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Aging - Federal Council on Aging (1)

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The original documents are located in Box 3, folder "Aging - Federal Council on Aging (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 Gerald R. Ford donated to the United States of America her copyrights in all of her husband's unpublished writings in National Archives collections.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 October 26 Sarah Massengale: per your request. file Velma Velma Shelton THE WHITE HOUSE WASHINGTON List of Attendees - Swearing In of Members of Federal Council on the Aging The Rose Garden, Thursday, October 21, 1976 Federal Council on the Aging The Honorable Dorothy L. Devereux The Honorable Frank B. Henderson Rev. Msgr. Charles J. Fahey The Honorable Harry Holland The Honorable John B. Martin The Honorable Nathaniel Winston, Jr. The Honorable Bernard E. Nash The Honorable Arthur Fleming Staff Cleonice Tavani Robert M. Foster F. Richard Williams FORD & LIBRARY GERALD Alice B. Freer Muriel Shurr Joan Catherine Ellerbusch Office of the Commissioner on the Aging Mr. Donald F. Reilly, Deputy Commissioner Mr. Decker Anstrom, Assistant to the Commissioner Ms. Mercia Decker Gene Handelsman Cernoria Johnson Donald Smith Gilbert Colon Veterans Administration X The Honorable Richard L. Roudebush, Administrator mr Donald Kendall, Special assistant Social Security Administration The Honorable James B. Cardwell, Commissioner HEW The Honorable Marjorie Lynch, Under Secretary Robert H. Carr John Guy Mille Mrs. Anita S. Williams Linda Meade William Ballenger Douglas J. Bielan Leslie Taylor Foster - 2 - HEW (Continued) Mrs. Helen N. Martin (wife of John Martin of FCOA) Mrs. Thelma A. Holland (wife of Harry Holland of FCOA) Mrs. Martha Casey Winston (wife of Nathaniel Winston, M.D., of FCOA) Mrs. Julia Vandalia Taft + Dr. Stanley B. Thomas, Jr., Assistant Secretary Justice The Honorable Harold R. Tyler, Jr., Deputy Attorney General HUD Robert G. Sykes Indian Health Service Dr. Meritt William Stark of Aberdeen, South Dakota Senate Hugh Branson, Senator Baker's Administrative Assistant Gary L. Burhop, Senator Brock's Administrative Assistant House Frances Light Curry, Congressman Quillen's Adm. Assistant Rita Marie DeCenzo, Congressman Rhodes' Adm. Assistant Supreme Court The Honorable John Paul Stevens, Associate Justice American Association of Homes for the Aged Rev. Msgr Charles Fahey is being sworn in. David Crowley Kevin Crowley Dennis Crowley Estelle C. Waters, Methodist Home Elfie D. Lesko, Methodist Home Doris Bangle, The Hermitage Bruce Pfeiffer, The Hermitage Rashey B. Moten, Catholic Charities Rev. Msgr. Laurance J. Corcoran, Catholic Charities Carol D. Hiett, Catholic Charities William P. Harris, Baptist Home of D. C. Roger L. Stewart, Baptist Home of D. C. William D. Hughes Kathleen Wilson Marguerite Tierney June B. Owens, Friendship Terrace Norman L. Owens, Friendship Terrace Administrator Gertrude L. McCracken, Presbyterian Home of D. C. Irene B. Gitchel, Presbyterian Home of D. C. - 3 - American Association of Homes for the Aged (Continued) Lawrence F. Lane Richard D. Reichard, National Lutheran Home for the Aged Melba Reichard, National Lutheran Home for the Aged Lula W. Hottel, Episcopal Church Home Garland K. Lewis, Episcopal Church Home Marjorie Lee Tivol Bettye J. Collins Linda Ann Kovach Thomas E. Herrmann Leslie Levich Knight Sue Elkins Anna Christina Nelson Alison Brock Owings Lois Wasser David R. Matlack, Executive Director, Washington Home for the Mary Hoyt Joyce, Wash. Home for the Incurables Incurables Charles P. Moncure, Goodwin House James K. Meharg, Jr., Goodwin House Mary Osada, Goodwin House Erica E. T. Kearse, Goodwin House Gale V. Adams, Goodwin House National Council on the Aging Mother M. Bernadette de Lourdes, President National Council of Senior Citizens Paul Schuler Genevieve Johnson Walter A. Jones National Institute on the Aging Dr. Robert Butler National Center on the Blacked Aged Dr. Delores Davis Marlene Johnson Elizabeth Brooks George Sherman Sara Kresenbaum Donald Wong Sonya Reed American Association of Retired Persons Peter W. Hughes, Director of Legislation Mrs. Prestonia W. Morgan Dr. Clayton D. Hutchins Dr. Frederick J. Ferris Mrs. Betsy W. Messer - 3 - American Association of Retired Persons (Continued) Mr. Ernest Giddings Mr. Clayton A. Seeber Mrs. Carolyn Capizola Ms. Jewell M. Reagan Institute of Gerontology Dr. Clavin Fields, President Lois Powell Phillis Robinson Barbara Newsome Rita Williams Ola Jackson Dr. Kunio Oota, of Tokyo Gerontology Institute Gerontological Society Jacqueline Robinson Stephanie Tames Carolyn Graves Rose Closter Gladys Romero Thomas Byerts Katie Byerts John Cook Rith Dee Carol Schutz Patricia Carter Lee Broder National Council of Sr. Citizens Rudolph T. Danstedt, Assistant to the President Alvin Rucker, Assistant to the Executive Director No Greater Love Ms. Carmela LaSpada Mrs. Betty Williams FORD & LIBRARY OERALD Mrs. Edith Bradley Mr. an d Mrs. Herb Jackobs Other Invited Guests Mr. Zacharia D. Blackistone, Blackistone Florists, Wash, D.C. Mr. Charles Fenwick, accompanying Mr. Blackistone Mr. Milton Kronheim, Milton S. Kronheim & Co., Inc., Wash, D.C. Colonel William B. Williams, USAF (Ret) Gwendoline M. Taylor Arthur Dufresne of the New England Regional Commission - 4 - Joseph E. Aldridge, Jackson Mississippi Margaret S. Alexander, Wash, D. C. Eunice M. Anderson, Sioux Falls, S.D. Margaret Arnold, Wash, D. C. Ed Doulin, Hot Springs, Arkansas Robert Bidlack, Indianapolis, Indiana Guy Brown, Chillicothe, Ohio Kay Valery, Mt. Hermon, Calif. Margaret R. Colarusso, Philadelphia, Pa. Cecil L. Cannon, Atlanta, Georgia Nettie Farris Cannon, Atlanta, Georgia Lyal Holmberg Dudley, Topeka, Kansas Flo Burke Eley, Fairfax, Virginia William H. Emory, Jr., Richmond, Va. Thomas M. Glass, Buffalo, New York Thomas M. Gioia, St. Louis, Missouri Sylvia Hermann, Bethesda, Md. David Hurst, Hot Springs, Arkansas Lillian S. Hurst, Hot Springs, Arkansas Thomas J. McDermott, Philadelphia, Pa. Emily Bell McNally, Atlanta, Georgia Joseph L. McQuade, Oak Hill, West Virginia Marian McQuade, Oak Hill, West Virginia Frank Milner, Washington, D. C. Desiree Mittelstaedt, Ridgewood, New Jersey Elly Peterson, Washington, D. C. Maria Redo, New York City Tom Ruffin, Arlington, Va. Cecile Reeves, McLean, Virginia Caroline K. Simon, New York City Margaret Taylor, Washington, D. C. Charles Trout, Roscommon, Michigan Rebecca M. Trout, Roscommon, Michigan Frank J. Troy, Toledo, Ohio Harold Trupp, Waterloo, Iowa Bernard S. VanRensselaer, Washington, D. C. Suzy E. F. Yazbeck, Suitland, Maryland Estelle Zapanta, Monteray Park, Calif. Robert D. Blue, Eagle Grove, Iowa Harry P. Cain, Miami Lakes, Florida Roy A. Davidson, Alexandria, Va. Janet L. Goeske, Riverside, California Ladd H. Plumley, Worchester, Mass. Anita Ramirez, Los Angeles, Calif. Jessy Sullivan, Sapulpa, Okla. Julia N. Jelowtski, Cambridge, Mass. National Association of Retired Federal Employees Mr. John McClelland, President - 5 - Senate Committee on Aging David A. Affeldt William E. Oriol Patricia G. Oriol Brice Henderson, Adm. Asst to Senator Scott Others in Attendance Gwendolyn S. Fortune of the Federal Council on Aging Staff Dr. Virginia Trotter, Assistant Secretary of HEW Mr. Joseph Hunt safo THE WHITE HOUSE WASHINGTON October 20, 1976 SWEARING IN CEREMONY FOR SIX NEW MEMBERS OF THE FEDERAL COUNCIL ON THE AGING Thursday, October 21, 1976 11:00 - 11:15 a.m. (15 minutes) The Rose Garden East Room From: William J. Baroody, Jr. Milton E. Mitler I. PURPOSE To swear in six new members of the Federal Council on the Aging who have been recently confirmed by the Senate, and to briefly discuss major issues concerning the aging citizens. II. BACKGROUND, PARTICIPANTS AND PRESS PLAN A. Background: 1. The Federal Council on the Aging was established by Public Law 93-29, May 3, 1973. It is composed of fifteen members appointed by the President with the advice and consent of the Senate for terms of three years. At least five of the members must be older persons. The current membership includes nine who are older persons. The Secretary of HEW and the Commissioner on Aging serve as ex-officio members of the Council. The Council officially got underway with Senate approval on June 5, 1974 of the fourteen persons nominated by President Nixon on March 27, 1974. A fifteenth member has been added to complete the number called for by Public Law. - 2 - 2. The Council is commissioned to advise and assist the President on matters relating to the special needs of older Americans; to assist the Commissioner on Aging in making an appraisal of the Nation's existing and future personnel needs in the field of aging; to review and evaluate the impact of Federal policies regarding the aging; to serve as a spokesman on behalf of older Americans by making recommendations to the President, to the Secretary of HEW, to the Commissioner on Aging, and to the Congress with respect to Federal policy and programs regarding the aging; to inform the public about the problems and needs of the aging; and to provide public forums for discussing and publicizing the problems and needs of the aging. 3. The Federal Council on the Aging budget for FY 1976 of $500, 000 was provided as a separate line item for the first time this year. In previous years their budget has been provided as a part of the Administration on Aging budget. The President's FY 1977 budget proposes the same level of funding. 4. The Council meets at the call of the Chairman, but not less than four times a year. As directed by the Congress the Council has undertaken three specific studies: (1) A study on State formulae for funding programs under the Older Americans Act; (2) a study on the interrelationships of benefit programs for the elderly operated by Federal, State and local government agencies; and (3) a study of the combined impact of all taxes on the elderly. 5. The Council urges legislative action to develop high standards of safety and care in nursing homes. They have expressed to the President their concern about the financial burden on the elderly, citing particularly the additional costs in relation to Medicare, Medicaid and food stamps. 6. Other specific projects of the Federal Council on the Aging are a study on the special problems of the older woman; a study of asset tests and the treatment of income from asset as a condition of eligibility for Federal benefit programs for the elderly; health manpower needs for services to older Americans; follow up to recommendations of the White House Conference on Aging; Medicare and Medicaid changes - including home health care; mandatory retire- ment; and the progress of pension reform. - 3 - 7. The President last met with this Council on May 15, 1975, in The Roosevelt Room. 8. Of the six members to be sworn in, three will be reappointed, two will be new appointees to replace members whose terms expired on June 5, 1976, and one will be a new appointee vice a member who has resigned. A brief biographical sketch for each new member is attached. The Honorable Bertha S. Atkins who has served as Chairman of the Council since 1974 is being reappointed, but will not be able to attend this swearing in ceremony because of a commitment which she made some time ago and which she is unable to adjust. The Honorable John B. Martin (Reappointment) The Honorable Dorothy L. Devereux (Reappointment) Mr. Harry Holland (New appointee) Nathaniel Winston, M.D. (New appointee) Monsignor Charles J. Fahey (New appointee vice Charles J. Turrisi who has resigned) B. Participants: A list is attached. C. Press Plan: Full Press III. TALKING POINTS - To be provided by Bob Orben's office. Federal Council on the Aging BIOGRAPHY Name: ADKINS, Bertha S. (Miss) born: 8-24-06, Salisbury, Maryland Home Address: Business Address: P.O. Box 396 (Retired) Oxford, Maryland 21654 Bertha Adkins, who was appointed Chairman of the Federal Council on the Aging by the President and has been a member of the Federal Council since June 1974. Miss Adkins was Under Secretary of Health, Education, and Welfare in 1958-61 during the Eisenhower Administration. During that time, she was the key departmental official involved in planning the 1961 White House Conference on Aging. She has just completed service as a Vice Chairman of the 1971 White House Conference on Aging and was Executive Vice Chairman of the Advisory Committee on Older Americans until it was super- ceded by legislation establishing the Federal Council on the Aging. Miss Adkins has a bachelor's degree from Wellesley College in Massachu- setts and a M.A. from Columbia University. She also has several honorary doctoral degrees. She was Dean of Women in Western Maryland College and Dean of Residence at Bradford Junior College in Massachusetts before coming to Washington in 1950 as Executive Director of the Women's Division of the Republican National Committee. In 1959, she was United States delegate to the United Nations Seminar on the Participation of Women in Public Life, held in Bogota, Colombia. The same year she made an official trip to Poland under auspices of the Inter- national Education Exchange Program of the Department of State. She also served on the Defense Advisory Committee for Women in the Service for the Defense Department. When Miss Adkins left HEW in 1961 she became Headmistress of the Foxcroft School in Middleburg. Virginia, She retired in 1967 to her home in Oxford, Maryland. She is a member of the Talbot County Commission on Aging and is Chairman of the Talbot County Chapter of the American Red Cross. She also has been a member of the Advisory Board to the Social Security Administration. 10-18-76 Federal Council on the Aging BIOGRAPHY Name: DEVEREUX, Dorothy L. (Mrs.) born: 11-8-11, Spokane, Washington (h. John William Devereux, d.) Home Address: 2721 Huapala Street Honolulu, Hawaii 96822 Dorothy Devereux was appointed to the Federal Council on the Aging in June 1974. She is a member of the Council Committee on Aging Research and Manpower. Mrs. Devereux was a registered nurse who practiced her profession prior to and for one year following marriage to physician John Devereux. She had received her R.N. from California Lutheran School of Nursing in 1931 and did post graduate work at Chicago Lying-In Hospital. Settling in Hawaii, Mrs. Devereux then embarked on virtually too full-time careers of rearing four children and continuous service as a volunteer with groups concerned about education, youth, health, the handicapped and aging. She has been: President of the Hawaii Congress of Parents and Teachers, President of the Oahu Health Council, President of the Oahu Society for Crippled Children and Adults, President of the Women's Auxiliary to the Hawaii Medical Association and Chairman of the Steering Committee for Hawaii's first Conference on Aging in 1954. She was a member of the House of Representatives of the Territory of Hawaii in 1958 and then continued in that body after statehood had been achieved until 1972. She is presently: Chairman, Review Committee of the Hawaii State Compre- hensive Health Planning Advisory Council, member, Board of the Health and Community Services Council, member, Governor's Task Force on Planning for Implementation of P.L. 93-641, member, Women's Committee, President's Committee on Employment of the Handicapped, the Governor's Committee on Employment of the Handicapped, Hawaii Mental Health Association, the Salvation Army Advisory Board, and a member, the Salvation Army Children's Facilities Advisory Council. FORD LIBRARY & GERALD 4-7-76 Federal Council on the Aging BIOGRAPHY Name: FAHEY, Charles J. (Rev. Msgr.) born: 4-13-33, Baltimore, Md. Home Address: Business Address: 672 W. Onondaga Street Director Syracuse, New York 13204 Catholic Charities of Diocese of Syracuse 240 E. Onondaga Street Syracuse, New York 13202 Charles Fahey has been a member of the Federal Council on the Aging since June 1974. He is a member of the Council Committee on Senior Services and was recently appointed Chairman of a special FCA Task Force on Services to the Frail Elderly. Monsignor Fahey is both a priest and a social worker and has been involved in some aspect of service to the elderly for most of his priestly and professional life. He is currently Director of Catholic Charities for the Roman Catholic Diocese of Syracuse with responsibility for a variety of aging programs such as the development of residential and nursing home facilities, and social, nutuitional and recreational programs in 160 parishes. Monsignor Fahey served in several different posts in connection with the 1971 White House Conference on Aging including chairmanship of the Special Section on Long Term Care. He is President of the American Associa- tion of Homes for the Aging. In 1972, he was awarded that organization's National Award of Honor. He was ordained in February 1959 and named an honorary prelate in December 1971. He received a Master's degree in Social Work from the Catholic University of America in 1963. In addition to his major work assignments with Catholic Charities, Msgr. Fahey has been very active with a wide range of local, state and national health, social welfare and religious organizations. He was Chairman of the Commission on Aging of the National Conference of Catholic Charities in 1967-72 and continues to serve as a member. Also on the national level, he is a member of the National Council on the Aging, the Gerontological Society and the Academy of Certified Social Work of the National Association of Social Workers. He is presently Chairman of the New York State Council of Catholic Chari- ties Directors, member of the Board of his area's Comprehensive Health Planning Agency, and a member of the Board of the United Way of Onondaga County along with many other affiliations. 10-18-76 Federal Council on the Aging BIOGRAPHY Name: HOLLAND, Harry born: 4-25-04, Marion, Ill Home Address: Business Address: 3626 North 5th Avenue Retired Apt. A-1 Phoenix, Arizona 85013 Harry Holland retired in January 1973 as District Manager of the Social Security Administration in Phoenix, Arizona after more than 36 years of service with the Administration from its inception. Mr. Holland is Chairman of the Consulting Panel on Aging to the Area Agency on Aging and Chairman of a Task Force on Retirement and Aging established by Governor Raul Castro. Previously, he served on the Ad- visory Council of the predecessor of the Department of Economic Security under every Governor since the Council was established by Governor McFarland. For many years, he has been active in the Arizona Council for Senior Citizens and was the group's President in 1965. He is the immediate Past President of the Arizona Council for Senior Citizens. Mr. Holland has a degree in public administration from the University of Virginia, a field in which he continued with graduate work at Col- umbia University. In the late Forties, Mr. Holland was invited to participate in the Con- ference on Aging which was the precurser of the White House Conferences. This conference, the first of its kind, was called by President Harry Truman and directed by Oscar Ewing. He also served on the staff of the White House Conferences on Aging in 1961 and 1971. In the course of his Federal career, Mr. Holland received many honors and awards. He received the Director's Citation, the highest award of the Social Security Administration, in 1958. In 1963, Dr. Ethel Percy Andrus presented him with a citation for excellence in service to the American Association of Retired Persons/National Retired Teachers Asso- ciation. In 1972, he was the recipient of the Department of Health, Education, and Welfare's Superior Service Award and the American Society of Public Administration's Distinguished Service Award. He also has a long record of service to the Boy Scouts. While he was living in Tucson, he was President of the Catalina Council and received the Silver Beaver Award. FORD LIBRARY 2/12/76 Federal Council on the Aging BIOGRAPHY Name: MARTIN, John B. (Mr.) born: 10-3-09, Grand Rapids, Mich. Home Address: Business Address: 7607 Glendale Road Special Consultant Chevy Chase, Maryland 20015 American Association of Retired Persons National Retired Teachers Association 1909 K Street, N.W. Washington, D. C. 20006 John Martin has been a member of the Federal Council on the Aging since June 1974. He is Chairman of the Council Committee on Senior Services. Mr. Martin was appointed by President Nixon as U.S. Commissioner on Aging May 28, 1969 and as Special Assistant to the President for the Aging on June 24, 1969. He served in these position until March 1973 and is now a Special Consultant to the American Association of Retired Persons - National Retired Teachers Association. He was educated at Dartmouth, A.B., in 1931; Oxford, as a Rhodes Scholar, B, Litt., 1933; and the University of Michigan Law School, J.D., 1936. Mr. Martin has been interested and active in the field of aging for many years. He served as Vice-Chairman of the Michigan Commission on Aging from 1960 to May 1963, and as Chairman from May 1963 to March 1967, In 1959-1960, he was the Chairman of the Grand Rapids Coordinating Council on Aging. He served as a member of the National Planning Advisory Com- mittee for the White House Conference on the Aging, held in January of 1961. Mr. Martin served as legal secretary to the Chairman of the Securities and Exchange Commission in 1936, and as Deputy Chief of the Ohio State Division of Securities in 1941. He helped to organize and served as Deputy Director, U.S. Office of Civilian Defense, 1942-1944. In 1944, he was commissioned in the USNR, served in Europe and was discharged with the rank of Lieutenant Commander in 1946. After the War, he served as a member of the United States Prosecutor's staff at the Nuremberg War Trials. In 1948, he was elected to the Michigan State Senate from Grand Rapids, and in 1950 was elected State Auditor General, serving until 1954. Mr. Martin was elected Republican National Committeeman for Michigan in 1957, and again in 1960 and 1964. He served as delegate, and as Chairman of the Committee on the Executive Branch, in the 1961-62 Michigan Consti- tutional Convention. 10-18-76 Federal Council on the Aging BIOGRAPHY Name: WINSTON, Nathaniel T., Jr. (Dr.) born: 10-15-27, Johnson City, Tenn. Home Address: Business Address: 2106 Chickering Lane Vice President Nashville, Tennessee 37215 Hospital Affiliates Internat'l., Inc. 4525 Harding Road Nashville, Tennessee 37203 Nathaniel (Nat) T. Winston, Jr. is a psychiatrist currently serving as Vice President in charge of Professional Relations for Hospital Affiliates, Inc. of Nashville, Tennessee. As Commissioner of Mental Health in Tennessee from 1965 to 1969 he showed particular concern about the problems of the aging. He es- tablished separate and special programs for the aging in the three large state psychiatric facilities under his jurisdiction. He served his entire time as Commissioner on the Governor's Commission on Aging Panel for the State of Tennessee. Dr. Winston entered the armed services late in 1944 and served in the infantry in the Pacific theater before' returning to Vanderbilt University in 1947. Upon graduation he was elected Phi Beta Kappa and went on to complete medical school at Vanderbilt. In 1958, he began private practice in his home town of Johnson City serving also as the first director of the Johnson City Mental Health Clinic. In 1960, he was appointed the first superintendent of Moccasin Bend Psychiatric Hospi- tal in Chattanooga. The National Red Cross magazine indicated the hospital had brought about a "quiet revolution in the treatment of the mentally ill". Dr. Winston has been active in the volunteer senior citizens program through- out Tennessee. He was instrumental in obtaining Federal grants for a number of programs and facilities for the elderly. In 1969, he was selected as the out- standing citizen of Nashville by the Nashville JayCees. In 1970, Dr. Winston served as the state campaign chairman for the successful senatorial race of Senator Bill Brock. In 1972, he was the national chairman of the Country and Western stars for the re-election of the President. In 1974, he was unsuccessful candidate for the Governorship of Tennessee running on the Republican ticket. GERALD FORD LIBRARY 10-18-76 MEMBERS OF THE FEDERAL COUNCIL ON THE AGING TO BE SWORN IN - The Honorable Bertha S. Adkins, of Oxford Maryland. Former Under Secretary of HEW. Has served as Chairman of the Council since 1974. To be reappointed. The Honorable John B. Martin, of Chevy Chase, Maryland. Former Commissioner on the Aging. Special Consultant to the American Association of Retired Persons and the National Retired Teachers Association. Has served for 2 years - to be reappointed. The Honorable Dorothy L. Devereux, of Honolulu, Hawaii. Former member of the Hawaii State House of Representatives. Has served for 2 years - to be reappointed. Mr. Harry Holland, of Phoenix, Arizona. Retired Director of Social Security for Arizona. Active in Senior Citizens' activities in Arizona. Sponsored by Congressman Rhodes. New appointee. Nathaniel Winston, MD, of Nashville, Tennessee. Sponsored by Senators Baker and Brock. New appointee. Monsignor Charles J. Fahey, of Syracuse, New York. President of the American Association of Homes for the Aging. New appointee, vice Charles J. Turrisi who has resigned. OTHER MEMBERS The Honorable Frank B. Henderson, of Worthington, Pennsylvania. Director, Nutrition Services, Armstrong County Community Action Agency. The Honorable Frell M. Owl, of Cherokee, North Carolina. Retired from Bureau of Indian Affairs. Member of the Indian Advisory Council of the U. S. Senate Special Committee on Aging. The Honorable Lennie-Marie P. Tolliver, of Oklahoma City, Oklahoma. Professor and Associate Director, School of Social Work, the University of Oklahoma. The Honorable Selden G. Hill, of Orlando, Florida. Member of the Advisory Board of the Florida State Division on Aging. He was Assistant Director of the War Manpower Commission of the U. S. Civil Service Commission. - 2 - The Honorable Nelson H. Cruikshank, of the District of Columbia. President, National Council of Senior Citizens. Former Director of Department of Social Security, AFL-CIO. The Honorable Sharon M. Fukii, of Santa Monica, California. Vice President of Gerontological Planning Associates. The Honorable Hobart C. Jackson, of Philadelphia, Pennsylvania, Executive Vice President, Stephen Smith Geriatric Center and Administrator of the Stephen Smith Home for the Aged. Mr. Jackson was the founder of the Caucus of the Black Aged and presently serves as Chairman. The Honorable Garson Meyer, of Rochester, New York, former Chief Chemist, Eastman Kodak and the President Emeritus of the National Council on the Aging. The Honorable Bernard E. Nash, of Camp Springs, Maryland. Executive Director for the National Retired Teachers Association and the American Association of Retired Persons. FEDERAL COUNCIL ON THE AGING SWEARING-IN CEREMONY THURSDAY, OCTOBER 21, 1976 FORD & LIBRARY GERALD -1- LET ME WELCOME YOU TO THE WHITE HOUSE THIS MORNING FOR THE SWEARING INTO OFFICE OF FIVE MEMBERS OF THE FEDERAL COUNCIL ON THE AGING. THE SIXTH MEMBER, THE HONORABLE BERTHA ADKINS, WHO IS ALSO THE CHAIRPERSON OF THE COUNCIL, IS BEING SWORN IN AT THIS TIME IN AUGUSTA, MAINE, WHERE SHE IS ADDRESSING GOVERNOR JIM LONGLEY'S CONFERENCE ON AGING. -2- IN THE TWO YEARS SINCE ITS FORMATION -- THE COUNCIL HAS MADE SUBSTANTIAL CONTRIBUTIONS TO THE WELL-BEING OF OLDER AMERICANS -- PARTICULARLY IN MAKING RECOMMENDATIONS DESIGNED TO IMPROVE TAX POLICY AND COORDINATE BENEFIT PROGRAMS FOR OLDER PERSONS® -3- EARLIER THIS YEAR, I HAD THE OPPORTUNITY TO CALL TO THE ATTENTION OF ALL AMERICANS -- ONE OF THE COUNCIL'S MOST SIGNIFICANT ACHIEVEMENTS -- THE BICENTENNIAL CHARTER FOR OLDER AMERICANS® THE CHARTER IS A "BILL OF RIGHTS" FOR AMERICA'S SENIOR CITIZENS -- A TESTAMENT OF OUR NATION'S HEARTFELT CONCERN FOR OUR OLDER CITIZENS® -4- IT HAS BEEN SAID THAT HISTORY JUDGES A SOCIETY ON HOW WELL IT CARES FOR ITS OLDER PEOPLE IN AMERICA -- IN RECENT YEARS, THE FEDERAL COUNCIL ON THE AGING HAS LED THE WAY TO A RECORD OF SOLID PROGRESS IN HELPING MANY OF OUR OLDER CITIZENS LEAD INDEPENDENT, SATISFYING AND HEALTHY LIVES -5- SINCE THE 1971 WHITE HOUSE CONFERENCE ON AGING FIRST FOCUSED NATIONAL ATTENTION ON THE PROBLEMS AND CONCERNS OF OLDER AMERICANS: -- SOCIAL SECURITY BENEFITS HAVE RISEN BY 50 PERCENT -6- -- A NEW NATIONAL NETWORK OF STATE AND AREA AGENCIES ON AGING HAS BEEN ESTABLISHED -- NUTRITION PROJECTS FOR THE ELDERLY HAVE BEEN ESTABLISHED AND ARE NOW SERVING OVER 300 THOUSAND HOT MEALS A DAY -- SPECIAL HOUS ING PROGRAMS FOR OLDER AMERICANS HAVE ALSO BEEN SET UP * -7- IN ADDITION, I WILL SIGN A BILL WHICH GUARANTEES THAT THE DESERVING AGED, BLIND, AND DISABLED RECIPIENTS OF SUPPLEMENTAL SECURITY INCOME BENEFITS WILL RECEIVE ANNUAL COST-OF-LIVING INCREASES FROM THE FEDERAL GOVERNMENT® THIS IS A VERY IMPORTANT CHANGE WHICH CORRECTS A SERIOUS DEFICIENCY IN CURRENT LAW. -8- I MIGHT ADD THAT THIS CHANGE WAS RECOMMENDED NEARLY A YEAR AGO BY THE COUNCIL. THIS IS A GOOD START; BUT, OUR EFFORTS IN BEHALF OF OLDER AMERICANS HAVE ONLY BEGUN. OUR FIRST PRIORITY MUST BE TO PROTECT THE RETIREMENT INCOME OF OLDER AMERICANS® -9- INFLATION -- WHICH HITS THOSE ON FIXED INCOMES HARDEST -- IS THE FOREMOST THREAT TO THE STABILITY AND VALUE OF RETIREMENT INCOME® WE HAVE CUT INFLATION IN HALF BUT, IF OUR OLDER CITIZENS ARE TO FULLY ENJOY THEIR LATER YEARS -- IT MUST BE CUT FURTHER -- AND IT WILL BE! -10- WE MUST STRENGTHEN THE FINANCIAL UNDERPINNINGS OF THE SOCIAL SECURITY SYSTEM CONGRESS ADJOURNED WITHOUT ACTING UPON MY PROPOSALS TO ENSURE THE FISCAL INTEGRITY OF THE SYSTEM I WILL URGE THE NEW CONGRESS TO MAKE THIS ITS FIRST ORDER OF BUSINESS® -10A- I WILL ALSO URGE THE NEW CONGRESS TO ENACT MY PROPOSAL OF EARLY THIS YEAR TO PROVIDE OLDER AMERICANS WITH PROTECTION AGAINST THE DEVASTATING FINANCIAL EFFECTS OF EXTENDED ILLNESS® -11- ANOTHER AREA OF GREAT CONCERN TO OLDER AMERICANS IS THE SPECIAL THREAT TO THEIR WELL-BEING POSED BY CRIME® OUR OLDER CITIZENS HAVE EARNED THE RIGHT TO LIVE SECURELY AND TO WALK THE STREETS WITHOUT FEAR. THAT IS WHY I WAS PARTICULARLY GRATIFIED BY A PROVISION IN THE CRIME CONTROL ACT WHICH I RECENTLY SIGNED -12- THIS NEW PROVISION REQUIRES THAT STATE CRIME CONTROL PLANS DEAL SPECIFICALLY AND FIRMLY WITH THE CRIMINAL ATTACKS WHICH ARE MADE AGAINST OUR SENIOR CITIZENS® -13- ALL AMERICANS CAN COUNT ON MY ADMINISTRATION AND THE FEDERAL COUNCIL ON THE AGING TO CONTINUE TO SEE THAT THESE AND THE MANY OTHER ISSUES WHICH PARTICULARLY CONCERN OUR OLDER CITIZENS ARE MET HEAD ON -14- I LOOK FORWARD WITH GREAT CONFIDENCE TO THE LEADERSHIP MISS ADKINS, MR. MARTIN, MONSIGNOR FAHEY (Fay-hee), MR. WINSTON, MRS. DEVERAUX (Dehver-row), AND MR. HOLLAND -- WILL PROVIDE IN THE YEARS TO COME. -15- AND NOW, JUSTICE STEWART, WILL YOU PLEASE SWEAR IN THESE DISTINGUISHED MEMBERS OF THE FEDERAL COUNCIL ON THE AGING. END OF TEXT FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 THESE ARE THE MAIN PROJECTS OF F.C.A. IN ORDER OF IMPORTANCE OTHER THAN THOSE REQUIRED IN THE OLDER AMERICAN ACT. ALSO, A BIO ON MISS ADKINS WHO WILL BE GIVING THE KEYNOTE ADDRESS AT THE GOVERNORS CONF. IN AGUSTA, MAINE AT 11A. M. ON THURS OCT 21. L. A study of asset tests and the treatment of income from assets as a condition of eligibility for federal benefit programs for the elderly. 2. Health Manpower needs for services to older Americans. 3.Follow up to recommendations of the White House Conference on Aging. 4.Special problems of older women. 5.Medicare and Medicaid changes (including home health care). 6.Mandatory Retirement. 7.Progress of pension reform. NOTE: Sara, at this point we are part in one building and part in another due to our move. Sorry, this not in better form. It would be good for the record, I think, if the President could mention why Miss Adkins is not present. RW. Dick Williams FORD LIBRARY & GERALD Federal Council on the Aging BIOGRAPHY Name: ADKINS, Bertha S. (Miss) born: 8-24-06, Salisbury, Maryland Home Address: Business Address: P.O. Box 396 (Retired) Oxford, Maryland 21654 Bertha Adkins, who was appointed Chairman of the Federal Council on the Aging by the President, is serving a one-year term on the FCA to June 5, 1975. Reapposibled chamine OTH, 1976 Miss Adkins was Under Secretary of Health, Education, and Welfare in 1958-61 during the Eisenhower Administration. During that time, she was the key departmental official involved in planning the 1961 White House Conference on Aging. She has just completed service as a Vice Chairman of the 1971 White House Conference on Aging and was Executive Vice Chairman of the Advisory Committee on Older Americans until it was super- ceded by legislation establishing the Federal Council on the Aging. Miss Adkins has a bachelor's degree from Wellesley College in Massachu- setts and a M.A. from Columbia University. She also has several honorary doctoral degrees. She was Dean of Women in Western Maryland College and Dean of Residence at Bradford Junior College in Massachusetts before coming to Washington in 1950 as Executive Director of the Women's Division of the Republican National Committee. In 1959, she was United States delegate to the United Nations Seminar on the Participation of Women in Public Life, held in Bogota, Colombia. The same year she made an official trip to Poland under auspices of the Inter- national Education Exchange Program of the Department of State. She also served on the Defense Advisory Committee for Women in the Service for the Defense Department. When Miss Adkins left HEW in 1961 she became Headmistress of the Foxcroft School in Middleburg. Virginia, She retired in 1967 to her home in Oxford, Maryland. She is a member of the Talbot County Commission on Aging and is Chairman of the Talbot County Chapter of the American Red Cross. She also has been a member of the Advisory Board to the Social Security Administration. PLEASE NOTE--Miss Adkins was nominated by President Ford for an additional three year term as a member of the council and as its chairman. The nomination has not yet been confirmed. more - 3-26-75 ADKINS, BERTHA SHEPPARD R b. Salisbury, Md, 8 24, 06; d. Frederick Paul Adkins and Edna May Shep- pard A: single. Educ: Wellesley Col, A.B, 28; Columbia, A.M, 43. Hon. LL.D, West. Md. Col, 53, Hood Col, 58 and Wheaton Col. 60; hon. L.H.D, Wilson Col, 59. Polit. & Govt. Pos: Rep. Nat. Committeewoman, Md, 48-58; exec. dir, Women's Div, Rep. Nat. Cmt, 50-53; asst. chmn, Rep. Nat. Cmt. and head of Women's Div. 53-58: Undersecy. of Health, Educ. and Welfare, 58-60. Bus. & Prof. Pos: Teacher, private sch. Salisbury, 28-32; secretarial work, 32-34; down ci women, West. Md. Col. 34-42; dean of residence, Bradford Jr. Col, Mass. 42.46. headmistress. Foxcroft Sch. Middlehurg, Va, 61-67. Mem: P1 Lainda Theta. Harbor Club (Faston. Md): Sulgrave Club (Wash.). Trustee, Am. Univ. Rel. Methodist Mailing Add. P.O. Box 396, Oxford, Md. 21654. R.FORD is GERALD LIBRARY Massingale THE WHITE HOUSE WASHINGTON October 20, 1976 1976 001 20 N ID 42 MEMORANDUM FOR: JAMES CANNON FROM: ROBERT T. HARTMANN SUBJECT: Swearing-In Ceremony, Federal Council on the Aging - October 21, 1976 I would like your priority attention and personal response on the attached draft (even if you approve it as is) by 4:00 p.m., October 20, 1976 Please return your comments to Bob Orben in the Editorial Office in Room 115, OEOB (Ext. 6573). Thank you for your cooperation. FORD LIBRARY & 93 Please check one box and sign below: ( ) I approve the draft without changes. ( ) Suggested revisions are noted on the draft or attached separately. Initials: 102007 (Denison) Oct. 19, 1976 THIRD DRAFT SWEARING IN CEREMONY, FEDERAL COUNCIL ON THE AGING 10/21/76. It is a great honor for me to have this opportunity of asking to swear into office six members of the Federal Council on the Aging. In the two years since its formation -- the Council has made substantial contributions to the well-being of America's aging -- particularly in the areas of tax policy and coordinating benefit programs for older persons. Earlier this year, I had the opportunity to call one of the Council's most significant achievements -- the Bicentennial Charter for Older Americans -- to the attention of all Americans. The Charter is a "Bill of Rights" for America's elderly -- a testament to our Nation's heartfelt concern for its senior citizens. FORD LIBRARY 'd 078839 It has been said that history judges a society on how well it cares for its older people. In America -- in recent years, the Federal Council on the Aging has led the way to a record of solid progress in helping the vast majority of our elderly lead independent, satisfying and healthy lives. Since the 1971 White House Conference on Aging first focused national attention on the problems and concerns of older Americans. - Social Security benefits have risen by 50 percent. - A new national network of State and area agencies on aging has been established. - Special housing programs for the elderly have been set up. This is a good start; but, our efforts in behalf of older Americans have only begun. Our first priority must be to protect the retirement income of older Americans. Inflation -which hits those on fixed incomes hardest -- is the foremost threat to the stability and value of retire- ment income. We have cut inflation in half. But, if our elderly are to fully enjoy their later years -- it must be cut further. -2A- We must strengthen the financial underpinnings of the Social Security System. Congress adjourned without acting upon my proposals to ensure the fiscal integrity of the system. I will urge the new Congress to make this its first order of business. -3- I have also asked the Social Security Administration to carefully review the current retirement earnings test. Today, older persons lose benefits when they earn more than 2,760 dollars a year. The test must be liberalized so that older people -- who need the income -- remain in the work force without losing their hard earned retirement benefits. To further this objective -- the Veterans Administration is preparing a report on overall pension reform proposals that will deal with the reduced benefits that are paid to retired persons who are eligible for both V.A. and Social Security payments. America's veterans have earned -- with their courage and their sacrifice -- an adequate retirement income. They must not be shortchanged. Finally, our older citizens have earned the right to live securely and to walk the streets without fear. That is why I was particularly gratified by a provision in the Omnibus Crime Control Act which I recently signed. This new provision requires that State crime control plans deal specifically and firmly with the criminal attacks -4- which are made against our senior citizens. All Americans can count on the Federal Council on the Aging to continue to see that these and other issues which particularly concern our older citizens are met head on. forward to the leadership Miss Adkins, Mr. Martin, Monsignor Fahey (Fay-Hee), Mr. Winston, Mrs. Deveraux (Dehver-Row), and Mr. Holland -- will provide in the years to come. THE WHITE HOUSE WASHINGTON October 20, 1976 MEMORANDUM FOR: SARAH MASSENGALE FROM: ROBERT T. HARTMANN SUBJECT: Swearing-In Ceremony, Federal Council on the Aging October 21, 1976 I would like your priority attention and personal response on the attached draft (even if you approve it as is) by 4:00 p.m., October 20, 1976. Please return your comments to Bob Orben in the Editorial Office in Room 115, OEOB (Ext. 6573). Thank you for your cooperation. FORD is LIBRARY Please check one box and sign below: ( ) I approve the draft without changes. Suggested revisions are noted on the draft or attached separately. Initials: Sem (Denison) Oct. 19, 1976 THIRD DRAFT SWEARING IN CEREMONY, FEDERAL COUNCIL ON THE AGING 10/21/76. It is ustiguart a great honor for me to have this opportunity of asking to swear into office six members of the Federal The sixth member Chanwoman Britha Adkins, cannot be heretoday because she asperting to the Macke governor's conference on Council on the Aging. In the two years since its formation - Agurg, the Council has made substantial contributions to the well-being of America's aging -- particularly in the areas of tax policy and coordinating benefit programs for older persons. Earlier this year, I had the opportunity to call one of the Council's most significant achievements -- the Bicentennial Charter for Older Americans to the attention of all Americans. The Charter is a "Bill of Rights" for America's elderly -- a testament to) our Nation's heartfelt our concern for its senior citizens. It has been said that history judges a society on how well it cares for its older people. In America -- in recent years, the Federal Council on the Aging has led the way to a record of solid progress in helping the vast majority of our elderly lead independent, satisfying and healthy lives. FORD is LIBRARY -2- Since the 1971 White House Conference on Aging first focused national attention on the problems and concerns of older Americans - Social Security benefits have risen by 50 percent; - A new national network of State and area agencies on aging has been established; - Special mulrition projects for the elduly have been istablished andare mow serving over 300, 000 hot meals aday; - Special housing programs for the elderly have been set up. This is a good start; but, our efforts in behalf of older Americans have only begun. Our first priority must be to protect the retirement income of older Americans. Inflation -which hits those on fixed incomes hardest -- is the foremost threat to the stability and value of retire- ment income. We have cut inflation in half. But, if our elderly are to fully enjoy their later years -- it must be cut further. -2A- We must strengthen the financial underpinnings of the Social Security System. Congress adjourned without acting upon my proposals to ensure the fiscal integrity of the system. I will urge the new Congress to make this its first order of business. -3- I have also asked the Social Security Administration to carefully review the current retirement earnings test. Today, older persons lose benefits when they earn more than 2,760 dollars a year. The test must be liberalized so that older people -- who need the income -- remain in the work force without losing their hard earned retirement benefits. Jam also looking forward to receiving To further this objective -- the Veterans Administration is preparing a report ^on overall pension reform proposals that will that the Vet. Adminis preparency deal with the reduced benefits that are paid to retired persons who are eligible for both V.A. and Social Security payments. America's veterans have earned --- with their courage and their sacrifice -- an adequate retirement income. They must not be shortchanged. Finally, our older citizens have earned the right to live securely and to walk the streets without fear. That is why I was particularly gratified by a provision in the Omnibus Crime Control Act which I recently signed. FORD & LIBRARY GERALD This new provision requires that State crime control plans deal specifically and firmly with the criminal attacks -4- which are made against our senior citizens. my Administration and All Americans can count on the Federal Council on the Aging to continue to see that these and other issues which particularly concern our older citizens are met head on. / look forward to the leadership Miss Adkins, Mr. Martin, Monsignor Fahey (Fay-Hee), Mr. Winston, Mrs. Deveraux (Dehver-Row), and Mr. Holland -- will provide in the years to come. THE WHITE HOUSE WASHINGTON October 19, 1976 MEMORANDUM FOR: GEORGE DENNISON DAVID LISSY DAN McGURK MILT MITLER DICK PARSONS am FROM: SARAH MASSENGALE SUBJECT: Presidential Remarks on the Swearing-in of the Federal Council on the Aging Attached for your comments and recommendations are suggested remarks by the President for the swearing-in of the Federal Council on the Aging new members, tomorrow at 11:00 a.m. I would appreciate having your comments and recommendations by 5:00 p.m. today. Many thanks. FORD & LIBRARY GERALD GERRALO FORD LIBRARY Secretary Mathews and distinguished guests: I am very pleased to have this opportunity to swear into office six members of the Federal Council on the Aging. In its two years the Council, under the able leadership of its Chairman Bertha Adkins -- whom I am sorry could not be with us today due to a speaking engagement before the Maine Governor's Conference on Aging -- has made important contributions to the field of aging is such areas as tax policy and the relationship of benefit programs for older persons. This past May I had the opportunity of calling the nation's attention to the Bicentennial Charter for Older Americans that was developed by the Council. This Charter should help all Americans recognize that we must make every effort to recognize the worth and dignity of our older citizens. We have made progress since the 1971 White House Conference on Aging in helping older Americans to lead independent lives. We have reduced inflation, Social Security benefits have risen more than fifty percent, a new national network on aging of State and Area Agencies on Aging and nutrition projects has come into existence, and the Section 202 housing program for the elderly has been reauthorized. It is important as we enter our third century as a nation that we increase these efforts. I should think our Our first priority must be to protect the retirement income of older Americans. I reaffirm my commitment to continue to do all I can to insure 1st priority the integrity of the Social Security system. Congress did not act on my "decoupling" and financing proposals that would haveprotected the fiscal would integrity of the system. I will urge the new Congress to make these be the proposals a top priority. provision of adequate In addition, I am asking the Social Security Administration to review ways in which the system can better serve older persons, and to recommend to me changes that can be part of my FY 1978 budget request to the Congress. health care to One item I will ask be given special attention is the retirement earnings test. Presently older persons lose benefits when they earn more than the old $2,760. This serves as a disincentive for older people who need more income to remain in the work force, and I believe the law must be liberalized. coots. Older Americans have earned the right to an adequate retirement income. We must insure that our policies are consistent with this objective. about How To further this objective, I am also requesting the Veterans Administration to review and submit to me legislative proposals that will deal with the "One I problem of high reduction rates in retirement benefits older persons suffer caused by a simultaneous receipt of veterans benefits and Social Security benefits. This is an unfair situation. Veterans have earned with their priorities our top courage and sacrifice an adequate retirement income for their families. We must insure that our policies protect their income against inflation. I'd leave this H out. Our older citizens have also earned the right to live securely and without fear. That is why I was delighted to sign recently legislation extending the Omnibus Crime Control Act. This legislation includes a new provision that State crime control plans must give specific attention to dealing with criminal victimization of older persons. You can be assured this provision will be vigorously administered. Our nation can) NOT and will not tolerate its older citizens, who have contributed to our growth and prosperity all their lives, fearing for their physical and financial well-being because of the actions of criminals. I know that the Federal Council on the Aging will continue to give these and other issues their close attention. I look forward to the leadership Miss Adkins, Mr. Martin, Monsignor Fahey, Mr. Winston, Mrs. Deveraux, and Mr. Holland will provide the field of aging. Sarah I leave the "editorials" to the poets on the first floor, Dick FORD LIBRARY if GENALD HEALTH DELICATION. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE aging OFFICE OF THE SECRETARY USA WASHINGTON, D.C. 20201 Office of Human Development SPECIAL Administration on Aging October 11, 1976 TO : Sarah Massengale FROM: Decker Anstrom Male GERALD FORD LIBRARY Sorry we missed Saturday. Attached is a draft outline of proposed remarks for the President to make after swearing in the new members of the Federal Council on the Aging. Dr. Flemming has reviewed them and believes the outline represents a good positive statement in the field of aging. Several of the items do (or would) represent new initiatives. Specifically, they are: ... II.B.2.a - Full FY 1978 Social Security cost-of-living increase. ... II.B.2.b - Liberalize retirement earnings test. ... II.B.2.c - Eliminate benefit reduction when beneficiaries remarry. ... II.B.3.a - Sign SSI "pass-through" legislation. ... II.B.3.b - Request VA to study interrelationship of benefit increases. As you will appreciate, this outline only represents a substantive outline. The specific language, style and rhetoric need to be worked on by White House Staff. Dr. Flemming indicated that he very much wants to be involved in developing the actual text, however. This outline should form the basis for a fifteen minute statement. To cut it to five-seven minutes we would recommend the remarks be limited to Parts I, II.A, II.B, II.C.1 and III. I am available at any time to work further with you on this. Attachment OUTLINE OF PROPOSED REMARKS BY THE PRESIDENT UPON SWEARING INTO OFFICE NEW MEMBERS OF THE FEDERAL COUNCIL ON THE AGING I. I am pleased to have this opportunity to officially swear into office new members of the Federal Council on the Aging. A. In its two years the Council has made important contributions to the whole field of aging. B. It has served as an effective advocate for the needs of today's older persons. C. The Council has, under the very able leadership of its Chairman Bertha Adkins, provided some major insight into ways in which the problems of older persons might be better addressed. II. I am fully committed to insuring that older Americans are able to lead dignified and independent lives. A. I will continue my fight against inflation- the greatest threat to the quality of life of older persons. 1. We have reduced by nearly half the double digit inflation experienced in 1974. 2. I will continue to reduce taxes, cut Federal spending, and balance the budget in order to further reduce inflation. B. I will continue to take steps to protect the integrity of and to improve the Social Security system. -2- 1. As I indicated in my Special Message on Aging to the Congress last February, "Maintaining the integrity of the system is a vital obligation each generation has to those who have worked hard and contributed to it all their lives. I strongly re- affirm my commitment to a stable and financially sound Social Security system." a. To further that objective I introduced legislation to increase payroll taxes that would raise needed revenues necessary to stabilize the trust fund. (1) This proposal would cost no worker more than $1 a week. (2) It will stabilize the trust fund. (3) Yet Congress took no action on this legislation either. b. I also introduced legislation designed to "decouple" wage and price increases in computing future Social Security benefits . (1) This legislation would have solved this problem, and thereby protected the integrity of the Social Security system. (2) The Congress also took no action on this proposal. (3) I agree with the Council and others who conclude this problem must be promptly resolved in order to assure the soundness of the Social Security system, an objective to which I am completely committed. -3- 2. I will take several actions designed to increase Social Security benefits, and make the system more equitable. a. I will, as part of my FY 1978 budget, request full cost-of-living increases in Social Security benefits. (1) This will help protect the elderly's budgets against the hardships of inflation. (2) It will maintain the purchasing power of older Americans. b. I intend to request legislation that will further liberalize the Social Security earnings test. (1) Currently an older person loses $1 in benefits for every $2 earned above $2,760. (2) While this figure does change to account for inflation it is too low. (a) It only serves as a disincentive for older persons to continue working. (b) It penalizes those who need more income the most. (c) We can afford to encourage older persons to continue to be involved. (d) We can't tolerate policies that put our Nation's older persons on the shelf. c. I will also request legislation that will eliminate the loss in benefits that occurs under Social Security when older people remarry. -4- (1) Currently if two beneficiaries remarry their benefits as a couple are less than what they received as individuals. (a) We know two cannot live more cheaply than one. (b) Most importantly, we should not as a Nation force older people who wish to remarry to live on lower incomes. (2) We must do all we can to preserve the dignity and independence of older people. (3) We must also encourage in every way we can the institution of the family. (4) This legislation will do just that. 3. Finally, I am taking two other actions designed that when Social Security and Supplemental Security Income benefits increases take place to help offset inflation, the benefits in other programs do not decrease. a. I am signing H.D. which mandates that State supplements to the Supplemental Security Income not be reduced when Federal SSI benefits are increased due to increases in the cost-of-living. (1) Presently many States that supplement these Federal benefits lower their supplement every time the Federal benefit is increased to account for inflation. (2) Older persons never, as a result receive an increase in their net Federal/State benefit. -5- (3) This legislation insures that older persons will be protected against inflation, and share in future benefit increases. (4) I appreciate the Federal Council's leadership in helping identify this issue. b. I am requesting the Veterans Administration to study the problem of high reduction rates in retirement benefits older persons suffer caused by simultaneous receipt of veterans benefits and Social Security benefits. (1) This is an unfair situation, also identified by the Federal Council, and it should be corrected as soon as possible. (2) Veterans and their families must be protected against inflation. C. I will continue to take other actions that will contribute to maintaining the independence of older persons. 1. I will continue to support the Older Americans Act. a. This Act supports the national network on aging. (1) This network, which is composed of 56 State and 500 Area Agencies on Aging, and 800 Nutrition projects provides a firm foundation for providing services to older persons. -6- (2) These services, such as the more than 300,000 meals served a day in the national nutrition program, will help older persons to remain in their own homes. 2. I recently signed the FY 1977 appropriations bill for the Department of Housing and Urban Development that includes $750 million for the 202 housing program for the elderly and handicapped. a. This appropriation will support more than 30,000 new housing units for the elderly. b. By providing this kind of support we can help maintain the independence of older persons by FORD & LIBRARY GERALD providing alternative living arrangements. 3. I will continue to support volunteer programs for older Americans such as the RSVP Foster Grandparent, and Senior Companion programs. a. More than 200,000 older persons currently are involved in their communities as a result of these programs. b. They enable older persons to share their talents and skills with all of us, and help keep older persons involved in our society. 4. I fully support two initiatives of the Administration on Aging designed to provide more opportunities for older persons to be involved. -7- a. The Administration on Aging, working with the Office of Education, has been working to open up opportunities for older persons in public schools. (1) Schools can help to serve older persons, for instance by encouraging older people to participate in school lunch programs. (2) Older people can make rich and valuable contributions to schools by acting as teacher aides and special instructors. (3) I call on all educators to open their doors to older persons and help not only to use this community resource, the school, more effectively, but also to bring young and old together. b. The Administration on Aging, working with the President's Council on Physical Fitness, and the National Association for Human Development, has also been developing and promoting physical fitness programs for older Americans. (1) I believe that all Americans should make efforts to become and remain physically fit, healthy, and active. (2) Physical fitness programs designed for older Americans make good sense as a means of helping older persons to remain healthy, active involved members of our Nation. -8- D. I am especially concerned about the impact of crime on our ölder citizens, and will do everything in my power to insure that no older American lives her or his last days in fear of being victimized. 1. Our Nation can and must not tolerate its older citizens, who have contributed to it all their lives, fearing for the physical and financial well-being because of the actions of criminals. 2. I have proposed legislation designed to deal in a firm, tough manner with criminals. 3. I also just recently signed legislation extending the Omnibus Crime Control Act. a. This legislation mandates that State crime control plans must give specific attention to dealing with the problem of criminal victimization of older persons. b. I am delighted this legislation is now on the books. c. You can be assured it will be vigorously administered. III. I am pleased to have this opportunity to meet with the Federal Council on the Aging. A. I look forward to your contributions to the field of aging. B. I look forward to working with you and with all the American people to assure that our older citizens are treated with dignity and respect. UNIVERSITY OF SOUTHERN 1880 CALIFORNIA UNIVERSITY OF SOUTHERN CALIFORNIA MEDIUM ETHEL PERCY ANDRUS (213) 746-606c GERONTOLOGY CENTER UNIVERSITY PARK LOS ANGELES, CALIFORNIA 90007 September 28, 1976 Mr. H. P. Goldfield The White House Washington, D.C. 20500 Dear H. P.: This is simply a quick memo about the information that you requested by telephone today. Should you need greater information, please let me know. Just holler if you have any questions. See you in D.C. on the 7th. Take it easy, Ira Ira S. Hirschfield Assistant Dean Continuing Education ISH:cw YOF SOUTHERN 1380 UNIVERSITY OF SOUTHERN CALIFORNIA ETHEL PERCY ANDRUS (213) 746-606 GERONTOLOGY CENTER UNIVERSITY PARK LOS ANGELES, CALIFORNIA 90007 Ideas Relating to Programs and Issues Confronting Older Americans T. There presently exists legislation that enforces an earnings limitation for senior citizens receiving social security benefits. An older american between 65 and 72 years of age is allowed to earn a salary of no more than $2760 without losing a portion of his social security benefits. Simply stated, for every two dollars earned over this amount, he loses one dollar of his benefits. However, this is applicable only for those individuals who continue to work for a salary. Those deriving income from investments are not penalized, and therefore this legislation primarily affects the worker who is trying to augment his salary while also continuing to remain active. Unfortunately, this legislation adds to the series of policies and attitudes that discourage the senior citizen from remaining a part of the work force. It would be helpful either to elevate this earnings limitation to $3,600-4,000 or to eliminate it completely. According to the 1974 enclosed document of the Congressional Record, there are at least 2.5 million Americans aged 65 to 72, or their dependents, who are directly affected by the earnings ceiling. 2. The issue of tax relief for older american home owners and renters is worthy of careful consideration. Although this concern would cost the Administration considerably more energy in terms of time and fiscal resources, many senior citizens are being forced to give up their homes and apartments since their fixed incomes cannot cover the increased rental costs being assessed to them. Some states are issuing a deferred tax which is subject to acquisition at the time after which the person is deceased and while his estate is being settled. 3. The field of aging is growing at an overwhelming pace. There exists little good coordination at the national level of all activities, programs and policies transpiring throughout the country. A task force in this regard merits reflective thought. 4. When someone reaches the age of 65 there are a variety of benefits and policies about which they need to become informed. A booklet detailing all of this information in clear and easily understandable form would be of help to this "at risk" population. September 51974 CONGRESSIONAL RECORD-SENATE S16601 S16665 Tins LAW Ross Our SZHOK Crizenal I proposs that we make there proof SENATOR GOLDWATER AND THE 137 Senator BARRY GOLDWATER) truch by regealing the earnings test on for all our older citizens. EARNINGS IMMITATION The earnings limitation for SAcial Security benefits should D2 repeated. Iha spenking Mr. PERCY. Mr. President. 1 am sure of the penalty Imposed on individuals who my collengues are aware of the leadership are otherwise eligible for Social Security of the Senator from Arizona OVE. COLD- but who eam more than $2400 per year. As WATER) on behalf of the repeal of the the law now stands. an individual receiving Social Security is denied one dollar for every social security curnimes limitation two dollars he carns over this 32400 exempt Not long the distinguished Senator amount. until his benefits are cut off come wrote C. procest editorial for the News Bul- pletely. The only exclusion is for persons 72 letin of the American Association of Re- and older. tared Persons in which he set out in no This restrict in La an outrage against mill Ira uncertain terms the case for repeal of lions of citizens who have made years of So- this outrageous provision of the Social cial Security contributions from their hard- aarned salaries. It is wrong morally. because Security Act. each citizen should be able to tarn 80 in- This essay was concensed and repub- come. without unfair restrictions. to the lished in the August 1974 Reader's Digest. fill limit of bis ability and initiative. Social I want to take this opportunity to 25- Security should not be a contract to quit sociate myself with the Senator's posi- work.- tion. I have long advecated repeal 0.00 at :Did you know that income from invest-- the very least, liberalization of 2 restric- ments-stocks. bonds, rentals and so forth tion which works against an individual's is not counted to determining whose benefits shall be reduced? :: : only the individual ability to live with comfort and dignity The continues to work for : salary who is during retirement. AMRIGO am PASH 24 perspead And progress has been made. In 1972 situation where & really wealthy person the ceiling was raised from $1.680 to might draw tens of thousands of dollars D year from his investments and, st the same $2,100; ES of last January it went up 10 time, receive his full Social Security check. 11 52,400. Future increases will occur au- retirement Yet the Dian who has worked for C. salary tomatically as the cost 01 living increases. all of his life, and who might need :o con- Finally the Senate voted that year to tirue working as & matter of economic sur- raise the celling immediately to $3,000, vival. casnot do so under the law without but the other body has refused to 20 to being penalized. conference on this amendment - According is the Social Security Adminis- tratica. there are at least 2.5 million Ameri- President, I favor immediate re- cans aged to to 72. or their dependents, who peal of the carrings Insitation, but I are directly affected by the carnings celling. know this stands little chance of appro- Nearly a million of these Individuals tarn val. So I have introduced it bill. S. 3427. enough so that they receive no benefits at which provides for the gradual elimina- all, and most of the rest earn enough SU that tion over 10 years of this unfair restric- their benefits are reduced. Another 500,000 tion. We are moving in that direction by may be receiving full benefits. but are to- bits and pleces: lot us make the commit- tentionally holding their carnings down be- cause of the limitation. ment once and for All that we do indeed It is true that some progress has been made intend to 70 all the way and jet us set in liberalizing the restriction. In 1972, for the timetable DOW. example, an amendment passed which lifted I RSK unanimous consent that Senator the ceiling from $1080 to $2100. This followed GOLDWATER article, "This Law Robs Our R motion b7 me to abolish the ceiling en- Senior Citizens," be printed in the REC- tirely. which washdefeated on c. voice vote. Then. in June 1973. Congress raised the cell- :-ORD ing to $2400. It is now past time to reserve There being no objection. the article this statutory shackle completely. was ordered to be printed in the RECORD, Supporters of-the carnings limitation nt- shollows: tempt to Justify It mainly 03 two grounds. First. they say it would cost money-spproxi- mately st billion-to pay there people 65 and over who stul work. I doubt this statistic. I have asked the Social Security Adminis- tration for the basic assumptions used 1:1 computing their cost estimate. end have IC- quested that an Independent study be made by the Government Accounting Office. Tax- Ing account or Increased income and Social Security payroll taxes paid by older workers. the true cost 13 likely to be under $2 billion. If necessary. I would take the money on! or the general treasury by cutting wasted clac- where. in order to give these people the bene- first they have carned over an entire working life. The second argument for the earnings limi- tallon is equally wenk. Supporters say that Social Security wre: set up w Insure mainst Blio Ines of eachings. Thus, If n person does not-or cannot afford to-retiro nt 05. 1:0 suffers no liver of carnings and Is therefore entitled 10 no benefits. This 15 preposterous. Social Security pay- monts are not gratuition from n benevolent government. They are A repayment of our earnings. which we have deposited In file SHEET: PRESIDENT FORD'S RELATIONSHIP WITH THE FEDERAL COUNCIL ON THE AGING The Federal Council on the Aging has submitted several recommendations to the President. The following is a summary of these recommendations and the President's response to each recommendation. 1. The Council recommended "legislative action to develop high standards of safety and care in nursing homes." The President responded, on July 24, 1975: "The Department of Health, Education, and Welfare has set high standards of nursing home care and safety that must be met by nursing homes participating in the Medicare and Medicaid pro- grams. The enforcement of these standards is one of my Admin- istration's highest priorities. Federal funds pay 100 percent of the costs of inspection to monitor compliance with these standards. The Federal government pays its share of the costs of meeting nursing home standards through health care financing programs, primarily Medicare and Medicaid. Financial assistance is also made available by the Department of Housing and Urban Development to assist nursing homes in meeting selected fire safety standards. " 2. The Council requested an extension of the due date for two studies mandated by the Older Americans Act. The Administration proposed and signed legislation that extended these due dates. The studies were completed, forwarded to the President, and the President forwarded them to the Congress with favorable comments. 3. The Council expressed concern about the level of funding in the FY 1975 and 1976 budgets for programs for the elderly, and recommended that the President reconsider the impact of these fiscal proposals on older Americans. The President responded, on July 24, 1975: "I sympathize with this concern, but I am determined to reduce the burden of inflation on our older citizens, and that effort demands that government spending be limited. Inflation is one of the cruelest and most pervasive problems facing older Americans, so many of whom live on fixed incomes. A reduction of inflation, therefore, is in the best interests of all Americans and would be of particular benefit to the aging. " GERALD R. LIBRARY FORD 2. 4. The Council recommended that the Administration develop an amendment to the Social Security Act that would "decouple" price increases from wage increases in computing future benefits, thereby protecting the fiscal stability of the social Security system. The Council also asked that this amendment, and its effect on future outlays, be reflected in the Social Security Trustees Annual Report on the system. The President responded in a February 3, 1976 letter to Miss Adkins, the Council chairman: "I agree entirely with your assessment of the short-term deficit and the future adverse effects of the "coupled" system. I believe that legislative action must be taken as soon as possible to increase trust fund revenues and to "decouple" with a minimum of disruption to beneficiaries. Therefore I have announced and will send a proposal to eliminate the double index- ing for inflation in the calculation of future benefits, thus "decoupling" the system. Secretary Simon also wrote noting that this approval would be reflected in the Trustee's Annual Report. 5. The Council recommended that legislation be enacted that would man- date continuance of State Supplements to Federal Supplemental Secur- ity Income payments. The President responded on August 3, 1976: "The Federal Government took over this program from the States on January 1, 1974, and provided a basic payment level to recipients. For those individuals who received benefits under the State programs in December 1973 that were larger than the basic Federal payment level, and who continue to be eligible for SSI, States are required to supplement the basic Federal payment up to the level of the December 1973 payment to such recipients. The requirement does not apply to new recipients who became eligible after December 1973. The Council's legislative proposal would require that the size of the State supplementation to recipients carried over for the State programs on January 1, 1974, could not be reduced. Thus, whenever the basic Federal payment level is increased, this proposal would allow States to continue to maintain a disparity in the benefits for the carried over recipients versus those recipients who came on the rolls after December 1973 -- a disparity equal to the amount of the original State supplementation. Adoption of this recommendation would have two effects. First, it would dictate to the States how they should spend the taxes they assess on their residents. Such action would distort the original concept of the program of separate but complementary roles of the States and the Federal Government. Second, it would require the States to maintain payments to people based on the date they started receiving assistance, even though other residents of the States may have equivalent needs and incomes." 3. 6. The Council recommended that the Veterans' Administration be directed to study the problem of benefit reduction rates caused by simultane- ous receipt of benefits from pensions for veterans and other Federal benefit programs, such as Social Security. The President responded on August 3, 1976: "We share the concern of the Council. This problem is being studied by the Veterans' Administration within the context of total reform of the veterans' pension program. The Agency has discussed pension reform with both the House and Senate Veterans' Affairs Committees, and is committed to continuing these discussions with Congress this year. The relationship of veterans' pensions to other Federal bene- fits can best be addressed in the course of these discussions." 7. The Council prepared a Bicentennial Charter for Older Americans, and recommended that the President issue it in relation to Older Americans Month. The President, in a signing ceremony in the Rose Garden on April 5, 1976 issued a 1976 Older Americans Month Proclamation, and at that time urged that public forums be held during Older Americans Month to discuss the Charter. The President also commented: "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." The President met with the members of the Federal Council on the Aging in the Cabinet Room on May 16, 1975. At that time the Council briefed him on its work. The President indicated he was looking forward to receiving the Council's studies on the impact of taxes on the elderly and the interrelationship of benefit programs for older persons. After receiving those studies the President commented: "The Federal Council on the Aging Annual Report and attendant studies reflect an earnest effort to deal with the lack of equity and effi- ciency in the present patchwork of income security programs. This unfortunate situation, which has developed over the years, presents problems not only to the elderly and other population groups, but to the taxpayer who must pay the added costs resulting from such ineffi- ciency. My legislative proposals reflect careful consideration of how best to resolve these issues, and I urge prompt action on them by the Congress. Since many of the tax recommendations of the Council are directed towards State and local government, consistent with the enabling authority I am also transmitting this study to the Governors and legislatures of the States for their consideration. GERALD FORD LIBRARY Additional mention should be made of the substantial contribution of the two studies undertaken by the Federal Council on the Aging. The efforts of those that participated in the studies will contribute to our effort to provide necessary income and services to our less fortunate elderly citizens in an efficient manner. These reports will be sent for review and analysis to those Federal agencies serving older persons. After this review, decisions on the recommendations contained in the Council's report will be reflected in future legislative proposals and administrative actions of this Administration." The Chairman of the Council remains in steady contact with the President. FORD i LIBRARY OFRALD FOR IMMEDIATE RELEASE AUGUST 3, 1976 Office of the White House Press Secretary THE WHITE HOUSE Sarah Massingale TO THE CONGRESS OF THE UNITED STATES: I am transmitting herewith the Annual Report of the Federal Council on Aging, together with two studies undertaken by the Council as required by sections 205 (f-h) of the Older Americans Act (P.L. 93-29). Last year I indicated that I was looking forward to receiving then two studies from the Federal Council on Aging. The Council recognized its responsibilities and undertook the task in a forthright manner. I appreciate the fine work that the Council has done, particularly with the severe time constraints imposed upon it. The Council's report and studies provide documentation from the viewpoint of our elderly citizens, which support FORD 071639 LIBRARY the need for legislation along the lines of my proposed Financial Assistance for Health Care Act and the Income Assistance Simplification Act which I will be proposing shortly. My proposals would permit both Federal and State programs to be simplified and integrated into a coordinated system that would best meet the needs of our citizens. Council Recommendations With respect to the Supplemental Security Income (SSI) program, the Council has recommended in its program report that legislation be passed that mandates continuance of a specific State supplementation for certain recipients. The Federal Government took over this program from the States on January 1, 1974, and provided a basic payment level to recipients. For those individuals who received benefits under the State programs in December 1973 that were larger than the basic Federal payment level, and who continue to be eligible for SSI, States are required to supplement the basic Federal payment up to the level of the December 1973 payment to such recipients. The requirement does not apply to new recipients who became eligible after December 1973. The Council's legislative proposal would require that the size of the State supplementation to recipients carried over from the State programs on January 1, 1974, could not be reduced. Thus, whenever the basic Federal payment level is increased, this proposal would allow States to continue to maintain a disparity in the benefits for the carried-over recipients versus those recipients who came on the rolls after December 1973 --- a disparity equal to the amount of the original State supplementation. Adoption of this recommendation would have two effects. First, it would dictate to the States how they should spend the taxes they assess on their residents. Such action would distort the original concept of the program of separate but complementary roles of the States and the Federal Government. more 2 Second, it would require the States to maintain payments to people based on the date they started receiving assistance, even though other residents of the States may have equivalent needs and incomes. The Council also recommends that the Veterans' Administration (VA) be directed to study the problem of benefit reduction rates caused by simultaneous receipt of benefits from pensions for veterans with nonservice-connected disabilities and other Federal programs. We share the concern of the Council. This problem is being studied by the Veterans' Administration within the context of total reform of the veterans' pension program. The Agency has discussed pension reform with both the House and Senate Veterans' Affairs Committees, and is committed to continuing these discussions with Congress this year. The relationship of veterans' pensions to other Federal benefits can best be addressed in the course of these discussions. To assess the tax burden on the elderly, the Older Americans Act also required the Council to undertake a study of the combined impact of all taxes on the elderly. Since many of the tax recommendations of the Council are directed towards State and local government, consistent with the en- abling authority I am also transmitting this study to the Governors and legislatures of the States for their consideration. In recognition of the Bicentennial and the many contributions made by older Americans to the welfare of the nation, the Council's annual report requests the promulga-- tion of a Bicentennial Charter for Older Americans. I have asked Secretary Mathews of the Department of Health, Education, and Welfare, in consultation with the Administration on Aging, to promote discussion of these vital matters at forums of older persons organized by Advisory Committees to the Area Agencies on Aging. The Federal Council on Aging Annual Report and attendant studies reflect an earnest effort to deal with the lack of equity and efficiency in the present patchwork of income security programs. This unfortunate situation, which has developed over the years, presents problems not only to the elderly and other population groups, but to the taxpayer who must pay the added costs resulting from such inefficiency. My legislative proposals reflect careful consideration of how best to resolve these issues, and I urge prompt action on them by the Congress. Additional mention should be made of the substantial contribution of the two studies undertaken by the Federal Council on Aging. The efforts of those that participated in the studies will contribute to our effort to provide necessary income and services to our less fortunate elderly citizens in an efficient manner. These reports will be sent for review and analysis to those Federal agencies serving older persons. After this review, decisions on the recommendations contained in the Council's report will be reflected in future legislative proposals and administrative actions of this Administration. GERALD R. FORD THE WHITE HOUSE, AUGUST 3, 1976 #### FOR IMMEDIATE RELEASE AUGUST 3, 1976 Office of the White House Press Secretary THE WHITE HOUSE TO THE CONGRESS OF THE UNITED STATES: I am transmitting herewith the Annual Report of the Federal Council on Aging, together with two studies undertaken by the Council as required by sections 205 (f-h) of the Older Americans Act (P.L. 93-29). Last year I indicated that I was looking forward to receiving then two studies from the Federal Council on Aging. The Council recognized its responsibilities and undertook the task in a forthright manner. I appreciate the fine work that the Council has done, particularly with the severe time constraints imposed upon it. The Council's report and studies provide documentation, from the viewpoint of our elderly citizens, which support the need for legislation along the lines of my proposed Financial Assistance for Health Care Act and the Income Assistance Simplification Act which I will be proposing shortly. My proposals would permit both Federal and State programs to be simplified and integrated into a coordinated system that would best meet the needs of our citizens. Council Recommendations With respect to the Supplemental Security Income (SSI) program, the Council has recommended in its program report that legislation be passed that mandates continuance of a specific State supplementation for certain recipients. The Federal Government took over this program from the States on January 1, 1974, and provided a basic payment level to recipients. For those individuals who received benefits under the State programs in December 1973 that were larger than the basic Federal payment level, and who continue to be eligible for SSI, States are required to supplement the basic Federal payment up to the level of the December 1973 payment to such recipients. The requirement does not apply to new recipients who became eligible after December 1973. The Council's legislative proposal would require that the size of the State supplementation to recipients carried over from the State programs on January 1, 1974, could not be reduced. Thus, whenever the basic Federal payment level is increased, this proposal would allow States to continue to maintain a disparity in the benefits for the carried-over recipients versus those recipients who came on the rolls after December 1973 a disparity equal to the amount of the original State supplementation. Adoption of this recommendation would have two effects. First, it would dictate to the States how they should spend the taxes they assess on their residents. Such action would distort the original concept of the program of separate but complementary roles of the States and the Federal Government. more 2 Second, it would require the States to maintain payments to people based on the date they started receiving assistance, even though other residents of the States may have equivalent needs and incomes. The Council also recommends that the Veterans' Administration (VA) be directed to study the problem of benefit reduction rates caused by simultaneous receipt of benefits from pensions for veterans with nonservice-connected disabilities and other Federal programs. We share the concern of the Council. This problem is being studied by the Veterans' Administration within the context of total reform of the veterans' pension program. The Agency has discussed pension reform with both the House and Senate Veterans' Affairs Committees, and is committed to continuing these discussions with Congress this year. The relationship of veterans' pensions to other Federal benefits can best be addressed in the course of these discussions. To assess the tax burden on the elderly, the Older Americans Act also required the Council to undertake a study of the combined impact of all taxes on the elderly. Since many of the tax recommendations of the Council are directed towards State and local government, consistent with the en- abling authority I am also transmitting this study to the Governors and legislatures of the States for their consideration. In recognition of the Bicentennial and the many contributions made by older Americans to the welfare of the nation, the Council's annual report requests the promulga-- tion of a Bicentennial Charter for Older Americans. I have asked Secretary Mathews of the Department of Health, Education, and Welfare, in consultation with the Administration on Aging, to promote discussion of these vital matters at forums of older persons organized by Advisory Committees to the Area Agencies on Aging. The Federal Council on Aging Annual Report and attendant studies reflect an earnest effort to deal with the lack of equity and efficiency in the present patchwork of income security programs. This unfortunate situation, which has developed over the years, presents problems not only to the elderly and other population groups, but to the taxpayer who must pay the added costs resulting from such inefficiency. My legislative proposals reflect careful consideration of how best to resolve these issues, and I urge prompt action on them by the Congress. Additional mention should be made of the substantial contribution of the two studies undertaken by the Federal Council on Aging. The efforts of those that participated in the studies will contribute to our effort to provide necessary income and services to our less fortunate elderly citizens in an efficient manner. These reports will be sent for review and analysis to those Federal agencies serving older persons. After this review, decisions on the recommendations contained in the Council's report will be reflected in future legislative proposals and administrative actions of this Administration. GERALD R. FORD THE WHITE HOUSE, AUGUST 3, 1976 #### FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 August 5, 1976 PRESIDENTIAL RESPONSE TO THE 1976 FCA ANNUAL REPORT We thought you might be interested in the enclosed copy of the President's reply to the Annual Report of the Federal Council on the Aging for 1975. You should have received a copy of the report itself some months ago, but if you would like additional copies, please call or write: Mrs. Alice Freer Federal Council on the Aging Washington, D. C. 20201 Telephone: 245-0441 ClesTavani FORD LIBRARY i GERALD Cleonice Tavani Executive Director Enclosure Office of the White House Press Secretary THE WHITE HOUSE TO THE CONGRESS OF THE UNITED STATES: I am transmitting herewith the Annual Report of the Federal Council on Aging, together with two studies undertaken by the Council as required by sections 205(f-h) of the Older Americans Act (P.L. 93-29). Last year I indicated that I was looking forward to receiving then two studies from the Federal Council on Aging. The Council recognized its responsibilities and undertook the task in a forthright manner. I appreciate the fine work that the Council has done, particularly with the severe time constraints imposed upon it. The Council's report and studies provide documentation, from the viewpoint of our elderly citizens, which support the need for legislation along the lines of my proposed Financial Assistance for Health Care Act and the Income Assistance Simplification Act which I will be proposing shortly. My proposals would permit both Federal and State programs to be simplified and integrated into a coordinated system that would best meet the needs of our citizens. Council Recommendations With respect to the Supplemental Security Income (SSI) program, the Council has recommended in its program report that legislation be passed that mandates continuance of a specific State supplementation for certain recipients. The Federal Government took over this program from the States on January 1, 1974, and provided a basic payment level to recipients. For those individuals who received benefits under the State programs in December 1973 that were larger than the basic Federal payment level, and who continue to be eligible for SSI, States are required to supplement the basic Federal payment up to the level of the December 1973 payment. to such recipients. The requirement does not apply to new recipients who became eligible after December 1973. The Council's legislative proposal would require that the size of the State supplementation to recipients carried over from the State programs on January 1; 1974, could not be reduced. Thus, whenever the basic Federal payment level is increased, this proposal would allow States to continue to maintain a disparity in the benefits for the carried over recipients versus those recipients who came on the rolls after December 1973 a disparity equal to the amount of the original State supplementation. Adoption of this recommendation would have two effects. First, it would dictate to the States how they should spend the taxes they assess on their residents. Such action would distort the original concept of the program of separate but complementary roles of the States and the Federal Government. more (OVER) c. Second, it would require the States to maintain payments to people based on the date they started receiving assistance, even though other residents of the States may have equivalent needs and incomes. The Council also recommends that the Veterans' Administration (VA) be directed to study the problem of benefit reduction rates caused by simultaneous receipt of benefits from pensions for veterans with nonservice-connected disabilities and other Federal programs. We share the concern of the Council. This problem is being studied by the Veterans' Administration within the context of total reform of the veterans' pension program. The Agency has discussed pension reform with both the House and Senate Veterans' Affairs Committees, and is committed to continuing these discussions with Congress this year. The relationship of veterans' pensions to other Federal benefits can best be addressed in the course of these discussions. To assess the tax burden on the elderly, the Older Americans Act also required the Council to undertake a study of the combined impact of all taxes on the elderly. Since many of the tax recommendations of the Council are directed towards State and local government, consistent with the en- abling authority I am also transmitting this study to the Governors and legislatures of the States for their consideration. GERALD FORD LIBRARY In recognition of the Bicentennial and the many contributions made by older Americans to the welfare of the nation, the Council's annual report requests the promulga- tion of a Bicentennial Charter for Older Americans. I have asked Secretary Mathews of the Department of Health, Education, and Welfare: in consultation with the Administration on Aging, to promote discussion of these vital matters at forums of older persons organized by Advisory Committees to the Area Agencies on Aging. The Federal Council on Aging Annual Report and attendant studies reflect an earnest effort to deal with the lack of equity and efficiency in the present patchwork of income security programs. This unfortunate situation, which has developed over the years, presents problems not only to the elderly and other population groups, but to the taxpayer who must pay the added costs resulting from such inefficiency. My legislative proposals reflect careful consideration of how best to resolve these issues and I urge prompt action on them by the Congress. Additional mention should be made of the substantial contribution of the two studies undertaken by the Federal Council on Aging. The efforts of those that participated in the studies will contribute to our effort to provide necessary income and services to our less fortunate elderly citizens in an efficient manner. These reports will be sent for review and analysis to those Federal agencies serving older persons. After this review, decisions on the recommendations contained in the Council's report will be reflected in future legislative proposals and administrative actions of this Administration. GERALD R. FORD THE WHITE HOUSE, AUGUST 3, 1976 #### THE WHITE HOUSE WASHINGTON Sarah: Attached is the package I sent to Jim Cavanaugh. Also attached is a copy of the April O'Neill memorandum and suggested transmittal message to the Governors. It is important that Steve transmit on behalf of the President. Judy 7/28 Sarah: the transmittal message says the President is transmitting report to Governors, does that need to be changed since Steve will be doing it on the President's behalf. THE WHITE HOUSE WASHINGTON July 28, 1976 MEMORANDUM FOR JIM CAVANAUGH FROM: JUDY JOHNSTON judy SUBJECT: Aging Reports The attached Federal Council on the Aging Report was due to the Congress in March. The two studies were due January 1. In April, OMB sent you the attached memorandum which on the original Paul O'Neill indicated "hold until after IASI SBI message is sent". You advised me to hold the package on April 27. Since there is no date for the the submission of the SSI message, Sarah asked me to staff a revised version of the message, indicating that the President would submit the Income Simplification Act shortly. Also, for your information one of the studies, the tax study needs to be transmitted to the Governors and the Legislatures of the States. John Ratchford indicates that it would be proper for Steve McConahey to transmit the studies on behalf of the President as Sarah suggests. If you need any more information, please give me a call. Sarah also has a copy of the package. If you now want the package to go to the Hill, a routine memorandum is attached. FORD LIBRARY R2-2 APR 16 1976 MEMORANDUM FOR JAMES B. CAVANAUGH Subject: Comments on the Annual Report of the Federal Council on Aging and Mandated Studies The Federal Council on Aging was established pursuant to the Older Americans Act, P.L. 93-29, to advise and assist the President on matters relating to the special needs of older Americans. The Council is required to make an annual report of its findings and recommendations to the President not later than March 31 of each year. The President is required to transmit each report together with his comments and recommendations. The statute, as amended, mandates the completion of two studies by January 1976-one on the impact of taxes on the elderly, and one on the interrelationships of benefit programs serving the elderly. The statute requires Presidential comments and recommendations on the "benefits" study, but they are not necessary for the tax study. The results of the tax study must be transmitted to the Governors and legislatures of the States. Since the annual report contains the study findings, we recommend all three reports be transmitted simultaneously. Attached is a synopsis of various subjects treated in the annual report and comments with respect to present policy. We recommend transmittal of the annual report and studies as required by law. My staff has prepared draft transmittal messages to the Congress and Governors. (signed) Paul H. O'Neill Paul H. O'Neill Deputy Director Attachments CC: Official file - DO Records Director - Director's chron Mr. Fairley Deputy Director Ms. Sweeney HR/IM:PLFairley:jcs:bjg Menthayer Mr. Hanna Mr. Kleinberg 13-W-Ue BRIGHTS 442 WWB THE WHITE HOUSE ACTION WASHINGTON July 28, 1976 MEMORANDUM FOR THE PRESIDENT FROM: JIM CANNON SUBJECT: Annual Report Attached for your consideration is a proposed message to the Congress transmitting the second annual report of the Federal Council on the Aging, together with two studies undertaken by the Council to fulfill the legislative mandate of the 1973 Amendments to the Older Americans Act. One of the studies deals with the impact of taxes on the elderly and the other on the interrelationships of benefit programs serving the elderly. A summary of the recommendations of the Council is provided in the transmittal message. OMB, Max Friedersdorf, Counsel's Office (Lazarus) and I recommend approval of the message to the Congress which has been cleared by the White House Editorial Office (Smith). RECOMMENDATION That you sign both originals of the message at Tab A. FORD LIBRARY is GERALD To the Congress of the United States: I am transmitting herewith the Annual Report of the Federal Council on Aging, together with two studies under- taken by the Council as required by Sections 205 (f-h) of the Older Americans Act (P.L. 93-29). Last year I indicated that I was looking forward to receiving then two studies from the Federal Council on Aging. The Council recognized its responsibilites and undertook the manner. task in a forthright fashion. I very much appreciate the particularly fine work that the Council has done especially within An the time constraints imposed apon on it. The Council's report and studies provide documentation, from the viewpoint of our elderly citizens, which support the need for legislation along the lines of my proposed Financial Assistance for Health Care Act and the Income Assistance Simplification Act which I will be proposing shortly. My proposals would permit both Federal and State programs to be simplified and integrated into a coordinated system that would best meets the needs of our citizens. Council Recommendations With respect to the Supplemental Security Income (SSI) program, the Council has recommended in its program report that legislation be passed that mandates continuance of a specific State supplementation for certain recipients. The Federal Government took over this program from the States on January 1, 1974, and provided a basic payment level to recipients. For - 2 - those individuals who received benefits under the State programs in December 1973 that were larger than the basic Federal payment level, and who continue to be eligible for SSI, States are required to supplement the basic Federal payment up to the level of the December 1973 payment to such recipients. The requirement does not apply to new recipients who became eligible after December 1973. The Council's legislative proposal would require that the size of the State supplementation to receipients carried over from the State programs on January 1, 1974, could not be reduced. Thus, whenever the basic Federal payment level is increased, this proposal would allow States to continue to maintain a disparity in the benefits for the carried-over recipients versus those recipients who came on the rolls after December 1973 - a disparity equal to the amount of the original State supplementation. effects 2 Adoption of this recommendation would have two defects. First, it would dictate to the States how they should spend the taxes they assess on their residents. Such action would distort the original concept of the program of separate but complementary roles of the States and the Federal Government. Second St sales Scrent, t would require the States to maintain payments to people based on the date they started receiving assistance, even though other residents of the States may have equivalent needs and incomes. - 3 - The Council also recommends that the Veterans' Administration (VA) be directed to study the problem of benefit reduction rates caused by simultaneous receipt of benefits from pensions for veterans with nonservice-connected disabilities and other Federal programs. We share the concern of the Council. This problem is being studied in some detail by the Veterans' Administration within the context of total reform of the veterans' pension program. The Agency has discussed pension reform with both the House and Senate Veterans' Affairs Committees, and is committed to continuing these discussions with Congress this year. The relationship of veterans' pensions to other Federal benefits can best be addressed in the course of these discussions. To assess the tax burden on the elderly, the Older Americans Act also required the Council to undertake a study of the combined impact of all taxes on the elderly. Since many of the tax recommendations of the Council are directed towards State and local government, consistent with the enabling authority I am also transmitting this study to the Governors and legislatures of the States for their consideration. In recognition of the Bicentennial and the many contributions made by older Americans to the welfare of the nation, the Council's. annual report requests the promulgation of a Bicentennial Charter for Older Americans. I have asked Secretary Mathews - 4 - of the Department of Health, Education, and Welfare, in consultation with the Administration on Aging, to promote discussion of these vital matters at forums of older persons organized by Advisory Committees to the Area Agencies on Aging. The Federal Council on Aging Annual Report and attendant deal studies reflect an earnest effort to grapple with the lack of equity and efficiency in the present patchwork of income security programs. This situation, unfortunate which has developed over the years, presents problems not only to the elderly and other population groups, but to the taxpayer who must pay the added costs resulting from such inefficiency. My legislative proposals reflect careful consideration of how best to resolve these issues and I urge prompt action on them by the Congress. Additional mention should he wode of greatly appreciate the substantial contribution made think by of the two studies undertaken by the Federal Council on Aging Their efforts, and The the efforts of those that participated in - the their studies efforts, will will be untibute a valuable Ematemelly asset to us in (Atur providing effort to provide promiter necessary income and services to our less fortunate elderly citizens in an efficient manner. These reports to Federal sent will for be disseminated review and analysis those agencies serving older persons, for their review and analysis. After this review, decisions on the recommendations contained in the Council's report will be reflected in future legislative proposals and administrative actions of this Administration. To the Congress of the United States: I am transmitting herewith the Annual Report of the Federal Council on Aging, together with two studies under- taken by the Council as required by Sections 205 (f-h) of the Older Americans Act (P.L. 93-29). msert The Council's report and studies provide documentation, from the viewpoint of our elderly citizens, which support the need for legislation along the lines of my proposed Income Assistance Simplification Act and Financial and the I ASA which I well be proposury shortly Assistance for Health Care Act My proposals would permit both Federal and State programs to be simplified and integrated into a coordinated system that best meets the needs of our citizens. Supplemental Council Recommendations With respect to the Social Security Income (SSI) program, the Council has recommended in its program report that legislation be passed that mandates continuance of a specific State supplementation for certain recipients. The Federal Government took over this program from the States on January 1, 1974, and provided a basic payment level to recipients. For those individuals who received benefits under the State programs in December 1973 that were larger than the basic Federal payment level, and who continue to be eligible for SSI, States are required to supplement -2- level of of the the basic Federal payment up to the December 1973 payment to such recipients. This requirement does not apply to new recipients who became eligible after December 1973. The Council's legislative proposal would require that the size of the State supplementation to recipients carried over from the State programs on January 1, 1974, could not be reduced. Thus, whenever the basic Federal payment level is increased, this proposal would allow States to continue to maintain a disparity in the benefits for the carried-over recipients versus those recipients who came on the rolls after December 1973--a disparity equal to the amount of the original State supplementation. world hare would Adystion This recommendation two lefects. First, it dictates to the States how they should spend the taxes they assess on their residents. Such action would distort the original concept of the program of separate but complementary roles of the States and the Federal Government. Second, it would require the States to maintain payments to people based on the date they started receiving assistance, even though other residents of the States may have equivalent needs and incomes. The Council also recommends that the Veterans' FORD & LIBRARY GERALD Administration (VA) be directed to study the problem of benefit reduction rates caused by simultaneous receipt of benefits from pensions for veterans with nonservice- we share the concern connected disabilities and other Federal programs. / This of the 15 being council. problem has been studied in some detail by the Veterans' -3- Administration within the context of total reform of the veterans' pension program. The Agency has discussed pension reform with both the House and Senate Veterans' Affairs discussions Committees, and is committed to continuing these dialogues with Congress this year. The relationship of veterans' pensions to other Federal benefits can best be addressed in the course of these discussions. To better assess the tax burden on the elderly, the Older Americans Act also required the Council to undertake a study of the combined impact of all taxes on the elderly. Since many of the tax recommendations of the Council are directed towards State and local government, consistent with the enabling authority, I am also transmitting this study to the Governors and legislatures of the States for their consideration. In recognition of the Bicentennial and the many contributions made by Older Americans to the welfare of the nation, the Council's annual report requests the promulgation of a Bicentennial Charter for older Americans. I have asked Secretary Mathews of the Department of Health, Education, and Welfare, in consultation with the Administration on Aging, [ to evaluate and refine this charter, and to promote discussion of these vital matters at forums of older persons organized by Advisory Committees to the Area Agencies on Aging. -4- The Federal Council on Aging Annual Report and attendant studies reflect an earnest effort to grapple with the lack of equity and efficiency in the present patchwork of income security programs. The situation, which has developed over the years, presents problems to not only the elderly and other population groups, but to the taxpayer who must pay the added costs resulting from such inefficiency. My legislative proposals reflect careful consideration of how best to resolve these issues and I urge prompt action on them by the Congress. I greatly appreciate the substantial contribution made by the two studies undertaken by the Federal Council on Aging. Their efforts, and the efforts of those that participated in their efforts, will be a valuable asset to us in providing necessary income and services to our less fortunate elderly citizens in an efficient manner. These reports will be disseminated to those Federal agencies serving older persons for their review and analysis. After this review, decisions on the recommenda- tions contained in the Council's report will be reflected in future legislative proposals and administrative actions of this Administration. Last your indicated then two that J was looking for ward to receiving two studies from the Federal Council in Aguy The Cornal they recognized that responsibilities and undertook the task appriciate the work that the Cornel has done, in a forthright fink fashion I very much especially a then the time constraints imposed on than it. GERALD FORD LIBRANT full FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 July 28, 1976 TO : FCA Executive Mailing List FROM: Cleonice Tavani Executive Director INFORMATION MEMORANDUM To keep you posted on activities of the Federal Council on the Aging, we recently sent you copies of monthly summaries for May and June. Enclosed are minutes of the May quarterly meeting of the Council. We have also sent you a copy of the Bicentennial Charter in its 11 X 14 inch red, white and blue format (suitable for framing). If you would like more copies, either folder or not folded, please contact the FCA Secretariat. The next quarterly meeting of the Council will be held'on Monday, September 13 and Tuesday, September 14. Major agenda items will be critiquing of 1971 White House Conference on Aging recommendations, proposed study of assets and asset test- ing for income conditioned benefit programs and recommendations for services to the frail elderly. The FCA Secretariat is expected to move with AoA in the next month or so to the HEW North Building. We hope to have the same telephone number, namely, 245-0441. There will be no change in our mailing address: Federal Council on the Aging; Washington, D.C. 20201. Hope you are enjoying the bicentennial summer. Cleo Tavane FORD LIBRARY 4 Enclosure Minutes of May 27-28, 1976 FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 SUMMARY MINUTES Meeting May 27, 1976 9:30 a.m. - 5:00 p.m. Donohoe Bldg., Rm. 3563 May 28, 1976 9:00 a.m. - 3:00 p.m. 400 Sixth Street, S.W. Washington, D.C. 20201 Chairman Bertha S. Adkins presided at a regular meeting of the Federal Council on the Aging. Executive Director Cleonice Tavani served as the recorder. The meeting was open to public observation and notice was published in the Federal Register. Attendance Members Bertha S. Adkins Frank B. Henderson Nelson H. Cruikshank Hobart C. Jackson Dorothy L. Devereux John B. Martin Charles J. Fahey Garson Meyer Selden G. Hill Bernard E. Nash Lennie-Marie P. Tolliver Ex Officio Members Arthur S. Flemming (5/27) FCA Staff Cleonice Tavani Robert M. Foster Alice B. Freer F. Richard Williams Leonard D. Cain (Consultant) Agency George E. Murphy SRS/HEW Muriel Shurr - AoA/HEW Phyllis Jones - OCA/HEW Phyllis Rosenberg - NIH/HEW Juanita Yates - OCA/HEW Mercia Decker - AoA/HEW Roberta Brown - AoA/HEW Sherry Hiemstra - AoA/HEW Eleanor O'Mara - AoA/HEW Yvonne Willis - AoA/HEW Marvin Taves - AoA/HEW Guest Speaker Public Dr. Robert N. Butler - Director 18 National Institute on Aging 2. FCA Minutes - May 27-28, 1976 1. Approval of Minutes of Meeting, March 16-17, 1976 The minutes of the meeting of March 16-17, 1976, previously mailed to members, were approved. 2. Progress Report from Task Force on the Frail Elderly As chairman of the Task Force on the Frail Elderly, Msgr. Fahey described the work involved with producing the draft report entitled "A Conceptual Base for a National Policy and Program for Services for the Frail Elderly" which had been sent to members before the meeting. He said that this working document attempts to identify and clarify some of the basic con- cepts involved with the "frail elderly project" as a prelude to a "pro- gram paper" which will contain the nuts and bolts of policy and program to be forwarded as part of the FCA annual report to the President for im- plementation. The major concepts in the paper developed by consultant Leonard Cain under the direction of the Task Force and Executive Director Cleonice Tavani are that of the notion of "entitlement" and of an identifi- able group, namely the "frail elderly". The concept of a "floor" of services must be further developed by the Council. Ms. Tavani used a chart to describe the total national policy framework within which the Council formulation for the frail elderly is being developed beginning with the "floor" of income which is now provided through Social Security and the Supplemental Security Income programs and the provisions for catastrophic medical care by means of Medicare and Medicaid. An incremental approach to the development of floor of services is the essence of the frail elderly concept. It begins with those as- pects which will enhance the functioning of the natural support systems.. starting with the family. When this level is not able to function, there should be the triggering of the formal set of services which the Council is postulating for the frail elderly. Dr. Cain reviewed the variety of existing Federal programs which use a certain age as a "trigger" for eligibility. He said that as far as is known, there is no trigger eligibility on the basis of change in social circumstances such as death of a care-giving spouse which is often an immediate cause of "frailty". It was agreed that chronological age be it 75 or any other age is not of itself a positive indication of frailty but the data would suggest that some age, set at 75 or nearby, is a fairly accurate indicator of a substantial number of persons having one or several chronically debilitating conditions. Msgr. Fahey summarized that the use of a particular age is really to establish a point at which "presumptive" eligibility is said to take place based on certain indicators with the goal of effecting administrative ease and economies in administering a benefit. It was agreed that it will be the work of the Committee on Re- search and Manpower to collect additional demographic data before the Council adopts a stand on a certain age. Particular attention will be given to collecting all available statistics regarding any ethnic differences. FORD LIBRARY 3. FCA Minutes - May 27-28, 1976 At the same time, there was general agreement that, if feasible, the FCA position would include a recommendation for permitting access to the same floor of services for those under this certain age if they meet certain specific eligibility criteria. The specific set of services which is being forwarded by the Council is being characterized by the Task Force as an attempt to enhance or assist any available family resources or to replace when necessary but in a "familial fashion". Considerable debate ensued about the changing role of the family today and just how much family, friends, neighborhood and church - society's traditional institutions - can be looked to either for assistance or as a model for helping the frail elderly. This is to be an area for further exploration by the Senior Services committee. Msgr. Fahey said that Dr. Cain would proceed to revise his paper and complete the sections that had been previously outlined. This second draft will be utilized by each of the Council standing committees at their scheduled meetings this summer to complete the aspects of the overall project which come under their scope of interest. Msgr. Fahey will work out the specifics with staff including recommendations for use of con- sultants by each committee to assist with their specific assignments. Dr. Cain will then be available to integrate and edit the work of each of the sub-units into a third draft to be reviewed by the Council at its September meeting, further revised by the Task Force with the possible assistance of an invitational seminar and a session at the Gerontological Society in October, then given final approval by the Council at its December meeting. The session at the Geronotological Society annual meeting in New York would be a presentation by certain members of the Council - not an offi- cial Council function. 3. Status of FCA Aging Manpower Projects Council member Bernard Nash and FCA staff Robert Foster reported for the Research and Manpower Committee, first on the postponement of the hearing on health manpower needs, in favor of a gathering of data. Letters were sent to the Secretary of HEW, the Secretary of Labor, other Federal agencies and national organizations asking for their assistance. They were asked for data on health manpower training programs, short and long- range planning to meet projected manpower requirements and asked to de- signate a contact person for any needed follow-up. After the material is all collected and given general analysis by staff, the committee will meet to determine further action. Mr. Nash is to testify at the Administra- tion on Aging hearing on social services manpower needs on May 28, in behalf of the Council. 4. Status of Assets Project Nelson Cruikshank, Chairman of the Economics on Aging Committee reported that FCA staff had set up a meeting on June 14 for him to meet with Dr. Robert Lampman, Professor of Economics, University of Wisconsin to obtain his views on FCA plans for the asset study. It is hoped that Dr. Lampman 4. FCA Minutes - May 27-28, 1976 will have time available during the summer to develop a study plan for the project. Several other economists and experts, primarily from within HEW have also been invited to obtain their views on procedures for implementing the recommendation contained in the FCA Benefits study regarding the way in which assets and asset income should be considered in determining eligi- bility for benefits. 5. Presidential Proclamation - Older Americans Month - FCA Bicentennial Charter Mrs. Alice Freer, Assistant to the Executive Director, reported that the President proclaimed May Older Americans Month in a White House Ceremony on April 5, 1976. He urged the marking of the month by arranging public forums on the Bicentennial Charter for Older Americans which was developed by the Federal Council. Mr. Martin and Ms. Tavani represented the Council at the ceremony. Announcement of the Charter and the Charter itself were published in May - June 1976 Aging magazine. The Administration on Aging has established procedures for distribution of the Charter, guidance on the holding of forums and means whereby any resultant recommendations will ultimately reach the Council for action. The Charter will be used by the National Commission on the Observance of International Women's Year, as discussion material in 50 State conferences. The FCA Secretariat will distribute the Charter to major national organ- izations while the National Clearinghouse on Aging handles all other dis- tribution. 6. President's Response to Annual Report and Council Studies No response has been received from the White House to the Annual Report and/or the two Council studies - The Interrelationships of Benefit Pro- grams for the Elderly and The Impact of the Tax Structure on the Elderly. 7. FCA Participation in FTC Hearing Miss Adkins reported that she had accepted a request to represent the Council at hearings to be held by the Federal Trade Commission on pro- posed regulations for the hearing aid industry. Miss Adkins would testify on June 9 in Chicago. The proposed rule allows cancellation of a purchase of a hearing aid within 30 days, with most of the purchase price refunded. The rule also requires written consent obtained prior to any sales visit to the home or place of business of the prospective customer, and provisions are designed to ensure that consumers have accurate and adequate information on the hearing aid. The Council authorized Miss Adkins' appearance and testimony in favor of the proposed regulations. Miss Adkins read to the Council the ad- vance statement which she had submitted to the FTC. The Council generally 5. FCA Minutes - May 27-28, 1976 agreed that insofar as possible during any colloquy following her formal presentation, Miss Adkins should reflect the Council's concern for pro- fessional technical consultation being available to the older person in making a decision to obtain a hearing aid. Mrs. Muriel Shurr, Program Analyst, Office of Planning and Evaluation, Administration on Aging brought to the attention of the Council informa- tion about rules being proposed by the Food and Drug Administration, for "Professional and Patient Labeling and Conditions for Sale for Hearing Aid Devices". The rules have two parts with the major one being a requirement of a medical examination. This requirement can be waived by anyone over 18; those under 18 must have a medical examination prior to purchase of a hearing aid. If a hearing aid dealer talks to a prospective user and finds any one of seven medical conditions, the person must be referred to an ear specialist or to a physician. The second part of the proposed regulation is more technical involving labeling and communication between the hear- ing aid dealer and the prospective buyer. The Council voted to comment on the Food and Drug Administration Rules, recommending that a medical evaluation be required of a prospective pur- chaser of a hearing aid in all cases except when religious beliefs pre- clude medical assistance from a physician. Recess for Demonstration, President's Council on Physical Fitness Dr. Richard 0. Keelor, Director of Program Development, President's Council on Physical Fitness and Sports gave a status report on a demonstration program on physical fitness for older Americans which is being funded by AoA. He led Council members through some of the exercises being used in the project and distributed training kits which have been developed. 8. Status of AoA Activities regarding the Frail Elderly Dr. Arthur Flemming, Commissioner on Aging had been asked to comment on the basic concepts of the frail elderly project of the Council as con- tained in the FCA annual report and Dr. Cain's paper and how AoAs current and future efforts related to the FCA activity. Dr. Flemming said he had trouble with the term "frail elderly" because it contributes to stereotypes about older persons. He also expressed concern about using an age cutoff. He found the concept of "a floor of services" as a challenging one. These are questions which Dr. Flemming wants to be considered, through his executive staff in connection with the whole forward planning process of AoA. Commission Flemming said that is is entirely possible that out of AoA exploration of the frail elderly concept there may emerge some very specific ideas for research proposals, and out of Council dialogue with Dr. Butler, (Director of National Institute on Aging), as well as the people at NIMH and their associates other ideas may emerge. 6. FCA Minutes - May 27-28, 1976 Dr. Flemming then provided for Council members an overview of the second supplemental appropriations bill, which contains money not for just fiscal 1976, but also the transition quarter to October 1976. By the end of the transition quarter, AoA will be allocating around $300 million to States. 9. Monitoring of Continuing Policy Issues a. Funding of Section 202 Housing Mr. Martin, Mr. Cruikshank, Msgr. Fahey and Mr. Jackson provided a general status report of the funding of housing under Section 202 of the Housing and Community Development Act. An authorization of $750 million for FY 1977 has been proposed by the House Appropriation Committee. There was agreement that Secretary Carla Hills has evidently become a champion of 202 and such other aids for housing for the elderly once she learned about its good track record and its real need. A continuing problem is providing much needed "soft" social services along with a physical home. There are certain provisions for allowing construction costs to include, for instance, space for health care in congregate senior housing. The problem is in paying for staff to conduct even a modest health screening program. There is an AoA - HUD staff committee and working agreement in this area which Council members agreed should be monitored for appropriate FCA follow-through on this issue of the relationships of social services to subsidized congregate housing. Hobart Jackson discussed his continuing concern that the 202 housing program does not provide for any special access to reduce the inequities that currently exist in the program with reference to its services to minorities. Only 3 percent of the tenants of these 202 housing develop- ments are black despite the fact that the black elderly represent 8 per cent of the elderly population. He believes there should be special efforts to develop minority sponsors in minority communities. It was agreed that working through the Economics Committee, Mr. Jackson would pre- pare a position for Council approval to be conveyed to the Secretary of HUD containing specific action steps for improving minority access to HUD assisted housing for the elderly. 9b. HUD Proposed Rules on Low-Income Public Housing Income Limits The Council approved a draft letter prepared by staff and distributed at the meeting supporting proposed rules by the Department of Housing and Urban Development regarding income limits for residents of low-income public housing. The Council expressed its particular support for a pro- vision restricting eviction of families based on income because of its particular importance to low-income elderly whose limited assets might increase in value based solely on inflation with no increase in "real" income. 7. FCA Minutes - May 27-28, 1976 9c. Follow-up. to National Policy Concerns for Older Women The Chairman had asked Mrs. Tolliver to serve as coordinator for follow- up to Council activities during 1975 marking International Women's Year. Mrs. Tolliver distributed a memo reporting that she had reviewed the pub- lication "Commitment To A Better Life" which had resulted from the Council hearing in September 1975. The Council approved Mrs. Tolliver's recom- mendation to ask the Administration on Aging, the National Institute on Aging, and the Social Security Administration to review the report and the recommendations contained therein to determine what areas they would be able to follow up, and also to seek for their inclusion certain recom- mendations in their program and research plans in the future. The Council also agreed to Mrs. Tolliver's proposal to cooperate with the National Commission on the Observance of International Women's Year on their planned series of state conferences. This continuing IWY activities have been funded by Congress for $5 million. The FCA would ask that the Commission consider that the "Commitment To A Better Life" become a part of their deliberations and also that older women be included in both plan- ning and implementation. 9d. Follow-up to WHCOA recommendations Cleonice Tavani, Executive Director, FCA, reported that the Administration on Aging is still working on preparing a report for Congressman Randall on the responses to the recommendations made by the White House Conference on the Aging. It is hoped that this material will be available as a re- source to the Council project of analyzing and critiquing the implementa- tion. At the staff level, the recommendations will be divided into appropriate sections for review by each of the Council committees. Concern was expressed with the feasibility of this project because of the great number of recommendations. It will be up to the Committees working with staff during the summer to determine which recommendations should be stressed as a base for still needed priority actions. It will also be necessary to further develop the overall format and scope of the project. 9e. Social Security - Decoupling and Long Term Financing Nelson Cruikshank reporting on the Social Security Trustees report, said that the Council could claim some modest success with respect to this report. (SSA staff briefing notes which had been prepared for Mr. Cardwell were distributed at the meeting. The Trustees reports were available as desired by members.) The FCA had asked that the Administration proceed with decoupling legis- lation. The White House has yet to act but Senator Bentsen has intro- duced a bill which would carry out essentially what the FCA supports. There is considerable difference of opinion within the Administration. 8. FCA Minutes - May 27-28, 1976 Social Security wants to decouple, maintaining the replacement ratio in benefits. There are pressures, largely from Treasury, to cut down the re- placement ratio and make it a part of the decoupling. There is also an issue as to whether the ratio of increases should be tied just to wages, which is what most people want who want to preserve the system, or tied to the price index. If benefits are related to past wages one more nearly assures that the standard of living on the part of the retiree is main- tained, rather than if it coupled to the price index. The FCA Committee on the Economics of Aging will continue monitoring Social Security includ- ing studying the implications of a seeming increase in withdrawals and intent to withdraw from the Social Security system by local government employee units. 9f. Medicaid Cost Reimbursement Regulations FCA staff in conjunction with several members had prepared a draft com- mentary for the Council on proposed HEW rules to amend regulations to the Medicaid programs regarding reimbursement for long-term care. This draft proposal was a point-by-point response and upon further consideration, the Council decided that it would be more effective to phrase an FCA position in general terms urging that the final regulations embody the following principles: 1. Modest cost associated with the social and human support of the long-term care patient should be construed as reasonable and be reimbursed. 2. No State should be allowed to develop reimbursement techniques which result in payment less than that which is reasonably incurred. Federal and State codes should be the minimum basis of such reasonableness. The letter to the Secretary of HEW will conclude with an affirmation that this policy should be the basis for equal access to quality care for all persons and that the special problems associated with long-term care of minority groups deserve special consideration and initiatives. 9g. Proposed Regulation on Proprietary Home Health Care Agencies At the last Council meeting, a letter was authorized to the Secretary of HEW supporting the position of the Commissioner on Aging on proposed HEW regulations regarding the use of proprietary home health services. The matter is still pending and there is a possibility public hearings will be held before the Secretary makes a final decision. The Council agreed to delegate to the Senior Services Committee respon- sibility to testify at any possible hearings before the next Council meet- ing if the Committee comes up with a position. 9. FCA Minutes - May 27-28, 1976 9h. Incorporating Elderly Concerns in New Health System Network Father Fahey said that the health systems agencies are now coming into being at the local level under the National Health Planning and Resources Act of 1974. These will have major impact on older people who consume so much of health care. It was agreed that a letter should be sent to the Secretary of HEW to urge that when HSA funding requests are reviewed by the Department, that particular attention should be given to their responsiveness to the health needs of their older citizens. Also that the technical assistance programs for HSAs contain a component on the health needs of the elderly. 10. Director of NIA as FCA Ex Officio Member Upon Miss Adkins recommendation, the Council agreed to recommend that the Director of the National Institute on the Aging should be an ex officio member of the FCA. An amendment to the Older Americans Act is required to fulfill this action. The NIA Director would have the same status as the Commissioner on Aging and the Secretary of HEW. 11. Report on National Institute on Aging Miss Adkins introduced Dr. Robert N. Butler, newly appointed Director of the National Institute on Aging, recently awarded a Pulitzer prize for his book "Why Survive: Being Old in America". The mission of the Institute, said Dr. Butler, is a broad-based one for bio-medical, behavioral, and social research and also to be available to examine in a precise, reproducible way studies that are related to health delivery and social care delivery. The Institute on Aging is very much like the traditional institutes at NIH like Cancer and Heart. NIA is the smallest institute. The Gerontology Research Center begun by Dr. Nathan Shock at Baltimore City Hospital in 1941 is now part of NIA as the major component of its intramural program. Dr. Butler invited the Council to visit the Baltimore facility. Addressing the particular concerns of the FCA regarding the frail elderly, Dr. Butler said Dr. Cain's work on the two-tier system is very useful. Dr. Butler is attuned to the functional definition of frailty rather than one that is chronologically age bound. He believes functional impairments or frailty go on through the course of life. He supports more effective care systems but at the same time he urged the Council to be concerned about the basic civil rights of the frail, preserving for them the oppor- tunity of choice. Dr. Butler commented on senile dementia as one of the most common causes of frailty in the later years. He said there is some promising evidence that it may be related to auto-immune phenomena and any program on the frail elderly has to involve effective research in this area. 10. FCA Minutes - May 27-28, 1976 With respect to the health manpower project of the Council, NIA is in- terested in cooperating but with its limited staff is concentrating on trying to understand aging research manpower need. Dr. Butler believes there should be a speciality of geriatric medicine. He suggested the Council support clinical gerontology in general including not only geriatric medicine but geriatric nursing, geriatric social work and other such specialties. Father Fahey described areas of study related to the frail elderly which he thought might impinge upon the work of NIA. There is the question of identifying frailty. Another is the criteria that would trigger some battery of fundamental services being available. He described the par- ticular services which the Council is proposing as this floor of services. Dr. Butler thought studies of family lifestyles should be undertaken through NIA to determine, for instance, how different ethnic groups care for their elderly. On the threshold question, Dr. Butler expressed his concern with global definitions such as "frailty". He believes in a multi-causal threshold theory. Speaking of the HEW Research Plan in Aging, Dr. Butler said it contained a list of long-term needs in four major categories: social and psycholog- ical sciences, biology of aging, investigative medicine and training. The report is titled "Our Future Selves" and will be available to the Council as soon as it goes from the HEW Secretary to Congress. Three appendix volumes will accompany the basic summary document. 12. Review of FCA Committee Plans for 1976 Miss Adkins listed the assignments given to each standing committee from the frail elderly project and the review of the implementation of the 1971 WHCOA recommendations. Garson Meyer said he was troubled that the Council might be sidetracking all of the other subjects by reason of the frail elderly project. He wondered if the Council should not be taking a little more positive action on other matters that had been brought up during the meeting. Miss Adkins replied that there was a need for addi- tional staff which was being pursued so that other priorities could be more fully addressed by the Council. Dorothy Devereux, reporting for the Research and Manpower Committee, said that a meeting was tentatively planned for July on the West Coast to re- view the progress on and further planning for the health manpower project. The committee will also review the research plan on aging being prepared by the National Institute on Aging. John Martin, chairman of the Senior Services Committee, described the continuing work of his committee in implementing the FCA "action" step which was contained in the Benefits study for "a minimum and internally consistent set of income-conditioned benefits and services for the elderly". In this connection, they will begin by examining existing service programs 11. FCA Minutes - May 27-28, 1976 such as are provided by Titles III and VII of the Older Americans Act, the means test and Title XX and the relationship of services to subsidized housing. The Committee on the Economics of Aging, under the chairmanship of Nelson Cruikshank, is meeting on June 14 with economist Robert Lampman of the University of Wisconsin and with several economists in HEW to further develop a work strategy on the assets project. This activity, for im- plementing the action step contained in the Benefits study for a study of the way in which assets and asset income are considered in determining eligibility for benefit programs, was assigned to the Economics Committee for monitoring. Dr. Lampman's report will then be considered at the meet- ing of the Economics Committee on August 5-6. The committee will also con- tinue their observations on the settlement of the "decoupling" issue in Social Security as well as its long-range financing aspects. Their over- all agenda includes: the impact of employment retirement income as a result of the enactment of ERISA (Employment Retirement Security Act) and on the continuing need for subsidized housing for the elderly with particular con- cern for the low-income minority elderly. Mr. Jackson and Mrs. Tolliver expressed their concern that with the full agendas of the committees and the very way in which they were structured around general issues such as health or housing often precluded an em- phasis on special concerns and special groups of the elderly such as minorities. Miss Adkins urged each committee to consider the concerns for the problems of minorities which have been expressed from time to time and to bring their recommendations for further appropriate Council action to the September meeting. Recorder: Certified: Cleinice Tavane Britha S. Aakin Cleonice Tavani Bertha S. Adkins Executive Director Chairman Federal Council on the Aging Federal Council on the Aging Materials distributed at Meeting GERALD Letter to Dr. Robert Lampman on assets project, 5-11-76 Memo from FCA Chairman to members on FTC hearing Letter to Secretary Hills on proposed rules on public housing Memo from Mrs. Tolliver to members on follow-up to IWY Letters to AoA, NIA, SSA requesting comments on FCA report on Older Women SSA briefing notes on Trustees Report, 5-24-76 Livda 2941 Folks R Bertha adkins R Dorothy Devereny R* Carl Endorfer nursing home up R*Mon Chas Fahey Cath church R John Uartin altern Winston (Brock) Holland (Rhodes) is on due for clearance Javits is upset about Fahry have not been announced or yent to Hul for confirmation FORD LIBRARY & GERALD appointments to Fedi council on aging Lindak Mames have to be approved by Senate act until are uplaced by confirmed replacement are dropping 2 prestigions people 5 vacancies coming upon June - cal be others on then Chas Carize Va political lay people (Fell employees) Free al NC (cndear Frank Henderson Penr (Sm w/ Scott) henny Tolliver (black) Hill FCa ( gunney in promotion) Cleo Tavane 11/14 Fedi Council on aging annual report due deliver to WH 1/1/76 well he 2 studies of 0 The mtg. Dec 3,4,5 to review report mut w/ clumbing, Fairley income maintenance coordination 531 food stamps medicard how maintain equity tax I tudy - re property Day not m favor of Fedi Assistance to states to help not property tax relief prosram (as Notanz proposed) do favor subsidized housing elduly don't do badly re tax system low income cd do better elderly as group are ok NOTE.-DO NOT USE THIS ROUTE SLIP TO SHOW FORMAL CLEARANCES OR APPROVALS DATE 7/19/26 TO: AGENCY BLDG. ROOM 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: FORD is LIBRARY GERALD (Fold here for return) To From Cleotavani PHONE BUILDING ROOM 245.0441 Donohoe 4022 FORM HEW-30 REV. 11/56 ROUTE SLIP GPO: 1975 O - 590-173 FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 AGENDA SENIOR SERVICES COMMITTEE Presiding: John B. Martin, Chairman Members: Charles J. Fahey Lennie-Marie P. Tolliver Frank B. Henderson Frell M. Owl (not attending) Chairman, FCA Bertha S. Adkins Consultant: Leonard D Cain Staff: Cleonice Tavani, Executive Director GEBALOR FORD JERNIA MEETING Room 4559 Donohoe Building Washington, D. C. Thursday, July 22 9:30 a.m. - 4:00 p.m. 1. Approval of Minutes of November 6,7, 1975 2. Development of Recommendations for a Senior Services System 3. Critique of 1971 White House Conference on Aging Recommendations Friday, July 23 9:30 a.m. - 4:00 p.m. 1. Review of Recommendations for Services to the Frail Elderly R send allen On copy of aak ins litter letter - then file all un 4 Fell Councel on Aging" FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 March 23, 1976 The Honorable William E. Simon Secretary of the Treasury U.S. Department of the Treasury Washington, D.C. 20220 GERALD FORD LIBRARK Dear Mr. Secretary: At the recent meeting of the Federal Council on the Aging on March 16-17, the members discussed your response of the 16th of February to our concerns about the Social Security program. We sincerely appreciate your interest in our views regarding the future of the system. As you know, the well-being of senior citizens of this country is heavily dependent upon benefits received from the Social Security program. Recent attacks on the soundness of financ- ing arrangements, both in the short run and in the long run, have aroused deep apprehensions which we believe are not only detrimental to an individual's sense of security, but also to his confidence in his government. It is, therefore, of crucial importance to both current retirees and workers and to future generations that the ill-founded predictions of alarmists be counteracted by carefully reasoned forecasts in the Trustees' Report and in related press releases. In particular, the press releases should indicate the assumptions used to develop the forecasts. We understand that there are two distinct aspects to the financing difficulties. First, there is the short-run prob- lem of benefit payouts in excess of current contributions which adversely affect the level of the trust fund. Second, there is a projected long-run difficulty attributable in part to an unintended but easily correctable error in the computa- tion of cost-of-living increases in benefits which, under certain wage and price relationships, may over-compensate future retirees. Additionally, the projected long-run dif- ficulty is attributable, in part, to the anticipated change in the future proportion of retirees in the population. We are, of course, pleased that the President has affirmed his support in regard to "decoupling" the system. We are also delighted that both the tone of the President's response to our letter of December 23 and the language of his budget proposals in this regard indicate that he is in favor of maintaining the present relationship of benefits to earnings over time. Federal Council on the Aging P. 2 Secretary Simon - March 23, 1976 Your letter indicates that there is a related concern arising out of the projected change in composition of the population; that is, benefits can only keep pace with earnings in the long run if payroll tax rates are raised sharply, with the result that intergenerational equity is violated by differing rates of return. It is not clear that intergenerational equity is the most prominent issue. Although it merits consideration, any reconciliation of this issue must be consistent with the primary goal of social insurance which is to provide adequate replacement of income which is lost due to retirement, death or disability. In this regard, it appears desirable to re- examine the assumption of complete reliance on exclusively internal pay-as-you-go financing in future years. Forecasts are only as reliable as the validity of the assump- tions upon which they are based. Therefore, we believe fore- casts for the Trustees' Report must represent a variety of reasonable assumptions about rates of growth in GNP, wages, prices, labor force participation rates, fertility rates, and so forth. It would appear equally desirable, given the current concerns of the American people of all ages, to include varied financing options as well. Additionally, since the "decoupling" issue is a major part of the President's Social Security financing proposals, and since Congress will most certainly "decouple" the system in ample time to prevent super-indexing of future benefits, we would urge that the forecasts of the Trustees' Report include the assumption of a decoupled system. We understand that the Pres- ident's position with respect to the decoupling issue, with which we are in accord, is to adopt the recommendations of the Advisory Council of 1975 which would preserve on into the future the present relation of benefits at the time of retirement to wages recently earned. We hope these views will be of value and look forward to a con- tinuing dialogue with you on the long-term financing of Social Security. We echo the sentiments of the President in emphasiz- ing the importance of restoring public confidence in a sound social insurance program. Bertha S. Adkins Chairman FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 March 18, 1976 Honorable David Mathews Secretary Department of Health, Education, and Welfare Washington, D.C. 20201 Dear Mr. Secretary: At the March 16-17 meeting of the Federal Council on the Aging, discussion was held on the question you are facing in establishing regulations for the use of health service organizations and profit-making agencies to provide home health services. Some of our Council members believe strongly that this is an area of service in which proprietary groups should not have a function. There are other members who sincerely believe that in our free society-if the service is of equal quality and equal cost-both proprietary and non-proprietary groups should be involved in providing home health care. We are all agreed, however, that if satisfactory answers are found to the questions raised by the Commissioner on Aging in a previous communication to you on these regulations, then you will have criteria for a successful program which will avoid many of the problems created in the nursing home field by the enactment of Medicare and Medicaid. Sincerely, Bertha S. Adkins Chairman WINTER, 1976 THE SENIOR INDEPENDENT Page 3 IS opinions Government Programs For Senior Citizens President Ford recently named Dr. Nat Winston and Mr. Harry Holland to the Federal Council on the Aging, ending a long battle to determine the future balance on that critical government agency. You and many of our best Members of the United States House of Representatives and the U.S. Senate sent strong messages of support for Dr. Winston to the President, and succeeded in winning the battle for these crucial seats on the Council. special The Alliance had fought to remove two men from the Unitersand Washington Report on LONG CARE L McGRAW HILL PUBLICATION EDITORIAL OFFICE NATIONAL PRESS BUILDING WASHINGTON D C 20045 TELEPHONE 1202) 347-4424 Ronald Schwartz. Editor Jerome F. Brazda, Executive Editor Dale R. Bauer, Publisher February 11, 1976 - Vol. 5, No. 7 Senior Citizen Groups Do Not Buy President's Pitch for Their Vote Political Appointments Made to Federal Aging Council Effort Is Underway in HEW to Repeal Medicaid Cost- Related Reimbursement: Medicare Hearings Begin FORD i LIBRARY 070830 Washington Report on Long Term Care - 2 FORD SEEKS TO DEFUSE AGING COUNCIL WITH NEW APPOINTEES President Ford has nominated two new members of the Federal Council on Aging who, when confirmed by the Senate, would replace two of the more outspoken members of the group that advises the President on mat- ters concerning the elderly. The two new appointees are Dr. Nat T. Winston Jr., a Nashville psychiatrist and vice president of Hospital Affiliates International, a multifacility, proprietary hospital firm; and Harry Holland of Phoenix, president of the Arizona Council for Senior Citizens. The two would replace Rev. Charles Fahey and Dr. Carl Eisdorfer, whose three-year terms on FCA will expire. However, President Ford did re-appoint Bertha Adkins, Dorothy Devereaux and John B. Martin, former Commissioner on Aging. Both Fahey and Eisdorfer were strong forces behind FCA's recommendations to President Ford opposing his cutbacks in social services and health programs (see LTC 8-1-75). The call for replacing Fahey, president of the nonprofit American Association of Homes for the Aging, was made this summer by the conservative National Alliance of Senior Citizens. Winston's nomination was pushed by this Washington-based organiza- tion and Sen. Bill Brock (R-Tenn.), while Holland's was backed by House Minority Leader John Rhodes (R-Ariz.). Winston was formerly chairman of the Brock re-election campaign committee and ran unsuccessfully as the Republican gubernatorial candidate in 1974. He was also national chair- man of the Country and Western Stars for the Re-election of President Nixon. HPW NEWS SCENE 1976:HOMES 1976: WITHOUT WALLS AMERICAN ASSOCIATION OF HOMES FOR THE AGING VOL. II, NO. 1 NEWS FROM THE NONPROFITS MARCH, 1976 God: 201 Well, certainly I admire Dick tity. At the end of 1976 we Short and his work for AAHA will have a better sense of who and at the Presbyterian Home we are. in High Point. The fact is my In 1974 at San Antonio we be- bishop in Syracuse, Bishop gan a process which was fur- David F. Cunningham, has given thered by the House of Delegates the Syracuse Charities staff the at San Diego. After a provoca- strongest support to develop tive and fruitful discussion, the services for the aging. This to- house instructed us to refer the gether with high caliber volun- matter to committee for further teer help and the progressive refinement. A committee, staff itself has enabled our chaired by Reverend Jerry D. diocese to sponsor the develop- Smart of Cincinnati, will follow FROM THE DESK OF THE ment of over $100 million in new through on this, and we should EXECUTIVE VICE PRESIDENT construction. More important, have a report by the spring the programs of service offered meeting of the house. During DAVID C. CROWLEY, by these many organizations 1976, AAHA will work even ACSW reflect a systemic approach to more closely with the state as- This issue of Newscene an- care of the aging from outreach sociations. Our members need service social service and both C viable AAHA PAGE 0 STAFF TABLE OF ORGANIZATION AMERICAN ASSOCIATION OF HOMES FOR THE AGING David C. Crowley Executive Vice President Services to Members Internal Functions Di ant Se FA FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 The enclosed material is sent to you because of your interest in the work of the Council. Cleo Tavani Sarah Massexgale FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 Meeting March 16, 1976 9:30 a.m. - 5:00 p.m. Donohoe Bldg. 400-6th St., S.W. March 17, 1976 9:00 a.m. - 3:00 p.m. Room 4549 Wash., D.C. 20201 Chairman Executive Director Bertha S. Adkins Cleonice Tavani 400-6th St., S.W. Room 4022 - Donohoe Bldg. Washington, D.C. 20201 (202) 245-0441 Vice Chairman Garson Meyer Agenda FORD & LIBRARY GERALD Tuesday, March 16, 1976 *9:30 a.m. 1. Approval of minutes of December 3-5, 1975 Council meeting, (previously mailed to members.) Adkins 9:45 a.m. 2. Status of FCA Annual Report and Studies on Taxes and Benefits. Adkins - Tavani 10:30 a.m. 3. Report on Assets Study Adkins -- Duskin 12:30 p.m. LUNCHEON RECESS 1:30 p.m. 4. Review of Presidential Message on Elderly Flemming 3:00 p.m. 5. Status of Hearings on Health Personnel Needs in Aging Eisdorfer - Foster 4:00 p.m. 6. Status of Aging Research Plan. Eisdorfer *Times subject to change Wednesday, March 17, 1976 9:00 a.m. 7. Briefing on Implementation of Housing Program for the Elderly William S. Warfield, Special Assistant to Assistant Secretary for Housing Production, Mortage Credit, HUD 10:00 a.m. 8. Further Action on Frail Elderly Priority Fahey - Cain 12 noon LUNCHEON RECESS 1:00 p.m. 9. Status of Policy Issues and Publication Regarding Older Women. Tolliver 10. Review FCA 1976 Schedule and Agenda Adkins - Tavani file FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 Bi-Monthly Report - January and February 1976 1. 1975 Annual Report to the President The Annual Report of the Council for calendar 1975 was submitted to the President on January 16, 1976 with copies to the Secretary of HEW, Assistant Secretary Thomas, Commissioner Flemming and Council members. Following transmittal of the report to Congress with the President's recommendations, it will be widely distributed. Ten thousand printed copies are to be ready in mid-March. The assistance of staff of the National Clearinghouse on Aging and a contractor for graphic design was utilized. The report contains summaries of the two mandated studies: The Impact of the Tax Structure on the Elderly and The Interrelationships of Bene- fit Programs for the Elderly as well as a "Bicentennial Charter for Older Americans" for suggested proclamation by the President. The report also highlights the Council priority on the "frail elderly". The Council postulates that there are a basic core of supportive social services - rather than primarily health services - which are needed by many of the oldest of the old. The following services should be avail- able to all frail older persons as an entitlement, regardless of the ability to pay: 1. A professional psycho-social-environmental assesment. 2. A skilled person to assist in securing the services and benefits to which an older person is entitled and who would arrange for and supervise personal care from a "significant other". 3. The provision of the physical presence of a "significant other" to assist in simple daily coping. The Council urges the President to assign to the Domestic Council Com- mittee on Aging responsibility for coordinating efforts for viable legislative and administrative proposals for the care of this population based on working models. The annual report also describes the Council's concern about due atten- tion being given to older women as part of the observance of International Women's Year in 1975 and into the proposed International Women's Decade. (The publication of the highlights of the hearing on older women con- ducted by the Council in September 1975 is in its final stages). 2. Studies on Taxes and Benefits The Government Printing Office has delivered completed copies of the Congressionally-mandated studies. Although these documents were - 2 - reproduced by offset methods, considerable FCA staff time was spent in arranging for the printed covers and keeping straight the two main re- ports and the three appendices of the benefits study. It is hoped that distribution of the studies to State and area agencies, national organi- zations, Federal staff and individual requesters can be coordinated with the issuance of the President's response to the studies to the Congress. The White House has indicated that the response should be forthcoming before mid-March. 3. Regular Council Meeting, March 16-17, 1976 A main agenda item for the quarterly Council meeting of March 16-17 to be held in Room 4549 of the Donohoe Building is a review of the Presi- dent's message on the elderly. There will also be a review of the President's comments of the FCA studies if that is available. A mailing to Council members on the meeting contained copies of the President's message and reactions to it by the major national senior citizen organi- zations. The Federal Register notice for this meeting was sent to certain Senators and Congressmen, their staffs, certain Federal employees, and almost 100 national organizations. 4. Decoupling in Social Security GERALO FORD LIBRARY The letter of 12-24-75 of the Council Chairman to the President on the "decoupling issue" in Social Security was answered by the President on February 3. He indicated that the Administration will submit legisla- tion to Congress to correct the funding problems caused by coupling of a continuing additional add-on to the cost-of-living increases granted to Social Security beneficiaries. Chairman Adkins followed up with a letter to Social Security Commissioner Cardwell notifying him that the Council was encouraged by the President's affirmative response and that the Council trusted that the President's statement that "a minimum of disruption to beneficiaries" means no interruption in the present relationship of benefits at the time of retirement to wages recently earned. Treasury Secretary Simon responded to the decoupling letter on 2-16-76. He expressed interest in the Councils' views on the question of the long-term relation of benefits to pre-retirement benefits. 5. Council Nominees On January 23, in Presidential Documents: Gerald R. Ford, 1976, Vol. 12 No. 4, The President announced his intention to nominate five persons to be members of the Federal Council on the Aging for terms expiring June 5, 1978. The are: Bertha S. Adkins, of Oxford, Md., retired. This is a reappointment. Mrs. John William Devereux, of Honolulu, Hawaii, retired community worker and former State legislator. This is a reappointment. John B. Martin, of Chevy Chase, Md., legislative consultant, American Association of Retired Persons and National Retired Teachers Association - 3 - and former United States Commissioner on Aging, Washington, D.C. This is a reappointment. Harry Holland, of Phoenix, Arizona, President, Arizona Council for Senior Citizens and Chairman, Governor's Task Force on Retirement and Aging. He will succeed Monsignor Charles J. Fahey whose term has expired. Nat T. Winston, Jr., of Nashville, Tenn., Vice President, Hospital Affiliates Inc., Professional Relations. He will succeed Dr. Carl Eisdorfer whose term has expired. As of March 1, the confirmation of these persons was still pending in the Senate Committee on Labor and Public Welfare. Under the Council's enabling legislation, the members currently filling this term remain in office until their successors are confirmed by the Senate. The FCA Secretariat has completed the paper work incidental to the June 6, 1976 term expirations of FCA Council members. 6. Proposed Aging Personnel Hearing At its December meeting, the Council approved a hearing in March on "Manpower Needs for Services to the Frail Elderly". During January and February, contacts were made with all members of the Research and Man- power Committee to review what appeared to be problems in most effec- tively implementing this Council action. It was the concensus that the planned format of the hearing was too broad to accomplish the goals of the hearing; the frail elderly definition on age base for entitlement needs further study and the Council has to study further the components of the frail elderly programs prior to considering hearings on manpower needs for services to the frail elderly. The views of the Committee members were presented to the Council Chair- man and it was agreed to postpone the hearing until further work can be completed by the Committee. Dr. Eisdorfer, Chairman of the Committee, will present a report to the Council in March based on suggestions from Committee members and will recommend a hearing focused on health manpower needs for the elderly. The plan will provide coordination and avoidance of duplication with AoA in the Hearings they plan on "Social Service Manpower Needs for Older Americans.' The FCA will attempt to solicit testimony related to the frail elderly in both the FCA and AoA Hearings. 7. Meeting on Preliminary Work on Assets Study As a required followup to recommendations in the tax and benefits studies the Council Chairman, FCA staff and Council member, Nelson Cruikshank met with Mrs. Elizabeth Duskin, consultant to the Council, on February 26 to review a preliminary paper on Asset Tests as a Component of Income Conditioned Programs." Highlights of the report include: wealth holdings are usually considered in determining eligibility - but not benefit levels, except as an asset in - 4 - produces income for most services and income maintenance programs. Income is usually measured as a cash flow over a given period of time. Assets are a list of the stock of items of value on hand that have been accumulated over a period of time. Assets are more difficult to measure than income. At present, we measure an income and an asset level below which an economic unit is eligible for income maintenance programs. A problem here is that low income slightly above allowed assets results in disqualification. Mathematically, all assets could be considered as a flow of income by treating the dollar value of assets like a lifetime annuity. This would then provide a measure of income and the annuity value of assets. This allows a rational way of distinguishing between the economic status of two households with different incomes and asset levels. An obvious failure of assets tests is that they favor the non-frugal individual and thus, for low income units work against self-sufficiency. They also result in under reporting and transfer of assets. Another problem in considering assets is how to measure their differences in liquidity, rates of return, divisibility to different owners, manner of acquisition, legal manner in which owned (singly or jointly), extent value fluctuates and ease in assigning a dollar value. The preliminary paper will be expanded and will contain recommendations for Council action at the March meeting. 8. Meeting with Consultant for Frail Elderly Task Force Msgr. Charles Fahey, Bernard Nash and FCA staff met on February 24 with Leonard Cain who is to serve as senior consultant to the Council on the frail elderly"issue. Dr. Cain is on sabbatical leave from his position as Professor of Sociology and Urban Studies at Portland State University. He is a nationally prominent gerontologist and has written extensively on a variety of issues. His particular interest in the legal status of age will be especially pertinent to the definition of the frail elderly and the Council's proposal that entitlement to a floor of basic services be based on the attainment of a certain age such as 75. 9. Briefing on Federal Advisory Committee Act Robert Tarr, Committee Management Officer, Office of the Secretary, conducted a briefing on February 18 attended by FCA staff on the Annual Comprehensive Report on Advisory Committees for submission from advisory bodies to the Committee Management Office in the Office of Management and Budget. Mr. Tarr reported on S.2947, a bill to amend the Federal Advisory Com- mittee Act sponsored by Senator Metcalf, which would extend the Acts' coverage to additional units of government, open the advisory committee selection of membership to public scrutiny and further limit closed meetings. As of October 1, 1975 the number of Federal advisory bodies was 1,341. - 5 - This required report on FCA's calendar year activities, roster, meeting, and budget is being prepared for March 15 submission to OMB. 10. Meeting with Staff from The Institute of Medicine of the National Academy of Sciences On February 23, the FCA staff met with staff from Institute of Medicine regarding the work the Institute is doing on care of the elderly. They have planned an Anglo-American Conference on Care of the Elderly: Meeting the Challenge of Dependency, to be held in Washington, D.C., May 17-19, 1976. The Conference is jointly sponsored by The Royal Society of Med- icine of England. Two Council members are on the program Carl Eisdorfer, Ph.D., M.D. on Mental Health of the Elderly and Nelson H. Cruikshank as one of the Commentators for the Conference. The Council Chairman has been sent a personal invitation to attend and has been offered time to give a presentation at the Conference. In addition to discussion of the Conference, staff of the Institute were notified of the responsibilities, program and plans of the Council. They were especially interested in the progress we have made in developing a proposed program for the frail elderly and a continuing liasion with Institute staff has been established. 11. Publication on Older Women Under contract with the Federal Council, Dorothea Lewis has prepared a publication summarizing the testimony received in connection with the hearing on the special needs and concerns of older women which was con- ducted by the Council in September. The printing should be completed in the latter part of March. Council staff has continued liaison with staff of the Commission on International Women's Year to assure their continued attention to older women in planning for the proposed International Women's Decade (IWD). 12. Activities of Chairman Chairman Bertha Adkins spoke at a luncheon session of the annual meeting of the Legislative Council of AARP-NRTA. She gave an overview of the functions of the Council and its current activities. Considerable in- terest was evidenced in the studies of taxes and benefits. 13. FCA Staff Activities Executive Director Cleonice Tavani participated in a panel discussion on "Trends in Public Social Services for the Aged" at the Annual Southern Conference on Gerontology held in Gainesville, Florida on February 11 and 12 under the auspices of the Center for Gerontological Studies and Programs at the University of Florida. At a Conference on Total Health and Aging held at Eckerd College in St. Petersburg, Florida, Ms. Tavani spoke on "The Well-Being of Older Americans at the Bícentennial". The meeting was held February 18-20 and was jointly sponsored by Eckerd College and the Geronotology Re- search and Education Center at Bay Pines Veterans Hospital. On the panel with Ms. Tavani were Dr. Alfred Lawton and Dr. Fred Cottrell. 0 On February 29, Ms. Tavani presented a paper on "Training Needs for Personnel in Services to the Frail Elderly" at the Annual Program Meet- ing of the Council on Social Work Education in Philadelphia. The session was chaired by John Price, Aging Program Director in the Philadelphia Regional Office of HEW. Ms. Tavani and F. Richard Williams, Assistant to the Chairman, attended the annual meeting of the National Association of State Units on Aging, February 9-10, 1976 at the Sheraton Park Hotel, Washington, D.C. Robert Foster attended a meeting of the Ad Hoc Coalition for Housing for the Elderly to review problems in the implementation and funding of Sec. 202. 14. FCA Program Analyst Position Selection for the Program Analyst Position has been made from the Office of Human Development Personnel List of screened applicants. Papers are being processed for Civil Service Commission approval. Cleenice Tavani, Executive Director Federal Council on the Aging HEW 400 6th Street S.W. Washington, D.C. Enclosed info on FCA members whose 2 - year terms are expiring June 5,1976 Cleo Tavani DAY/TIMER time-Saver RE-ORDER NO. 2806 © DAY-TIMERS, Allentown, Pa. 18001 - 3 - fill Fedl ROSTER Counerlo Agua Chairman Executive Director Bertha S. Adkins Cleonice Tavani Vice Chairman FORD & LIBRARY GERALD Federal Council on the Aging Room 4022, Donohoe Building 400 6th Street, S.W. Garson Meyer Washington, D.C. 20201 Members of the Council Bertha S. Adkins, of Oxford, Maryland, former Under Secretary of the Department of Health, Education, and Welfare. Nelson H. Cruikshank, of the District of Columbia, President, National Council of Senior Citizens. Former Director of Department of Social Security, AFL-CIO. Dorothy L. Devereux, of Honolulu, Hawaii, former Member of the Hawaii State House of Representatives. Carl Eisdorfer, M.D., Ph.D., of Seattle, Washington, Professor and Chair- man, Department of Psychiatry and Behavioral Sciences, University of Washington and Past President of the Gerontological Society; Member, Institute of Medicine, National Academy of Sciences. Charles J. Fahey, The Reverend Monsignor, of Syracuse, New York, Director of the Catholic Charities for the Roman Catholic Diocese of Syracuse and President of the American Association of Homes for the Aging. Sharon M. Fujii, Ph.D., of Santa Monica, California, Vice President of Gerontological Planning Associates. term exp 6-5-76 Frank B. Henderson, of Worthington, Pennsylvania, Director, Nutrition Services, Armstrong County Community Action Agency; Chairman, Building Committee, Board of Directors of Armstrong County Health Center. 6-5-76 Selden G. Hill, of Orlando, Florida, Member of the Regional Area-Wide Planning Council on Aging; Past President and Board Member, Retired Citizens' Association; has TV series for senior citizens in Orlando. Hobart C. Jackson, of Philadelphia, Pennsylvania, Executive Vice Pres- ident and Director, Stephen Smith Geriatric Center. Founder and first Chairman of the National Caucus on the Black Aged and presently a member of its Executive Committee. John B. Martin, of Chevy Chase, Maryland, former Commissioner on Aging, Legislative Consultant to the National Retired Teachers Association and the American Association of Retired Persons. - 4 - Garson Meyer, of Rochester, New York, retired Executive of Eastman Kodak; President Emeritus of the National Council on the Aging; Chair- man, Advisory Committee, New York State Office for the Aging; Chairman of the Board, Genesee Savings and Loan Association. Bernard E. Nash, of Camp Springs, Maryland, Program Consultant and former Executive Director of the National Retired Teachers Association and the American Association of Retired Persons; President, International Federation on Ageing. 6-5-76 Frell M. Owl, of Cherokee, North Carolina, Retired from the Bureau of Indian Affairs; Member of the Indian Advisory Council of the United States Senate Special Committee on Aging. 6-5-76 Lennie-Marie P. Tolliver, of Oklahoma City, Oklahoma, Professor and Associate Director, School of Social Work, the University of Oklahoma; Member, Salvation Army Senior Centers Board of Directors-Oklahoma City. 6-5-76 Charles J. Turrisi, of Norfolk, Virginia, retired as General Superin- tendent of Mails of Norfolk. He is legislative chairman for the Norfolk Chapters of the National Association of Retired Federal Employees and the American Association of Retired Persons. Ex-Officio Members The Secretary of Health, Education, and Welfare The Commissioner on Aging FOR IMMEDIATE RELEASE JANUARY 23, 1976 Office of the White House Press Secretary THE WHITE HOUSE The President today announced his intention to nominate five persons to be members of the Federal Council on the Aging for terms expiring June 5, 1978. They are: Bertha S. Adkins, of Oxford, Maryland, retired. This is a reappointment. Mrs. John William Devereux, of Honolulu, Hawaii, retired community worker and former State Legislator. This is a reappointment. John B. Martin, of Chevy Chase, Maryland, Legislative Consultant, American Association of Retired Persons and National Retired Teachers Association and former United States Commissioner on Aging, Washington, D.C. This is a reappointment. Harry Holland, of Phoenix, Arizona, President, Arizona Council for Senior Citizens and Chairman, Governor's Task Force on Retirement and Aging. He will succeed Charles J. Fahey whose term has expired. Nat T. Winston, Jr., of Nashville, Tennessee, Vice President, Hospital Affiliates Inc., Professional Relations. He will succeed Carl Eisdorfer whose term has expired. The President also announced his intention to redesignate Bertha S. Adkins as Chairman of the Council upon confirmation by the Senate. The Council meets at the call of the Chairman but not less than 4 times a year to advise and assist the President and the Commissioner on Aging on matters relating to the needs of the elderly and to serve as a spokesman on behalf of the elderly by making recommendations to the President, the Secretary of HEW, the Commissioner on Aging and the Congress. The Council consists of the Secretary of HEW and the Commissioner on Aging serving as ex-officio members together with 15 members appointed by the President with the advice and consent of the Senate. # # # FORD LIBRARY file FOR IMMEDIATE RELEASE JANUARY 23, 1976 Office of the White House Press Secretary Sarial THE WHITE HOUSE IS THIS ALL BRAIGHT The President today announced his intention to nominate five persons to be members of the Federal Council on the Aging for terms expiring June 5, 1978. They are: & Bertha S. Adkins, of Oxford, Maryland, retired. This is a reappointment. Mrs. John William Devereux, of Honolulu, Hawaii, retired community worker and former State Legislator. This is a reappointment. John B. Martin, of Chevy Chase, Maryland, Legislative Consultant, American Association of Retired Persons and . National Retired Teachers Association and former United States Commissioner on Aging, Washington, D.C. This is a reappointment. Harry Holland, of Phoenix, Arizona, President, Arizona Council for Senior Citizens and Chairman, Governor's Task Force on Retirement and Aging. He will succeed Charles J. Fahey whose term has expired. Nat T. Winston, Jr., of Nashville, Tennessee, Vice President, Hospital Affiliates Inc., Professional Relations. He will succeed Carl Eisdorfer whose term has expired. The President also announced his intention to redesignate Bertha S. Adkins as Chairman of the Council upon confirmation by the Senate. The Council meets at the call of the Chairman but not less than 4 times a year to advise and assist the President and the Commissioner on Aging on matters relating to the needs of the elderly and to serve as a spokesman on behalf of the elderly by making recommendations to the President, the Secretary of HEW, the Commissioner on Aging and the Congress. The Council consists of the Secretary of HEW and the Commissioner on Aging serving as ex-officio members together with 15 members appointed by the President with the advice and consent of the Senate. # # # BERALO, FORD LIBRARY THE WHITE HOUSE ACTION MEMORANDUM WASHINGTON LOG NO.: Time: Date: 1/20 1200noon FOR ACTION: James Lynn CC (for information): Sarah Massengale FROM THE STAFF SECRETARY DUE: Date: January 26 Time: 400pm SUBJECT: Annual Report- Federal Council on Aging ACTION REQUESTED: For Necessary Action For Your Recommendations Prepare Agenda and Brief Draft Reply X For Your Comments Draft Remarks X Transmittal Message (last REMARKS: year's message attached FYI) X 1-page summary of report I understand that a copy of the report has already been transmitted to Paul Fairley. Please return to Judy Johnston, Ground Floor West Wing FORD LIBRARY & GERALD PLEASE ATTACH THIS COPY TO MATERIAL SUBMITTED. If you have any questions or if you anticipate a delay in submitting the required moterial, please telephone the Staff Secretary immediately. FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 January 16, 1976 The President The White House Washington, D.C. 20500 Dear Mr. President: On behalf of the Federal Council on the Aging, I have the honor of presenting the second annual report of the Federal Council on the Aging. In this year of the bicentennial of the founding of these United States, we ask that you lead the way in honoring that group of Americans who have contributed so much to the strength of this nation and now deserve a status and role of worth and value. We look forward to working with you and the Congress towards a better life for older Americans in 1976. Sincerely, Bertha S. Adkins Chairman I am transmitting herewith the Annual Report of the Federal Council on Aging, together with my comments and recommendations. The Federal Council on the Aging was established by the 1973 amendments to the Older Americans Act of 1965 to advise and assist the President on matters relating to the special needs of older Americans, and for other pur- poses specified in the enabling legislation. Members of the Federal Council on the Aging were confirmed by the Senate on June 5, 1974. As the annual report indicates, the Federal Council on the Aging has undertaken a number of advocacy activities pursuant to its legislated mandate. The report, as sub- mitted to me by the Secretary of Health, Education, and Welfare for transmittal, does not include supporting data or analysis which would provide the basis for a detailed review of policy positions and recommendations. Since the Council was only recently formed, the Administration, on behalf of the Federal Council on the Aging, has requested that the Congress authorize an extension until January 1, 1976, of the date for submission to the Congress of the two legislatively mandated studies. One study calls for a review of the interrelationships of all benefit programs -- Federal, State, local -- serving the elderly. Such information could be useful to the Executive Branch and the Congress to identify duplicative and overlapping programs and to propose the necessary re- forms so that our resources may be more effectively applied to help those most in need. fele agua ANNUAL REPORT to the President - 1975 Federal Council on the Aging FEDERAL COUNCIL ON THE AGING WASHINGTON, D.C. 20201 January 16, 1976 The President The White House FORD & BIBRARY 038870 Washington, D.C. 20500 Dear Mr. President: On behalf of the Federal Council on the Aging, I have the honor of presenting the second annual report of the Federal Council on the Aging. In this year of the bicentennial of the found- ing of these United States, we ask that you lead the way in honoring that group of Americans who have contributed so much to the strength of this nation and now deserve a status and role of worth and value. We look forward to working with you and the Congress towards a better life for older Americans in 1976. Buhad.Askins Sincerely Bertha S. Adkins Chairman ANNUAL REPORT 1975 Contents Federal Council on the Aging Washington, D.C. 20201 Contents Preface 1 Council Roster 3 1975 Overview 5 Study of The Impact of The Tax Structure on the Elderly 13 Study of The Interrelationships of Benefit Programs for the Elderly 25 Bicentennial Charter for Older Americans 41 National Policy for the Frail Elderly 45 Focus on Older Women-International Women's Year 51 Personnel Needs in the Field of Aging 55 1976 Agenda 57 Council Stewardship 61 Preface Legislative Mandate The Federal Council on the Aging was created by the Congress under provisions of the 1973 amendments to the Older Americans Act, for the purpose of advising the President, the Secretary of the Department of Health, Education, and Welfare, the Commis- sioner on Aging and the Congress on matters relating to the special needs of older Americans. The Older Americans Act directs the Federal Council on the Aging to perform the following functions: 1. Advise and assist the President on matters relating to the special needs of older Americans; 2. Assist the Commissioner in making the appraisal of the Nation's existing and future personnel needs in the field of aging; 3. Review and evaluate on a continuing basis, Federal policies regarding the aging and programs and other activities affect- ing the aging conducted or assisted by all Federal departments and agencies for the purpose of appraising their value and their impact on the lives of older Americans; 4. Serve as a spokesman on behalf of older Americans by making recommendations to the President, to the Secretary, the Commissioner, and to the Congress with respect to Federal policies regarding the aging and federally conducted or as- sisted programs and other activities relating to or affecting them; 1 5. Inform the public about the problems and needs of the aging, in consultation with the National Clearinghouse on Aging, by collecting and disseminating information, conducting or commissioning studies and publishing the results thereof, and by issuing publications and reports; 6. Provide public forums for discussing and publicizing the problems and needs of the aging and obtaining information relating thereto by conducting public hearings, and by con- ducting or sponsoring conferences, workshops, and other such meetings. Membership The Council is composed of fifteen members nominated by the BERALD FORD LIBRARY President and confirmed by the Senate. The Secretary of the Council Members Department of Health, Education, and Welfare and the Com- missioner on Aging serve as ex-officio members of the Council. Nine members of the Council are themselves older persons. Chairman Executive Director They and the other members fully represent older Americans, Bertha S. Adkins Cleonice Tavani national organizations with an interest in aging, business, labor, Federal Council on the Aging and the general public as called for in the law. Vice Chairman Room 4022, Donohoe Building Garson Meyer 400 6th Street, S.W. Washington, D.C. 20201 Members of the Council BERTHA S. ADKINS, of Oxford, Maryland, former Under Secre- tary of the Department of Health, Education, and Welfare. NELSON H. CRUIKSHANK, of the District of Columbia, President, National Council of Senior Citizens; former Director of De- partment of Social Security, AFL-CIO. DOROTHY L. DEVEREUX, of Honolulu, Hawaii, former Member of the Hawaii State House of Representatives. CARL EISDORFER, M.D., Ph.D., of Seattle, Washington, Pro- fessor and Chairman, Department of Psychiatry and Behavioral Sciences, University of Washington and Past President of the Gerontological Society; Member, Institute of Medicine, National Academy of Sciences. CHARLES J. FAHEY, The Reverend Monsignor, of Syracuse, New York, Director of the Catholic Charities for the Roman Cath- olic Diocese of Syracuse and President of the American Associ- ation of Homes for the Aging. SHARON M. FUJII, Ph.D., of Santa Monica, California, Vice President of Gerontological Planning Associates. 2 3 FRANK B. HENDERSON, of Worthington, Pennsylvania, Director, Nutrition Services, Armstrong County Community Action Agency; Chairman, Building Committee, Board of Directors of Armstrong County Health Center. SELDEN G. HILL, of Orlando, Florida, Member of the Regional Area-Wide Planning Council on Aging; Past President and Board Member, Retired Citizens' Association; has TV series for senior citizens in Orlando. HOBART C. JACKSON, of Philadelphia, Pennsylvania, Executive Vice President and Director, Stephen Smith Geriatric Center; founder and first Chairman of the National Caucus on the Black Aged and presently a member of its Executive Committee. JOHN B. MARTIN, of Chevy Chase, Maryland, former Commis- sioner on Aging, Legislative Consultant to the National Retired Teachers Association and the American Association of Retired 1975 Overview Persons. GARSON MEYER, of Rochester, New York, retired executive of Annual Reports Eastman Kodak; President Emeritus of the National Council This second annual report of the Federal Council on the on the Aging; Chairman, Advisory Committee, New York State Aging is presented in accordance with provisions of the Older Office for the Aging; Chairman of the Board, Genesee Savings Americans Act. The Council is required to transmit " find- and Loan Association. ings and recommendations to the President not later than March BERNARD E. NASH, of Camp Springs, Maryland, Program Con- 31 of each year. The President shall transmit each such report sultant and former Executive Director of the National Retired to the Congress with his comments and recommendations." Teachers Association and the American Association of Retired The first report of the Council was issued in March 1975, Persons; President, International Federation on Ageing. some ten months after confirmation by the Senate of nominees for this newly established body. It is our intent to issue our FRELL M. OWL, of Cherokee, North Carolina, retired from the reports on a calendar year basis from now on thus there will Bureau of Indian Affairs; member of the Indian Advisory be some overlap between these first two reports. Council of the United States Senate Special Committee on A major concern expressed by the Council in its initial re- Aging. port was about the level of funding for programs to assist the LENNIE-MARIE P. TOLLIVER, of Oklahoma City, Oklahoma, Pro- elderly. We stated that their urgent humanitarian needs fessor and Associate Director, School of Social Work, the Uni- require special attention in strategies by both the executive versity of Oklahoma; member, Salvation Army Senior Centers and legislative branches of government to offset the effects Board of Directors, Oklahoma City. of recession and inflation." On July 24, 1975, the President transmitted this report to CHARLES J. TURRISI, of Norfolk, Virginia, retired as General the Congress indicating sympathy with this concern but with Superintendent of Mails of Norfolk; legislative chairman for a determination " to reduce the burden of inflation on our the Norfolk Chapters of the National Association of Retired older citizens, and that effort demands that government spend- Federal Employees and the American Association of Retired ing be limited." Persons. The Presidential response concluded, "The perspective and recommendations of this report are limited to a particular area Ex-Officio Members of interest and advocacy. The report does not reflect the Ad- The Secretary of Health, Education, and Welfare ministration's policies, which must reflect a broader range of The Commissioner on Aging responsibilities and priorities." 5 4 The Council respectfully submits that it has a legal respon- Labor and Public Welfare of the Senate, and the Committee sibility to speak out in a particular area of interest and ad- on Education and Labor of the House of Representatives. In vocacy, namely the national concerns for the elderly of this addition, the Chairman of the Council reported on the study in nation. At the same time, the Council is cognizant that the testimony before the respective House and Senate committees. needs of the elderly must be seen in the perspective of other The Council is pleased that one of the major recommendations groups within the population who have urgent humanitarian of the study does appear in the Older Americans Act Amend- needs. ments of 1975 as finally enacted. The Council advocated an increase from $160,000 to $200,000 for the minimum allotment Studies of Benefits and Taxes to each State for State administrative costs. The Council also We believe that the intent of the Council to serve as advocate highlighted direct funding for Older Americans Act programs for the elderly in both a thoughtful and sensitive manner is to federally recognized Indian tribes and a provision to this reflected in the two Congressionally-mandated studies which effect has now been enacted. We would hope that the Council were recently completed and submitted to the President. (Sum- had some role in bringing about this needed change. However, maries of these studies are included in this second annual there is no reflection in either the law or the reports on the report.) legislative deliberations which indicate that the executive or Among the recommendations that are being suggested are legislative branches gave attention to the other major findings several which call for government aid to be directed to the and recommendations of this Federal Council report. We would poorest among the elderly and, indeed, to the poor of all ages suggest that they are still significant and we would hope that and that this aid-be it in cash or kind-be more efficiently and further attention will be given to the Council study on State effectively directed to its intended beneficiaries. We hope that formulae for funding programs under the Older Americans Act. we have also provided sufficient data of such quality that our conclusions and recommendations will be given full and careful Policy positions have also been taken on the following matters during 1975: consideration. Appointment of Advocates for Elderly Frail Elderly to Health Advisory Bodies This report also highlights a group among the elderly whose On April 30, Chairman Bertha Adkins wrote to Secretary of needs are not necessarily financial. The Council is still develop- Health, Education, and Welfare Caspar Weinberger concerning ing recommendations for national policies for a system of care for those whom we call the "frail elderly." These are the elderly appointments of advocates for the elderly to advisory bodies; specifically the appointment of a physician with expertise in -usually the oldest of the old-who require support from the field of geriatrics to the National Professional Standards society because of an accumulation of the debilities of increas- Review Council and the appointment of one or more persons ing age. We do suggest some needed national actions which will move us towards the goal of a rational system of care for the with expert knowledge of the special health needs of the elderly to the new National Council on Health Planning and Develop- frail elderly. ment. Also included in the report are a number of other recom- mendations for action in 1976 with special sections on a Bicen- Coordinated Social Service tennial Charter for Older Americans and on the needs of older Planning For the Elderly women. Following the Council meeting of May 15-16, the Chairman State Formulae Study communicated to Secretary Weinberger the Council's interest in having regulations for Title XX of the Social Security Act It is in order at this point to review the reception of the specify that the State plans for social services must show close first Congressionally-mandated study of the Federal Council. coordination with the State plan required for Title III of the This study on State formulae for funding programs under the Older Americans Act. Senator Frank Church was also informed Older Americans Act was duly completed and submitted on of Council interest in his amendment to this effect and letters December 30, 1974 to the Commissioner on Aging, the Secre- were sent to Senators Williams, Javits and Eagleton containing tary of Health. Education and Welfare and the Committee on the Council recommendation that the provision of S. 1426 6 7 calling for these strong linkages be adopted. Elderly established under the Health Revenue Sharing and Also recommended was that, whenever any human services Health Services Act of 1975. In a similar vein, a letter was sent legislation affecting the elderly is proposed which calls for plan- to the Senate and House Appropriations Committees recom- ning at the State level, a requirement should be included whereby mending an appropriation for the Committee on Mental Health coordination with the Older Americans Act Title III State plan and Illness of the Elderly of sufficient proportion to accomplish be mandated. its legislated goals. Secretary Mathews, in his reply to the Council on October 3 Construction Loans for the Elderly and Handicapped indicated that HEW was moving in a positive manner to imple- On July 29, the FCA Chairman wrote members of the Senate ment the legislation but that their actions were limited due to and House Appropriations Committees for Housing and Urban funding uncertainties at the present time." He concluded, Development notifying them of the Council's concern that the "I am sure at the appropriate time, the Committee and its proposed Sec. 202 regulations for the Housing Act of 1959 on staff will take advantage of this offer." construction loans for the elderly and the handicapped did not provide to non-profit organizations adequate access to perma- Women and Social Security nent financing and therefore would not meet the needs of At the request of the Special Committee on Aging of the poor and minority elderly. The Council recommended that the United States Senate, the Council reacted at its December meet- Conference Committee approve the Senate version of the HUD ing to the working paper on "Women and Social Security" which appropriation bill as it related to the implementation of Sec- had been prepared by the Committee's Task Force on Women tion 202. Favorable response to this recommendation was re- and Social Security. The Council endorsed all the recommenda- ceived from 18 members of the Conference Committee. tions of the Task Force and suggested that the highest priority A similar letter was sent to Secretary Carla Hills of HUD. for change be given to those recommendations that eliminate Her reply indicated her concern with the housing needs of the sex discrimination. elderly and the prospect of a modification of the final regula- tions which would assist sponsors in obtaining financing under The Council urged particular attention to the following matters: HUD's mortgage insurance programs. An age-62 computation point be made applicable for men Foster Grandparents Program born before 1913. The Council's recommendation that there be no change in the basic concept of the Foster Grandparents program as a The substantial recent current work test to qualify for dis- service solely for children was communicated to the Director ability insurance should be eliminated. of ACTION. This recommendation was occasioned by proposals The duration of marriage requirement should be reduced to expand the role of Foster Grandparents to the care of the from 20 to 15 years for a divorced wife (or husband) to qualify adult retarded. The Council indicated their support for ex- for benefits on the basis of the spouse's earnings record, and the panded services to the adult retarded through other senior consecutive years requirement should be removed. programs under ACTION such as Senior Companions and The computation of primary benefits and wife's or husband's R.S.V.P. The Director of ACTION replied expressing his appreciation benefits should be adjusted to increase primary benefits for of the support of the Council in their recommendation which workers by approximately one-eighth and to reduce the propor- coincided with the position taken by ACTION on the Foster tion for spouses from one-half to one-third, thus, maintaining the present total benefit of one hundred and fifty percent for a Grandparents program. couple, and at the same time improving the protection for single Committee on Mental Health and Illness of the Elderly workers, working couples and widows. As a result of Council action at its September 26-27 meeting, The Council did not agree with adding a dependency test for Chairman Adkins extended to the Secretary of Health, Edu- women the same as the present one for men, since this action cation, and Welfare an offer of assistance and cooperation in would represent a program deliberalization and is therefore the work of the Committee on Mental Health and Illness of the regressive. 9 8 The Council concurred with the goals of the Task Force Social Security which have emerged in recent months in the Report and recommended further study for indexing earnings press and television. These attacks have caused unnecessary before retirement to changes in average earnings and indexing worry especially among the elderly which you, Mr. President, benefits after retirement to changes in prices. by taking action now, can do much to allay. The Council recommended additional study of the Social Se- The Federal Council's action contained one further point which curity problems relating to the homemaker. "We recognize the the members were most anxious for me to emphasize in my problems but question the appropriateness of using an earnings communication to you. That was that this decoupling issue, an replacement system to provide benefits when no actual earnings easily correctable feature of the program, should be kept sep- have been lost." arate from other changes in the program which would not enjoy the unanimity of support that it does. Any attempt, for exam- The Council also recommended further study on the special ple, to combine the decoupling issue with a proposal to reduce problems of older minority women and Social Security in regard the long term basic wage replacement ratios would not only to low lifetime earnings, years of uncovered employment and confuse the issue but most likely make impossible early action a lifetime expectancy that is less for women who are not from on the technical correction." minorities. Social Security and the "Decoupling Issue" At the Council's December 3-5 meeting, it was agreed that the Administration should be asked to develop an amendment to the Social Security Act to correct the "decoupling" problem. Under the present automatic benefit provisions of the act, in a situation where both wages and prices had risen steadily, future workers would get in effect a double upward adjustment of their retirement. This would occur because the impact of the rising wages and rising prices would be entered twice in the computation of the benefit—once in the determination of the average wage on which benefit amounts are based and again by adjusting the amount for rising prices. This would result in the long run in paying present workers unjustifiably high (and costly) benefits when they retire-a situation which the Congres did not foresee and certainly never intended. In a letter to the President on December 23, 1975, Chairman Bertha Adkins further stated, "While this desirable correction runs to the longer range prob- lems of the Social Security system it has an immediate urgency. In the absence of a positive position by your Administration, the Trustees in their Annual Report will have no alternative to basing their central set of estimates to the soundness of the sys- tem on provisions of the Act as it now stands. With an Admin- istration position calling for correction of this technical error, the Trustees would have a basis for reassuring the public of the essential strength of the program. This is especially important in view of the wave of unfounded and irrational attacks on 10 11 Study of the Impact of the Tax Structure on the Elderly On December 29, 1975, the Council submitted to the Presi- dent their study of the combined impact of all taxes on the elderly thereby fulfilling a mandate given by the Congress in the 1973 amendments to the Older Americans Act. The law further directs the President to " submit to Congress, and to the Governor and legislatures of the States, the results thereof and such recommendations as he deems necessary." The report* consists of a description and analysis of various taxes which impact on the elderly as well as recommendations from the Council for the consideration of the President. Eliza- beth T. Duskin served as consultant to the Council for this study. She carried out the research; the conclusions and rec- ommendations which are included in the following excerpt from the report reflect formal Council action. It should be noted that approval was unanimous on the recommendations except for D-2 on property tax on which there was one dissent- ing vote. The Secretary of the Department of Health, Education, and Welfare and the Commissioner on Aging are ex-officio members of the Council but they do not participate in the development of recommendations by the Council because of the fact that such recommendations are made, under the law, to them, to the President, and to the Congress. * Copies of the full report will be for sale from the Superintendent of Docu- ments, U.S. Government Printing Office, Washington, D.C. 20402. 13 I. OBJECTIVES OF THE STUDY burden on the aged population is slightly greater than that This Congressionally mandated study assesses the impact of of the non-aged. the tax structure at the Federal and State-local levels on the The elderly are treated preferentially across all income income position of the population aged 65 years and older rela- levels by the Federal individual income tax and State and tive to the non-aged population. Philosophically, the study is local individual income taxes, separately and combined. not directed towards the question of adequacy of income or This is primarily due to the double exemption allowed and well-being of the elderly. Instead, with implicit recognition of the preferential treatment of retirement income. the unmet needs of the elderly, two related questions are asked: The elderly as a group pay lower payroll taxes than the First, given that many elderly are in the unfortunate cir- non-elderly, largely due to their lower rate of labor force cumstances of poverty or near-poverty, is it the fault of the tax participation. structure? The simplified answer derived from the study is, on The elderly, on average, spend slightly less than the non- balance, the tax system is not a significant contributor to the elderly on sales taxes. This is in part due to the constraint relatively low-income position of the elderly as a group. imposed by low current incomes, and in part due to lower Second, are specific taxes, tax preferences, and tax relief consumption of highly taxed items. Nevertheless, the sales programs equitable and adequate for the job which they are tax is judged to be unduly burdensome to all lower income intended to do? Do they shield lower income households, among groups. which the elderly are disproportionately represented, from un- Property tax liabilities disproportionately impact the due hardship and provide for a fair sharing of tax burdens? current incomes of the aged relative to the non-aged; prop- Evidence is presented that this is not always the case. erty tax burdens are also more heavily directed towards The recommendations advanced by the Federal Council on the elderly, regardless of shifting assumptions.¹ the Aging are presented in the spirit that where a goal is to be achieved, the path to be taken should be the most equitable, To place these findings in an operational policy context, sev- efficient and adequate for the intended purpose. eral distinct aspects of the tax structure and tax-related relief programs were examined to determine the effect of these ele- II. SUMMARY OF FINDINGS AND RECOMMENDATIONS ments on the distribution of income between the aged and the Primary emphasis of this study is directed towards the non-aged and among the aged. The elements examined include: burden placed upon lower income elderly households. Since an -the design of the structural provisions provided to raise overall view based on average measures may not clearly picture revenues; either the contribution of specific taxes to the total impact, or -the system of preferences, or "tax expenditures" grafted the burden placed on families in the lower end of the income on to the basic structure, which are designed to provide distribution, several taxes have been selected for individual financial assistance through a reduction in tax liabilities; study: -related tax relief programs, outside of the tax structure The individual income tax; itself. The Social Security payroll tax; Therefore, both the level of tax impact and the redistribu- The sales tax; tional aspects of the tax system and its appendages are con- The property tax. sidered. A summary of the major points of the study follows: In general, the initial findings of the study are that: Income Characteristics of the Elderly The overall effect of the tax structure appears to have no greater impact on the aged than the non-aged, subject More so than any other age class, the elderly are dispropor- to one qualification. If the corporate income tax and the tionately represented at the lower end of the money income property tax are assumed to be "progressive,"¹ then the 1 A tax liability is a legal obligation to pay, but the burden, in the first round of effects, may be shifted forward to consumers through higher prices, 1 With a progressive tax, the ratio of taxes to income rises as income rises; or backward to producers through lower profits. A tax burden refers to the with a regressive tax, the fraction of income extracted is the same at all actual reduction in real income of an individual or family; whose real income income levels. is reduced as determined by the shifting process. 14 15 distribution. Almost 50 percent of elderly units are represented a comprehensive measure of economic circumstances is used. among households receiving less than $5,000 census-defined This is particularly obvious when the corporate income tax- money income; aged blacks are significantly less well-off than which is an indirect "wealth" tax, and the property tax-which aged whites. is direct "wealth" tax, is under consideration. The elderly, on It is important to note that money income is but one dimen- average, pay more of both these taxes; the above average sion of judging economic circumstances. Net worth is also a amount is sufficient to outweigh the lower average payments of significant determinant, and average net worth among the income, payroll, and sales taxes. This is merely a restatement elderly is greater than the average for the population as a of the previously noted observation: average net worth among whole. However, evidence suggests that although asset owner- the elderly is greater than the average for the general popu- ship is important among the elderly as a group, significant asset lation. holdings are concentrated among a small proportion of the Clearly, this is not the same as saying that the tax structure elderly. does not harshly impact the income position of all the aged. Instead, it points out that an overview of the average effect of The Aggregate Picture of Tax Impact: The General Population the tax structure on the elderly is insufficient to determine its impact on lower income elderly. Several taxes are therefore Two major general conclusions emerge from consideration of examined individually. the tax system as a whole: 1 The tax structure has very little effect on the relative The Individual Income Tax: Federal and State-Local Levels distribution of income for almost 90 percent of all families. The aged as a group are treated more favorably than the non- For this majority, the total system is proportional to in- aged by the individual income tax, particularly at the Federal come. level. This is due in large part to the double exemption, the Both the rich (upper three percent of the income distri- retirement income credit and the exclusion of certain forms of bution) and the poor (lower ten percent of the income retirement income, such as Social Security benefits, from tax- distribution) pay higher effective tax rates than the large able income. These preferences, in conjunction with the low- middle range-regardless of shifting or incidence assump- income allowance, effectively shield low-income elderly from tions. However, the conclusions regarding whether the rich undue burdens from the income tax system. pay higher rates than the poor or vice versa, is sensitive to the assumptions made about the incidence of certain However, under existing preferential provisions in the in- taxes-particularly the corporate income and property tax.2 come tax structure, middle and upper-income elderly receive greater per capita benefits than lower income elderly. A sub- The Aggregate Picture of Tax Impact: The Elderly stantial number of elderly, those whose income is too low to require filing a tax return, receive no benefits at all. Using a comprehensive definition of income, which includes both current money income plus the potential claims on income Recommendation A represented by asset holdings, the aged fare no worse, on average, than the non-aged. This conclusion is reached under No further preference for the elderly should be sought the assumption that the corporate income tax and the property via the existing individual income tax system. Cash or tax are "regressive," that is, they impact lower income groups in-kind benefits or a negative income tax system are more heavily than upper income groups. On the other hand, better suited to attaining redistributional goals. if the reverse is assumed, the elderly pay a slightly larger pro- portion of income in taxes than the nonelderly. The Payroll Tax The explanation for this perhaps unexpected result is that The elderly as a group pay lower payroll taxes than the non- the asset position of some elderly shows up significantly when elderly, largely due to their lower rate of labor force participa- tion. For those who are subject to payroll taxes-particularly 1 Joseph A. Pechman and Benjamin A. Okner, Who Bears the Tax Burden? the Social Security payroll tax, suggestions to excuse post-re- The Brookings Institution, 1974. 2 There is general agreement on the direction of shifting in the case of most tirement earnings from further contributions must be evaluated other taxes. in the light of many complicated issues. 16 17 How many elderly depend upon post-retirement earnings Therefore, it is not clear that relief from payroll tax obliga- and contributions to obtain eligibility? (This may be par- tions on post-retirement age earnings would be beneficial to all ticularly important to women who either enter the labor elderly, to the Social Security program or to the nation. force later than men or have interrupted work histories.) Further study should be directed towards comparisons of How would benefit levels of workers currently past re- the costs to the system and the fairness to participants under tirement age be affected in the future? various options— Would benefit levels of future retirees be affected? 1. The payroll tax is terminated on post-retirement age earnings How would this affect the long-term actuarial balance credit is given on such untaxed earnings towards eligibil- of the system? ity and benefit payments; Will the method of financing Social Security be altered? no credit is given for untaxed earnings; How will payroll tax relief affect labor force participation no credit is given on untaxed earnings but an actuarial by the elderly By the non-elderly? increase in benefit levels is included to compensate for the Would selective taxation on the basis of age be constitu- shorter period of benefit collection. tional? 2. The payroll tax on post-retirement age earnings is continued Consideration of each of the above issues in light of the both post-retirement earnings and an actuarial increase functioning of the Social Security system leads to the following in benefit levels to compensate for the shorter period of observations: benefit collection are included in benefit calculations. Relief from payroll taxes on post-retirement earnings on Within each of these options, it is important to know who a voluntary basis would introduce an element of uncertainty among the employed elderly will benefit most. Additionally, op- to Social Security financing; hence, compulsory termination tions should be studied within the larger context of the impact of payments at and above a specified age is preferable from of the payroll tax on lower income workers of all ages. the point of view of program administration. Recommendation B Under compulsory termination of payroll tax obligations— Action to relieve the elderly worker of the payroll tax Some small number of workers in covered employment should be deferred: further study should be directed might not obtain sufficient quarters for eligibility. This towards alternative means of relieving the burden of assumes that the system would continue the current prac- the payroll tax on all lower income earners, taking into tice of not counting untaxed earnings towards eligibility. account the impact on the elderly worker and the costs Payroll tax relief on current (higher) wages may act to the system. to reduce benefit levels from what they might otherwise have been. Therefore, such relief may not be in the best The Sales Tax interest of all those who voluntarily postpone benefits to remain in the labor force. This assumes that untaxed earn- The elderly as a group are more lightly burdened by the sales ings are not included in benefit calculations. tax than the non-elderly. This is in part due to the constraint The short-run problem of a shortfall in revenues relative of low incomes and in part to lower consumption of highly taxed commodities such as liquor, tobacco, gasoline and auto- to benefit payout will be aggravated. mobiles. Nevertheless, the sales tax does adversely affect the Relief would act to raise tax rates, taxable income ceil- ability of all lower income groups, among which the elderly are ings, and possibly reduce benefits of future retirees. disproportionately represented, to purchase the basic essentials In a slack labor market, providing an incentive for the of living. elderly to participate in the labor force may displace The alternatives to the inherently regressive sales tax at the younger workers, so that no net gain to the economy would State-local level are (1) increasing reliance on State income result. taxes, and (2) reducing the regressivity of State and local sales 18 19 taxes. These options, however, present their own difficulties to The Federal government could institute a program of the fiscal structure of States. countercyclical revenue sharing. This could take the form of a revision of current general revenue sharing. In the case of the income tax- Because of its very important relationship to the matter Higher marginal tax rates are required by income taxes of the stability of States' fiscal structure, careful considera- to collect the same amount of revenue as broad based sales tion should be given to the federalization of responsibility tax, thus providing an incentive for out-migration of higher for such income maintenance and related programs as Aid income residents. for Dependent Children, Medicaid and Unemployment Com- Revenues from a graduated income tax are less stable pensation. Further inquiry is required to determine the than sales tax revenue. They automatically increase during most desirable form of Federalized provision and the con- prosperous times, but automatically decrease during eco- sequent net costs, considering the potential offsets of cur- nomic declines when demands for public assistance and rent outlays. unemployment compensation rise. Independent of Federal action, States could reduce the re- The widespread adoption of the individual income tax at the gressivity of the sales tax in the following manner: State level (as of 1972 six States did not have an income tax) operates against the possibility of significant out-migration of Recommendation C-2 high-income residents, but the problem of the instability of this A credit or rebate against State and local taxes targeted source of revenue remains. at lower income households, including both sales and The difficulties present in reducing the regressivity of the property taxes, should be considered as a replacement sales tax by exempting basic essentials such as food and drugs for existing "circuit-breaker" and homestead exemption include loss of substantial revenues and poor targeting of bene- programs. Such a credit or rebate should gradually fits since both needy and non-needy households consume ex- diminish as income rises. Consideration should be given empted items. to provision of rebates to family units whose State in- Since the sales tax is a relatively stable source of revenue, come tax liability is less than the amount of credit among other features which may be attractive to burdened entitlement. Equity requires that both the aged and State and local governments, elimination of this fertile revenue non-aged be included. source is probably not feasible under present circumstances. The Property Tax Recommendation C-1 The unpopularity of the property tax rests on the belief that The Federal Council on the Aging recommends that the tax is regressive, administered unevenly and particularly encouragement should be given to States to place greater burdensome to older people with low incomes. Property tax reliance on the income tax rather than the sales tax. relief at the State and local levels, particularly for the elderly, has increased significantly in recent years. Federal interven- Steps which might be taken by the Federal government to tion in property tax relief is a current issue. encourage States to move in this direction include the following: Alternative propositions are examined in this study with Disallow deductibility of State and local sales taxes in the conclusion that property tax liabilities are a burden to calculating Federal liabilities. This would deny States a lower income aged-as well as to all lower income persons but subsidy and provide an incentive to decrease reliance on property tax relief in existing forms is inequitable and an in- sales taxes. efficient means of attacking the underlying problem of current Accompany the above action by using the revenue gains income inadequacy. to the Federal government to provide a credit based on Neither the claim that the property tax is regressive nor that State income tax liabilities with a maximum ceiling per it is progressive can be resolved due to lack of data availability household which declines as income rises. This would pro- 1 "Cyclical" refers to recurring periods of economic prosperity and reces- vide an incentive to States to increase reliance on the per- sion; counter-cyclical programs are intended to act as offsets to recession sonal income tax. and inflation, in turn. 20 21 and hence, empirical support. If the proper concept of "income" the short-run, the unique effiort of New Mexico should be (average income over five years or more) is employed in meas- considered as a more equitable alternative to States in the uring property tax burdens, however, the tax appears to be future. roughly proportional to income. Evidence further supports the view that property tax liabil- Recommendation D-1 ities do impact the elderly disproportionately in terms of current A credit or rebate against State and local taxes targeted income; property tax burdens have a disproportionate impact at lower income households, including both property and on the elderly regardless of whether the tax is viewed as re- sales taxes, should be considered as a replacement for gressive or progressive. existing "circuit-breaker" and homestead exemption However, current forms of property tax relief are not con- programs. Such a credit or rebate should gradually sistent with any existing theory of property tax burdens, but diminish as income rises. Consideration should be given are analogous to "backdoor" income maintenance or housing to provision of rebates to family units whose State in- allowance programs. As such, they are seriously flawed. come tax liability is less than the amount of credit en- As long as property tax liabilities enter into the calculations, titlement. Equity requires that both the aged and non- greater benefits from such programs go to those with greater aged be included. (This was also presented in the context net worth within any income class; this is not consistent with of the sales tax as Recommendation C-2.) equity considerations. Other inequities exist which violate the principle of ability-to-pay, the equal treatment of households in Recommendation D-2 similar circumstances (horizontal equity), and the notion that At the national level, adequate income maintenance or households in greater need should receive greater benefits (verti- housing allowances to all lower income households is a cal equity). Attempts to correct the "unfair" program elements preferred vehicle for Federal aid. Therefore, Federal result in unfortunate trade-offs-either other inequities result intervention is not recommended in the form of prop- or the programs may become administratively complex and erty tax relief assistance, since-in addition to the unwieldy or excessively costly. poorly focused benefits of existing programs-Federal In any case, average annual benefits ($143 for circuit- action in this area would encourage States to change breakers; $173 for homestead exemptions) are not sufficient to their tax structure to gain maximum Federal dollars merit a program with this degree of complexity. and, therefore, to increase reliance, on the property When property tax relief programs are considered as housing tax. allowances or income maintenance programs, it is less clear why one particular cost of housing has been singled out for relief. In fact, property tax relief does not require that benefits, i.e., funds that are freed for other uses, be spent in any particular manner. Hence, income maintenance, which provides assistance to those deemed needy and deserving, to purchase adequate housing or other basic essentials may be a more direct, efficient and equitable form of relief from undue burdens for the elderly poor as well as other lower income groups. If the popular acceptance of State and local property tax relief programs rests on the basis that it helps in reforming the regressive tax structures at the State and local level, then why exclude other more obviously regressive taxes such as the sales tax? Presently, New Mexico does include all State and local taxes in its Low Income Tax Credit (LITC). Although the political acceptability of property tax relief is a reasonable rationale for the continuing existence of present programs in 22 23 Study of the Interrelationships of Benefit Programs On December 29, 1975, the Council submitted to the President their study of the interrelationships of benefit programs for the elderly operated by Federal, State and local government agen- cies. This study was mandated by the Congress in the 1973 amendments to the Older Americans Act which also directs the President to " submit to Congress recommendations for bringing about greater uniformity of eligibility standards, and for eliminating the negative impact that one program's stand- ards may have on another." The Council contracted with the Urban Institute on June 25, 1975 to carry out the study under contract #HEW-100-75-0120. The conclusions and recommendations (a summary of which follows), while based upon the findings of the Urban Institute study, reflect the formal unanimous action of the Federal Coun- cil on the Aging.* The staff of the Human Resources and In- come Security Project of the Institute compiled the supporting data for this activity which is contained in the three appendices described briefly as follows: APPENDIX I Handbook of Federal Programs Benefiting Older Americans presents each of 34 programs in a consistent framework based primarily upon common program elements, such as mode of * The main report and its appendices may be purchased individually or to- gether from the Superintendent of Documents, Government Printing Office, Washington, D.C. 20402. 25 financing, eligibility criteria, benefit formulae, magnitude of particularly significant group to consider because they have program cost and number of beneficiaries. special needs, a high incidence of poverty, are the focus of APPENDIX II several programs, and are particularly likely to participate in more than one benefit program. Having surveyed Federal pro- Programs for Older Americans in Four States: A Case Study grams nationwide and State programs in four States, and after of Federal, State, and Local Benefit Programs reports on visits analyzing the interaction of the major Federal programs affect- to four States for the purpose of identifying and describing ing the elderly (via the Transfer Income Model and other benefit programs for the elderly which would be illustrative, analysis), we have now developed a set of recommendations although not necessarily statistically representative of State- which would mitigate or eliminate the most serious problems level activities nationwide. arising from the complex of overlapping programs for older APPENDIX III Americans. The Combined Impact of Selected Benefit Programs on Older Our recommendations flow largely from the nationwide study Americans: A TRIM Analysis focuses on the interrelationships since the State studies were limited to four States. TRIM among selected benefit programs for the elderly and attempts analysis has demonstrated that in 1975 approximately 22 per- to measure the level and extent of these interrelationships. It cent of older Americans will receive assistance from at least contains the results of the computer simulation model utilized one of the three income-conditioned programs-SSI, Food for the analysis. Stamps and Medicaid. Of these beneficiaries, 49 percent are estimated to participate in only one program, 34 percent in I. PHILOSOPHY AND SCOPE OF WORK two programs and 17 percent in all three programs. The most Over the past 15 years government expenditures on social significant overlap is between SSI and Medicaid with 41 per- welfare programs have increased dramatically. Much of this cent of the recipient units receiving assistance from both. The growth has been due to increased participation in and the ex- Food Stamp/Medicaid overlap affects 26 percent of the recipient pansion of coverage of the public assistance programs enacted units while the Food Stamp/SSI overlap involves only 18 per- in the 1930s. Equally important, however, has been growth cent. Thus, considerable overlap exists between programs. Over resulting from the creation of new programs. While new pro- 50 percent of the participants, nearly 3.5 million units, receive grams have most often been established in response to a real benefits from 2 or more programs, and all of these units are need, very little concern has been shown for the relationships likely at some time to be affected by program interactions. among programs. Not only is each individual program complex, We have, therefore, limited the scope of our work to the but each program's specific provisions are often unique, even existing framework of programs. In particular, we have not though its goals might be similar to those of another program. attempted to design a new set of programs to provide income This has led to administrative complexity and expense, and and services for the elderly. The set of recommendations given confusion among the potential recipients. Indeed, in some cases here is far more modest. there has been great divergence between planned and actual We have made no effort to address the issue of what con- impact. The situation has been made even more complicated stitutes a fair share of the national income for the elderly. and confusing by the tangled mix of benefits, which now include Wherever possible, the recommendations made in this report cash, food, housing, and medical care, as well as a long list of are intended to be neutral with respect to this issue. In no services. Different kinds of benefits flow from different pro- case have we made a recommendation whose sole purpose was to grams. increase or decrease the fraction of national income going to Clearly the present situation should be improved. However, the aged population. Whenever accurate data were available no simple solutions are available. One major difficulty is the either from outside sources or from analysis performed by the lack of information about the extent and, in some cases, the Urban Institute, we have made estimates of costs associated nature of the problem. with our recommendations. The objective of this study is to provide information and Our underlying philosophy has been to make recommenda- make recommendations regarding the effects of the interrela- 1 See "The Combined Impact of Selected Benefit Programs on Older Ameri- tionships of benefit programs for the elderly. The elderly are a cans," Appendix III for a description of the Transfer Income Model. 26 27 tions which would move our society towards a system in which We recommend study of changes which should bring about all elderly individuals in similar economic circumstances would increased participation and, thus, diminish the degree of in- be treated the same. Often the failure of the existing set of equality. programs to meet this standard is caused by the interrelation- Fifth, we consider administration and program evaluation. ships among the programs. Currently, the application process for the needs-tested programs The issue of racial and other discrimination in administra- is spread across several agencies. We recommend consideration tion of benefit programs was beyond the scope of this study. of consolidating this process. In addition, we recommend that This is not to say that there is no racial discrimination in the a study be undertaken to consider the larger issue of what an provision of benefits to the elderly. Indeed, the Federal Council ideal set of programs for the elderly should be. is continually concerned with examining Federal programs to assure equity for all older Americans. II. RECOMMENDATIONS Our recommendations fall into five broad areas. First, we consider the implications of the ways in which A. Reduction in Benefits in One Program Resulting some programs count income received from other programs. from Increasing Benefits in Another Some programs reduce their benefit as benefits from other programs increase. While the principle underlying this benefit Introduction reduction is sound, it can lead to (1) the failure to pass through cost-of-living adjustments, and (2) high cumulative benefit Many of the programs which provide income for older Ameri- reduction rates on earnings and other non-transfer income. In cans reduce their level of support as the individual's income some cases (the State supplements to the Supplemental Secur- from other sources increases. Usually benefits are reduced by ity Income (SSI) program), this may have been intentional. less than a dollar for every dollar of income from other sources. However, where the benefit reduction rules have led to in- There are even cases where benefits are reduced by more than equity, we have recommended changes in the rules. one dollar when income from other sources rises by one dollar. Second, we consider the income tests used in the program Benefits must be reduced as income rises if the program is to for older Americans with low incomes. Currently some of the be restricted to the low-income group. However, high rates of tests (1) do not always take into account changes in the cost benefit reduction discourage a person from helping himself. of living, (2) vary substantially (even in their definition of income) from program to program and (3) do not always Cancelling Out Cost of Living Increases phase out benefits smoothly as income increases. In some pro- grams, the standard income test is waived entirely if a person During periods of price stability, the level of benefits re- is already receiving benefits from another program. We rec- ceived by participants from all programs would remain the ommend changes which would at least partially remove in- same-barring a change in the laws or a change in individual equities caused by the income tests currently used. circumstances. During periods of price inflation, however, the total benefits of some recipients rise at the same rate as the Third, we consider the asset tests in most programs for Consumer Price Index (CPI), while the total benefits of other older Americans with low incomes. Currently the tests (1) do recipients do not increase at all. The latter happens to all not phase out benefits smoothly as assets increase, (2) treat persons who receive benefits from two or more programs, one homeowners and renters differently, (3) may discriminate of which does not automatically increase its benefit levels and, against the elderly versus the nonelderly and (4) vary sub- in addition, reduces its benefits by one dollar for every dollar stantially (both in the treatment and definition of assets) from of benefits received from other programs which are indexed program to program. We recommend study of changes which to the CPI. would at least partially remove the inequities caused by the One important example of this situation is the relationship asset tests currently used. between SSI State supplements, on the one hand, and the Fourth, we note that several programs have low rates of Federal SSI payments and Social Security retirement benefits participation. This leads to a situation where some persons are on the other. The SSI State supplements are not as a rule getting benefits, while other similarly situated persons are not. increased at the same rate as the CPI. Furthermore, SSI Federal 28 29 payments and Social Security payments are considered to be reduction rates caused by simultaneous receipt of bene- part of countable income. The result is that as long as the in- fits from Pensions for Veterans with Non-service-con- dividual is entitled to a supplement, that supplement will be nected Disabilities and other Federal programs (par- reduced by the amount of his SSI Federal payment and Social ticularly Social Security payments) because in our Security income is increased (except for the few states where findings there appears to be an inequity. the supplements themselves are indexed). In other words, every Whatever changes are made, the benefit schedule should be additional dollar the Federal government gives to the recipient modified in such a way as to keep total costs of the program to compensate him for the increase in the cost of living is taken the same as they are now. away by the State government. B. Income Tests Recommendation 1. Adjusting for Changes in the Cost of Living We recommend that mandatory SSI State supplements Many of the transfer programs for the elderly do not adjust remain unchanged when benefits from Federal social their allowable levels of income or their benefit levels for changes insurance and needs-tested programs (including SSI and Social Security) are increased due to increases in the in the cost of living. Since benefit levels usually depend upon the level of countable income (with benefits eventually reaching cost of living. zero when countable income reaches a certain point), these two If mandatory SSI payments had not been reduced due to cost- problems can be considered together. of-living adjustments in the Federal SSI program, the total cost If benefits and allowable levels of income are fully adjusted for of mandatory SSI payments would be at most $150 million per changes in the cost of living, the real level of income being paid year greater in 1975 than it is without them. Over time, annual to recipients remains constant regardless of what is happening costs of this change will rise as the amount of inflation experi- in the rest of the economy. However, if benefits and allowable enced since the program's inception rises. However, by the year levels of income are not adjusted for changes in the cost of living, 2000 the annual cost of this change will have fallen to near all recipients will experience a decline in their real level of zero since the mandatory supplemental payments are made only income during periods of inflation, and some recipients will lose to persons receiving payments from the State-administered Old eligibility altogether. Age Assistance programs before SSI began. Recommendation 3. High Cumulative Rates of Benefit Reduction We recommend that the income standards, benefit High cumulative rates of benefit reduction can occur when schedules, income disregards, allowable asset levels, and two programs simultaneously reduce their benefits as a third exclusions from assets of the SSI, Food Stamps, Medi- source of income increases. A further complication occurs if caid, Pensions for Veterans with Non-service-connected one of the two programs reduces its benefits as benefits from Disabilities, and Pensions for Widows and Children of the other program increases. This study has found that this Veterans programs be increased at the same rate as occurs when a person is receiving Social Security and a Vet- the cost of living. eran's Pension for a Non-service-connected Disability. Programs providing particular types of goods or services High benefit reduction rates discourage the elderly from work- rather than money should use the increase in the price of goods ing to support themselves. Benefit reduction rates which exceeds or services they provide rather than the overall Consumer Price 100 percent actually punish persons who work to help them- Index. According to the Transfer Income Model, SSI would cost selves. about 2 percent more (an increase of about $72 million) in 1976 if the amount of earned and unearned income which is not counted by SSI for purposes of the income test had been in- Recommendation 2. creased at the same rate as the cost of living since the pro- We recommend that the President direct the Veterans gram's inception. The cost of Pensions for Veterans with Non- Administration to study the problem of the high benefit service-connected Disabilities and Pensions for Widows and 30 31 Children of Veterans programs would probably be less in 1975 not surprising that the lists of exclusions are not identical nor if automatic adjustments for the cost of living were made. This defined in the same way. is because legislated changes in the benefit schedules have ex- However, the widely varying rules have created a very con- ceeded changes in the cost of living. fusing and complex situation from the standpoint of adminis- The increased cost of Food Stamps resulting from the pro- tration. While we recognize that some heterogeneity among the posed change was not calculated, but we estimate the percentage programs may be necessary, we feel that all of the programs increase to be about the same as for SSI-namely about 2 should be viewed together and that adjustments in definitions percent in 1976. of countable income be made to achieve greater uniformity Because of the diversity of Medicaid rules, we have been wherever possible. One promising way to deal with this problem unable to estimate the increased cost resulting from the rec- is to allow a "standard deduction" from income in lieu of a ommendation. Since Medicaid income standards are not gen- set of particular exclusions. This approach is being recom- erally increased at the same rate as the cost of living currently, mended in currently pending legislation to alter the Food the percentage increase in costs would probably exceed 2 per- Stamp program. cent. To adjust allowable levels of assets, ideally one would use a Recommendation 4. price deflator particular to the type of asset being deflated. For example, the $25,000 limit on owner-occupied housing in In order to reduce complexity as well as improve equity, FORD SSI would be increased by the same percentage as a housing we recommend that what is included in countable in- price index (preferably an index specific to the area where the come and allowable exclusions be made more uniform person lived although currently separate indexes do not exist across the income-conditioned programs. GERALD for all areas). However, in the interests of simplicity the Con- sumer Price Index (CPI) would probably suffice. According to Links in Eligibility Between Programs our analysis, if the SSI homeowner exemption had been in- creased at the same rate as the overall cost of living, total bene- Another problem with the income tests occurs because in cer- fits paid out by the Federal SSI program would have increased tain cases with Medicaid and Food Stamps the program's income in 1975 by about 1.6 percent (approximately a $58 million in- standards are entirely ignored in establishing eligibility. In most crease). Although we have not calculated the increase in costs States, receipt of SSI payments results in automatic eligibility resulting from similar changes in the other benefit programs, for Medicaid. In all' States, receipt of SSI payments results in the percentage increase in costs should be roughly the same. eligibility for Food Stamps if all members of the household are eligible for SSI. This means that a person whose income is com- prised of earned income and Social Security benefits might fail Uniformity in Definition of Income to qualify for Medicaid or Food Stamps, while a person with equal total income comprised of SSI and earned income would Uniformity Across Programs qualify for both programs. If the link between Medicaid and SSI were broken, one con- An additional problem with income tests of the low-income sequence would be a dramatic increase in lack of uniformity programs is the lack of uniformity of the definition of countable among the States of eligibility criteria for Medicaid. This is income for purposes of the income test. This lack of uniformity because the States have a great deal of leeway in establishing complicates the application process and, in addition, results in eligibility for Medicaid for persons who are not receiving bene- persons in similar economic circumstances but receiving benefits fits from SSI or the Aid to Families with Dependent Children from different programs being treated differently. (AFDC) program. The result would be a large decline in per- The philosophical justification for exclusions is that certain sons eligible for Medicaid. In order to prevent this from hap- expenditures of income (e.g., food, medical expenses, educa- pening while, at the same time, treating persons similarly who tional expenses) are essential or highly desirable and should, are in similar economic circumstances, uniform national income therefore, not be included as part of countable income. Since standards could be established to determine eligibility for Medi- the programs were designed by different Congressional com- caid. However, the côsts, changes in caseloads, and distribution mittees at different times under different Administrations, it is of benefits of taking this step are not known. 32 33 Recommendation 5. criminate against persons who rent rather than owning housing. Third, asset tests discriminate against the aging vis a vis the We, therefore, recommend that the Department of non-aging since elderly persons of a given economic status are Health, Education, and Welfare study the advisability more likely to have accumulated wealth than the young and of breaking the eligibility link between SSI, on the one middle-aged and are more dependent upon wealth income. Finally, hand, and Food Stamps and Medicaid on the other; the definitions of countable assets vary among the programs, lead- administrative complications of breaking these links; ing to inconsistencies and complexities among the programs. and-in relation to such removal of links-the advis- As long as there is a limit to total assets there will be an ability of establishing uniform national standards for abrupt cessation of benefits as assets rise in value, and, as long determining eligibility for Medicaid. as certain types of assets are excluded, persons in similar eco- nomic circumstances will be treated differently. Smoothing the Phase out of Benefits In all means-tested programs there are income tests which Reducing the Inequities of Asset Tests result in all benefits being cut off if income rises above some In all of the above cases applying a cost-of-living adjustment to level. In some cases, notably the Federal SSI program, benefits the asset limitation would keep constant over time the relation- decline smoothly as income rises. In other programs, including ship between real asset levels and benefit levels. This was rec- Medicaid, Food Stamps, Pensions for Veterans with Non-service- ommended as part of Recommendation 3 (above). connected Disabilities, Pensions for Widows and Children of While this recommendation would prevent persons from creep- Veterans, Low Rent Public Housing and the Rent Supplement ing across asset limits with no change in real asset holdings, it programs, a benefit ranging from a few dollars up to hundreds would not address the more fundamental problems caused by of dollars per year can be cut off if income increases by a small the absolute limit to assets and the exclusions, as well as the amount (in some cases even by one dollar). Changing benefit unfair treatment of the elderly vis a vis the remainder of the schedules slightly can smooth the phase out of benefits. population. C. Asset Tests FCA ACTION 1. How Programs Treat Assets and the Resulting Inequities The Federal Council on the Aging will initiate a study Several programs which help older Americans, including SSI, of the philosophical and administrative rationale con- Medicaid, Food Stamps, Pensions for Veterans with Non-service- nected with the way in which assets and asset income connected Disabilities, and some housing programs, use asset are considered in determining eligibility for benefit tests as well as income tests in determining eligibility for parti- programs and the various options available to reduce cipation. The rationale for employing an asset test is that per- the inequities in the existing asset tests. sons with substantial wealth should not be helped even if their measured income is low since assets can either be sold and used In carrying out this study, the Federal Council on the Aging for support or be converted into income-producing assets (if will draw upon existing analyses and data and work closely with they are not already). concerned Federal departments and agencies. Asset tests as presently used cause four types of inequities. First, a small increase in a persons's assets (in theory even one D. Participation of Eligibles dollar) can result in loss of eligibility for a program yielding sizable benefits. For example, an individual with $1,500 worth Programs for the elderly can be grouped under three broad of stocks and bonds and no other assets would be eligible for categories: retirement programs (including Social Security), SSI provided he met all the other tests, while an individual with other entitlement programs which are categorical in nature $1,501 worth of stocks and bonds and no other assets would (e.g. one must have low income, or be disabled, or be a veteran be ineligible even though his income might be the same or lower to qualify), and programs which have closed-ended funding and than the first individual's income. Second, because there is thus must ration their benefits to less than the number eligible. usually an exception for owner-occupied housing, asset tests dis- In the latter two groups of programs, the issue of participation 34 35 (2) attitudes towards programs; and (3) availability of the arises.¹ Consider first the entitlement programs which have program. categorical eligibility requirements. These include SSI, Food All of these types of Federal programs are State or locally Stamps, Pensions for Veterans with Non-service-connected administered, and in many cases there are insufficient data at the Disabilities, Pensions for Widows and Children of Veterans, national level to know who among the eligibles apply for the Medicare and Medicaid. All have open-ended funding, and those services and, among those that apply, who receive benefits. In who qualify are legally entitled to benefits. Yet a large number other words, we do not have sufficient data to construct profiles of eligible older Americans do not receive benefits from some of those receiving services, those on waiting lists, and those who of these programs. The two most outstanding cases are the SSI for one reason or another do not apply at all. Lack of such in- and Food Stamp programs. formation also limits the ability to determine how many of When SSI was implemented in January 1974, DHEW esti- these recipients participate in other programs, and therefore does mated that about 3.8 million non-institutionalized units (fam- not allow an assessment of the magnitude of the problems, if ilies or single individuals) age 65 or over would be eligible for any, of deleterious program interactions. Federal benefits. However, about half this number actually re- ceived SSI benefits in the first six months of operation (Janu- Recommendation 6. ary-June, 1974). Our analysis using the TRIM model suggests that there will be about a 65 percent participation rate (ratio We recommend that the Administration on Aging con- of recipients to eligibles) in 1975.2 A large number of older duct a study to determine the magnitude and the dis- low-income people who are eligible for SSI are not receiving tribution (by age, sex, education, income, race, health benefits. status, size of community, urban versus rural, region) Estimates of participation in the Food Stamp program by of (a) eligibles, (b) participants, and (c) eligible non- eligible households have ranged from 30 to 60 percent, though participants for all of the Federal income-conditioned there is evidence that some of the nonparticipants are eligible benefit and service programs for the elderly; and to for only short periods of time during any given year. determine the reasons for nonparticipation of those who With the exception of Medicare, there is little information on are eligible. the participation rates in the other entitlement programs. This study should build upon the work which has already For entitlement programs, we hold the view that all families been done in this area. However, it should pay particular atten- or individuals eligible for benefits from programs with open- tion to programs which have not already been studied. ended funding should have the opportunity to receive those benefits. Outreach Information There is a need for a careful evaluation of a wide variety of There is a need to know not only how many eligibles do not outreach methods. Relative effectiveness can best be measured participate in these entitlement programs, but who they are in a controlled experiment, and such an experiment could explore and why they don't participate. One would like to know how the effectiveness of utilizing existing institutions as well as participation rates are related to: (1) knowledge of programs; alternative methods of outreach (e.g. radio, TV, mail, personal contact by peers, personal contact by agency personnel). 1 There is a set of issues which might be broadly regarded as participation issues involving retirement programs for older Americans, such as vested Recommendation 7. rights, the relationships of contributions to benefits, and whether everyone who is entitled to benefits actually receives them. However, the scope of this We recommend that the Administration on Aging con- section will be limited to the more common concept of participation, that duct a series of controlled experiments to test the rela- being in the other types of programs available to the elderly. tive effectiveness of various methods of outreach, by 2 This figure is not directly comparable to the former because it is for 1975. Also, the CPS does not provide the value of owner-occupied homes, a critical socio-economic-demographic subgroups of the popula- factor in the number eligible for SSI (persons with homes valued in excess tion. of $25,000 are ineligible for SSI payments). We therefore used the 1970 Census Public Use Sample, which has information on the value of owner- As with the preceding recommendation, this study should build occupied homes, to make adjustments to the number of eligibles calculated from the CPS. on existing information wherever possible. 36 37 not necessarily lead to separate administration of determination It is essential that the study address the issue of the effec- of eligibility. tiveness of alternative methods of outreach for minority groups The administrative expenses could be shared by the separate and for various age cohorts of the elderly (e.g., different funding agencies (much like the Food Stamp program and methods for persons who are 85 than for persons who are 65). AFDC now share administrative costs). Such centralization Finally, the study should focus on attitudinal issues. No out- would benefit both the "givers" (taxpayers) and the "receivers" reach effort will work effectively unless the climate of the (aging beneficiaries). agency is perceived by the elderly to be encouraging and sympa- Thus, while we endorse in principal the notion of some cen- thetic. tralization of local administration of a number of Federal pro- grams, we recognize that the issue must be given further study to arrive at the most efficacious organizational structure. E. Administration and Program Assessment Recommendation 8. Central Determination of Eligibility and Benefits We recommend that the executive branch should study Our study of programs for older Americans has shown that the desirability, feasibility, cost effectiveness, and con- an elderly individual or family could conceivably receive bene- venience to the elderly of having a simplified system at fits at the same time from a social insurance program (Old the local level to determine eligibility and benefit levels Age, Survivors, and Disability Insurance), five separate income- for all federally funded income-conditioned programs conditioned Federal programs (Supplemental Security Income, (including services) for those age 65 or older. The Medicaid, Food Stamps, Pensions for Veterans with Non-service- relationship to the administration of the social insurance connected Disabilities, and one of several housing programs) programs should also be considered. not to mention State-level income-conditioned programs and other State and Federal programs for which eligibility is not The study should bear in mind the important human element conditioned on income. If benefits were only received from the as well as cost-effectiveness. The study should look at a wide Federal social insurance and income-conditioned programs range of options for local organization, should develop a set of mentioned above, an elderly person would have to deal with administrative proposals, and should bear in mind that enabling four or five separate agencies,¹ be certified for initial eligibility legislation may be required for many of the changes which are six separate times, and report back to these four or five offices recommended. While all programs should be included, the study at various (and different) times throughout the year to report may show that not all of the programs should be incorporated income and assets for recalculation of benefit levels. Finally, in in a new local system. determining benefits each of the programs has different defini- While the FCA strongly endorses information and referral tions of income and assets, different income and asset disre- services, they should not be considered a substitute for the gards, and, in some cases, different accounting periods (the simplified system approach contained in recommendation 8. length of time income is averaged for calculating benefits). Reassessment of Programs for the Elderly The practice of having separate agencies to administer each A number of programs for older Americans are designed for, program and the diversity of practices and procedures across and available to, those at all income levels. Some of these are agencies is confusing, if not bewildering, to even the most recreational in nature, others attempt to mitigate loneliness or sophisticated potential beneficiary-and it is inefficient, im- insecurity, still others are designed to convert the free time of posing an unnecessary expense on taxpayers. Separate admin- retired people into productive uses, beneficial to both the elderly istering agencies exist presumably because the programs are and the community. Another set of programs are available only funded by separate Federal agencies under different legisla- to elderly individuals or families who are in economic need. tion. Furthermore, the income-conditioned programs have a Their purpose is to provide in-kind benefits or services which means test while the social insurance retirement benefit is de- the more financially secure can afford to purchase and which pendent on one's covered employment record. But this need society deems as necessities (food, medical care, housing), or to provide cash to buy these and other necessary goods and 1 Social Security and SSI are administered by the same office, and, in most services. States, Medicaid and Food Stamps are administered by one agency. 38 39 This latter set of programs-available only to those in eco- nomic need-are commonly called income-conditioned programs; the level of cash or in-kind benefits are highest for those with the most need (lowest incomes), and are less for the less needy (i.e., decline as income rises, with benefits diminishing to zero at modest levels of income). All of these programs are intended to raise the economically deprived to a standard of living which society deems as "minimally acceptable." Some argue that there should be only one program for the elderly who are in economic need, that being an income-condi- Bicentennial Charter tioned cash program which raises the income level of all older Americans to a minimally acceptable standard. Others argue for FORD & LIBRARY 076830 that such a simple approach is unsatisfactory because (1) the elderly may not have sufficient knowledge to spend the money Older Americans in a way to maximize their own well-being (e.g. spend too little on food), or (2) they may not spend the money in a way which those who are providing the money (taxpayers) would like them to spend it (e.g. not enough on housing, resulting in unsightly Upon the request of the Commissioner on Aging, the Federal neighborhoods), or (3) that the needs of the elderly vary so Council has prepared a revision of the Senior Citizens Charter much due to health, initial housing facilities, etc., that one developed by the 1961 White House Conference on Aging. In program cannot adequately take account of their special needs, developing this new Charter, the Council has drawn on many or (4) that it is inefficient for the private market to provide resources including the objectives of the 1965 Older Americans their special needs on a pay-for-service basis. Act. Dr. Flemming has further asked the Federal Council to transmit this statement to the President so that it might be For whatever reason, or combination of reasons, there are incorporated in a Presidential proclamation during the Bicen- at least eleven Federal and federally-subsidized State benefit tennial Year of 1976. programs,¹ plus a number of social service and health programs designed to assist the low-income and vulnerable elderly. There It is the Commissioner's hope that this new statement, which is some question as to whether the Federal monies for all of we are calling the "Bicentennial Charter for Older Americans," these programs are best spent in such a variety of programs; will be considered at forums of older persons organized by whether the same amount of Federal funds would be more Advisory Committees to the Area Agencies on Aging in order effective if devoted to fewer programs, since most of the pro- (1) to determine progress or lack of progress at the Federal, grams have the same basic objective, namely to help those State and local levels in implementing the Charter's goals, and older Americans who have insufficient resources to help them- (2) to recommend specific action programs at Federal, State and selves. local levels in both the public and private sectors, designed to accelerate the implementation of both the rights and responsi- bilities contained in the Charter. FCA Action 2. These action recommendations are to flow from local to State Studies will be initiated by the Federal Council on the Aging to develop recommendations for a minimum and and then to the Federal Council on the Aging. The Council hopes that at the time of our next annual report, we shall be able to internally consistent set of income-conditioned benefits close the bicentennial year with a set of recommendations which and services for the elderly to replace the current set will focus on needed national actions to enhance the lives of all of overlapping, often-inconsistent set of State and older Americans. Federal programs now in existence. The Federal Council on the Aging, therefore, requests that the 1 These include Medicaid, SSI, Food Stamps, four different housing pro- President promulgate the following Bicentennial Charter for grams and four separate programs for veterans. Older Americans in 1976: 40 41 BICENTENNIAL CHARTER I. The Right to Freedom, Independence and the Free FOR Exercise of Individual Initiative. OLDER AMERICANS This should encompass not only opportunities and re- sources for personal planning and managing one's Two hundred years ago, a new nation was life style but support systems for maximum growth founded based on the self-evident truths that all men and contributions by older persons to their community. -and women are created equal and that they are en- dowed by their Creator with certain inalienable rights. II. The Right to an Income in Retirement Which A Constitution was set forth for governance of these Would Provide an Adequate Standard of Living. new United States of America with the goal of form- ing a more perfect union, establishing justice, insur- Such income must be sufficiently adequate to assure ing domestic tranquillity, providing for the common maintenance of mental and physical activities which defense, promoting the general welfare, and securing delay deterioration and maximize individual potential the blessings of liberty to ourselves and our posterity. for self-help and support. This right should be assured regardless of employment capability. In the two hundredth year of this nation's existence, it is good and well that we call special at- tention to a group of citizens which literally did not III. The Right to an Opportunity for Employment exist at the time of our Revolution. The approximate Free from Discriminatory Practices Because of Age. life span in 1776 was 32 years. In 1976, it is projected Such employment when desired should not exploit to be 71 years and we now have a virtual "generation" individuals because of age and should permit utiliza- of older Americans whose roles, contributions, rights tion of talents, skills and experience of older persons and responsibilities need to be given particular atten- for the good of self and community. Compensation tion at this time in our history. should be based on the prevailing wage scales of the community for comparable work. Americans of all ages have the ultimate respon- sibility to be or become self-reliant, to care for their families, to aid their neighbors and to plan prudently IV. The Right to an Opportunity to Participate in the for their old age. Older persons have the responsibility Widest Range of Meaningful Civic, Educational, to make available to the community the benefits of Recreational and Cultural Activities. their experience and knowledge. Society-be it through the institutions of the public or the private The varying interests and needs of older Americans sector-has the responsibility to assist citizens to be require programs and activities sensitive to their rich prepared for their later years as well as to assist and diverse heritage. There should be opportunities directly so many of the very old who for one reason for involvement with persons of all ages in programs or another cannot cope with the burden of increasing which are affordable and accessible. physical, mental, social and environmental debilities. V. The Right to Suitable Housing. There follow certain basic human rights for older Americans based on the "laws of nature and of The widest choices of living arrangements should be nature's God" as set forth in the founding documents available, designed and located with reference to spe- of this nation some two hundred years ago. cial needs at costs which older persons can afford. 42 43 VI. The Right to the Best Level of Physical and Mental Health Services Needed. Such services should include the latest knowledge and techniques science can make available without regard to economic status. VII. The Right to Ready Access to Effective Social Services. These services should enhance independence and well- being, yet provide protection and care as needed. VIII. The Right to Appropriate Institutional Care National Policy When Required. for the Care should provide full restorative services in a safe environment. This care should also promote and pro- Frail Elderly tect the dignity and rights of the individual along with family and community ties. In its first annual report, the Federal Council on the Aging IX. The Right to a Life and Death With Dignity. identified as a priority concern, that group among the elderly who with advancing age are beset with increasing physical, Regardless of age, society must assure individual citi- emotional, social, economic and environmental debilities. Many zens of the protection of their constitutional rights need almost daily-but not 24-hour-aid, to enable them to cope and opportunities for self respect, respect and accept- with the world around them. While no one age group among the ance from others, a sense of enrichment and contribu- elderly is necessarily frail, we note that the dependency creat- tion, and freedom from dependency. Dignity in dying ing elements are more likely to occur among the older of the includes the right of the individual to permit or deny old. the use of extraordinary life support systems. While some elderly do enjoy the support of families or neigh- bors, many are isolated in contemporary circumstances. As past generations revered and cared for their elders, so too does the array of new national, State and local government and volun- tary programs show increasing concern for the aged. In the We pledge the resources of this nation to the ensuring aggregate, the programs do not match the total need. But then, of these rights for all older Americans regardless of there has not been an examination of the various caring and race, color, creed, age, sex or national origin, with the supporting programs to determine which are most effective caution that the complexities of our society be mon- at reaching the subgroups among the elderly most in need of itored to assure that the fulfillment of one right, does services. not nullify the benefits received as the result of an- In essence, the Federal Council on the Aging is saying that other entitlement. We further dedicate the technology the "frail elderly" should receive a first priority on services and human skill of this nation so that later life will be and that a thoughtful process should be undertaken to deter- marked in liberty with the realization of the pursuit mine the "floor" or "basic core" of such social services. This of happiness. process should include a review of these premises, the definition of the target group, and an assessment of the effectiveness and cost of services of varying packaging and levels. 44 45 During this past year, the Council has consulted with lead- We appreciate the flexibility of the nation's emerging com- ing scholars, government officials-both past and present-as munity mental health system and the new interest in the elderly well as leaders from practice and consumer groups in the field on the part of National Institute of Mental Health. But many of of aging to identify the national policy issues in developing a the mental frailties of our target group of elderly are going to system to meet the unique combination of needs of this growing require ongoing support primarily of a social, environmental segment of the aging population. nature which do not gibe with the major treatment goals of These deliberations, including an invitational seminar with psychiatry. Then, too, there is the stigma of being labeled men- some of these leaders and a roundtable at the annual meeting tally ill when it is the world around you that cannot adjust to of the Gerontological Society, have been useful in building a your being a "normal" eighty year old person. base of knowledge. But there is still much more thinking and Existing public social services are not amenable to a focus testing that must be done at a national level before we can be on the frail elderly. These services are characterized by eligibil- assured that every frail older American will have available ity linked to income and assets while a system of social inter- the kind of loving and long-term care that many families could vention and support is needed by many older persons who are provide in a less complex and urbanized society. not impoverished. The availability and level of public social The "frail elderly" is a working "term of art." It does not services is highly discretionary on the part of State and local imply that all elderly are frail. As a matter of fact, the modi- government. Channeling aid to the frail elderly on a universal fier "frail" was to indicate that this was a subgroup within basis would require radical restructuring. the elderly. (There is indeed a group of "frail" persons under The Council lauds the valuable "laundry lists" of services sixty-five who are beyond our purview). which have been developed in a number of recent research and demonstration efforts by the gerontological community under Entitlement At a Certain Age projects designed with such goals as "alternatives to institu- tionalization." They range from day care to mobile medical vans There are problems with using age, particularly when sub- to telephone reassurance. Hopefully, the day will come when groups such as minorities are considered, but the age seventy- many of these admirable services will be more widely available five is being studied by the Council to determine if correlations -perhaps with some Federal funding, perhaps with the in- with other indicators are sufficient to utilize it as a threshold volvement of State and local government and certainly within for entitlement to a set of specifically defined services and as this country's long history of private philanthropy. the population for public policy purposes. Basic Core of Social Services Needed Several Care Systems Impact Frail Elderly However, at this time, the Council postulates that there are Many of the frail elderly need and are receiving aid for their a basic core of supportive social services which are needed by acute and episodic medical conditions from this nation's health many persons within the "frail elderly" categorization. The care system. There is need for increased home health services as following services should be available to all frail elderly as an part of recuperation from such medical incidents. But the Fed- entitlement, regardless of their ability to pay: eral Council feels that the American health care system cannot 1. A professional psycho-social-environmental assessment. deal with the chronic conditions of an increasing number of the elderly population. They need ongoing and less structured social 2. A skilled person to assist in securing the services and benefits care arrangements and the Council is reluctant to add these to which an older person is entitled and who would arrange for essentially social services to the health care system. Effective and supervise appropriate personal care from a "significant application of sophisticated medical technology requires pre- other." This person could be considered a broker, case manager or an individual advocate. cisely defined and costly treatment methods and highly skilled and compensated practitioners. The health care system is not 3. The provision of the physical presence of a "significant other" designed-nor should it be the Federal Council believes-to to assist in simple daily coping. This would be a non-professional deliver the long-term social supports needed by the frail elderly and perhaps even a relative or friend of the older person. to enable them to cope with everyday living, to say nothing of negotiating the various programs available in the community This entitlement to the assessment, case management and for them. "significant other" would serve as a floor of services which, while 47 46 not sufficient in and of itself to solve all the problems of the Recommendations to the Administration and Congress elderly, could spell the difference in the instance of many elderly between a life that is basically satisfying and one that is not; Finally, the Council calls upon the executive and legislative between living in a community-based housing arrangement and branches of government to give priority to the frail elderly in institutionalization. the following ways: 1. The Federal Council on the Aging urges the Pres- Planned Federal Council Actions ident to assign to the Domestic Council and its Commit- The Federal Council will continue its Task Force on the Frail tee on Aging responsibility for coordinating efforts of Elderly in 1976. During this year, the Council will move for- at least the Departments of Health, Education, and ward in its exploration of national policy issues concerning the Welfare, Housing and Urban Development and Trans- frail elderly, particularly in these areas: portation towards the goal of a social support system for the frail elderly. This effort should begin by identi- 1. The notion of "frailty" and the relationship of "frailty" with fying the interrelationships between the social and age. health care services available under HEW auspices with such non-HEW activities as the housing programs of 2. Models of social intervention including the scope of services; HUD and the ever-growing transportation services of the sponsorship and the systemic implications; and the cost DOT. factors of creating such services as an entitlement and the vari- ous schemes of co-insurance, deductibles, as well as the overall 2. The Federal Council recognizes the value of con- philosophy of payment. sidering the elderly within policy studies of the long term care needs of the disabled and chronically ill of all 3. The relationship of these services to such other programs ages. We urge the continuation and extension of such as subsidized housing, multi-generational social services, aged- activities within HEW. only social services, health care, transportation and income maintenance. 3. The Council urges priority emphasis and appropriate funding, over a three-year period, for such research, It is the intention of the Federal Council to present these demonstration and evaluation efforts as required to concepts to a variety of academicians, practitioners, policy develop viable legislative and administrative proposals makers and consumer groups so that the concepts might either for the care of this population based on the feasibility be verified, modified, or perhaps discarded as being impractical of working models. There should be full funding of exist- or too costly. The products of these efforts will be continually ing research and demonstration authorities in such laws communicated to the executive and legislative branches for ap- as the Older Americans Act, the Social Security Act, propriate implèmentation such as new experimentation or new and the Health Planning and Health Revenue Sharing laws. Act. However, additional funding would be needed dur- Preliminary discussions with these experts and concerned citi- ing this period of time and should be made available. zens support the Council's priority on the "frail elderly" and We would want to see an essential difference in future on this method of developing national policy for them. Such an efforts, namely, that there be coordination of plans for approach is felt to be timely because human services resources these research efforts, full evaluation methods and elim- are becoming ever more precious. Hopefully, a number of persons ination of projects of such limited scope that usable data served by such a system would be maintained in dignity in their for this national policy effort would not be produced. own homes without the need of premature and costly institu- tionalization. Philosophically, the desired goal of normalcy would The Federal Council will serve in an advisory capacity to these be furthered. efforts in addition to the monitoring role already set forth in These efforts of the Federal Council will, at the very minimum, the Council's very establishment by the Congress. introduce fresh and potentially very important concepts into the public policy debate in such a way as to be amenable to rational treatment both in legislation and administration. 48 49 Focus on Older Women- International Women's Year The Federal Council on the Aging is charged with advising the executive and legislative branches of government on matters relating to older American women and men. But in observance of International Women's Year, the Council has tried to draw national attention to the particular concern and problems of older women. The Council's main effort was a hearing on September 28, 1975 in Washington, D.C. on "National Policy Concerns for Older Women" held in conjunction with the annual meeting of the National Council on the Aging. Over three hundred persons heard some twenty leaders from national aging organizations and the women's movement testify to the special problems of older women. Highlights of their testimony will be contained in a publication which will be issued by the Council in early 1976 and given wide distribution. The testimony will be further analyzed for future Council action. 1975 was marked as International Women's Year in declara- tions issued by the United Nations, the President of the United States and many governors and mayors. This year of women has been spent in efforts to promote equality between men and women, integrate women into the total social and economic development efforts of nations and recognize women's increasing contribution to strengthening world peace. 51 A World Plan of Action was adopted by the United Nations in the 75+ group.* sponsored World Conference of the International Women's Year which was held in Mexico City from June 19 to July 2. The The Federal Council on the Aging has a particular interest World Plan of Action provides a set of guidelines and time- in this predominantly female segment of the aging population. tables for action to improve the status of women throughout the Many persons over the age of 75 are apt to be frail and require world. Its purpose is to stimulate national and international continuing intervention by society in their daily lives. The action to help solve the problems of underdevelopment and exist- Federal Council on the Aging has been developing policy rec- ing socioeconomic conditions that place women in an inferior ommendations for the frail elderly as a priority concern and position. during 1976 hopes to bring to national debate and attention Many of these recommendations were developed in the con- some of the key policy issues which must be resolved in order text of the needs of and opportunities for the young and to meet the physical, social, economical, psychological and en- middle-aged woman. Even though we are the Federal Council on vironmental needs of SO many in this population. the Aging, we urge the United States government to work vig- During 1975, the Federal Council gave strong support to orously to achieve the goals set forth in the World Plan in such the work of the United States Commission for International areas of education, employment, and parity in the exercise of Women's Year and encouraged their special interests in older civil rights. These efforts can prevent the problems faced by women. In a statement on December 29th to a meeting of the SO many of today's older women who are the victims of past Committee on the Special Problems of Women of the U.S. discrimination. Commission, FCA Chairman Bertha Adkins indicated her It is incumbent upon the United States of America to assume pleasure with the continuation of IWY concerns into 1976. leadership among the developed nations to address the phe- She said that the Council looked forward to participating in nomenon of a sizable elderly population. The IWY World Plan these activities to assure a focus on older women. of Action gives but fleeting specific reference to older women in its 206 sections. Number 157 states: Miss Adkins explained the interest of the Council in the problems of the elderly, especially the frail elderly. But she Special attention should also be given to the needs of also stressed the positive aspects of aging. elderly women who frequently receive less protection and assistance than men. They predominate numer- Growing old presents certain problems, it is true. But ically in the age group of 50 years and over, and many there are compensations as well. There is a freedom are indigent and in need of special care. to speak and act without the inhibitions of youth that brings a pleasure in becoming a "character." There This hardly describes the dimensions of the situation. The are tax benefits, reduced fares for transportation, op- elderly are becoming an increasing proportion of the American portunities for continuing in education. There are population because of major changes in fertility, mortality and opportunities for making new friends in community immigration. The age and sex composition on the elderly has centers with a variety of activities to stimulate one's changed dramatically since 1900 with females benefiting more interest in life. than males in greater life expectancy during the 20th century. For females, the average length of life increased from 48 years Miss Adkins explained how older people with training could in 1900 to 75 years in 1973, an increase of 56 percent; for males, well provide services to the frail elderly to enable them to re- the increase was from 46 to 68 years, only 46 percent. Between main in their homes instead of going into institutions. "This 1900 and 1974, the percentage of the U.S. population aged activity will enable them to earn some additional income as well 65+ more than doubled (4.1% in 1900 to 10.3% in 1974) as benefit from the psychological awareness of being needed. while the number increased sevenfold (from 3 million to 22 All of us need to remember-We make a living by what we get. million). We make a life by what we give." In looking towards the future, highly significant projections have been developed regarding women over the age of 75. They constituted only one-tenth of the elderly population in 1900 * Statistics cited were developed by the Administration on Aging, Facts and one-sixth in 1974 but they will be one-fifth of the elderly About Older Americans 1975, Statistical Memo No. 31, DHEW Publication No. (OHD) 75-20013, May 1975 and by Herman B. Brotman, Consulting in the year 2000. There are presently 169 women per 100 men Gerontologist. 52 53 Personnel Needs in the Field of Aging The Older Americans Act directs the Federal Council to assist the Commissioner on Aging in appraising the nation's existing and future personnel needs in the field of aging and the adequacy of efforts to meet these needs. The Council has established a standing Committee on Research and Manpower in the Field of Aging to give leadership to such Council efforts. Among the pertinent activities undertaken under Council auspices during 1975 are the following: 1. Reviewed and made suggestions to the Commissioner on Aging on a report on "Manpower Needs in the Field of Aging: The Nursing Home Industry" which had been prepared by the Department of Labor for the Administration on Aging. 2. Approved plans for a hearing on manpower needs for services to the "frail elderly" to be held in early 1976 in Washington. Policymakers will be asked to testify on personnel needed to serve this target group. Statements will be requested from rele- vant organizations. The testimony and statements will be an- alyzed to present recommendations on national policy for man- power needs of the frail elderly to the Council. 3. Will assist the Commissioner with projected hearings on social services manpower needs in the field of aging. 4. Offered assistance to the new HEW Committee on Mental Health and Illness of the Elderly in studying manpower needs in mental health services for the elderly. 55 1976 Agenda Other sections of this report deal with a number of national policy and program matters affecting the elderly to which the Federal Council on the Aging will be giving continuing attention during the coming year. We shall want to give attention to the implementation of the recommendations that were included in our recently completed studies on benefits and taxes. We look forward to reviewing the response of the President to these studies and our annual report. We shall begin in the immediate future our study on the treat- ment of personal assets of the elderly in the determination of eligibility for various government benefits and services. The Council will continue its priority concern for the frail elderly. But there are a number of other matters which the Council has identified as being of serious impact on the elderly and deserv- ing of the attention of a body which is to advise the executive and legislative branches of government. This list will increase as the year progresses but, at this time the following are issues that will receive major attention of the Council. Included are certain recommendations which we hereby commend to the attention of the President and the Congress. Funding of Programs Affecting the Elderly In its concern that the elderly have an adequate income cap- able of withstanding the effects of inflation, we urge the Presi- dent and the Congress to consider the special needs of the elderly-so many of whom are poor-as funding levels are set for programs of substantial benefit to older Americans. 57 Subsidized Housing for the Elderly at least a period of one year after it takes office in which to complete its assignments. Far too many older people today are living in housing that is substandard, difficult to maintain, too expensive, or not designed Reimbursements for Nursing Home Care for their age and condition. The Federal Council urges a con- tinuing and expanded Federal role in improving the living ar- The Federal Council strongly supports high standards of rangements of the elderly. Of particular importance, at this safety and care in nursing homes and recognizes that such stand- time, is the most effective use of the $375 million appropriation ards can only be implemented and maintained if there is full for the program of Construction Loans for Housing for the reimbursement to providers on a reasonable cost related basis. Elderly and Handicapped pursuant to Section 202 of the Housing On July 1, 1976, amendments to the Social Security Act Act of 1959 as amended by the Housing and Community De- passed by Congress in 1972 (P.L. 92-603) become effective re- velopment Act of 1974. Coupled with the Section 8 program quiring States participating in Medicaid to reimburse skilled providing housing assistance payments, there is the opportunity nursing and intermediate care facility services on a reasonable cost-related basis. for beginning to meet the severe housing needs of older Americans. State plans to carry out the new requirements of the law are to be sent to the Department of Health, Education, and Welfare The Council will monitor the implementation of these programs in early 1976. The Council will monitor the State plan review to evaluate their impact and benefit to the elderly. In addition, process in HEW to assure that the intent of Congress is carried the Council will work towards the assurance of access to this out which would link costs reasonably incurred for providing housing for poor and minority older persons. quality care to reimbursement rates. The Council will also eval- uate the impact this legislation has on generally improving Administration of Supplemental Security Income Program nursing home care. The Council supports those efforts of the Social Security Administration and the Congress for improvement of the ad- National Health Insurance and Long Term Care ministration of the Supplemental Security Income program. In The Federal Council on the Aging is watching with great addition, we hope that these activities might be aided by the interest the National Health Insurance debate. The recommenda- findings and recommendations contained in the benefits and tax tions of the 1971 White House Conference on Aging continue studies recently completed by the Council. to have validity and can serve as criteria against which the various proposals should be judged. Aging Research Plan We have particular concern about the area of long term care. While disclosures during 1975 continue to raise questions as to The Federal Council on the Aging has had early involvement on the part of members and staff in the development of the the adequacy and quality of long term care in the United States, there is little indication from current legislative proposals that aging research plan which is mandated by the Research in a coherent national policy on long term care will evolve under Aging Act. The Council's committee on Research and Manpower the framework of a national health insurance scheme. Yet, there in Aging will review the plan and draft a position for the is no group in our country more at risk and more in need of a Council's consideration. The Council has a continuing interest rationalized, accessible system, than those with chronic health in the implementation of the plan. problems. Federal Council deliberations regarding the frail elderly give Mental Health Needs of the Elderly rise to the conviction that for many of the "old-old" a comple- The Council has communicated to the Secretary of Health, mentary but separate system of social intervention is a neces- Education, and Welfare, its offer of support for the Committee sary and more appropriate and economical strategy than provid- on Mental Health and Illness of the Elderly which was estab- ing essentially social services through a health care system. lished under provisions of the Health Revenue Sharing and Activities under the auspices of the Federal Council on the Health Services Act. The Council also supports the provisions Aging are underway to test the validity of this approach and of such monies as are required for this advisory body to carry are described in greater detail in another section of the annual out its functions. We trust that the Committee will be granted report. 58 59 Viability of Area Agency on Aging Concept The 1973 amendments to the Older Americans Act established the area agency on aging as a new concept for providing a focal point at the community level for planning and coordinating services to the elderly. During this coming year, the results of various evaluation efforts as well as a solid body of experience will be available with which to make some determination of the validity of the basic philosophical concepts behind the area agency on aging. The Council will review these findings and determine if recommendations are in order to the executive and/ or legislative branches. Relationship Between Title XX of the Social Security Act and Titles III and VII of the Older Americans Act Council Stewardship The resolution of the controversy over the use of the group means test in social service programs for the elderly funded The Council strives to carry out the spirit and the letter of under Title XX of the Social Security Act is of great concern the various Federal laws which affect its operation, particularly to the Council. We would hope that such a determination of the Older Americans Act and the Federal Advisory Committee eligibility could be continued. However, the Council recognizes Act. The Older Americans Act defines our mission of advocacy for that there are broader issues regarding the very use of the older Americans and certain specific operating procedures. The means test for social services for the elderly which must also be Federal Advisory Committee Act sets forth standards to insure addressed. Obviously, the use of the means test in the Social the effective use of all advisory bodies within the Federal govern- Security Act and not in the Older Americans Act for some of ment. the same kinds of programs reaching the same kinds of older Accordingly, the Council held the four quarterly meetings persons must also be examined and will be by the Council. This called for by the Older Americans Act on March 13-15, May effort will also be related to the broader endeavors of the 15-16, September 26-27 and December 3-5. These meetings were Council contained in its study of benefit programs whereby all duly announced in the Federal Register but, in addition, some benefit and service programs for the elderly will be examined 300 notices were sent to representatives of national organiza- with a goal of elimination of overlapping and confusing programs. tions and staff of various Federal agencies, Congressional mem- bers and committees with a special interest and responsibility Review of Private Pension Plans in the aging field. A number of these persons as well as the general public do attend Council meetings and minutes are sent In this coming year, the Council will examine the effectiveness upon request. AGING magazine, the publication of the Admin- of private pension plans in contributing towards the economic istration on Aging, regularly carries stories on Council activities. security of the elderly. A part of this review will involve an All documents relevant to Council official actions are maintained assessment of the first years of experience with the provisions in the office of the FCA Secretariat and are available for public of the Employees Retired Income Security Act (ERISA) with respect to its effect on improving the retirement income of inspection and copying. The Council was received by President Gerald R. Ford at the present and future retirees. White House on May 16 as part of the observance of Older Americans month. Miss Adkins summarized the current major activities of the Council for the President. He expressed par- ticular interest in the Council's study of the interrelationships of benefit programs. He noted that his Cabinet-level Domestic Council was continually surveying existing programs to assess 61 60 their merit and that the Council's efforts could lead to recom- mendations for improving programs for older Americans. The The Chairman appointed an ad hoc committee on the Bicen- President reiterated that he did not consider the Council as tennial Charter on Older Americans, chaired by Garson Meyer, "window dressing" and that its recommendations would get to review the statement of rights and obligations of older high-level attention. persons which was adopted by the delegates to the White House Council members received briefings during the year on legis- Conference on Aging in 1961. This committee met on November lation and issues affecting the elderly from a number of Federal 11 to draft the Bicentennial Charter for Older Americans which officials including the Commissioner on Aging and the Commis- is conveyed in this annual report to the President. sioner of the Social Security Administration, the Director of On September 28, the Council held a hearing on "National Income Security Policy-DHEW, and representatives of the Policy Concerns for Older Women" to mark the observance of National Institute on Aging and the Department of Labor. International Women's Year. Chairman Bertha Adkins chaired the panel which heard the views of some twenty invited leaders from national aging organizations and the women's movement Council Sub-Units testify to the special problems of older women. In addition to In order to expedite the work of the Council and the most Council members Garson Meyer, Dorothy Devereux, Lennie- effective use of the quarterly meetings, members participate in Marie Tolliver and Sharon Fujii, the hearing panel included a range of other activities both individually and in groups. There Margaret Long Arnold representing the U.S. Commission for are three standing committees. Each met twice during 1975. International Women's Year and Patricia S. Lindh, Special As- sistant to the President. The Council plans to issue a publication The Committee on Senior Services headed by John Martin with the highlights of the hearing early in 1976. had as its major responsibility during 1975 the liaison and super- vision of the study on the interrelationships of benefit programs. Activities of the Chairman Nelson Cruikshank is the chairman of the Committee on the Economics of Aging to which was assigned the conduct of the As part of the general responsibility of the Federal Council study on the impact of taxes on the elderly. on the Aging to inform the public of the needs and contributions of older Americans, the Chairman participated in a number of Dr. Carl Eisdorfer serves as chairman of the Committee on activities. Miss Adkins' major appearances included: Research and Manpower in the Field of Aging. He thereby is Testimony before the Select Subcommittee on Education of an ex-officio member of the advisory body to the National In- the House and Labor Committee, January 31, 1975, on exten- stitute on Aging. This provides liaison for the Council not only sion of the Older Americans Act. to this new Federal agency but also to the national aging re- Testimony before the Subcommittee on Aging of the Senate search plan which the NIA has been asked to prepare for the Committee on Labor and Public Welfare, April 23, 1975 on Secretary of HEW. extension of the Older Americans Act. To launch the Council's identification of the frail elderly as Address before the Sixth International Congress in Social a priority concern, a seminar was held on March 14, 1975. Gerontology, Paris, France June 2, 1975 on "The Relationship Nationally known experts were invited to share their thinking of the Federal Government to the Older American." with Council members. Out of this process it was decided to Received National Retired Teachers Association/American establish a task force to provide a focus for the Council's work Association of Retired Persons award for outstanding contri- in this area. Monsignor Charles Fahey was named chairman of butions in service to her community by helping the elderly, the Task Force on the Frail Elderly by Miss Adkins. the disabled or poor; and by raising public consciousness about This task force met in April in Washington and in October at such issues. October 1, 1975. Louisville, Kentucky during the annual meeting of the Geron- Keynote Speaker-"Quality of Life for the Aging Seminar" tological Society. Taking advantage of the gathering of leading University of Tulsa-Tulsa County Medical Association, Tulsa, gerontologists, the task force members conducted a roundtable Oklahoma December 11, 1975. discussion on "Developing National Policy for the Frail Elderly." Keynote Speaker-"Federal Perspectives on the Aged" Gov- Over forty persons participated. ernor's Committee on Aging, Austin, Texas December 12, 1975. 62 63 Staff Support According to provisions of the Older Americans Act, the Secretary of the Department of Health, Education, and Welfare and the Commissioner on Aging are to make available to the Council such staff, information, and other assistance as it may require to carry out its activities. This is done in a variety of ways. The Secretariat for the Federal Council on the Aging is located in the Administration on Aging. Staff is composed of four pro- fessional persons-one of whom is a re-employed Federal annui- tant, an administrative aide and a secretary. FCA staff attend a wide range of meetings in various parts of the country both to learn about developments in the field as well as to disseminate information about the Council. The placement of the Secretariat in AoA and the Office of Human Development provides informal as well as formal utiliza- tion of their staffs and supportive services. The Committee Management office in the Office of the Secretary aids in carrying out the provisions of the Federal Advisory Committee Act. Various units within departments other than HEW have given ready response to FCA requests for resource speakers and materials. Short-term employees and contractors have been utilized to assist with certain FCA projects such as the Congressionally mandated studies, the preparation of the Bicentennial Charter for Older Americans and the publication of the hearing on older women. The FCA budget for FY 1976 of $500,000 is provided as part of the AoA appropriation. The President's FY 1977 budget proposes the same level of funding as the previous year. 64 DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE POSTAGE AND FEES PAID WASHINGTON, D.C. 20201 U.S. DEPARTMENT OF H.E.W. U.S.MAIL OFFICIAL BUSINESS HEW-391 Sarah Massengale DHEW Publication No. (OHD) 76-20955

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Aging - Federal Council on Aging (1)

This file contains materials relating to Cleonice Tavani, Arthur S. Flemming, and Bertha Adkins.

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sourceUrl	https://catalog.archives.gov/id/1523515
contentType	document
collections	Sarah C. Massengale Files (Ford Administration) Sarah Massengale's Health, Social Security and Welfare Files
subjects	Old age Taxation Pensions Federal aid
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url	https://catalog.archives.gov/id/1523515
naId	1523515
coverageEndDate	logicalDate 1976-10-31 month 10 year 1976
coverageStartDate	logicalDate 1975-03-01 month 3 year 1975
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recordType	description
ocrSource	nara-archive

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