public awareness and to encourage citizen
= 4 -
involvement in efforts to reduce the circumstances of crime against
older persons, particularly older persons in urban communities where
the incidence of victimization is highest.
3. To involve other Federal agencies and private organizations representing
older persons in the creation of a consortium to formulate a national
strategy for crime prevention programs for aging persons.
4. To increase the level and accessibility of legal services and
counseling available to older persons to protect their rights and
redress the injustices they suffer as a result of criminal victimization
and/or failure to receive rightful benefits under established
programs.
5. To expand the level of commitment of resources at the Federal, State
and local levels applied to address the problem of crime and the older
person.
OBJECTIVE ONE: To expand the base of knowledge about the actual extent of
criminal victimization of older persons, the factors relating to such
victimization and the constraints imposed upon older persons due to fear
of actual or presumed danger of victimization
To the end of promoting this objective the Law Enforcement Assistance
Administration will (1) seek to develop instruments that will uncover the
factors impinging on victimization of older persons and use the data as a
foundation for planning future efforts; (2) work with the Administration
on Aging to field test in selected communiti-s the instruments which are
- 5 -
developed. (3) gather from local communities data on the frequency,
type and location of reported crimes against older persons, and communicate
such data to the Administration on Aging.
The Administration on Aging will: (1) assist the Law Enforcement Assistance
Administration, as requested, in development and/or field testing instru-
ments to uncover factors impinging upon victimization of the elderly;
(2) will disseminate to State and area agencies data received from the
Law Enforcement Assistance Administration on crimes against older person.
OBJECTIVE TWO: To increase the level of public awareness and citizen
involvement in efforts to reduce the circumstances of crime against older
persons, particularly in urban communities where the victimization of older
persons is highest.
To the end of promoting this objective the Law Enforcement Assistance
Administration, in cooperation with the Administration on Aging, will:
(1) participate in gathering documentation on the following two components
of a project currently funded in Kansas City as a joint effort of the
Law Enforcement Assistance Administration and the Administration on Aging
(a) the public education programs conducted through the project on ways to
reduce crimes against the elderly; (b) the involvement of social service
agencies with the criminal justice system to provide better service to
older persons; (2) in cooperation with the Administration on Aging contri-
bute to the preparation of a publication embodying a report on the methods
used and the subject content developed by the Kansas City project on items
(a) and (b) above; (3) distribute the subject publication, which will be
printed by the Administration on Aging, to State and local agencies and
organizations which are components of the law enforcement network.
- 6 -
The Administration on Aging, in cooperation with the Law Enforcement Assis-
tance Administration, will: . (1) assume primary responsibility to work with
the grantee of the Kansas City project to develop appropriate documentation
and reporting procedures to assure the collection of content material related
to (a) the public education programs conducted through the project on ways
to reduce crime against the elderly; (b) the involvement of social service
agencies with the criminal justice system to provide better services to
older citizens; (2) in cooperation with the Law Enforcement Assistance
Administration, accept lead responsibility to prepare a publication embodying
a report on the methods and subject content developed by the Kansas City
project on items (a) and (b); (3) assume responsibility for printing the
subject publication in sufficient quantity for distribution to components
of both the law enforcement and aging networks; (4) distribute the printed
publication as a technical assistance document to the aging network of
State and area agencies and Title VII nutrition projects.
OBJECTIVE THREE: To involve other Federal agencies and private organizations
representing older persons in the creation of a consortium to formulate a
national strategy for crime prevention programs for aging persons.
To the end of promoting this objective the Law Enforcement Assistance
Administration will: (1) designate a staff person responsible to continue
discussion with other Federal agencies and private organizations representing
the elderly for the purpose of establishing a national consortium; (2) invite,
in cooperation with the Administration on Aging, designated representatives
of such other Federal and private organizations to attend an exploratory,
full day planning meeting for the purpose of establishing an action plan
designed to bring the subject consortium into being; (3) provide, with
- 7 -
the support of the Administration on Aging, initial staff and logistical
support for the conduct of the exploratory planning meeting; (4) as
appropriate, provide continuing staff support to the end of bring the
consortium into being.
The Administration on Aging will: (1) designate a staff person responsible
to work with the staff person designated by the Law Enforcement Assistance
Administration to support, as requested, the efforts of the Law Enforcement
Assistance Administration in interesting other Federal agencies and private
organizations representing older persons to participate in a consortium .to
L
formulate a national strategy for crime prevention programs for older
persons; (2) invite, as co-sponsoriwith the Law Enforcement Assistance
Administration designated representatives of other Federal agencies and
private organizations to attend an exploratory meeting for the purpose of
establishing an action plan designed to bring into existence the subject
consortium; (3) provide the Law Enforcement Assistance Administration,
as requested, staff support for the conduct and planning of the meeting;
(4) as appropriate, continue to provide staff support to the end of bringing
the consortium into being.
OBJECTIVE FOUR: To increase the level of accessible legal services and
counseling available to older persons to protect their rights and redress
the injustices they suffer as a result of criminal victimization and/or
the failure to receive rightful benefits under established programs.
To the end of promoting this objective the Law Enforcement Assistance
Administration will: (1) provide the Administration on Aging with program
description materials of the National District Attorney's Association
- 8 -
Economic Crime Project funded by the Law Enforcement Assistance Administra-
tion for the purpose of allowing the Administration on Aging to disseminate
such materials as technical assistance to the aging network; (2) encourage
recipients of awards under the National District Attorney's Association
Economic Crime Project to contact and work cooperatively with area agencies
on aging in their respective communities to identify and assist older
victims of fradulent schemes in such areas as auto repair, home improvements,
land swindles; (3) receive from the Administration on Aging, and disseminate
to the law enforcement network, program description materials on the legal
services projects funded by the Administration on Aging
The Administration on Aging will: (1) provide the Law Enforcement Assistance
Administration with program description materials on the legal services
projects funded by the Administration on Aging for the purpose of distribu-
tion to the law enforcement network; (2) disseminate to the aging network
program description materials, as technical assistance, on the National
District Attorney's Association Economic Crime Project, which is funded
by the Law Enforcement Assistance Administration; (3) direct recipients of
legal service awards from the Administration on Aging to contact and work
cooperatively, as appropriate, with grantees under the National District
Attorney's Association Economic Crime Project.
OBJECT FIVE: To expand the level of commitment of resources at the Federal,
State and local levels for addressing the problem of crime and the older
person
To the end of promoting this objective the Law Enforcement Assistance
Administration will: (1) set aside in Fiscal Year 1976 for discretionary
grants $00,000 for a special police program to improve protection for the
- 9 -
elderly. The two phased program will create a training team to present
a program in service for the'elderly at the police academies throughout
the nation; (2) will continue to encourage and endorse consideration,
under the Law Enforcement Assistance Administration system of block grants,
of the needs of older persons who are actual or potential victims of crime;
(3) will encourage designated agencies at the State level which receive
block grants from the Law Enforcement Assistance Administration to consult
with State Agencies on Aging about the needs of older persons in the process
of developing State plans.
The Administration on Aging will: (1) exercise its authority under Section
404 (c) of the Older Americans Act to make grants to support training of
lawyers and paraprofessional persons to provide legal counseling and
services to older persons; and train persons employed by or associated
with public and private non-profit agencies or organizations who will
identify legal problems affecting older persons, develop solutions for such
problems and mobilize the resources of the community to respond to the
legal needs of older persons; (2) encourage State and area agencies to
determine needs for crime prevention programs and low-cost protective devices
for older persons, such as burglar alarms for homes and apartments; and to
mobilize other resources at the State and local level to support such
programs of prevention; (3) promote cooperative efforts between State and
area agencies on aging and State and local law enforcement agencies to
support sommunity education programs for crime prevention against older persons.
Signed in Washington:
Richard W. Velde
Arthur S. Flemming
Administrator
Commissioner
Law Enforcement Assistance Admin.
Administration on Aging
FOR IMMEDIATE RELEASE
APRIL 5, 1976
OFFICE OF THE WHITE HOUSE PRESS SECRETARY
THE WHITE HOUSE
REMARKS OF THE PRESIDENT
UPON SIGNING THE PROCLAMATION FOR
OLDER AMERICANS MONTH - 1976
THE ROSE GARDEN
3:06 P.M. EST
Secretary Mathews and distinguished guests:
Sarah
It is especially fitting this year that we set
aside a period to honor our older citizens. Their insight
and experience, their wisdom and their courage has contributed
beyond measure to the developments of our 200-year-old Nation.
We must make it possible for older Americans to continue
their involvement in our national life.
One of the best ways we can draw upon their
{
strengths and skills is in the job and volunteer markets.
Too often older and even middle-aged Americans are the
victims of myths and prejudices regarding their capabilities.
Americans must repudiate these myths and prejudices, as we
have repudiated others, and assure our older Americans the
chance to prove that time has only enhanced their demonstrated
abilities.
It is important that our Nation makes every effort
to recognize the worth and the dignity of our older citizens.
To this end, the Federal Council on Aging has prepared a
Bicentennial charter for our older Americans. This charter
sets forth principles to guide us in evaluating our Nation's
response to the problems facing older persons and appreciating
the response to the problems now confronting our Nation.
One of these principles is the right to an adequate
standard of living in retirement. Let me reaffirm that older
Americans have earned the right to live securely, comfortably
and independently.
GERALD R.FORD
As I said before, the value of our Social Security
system is beyond question. I will do all that I can to insure
the integrity of the trust fund so that future generations
of retirees may continue to rely on it.
With these thoughts and commitments in mind, I am
happy today to join in this annual proclamation designating
an Older Americans Month. I urge all organizations concerned
with employment and volunteer services to observe this month
with ceremonies, activities and programs designed to increase
opportunities for older persons, and I urge that such programs
include public forums for discussion of the Bicentennial charter
for older Americans.
I ask all Americans to join me in reflecting upon
the achievements and the needs of our older citizens.
END (AT 3:10 P.M. EST)
FOR IMMEDIATE RELEASE
APRIL 5, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
Sarah
OLDER AMERICANS MONTH, 1976
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
Among our Nation's most precious natural resources
are the collective wisdom, experience and abilities of
our older citizens.
In recent years we have become more aware of the
important contributions older Americans have made in the
past and in the tremendous potential they hold for the
future. We are increasing our efforts to ensure that
they have the opportunity for independent living through
security of income, maintenance of health and continued
useful involvement in the life of our Nation.
America's older citizens have earned the gratitude
and respect of our society, as well as our recognition
of their worth and dignity. In this spirit, the Federal
Council on Aging has prepared the Bicentennial Charter for
Older Americans expressing their rights and obligations.
The job market and the area of volunteer services
provide some of the best opportunities to draw on the
strengths and talents of older Americans. Unfortunately,
older, and even middle-aged workers, are too often the
victims of myth and prejudice regarding their capabilities.
Our society needs the know-how, experience, judgment and
eagerness to serve that these citizens bring to the job.
NOW, THEREFORE, I, GERALD R. FORD, President of the
United States of America, do hereby designate the month
of May, 1976, as Older Americans Month.
I urge all State and Area Agencies on Aging and
other private and public organizations that are related
to the field of aging to observe this month by arranging
public forums where the Bicentennial Charter for Older
Americans will be discussed and recommendations developed
for implementation.
I urge all organizations concerned with employment
to observe this month with ceremonies and programs de-
signed to increase employment opportunities for older
workers.
I urge all organizations engaged in the delivery of
services to persons in need to observe this month by in-
creased emphasis on efforts to recruit, train and place
older volunteers.
more
2
And I urge all Americans to observe this month by
focusing on the achievements of older persons and supporting
programs to make the last days of life the best days for
increasing numbers of our older Americans.
IN WITNESS WHEREOF, I have hereunto set my hand this
fifth
day of April in the year of our Lord
nineteen hundred seventy-six, and of the Independence of
the United States of America the two hundredth.
GERALD R. FORD
#####
FOR IMMEDIATE RELEASE
APRIL 5, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
OLDER AMERICANS MONTH, 1976
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
Among our Nation's most precious natural resources
are the collective wisdom, experience and abilities of
our older citizens.
In recent years we have become more aware of the
important contributions older Americans have made in the
past and in the tremendous potential they hold for the
future. We are increasing our efforts to ensure that
they have the opportunity for independent living through
security of income, maintenance of health and continued
useful involvement in the life of our Nation.
America's older citizens have earned the gratitude
and respect of our society, as well as our recognition
of their worth and dignity. In this spirit, the Federal
Council on Aging has prepared the Bicentennial Charter for
Older Americans expressing their rights and obligations.
The job market and the area of volunteer services
provide some of the best opportunities to draw on the
strengths and talents of older Americans. Unfortunately,
older, and even middle-aged workers, are too often the
victims of myth and prejudice regarding their capabilities.
Our society needs the know-how, experience, judgment and
eagerness to serve that these citizens bring to the job.
NOW, THEREFORE, I, GERALD R. FORD, President of the
United States of America, do hereby designate the month
of May, 1976, as Older Americans Month.
I urge all State and Area Agencies on Aging and
other private and public organizations that are related
to the field of aging to observe this month by arranging
public forums where the Bicentennial Charter for Older
Americans will be discussed and recommendations developed
for implementation.
I urge all organizations concerned with employment
to observe this month with ceremonies and programs de-
signed to increase employment opportunities for older
workers.
I urge all organizations engaged in the delivery of
services to persons in need to observe this month by in-
creased emphasis on efforts to recruit, train and place
older volunteers.
more
GERALD FORD LIBRARY
2
And I urge all Americans to observe this month by
focusing on the achievements of older persons and supporting
programs to make the last days of life the best days for
increasing numbers of our older Americans.
IN WITNESS WHEREOF, I have hereunto set my hand this
fifth
day of April in the year of our Lord
nineteen hundred seventy-six, and of the Independence of
the United States of America the two hundredth.
GERALD R. FORD
#####
FOR IMMEDIATE RELEASE
APRIL 5, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
OLDER AMERICANS MONTH, 1976
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
Among our Nation's most precious natural resources
are the collective wisdom, experience and abilities of
our older citizens.
In recent years we have become more aware of the
important contributions older Americans have made in the
past and in the tremendous potential they hold for the
future. We are increasing our efforts to ensure that
they have the opportunity for independent living through
security of income, maintenance of health and continued
useful involvement in the life of our Nation.
America's older citizens have earned the gratitude
and respect of our society, as well as our recognition
of their worth and dignity. In this spirit, the Federal
Council on Aging has prepared the Bicentennial Charter for
Older Americans expressing their rights and obligations.
The job market and the area of volunteer services
provide some of the best opportunities to draw on the
strengths and talents of older Americans. Unfortunately,
older, and even middle-aged workers, are too often the
victims of myth and prejudice regarding their capabilities.
Our society needs the know-how, experience, judgment and
eagerness to serve that these citizens bring to the job.
NOW, THEREFORE, I, GERALD R. FORD, President of the
United States of America, do hereby designate the month
of May, 1976, as Older Americans Month.
I urge all State and Area Agencies on Aging and
other private and public organizations that are related
to the field of aging to observe this month by arranging
public forums where the Bicentennial Charter for Older
Americans will be discussed and recommendations developed
for implementation.
I urge all organizations concerned with employment
to observe this month with ceremonies and programs de-
signed to increase employment opportunities for older
workers.
I urge all organizations engaged in the delivery of
services to persons in need to observe this month by in-
creased emphasis on efforts to recruit, train and place
older volunteers.
more
2
And I urge all Americans to observe this month by
focusing on the achievements of older persons and supporting
programs to make the last days of life the best days for
increasing numbers of our older Americans.
IN WITNESS WHEREOF, I have hereunto set my hand this
fifth
day of April in the year of our Lord
nineteen hundred seventy-six, and of the Independence of
the United States of America the two hundredth.
GERALD R. FORD
#####
THE WHITE HOUSE
WASHINGTON
April 2, 1976
SIGNING OF THE OLDER AMERICANS PROCLAMATION
Monday, April 5, 1976
3:00 p.m. (15 minutes)
The Oval Office
From: Jim Cannon
I. PURPOSE
To sign the Older Americans Proclamation designating
May as Older Americans Month.
II. BACKGROUND, PARTICIPANTS & PRESS PLAN
A. Background: Each year a proclamation is issued
designating May as Older Americans Month. This
year the proclamation discusses the importance
of employment and volunteer service for older
citizens and for society and the Bicentennial
Charter for Older Americans prepared by the
Federal Council on Aging. The Charter is an
update of the Charter for Senior Citizens
developed by the 1961 White House Conference
GERALD FORD LIBRARY
on Aging.
B. Participants: List attached at Tab A
C. Press Plan: Open Press Opportunity: to be announced
III. TALKING POINTS
1. It is especially fitting this year that we set aside
a period of time to honor our older citizens. Their
insight and experience, their wisdom and courage, has
contributed beyond measure to the development of our
200-year-old nation.
2. We must make it possible for older Americans to
continue their involvement in our national life.
One of the best ways we can draw upon their strengths
and skills is in the job and volunteer market. Too
often older, and even middle-aged, Americans are the
victims of myths and prejudices regarding their
capabilities. Americans must repudiate these myths
and prejudices, as we have repudiated others, and
- 2 -
assure older Americans the chance to prove that
time has only enhanced their demonstrated abilities.
3. It is important that our Nation make every effort
to recognize the worth and dignity of our older
citizens. To this end, the Federal Council on
Aging has prepared a Bicentennial Charter for
Older Americans. This Charter sets forth principles
to guide us in evaluating our nation's response to
the problems facing older persons, and in appreciating
their response to the problems now confronting our
nation.
4. One of these principles is the right to an adequate
standard of living in retirement. Let me reaffirm
that older Americans have earned the right to live
securely, comfortably and independently. As I
have said before, the value of our Social Security
system is beyond question. I will do all I can to
ensure the integrity of the trust fund so that future
generations of retirees may continue to rely on it.
5. With these thoughts and commitments in mind, I am
happy today to sign this annual proclamation desig-
nating May as Older Americans Month. I urge all
organizations concerned with employment and volunteer
services to observe this month with ceremonies,
activities and programs designed to increase oppor-
tunities for older persons. And I urge that such
programs include public forums for discussion of the
Bicentennial Charter for Older Americans.
6. I ask all Americans to join me in reflecting upon
the achievements and the needs of our older citizens.
BERALD FORD LIBRARD
PARTICIPANTS
Government
Secretary F. David Mathews
Stanley Thomas
Assistant Secretary for
Human Development
Department of Health, Education
and Welfare
Dr. Arthur Flemming
Commissioner of Aging
Department of Health, Education
and Welfare
Victor Hruska
Director, Older Americans
Volunteer Programs
ACTION
John Martin
Federal Council on Aging
Cleo Tavani
Executive Director
Federal Council on Aging
Associations
John F. McClelland
President
National Association of
Retired Federal Employees
Nelson Cruikshank
President
National Council of Senior Citizens
William Hutton
Executive Director
National Council of Senior Citizens
Joseph C. Davis
Grey Panthers
Austin Kerby
FORO i LIBRARY GERALD
Director of Economics
American Legion
- 2 -
Jack Ossofsky
Executive Director
National Council on the Aging
Mrs. Alice Van Landingham
President-Elect
American Association of Retired
Persons
Cy Brickfield
Counsel
American Association of Retired
Persons
Miss Harriet Miller
Executive Director
American Association of Retired
Persons
Mrs. Crettie Lee
National Center on Black Aged
Mrs. Mae B. Phillips
National Center on Black Aged
Fred Brummitt
Treasurer
National Retired Teachers
Association
Colonel Donald C. Foster
Executive Director
Retired Officers Association
Colonel Minter L. Wilson, Jr.
Director of Communications
Retired Officers Association
Arthur C. Clinkscales, III
Director
National Alliance for Senior Citizens
Others
LIBRURY GERALD ? FORD
Mr. and Mrs. James E. Mills
President Ford Committee
Z. D. Blackistone
Florist
Participants
Dr. Arthur Flemming
Commissioner of Aging
Department of Health, Education
D
and Welfare
Stanley Thomas
Assistant Secretary for
Human Development
Department of Health, Education
D
and Welfare
John F. McClelland
President
D
National Association of Retired
Federal Employees
Rucker-
Nelson Crulkshank
D
(
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President
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National Council of Seniro Citizens
Mr. William Hutton
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Executive Director
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National Council of Senior Citizens
Joseph C Davis
Grey Panthers 363-5765
Abrams
President
Mational Council on the Aging
11/22
Jack Ossofsky
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Executive Director
D
National Council on the Aging
Mrs. Alice Van Landingham
President-Elect
American Association of Retired
D
Persons
Fred Brummitt
Treasurer
0
National Retired Teachers Associations
Cy Brickfield
11 Counsel
American Association of Retired Persons
FORD is LIBRARY GERALD
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Colonel Donald C. Foster
12
Executive Director
331-1111
Retired Officers Association
Colonel Minter L. Wilson, Jr.
Director of Communications
13
Retired Officers Association
Arthur C. Clinkscales, III
338-5632
Director
14
National Alliance for Senior Citizens
15
Secretary F. David Mathews
16 John Martin
Federal Council n Aging
V
Agencies
Mrs. Crettie Lee
National Center on Black Aged
785-8766
Mrs Mae B. Phillips
Naitonal Center on Black Aged
Associations
Harriet Miller
Executive Director
American Association of Retired Persons
Austin Kerby
5,
Director of Economics
American Legion
Others
Victor Hruska
Director, Older Americans
Volunteer Programs
ACTION
Z. D. Blackistone
Florist
geber
FORD is LIBRARY GERALD
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Cleo Tavani
Exec Diver Fedl Council other on Agency
Mr. and Mrs. James E. Mills
Chrise
President Ford Committee
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(Boorstin)
April 2, 1976
FIRST DRAFT
TALKING POINTS: PROCLAMATION OF OLDER AMERICANS MONTH, 1976
It is especially fitting this year that we set aside
a period of time to honor our older citizens. Their insight
and experience, their wisdom and courage, has contributed
beyond measure to the development of our 200-year-old nation.
We must make it possible for older Americans to continue
their involvement in our national life. One of the best ways
we can draw upon their strengths and skills is in the job and
volunteer market. Too often older, and even middleaged,
Americans are the victims of myths and prejudices regarding
their capabilities. Americans must repudiate these myths
and prejudices, as we have repudiated others, and assure
older Americans the chance to prove that time has only enhanced
their demonstrated abilities.
GERALD FORD CIBRARY
It is important that our Nation make every effort to
recognize the worth and dignity of our older citizens. To this
end, the Federal Council on Aging has prepared a Bicentennial
Charter for Older Americans. This Charter sets forth principles
to guide us in evaluating our nation's response to the problems
-2-
facing older persons, and in
appreciating
their response
to the problems now confronting our nation.
One of these principles is the right to an adequate
standard of living in retirement. Let me reaffirm that older
Americans have earned the right to live securely, comfortably
and independently. As I have said before, the value of our
Social Security system is beyond question. I will do all I
can to ensure the integrity of the trust fund so that future
generations of retirees may continue to rely on it.
With these thoughts and commitments in mind, I am happy
today to sign this annual proclamation designating May as Older
Americans Month. I urge all organizations concerned with
employment and volunteer services to observe this month with
ceremonies, activities and programs designed to increase opportunities
for older persons. And I urge that such programs include public
forums for discussion of the Bicentennial Charter for Older
Americans.
FORD is LIBRARY GERALD
I ask all Americans to join me in reflecting upon the
achievements and the needs of our older citizens.
DRAFT
July graston
4/2/76
9.F W.W.
RE: Older Americans Month, 1976: A Proclamation
are
N.B. wisdom
Among our nation's most precious natural resources is the
experience
& ability
collective wisdom, experience, and productive ability of our
are
senior citizens.
among.
In recent years we have become more aware of the truly important
contributions older Americans have made in the past and in the
are increasing
better,
tremendous potential they hold for the future. We have begun
more
This is a
our efforts to ensure They have
direct,
negative
to make progress toward ensuring senior citizens of the opportunity
& shorter
statement,
suggesting
for security of income, maintenance of health, and continued ing use-
we have only
just started
fulness. and we are increasing these efforts.
kng" is more
to make any
on going tense;
progress; rather
rather than post tense,
than stating the
positive aspect
As they have expressed
recognized in
of increasing
We are recognizing their rights and our obligations to them through
It's my
efforts to
achieve a
the Bicentennial Charter for Older Americans prepared by the
That understanding This is
inaccurate,
goal.
Federal Council on Aging, we should express our
The Charter
sets forth. The
Rights and
Obligations of
America's senior citizens have earned the gratitude and respect Older Americans
of our society, and now we should afford them a future of pride
by providing opportunities for a meaningful and future. productive
meaningful future
and human dignity
This word suggests its a bont time we did something,
rather Than being a reminder of our continuing
obligation.
The thrust of
The Proclamation The job market and volunteer services provide some of the
how's
was that it was
opportunities for engaging
that
?
goody beneficial best outlets for the talents of older Americans. Unfortunately,
farthe Nation
BRARY
to utilize The older and even middle-aged worked are too often the victims of
resources of of our older citizens,
rather than simply it's a decent
Its good to do, not because its humane, but because
thing to give them some way
its better for everyone -
to have something to do.
-2-
myth and prejudice regarding their capabilities. Our society
needs the know-how, experience, judgment and eagerness these
solid citizens bring to the job.
3:
NOW, THEREFORE, I, GERALD F. FORD, President of
the United States of America, do horeby designate the
month of May, 1976, as Older Americans Month.
I urge all organizations conderned with employment
and volunteer service to observe this month with appro-
priate ceremonies, activities, and programs designed
to increase employment and volunteer opportunities for
older persons. Such programs should include public
forums for discussion of the Bicentennial Charter for
Older Americans.
I ask all Americans to reflect upon the achieve-
ments and the needs of our older citizens and to do all
in their power to make these years something to welcome.
IN WITNESS WHEREOF, I have hereunto set my hand
this
day of
,
in the year of our
Lord nineteen hundred seventy-six, and of the Independence
of the United States of America the two hundredth.
cc: Sarah Massengale
Jim Cavanaugh
Judy Johnston
fell -
older American
Month Proclamation,
1976
(Boorstin)
April 2, 1976
FIRST DRAFT
TALKING POINTS: PROCLAMATION OF OLDER AMERICANS MONTH, 1976
It is especially fitting this year that we set aside
a period of time to honor our older citizens. Their insight
and experience, their wisdom and courage, has contributed
beyond measure to the development of our 200-year-old nation.
2
We must make it possible for older Americans to continue
their involvement in our national life. One of the best ways
we can draw upon their strengths and skills is in the job and
volunteer market. Too often older, and even middleaged,
Americans are the victims of myths and prejudices regarding
their capabilities.
Americans must repudiate these myths
and prejudices, as we have repudiated others, and assure
older Americans the chance to prove that time has only enhanced
their demonstrated abilities.
FORD is GRANTO LIBRARY
It is important that our Nation make every effort to
3.
recognize the worth and dignity of our older citizens. To this
end, the Federal Council on Aging has prepared a Bicentennial
Charter for Older Americans. This Charter sets forth principles
to guide us in evaluating our nation's response to the problems
-2-
facing older persons, and in
appreciating
their response
to the problems now confronting our nation.
4.
One of these principles is the right to an adequate
standard of living in retirement. Let me reaffirm that older
Americans have earned the right to live securely, comfortably
and independently. As I have said before, the value of our
Social Security system is beyond question. I will do all I
can to ensure the integrity of the trust fund so that future
generations of retirees may continue to rely on it.
5.
With these thoughts and commitments in mind, I am happy
today to sign this annual proclamation designating May as Older
Americans Month. I urge all organizations concerned with
employment and volunteer services to observe this month with
ceremonies, activities and programs designed to increase opportunities
for older persons. And I urge that such programs include public
forums for discussion of the Bicentennial Charter for Older
Americans.
6.
I ask all Americans to join me in reflecting upon the
achievements and the needs of our older citizens.
In this 200th year of our independence it is appropriate
to set aside a period of time to honor our older citizens
who have contributed so much to the development of our nation.
They possess the insight, the experience, the wisdom and the
courage on which we must draw to deal constructively with
today's challenging and complicated issues.
We must make it possible for older persons to continue
to be involved in the life of our nation. One of the best
opportunities for using the strengths of older Americans is
in the job and volunteer market. Too often older, and even
middle-aged, persons are the victims of myths and prejudices
regarding their capabilities. There is no finer way of demon-
strating our respect for older persons than to assure them
the opportunity to prove that time has only enhanced their
demonstrated abilities.
It is also important that our nation, by its deed,
recognize the dignity and worth of our older citizens. The
Federal Council on Aging has prepared a Bicentennial Charter
for Older Americans. This Charter sets forth principles which
should be used as the basis for discussion and evaluation of
the responses of older persons and of our society to the
problems that confront us.
While affirming the right of older Americans to continue
to participate in the life of our nation, let me also affirm
that they have earned the right to live securely, comfortably
- 2 -
and independently. As I have said before, the value of the
Social Security system is beyond question. I will do all
I can to assure the integrity of the trust fund so that
older persons and future retirees may continue to rely on
it.
I am very pleased today to sign this annual proclamation
designating May as Older Americans Month. I urge all
organizations concerned with employment and volunteer service
to observe this month with ceremonies, activities and programs
designed to increase employment and volunteer opportunities
for older persons. And I urge that such programs include
public forums for discussion of the Bicentennial Charter for
Older Americans.
I ask all Americans to reflect upon the achievements and
the needs of our older citizens and to join me in doing all
in our power to make these years something to welcome.
Fleming draft
In this 200th year of our independence, it is important that our nation,
by its deeds, recognize the dignity and worth of our older citizens. They
have provided the strength which has made it possible for us to deal with
developments that threatened to undermine and destroy the form of government
bequeathed to us by our forefathers. They possess the insight, the vision,
the wisdom, and the courage on which we must draw if we are to deal
constructively with today's challenging and complex issues.
The Federal Council on Aging, created when the Older Americans Act was
amended in 1973, has prepared a new Bicentennial Charter for Older
Americans--an update of the Charter for Senior Citizens developed by the 1961
White House Conference on Aging. This Bicentennial Charter sets forth
principles which can be used to analyze and to evaluate our nation's response
to the problems that confront older persons and the response of older persons
to the problems now confronting our nation.
The Bicentennial Charter, for example, speaks to the "right to an
opportunity for employment free from discriminatory practices because of age"
and the "right to an opportunity to participate in the widest range of
meaningful civic, educational, recreational and cultural activities".
We must make it possible for older persons to continue to be involved
in the life of our nation. One of the best opportunities for capitalizing on
the strengths of older Americans is in the job market, where older, and
distantions
even middle-aged, persons are too often the victims of myths and stereotypes
about their capabilities. Likewise older persons are the victims of these
same and stereotypes in the recruitment of volunteers who oftentime
represent the difference between success and failure in the delivery of
services to those who are in need.
-2-
There is no finer way of demonstrating our respect for older persons
than to give them the opportunity of proving that time has only enhanced
their demonstrated abilities.
NOW, THEREFORE, I GERALD R. FORD, President of the United States of
America, do hereby designate the month of May, 1976, as Older Americans
Month.
1. I urge State and Area Agencies on Aging, organizations of older
persons and other private and public organizations that are
related to the field of aging to observe this month by
arranging for public forums where the Bicentennial Charter
for Older Americans will be discussed by older persons and
where older persons will develop recommendations for action,
addressed to both public and private bodies, designed to
implement the principles set forth in the Charter.
2. I urge all employer and employee organizations and other
organizations officially concerned with employment, both
public and private, to observe this month with appropriate
ceremonies, activities and programs designed to increase
employment opportunities for older workers.
3. I urge all organizations, both public and private, engaged
in the delivery of services to persons in need to observe
this month by placing increased emphasis on the utilization
of volunteers and by intensifying their efforts to recruit,
train and place older volunteers.
-3-
4. I urge all Americans to observe this month by focusing on
both the achievements and needs of older persons and by
resolving to support those programs in both the public and
private sector which, if implemented, will help to make the
last days of life the best days for increasing numbers of our
older Americans.
IN WITNESS WHEREOF, I have hereunto set my hand this
day
of
,
in the year of our Lord nineteen hundred seventy-six,
and of the Independence of the United States of America the two hundredth.
FORD in LIBRARY 938870
DRAFT
Smith
smassergale
4/2/76
220
RE: Older Americans Month, 1976: A Proclamation
Among our nation's most precious natural resources is the
collective wisdom, experience, and productive ability of our
senior citizens.
In recent years we have become more aware of the truly important
contributions older Americans have made in the past and in the
tremendous potential they hold for the future. We have begun
to make progress toward ensuring senior citizens of the opportunity
for security of income, maintenance of health and continued use-
fulness, and we are increasing these efforts.
We are recognizing their rights and our obligations to them through
the Bicentennial Charter for Older Americans prepared by the
Federal Council on Aging.
America's senior citizens have earned the gratitude and respect
of our society, and now we should afford them a future of pride
and human dignity.
The job market and volunteer services provide some of the
best outlets for the talents of older Americans. Unfortunately,
older and even middle-aged worked are too often the victims of
-2-
myth and prejudice regarding their capabilities. Our society
needs the know-how, experience, judgment and eagerness these
solid citizens bring to the job.
3.
NOW, THEREPORT, I, GERALD R. FORD, Provident of
the United States of America, do hereby designate the
month of May, 1976, as Older Americans Month.
I urge all organizations concerned with employment
and volunteer service to observe this month with appro-
priate ceremonies, activities, and programs designed
to increase employment and volunteer opportunities for
older persons. Such programs should include public
forums for discussion of the Bicentennial Charter for
Older Americans.
I ask all Americans to reflect upon the achieve-
ments and the needs of our older citizens and to do all
in their power to make these years something to welcome.
IN WITNESS WHEREOF, I have hereunto set my hand
this
day of
,
in the year of our
Lord nineteen hundred seventy-six, and of the Independence
of the United States of America the two hundredth.
CC: Sarah Massengale
Jim Cavanaugh
Judy Johnston
OLDER AMERICANS MONTH, 1976
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
The past few years have reminded us of the much
needed lesson that we must preserve our precious natural
resources. The collective wisdom, experience, and pro-
ductive abilities of our older citizens are among our
greatest natural resources.
We are becoming more aware of the importance of
the contributions our older workers have made in the
past. And we are increasing our efforts to ensure that
our older citizens have the opportunity for security
of income, maintenance of health, and continuing usefulness.
The Bicentennial Charter for Older Americans prepared
by the Federal Council on Aging Again describes those Rights
and Obligations.
Respect for our older citizens is important. The
opportunities we give them to take pride in themselves
is no less important.
The job market and volunteer service provide some
from
of the best opportunities for utilizing the resources
possessed by Older Americans. Unfortunately, older
and even middle-aged workers are too often the victims
of myths and prejudices regarding their capabilities.
Our society needs the know-how, experience, judgment,
and eagerness these solid citizens bring to the job.
FORD LIBRARY
2
NOW, THEREFORE, I, GERALD R. FORD, President of
the United States of America, do hereby designate the
month of May, 1976, as Older Americans Month.
I urge all organizations concerned with employment
and volunteer service to observe this month with appro-
priate ceremonies, activities, and programs designed
to increase employment and volunteer opportunities for
older persons. Such programs should include public
forums for discussion of the Bicentennial Charter for
Older Americans.
I ask all Americans to reflect upon the achieve-
ments and the needs of our older citizens and to do all
in their power to make these years something to welcome.
IN WITNESS WHEREOF, I have hereunto set my hand
this
day of
,
in the year of our
Lord nineteen hundred seventy-six, and of the Independence
of the United States of America the two hundredth.
OLDER AMERICANS MONTH, 1976
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
The past few years have reminded us of the much needed
lesson that we must preserve our previous natural resources.
The collective wisdom, experience, and productive abilities
of our older citizens is one of those greatest natural resources.
We are becoming more aware of the importance of the
contributions our older workers have made in the past. And we
are increasing our efforts to ensure that our older citizens
have the opportunity for security of income, maintenance of
health, and continuing usefulness.
Respect for our older citizens is important but the
opportunities we give them to take pride in themselves is no
less important. A very meaningful security is the knowledge,
and the opportunity to prove, that time has only enhanced their
demonstrated capabilities.
The Federal Council on Aging has prepared a new Bicentennial
Charter for Older Americans -- an update of the Charter for
Senior Citizens developed by the 1961 White House Conference
on Aging. This charter sets forth principles which can be used
to analyze and evaluate both our nation's response to the
problems confronting older persons and the response of older
persons to the problems confronting our nation.
One of the best opportunities for benefiting from the
GERALD FORD LIBRARY
- 2 -
resources possessed by Older Americans, as pointed out in the
Bicentennial Charter for Older Americans, is in the job market,
where older and even middle-aged, workers are too often the victims
of distortions and prejudices regarding their capabilities.
Similarly, older persons are too often the victims of the same
distortions and prejudices when they offer their invaluable
services to help those in need. Our economy needs the know-how,
experience, judgment, and eagerness which these solid citizens
bring to the job.
NOW, THEREFORE, I, GERALD R. FORD, President of the United
States of America, do hereby designate the month of May, 1976,
as Older Americans Month.
I urge all employer and employee organizations, and other
organizations officially concerned with employment to observe
this month with appropriate ceremonies, activities, and programs
designed to increase employment opportunities for older workers.
I urge all public and private organizations related to the
field of aging to observe this month by arranging for public
forums where older persons can discuss the Bicentennial Charter
for Older Americans and develop recommendations for action.
And I urge all public and private organizations engaged
in the delivery of services to persons in need to observe this
- 3 -
month with increased emphasis on the use of volunteers and
expecially with intensified efforts to recruit, train and place
older volunteers.
I ask all Americans to reflect upon the achievements and
the needs of our older citizens and to do all in their power to
make these years something to welcome, rather than dread. Most
of all, I ask that we begin this joint effort today.
IN WITNESS WHEREOF, I have hereunto set my hand this
day of
,
in the year of our Lord nineteen
hundred seventy-six, and of the Independence of the United
States of America the two hundredth.
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION
The past few years have reminded us of the much-
needed lesson that we must preserve our precious
natural resources. The collective wisdom, experience,
and productive abilities of our older citizens is one
of those greatest natural resources.
Increasingly, we have become more aware of the
contributions our older workers have made in the past.
We have increased our efforts to ensure that our older
citizens have the opportunity for maintenance of income
and health and for self-realization and continuing
usefulness.
While respect for our older citizens is important,
the opportunities we give them to take pride in them-
selves is more so. The most meaningful security is
the knowledge, and opportunity to prove, that time
has only enhanced their' demonstrated capabilities.
One of our best opportunities for capitalizing
on the resources possessed by Older Americans is in
the job market, where older, and even middle-aged,
workers are too often the victims of myths and stcreo-
types about their capabilities. Our vital economy
needs the knowhow, experience, judgment, and eagerness
which these solid citizens bring to the job.
2
NOW, THEREFORE, I, GERALD R. FORD, President
of the United States of America, do hereby designate
the month of May, 1976, as Older Americans Month.
I urge all employer and employee organizations,
and other organizations officially concerned with
employment to observe this month with appropriate
ceremonies, activities, and programs designed to
increase employment opportunities for older workers.
I ask all Americans to reflect upon the achieve-
ments and the needs of our older citizens and to do
all in their power to make these years something to
welcome, rather than dread. Most of all, I ask that
we begin this joint effort today.
IN WITNESS WHEREOF, I have hereunto set my hand
this
day of
in the year of our
Lord nineteen hundred seventy-six, and of the Inde-
pendence of the United States of America the two
hundredth.