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Collection: Reagan, Ronald: Gubernatorial Papers,
1966-74: Press Unit
Folder Title: [Aging] - Aging in California 05/24/1971
Box: P33
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Spare
AGING IN CALIFORNIA
A resource document prepared for use
at the White House Conference on Aging
Sacramento, California -- May 24, 1971
TAXES
$
25%
the persons
senze 1931
with
signe
INDEX
Page
Introduction
Preface
A. The Aging in California
1
1. In General
1
2. Analysis of Census Date
3
3. Evaluation of Questionnaire
3
4. Profiles
5
B. What is Being Done
8
1. In General
8
2. Federal Programs for the Aging
9
(a) Administration on Aging
9
(b) Atomic Energy
12
(c) Post Office Department
12
(d) Department of Labor
13
(e) Federal Trade Commission
15
(f) Department of Health, Education and Welfare
17
(1) Food and Drug Administration
17
(2) National Institute of Child Health and
19
Human Development
(3) Health Services and Mental Health
21
Administration
(4) Social Security Administration
23
(5) Social and Rehabilitation Service
25
(6) Office of Education
27
(g) Department of Housing and Urban Development
29
(h) Internal Revenue Service
34
(i) Veteran's Administration
35
(j) Office of Economic Opportunity
40
3. State of California Services to the Aging
46
(1) Department of Education
47
(2) Department of Social Welfare
51
(3) Department of Health Care Services
53
(4) Department of Public Health
54
(5) Department of Mental Hygiene
55
(6) Department of Human Resources Development
58
(1) Commission on Aging
59
(2) Older Workers Program
63
(3) Development of Senior Aide Concept
64
(7) State Teachers Retirement System
67
(8) Department of Rehabilitation
67
(9) Franchise Tax Board
68
(10) Public Employees Retirement System
68
(11) Department of Veterans Affairs
69
(12) Department of Consumer Affairs
70
(13) State Personnel Board
71
i
Page
(14)
Department of Housing and Community Development
71
(15)
Department of Fish and Game
72
(16) Department of Youth Authority
72
(17)
Department of Corrections
75
4.
Services to the Aging -- Incorporated Cities of California
79
A.
In General
79
B.
Results of City Questionnaire
80
C.
Synopsis of Individual Programs Reported
81
D.
Summary of Additional Services
83
E.
Details of Selected City Programs
84
(1)
Los Angeles
84
(2)
Menlo Park
86
(3)
Palo Alto
88
(4)
Sacramento
88
(5)
San Jose
88
(6)
San Diego
89
5. Programs for the Aging -- Counties of California
90
6. Progress in Europe
99
C.
What Can Be Done -- Community Models
111
1.
In General
111
2.
The Local Coordinating Organization
112
(a)
Model Ordinance
112
(b)
Model Resolution
116
(c)
Technical Advisory Committee
118
3.
The Voluntary Service Organization
118
(a)
Preliminary Considerations
118
(b)
Constitution and By Laws, The Unincorporated
122
Association
(c)
Non Profit Corporations
127
(1)
In General
127
(2)
Formation
127
(3) Management
129
(4)
Powers
130
(5)
Membership
130
(6)
Sample Articles of Incorporation
131
(7)
By Laws
133
(8) Other Applicable Laws
134
D.
Working for a Prosthetic Environment
136
1. Definition
136
2.
The Problem
136
3.
Progress
136
4.
New Directions
139
5.
Conclusions and Recommendations
140
E.
Second Careers
142
1.
In General
142
2.
The Senior Service Corporation
142
3. Government Service
144
(a)
Full Time
144
(b)
Part Time
144
(c)
Government Services by Contract
144
ii
Page
(d)
Special Government Projects
145
(1) The Adult Aid Program of Orange County
145
(2) Love to Share
145
(3) Green Thumb and Green Light
146
(4) Community Representatives
147
4. Part-time Employment Through Referral Services
147
5.
Other Programs
151
(a)
In General
151
(b)
OEO Funded Projects
151
(c)
Special Research and Training Projects
156
F. Training
164
G.
Preventive and Supportive Services
170
iii
INTRODUCTION
This document has been prepared for use at the California Statewide
Conference on Aging to be held in Sacramento on May 24th, 1971.
It is made available to you for two purposes. First, we believe it
will be a helpful resource document in your deliberations. Second, we want
your comments and suggestions as to any changes that will correct or improve
this material.
Please send your suggestions to:
Institute for Local Self Government
Claremont Hotel Building
Berkeley, California 94705
Attention: Mr. S. Williams
This material is the first compilation of its kind and will be used as
part of a larger document that will constitute California's report to the White
House Conference of 1971. It is intended that the findings and recommendations
developed at the Statewide Conference will also be included in that report.
We realize the information on Federal Government activities omits some
programs and is very brief on others. We believe, however, it amply demonstrates
the scope and depth of Federal involvement. The treatment of programs by
volunteer groups in California is not an attempt to describe all of the fine
programs that are being carried out. They are too numerous for that. It is only
an effort to describe some of the typical programs which are illustrative of
many others, and which offer an insight into what any local group can do with
proper organization and committment. We invite descriptive information on any
other volunteer programs that you believe warrant inclusion herein.
You who are attending this conference carry both a heavy responsibility
and great opportunity. What you here accomplish may well set a pattern for the
White House Conference, and in so doing, make a significant contribution towards
meeting the needs of our nation's aging.
We wish you success in both.
Institute for Local Self Government
By:
Spencer Williams
Project Director
Preface
All who are today old were one day young. All who are today
young will one day, with good health, and good luck, be old. All belong
to the continuum of human existence which begins with birth and ends with
death. As such, all share many common interests, fears, hopes and
frustrations. Physical and psychological differences between young
and old, on the other hand, tend to set them apart. It has always been
thus. But with our penchant for classifying, categorizing and over-
simplifying, for accentuating the negative, looking for areas of difference
and disagreement rather than areas of commonality and agreement, American
society seems to have opened an almost unbridgable chasm between young
and old. To the knowledgable, this chasm is more apparent than real.
The old have compassion, understanding, and love for the young, not only
their own young, but for young people in general. And the young - -
those at least who take time from their daily struggle for survival and
achievement to contemplate the problems of the older citizens - - also
possess a reciprocal well of compassion, understanding, and affection.
Whatever its dimensions, however, the chasm persists. While
the reasons are many, the excuses are few. Some of us immaturely fear
the implications of our own aging process and thus shun the elderly.
Others are merely indifferent, so imbued with our own daily concerns.
we cannot or will not take the time to be concerned with anyone else's
problems, particularly those of the aging. To some a person reaching 65
becomes an indistinguishable member of a faceless horde, almost of another
species, somehow no longer needing love or being capable of love, no
longer desiring the usual amenities of life or being capable of enjoying
them, no longer needing the challenge of life or experiencing the pleasures
of achievement, no longer capable of concern about illness, poor housing,
finances, national or world problems.
We have long been a youth-oriented society and properly SO.
As an emerging nation of the 19th and early 20th century, our great leap
into world prominence was accomplished to a great extent by the courage,
determination and imagination of our young people. Even today we re-
cognize that the future of our nation rests on the ability and stability
of the "now generation" and their performance in the years ahead. But
too many of us, young and old alike, are in danger of becoming youth
cultists, mistaking energy for ability, education for knowledge,
innovatedness for judgment. We seem too ready to pawn the value of
experience for the excitement and adventure of change.
For these and other reasons, our elderly population has become
the single-most tragically alienated, disadvantaged, and disserviced
segment of American society. Thousands of vigorous, talented, experienced
persons are forced into retirement at the peak of their productivity and
at a time when the nation truly needs their services. The relative income
of the over-65 population is but 50% of those under 65, and is dropping.
While the percentages of all other age groups living below the poverty
line is diminishing, the percentages of the aging who live in poverty is
increasing. Inflation and sky-rocketing health costs hit hardest at our
aged population living on fixed incomes and afflicted by the growing
disabilities of old age. The labor market is all but closed to the
physically active and mentally sharp senior who seeks to supplement his
income.
These are not new problems, but they affect ever-increasing
numbers of persons as our aging population continues to grow rapidly.
In 1900 there were 3 million Americans aged 65 and more, comprising 4%
of our population. Today we have over 20 million Americans aged 65
and over constituting 10% of the total population. To put it in
another perspective, since 1900 our total population has grown 300%
and our over-65 population has grown almost 700%. This is an acceler-
ating trend which will experience even more rapid growth when medical
researchers solve the problems of heart disease, cancer and stroke.
While in the words of John B. Martin, U. S. Commissioner
on Aging, it may not be easy to "sell" a comprehensive program for the
aging - - to raise it high on the list of national priorities - -
we should be fully aware of the consequences of our failure to do SO.
Today's crisis will become tomorrow's national calamity if we do not.
The "sale" must be made to our entire population, particularly our
security-assuming under-40 segment. The time for the sale is now.
The forum for the sale is the President's White House Conference of
1971. The terms of the sale must be clear and unequivocable:
1) Develop a plan now that will adequately serve the
needs of tomorrow's aging.
2) Fulfill a grateful nation's obligation to yesterday's
youth whose vigor, courage and sacrifice made today - - and tomorrow - -
possible.
It is hoped that this document will be of assistance to
California's Commission on Aging in its efforts to stimulate a public
awareness of the problems of our aging citizens and develop local
programs for their solution. It is also hoped that this document may
contribute to the success of the White House Conference on Aging, 1971.
Spencer Williams
Project Director
A. The Aging in California.
1. In general. Californians are proud of California. Perhaps it
is because so many have come from so many other places that "pride of state"
has developed as a simple and perhaps the only factor of commonality that
binds them.
Perhaps it is because they have so much to be proud of. In addition
to the variety and extent of its vast natural resources - beaches and
mountains, lakes and streams, deserts and forests - California ranks first
in more economic and social indicators than does any other state: Popula-
lation, personal income, farm income, number of scientists, tax receipts
and expenditures, housing construction, retail sales, motion picture theatres,
births (second in deaths), marriages (and divorces), public schools.
California's over-65 population of 1.8 million - which is second only
to New York with almost 2 million - benefits indirectly from some and
directly from other such "firsts". In its various Welfare programs affect-
ing aging recipients, California's payments to the blind (AB) ranks first,
the totally disabled (ATD) second, and Old Age Security (OAS) third
nationally. The California law currently provides for an automatic cost of
living increase for old-age assistance recipients. In his Welfare Reform
proposal, Governor Reagan is recommending a forward step long advocated by
students of public assistance for truly needy adults no longer able to
support themselves; take the aged, blind and totally disabled out of the
"Welfare" category and allow them to live in dignity under an automated,
"pension" type system. California now ranks second in the number of doctors
and fourth in the number per 100,000 population; second in the number of
dentists and eighth in the number per 100,000; second in the number of
nurses, although 27th in the number per 100,000; first in the number of
-1-
hospitals and second in the number of hospital beds; first in the number of
nursing homes and nursing home beds.
Despite these glowing statistics, California's aging suffer the same
problems of alienation, reduced purchasing power, inadequate housing, immo-
bility, and forced retirement that plague seniors in our other states.
The area of transportation is but one example of the plight of senior
Californians. Californians' historical reliance on the automobile as the
principal means of transportation has inhibited the growth and development
of adequate public transportation systems in the state. Cars are expensive
and California's crowded highways and freeways are hazards that most seniors
avoid with a passion. What public transportation is available is scattered
and is primarily oriented to and scheduled for the journey to work require-
ments of the low income workers living close to urban centers. For most
senior Californians, if you don't have a car or someone to drive you, you
just don't go. They, thus, suffer equally, if not more severally than most
others from the shrinking capacity for self-maintenance and the reduced
ability to maintain social contacts and social participation which forced
immobility brings. The same is also true of many other of the problem
areas singled out for special consideration by the White House Conference.
Despite its liberal property tax exemptions for seniors, California's
property taxes are among the highest in the nation and are forcing many
of its aging citizens to seek different and frequently substandard living
arrangements. Inflation and the high costs of living are also taking
their toll. And high unemployment caused by slowdowns in California's
space industry has generated fierce competition for the few job oppor-
tunities that were previously available to seniors.
-2-
In the sections that follow, we attempt to describe with more speci-
ficity the aging population of California. We also endeavor to describe
what is being done and what can be done to improve the quality of their
lives in the golden state.
2. Analysis of Census Data
The census of 1970 reveals that nationally older adults now constitute
9.9% of the population as compared to 9.2% in 1960. There are 20 million
people 65 or over -- one in every 10 persons. The number is increasing at a
rate of 900 per day, 330,000 a year. More than 70% of those over 65 have
joined this age group since 1961. One fourth of the aged are poor, and nine
out of every ten receive Social Security benefits-- an average of $117 a month.
About 2 million are on general assistance. Private pensions provide for only
about five percent of older population.
In California, the total population has increased 27% from 15.7 million
to 19.9 million and the 65 and over population has increased 32% from 1.37
million to 1.8 million. While in 1960 the 65 and over population constitutes
8.98% of the State's total, it is now 9.00%. In addition, while California
has 10% of the nation's total population, it has 9.2% of its aging. Of every
100 Californians over 65, 59 are women and 41 are men. In the 65-74 group,
however, 56 are women and 44 men, while in the 75 and over group, 62 are women
and 38 men.
The California census also reveals that 587,000 seniors are heads of
families, 343,000 are wives of heads of families and 198,197 are living with
an under 65 family member who is the head. 198,000 men and 399,000 women
over 65 are living alone, 35,000 are boarding with non-relatives and 94,000
reside in institutions.
A breakdown of the distribution of the 65 and over population by counties
and cities in California may be found in Appendix I.
3. Evaluation of Questionnaire
For the purpose of finding out what older Americans believed to be their
greatest needs, special assistance to the President for aging, John B. Martin,
prepared a questionnaire to be distributed nationally. Over 5,000 were completed
in California and returned to the Administration on Aging for tabulation.
Additional copies were reproduced in California and 17,000 were distributed,
filled out, collected and analyzed locally. The results are the subjectively
expressed opinions of the elderly who attended the Community Forums which were
held concerning their needs and problems. Since those attending are generally
already 'involved' in senior programs and activities, they probably do not
represent a true cross-section of all the elderly persons in California. For
example, while the census reveals 59% of California's over 65 are women and 41%
men, the distribution of those answering the questionnaire was 69% women and
31% men. Furthermore, since the questionnaires were not distributed in direct
relationship to the distribution of the aging population throughout the state,
there are additional reservations as to their validity to accurately represent
-3-
the thinking of our senior citizens. Despite the failure to qualify as a
'scientifically selected sample' the questionnaires have produced some interesting
information. 23.9% of the sample were college graduates; 15.5% lived in a retire-
ment or nursing home; 63% belonged to an active organization for retired persons.
While 90.1% of those questioned were retired, only 39% of those not retired
wished they were. 7.4% were working full time, and of the 92.6% not working
full time, only 9.4% would like to. A somewhat higher percentage (10.4%) were
working parttime, a much larger group (26.2%) would like to be.
A high percentage of seniors reported they could see a Doctor (87.7%) and
a Dentist (84.6%) when they wanted to, and of those receiving such services in
the preceding month 72.5% had enough to pay their doctor bills, and 62.5% had
enough to pay the dentist. 91.6% were happy in the neighborhood where they lived.
A sample of the California-collected questionnaire was analyzed for the
California Commission on Aging by George Jessup and Chris Johnson with particular
reference to the variables of age, sex, income and levels of education. While
a full reading of their report is recommended, the following are some of the
observations drawn from their tabluation:
Age:
Q: Do you have a health problem you feel needs attention, but is not getting
medical attention? A higher percentage of people in the age categories 55-65
years (27.5% to 28.3%) seems to answer affirmatively. It may be that retirement
and/or welfare benefits are not yet available to individuals in these age
categories, or that the younger people are having health problems associated with
aging that they have not yet become adjusted to.
Q: Do you have trouble paying for your housing costs? There appears to be an
age relationship in the ability to pay housing costs, the older the person, the
less trouble he has.
Q: Do you have trouble getting from home to places such as shopping, church
or visiting friends? The response indicates an age relationship with this question.
It appears that the older a person gets, the more trouble he has in getting around.
This, of course, is not too surprising in view of the aging processes going on.
Q: Do you have enough money to buy the food you like? The response indcates
an age relationship to this question, the older the individual (93.9%), the more
money he appears to have to buy the food he likes. In the age range 66-70 years,
only 67.2 have enough money to buy the food they like.
Q: How far did you go in school? It appears that the older persons responded
that they had higher educations than younger persons. 34.2% of those over 85 years
responded that they were college graduates compared to only 17.5% of those persons
under 55 years of age. It remains for the reader to speculate upon why the great
difference exists.
Income:
Q: Do you have a health problem you feel needs attention, but is not getting
medical attention? The response indicates an income relationship to this question.
It appears that those in the lower income classifications have a greater problem
getting medical attention.
Q: Do you have trouble paying for your housing costs? The response found
here indicates that the more money one has, the less trouble he has in paying
for housing costs.
-4-
Q: Do you have trouble getting from home to places such as shopping,
church or visiting friends? Here again, like many of the"common sense questions",
the less income a person has, the more difficult it is for him to get around.
Q: Do you have enough money to buy the food you like? The response is
probably influenced by the high percentage of persons earning more than $400
(95.6%) who have enough money to buy the food they like, compared to those who
make under $100 of whom only 45.6% have enough money to buy the food they like.
Q: How far did you go in school? As would, most likely, be expected,
a significantly larger percentage of those in the lower income categories also
were in the "no schooling" and "some grammer school" categories. Likewise, those
persons in the higher income categories had completed more schooling, with 49.4%
of those earning more than $400 responding that they were college graduates.
Education:
Q: Do you have a health problem you feel needs attention, but is not getting
medical attention? A high percentage of persons with little or no education
(37% - none, 35.6% - some grammer school) have a health problem that is not
getting medical attention, than those individuals with some college (14.4%) and
college graduates (6.9%) with similar problems.
Q: Are you usually able to see a doctor when you need one? There appears
to be a general relationship between level of education and ability to see a
doctor when necessary. For example, 22% of those individuals with no education
are unable to see a doctor when they need one, compared to 14.1% of those with some
grammer school.
Q: Are you usually able to see a dentist when you need one? Here again,
there seems to be a relationship between educational level and being able to see
a dentist when necessary. Twenty-seven percent of those with no education were
unable to see a dentist when necessary, compared to 15.6% of those who finished
grammer school and 5% of those who were college graduates.
Q: Do you have trouble getting from home to places such as shopping, church
or visiting friends? There appears to be a significantly greater percentage of
persons in the higher educational categories who have little or no trouble getting
around.
In concluding their report, the researchers stated that any interpretation or
inference regarding the data should be made by the Commission. The report points
out several significant associations between variables, and provides the Commission
with a general picture of how the "population" answered each question. It is
important that inferences be made only to the actual "population" of 16,517 question-
naires from which the sample was drawn and that attempt should be made to generalize
beyond this particular isolated "population".
4. Profiles:
The 1970 census data has not yet been sufficiently refined to provide a
profile of the composit over-65 Californian. The gross figures would indicate,
however, that such person is a white 69 year old widow on Social Security who
lives alone in the Los Angeles area and does not belong to any senior citizens
organization.
-5-
The typical adult recipients of Social Welfare in California have been
described by the State Department as follows:
TYPICAL ADULT RECIPIENTS
(Independent Living Arrangement)
Characteristics
OAS
AB
ATD
Social:
1. Age
72
67
62
2. Sex
Female
Female
Female
3. Marital
Widowed
Married
Married
4. Live Alone
Yes
No
No
5. Ethnic
White
White
White
6. Years in State
22
22
20
7. Years in Program
5
2
2
8. Age at Entrance
67
65
60
9. Property - Liquid
Saving-amount unknown
Saving-amount unknown
-Θ-
Real
-Θ-
-Θ-
-Θ-
10. Health
Good
Good
Disabled
11. Education
?
?
?
Eligibility:
1. Residence
In State
In State
In State
2. Age (Minimum)
65
16
18
3. Property Limits:
Liquid
$1,200
$1,500*
$1,200
Real (Home
None
None
None
(Income)
$5,000
None
$5,000
4. Other
Blind
Disabled
Needs Provided bv:
1. Basic Grant
Housing, food,
Housing, food, clothing,
Housing, food cloth-
clothing, household
and personal needs and
ing and personal
remedies and person-
needs related to blind-
needs and needs re-
al needs and needs
ness.
lated to disability.
related to age.
2. Special Grant
Attendant Care**
Attendant Care**
Attendant Care,
special diet and
transportation
Income
OASDI - $64
OASDI - $35
-8-
Payment of Aid:
1. Payee
Recipient
Recipient
Recipient
2. Payments per Month
One
One
One
3. Expenditure Control
None
None
None
4. Unmet Needs
None
None
None
5. Amount
$95
$135
$125
* None if used in 36-months plan for self-support
** Plus large variety limited only by maximum grant ceiling
-6-
OAS Typical Recipient
5'
R.I.P.
BACKGROUND
MR.
JONES
1895
EDUCATION
1965
RESOURCES
SAVINGS
SKILLS
HOME
72 yrs.
WHITE
GOOD HEALTH
22 YEAR STATE
RESIDENT
COUNTY X
SOC. SEC. ADM.
JAN.1
JAN.1
Pay-MRS. JONES $94
Pay-MRS. JONES $64
A.Auditor
Robt. Ball
[NEED-GRANT]
INCOME
-7-
B. What Is Being Done.
1. In General. The search for a solution to any problem should be preceded
by an evaluation of past efforts directed toward the same goal. Too often we
translate our new awareness of a problem into a belief that the problem is
new. Ecology and the preservation of our enviornment had been of deep concern
to many scholars for many years. This is not new, although the current public
awareness and concern is new
and welcome. Novices, will often translate
their lack of knowledge of what has been done in a particular field into a
conviction that nothing has been done. When this happens, plowed ground may be
needlessly re-plowed. When we start a project by "inventing the wheel", both
time and resources are wasted.
There are, of course, new ideas. 01d concepts must be continually tested
as to their validity. But a knowledge of what has been tried and failed, as
well as what has been tried and succeeded, are essential to sound and effective
planning for the future.
The following sections are presented to show in abbreviated form some of the
efforts that are being made today in the field of aging. Government and non-
government programs alike are being directed at the areas of greatest need. While
todays crisis in aging affords no time for resting on laurels, those who have
worked so long in the vinyards are entitled to reflect with understandable
satisfaction on the significant advances that have been made in the past ten
years.
-8-
2. Federal Programs for the Aging
(a) Administration on Aging.
The most significant development of 1969 was the enactment of the
Older Americans Act Amendments (Public Law, 91-69). It extended the duration
of the grant programs of the Older Americans Act of 1965, authorized a
national old Americans voluntary program, provided assistance to strengthen
the state agencies on aging as well as community projects. It authorized
areawide model projects. Another significant development in 1969 was the
appointment of Commissioner Martin to serve as the President's Special
Assistant on Aging, giving AOA's Commissioner for the first time a voice in
the highest council of government. 1970 saw much activity towards imple-
mentation of the 1969 amendments and the continuation and expansion of numer-
ous programs.
In administering Title IV of the Older Americans Act, the AOA
worked closely with state agencies on aging to stimulate their planning
activities and to evaluate delivery of services to the aging at the community
level. In 1970, two Federal matching grant programs were funded for state-
wide planning efforts and for the planning, training and delivery of commun-
ity services for the elderly.
In 1969, 816,000 older persons were served by 786 Title III projects;
in 1970, 1,800,000 older persons were served by 1,000 Title III projects. For
example, in 1969 and 1970 over 165,000 older persons were helped to maintain
independent living arrangements through such items of assistance as homemaker
and home health aid services, home delivered meals, home maintenance "chore"
services, adult day-care services and the like.
Opportunities for participation in community life were enhanced in
1969 and 1970 through development and support of a number of programs serving
the aging. These include job placements (15,400 in 1969), adult education
activities (103,900 in 1969 and over 100,000 in 1970), transportation services
(76,600 in 1969, 88,059 in 1970), recreation and leisure type services (505,000
in 1969, 528,713 in 1970), and through multipurpose senior center services
(509,000 in 1969, 600,000 in 1970).
The stimulation of the aging to render volunteer services to per-
sons in need in their own communities was also a major effort in 1969, with
40,700 seniors involved, and in 1970 when 50,000 persons participated. These
services included directing leisure time activities, providing tutoring ser-
vices for students, assisting in the operation of senior centers, providing
transportation services to other seniors, making home visits and telephone
contacts for shut-ins. In 1969 a total of 59 training projects provided
short-term training for 10,690 persons to serve the elderly. In 1970 a total
of 71 such training projects provided short-time training for over 15,000 per-
sons. Many of the projects prepared specialized personnel, professional and
nonprofessional, to better serve the elderly.
Research and demonstration grants under Title IV of the Older
Americans Act, contributed significantly to knowledge and improved practices
in aging. During 1969, 63 new and continuation projects were funded at a
cost of approximately $4,155,000. In 1970, 61 new and continuation projects
-9-
were funded at a cost of $3,082,000. Projects in this area are directed at
examining the major needs and problems of the nation's elderly population
and to develop better ways of dealing with them. In 1969, for instance,
data for differentiating the needs, interests, and abilities of low and
middle income elderly, between the "younger" and the "older" senior citizen,
and the aging in varying environmental settings, was accumulated. The con-
clusions drawn from an evaluation of these statistics will have far reaching
significance for the design, thrust, and cost of efforts on behalf of older
people in future years.
In 1968 Congress earmarked $2,000,000 to initiate a special program
to improve nutrition services for the elderly under Title IV. Under this
program a number of grants were made in both 1969 and 1970, and a number have
already been completed. The projects are basically designed to test tech-
niques and delivery systems for improving the diets of the elderly and for
combating social and psychological impediments through good dietary habits.
Such programs involve both metropolitan and nonmetropolitan areas and are
generally carried out in existing facilities in the communities, such as
schools, recreation centers, community centers, homes for the aging, social
halls, public housing, churches, and the like. While much data is still to
be evaluated, it appears that two major causes of malnutrition and under-
nutrition in American are lack of income and ignorance of what constitutes an
adequate diet. In addition, other social and psychological factors associated
with aging adversely effect the dietary habits of older people.
A number of other projects were funded by AOA in studying all
aspects of retirement living, in analyzing the problem of mobility and trans-
portation needs of the elderly, and in studying and developing a set of social
indicators for the aging which will assist in the ongoing assessments of the
status of older Americans.
Training programs were also conducted under Title V for the purpose
of sending significant numbers of graduates into responsible positions serving
the older population. By the end of 1970 eighteen universities were conducting
such programs in career training. Programs were also designed and funded for
short-term training of personnel to improve their skills in the field of aging.
In these two years, a total of 3,334 students received either short or long-
term training.
The foster grandparent program continues to be an extremely popular
program for older persons.
Since the funding of the initial twenty-one projects, in 1965, the
program has expanded to include sixty-eight projects in 40 states and
Puerto Rico. No new programs were funded in 1970. There are 187 participat-
ing institutions in which 4,300 foster grandparents serve 8,600 children on
any one day, and about 22,000 children a year. For the past two years, how-
ever, the number of projects and the number of older persons serving in the
program has remained the same. The number of children served has also re-
mained unchanged.
There are other areas, however, in which some changes have occurred.
Ten million dollars was allocated for this program in Fiscal Year 1968, nine
million was allocated in Fiscal Year 1969, and $8.7 million in Fiscal Year 1970
-10-
Also, the profile of individuals serving as foster grandparents has changed.
Initially, recruitment of males was difficult. Today, one foster grandparent
in every five is a grandfather. Nonwhite participation has increased from
26 to 32 percent. Encouraging is the fact that the 70 and over age group
has increased from 30 to 41 percent of the total participants during this
period. The younger foster grandparents, the 60 to 63-year-olds, have de-
creased comparably. In addition, foster grandparents today are generally
from lower income groups than when the program began. The average income is
now $1,052 for single grandparents and $1,675 for two-member families, ex-
cluding the stipend they receive as foster grandparents of about $1,700. In
addition to the stipend, foster grandparents receive an allowance to help
defray transportation costs, an annual physical examination, and, wherever
possible, a nutritious meal each day.
The attitudes of institutions have changed also. When this program
began, it was difficult to locate agencies and child-care institutions will-
ing to participate. Now, literally hundreds of requests each year for
Federal help to start new projects are turned away. The institutions also
now show a greater acceptance of the older person, of the nonwhite and of the
poor.
In both years, community planning efforts took high priority, with
130 planning projects in 1969, and 141 in 1970.
AOA has stepped up its cooperative efforts in HUD and its model
cities activities.
Since 33 percent of all Americans aged 65 or over live in central
cities and 27 percent of them are in the poverty status, the Administration
on Aging has devoted an increasing amount of attention to the needs of the
elderly in model cities areas. Since these elderly often have severe trans-
portation and mobility problems, accessible services are essential to them.
Increased health and welfare services are a critical need along with improved
housing. Too, there is an important concern for the involvement of older
persons themselves in the model cities planning process, plus the necessity
of acquainting model cities personnel with the problems of the elderly and
offering them technical assistance.
AOA activity in the model cities program has taken several direc-
tions. AOA has its own task force on model cities. Within AOA the Title III,
IV and V programs have given high priority to model cities. The Administration
on Aging has actively cooperated with other agencies within HEW on special
model cities efforts as well as in the HEW coordinated model cities effort.
The Administration on Aging, through an agreement between HEW and HUD, has
moved ahead on programs for the elderly in direct concert with the model cities
administration.
In addition to the foregoing, the AOA undertook implementation of
the Retired Senior Volunteer Program (RSVP) authorized by the Amendments of
1969. $500,000 was appropriated in early 1971 and senior volunteer programs
are now being established in each of ten regions. An aggressive public in-
formation program is also being carried out. Major support was directed to
Senior Citizens Month in May of 1970. A number of publications, films and
other documents are produced for distribution with particular emphasis on the
White House Conference on Aging.
-11-
Early in 1970, AOA began exploration with religious denominations
nationally on possible involvement of churches in community services for
older Americans, through technical assistance from AOA. The possibilities
of a private project are currently under study.
(b) Atomic Energy Commission.
The AEC spent approximately $5.7 million in 1969 and $5.6 million
in 1970 in research programs related to understanding of the problems of
aging. The research was conducted in 11 AEC laboratories and 23 university
hospital research projects. One important factor in aging being studied is
senescence of immune system. Research with mice indicate the immune system
capability declines with advancing age, increasing susceptability to infec-
tious agents. Ways to enhance immune competencies among the aging are being
researched. Another continuing focus of the Atomic Energy Commission's re-
search on aging is in determining the mechanism whereby radiation interacts
at the molecular and cellular level to bring about loss of functional adapta-
tion by the individual or species with passage of time. This includes studies
that are directed to determining those parameters that are characteristics of
the aging phenomenon and accelerated by irradiation; emphasis is also placed
on identifying the physical and physiological phenomenon associated with the
aging process and on studies on molecular and attendant cellular changes that
can be used to predict the onset of an aging process.
(c) Post Office Department.
The Postal Inspection Service is responsible for the investigation
enforcement of the mail fraud statute, Section 1341, Title 18, United States
Code. It is the oldest "consumer protection law" ever enacted by Congress.
It provides felony sanctions for any use of the mails in furtherance of a
scheme to obtain money or property on the basis of fraudulent representations.
While not limited to protection of the aging, the aging are partic-
ularly susceptible to this type of fraud, and thus are important beneficiaries
of this governmental activity.
The following are typical fraudulent practices that have been
detected and successfully prosecuted:
Win a free vacation "contest" in which the purported winners
make a modest $25.00 "registration deposit" to assure their
nonexistent winnings.
Medical frauds purporting to sell quack cures for arthritis,
cancer, obesity, impotency, diabetes, etc.
Home improvements, debt consolidation and mortgage rackets.
Matrimonial schemes.
Stocks, bonds, oil and gas leases and other investment swindles.
Funds solicitation for nonexistent charities or for worthwhile
announced purposes and thereafter being diverted to other uses.
-12-
In addition to enforcement, the Department is engaged in a vigor-
ous prevention-through-public-information program, and in 1970 cooperated
with the CTC in the field of consumer protection to establish in each metro-
politan area of the Nation a system of channeling consumer complaints to the
proper agency for prompt action.
(d) Department of Labor.
Of the programs administered by the Department of Labor, the most
important to the aging are the Age Discrimination in Employment Act of 1967
and the various job development efforts of the Manpower Administration spe-
cifically directed at training older workers for employment in government
and military.
The purpose of the Age Discrimination Act is to promote employment
of older persons based on their ability. The administration and enforcement
of the Age Discrimination in Employment Act of 1967 was redelegated to the
Administration of the Wage and House and Public Contracts Division in the
Department of Labor.
The Manpower Administration has continued in its efforts to train
"older workers" for jobs in industry and government when those jobs are within
reach of their attainment. What has been attempted more is the use of older
trained, unemployed, or retired persons to fill the positions of supervisors,
counselors, and administrators in the manpower programs. It is found that
older workers, especially indigenous ones, establish a rapport with the en-
rollee many times better than younger workers. Older workers generally estab-
lish good relationships with older enrollees or older people in the community.
Operation Mainstream has been the program which provided the vehicle
for older workers. Due to the fact that Mainstream was primarily relegated to
rural and semirural areas, and that the exodus of younger people from those
areas has been pronounced, we find that this program has provided a surer
avenue to jobs for older persons.
In Fiscal Year 1969, the Department of Labor funded 207 Operation
Mainstream programs at a cost of $31 million, in 1970 its combined OEO-Labor
funding exceeds $40 million. In addition, there were five national contracts
for older workers in 1969 and six in 1970, funded for approximately $10 mil-
lion and $12 million, respectively. Operation Mainstream projects are admin-
istered by the Regional Manpower Administrators. The older worker programs,
although funded with Mainstream funds, are administered by the national
office staff.
The older worker projects follow the same poverty guidelines as
other Mainstream programs do with one exception, the minimum age limit is
55 years. These projects are listed below:
-13-
1969:
Authorized
Sponsor
Funds
Slots
Nat'l Council of Senior Citizens
$3,200,000
1,132
(NCSC)
Nat'l Council on the Aging
2,300,000
500
(NCOA)
Nat'l Ret. Teachers Assoc.
738,000
313
(NRTA)
Nat'l Farmers Union
5,200,000
2,314
(Green Thumb)
(4,700,000)
(2,044)
(Green Light)
(500,000)
(270)
Virginia State College
320,000
115
1970:
Authorized
Sponsor
Funds
Slots
Nat'l Council of Senior Citizens
$3,446,912
1,148
(NCSC)
Nat'l Council on the Aging
3,582,028
572
(NCOA)
Nat'l Retired Teachers Assoc.
739,011
353
(NRTA)
Nat'l Farmers Union
Green Thumb/Green Light
6,700,160
2,680
Virginia State College
479,904
125
Total Action against Poverty,
Roanoke Valley
300,000
70
The Mainstream program has the highest percentage of persons 55 years
of age and over of any of the manpower programs. The programs include older
workers from approximately 15 percent in the new careers program to an average
of about 10 percent in other programs such as the Concentrated Employment
Program (CEP), Work Incentive Program (WIN), Job Opportunities in the Business
Sector (JOBS); and other training programs, including MDTA institutional and
On-the-Job Training (OJT).
Older worker service units were established in 27 cities, for the
purpose of providing specialized and intensified employment services to
middle-aged and older persons who were having difficulty in obtaining employ-
ment because of their age, or factors associated with age. In addition to
providing intensified services, the units were able to develop innovative
service methods and techniques for improving services to older workers. The
cities in which the units were located were Baltimore, Cleveland, New Orleans,
Minneapolis-St. Paul, Washington, D.C., St. Louis, Boston, Dallas, New York
City, San Antonio, Detroit, Rochester, N.Y., Buffalo, Long Beach, Oakland,
San Diego, Houston, Chicago, Los Angeles, Pittsburgh, Van Nuys, Kansas City,
Cincinnati, Milwaukee, Philadelphia, San Francisco, and Providence.
-14-
The NIIG is an applied research program focusing on the employment
and retirement of middle-aged and older workers. It was established to help
improve employment services by providing specialized training in industrial
gerontology to placement and counseling officers; encouraging, coordinating
and applying research on this subject; and developing and distributing written
and audiovisual material in this field.
Industrial gerontology is the study of the employment and retire-
ment problems of middle-aged and older workers. It begins where age "per se"
becomes a handicap to employment. Industrial gerontology is concerned with
aptitude testing and placement, job adjustment, retention, redesign, motiva-
tion, and mobility. It is concerned with the transition from employment to
retirement and with retirement itself, and retirement income with public and
private pension programs.
The experimental and demonstration projects carried on by the em-
ployment service have proved extremely beneficial in developing the senior
community service program. The older worker service units have provided an
older worker specialist who is fully cognizant of techniques for counseling,
job development and placement of older workers.
The five prime sponsors for the senior program have had the services
of the specialist and find that they have been invaluable in the recruitment,
selection, continuing counseling, and job placement that is necessary in pro-
grams of this type.
(e) Federal Trade Commission.
The Federal Trade Commission enforces laws designed to protect
against unfair methods of competition and to halt in interstate commerce
unfair or deceptive acts or practices. In carrying out this charge it has
become apparent to the Commission that elderly consumers are among those most
likely to find it hard to obtain goods and services they need and want at
costs they can afford -- cost in terms of money and in terms of health,
safety, and convenience. The Commission is aware that the elderly make up a
high proportion of the poor -- the group upon which noncompetitive practices
and unfair and deceptive practices in the marketplace are likely to have
greatest impact.
Properly informed, the elderly, as individuals, can maximize their
satisfactions through their buying decisions.
Properly informed, elderly consumers, particularly in groups, can
interfere directly with or at least blunt illegal conduct and persistent
practices inimical to a sound market.
It is recognized that elderly consumers, particularly, need to
understand their rights and responsibilities. They need this ammunition if
they are to avoid the hazards of the marketplace -- and to avoid the buyer-
seller transaction induced by unfair and deceptive practices.
A brief review of activities of the Commission of particular
relevance to the elderly follows.
-15-
In recent years senior citizen groups and community organizations
concerned with the elderly have been among the target groups for which both
field and headquarters staff of the FTC have undertaken education/information
efforts; talks and conference participation, printed consumer bulletins and
press releases, for example.
Consumer Education/Information
Efforts at the local level are essential to deter unfair and decep-
tive market practices frequently confronting elderly consumers. From one FTC
field office are these 1964 examples of current activities designed to meet
needs of older consumers:
The attorney-in-charge chaired the Mayor's Consumer Protection
Committee for S nior Citizens in Los Angeles. This committee tries to co-
ordinate and make more effective the protection and education efforts of
local organizations and agents. For example, arrangements have been made for
personnel in the office of the mayor to receive and distribute complaints to
the proper agencies for handling.
The California Attorney General's Office and the Los Angeles FTC
Field Office have worked together for the past six years to create interest
among the black and brown people in the poverty areas. They have published
pamphlets, prepared comic strips, made radio and television appearances, and
designed inservice training components for social workers.
Federal-State-Local Cooperation
In 1969-1970 the Commission pursued an aggressive program to spark
State and local interest in halting deceptive and unfair competition. With
limited success thus far, it has encouraged States to adopt the model "little
FTC Act" which provides weapons by which State governments can put an end to
unfair market practices which often plague the elderly.
The FTC tries to enlist aid of State and local officials in the
enforcement of acts for which FTC is responsible, such as the Fair Packaging
and Labeling Act and the Truth in Lending Act.
Action to Stop Unfair, Deceptive Practices
While not a blueprint of the agency's total program, the Commission
emphasizes the halt of irregular marketplace practices with particular impact
on the elderly and others unable to afford to be victimized. The case-by-
case approach is used in ordering individual firms to stop deceptive and
unfair practices. However, the Commission cannot rely exclusively or even
primarily on this approach. Nor can it rely entirely upon guidance to the
industry in the form of written guides, advisory opinions or trade regula-
tions and rules. Guidance and force both are used. Complementary education
efforts are proposed as described above.
The Commission is specifically assigned responsibility for enforc-
ing the Wool, Fur, and Textile Acts.
-16-
Older shoppers who must guard their clothing dollars carefully
should be pleased at the increased activity in the recent past in the FTC
enforcement of laws that require truthful labeling and advertising of woolen
and textile fiber products. Recently the FTC has proposed rules which would
require manufacturers to put permanent labels in garments to show how to
care for them.
The Commission has used its power to try to stop selling practices
which misrepresent income producing business offers to the elderly. For
example, sharp practices in the selling of franchises and other do-it-yourself
business.
False and misleading advertising is continuing to receive special
scrutiny, through the monitoring of printed and broadcast media.
Other questionable practices in which the Commission has taken
action include automobile warranties, magazine sales practices, unsolicited
credit cards, pricing of automobile tires, pricing practices of the automobile
industry, appliance warranties, labeling and advertising of insecticides and
pesticides, and retail food store advertising and marketing practices.
(f) Department of Health, Education and Welfare.
(1) Food and Drug Administration
Virtually all of the FDA's many programs to enforce the Federal
Food, Drug, and Cosmetic Act and related laws benefit the elderly as much,
or more, than any other age group. It is protecting the health and pocket-
books of all consumers to the extent of more than $100 billion of the Nation's
commerce in consumer products. Health protection naturally comes first,
leaving a fraction of its resources for matters that involve only economics.
But many health problems also have an economic aspect, so there is a substan-
tial benefit to the consumer's pocketbook in that way.
The following are some of its more important programs:
(i) Corrective actions of special concern to the elderly
consumer.
These include actions to insure potency, purity, safety, and effec-
tiveness of drugs. The FDA's authority and resources to deal with
defective drugs have been strengthened substantially. Manufacturers
recalled defective drugs from the market over 700 times during 1969
alone.
In 1970 highest priority was given to the matter of drugs
effectiveness and the removal of ineffectual drugs from the
United States market.
A monumental study was conducted by the National Academy of
Sciences - National Research Council, under contract with the FDA,
in which 2,824 separate reports involving 10,000 therapeutic claims
for more than 4,300 formulations manufactured by 335 companies were
evaluated. Orders to make labeling changes or to halt marketing
affected 7 percent.
-17-
An intensified drug inspection program is also under way in
which FDA inspection teams remain in a plant until all questionable
manufacturing practices have been corrected. Many elderly consum-
ers, misled by lay press articles and mail order advertising about
so-called "youth drug" from Europe, called KH-3, have been attempt-
ing to import it. Hundreds of shipments have been detained at
ports of entry because neither safety nor effectiveness have been
established as required by U.S. law. FDA has detailed its charges
against the drug in a seizure case filed in the Federal District
Court at Los Angeles.
False and misleading claims for vitamin and mineral food sup-
plements continue to be aimed particularly at the elderly consumer.
A court action now underway involves mail order promotion of
"Golden 50" tablets for preventing tiredness, lack of pep, worry
and weakness, and increasing sexual interest, potency and activity.
Illustrations and sales copy claim nutritional value of one capsule
equal to that of larger quantities of expensive foods. Ads in
religious and other periodicals, and mailing lists of elderly
people are used to sell the product. Regulation of therapeutic
devices has been largely confined to court proceedings against
defective or misbranded products.
(ii) Study of health practices and opinions
This project, suggested by the Committee on Aging, to study sus-
ceptibility of consumers to health fallacies and misrepresentations,
involved the interview of more than 2,800 randomly selected con-
sumers. Twenty-two and eight-tenths percent of the sample were
over 65. The final report is due for early publication and is ex-
pected to shed new light on the health practices and opinions of
the American public in general, and of the elderly consumers in
particular.
(iii) Implementation of the Fair Packaging and Labeling Act
It is estimated that about 85 percent of the food packages on
grocery shelves are now in compliance with this law.
Regulations spelling out new labeling requirements for non-
prescription drugs, devices, and cosmetics became effective
December 31, 1969. Labeling of prescription drugs is not involved
under the Fair Packaging and Labeling Act, being covered in much
greater detail by the Federal Food, Drug, and Cosmetic Act.
Plans are being drafted for a program to obtain State assis-
tance in developing regulations against nonfunctional slack-filling
of packages.
(iv) L-Dopa cleared for Parkinson's Disease
Probably the most important single FDA action affecting the elderly
in 1970 was its approval of the new drug L-Dopa for the treatment
of Parkinson's disease. There are about 1.5 million sufferers from
-18-
Parkinson's disease in the United States, most of them in the
over-60 age group. In view of the known hazards in its use, which
were deemed outweighed by the benefits, FDA issued a newsletter to
all physicians explaining the precautions to be taken in its use,
and also required the manufacturer to continue intensive research
on long-term effects.
(2) National Institute of Child Health and Human Development
(NICHD)
Aging Program
Aging may represent many biological and psychological processes;
it may stem from changes in individual cells or it may be a by-product or
accompaniment of disease. So many possible causes must be investigated that
progress in aging research is particularly vulnerable to manpower and fund
shortages. Yet, everyone who lives to adulthood experiences some degree of
aging. Research to unravel the complexities of the aging process and to
attempt modification of aging's effects on the human mind and body is there-
fore of potential benefit to all people.
The NICHD is in the important business of providing support for
research in the biological, medical, and behavioral aspects of aging, and for
training scientists to carry forward this multifaceted and most imperative
research.
The Adult Development and Aging Branch
This branch supports research at universities, medical schools, and
laboratories throughout the United States in four general areas. They are
aging and disease; cellular aging; intellectual changes with age; and life in
the later years. It also supports training for research in aging.
Aging and Disease
Experiments in aging must distinguish between aging processes and
disease processes, although the two are often interrelated. Many cell and
body functions decline with age, contributing to the development of disease.
It takes a long time to study progressive changes with age in humans and the
effects of varying life style and environmental factors on those changes. In
addition, certain procedures are not suitable for human experimentation be-
cause they may have harmful effects. For these reasons, experimental animals
with short-life spans are used in many aging studies. As in human studies,
the disease processes that affect the experimental animals must be taken into
account in studying their aging processes. Long-term studies in humans also
continue to receive NICHD support.
Cellular Aging
Diseases during one's lifetime eventually causes an accumulation of
damage to the body which represents one aspect of the aging process. However,
the unfortunate physical changes that occur with increasing age are not all
due to disease. Apparently, certain changes occur because of the way the
body is constructed, i.e., they are intrinsic aging processes. They occur in all
persons and contribute to serious impairment in the functioning of the body
with age.
-19-
Some of these changes are in molecular structure, some in the cells,
and some in the organ systems. However, molecular and cellular changes are
probably responsible for organ changes and are therefore the target of more
research.
NICHD is building a program of research on aging of specific cell
types that can be studied by transplantation and tissue culture.
Another area of NICHD supported research deals with the cells of
the body that never divide. Most of their components are periodically de-
stroyed and recreated, just as in a dividing cell. However, deoxyribonucleic
acid (DNA) -- which is responsible for control of many cell activities -- is
formed anew only during cell division. The DNA in nondividing cells, there-
fore -- such as in brain and muscle cells -- is 80 years old in an 80-year-
old man. It would not be surprising if changes had occurred in this complex
molecular structure exposed for decades to its microenvironment of thermal
and chemical energy. Such changes might well have led to loss of cell
efficiency.
Studies are also being conducted on an abnormal material that
accumulates in aging cells, particularly those of the brain and heart. This
brown material, often called age pigment, may occupy as much as 25 percent
of a cell's volume. It seems likely that it may cause some of the loss of
function that occurs with increasing age.
Intellectual Changes with Age
Modern man is at least as dependent on his mental processes as on
his physical well-being, and he experiences profound changes in mental func-
tion with increasing age. Understanding and perhaps learning to modify these
changes would be a significant contribution of research. Many investigators
are examining the problems a person faces in performing complex tasks, many
of them posed by technological advances requiring rapid detection, storage,
retrieval, and processing of information by the brain. The modern air pilot
faces this type of problem in the safe guidance of his aircraft from takeoff
to landing. The age of the pilot is one of the factors that affects his
performance, positively in some ways, negatively in others. This type of
research needs to be expanded to cover a larger range of psychological
functions. Research is needed on thinking, learning, remembering, and
creativity, with regard to the processes themselves and to the effect of
aging on each of them.
Extensive additional research is being supported in the biological
and psychological aspects of aging.
Statistics on the NICHD Aging Program
The expenditures for research and training in aging by NICHD in
Fiscal Years 1969 and 1970 were;
-20-
Adult Development and Aging Branch (ADAB)
1969
1970
Research Grants
$3,485,047
$3,225,564
Training Grants
1,976,642
2,054,033
Fellowships
133,527
68,402
Research Career Dev. Awards
174,819
182,570
Contracts
167,955
45,064
Subtotal ADAB
$5,937,990
$5,575,635
Gerontology Research Center
1,700,000
2,132,000
Adult Development & Aging
Info.
86,000
92,000
Total
$7,723,990
$7,799,635
(3) Health Services and Mental Health Administration
The Health Services and Mental Health Administration under the
direction of the administrator, is responsible for providing leadership and
direction to programs and activities designed to improve general health ser-
vices and mental health programs for the total population and for achieving
the development of health care and maintenance systems that are adequately
financed comprehensive interrelated and responsive to the needs of indi-
viduals and families in all socioeconomical and ethnic groups. The elderly,
of course, along with all of the rest of the population benefit from such
programs. However, special attention to the needs of the elderly is re-
quired for certain facets of physical and mental health services and pro-
grams. The multiplicity of illness which often occurs in the same individual
making treatment more complex, the lack of mobility which serves as a barrier
to obtaining available health services, and the onset of senility, are but a
few problems which require special consideration in organizing health pro-
grams for delivering services to and preparing health personnel to deal with
the aged.
To provide a focal point for the many diverse efforts in health
services for the aged, the position of coordinator of health of the aging
has been established within one of HSMHA major components, mainly the
Community Health Service. This component is the organizational unit spe-
cifically involved in health aspects of Medicare and with particular concern
with the delivery of health services to the aged.
The Community Health Service component of HSMHA has a number of
other specific functions. It is responsible for the comprehensive health
planning program enacted by Congress and carried out by the Federal Government
in partnership with State and local governments and the private sector. It
is also responsible for the establishment of National Standards for providers
of services under the Medicare program. For the first time, this effort
moves towards the establishment of a National Standard for the delivery of all
types of health care services. The Health Standards Division has instituted
several ongoing programs to promote and maintain the quality of care provided
to elderly persons. Of particular significance is the effort of upgrading
-21-
State licensure and certification requirements, tightening national accredi-
tation programs, and establishing both standards for and surveillance of the
delivery of health care.
The Division of Health Care Services promotes the development and
utilization of improved methods of health services organization delivery and
financing at the community level. The Division of Health Resources encourages,
assists and supports appropriate agencies and organizations in' developing
needed health care resources and increasing their capacity to provide for the
delivery of quality effective services. A major effort of this division in
1970 was its concentration on the health facilities survey improvement program
to improve and standardize the performance of State and Federal personnel en-
gaged in surveying and certifying health facilities for licensure and parti-
cipation in Medicare and Medicard programs. The nursing home branch continued
during 1970 to direct its efforts toward improvement of health and social ser-
vices of long-term care patients in nursing homes.
The National Institute of Mental Health, assigned to HSMHA for
administrative purposes, has a section on mental health of the aging in the
Division of Special Mental Health Programs. This section is concerned with
programs of applied research concerning the mental health of aging persons.
The NIMH has found that while persons over age 65 are an exceedingly high
risk group insofar as mental health problems are concerned, they are as a
group the lowest in utilization of mental health services. Accordingly,
programs and research projects are directed at improving this situation. For
example, new applied research studies funded for the first time in 1970 in-
clude one which is assessing the effects of services and programs offered by
an older adult program in a community center to aged individuals who have
undergone various types and degrees of role changes. Another project provides
an intensive case finding and service program which will yield information
about the life style, attitudes, and social functioning of low income urban
aged.
The hospital improvement program operated by NIMH since 1963 de-
voted 20 projects in 1970 to improvement of facilities concerned with aged
persons. NIMH is also stimulating projects to train new types of profes-
sional workers to help care for those aged who are already mentally impaired
or to prevent mental illness in arising. The major portion of NIMH funds
concerned with aging is being used for teaching grants and trainee stipends
at social work schools. In 1970, 17 universities had training grants
in the field of aging. Training was also stimulated in psychiatric social
work, psychiatry, psychiatric nursing, and in general, directed at upgrading
the efficiency of mental health personnel.
HSHMA is also responsible for the regional medical programs services
which are conducted through grants and contracts in an effort to assist the
nation's health institutions and health professions to improve the organization
of health resources and accessibility of care and to enhance man power capability
at community levels within the framework of voluntary cooperative relationships.
The purpose is to improve the quality of care to individuals, but especially
those threatened by or suffering from heart disease, cancer, stroke, and kidney
-22-
disease. During fiscal 1970, funds were available to the 54 programs for support
of about 600 components activities with a specific categorical disease. Two multi-
phasic screening programs were funded in East Palo Alto and in the San Joaquin
Valley. Rehabilitation activities associated with majority of stroke patients, was
the subject of training and research. Home health aid projects were also stimulated
and as of July 1st, the Hill-Burton program administered by the Health Facility
Planning and Construction Service, had provided assistance for the construction of
93,749 longterm care beds in chronic disease hospitals, nursing homes, and units
of general hospitals. Also in 1970, 63.6 million dollars was appropriated for the
construction of long term care facilities which should stimulate the construction
of approximately 8,900 longerm care beds.
(4)
Social Security Administration
Social Security Administration
The Social Security Administration administers the Federal social security pro-
gram, which is the Nation's basic method of assuring income to the worker and
his family when he retires, becomes disabled, or dies, and of assuring hospital
and medical benefits to persons 65 or over. When earnings stop or are reduced
because the worker retires, dies or becomes disabled, monthly cash benefits are
paid to replace part of the earnings the family has lost.
Developments in Social Security
About 92 million people contributed to social security in calendar year 1969,
and 95 million in 1970. Today, 95 out of 100 mothers and children are protected
against the risk of loss of income because of the death of the family breadwinner.
The survivorship protectionalone, as of January 1, 1969, had a face value of about
$960 billion, and as of January 1, 1970 $1,130 billion.
About 24.9 million men, women, and children were receiving monthly social security
benefits as fiscal year 1969 ended, and 25.8 million in 1970. The beneficiaries
include about 16.8 million retired workers and dependents of retired workers,
2.6 million disabled workers and their dependents, and 6.3 million survivors of
deceased workers. About 0.6 million noninsured persons 72 and over were receiving
special payments that are provided to certain aged persons getting no public
assistance payments and little or no other governmental pensions. Virtually the
entire cost of these special payments is borne by general revenues of the U. S.
Treasury.
Ninety percent of those who were 65 or over at the beginning of 1970 were receiving
benefits or would be eligible to receive benefits when they or their spouses retire.
Of those who reached 65 in 1970, 93 percent were eligible for social security cash
benefits. Projections to the year 2000 indicate that 96 to 98 percent of all aged
persons will then be eligible for cash benefits under the program.
Beneficiaries and Benefit Amounts
During the fiscal year ended June 30, 1970, benefits paid under the old age, survivors,
and disability insurance program totaled $29,045 million -- an increase of $3,351
million over the amount paid in the preceding fiscal year, and $6,220 million over
1968. Total benefit payments to disabled workers and their dependents in 1970 were
$2,778 million, 14 percent higher than in fiscal year 1969. Old-age and survivors
insurance monthly benefits rose 11 percent to $26,267 million. Lump-sum death pay-
ments amounted to $288 million, about $2 million higher than in the previous fiscal
year.
-23-
The number of monthly benefits in current-payment> status increased by 0.8 million
to 25.8 million during the year, and the monthly rate rose $453 million (21 percent)
to 2.6 billion.
In December, 1969, the average old-age benefit being paid to a retired worker who
had no dependents also receiving benefits was $117 a month. When the worker and
his wife were both receiving benefits, the average family benefit was $169. For
families composed of a disabled worker and a wife under 65 with one or more entitled
children in her care, the average was $238; and for families consisting of a widowed
mother and two children; the average benefit was $256. The average monthly benefit
for an aged widow and widower was $88. (amendments effective January, 1970, raised
benefits 15 percent)
During the fiscal year 1969, a period of disability was established for about 347,000
workers, 35,000 more than the previous high set in fiscal year 1968. During 1970
the period of disability was established for 335,000, 12,000 leass than 1969. The
number of persons determined to have been disabled since childhood totaled 26,000
in 1969 and 25,000 in 1970.
The number of disabled workers receiving monthly benefits rose nine percent in fiscal
year 1970 and totaled 1,435,900 at the end of June. Benefits were being paid to about
1,131,000 wives, husbands, and children of these beneficiaries. By the end of June,
1970, child's benefits were being paid at a monthly rate of $19.2 million to 263,000
disabled persons 18 and over -- dependent sons or daughters of deceased, disabled, or
retired insured workers -- whose disabilities began before they reached 18. About
29,000 women were receiving wife's or mother's benefits solely because they were the
mothers of persons receiving childhood disability benefits. The number of disabled
widows and widowers receiving monthly benefits was about 32,000 at the end of June
1969 and 45,000 at the end of June, 1970.
Medicare paid out $6.3 billion in 1969 and $6.8 billion in 1970 for the health-care
expenses of men and women age 65 and over covered by the program. About $4.7 billion
was paid in 1969 and $4.8 billion in 1970 for hospital care, extended care facility
care, and other services covered by the hospital insurance program. In addition,
$1.6 billion was reimbursed for physicians services and various related health and
medical items covered by the supplementary medical insurance program in 1969 and
$2 billion in 1970.
The medicare program depends for its success upon the understanding and cooperation
of large numbers of people and a variety of institutions. Twenty million older
people, just bout all those over age 65, are covered automatically under the hospital
care portion of the program. Of these people, 96 percent have also signed up for
the voluntary part of medicare and pay a monthly premium to get additional coverage
for physicians' bills. Over 17 million hospital stays have been paid for during the
fiscal years 1968 - 1970. Over 76 million medical bills have been paid under the
supplementary plan.
There are about 6,800 hospitals involved, 200,000 physicians and 4,650 extended
care facilities in addition to 2,350 home health agencies, 2,680 private laboratories
and many other health service providers. Some 130 Blue Cross and Blue Shield and
private insurance contractors help in the administration of the program and 52 State
agencies are involved in the certification of eligibility of providers in terms of
quality standards.
-24-
(5)
Social and Rehabilitation Service
Activities Affecting the Aging
The Social and Rehabilitation Service has responsibilities to the Nation's older
population which extend far beyond its obvious responsibilities to them through
the Administration on Aging. The Assistance Payments Administration administers
the old age assistance program, to provide badly needed cash benefit supplementation
for inadequate -- or nonexistent -- incomes in old age. The Medical Services
Administration administers the medicaid program which meets medical needs of the
older poor and near-poor beyond any protection they may have through medicare and
other programs. The Office of Research, Demonstrations, and Training conducts
research and demonstration projects which extend the frontiers of knowledge
concerning welfare and rehabilitation for the aged and others. The Rehabilitation
Services Administration provides rehabilitation services for the aged who are
handicapped, including those whose handicaps are due solely to advanced age. The
newly created Community Services Administration brings together under unified
direction the provision of social services to individuals and families, including
the aged, who are or who may become clients served by public assistance.
Old Age Assistance
In June 1970 SRS's Assistance Payment Administration served 2,052,000 persons aged
65 or over through the old age assistance program. While this is a slight increase
in number from the preceding year it represents a marked decrease from the all-time
high of 2,810,000 aged persons in September 1950. This overall decline has come
about despite a steady increase in the number of aged people in our population.
The decline is due primarily to the rapid increase in the number of persons receiving
old age survivors disability insurance and the increase of these insurance benefits.
All 50 States, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands
have old age assistance programs. The national average assistance grant in June
1969 was $74.75. This represents an increase of approximately $2.50 over the pre-
ceding year.
As a means of encouraging dependent elderly people to attain either partial or full
self-support 35 States now provide for a disregard of some portion of earned income
in determining the amount of assistance payments. Additionally, 23 States allow for
some disregard of income which is incurred from sources other than earnings.
According to the latest study available the medican age of old age assistance re-
cipients is approximately 77 years and trends indicate that this median age will
increase in the future. The proportion of assistance recipients living alone in
their own homes is approximately 35 percent.
Medical Assistance
All states except Arizona and Alaska had Medicaid (Medi-Cal in California) programs
operational as of January 1, 1970. In fiscal year 1970, total expenditures for
medical assistance under all federally aided public assistance programs were $5.1
billion, of which $2.6 billion came from the Federal Government.
Medicaid permits the Federal Government to contribute to the cost of the care of
aged individuals in institutions for mental diseases when the State inclused this
service, and 34 States did so in fiscal year 1969. Over 69,000 mental patients were
enrolled in the program. The States involved received about $150 million of Federal
funds to help them improve the care of the patients and to develop comprehensive
mental health programs.
-25-
Research and Demonstrations
The demonstration projects program in public assistance under section 1115 of the
Social Security Act provided grants for at least 21 different projects during the
calendar year 1969 and 24 in 1970, all of which were totally or partially concerned
with providing a variety of services to elderly recipients in public welfare. These
projects were carried out under the auspices of State public welfare agencies.
Rehabilitation Services
The major goal of the Rehabilitation Services Administration's program for the
aging is to rehabilitate as many odler handicapped individuals as possible into
gainful employment through activities of the State-Federal rehabilitation program
administered by the agency.
Today, large numbers of older people are "existing" at the poverty level, or below,
and when such a predicament is compounded by a disability it is indeed tragic as
it is more difficult for the older handicapped person to obtain employment.
It is estimated that there are over four million disabled people 40 years of age
and older eligible for, and in need of, rehabilitation services.
In an effort to alleviate this situation, State rehabilitation agencies have been
intensifying their efforts to serve the aged handicapped and a steady increase in
the number of these individuals rehabilitated has resulted. For example, in fiscal
year 1959, a total of 80,739 disabled persons were rehabilitated into employment,
24,275 of whom were aged 45 and beyond, while in fiscal year 1970 a total of 266,970
handicapped persons were rehabilitated of which an estimated 71,2000 -- almost three
times the 1959 figure -- were 45 years of age and over.
Community Services
The Community Services Administration, established in November 1969, is the newest
component of the Social and Rehabilitation Service. The new Administration has as
one of its responsibilities providing social services to aged and handicapped in-
dividuals in the public assistance program. A principal objective of the Community
Services Administration is to strengthen and extend social services to the aged in
States and to help them toward an increased participation in family and community life.
At the same time, Regional Community Services Administration counterpart staff have
been appointed so that a unified and comprehensive approach, at the Federal level,
to work with States administering the service programs for aged and handicapped in-
dividuals is underway.
Through its Division of Services to the Aged and Handicapped, the Community Services
Administration is responsible for policy and program development for services to the
aged in the public assistance program and will maintain liaison and joint planning
on the operating levels with those Federal and national agencies and organizations
active in the field of aging.
As of the quarter ending March 31, 1969, 223,000 aged individuals, approximately
17 percent of the total aged in the program, received a variety of services which
helped them with such problems as meeting health needs, home maintenance, finding
employment, securing adequate housing and community participation in the form of
adult education and recreation activities. Of this number, 80,000 needing protection
were helped to find a protective institutional placement, or were helped with problems
of money management or daily living.
The Federal expenditures for the provision of social services to the aged for fiscal
year 1969 was $39.3 million, and in fiscal year 1970 $70,422,000.
-26-
(6)
Office of Education
Adult Basic Education
The adult basic education program authorized under the Adult Education Act of 1966,
as amended, provides instruction in basic skills -- reading, writing, speech,
comprehension, computation -- up to and including the twelfth grade level for per-
sons 16 years of age and older who need and desire such skills. Adults enroll be-
cause they want to prepare for a job or job promotion, they want to be able to
follow their children's progress in school, or they want to be more functioning
citizens. The program is administered by State education agencies according to
State plans submitted to the U. S. Office of Education and approved by the U. S.
Commissioner of Education. Facilities and resources of local public school sys-
tems are utilized where available.
During fiscal year 1969 and 1970, the reports of age distribution in appropriate
adult basic education activities indicated the approximate extent to which persons
over 45 years of age participated in the program:
1
State grant program
Number of enrollees
1969
1970
45 to 54
83,700
77,148
55 to 64
41,850
39,448
65 and over
20,925
15,100
1
Teacher training program
Number of participants
Age:
40 to 49
1,119
1,239
50 to 59
589
649
60 and over 1
241
261
Public Library Services
The Division of Library Programs during the past year has maintained liaison with
the Administration on Aging. Staff have been particularly concerned with the public
library's role as part of the total community ffort in the field of aging. With
increased free time, older adults are now making greater use of their public libraries
-- for informa tion, inspiration, and leisure-time reading. Many kinds of library-
sponsored adult education programs are in evidence. These include film series,
lectures, forums, television programs, and discussion groups.
Service Developments
The possibility of some Federal assistance for institutional services and general
services for handicapped people through public (and other) libraries supported by
titles IV-A and IV-B has strengthened existent programs and permitted long-needed
innovations in this area.
For example, one State agency, the Washington State Library whose institutional
services are directed to 12,000 institutionalized residents, is now participating
in the State's plan to move from solely institutional residential sites to halfway
houses and local residential sites whose objective is to place these State dependents
closer to a community setting. The Washington State Library is, with assisting
Federal funds, responding to this shift in custodial and care philosophy by establish-
ing nearby library services and by encouraging and promoting public library services
to sustain the homebound and handicapped. In this shift, library services are becoming
more available and more specifically aimed at the aged both throughthe program ac-
tivities of the State government and through the leadership offered to public libraries
striving to strengthen their services for senior citizens.
-27-
Community Services and Continuing Education
Community service and continuing education programs, authorized by Title I of the
Higher Education Act of 1965, have established a number of programs designed to
assist the older American. In 1970, a total of 7,360 persons participated in
20 programs developed for the older American in 12 States.
Recognizing that early retirement and advances in medical science have afforded
the senior citizen many years for useful activities, the Title I program is
attempting to find solutions to the problems which confront the older adult and
to increase the possibilities for effective utilization of this potential reservoir
of knowledge, manpower, and experience.
Manpower Development and Training Program
(Public Law 87-415, as amended)
Althought the Manpower Development and Training Act (MDTA) since its inception has
afforded opportunities for training to persons 45 years of age and older, the 1966
amendments recognized the special training and employment needs of this age group
and gave impetus to programs meeting these special needs.
In fiscal year 1970, the participation of older workers in the program continued
at about the same level as the previous year, with persons 45 years of age and older
representing about 10 percent of the enrollments both in institutional and on-the-
job training. Cumulatively (fiscal years 1963-1970), however, the participation is
slightly higher, at 11 percent of the total enrollment. Following is the participa-
tion for both institutional training and on-the-job training for fiscal years 1969
and 1970.
Total MDTA
Institutional
OJT
1969
Total enrolled
220,000
135,000
85,000
45 and older
22,000
13,500 (10%)
8,500 (10%)
1970
Total enrolled
226,000
135,000
91,000
45 years or older
22,000
13,100 (9%)
9,100 (10%)
A number of training programs have been developed which meet the special training
needs of the older group.
MDTA has also provided training in new and emerging occupations particularly suited
to the older worker.
The AMIDS (Area Manpower Institutes for the Development of Staff) are providing
training, staff development and technical assistance to all manpower personnel
working with the disadvantaged (and by definition, this includes persons 45 years
of age and older). AMIDS were developed by the Office of Education in response
to the need for counselors and instructional personnel in MDTA programs who possessed
a unique understanding of the special learning and human needs of persons enrolled
in MDTA programs. The AMIDS programs have been extended to all manpower personnel
working with the disadvantaged whether in the MDTA program, State agencies such
as the employment service and private industry.
-28-
(g)
Department of Housing and Urban Development
The Department of Housing and Urban Development now administers 21 different pro-
grams which provide some form of assistance (directly or indirectly) to our elderly
population. Housing programs directed specifically and exclusively to the elderly
population (such as low-rent public housing projects designed for the elderly and
nonprofit and limited-profit sponsored housing under section 202) have been in operat-
tion for more than a decade. These latter programs account for the sharp rise in
federally subsidized independent living accommodations designed for the elderly, from
1,100 units in 1960 to 180,000 in 1970.
"Designed for the elderly" tells only part of the story, for the elderly have occupied
low-rent public housing from its inception, and their participation in the program,
before the provision of housing specifically designed for the elderly, had reached
77,000 general purpose units in 1960, and 156,000 by 1970. Thus, by mid-1970, federally
assisted programs have produced over 336,000 subsidized independent living accommodations
occupied by the elderly.
The steady rise observed in the number of general purpose low-rent public housing
units occupied by elderly households probably will continue as a result of normal
operations in both tenant intake and the aging process At the same time, the
present pipeline of units under construction, awaiting construction, and in appli-
cations awaiting approval indicate a continued high rate of participation by the
elderly, in spite of the phasing out of the section 202 program, which is a direct
loan program being converted to an interest subsidy program under section 236.
The older population also benefited from significant progress in 1970 in HUD programs
not specifically identified as for the elderly. Recognition of their particular
needs due to static and limited incomes was most starkly revealed in the model cities
program. The aged population in these depressed neighborhoods ranged from 10 percent
of the areas' population to 50 percent in some cities Special programs for the
senior citizens clearly were indicated and HUD instituted a series of actions to meet
these needs.
HUD small town, new communities, and breakthrough also focused attention on the
particular requirements of the elderly as a normal part of the general population
in these emerging programs. About 60 percent of home rehabilitation grants in urban
renewal and code enforcement areas continued in 1970 to be made to couples or individual
homeowners aged 62 and over.
Interagency and cross-disciplinary teams have worked together in 1970 to assure
services that would result not only in improved shelter but, so far as possible,
a total living environment and the services needed by the elderly to sustain their
independence and freedom from institutionalization. Programs on nutrition, education,
health maintenance, transportation, and home aids have marked the year's effort to
bring services within housing complexes or within easy access of the residents.
Services emanating from housing centers have stressed the neef for a neighborhood
approach rather than community space and services restricted to the fortunate few
in housing developments - thus housing becomes a community resource for the older
population.
HUD health-related programs also increased in number in the past year. The FHA
section 232 nursing home beds under insurance increased from 52439 at December 31,
1968, to 70,739 at August 31, 1970, with another 12,738 beds committed but not yet
insured. A large percentage of the occupants were elderly.
-29-
The first year of the intermediate care facilities program saw the completion
of HUD-HEW criteria for construction and operation.
HUD participated in an increasing number of conferences, seminars, and uni-
versity gerontological center activities.
Research and Technology and the Elderly
Research on the transportation needs of the elderly population was included
in studies undertaken in 1970. These studies were jointly funded in cooperation
with the Department of Health, Education, and Welfare and with the Department of
Transportation and focused on the mobility patterns of the older population. A
two-day workshop on early findings was held in May 1970. Another study, funded
by HEW and HUD, covered the selection of tenants for housing for the elderly and
handicapped and the services required to permit this group to live independently.
In addition, formulation of a study on the effectiveness of current housing pro-
grams for the elderly should be ready for activation early in 1971.
Operation Breakthrough
The special needs of the aging are also served in HUD's breakthrough program.
In 1970 all nine of the breakthrough sites broke ground. Housing units specifi-
cally designed for the elderly will be available on the sites. Of the approximate
total of 2800 housing units, about 1700 are assisted, about 200 are public housing
for the elderly, and about 1500 are supported by the 236 and 235 FHA programs, a
limited number of which will be available to the elderly.
Metropolitan Planning and Development -- Resources for the Elderly
The Office of Metropolitan planning and Development, HUD, embraces a series
of programs designed to improve the quality of life for persons of all ages.
Several of these programs have particular significance for the older population,
the majority of whom reside in metropolitan areas or small towns. Thus, programs
for neighborhood facilities, open space land (including small city parks), small
town assistance, and new community assistance reflect concern for the elderly
population and their special need for environmental improvements. The following
are highlights of some of these programs:
Neighborhood facilities program
The neighborhood facilities program provides two-thirds grants (three quarters
in Economic Development Administration (EDA)-designated redevelopment areas) to local
public bodies to assist in the construction of multiservice neighborhood centers
for low-income neighborhoods. Funds cover the acquisition of land, demoliton, new
construction, rehabilitation of existing structures, landscaping, architectural/
engineering fees, parking lots and other minor outdoor development. Funds for the
operation of services and activities that will take place in the facility must be
obtained from sources other than HUD. Grants are made only to public bodies;
however, nonprofit organizations having the legal, financial and technical capacity
may subcontract with the public body to own and/or operate the facility.
As of June 30, 1970, 440 neighborhood facilities projects had been approved by
HUD. Of these, 49 percent offer some type of service or activity designed specifi-
cally for senior citizens. (In projects approved during the first half of fiscal
year 1971, 54 percent included senior citizens activities.)
-30-
Open space and small city parks
The open space program encourages local communities to be aware of the unde-
veloped needs of any park service area. With grants from this program, various
communities have developed specialized parks, for example, tot lots, active rec-
reation areas, and parks for older citizens. Parks developed in areas where senior
citizens reside should be developed to meet their needs.
Small towns
The department recognizes the advantages of the "small town way of life" and
is continually seeking to improve its services and programs to smaller communities.
A basic objective is to preserve and improve both the small and large community--
so that citizens will have meaningful opportunities to choose either option. The
potential of the small town and new community development is an alternative to
metropolitan congestion and suburban sprawl, and the problem of accommodating a
population which will double in the next 50 years is receving new emphasis and
attention.
This effort has significant impact on the population over age 65 since two-
thirds of them live in nonmetropolitan areas or small communities outside central
cities.
Health programs serving the elderly
A number of HUD administered programs have a direct bearing on serving the
health needs of the elderly.
Section 232 of the National Housing Act authorizes FHA to provide mortgage
insurance for proprietary and private non-profit nursing homes. Joint financing
with Federal Hill-Burton grants is permissible. As of December 1970, there were
11 FHA-insured nursing home projects which had received Hill-Burton grants. These
represent 1,287 beds and $11,612,500 in mortgage amounts. In addition, there are
another 14 FHA insured homes withour Hill-Burton monies representing 1625 beds and
$14,864,800 in mortgage amounts. As of August 1970, FHA has insured 716 nursing
home projects which contain 70,739 beds and $529,089,609 in mortgage amounts.
Intermediate care facilities
Of direct importance to the elderly was the expansion in 1969 of the FHA
section 232 nursing home program to include funding for intermediate care
facilities. Before this, the major resources of the Department in behalf of
the elderly had been for dwellings for the well elderly who are capable of in-
dependent living and self-management, and at the other extreme, for nursing homes.
A number of older people fall between these poles who cannot live independently
and yet do not need skilled nursing home care. Vendor payments under the 1967
Social Security Amendment will make intermediate care facilities usable by re-
cipients of old-age assistance, aid to the blind, and aid to the disabled.
To help finance facilities for this in-between group, section 111 of the 1969
Housing Act authorizes FHA insurance to finance new or rehabilitated intermediate
care facilities, or combined nursing homes and intermediate care facilities. These
can be financed under the same terms and conditions as provided for a nursing home,
and the program is administered by the nursing home branch.
The mortgage is limited to a principal obligation not exceeding $12,500,000
or 90 percent of the estimated value of the property or project including major
movable equipment. The Secretary must require certification by the State agency
designated by the Public Health Service Act as to the need of such facilities
and that there are appropriate standards for their operations.
-31-
During 1970, HUD in consultation with the Department of Health, Education,
and Welfare completed joint directives relating to the health and medical aspects
of intermediate care facilities. Some 24 projects now are in process with seven
completed and in operation and six under construction.
Nonprofit hospitals
The 1968 Housing Act authorized FHA to insure mortgage loans on nonprofit
hospitals for construction or rehabilitation, including equipment to be used in
the operation, under section 242.
The maximum interest rate on these loans is 8 percent, plus one-half of 1
percent mortgage insurance premium and the maximum term is 25 years. The maxi-
mum insurable loan is 9U percent of the estimated replacement cost of the building
and major equipment, with the limit of $25 million for any one loan. Before
insuring any mortgage under section 242, a certification of need must be obtained
from the appropriate State agency certifying that there is a need for the hospital.
A memorandum of agreement has been signed between HEW and HUD under which HEW
processes hospital facility proposals under the mortgage insurance program, through
its regional office, using Hill-Burton procedures and construction and design stand-
ards. A Hill-Burton grant may be combined with an FHA-insured loan.
This program became operational in May 1969. As of November 1970, 11 hospital
loans had been insured, and firm commitments have been given on 13 additional pro-
posals. A number of additional hospital proposals are being processed by HEW and FHA.
Group practice facilities program
The Demonstration Cities and Metropolitan Development Act of 1966 authorizes
HUD, under title XI of the National Housing Act, to insure mortgage loans financing
the construction or rehabilitation of, and the purchase of equipment or facilities
for the group practice of medicine, dentistry, or optometry. The program is ad-
ministered by the FHA which receives technical guidance and assistance covering
medical and health aspects of the program from the Public Health Service of the De-
partment of Health, Education, and Welfare.
Group practice makes possible more efficient use of scarce manpower and costly
health care facilities and equipment. It can be particularly beneficial to small
communities and low-income urban areas where adequate health facilities of a com-
prehensive nature may not otherwise be conveniently available, particularly to
the elderly.
HUD Housing for the Elderly
Demand for housing for the elderly remained high in 1970. The Department of
Housing and Urban Development continued to give housing for the elderly close
attention through a variety of financial tools using both public and private sponsors.
Housing units specifically designed for the elderly approved or committed for
mortgage insurance or annual contributions in public housing during the first 8 months
of calendar year 1970 showed an increase in excess of 15,000 units over the same
months of 1969. The comparison by major programs for this period follows:
PROGRAMS APPROVED OR COMMITTED (First 8 months both calendar years) 1970
1969
Low-rent public housing
33,481
23,666
202 direct loan program
398
3,032
FHA 236 insurance program (interest subsidy)
7,739
0
FHA 231 program
88
0
-32-
The cumulative number of approved units from program inception through
August 31, 1970 is:
Low rent public housing
282,757
202 direct loan program
45,106
FHA 236 program
9,883
FHA 231 and 207 programs
43,657
The department also administers a housing subsidy program under private
auspices (sec 202 (d) (3) "Below market interest rate, a rent supplement program
for low income families (sec 202 and 231 affecting 4200 elderly persons in 1970
and $3.7 million) urban renewal home rehabilitation loans and grants (Sec 312 of
the Housing Act of 1949 and affecting loans for 25,700 dwelling units amounting
to $100 million, and direct grants for 25,300 cases in the amount of $53 million),
and others.
Several items of legislation in 1970 were also of special significance to the
elderly:
1970 Uniform Relocation Act
With the vast increase in public programs in densely populated urban areas,
the dislocation from homes and businesses has caused the affected citizens, in-
cluding the elderly, to bear the burden of meeting these public needs. To alle-
viate this situation, the Uniform Relocation Assistance and Real Property Acqui-
sition Act of 1970 was signed by the President on January 2, 1971. This act
responds to the fact that relocation is a serious and growing problem in the
United States and that the pace of displacement will accelerate in the years
immediately ahead. The committee report states that it "recognizes that advisory
assistance is of special importance in the relocation process especially for the
poor, nonwhite, the elderly, and people engaged in small business."
Several features of this act may well benefit the older population who must
leave their homes and seek new housing arrangements. Fixed payment limitations
for moving expenses have been increased for individuals and families from $200
to $500. Additional relocation payments to rent housing or make a down payment have
been increased from $1,000 to a maximum or $4,000 based on an assistance period
extended from 2 to 4 years; replacement housing payments and the amountis increased
from $5,000 up to a maximum of $15,000. This may include giving up owner-occupied
housing, financial assistance will be available to cover the differential in the
aggregate interest and other debt service.
Since many elderly owner occupants find difficulty in finding replacement
housing they can afford, this liberalization of funds for defraying at least the
financial difficulty is significant. In addition, a relocation advisory service is
established to minimize hardships in adjusting to relocation. This service can be
valuable to the elderly, particularly to the lone woman not experienced in real
estate transactions or in finding housing resources.
1970 Housing Act
The Housing Act of 1970, signed by the President on December 31, 1970, fills
the gap in housing programs for the elderly by recognizing the needs of the frail
but not ill older persons. Rental congregate housing with both public and private
sponsors is expressly endorsed. Such housing should alleviate the necessity for
premature residence in medically oriented institutions.
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The Secretary is authorized to insure mortgages covering rent supplements and
section 236 rental assistance projects designed to be occupied by displaced,
elderly or handicapped persons. Those projects may contain community kitchens,
common dining areas, and other shared facilities. Up to 10 percent of section 236
interest reduction payments and 10 percent of the contracts to make rent supplemtn
payments may be made with respect to such congregate facilities.
Congregate public housing also is included. In the provision of housing pre-
dominantly for displaced, elderly, or handicapped families, the Secretary of HUD
is directed to encourage public housing agencies to develop such housing wherever
practicable, for use in whole or in part as congregate housing. Congregate hous-
ing is defined to mean projects with central dining facilities where some or all
of the units do not have kitchen facilities. Up to 10 percent of the newly
authorized annual comtribution contract authority can be set aside for this con-
gregate program for the low-income elderly, displaced, or handicapped persons.
Through these enactments HUD will be in a better position in the years ahead
to provide residential facilities and services needed by millions of older people
caught between inability to live independently but not needing the costly and
socially less desirable medical facility. It is foreseen that residents of such
congregate facilities will be as self-sustaining as their capacity will permit, will
have "their own front door key" and services, such as nutrition programs, will be
developed to sustain an independent environment as long as health permits. It also
may mean, as the program is developed, that many older people in nursing homes may
now be accommodated in congregate housing projects.
The act also makes clear that tenants may serve on boards of local hosuing
authorities. This reinforces the President's expressed desire to involve older
people in the planning and operation ofprograms established in their behalf.
(h) Internal Revenue Service
The Internal Revenue Service reports that it has prepared and distributed two
publications for elderly taxpayers to assist them in preparing their tax returns.
They also report that there are two areas in which the revenue service has attempted
to improve its service to elderly taxpayers during 1970. They are (1) improvements
in the form 1040; and (2) increases in the amounts and types of taxpayer assistance
training provided.
The consolidated form 1040 introduced in 1969 extends the level of income from
$5,000.00 to $20,000.00 of those persons who can have their income computed by the
Internal Revenue Service by taking the short form. The new rules included pension
and annuity income for the first time so that the elderly can take advantage of
the short form. In computation of the tax, IRS will take into consideration the
annuity and retirement income aspects of the taxpayers income as well as the retire-
ment income credit to which the taxpayer is entitled. The procedure for those who
prefer to compute their own tax has also been simplified.
The IRS has also begun and expanded a nationwide program to provide taxpayer
assistance training for the elderly. Through this program representatives of the
various retirement and elderly organizations receive specialized training from the
IRS in completing tax forms. These trainees can then go back to their organizations
and assist in the preparation of tax forms.
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(i)
Veterans Administration
The Veterans Administration reports there are 1.96 million veterans over 65
today, and that this will increase to 5.10 million by 1985. They further report
by 1985 almost one-half (49%) of the total male population will be veterans.
Accordingly, the VA programs are concerned not only with caring for the current
needs of veterans of all ages, but in anticipating future needs and improved ways
of dealing with and preventing such problems, particularly among the aging. The VA
has reported the following programs:
(1) VA hospitalization
As of November 26, 1968, there were 23,940 patients 65 years and
older remaining in VA hospitals. They represented 26.3 percent
of all patients in VA hospitals on that date. Within that group,
9,655 were 75 or older. During calendar year 1968, 23.8 percent
of all discharges from VA hospitals were represented by the
65-and-older group.
Since many of the conditions affecting older individuals tend to
be chronic, the older veterans represent a high percentage of the
population in long-term facilities, and special programs to meet
their needs have been developed.
(2) Extended care service
(a) Inpatients. -- Within the VA Department of Medicine and
Surgery, the Extended Care Service operates a system of
facilities for long-term care. These serve not only the
aging veteran, but all those requiring such long-term
care. However, well over one-half of all patients cared
for in these facilities are aged 65 and over.
Specifically, the Extended Care Service consists of
intermediate care for patients who are chronically ill
but still require more or less daily medical services
in a ward, nursing home care for those who require con-
tinued or protracted nursing care but do not require
daily medical supervision; domiciliary care for veterans
who are ambulatory and able to perform activities of
daily living despite chronic medical or psychiatric dis-
abilities; restoration programs for those who may be
expected to be able to return to community living after
a period of rehabilitation; and hospital-based home care
for those who are bedridden, but can be cared for at
home with professional support by the hospital staff.
Some of these programs are paralleled by similar facil-
ities operated by the several States and by individual
community enterprises.
Throughout the Extended Care Service, emphasis is placed
on encouraging the patient to make maximum use of his
remaining facilities and on preventing further deteri-
oration. The goal is always to reduce institutional-
ization to a minimum, and to treat the individual patient
at the lowest level of institutional care consistent with
his well-being.
35_
(b) Outpatients. -- In the outpatient treatment program as well,
the older age group -- 65 and over -- continued to represent
a sizable percentage of the total load. In fiscal year 1969,
patients in this age group made over 908,000 visits to staff
and fee basis physicians for outpatient treatment, represent-
ing about 14 percent of the total outpatient treatment load.
(3) Social work service
Social workers do assist each older person in the VA Health Care
System to utilize his remaining abilities to the fullest extent
possible. Every effort is made to encourage movement from a sick
dependent role which implies prolonged institutionalization to a
more healthy independent role in a private family setting located
in the mainstream of community life. For some, continued care
in an institution of some type is necessary and the VA offers
long-term nursing care in VA hospitals and in private nursing
homes in the community. Some ambulatory self-care patients are
transferred to VA domiciliaries where many rehabilitation services
are available to assist in the restoration process. Others,
without families, who are able to live more independently are
assisted in moving into a well-developed foster home program where
they can enjoy the full benefits of private family life. Social
workers offer necessary supporting services to ensure continuous
successful living in the community. Most older patients prefer
to return to their own families and special attention is given to
providing services to reestablish and maintain the integrity of
these family groups.
In addition to offering direct services to patients and their
families, VA social workers organize and direct the activities
of volunteers who are interested in helping patients in readjust-
ing to all facets of community life. Social workers also parti-
cipate with other public and private health and welfare organ-
izations on both a local and national level in identifying needs
of the older person and developing programs to meet these needs.
(4) Voluntary service
Retired and elderly citizens serving as volunteers have become
the backbone of the VA voluntary service program and their ser-
vices are considered indispensable in the care and treatment of
patients in the hospital and those patients returning to their
homes and communities.
The older volunteers have demonstrated they have the time,
patience, and the capacity to win the confidence of patients
through the development of personal relationships. This so-
called friendship or companionship therapy is getting mar-
velous results in motivating and stimulating patients, many
of whom are elderly, to regain the limits of their potential
for restoration and return to community living.
The elderly volunteers in supplementing the efforts of hospital
staff have made it possible to expand and extend many services
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and programs for patients and to improve the quality of the care
and treatment activities.
Through voluntary service retired and elderly volunteers have
found and made new lives of their own. They are the pride and
joy of their families because they have discovered that they
can be just as essential to society in their later years as in
the earlier years of their lives.
(5) Psychology service
The psychological facets of the elderly have assumed increasing
importance. The appropriate care, treatment, and rehabilitation
of the aging veterans is in a large part determined by their
mental outlook and their mental status. To meet the problems
presented by these patients, psychologists in the Veterans'
Administration now work in the nursing home units, intermediate
care services and domiciliaries as well as in the psychiatric
hospitals where there are large numbers of aged veteran bene-
ficiaries. These veterans post the broadest diversity of psycho-
logical problems. For instance, efforts have been ongoing to
assist nursing home supervisors in establishment of psycholog-
ically harmonious environments in the VA nursing home units.
This has included both the mental and physical aspects. The aim
is to assist the elderly patients to maintain their spatial and
temporal orientations, thus keeping confusion, memory loss and
anxiety at minimal levels. Psychology trainees are encouraged
to work in these areas with preference for appointment being
given to psychology students who have major interests in the
problems of the aged and to universities which are engaged in
psychology programs in gerontology.
Special programs based upon principles developed from learning
theory are currently being utilized to assist the aged veteran
patient. Classlike sessions are held to teach and to help retain
such things as the date, where they are (hospital location), the
names of people who care for them, etc. These orientation classes
have significantly reduced the development of confusion and re-
gression in many elderly patients, as well as helping aged vet-
erans to regain lost faculties. On an individual patient basis
"reinforcement therapy" techniques, instituted by psychology, are
being used to assist in the development of appropriate behaviors
which are needed in order to allow the psychiatrically aged
patients to maintain themselves in noninstitutional settings.
Such things as neatness, eating habits, and control of bodily
functions are especially helped by these psychological treatment
techniques. This particular therapeutic approach is readily
adapted to the types of problems encountered with the elderly
psychiatric patients.
New automated equipment for the measurement of psychological
deficits in the aged has been developed by VA psychology.
Studies using this equipment will become one of the main compo-
nents of a Psychological Aging Study Center being developed by
the VA in conjunction with a major university in Florida.
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(6) The research program on aging
To meet its responsibilities to our increasing number of aging
citizens and older patients, the Veterans' Administration sponsors
basic and clinical research programs on a broad front. Aging
studies include investigations in the mechanisms of aging from
the standpoint of current concepts in biology, heredity, bio-
chemistry, disease processes, and the environment with emphasis
on the changes that occur with age. Thus, just as fundamental
research was important to broadening and strengthening our
knowledge of disease processes, fundamental research is of vital
importance for advancing our understanding of aging or of mech-
anisms bearing on the aging process.
Department of Veterans Benefits
(1) Guardianship program
There have been three areas of development in the guardianship
program which affect aging incompetent VA beneficiaries. There
has been a policy change, concerning the type of court-appointed
fiduciary preferred. Previously, corporate guardians were pre-
ferred over individual guardians. This policy has been reversed.
The cases in which it is necessary, in the best interests of the
beneficiary, to obtain a court-appointed fiduciary have increas-
ingly involved veterans and other adults who live alone in room-
ing or boarding homes without relatives to look after them. In
such cases, an individual guardian is usually in a better position
to give more personal attention to the beneficiary and to take
more immediate action in emergency situations than a corporate
guardian would be able to do.
The Federal fiduciary concept has been expanded in an effort to
provide more alternatives to a court-appointed fiduciary. The
appointment of a State court fiduciary, with the attendant costs,
fees, and commissions, decreases the amount of money available
for the care of the beneficiary. Also, the stigma of incom-
petency still exists when an individual has a court-appointed
fiduciary. These factors can be avoided if a suitable fiduciary
relationship can be established with a Federal fiduciary.
The timing and frequency of personal contacts with beneficiaries
has been tailored to each individual case in order to give neces-
sary service within available resources. Experience has shown
that where an incompetent beneficiary is living with relatives,
friends, or in other types of sheltered environment, personal con-
tacts by our field personnel need not be as frequent as in situa-
tions where the beneficiary is living alone without anyone to
look after him. Scheduling contacts in accordance with each sit-
uation assures that our attention is focused where the need is the
greatest.
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(2) Compensation and pension programs
The Veterans' Administration, through the various programs admin-
stered by the Department of Veterans Benefits (compensation, pen-
sion, and dependency and indemnity compensation), provides all or
part of the income for over 1,700,000 persons age 65, or older.
This total is broken down to: 986,972 veterans, 607,402 widows,
148,296 mothers and 56,393 fathers of veterans.
(3) Educational assistance
Public Law 90-631, enacted October 23, 1968, and effective
December 1, 1968, extends eligibility for a maximum of 36 months
entitlement to educational benefits under the provisions and at
the rates of chapter 35 of title 38, United States Code, to widows
of veterans who died of service-connected causes or wives of
veterans who are permanently and totally disabled from service-
connected disabilities. Counseling under this law is optional but
not mandatory. This portion of the law is primarily intended to
assist the wives and widows of the younger veterans of the
Vietnam era. However, the law contains no age limit so that the
benefit would be equally available to wives and widows over age 65
who are otherwise qualified. It is not presently possible to
determine whether many in this older category will choose to take
advantage of the benefit.
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(j) The Office of Economic Opportunity
The efforts of the Office of Economic Opportunity are increasingly concerned
with the elderly because their numbers are increasing, and their poverty status is
also on the rise. The 65 and over population accounted for 15% of the poor people
in 1959, 18% in 1968 and 20% in 1970. One of the reasons for this phenomenon is
the increasing average, life span of persons who reach 65. While once people were
expected to live but a few years past retirement, today a man reaching 65 can ex-
pect to live an additional 14 years, and a woman, an additional 16 years past 65.
The aged poor have all the problems of other poor, plus the multiple handicaps
of age itself. Furthermore, many of the aged poor lived comfortable middle class
lives only to find that their carefully saved retirement funds are inadequate to
sustain themselves. Thus the OEO is concerned with both the elderly who have been
poor all their lives, and the new poor, who only achieved that status upon reaching
old age.
Adequate income is the first line against poverty and OEO is concerned with
new and innovative programs which will provide employment income for the elderly
poor. These include services as foster grandparents, senior aids of Mainstream,
green thumbers, green lighters, child day care centers aides, and a host of others.
Increased income is not the only benefit of such programs, however, and the in-
creased sense of worth that derives from it appears to have a direct link to better
health, and in many cases, a lessening of the use of such tax-supported facilities
as nursing homes.
Income is not the only need of the elderly, and thus the OEO is concerned with
programs concerned with housing for the elderly, health, transportation, nutrition
and socialization. Also underway are pilot OEO funded programs such as SOS (Senior
Opportunities for Service) and FIND, an outreach and referral program that has
proven of significant value informing seniors of the benefits to which they are
entitled.
OEO estimates that it presently serves 1,500,000 to 1,750,000 of the elderly
poor including the 700,000 reached by the SOS programs, and that $69.7 million is
the approximate cost of serving this group of the poverty population.
OEO is represented on all cabinet and sub-cabinet interdepartmental committees
of the Federal Government concerned with the elderly. It has also been involved in
the preliminary activities of the White House Conference on Aging and is represented
on several of the 14 task force secretariats which are treating such topics as
income, health, housing, nutrition, employment-retirement, and transportation.
There is a continuing exchange between OEO, AOA, HEW, Labor and other agencies
on both the policy planning and program operating levels. It has worked very closely
with HUD in the model cities programs and has entered into mutual funding arrangements
with HUD and a number of other agencies carrying out programs of benefit to the aging.
Older Persons Advisory Committee
The Office of Economic Opportunity in 1970 reestablished an Older Persons
Advisory Committee to help assure that all OEO programs, whenever feasible, addressed
themselves to the needs of the elderly poor. The committee was appointed to advise
the agency director of the nature and extent of specific problems faced by the
elderly poor, the impact of OEO and other antipoverty efforts on the plight of
older persons at the local level, and the consolidation, simplification, and the
strengthening of local, State and national programs affecting the elderly. In
addition, it is intended that the committee will encourage the establishment of
local programs involving private groups and State and local governments to assist
the older poor.
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Regional Aging Coordinators
During 1970, a coordinator on aging was appointed in each of the 10 OEO
regional offices to provide assistance to the regional directors, the State eco-
nomic opportunity offices, and the community action agencies in insuring more
involvement of the elderly poor in all programs of OEO, and the better us of
services provided by State and other community agencies.
Manpower Programs
(EOA - Title I)
OEO funds three manpower programs that serve the elderly---the concentrated
employment program (CEP), new careers, and Operation Mainstream. The adminis-
tration and operation of all three have been delegated to the Department of Labor,
Operation Mainstream has by far the most significant impact on the elderly of any
of OEO's manpower programs for that age group.
The most recent guidelines published by the Department of Labor state Opera-
tion Mainsteam's purpose to be the provision of work-training and employment pro-
jects, augmented by necessary supportive services designed to provide pemanent
jobs at decent wages for adults with a history of chronic unemployment. Designed
for rural areas and towns, projects concentrate on work experience and training
activities that will improve communities and those low-income areas where the
projects may take place. Such projects may seek to decrease air and water pollu-
tion, improve parks, protect wildlife, rehabilitate slum housing, or extend edu-
cation, health, and social services.
Priority enrollment is given to those who have been chronically unemployed
(defined as unemployed for more than 15 consecutive weeks, repeatedly unem-
ployed during the past 2 years, or employed less than 20 hours a week for more
than 26 consecutive weeks); have completed some training but remain unemployed;
lack current orospects for training or employment because of age of some other
factor. In fiscal 1970, the obligation for Mainstream was $51 million, compared
with $41 million in fiscal 1969, and enrollment as of June 1970 totalled 12,687
compared with 10,261 in June 1969.
Operation Mainstream includes several projects that concentrate exclusively
on people over 55 who meet the previously stated qualifications. In June 1970,
enrollment opportunities in these older worker projects totaled 4,628 compared
with 4,373 slots in June 1969. Actual enrollment in these older worker projects
totaled 4,315 in June 1970. Outside of the older persons project, an additional
900 enrollment slots were provided for workers 45 and over in the regular Main-
stream program.
The largest of the older worker programs is the Green Thumb program, spon-
sored by the National Farmers Union (under national contract) and now operating
in 15 States. Subsidiary to the Green Thumb is the Green Light program, directed
at serving unemployed older women and operating in 10 States. These two programs
were funded at $5.4 million in fiscal year 1970 compared with $5.2 million in
fiscal year 1969, with enrollment opportunities of 2,435 in fiscal year 1970,
and 2,313 in fiscal year 1969. At the end of June 1970, there were 2046 enrollees
in the Green Light program.
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There were for other older persons programs funded during 1970. A contract
with the National Council of Senior Citizens was expanded from 1,132 authorized
slots in 1969, to 1,148 slots in 1970. Similarly, a contract with the National
Retired Teachers' Association was expanded from 313 slots to 433 slots. Con-
tracts with Virginia State College, 115 slots, and the National Council on Aging,
500 slots, were renewed at the same level. These programs involve enrollees in
a variety of social, health, and educational services to their communities.
Senior Opportunities and Services
(EOA - Title II, Section 222 (a)7)
The Senior Opportunities and Services program authorized by the 1967 amend-
ments to the Economic Opportunity Act, is designed to identify and meet the
special economic, health, employment, welfare, and other needs of persons above
the age of 60 in projects which serve and/or employ older persons as the exclusive
or predominant participant or employee group. The projects deal with specific
problems of the older poor that cannot practically be met by more general pro-
grams designed to serve all or younger age groups.
These projects provide maximum opportunity for older poor persons to develop,
direct, and/or administer such programs while utilizing existing services and
other programs to the maximum extent feasible.
In fiscal year 1970, a total of $6.8 million was allocated from senior opportun-
ities and services funds, of which $400,000 was used for migrant and Indian projects
and a special project conducted by VISTA. The total of SOS rograms increased from
194 to 208 and served more than 700,000 elderly poor.
Employment
A major and lasting benefit of many SOS programs is their extensive training
and use of elderly poor persons to assist others and the extent to which other
local, State, and Federal as well as private agencies are recognizing the useful-
ness of this service and adding elderly poor nonprofessional and paraprofessional
aides to their own staffs. The institutional change already effected in health,
educational, and welfare institutions is significant. Many SOS programs start
with a commitment from other public agencies to give full- or part-time employ-
ment to seniors once they have received training.
Other SOS programs are attacking difficult transportation problems of the aged
poor, providing consumer education (training the elderly poor in areas of food buy-
ing, budgeting, home management), helping form discount clubs and co-ops to enhance
purchasing power; training older persons to recognize fraudulent insurance and
other confidence schemes.
Outreach and referral services
An almost universal service of OEO's aging programs is the use of trained
low-income aides to inform and assist the elderly poor to better utilize the other
programs and services for which they are eligible. An early nationwide OEO pro-
gram---medicare alert--and subsequently project FIND, disclosed that large
numbers of the elderly poor because of ignorance, language barriers, shyness,
or other reasons were failing to register for medicare, food programs, and other
services for which they are eligible. A major service to this poorest and most
helpless segment of the older poor is that of finding and connecting them with
existing services.
.42-
It is well established that older poor persons, trained as aides and
possessing language qualifications, are able to reach this group more effec-
tively than anyone else, including professional social workers.
Fiscal year 1971 findings and plans
In fiscal year 1971, a minimum $7.8 million will be used to continue the fund-
ing of local senior opportunities and services projects and, for the first time,
assume the costs of training and technical assistance services in the older persons
program area.
A continued strong training and technical assistance effort, conducted by the
National Council on the Aging, is considered essential to focus local projects on
their prime goals of resource mobilization and institutional change. With the
assumption of the cost of this contract, the fiscal year 1971 budget will provide
for a small increase in funds for operating field programs.
Serving the Older Poor Through A11-Age Programs
The newly created Office of Special Programs coordinating function has in-
creased the agency's emphasis on meeting the needs of the elderly in and through
such all-age programs as neighborhood health centers, legal services, community
action agencies, programs for Indians and mirgrants, and VISTA. Special pro-
grams maintains liaison with all operational segments of the agency, serving
within OEO as an advocate for the elderly poor.
Health affairs programs
The Office of Health Affairs makes funds available, especially through the
comprehensive health services program and emergency food and medical services
program, to provide assistance to the elderly poor. About $7.4 million is spent
to serve the elderly in 50 comprehensive health services demonstration projects
being developed across the country. Approximately $16.2 million is channeled
through the emergency food and medical services programs to meet the nutrition
needs of the elderly poor in projects aimed specifically at the aged and those
designed for all age groups including the elderly. Special pilot projects have
included meals-on-wheels and hot lunch programs. The Office of Special Pro-
grams is pulling together the experience of EFM, as well as SOS programs to
develop improved and better coordinated programming in the area of nutrition for
the elderly. The problem here is not just to provide nutritious meals for the
older poor, but to build that feature into a comprehensive service and income
program accompanied with adequate research and evaluation to assure effectiveness
and replicability.
Legal services programs
The 265 neighborhood legal services projects handle the legal problems of all
who are within the OEO poverty guidelines. No breakdown by age groups is avail-
able, but clearly a number of the elderly are being served by the local projects
at present and more will be in the future as their needs and problems are focused
upon.
VISTA
Volunteers in Service to America (VISTA) has always sought older persons as
volunteers and the percentage serving at a given time has fluctuated between 6 per
cent and 16 percent. A total of 2,700 older persons, or 12 percent of the overall
VISTA enrollment since the program's inception, are or have been in the age 50 group.
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Research and Demonstration Projects
OEO has planned its research and demonstration projects so that the knowledge
and experience gained from them could be channeled not only to local community
action agencies, but to many other public, private, and volunteer agencies which
increasingly are concerning themselves with the problems of the older poor. Among
such projects specifically designed to aid the aged poor are:
Project Late Start
The National Retired Teachers Association and the American Association of
Retired Persons received in 1970 a second-year grant of $252,000 to continue a
research project to test, in four diverse geographic and ethnic locations, the
thesis that low-income elderly people can have their life pattern altered and
their problems ameliorated by a concentrated group experience which seeks to be
educational and informative.
Rural housing repair
A pilot program to repair the substandard homes of elderly poor persons.
The program trains older poor persons as construction workers to repair homes
owned by elderly, blind, or disabled recipients of public assistance.
The project has a double focus: To solve substandard housing problems and
to reduce unemployment, especially among the elderly poor.
Housing assistance and social service project
A research and demonstration project conducted by the Cambridge (Mass)
Economic Opportunity Committee has mobilized the elderly poor into an effective
action group around a common issue affecting their lives: Critical housing
problems and solutions to their need for related social services required for their
well-being. The project was refunded in 1970 for a second year for $229,651.
Community development rural programs
Nine OEO rural projects seek to overcome the complex problems of bringing
services to and economically developing sparsely populated areas. The programs
are experimenting with self-supporting transportation systems, leadership training,
saturation use of outreach centers, development of small business enterprises, and
a communications system to increase awareness of opportunities and services avail-
able to the rural poor. Although these projects are not aimed exclusively at the
older poor, they reach substantial numbers of such people.
Consumer programs
OEO's consumer research and demonstration programs reach the elderly poor,
although this is not the only target group. An estimated $0.1 million was aimed
at older poor citizens in fiscal year 1970.
Legal research and services for the elderly
Legal Research and Services for the Elderly (LRSE), a national demonstration
project, was initiated in fiscal year 1968. Its latest funding, in the amount of
$414,735, was announced in December 1970. The grantee is the Washington-based
National Council of Senior Citizens
LRSE was funded to research and identify the particular problems facing the
elderly poor; to examine the law and the major legally sanctioned institutions
that affect the elderly; to devise models and methodologies to meet their needs;
to provide new systems for eliminating the negative impact to our social, economic,
and administrative institutions on their lives; and to devise methods for educating
the elderly poor community as to their rights.
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A study of the use of older persons in child care
Urban Systems Research and Engineering, Inc., of Cambridge, Mass, recently
completed a study for OEO on "Meeting the Needs of the Elderly Poor: A Study of
the Use of Older Persons in Child Care." Excerpts from their report condlude:
"We have conducted an in-depth study of the ways in which the Government
can assist the elderly by intervening in a particular market the market for child-
care workers. This market appears for several reasons to be on the verge of a
substantial expansion, and the area of child care is one for which older persons
are in many ways, well suited. In carrying out this analysis, we emphasize that
the objective of the effort is not to use funds Intended for the elderly as a method
of subsidizing child-care services, but rather to achieve a mutual compatibility
of interest in which the quality of child care available for a given cost is
increased by drawing on the resources which older persons can provide and in
which the welfare of older persons is increased through greater involvement in
paid employment of a rewarding nature."
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3. STATE OF CALIFORNIA SERVICES TO THE AGING
The following questionnaire was mailed to 42 Departments and Agencies
of the State:
QUESTIONNAIRE
To: Mr. Spencer Williams
455 Capitol Mall, Suite 700
Sacramento, California 95814
1. We are participating in programs for the aging affecting the following
areas of need:
( ) Housing
( ) Recreation
( ) Health
( ) Transportation
( ) Job opportunities
( ) Education
( ) Nutrition
( ) Other (please attach
description)
( ) None
2. Attached is descriptive material concerning the above program(s).
3. Attached are copies of laws and/or regulations by which such programs are
being implemented.
4a. Our annual financial participation equals:
$ Federal
State
Local
b. The number of persons affected totals
.
5. (Optional) The following are our comments as to the effectiveness of these
efforts and our recommendations as to the future directions that should be
taken in programs designed for the aging (please attach).
Very truly yours,
(Name)
(Office/Department/Board)
Responses were received from 42 of the 42. Of these, 251 indicated
they have no programs directly relating to the aging. The Department of Public
Works, however, pointed out that its program of relocating persons whose homes
are acquired for highways or other public purposes benefited a number of per-
sons in the over-65 category. The Department of Parks and Recreation stated
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that several of their desert parks were particularly attractive to persons
over 65, and that a current survey underway on the use of trailers and campers
indicated a high incidence of use by older Californians. In addition, its
current program of adding ramps to park entrances and making doorways wider
for wheelchairs has proven of particular convenience to senior Californians.
Seventeen departments reported direct services to the aging. These
included 21 separate programs affecting from 14 aged persons in the smallest
program, to over 1,951,180 aged persons in the largest. Total identifiable
expenditures reported are $722,719,000 federal, $743,814,000 state, and
$313,206,000 local. These programs are summarized below.
1. Department of Education
The Education Code of the State of California (Sections 5553 and 5701)
specifically authorize the establishment of adult education programs in high
schools and community colleges. During the 1969-1970 school year, there were
approximately 1,000,000 adults enrolled in the high school and unified school
districts of California. Approximately 100,000 of these adults were 50 years
of age or over. Discretion to establish such classes is vested in the Govern-
ing Board of the School District (5702) although, if established, classes must
conform to normal study and graduation requirements (5705) and standards
prescribed by the State Board of Education (5708).
Public School Adult Education in California (including the adult edu-
cation offered in the community colleges) is financed partly by State appor-
tionment (2 percent of the State educational dollar which equaled $28.9 million
in the 1969-70 Fiscal Year) and local district tax funds. Limited financial
reimbursement is available for certain vocational classes.
A 1967 Review of Educational Opportunities Available to Older Adults
(over 50 years of age) in California's Public Adult Education Programs reported
as follows: 3
For the purpose of obtaining current information on the educational
opportunities available to our older adults through California's public school
adult education program, the Bureau of Adult Education in May, 1967, mailed a
questionnaire on the education of the aging to administrators of adult educa-
tion programs in adult schools and junior colleges. Specifically the question-
naire sought information as to the ways the adult education program is serving
the educational needs of older adults. Ages 50 years and over were chosen as
falling within the area of "aging". Information was sought on the nature of
the organization and the responsibilities of local committees working with the
problems of the aging. Administrators were asked to state the major problems
involved in planning and organizing educational programs for older adults and
to indicate any plans for the future. Approximately 50 percent (156) of the
administrators responded to the questionnaire. A summary of the information
gathered from the questionnaire is presented in the following paragraphs.
The administrators were asked to check on a form provided the areas
of study in the regular program in which there was a fair concentration of
older adults. The following areas and the frequency of their listings are
indicated below:
1. Fine Arts - 74
2. Crafts - 69
3. Homemaking - 68
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4. Business Education - 57
5. Americanization - 47
6. Civic Education and Special Fields - 43
7. Industrial Education - Vocational and Industrial Arts - 40
8. English, Foreign Languages, and Speech Arts - 36
Approximately one-half of the schools reporting indicated that
specific classes were organized for older adults. The titles of some of the
classes primarily organized for older adults are as follows:
1. Arts and Crafts
2. Retirement Planning
3. Leadership Training for Mature Adults
4. Lip Reading
5. Dactylology
6. Gerontology
7. Choral Instruction (Senior Citizens' Chorus)
8. Spanish for Older Adults
9. Driver Improvement for Senior Citizens
10. Clothing Construction
11. Citizenship and Elementary English
12. Physical Exercises for Older People
13. Public Affairs and World Affairs (Current Events)
14. Music Appreciation
15. Practical Gardening
16. Understanding the Older Adult
17. Painting
18. Investment and Securities
19. Consumer Education for Homemakers
20. Applied Psychology
21. New Horizons for Mature Workers
22. Home Health Aides
Information was also sought as to lecture series that were specifically
concerned with the problems of aging. Quite a number of our adult educators
reported lecture series specifically planned for the older adult. Examples of
titles of lecture series reported are as follows:
1. Retirement Planning
2. Psychological Aspects of Aging
3. Health for Senior Citizens
4. World Religions
5. Personal Improvement
6. Health Education for Diabetics
7. Financial Planning and Tax Benefits
8. Estate Planning
9. Medicare and What It Means To You
10. Services to Older Adults
11. Nutrition and Food Preparation
12. Fraud and Medical Quackery
13. California's Diminishing Resources
14. Social Security Benefits
15. Consumer Education for Limited Budgets
16. Preparing a Will
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17. Give Your Heart a Fighting Chance
18. Trends in Modern Literature
19. Living in Later Life
20. Role of the Aged from Primitive Society to Modern Times
Most of the adult educators reported that the older adults are
served through the school's regular counseling program. The adults over fifty
who are interested in elementary certificates and high school diplomas are
given special encouragement and counseling time. Older adults avail themselves
of the testing services and individual counseling. The nature of the counsel-
ing includes the encouragement of adults to develop interests and skills in new
fields through a planned educational program. Group guidance opportunities are
provided through gerontology and psychology classes. Gathering information on
job opportunities in the community for older adults was listed as guidance
activity. One school reported a full-time state employment representative on
campus to provide current employment information. The guidance staff in a
number of instances work closely with senior citizen groups, the older age
specialist in the Department of Employment, the Social Security offices, social
welfare agencies, and boarding and convalescent home operators. The Los Angeles
City Schools report a gerontology specialist for their adult education program.
In rating the tasks of major concern to adult schools and junior
colleges in the field of aging, the administrators listed the following in the
order of their importance:
1. Developing skills and interests appropriate to advancing years
2. Planning for retirement
3. Developing a better understanding of the physiological and
psychological changes incident to aging
4. Developing the attitudes and outlooks appropriate to a changing
family life
5. Developing mental hygiene practices and increased mental health
and emotional security
6. Planning through consumer education for a more economical way
of living
7. Training to overcome physical handicaps such as hard of hearing,
heart disease, and so forth
8. Training of older citizens for more active participation in
public affairs
9. Training people to work with older adults
10. Improving the level of community understanding about the aging
process
11. Vocational and educational guidance for older adults
12. Retraining for full-time or part-time jobs
Approximately 50 percent of the adult educators reporting indicated
that there is a local committee working with the problems of the aging.
Numerous agencies are represented on the local committee. The ones most
frequently mentioned are the Community Welfare Council, social welfare, recrea-
tion department, senior citizen groups, church groups, public library, Red Cross,
Chamber of Commerce, mental health associations, Salvation Army, service clubs,
social security, employment, and city and county health departments. In most
every instance the local adult administrator is either a member or serves as a
consultant or advisor to the group. The administrator works cooperatively with
the groups and leaders of the community in determining the educational needs of
adults.
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There are some excellent examples of the cooperative efforts of
several agencies in organizing the educational programs for older adults. A
course in "Understanding the Older Adults" for use in adult education classes
was prepared under the auspices of the Office of the Los Angeles County Super-
intendent of Schools and the California State Department of Social Welfare.
The impetus for this course of study came through requests from the nonprofit
and proprietary homes for the aged in Southern California, licensed by the
California State Department of Social Welfare. The course is intended to
assist operators, administrators, and staff of homes for the aged in a better
understanding of the older adult through an increased awareness of his psycho-
logical and physical needs and the ways of meeting these needs. The course was
formulated in a trial draft in 1963 and tested in three different teaching
situations in the adult education programs of Long Beach and Los Angeles City
and revised in 1966 in accordance with the outcome of these pilot projects.
Another example of the cooperative efforts of several agencies in the
community is the pre-retirement program offered by the Los Rios Junior College
District and the adult education division of the Sacramento Unified School
District. The Community Welfare Council was responsible for organizing an
adult education committee within the committee on aging, which included rep-
resentation from the adult education divisions of the schools in Sacramento
County. This committee was responsible for organizing a pre-retirement lecture
series, which has been presented twice a year for the last several years. The
topics included in the lecture series are as follows: viewing retirement,
nature of work and leisure, insurance planning, wills and property management,
investments, government retirement plans, social security and medicare, budget-
ing, employment, frauds, physical health and nutrition, mental health, philosophy
of life, and living arrangements. The schools offering these series have re-
ported excellent attendance. The significant part of this effort is the fact
that the schools are continuously evaluating and improving their programs in
close cooperation with other agencies represented on the committee.
In the field of driver education for older adults, meetings have been
held in Long Beach, Menlo Park, Santa Cruz, and Paradise to consider the problems
of the older driver. These meetings were held in senior citizen centers.
Representatives of the State Department of Motor Vehicles, California Commission
on Aging, State Department of Education, as well as local adult school people
participated in the deliberations. One of the specific outcomes of these meet-
ings was the organization of a driver improvement class (behind the wheel and
classroom instruction) at Paradise High School. Among the other outcomes from
these meetings was the realization that such a program to be successful must
avail itself of all possible communication media, including television, as well
as the preparation of written materials for distribution. It was suggested
that classes in driver improvement could be conducted informally in senior
centers under the leadership of older adults and as preparation for this role,
an adult education class in training volunteer leaders could be offered.
A review of the questionnaire indicated that the following problems
are of major concern to adult educators in the planning and organizing of
educational programs for older adults:
1. Transportation to and from school
2. Finding suitable meeting places for classes
3. The need for more day classes and with it the problem of
finding adequate facilities and teachers
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4. Budget limitations of the school district to provide
educational programs for older adults
5. Lack of motivation and interest on the part of older adults
for planned types of educational experiences
6. Identifying the real educational needs of older adults
7. Finding well-qualified teachers with specific training and
appreciation of the problems on aging
8. Securing community cooperation and support for educational
programs.
9. Maintaining satisfactory and consistent attendance
10. Lack of good lay leaders
2. Department of Social Welfare
The State Department of Social Welfare reports that in addition to
social casework services, they are involved in a number of programs affecting
the over-65 population in areas of housing, nutrition, transportation, income
maintenance, payments for public and private institutional care and licensing
of facilities for the aging.
Fiscal participation (for the 1969-70 fiscal year) is as follows:
Federal $207,807,200, State $178,939,900, Local $29,960,500. 313,734
aged persons are involved in these programs.
Details of these programs are set forth below:
Old Age Security (OAS)
This is a public assistance program for needy persons 65 years of age
or older who reside in California. Money payments including other income may
not be less than the statutory minimum standard of $129 (effective December 1,
1969). Payments to aged persons including other income may not exceed $194
(effective December 1, 1969) unless he has a special need for attendant care
services to enable him to remain in his own home.
As of July 1970, there were about 313,700 aged persons receiving money
payments through this program, with the average statewide payment being $105.63.
This group represents about 17 percent of the people 65 or over in California.
Recipients had an average monthly income from all sources of approximately $54
with over 72 percent of them receiving federal social security benefits. About
30 percent of the recipients own their own home; 5 percent own income-producing
property; and about 73 percent have property reserves, mostly in savings, cash,
interment plots, or life insurance. The typical recipient of Old Age Security
in California is 76 years old, widowed, has resided in the state about 30 years
and has received OAS for six years. Seventy percent of the recipients are
women. Eighty-four percent of the aged recipients live in a house or apartment,
with almost one-half of these living alone. About 10 percent have other indepen-
dent living arrangements, with the balance in some type of out-of-home care
situation.
There is no limitation on the value of any property which is being
used by the recipient as a home. Real property, other than the home, may be
retained as long as the county assessed value does not exceed $5,000.00 and the
property is producing a reasonable income to help meet the person's needs.
-51-
An individual may have personal property such as savings, bank
accounts, deeds of trust, cash value of life insurance, and stocks and bonds.
The total value of such property may not be more than $1,200.00 or $2,000.00
if both husband and wife are receiving public assistance.
There are no property limitations on such items as personal effects,
clothing, personal jewelry, household furniture and equipment, foodstuffs, fuel,
musical instruments, items used for recreation, an automobile needed for trans-
portation, and certain burial reserves.
In some instances, money or other proceeds such as deeds of trust
received from the sale of real property are not considered when such money and
other proceeds are to be used to purchase a home.
Food Stamp Program
The Food Stamp Program is a voluntary program for all OAS recipients
and for certain nonrecipients over 65 who meet the eligibility requirements.
Those determined to be eligible by the County Welfare Department are permitted
to purchase food stamps from a stamp issuing office (a bank or other) at a
substantial discount, thus increasing their monthly food purchasing power. For
example, a family of one can pay $18.00 and obtain $28.00 worth of food stamps.
A family of two can pay $36.00 and acquire $56.00 worth of food stamps.
Food stamps may be used at local approved markets, and may be used to
purchase most foods except imported foods, liquor, tobacco and such nonfood
items as soap, dog food, or vitamins. They cannot be exchanged for cash.
Licensing
The Department of Social Welfare is concerned with the licensing of
residential care and extended care facilities, as distinguished from hospitals
and nursing or convalescent homes, licensed by the Department of Public Health,
and psychiatric care facilities, licensed by the Department of Mental Hygiene.
A "residential care home" is one designed to care for the aged who do
not wish or are unable to live alone but who do not need hospital or nursing
home care. It is a substitute for living in their own home.
There are more than 3,700 residential care homes in California, serv-
ing about 45,000 aged persons. They include about 378 larger homes accommodat-
ing some 26,000 persons, operated under auspicies of both proprietary and
nonprofit organizations. About 3,500 smaller group care and family homes oper-
ated by individual and corporated owners serve about 19,000 persons.
Licenses for homes offering residential care to less than 16 persons
are issued by county welfare departments under the delegated authority of the
State Department of Social Welfare.
The Department also has jurisdiction in the licensing of the newly
established classification of Extended Care Facilities. These are designed for
those who require more individual care than is available in a residential care
home but who do not require the professional medical and nursing services pro-
vided in nursing homes. As of December 1970 no facilities have been licensed
under this new classification.
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Legal Services
The Federal Government has authorized the establishment of Statewide
legal services for the poor (including OAS recipients) to be administered by
the Department of Social Welfare. California has not elected to institute this
program. Limited legal services are available under various OEO programs dis-
cussed elsewhere in this appendix.
3. Department of Health Care Services
The California Medical Assistance Program, known as Medi-Cal, is
California's implementation of Title XIX of the Social Security Act. One of
the first state plans approved by the U.S. Department of Health, Education, and
Welfare, it has been in operation since March 1, 1966. It offers a broad pro-
gram of comprehensive health care for over 1,951,000 public assistance recipients
of whom 313,700 were over 65 and under the OAS program, and about 200,000
medically indigent individuals of whom 32,000 are aged. Some aged persons are
also included in the Aid to the Blind and Aid to the Totally Disabled programs.
Medi-Cal services 4 are available on a free choice, fee-for-service
basis. Claims for payment are processed by three fiscal intermediaries respon-
sible for determining their validity and correctness, and for making payments.
Overall administration is provided by the Health and Welfare Agency, Office of
Health Care Services.
The Department reports that financial participation for Fiscal Year
1969-70 equals Federal $509,826,000, State $392,917,016, Local $216,260,843.
Figures are not available for costs of services to only those over 65.
Under the Medi-Cal program there are two groups of beneficiaries
designated as Group I and Group II. Group I beneficiaries are persons who are
eligible for a public assistance grant. (AFDC, AB, AID, OAS). This includes
persons who are actually receiving the grant and also persons who would be
eligible to receive the grant on the basis of resources and needs but preferred
not to take the cash grant. The individual who is a Group I beneficiary has no
responsibility for paying any part of the cost of his medical care.
Group II beneficiaries are persons who are like public assistance
recipients in every respect except that their income and resources are more
than will enable them to receive a cash grant under one of the categorical aid
programs. In other words, the individual to be covered under Medi-Cal Group II
or "Medically needy" has to be blind, permanently and totally disabled, sixty-
five years of age or older, or be in a family with dependent children. Group II
beneficaries have recently been granted the same scope of medical services
available to Group I.
The individual who is covered under Group II may have to share the
cost to the extent that his income in excess of the amount that is allowed for
his maintenance and the amount of resources is in excess of the amount allowed
by law. Under the present circumstances, a single individual is allowed $162 a
month for his maintenance. A single person is also entitled to a reserve amount
in cash or other assets of up to $1,200 plus $100 for each additional person to
a maximum of $2,000.
-53-
4. Department of Public Health
Dr. Louis Taylor, Director of the State Department of Public Health
reports as follows:
The Department of Public Health is currently participating in programs
for the aging affecting the following areas of need: health, nutrition, and
education.
The Department participates in the Mecicare and Medi-Cal programs,
both of which are concerned with the delivery of health care services to elderly
patients. Responsibility for licensing and certifying providers of the care
rests with the Department under the provisions of the California Hospital Act.
The Department is also concerned with the quality of care and the development
of adequate home care and certain other facilities.
Departmental staff organize and foster development of short-term
training programs designed to provide staff operating in new areas of health
care with the requisite knowledge to furnish satisfactory care (e.g., renal
dialysis and emphysema). Staff are also engaged in assisting in the develop-
ment of local programs of a very diverse nature, such as:
Day care centers for the elderly
Protective services
Homemaker services
Nutritional counseling services
Meals-on-wheels programs
Health education for senior citizens
All of California's approximate 1,900,000 citizens 65 of age and over are af-
fected in one way or another by the various departmental programs. Thus we do
not have presently available the total cost of the Department's activities in
support of the aged. We do have, however, cost data on a program which has a
major impact on this segment of the population. I am referring to expenditures
for local health services for the chronically ill and aged. For Fiscal Year
1970-71, such expenditures were estimated as follows: Federal $392,000, State
$575,000; Local $6,379.000.
The Department Program Budget for Fiscal Year July 1, 1970 to June 30,
1971 contains more detailed descriptive material in regard to these activities.
Your attention is invited to the descriptions of the Preventive Medical Program
and the Community Health Services and Resources Program found in Pages 627-657
of the budget.
There are two major problems affecting the health and well-being of
the elderly today.
The first problem area is concerned with the need of obtaining -- out-
side of an institution -- the help, largely supplied by nonprofessionals, in
personal care and housekeeping. This need is brought on by the infirmities and
chronic diseases which so frequently accompany advancing age. Homes could be
preserved and life made far more tolerable for many of the elderly, if such
service were available.
-54-
The other problem is that of obtaining the preventive and the simple
rehabilitative or restorative care which is so vital to those in the latter
years of life if one is to avoid the deterioration that leads to a bedfast and
totally dependent state. Much of the misery of old age, both to the person and
to his family, could be avoided if such care were generally received.
Studies to evaluate the actual needs of the elderly poor, the resources
now being expended to satisfy those needs, and what it would take to meet the
needs if they were handled on an organized basis, are presently underway in the
Department.
5. Department of Mental Hygiene
The Department of Mental Hygiene reports on four separate programs
directly affecting the over-65 population. The first, the Community Geriatric
Screening Project, described below has full Federal Financing ($38,758.00) and
affects 15,000 persons. The other three, also described below, are in-hospital
programs for which direct costs cannot be ascertained.
The Community Geriatric Screening Project is a statewide program to
encourage counties to develop more appropriate screening methods for the elderly
mentally disturbed. This project is the outgrowth of the Department of Mental
Hygiene Geriatric Screening Program carried on in San Francisco from 1964 to
1968 and which is described in the following material.
In 1966 the Geriatric Screening Project received an award for out-
standing achievement from the American Psychiatric Association.
In 1969 the Geriatric Screening Project was selected by the U.S.
Senate Special Committee on Aging as a model for screening and treatment of the
elderly mentally disturbed. A report on the program, "Complexities and Rewards
of Prevention", appears in "Mental Health and the Elderly: Action Programs to
Prevent, Reduce or Improve Institutionalization", published in December 1970 by
the U.S. Senate Special Committee on Aging.
The program is more specifically described as follows:
Community Geriatric Screening Project
In 1964 the Department of Mental Hygiene established a Geriatric
Screening Project in San Francisco with its primary objectives to reduce in-
appropriate admissions of the elderly to state hospitals and to provide alter-
nate plans by developing a utilizing community resources and services that would
more appropriately meet the needs of this group. San Francisco was selected for
the demonstration project because of its high rate of admissions of the aged to
state hospitals. Approximately some 500 persons were committed from that county
each year. Many had medical illnesses that produced temporary mental disturb-
ances. A significant number were in need of care and supervision only and did
not require skilled psychiatric treatment in a hospital.
The staff, all employees of the California Department of Mental Hygiene,
was composed of an internist, psychiatrist, a psychiatric social worker, a super-
vising psychiatric social worker who functioned as coordinator and a senior
stenographer.
-55-
The project staff evaluated all persons over 65 in San Francisco for
whom a petition of mental illness had been requested. In addition, requests
for evaluations and recommendations were accepted from the local County Welfare
Department, private physicians, community social agencies, landlords and friends.
A high percentage of the persons screened by the project staff were considered
crisis situations and therefore decisions had to be made and recommendations
implemented with little delay.
In providing direct services the emphasis was on screening persons
in their own home setting and thus prior to hospital admission. Examination
in the home provided for a more complete assessment and evaluation. A psychi-
atric social worker and physician made the home visit together which afforded
a coordinated clinical and social approach to the patient. The function of the
staff was to diagnose, to evaluate, to make recommendations, and to offer con-
sultation; staff members were not involved in any continuing, active treatment
program.
Alternatives to state hospitalization included maintaining the person
in his own home with community supportive services, such as, Homemaker's Service,
home health aids, attendant care, Meals-on-Wheels and Friendly Visitors. For
those requiring care and supervision not possible to be received in his own home,
boarding home, residential hotel and nursing home placements were utilized.
Some persons whose needs related primarily to counseling or social recreation
were referred to Senior Citizens Centers, social casework agencies and church
groups.
In the first three calendar years of the project, 1,290 persons were
directly served by the Geriatric Screening Project and commitments of the elderly
from San Francisco County to the state hospitals dropped from approximately 500
a year to 40 the first year; 12 the second year and 3 the third year. Concur-
rently, there was a marked reduction in the number of total yearly admissions of
this elderly group to the San Francisco County Hospital psychiatric ward. Prior
to the screening program, admissions averaged approximately 750 a year. In
1967, the third calendar year of the project, that figure had dropped to 262
admissions.
Of those 1,290 persons screened; 45% remained in their own homes with
supportive services; 10% were admitted to both county and private medical
hospitals; 33% were placed in nursing homes; 8% went to boarding homes or
residential hotels and 4% were committed to state mental hospitals. The number
of persons screened did not reflect the several hundred requests from physicians,
social workers and others for assistance in recommending suitable plans for an
elderly person.
In 1968 the operation of the project was terminated by the Department
of Mental Hygiene and transferred to San Francisco County as a unit of the
Community Mental Health Services.
In 1968 the Department of Mental Hygiene utilized Federal grant-in-aid
funds to support a statewide project to encourage counties to develop programs
similar to the Geriatric Screening Project. The objectives of the Community
Geriatric Screening Project are to assist counties in developing geriatric
screening units for the purpose of utilizing full community resources for the
care and treatment of the mentally disturbed aged person. Although methods and
procedures vary with each county, the general approach has been for the project
-56-
director to; (a) meet with appropriate persons in the Division of Local
Programs of the county for information and briefing, (b) meet with the County
Local Program Chief to describe how a geriatric screening unit might operate
and to assess his interest, (c) review clinical files of patients admitted to
the state hospitals over a two- or three-month period to determine the appropri-
ateness of the admission, (e) meet with those community agencies involved in
providing services to the aged mentally disturbed, and, (f) assist in the develop-
ment of an ongoing local program.
Comments
The effectiveness of the method of screening developed by the Geriatric
Screening Project was clearly demonstrated by its accomplishments. Not only was
unnecessary and costly hospitalization prevented but patients received care
appropriate to their individual needs. In urging local counties to develop
similar programs, one of the major problems encountered has been uninterest by
professional staffs in working with the aged. With this in mind, future programs
concerned with the aging should emphasize education in the field of aging at
all levels of professional care, as well as training ancillary personnel.
As states continue to move from the placement of the elderly in state
hospitals to community placement, screening will become increasingly more im-
portant. Regardless of where the screening takes place, at the state hospital
or in the community, both levels of screening must require emphasis on a thorough
and careful evaluation of each patient's needs and both must include a knowledge
of the suitability and appropriateness of the various resources to which patients
may be referred.
The Department points out that while the population of California has
continued to expand during the last decade, and the general population in the
State Hospitals has shown marked decline, the number of aged persons has de-
creased by a dramatic 84%. A large share of the credit for this accomplishment
goes to the Geriatric Screening Program, described above, and by the in-hospital
program described as follows:
State Hospital Geriatric Programs
The following are examples of the geriatric programs in the state
hospitals. There are some "typical" features among all of the programs, but
each of them is individualistic, reflecting that particular creative atmosphere
which has been established by the particular hospital staff.
Napa State Hospital Geriatric Resocialization Program
The program is designed to improve social skills, motivate the patient
to leave the hospital, and remove feelings of fearfulness, loneliness, depres-
sion, and feelings of isolation. This therapeutic program is divided into four
steps.
1. The first is to get the patient to develop a relationship with
one other person, a technician or other staff member.
2. When he is capable of being a "buddy" he is ready to join a small
discussion group.
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3. When he is able to hold his own in group discussions, he is
ready for the last step.
4. Becoming acquainted with community life.
The whole process usually takes from six to eight months. Since the
inception of the program in 1963, 800 patients have been in the program. Five
hundred of these have been able to leave the hospital and almost all of them
have remained out of the hospital. The return rate is between eight and nine
percent as compared with the entire hospital return rate of 33 percent.
Patton State Hospital Geriatric Program
Over 1,500 patients have been returned to live in the community from
the program since its inception in 1964. Less than five percent of these have
required rehospitalization at Patton. The goals of this program are through
medical and psychiatric care to ameliorate the patient's illness so that
(1) those who can be returned to community living can be placed at the earliest
date possible and (2) to provide an optimum sheltered hospital living situation
for those persons too debilitated to leave the hospital.
The present program located in six units has facilities for 225
patients. It is the intent of the staff to expedite program so that patients
are returned to the community from 60 to 90 days after admission. In many in-
stances placement is accomplished even faster. The program consists of three
phases: I Diagnostic Phase; II Intensive Treatment; and III Leave Planning.
Throughout this continuum the full resources of the treatment team are utilized
in order to maximize the treatment impact and expedite the program.
Stockton State Hospital Geriatric Program
The Stockton program is an intensive treatment program which focuses
on specific treatment goals for each patient. The goal is rapid emotional and
physical healing and shorter term hospitalization.
On the basis of information provided by the Stockton Geriatric Rating Scale,
a program is designed that incorporates seven special treatment subprograms.
This diminishes the fragmentation of staff attention between the largely
physical care problem and pronounced psychiatric disability. The factors are
deemed adequate for both research and clinical uses and are valid in predict-
ing outcome and in being sensitive to changes in patients' level of impairment.
6. Human Resources Development
The Department of Human Resources Development reports a number of
areas in which it is directly involved with senior Califorians.
It is charged with implementing the State law known as the "California
Law on Age Discrimination in Employment" (California Unemployment Insurance Code
Sections 2070-2078).
It has responsibility in carrying out Public Law 90-202 of the 90th
Congress, known as the Age Discrimination Act of 1967.
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It administers the Older Worker Program in California, and is the
administrative agency for the California Commission on Aging. These two
programs are discussed in detail below:
(1) Commission on Aging Program
Over 1,800,000 people over the age of 65 now live in California. Al-
though different levels of income, education, health and background are
represented, the same physiological and social processes of growing old are
shared by all. The social process, rather than the physiological process, is
the primary concern of the California Commission on Aging.
As the average age of our population decreases (52 percent is esti-
mated to be under the age 25), the pressure mounts to force the older members
of society to withdraw and thus create vacancies for younger individuals. At
the same time that the younger population is increasing, however, the popula-
tion of those who have reached an arbitrary retirement age but are still capable
of working and contributing to society is also increasing. As younger people
enter adult society in larger numbers, there is a greater need for the trained,
mature, experienced leadership which can be provided only by the senior members
of society.
Each community should utilize the full range of experience and knowl-
edge possessed by its senior citizens, and meaningful activity must be avail-
able for the mental and physical health of those same senior citizens. By
matching their knowledge and skills to the needs of the community, the commun-
ity gains in terms of an experienced work force, use of knowledge and skill
acquired during years of activity, increased income from taxes, decreased
reliance of senior citizens on public assistance and vigor and energy of those
who have something to give. By continuing to serve their community, the indi-
vidual gains by having meaningful activity, being able to retain control of his
income, savings and property, and the dignity of determining his own scope of
life, plus knowing that he is still useful.
Welfare and Institutions Code Sections 18300 through 18356 authorizes
the establishment and formation of the Commission on Aging.
The California Commission on Aging has many responsibilities but,
if any one goal of the Commission encompasses both its philosophy and its func-
tions, it is this: to work with other public and private organizations and
with the individual to provide the maximum opportunity for self-fulfillment
during the mature years.
In order to most effectively meet the total needs of California's
older residents, the Commission has assumed specific functions and objectives.
These include:
-- To review, evaluate, approve and supervise projects under
Title III of the Older Americans Act of 1965.
-- To assist and guide the communities of the State, through
consultation, in developing programs to meet the needs of
their senior residents.
-- To work closely with pertinent departments and agencies of
the state government in order that state resources shall be
used as effectively and efficiently as possible in behalf of
Senior Californians.
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--To act as a clearinghouse and information center on all aspects
of aging.
--To hold hearings on, and in other ways to study, all aspects
of the problems of aging and to advise the Governor of action
needed to solve these problems.
--To provide ready access to health education, preventive health
services, prompt medical treatment and restorative resources
based on the most advanced knowledge and techniques available,
for all older people.
--To assist in providing a wide range of housing and living
arrangements located, designed and priced in keeping with the
changing health and social characteristics, needs and interests
of the aging.
--To encourage services to protect all older people from exploita-
tion through false claims, frauds, quackeries, unnecessary services
and unreasonable charges, and to provide special assistance to
those unable to manage their own affairs.
--To promote educational opportunities for older persons and those
who work with them.
--To encourage full cooperation on the part of the family, community
and society in helping older people fulfill significant roles in
the post-parental and retirement years.
--To create opportunities for paid and voluntary services in
community agencies and to people of any or all age groups.
--To assure provision of institutional and medical care, community
and protective services and care and attention for the home-bound
by people sympathetic to the aged and trained to work with them.
--To involve older adults in planning and conducting programs
and services for seniors and for others in their communities.
Added Responsibilities of the Commission Under the 1969
Amendments of the Older Americans Act
In addition to administration, responsibilities now include planning
evaluation, and coordination. The State plan shall provide that effective
statewide planning will be carried out on an ongoing basis on behalf of all
older persons in the State, with emphasis being placed on assuring the conduct
of: (1) Special studies, including issue analyses and data gathering;
(2) review and evaluation of all major programs and services for the elderly
in the State; and (3) establishment of linkages with all other State planning
efforts and service programs that affect the elderly of the State.
Primarily responsible for studying the needs, problems and opportu-
nities of the Senior Californian are the twelve members of the Commission --
eight private citizens appointed by the Governor; and four legislative members,
two appointed by the Speaker of the Assembly and two by the President Pro Tem
of the Senate. Heading the Commission are the Chairman, appointed by the
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Governor for an indefinite term, and the Executive Director, appointed by the
members of the Commission. Completing the Commission staff are some seven
special consultants and clerks.
Financing the Commission's wide variety of service programs in aging
is primarily through Title III funds made available through the Older Americans
Act of 1965. Under the provisions of this act, maximum federal funds for the
first year of a project may constitute 75% of the cost, 60% of the cost in the
second and 50% of the cost in the third year. Nonfederal, funds complete the
financing of the Commission projects. These funds may come in part or whole
from the following sources:
-- State appropriation to the California Commission on Aging
-- County, municipal and local public governmental agencies
-- Nonprofit private agencies and organizations
The matching share on the part of the state, communities or other
nonfederal sources may be in the form of monies, facilities or services for
carrying out the activity or project approved by the Commission.
Since 1955, when it was established by statute, the Commission on
Aging has been sole coordinator for all state departments having programs for
the aging. Cooperative working arrangements between departments provides
specialized professional support as the need arises.
The Senior Californian newsletter is the official publication of the
California Commission on Aging. Published quarterly and distributed to all
interested individuals, groups and organizations throughout the state and
nation, the Senior Californian features news of Commission projects and their
activities; spotlights outstanding programs and the work being done in them by
Senior Californians; reports on opportunities for senior volunteers, and carries
articles of general interest to persons concerned with the older Californian.
In addition, the Commission periodically publishes brochures and
pamphlets featuring individual projects and the important work being done by
them.
Among its countless activities, the California Commission on Aging can
claim several "firsts". Two of these "firsts" include the establishment of the
Training Institutes for California's senior leaders. These institutes were
sponsored by the University of Southern California Gerontology Center in
1968-69 and by San Jose State College in 1969-70.
Presently, there are two such Centers in operation: in San Jose,
through the Recreation Department of the City of San Jose in cooperation with
the Department of Recreation and Leisure Studies at San Jose State College;
and in Los Angeles, through the Recreation Department of the City of
Los Angeles and the University of Southern California. Each center serves the
region in which it is located. Training programs can be offered in any part
of the region to meet the convenience of the workshop participants.
Gerontology Training Institutes: Three-day meetings held three times
a year to provide basic knowledge in gerontology as well as supplementary
information and skills for Title III project staffs, OEO staff personnel work-
ing in programs for the elderly and interested community members.
Although each institute includes some time for sharing specific pro-
gram ideas, the primary focus of these sessions is on the presentation and
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discussion of general material which might apply to all who work with older
people regardless of specific job or geographical location. This background
information can then be discussed and applied on a more specialized basis at
the regional workshops. These programs offer to Californians in the field of
aging curriculum, material similar to that presented to students in gerontology
courses. Participation in the institutes is by invitation.
As the response to each of the component parts of this education net-
work increased, it became evident that a statewide focus could serve to minimize
piecemeal or duplicated efforts by providing a coordinated approach. A state-
wide education and training program was initiated to integrate these various
levels of programs which were already in existence; to foster innovative educa-
tional concepts in the field of aging; and to stimulate the development of
services based on broader perceptions of basic problems and approaches.
The Commission has also established the first State civil service
classification in the United States designed for part-time employment of seniors.
In California, as demonstrated in these examples, older people are
assuming new roles -- those of volunteers, of helpers whose expenses are paid,
and of aides who receive some remuneration for their work. They are providing
leadership that has a great deal of meaning to their group, and is helping it
to become an important part of the community.
These programs are only a few examples of our total California pro-
gram. They are the ones which are indicating methods that are proving effec-
tive in a variety of local areas. We are hopeful that they may be used by our
large state agencies as part of a continuing program after they have been
tested through the three-year period of the Older Americans Act, or that other
communities may set up similar programs as they become ready to do so.
Since the enactment of the Older Americans Act of 1965, there has
been a growing concern about the problems confronting the elderly. An educated
community and trained personnel are paramount in formulating and implementing
social policies to insure the well-being of older persons. A community needs
information on which to base thoughtful approaches; professional personnel need
continuous access to current data to provide effective leadership and older
persons need information and ongoing training for self-help, for self-
development, for service to others and for communication with the total
community.
Beginning in 1967 the California Commission on Aging, through its
staff consultants and through its allocation of Older Americans Act Title III
funds, introduced a newwork of informational and educational programs through-
out California in order that all communities might be made aware of the needs
of their senior citizens and of ways in which resources can be mobilized for
improved services to meet these needs. Four different types of programs were
developed to provide education and training at the local, regional and state-
wide levels: Information Days, Regional Workshops, Senior Education Centers,
and Gerontology Training Institutes. Each has a specific purpose. Each pro-
vides basic information needed to further programs of service.
Information Days: One-day sessions focusing on programs and services
for the aging at the county level, sponsored cooperatively with local organiza-
tions and agencies.
A broad spectrum of services for the elderly, or one particular
topic in-depth may be explored through speakers and group discussions. Booths
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or tables offering informational material are made available by local agencies
to service the older person. These meetings are widely publicized to attract
as many senior Californians as possible and are attended by 200-500 persons,
depending on the locale. The primary purpose is to inform seniors about what
services are available in their local communities.
Regional Workshops: One-day symposia for those who work with older
persons either as professionals or volunteer leaders. The attendance of civic
leaders, educators, the ministry, public agency personnel and representatives
of the private sector is encouraged to broaden the total community's awareness
of everyone's need to identify with the aging process.
These meetings are designed to involve the participants in discuss-
ions of specific issues of concern which could then lead to community action.
There were three such workshops held during this past year in each of the five
California Commission on Aging Regions which are multi-county in scope.
Senior Education Centers: A comprehensive program of ongoing year-
round educational programs for professionals, community groups, volunteers,
students and senior Californians.
Through the cooperative efforts of a local government and a neighbor-
ing college or university, a training program in the field of aging is offered
to foster more creative and more comprehensive involvement in the community for
and by seniors.
Content depends on the needs of the specific group and the programs
vary from one-day workshops, panel discussion meetings, series of workshop
sessions and lecture presentations to practical demonstrations. Subjects in-
clude psychological, sociological and biological aspects of aging, nutrition,
health, recreation for nursing and residential care homes, volunteer orienta-
tion, and other similar topics.
(2) Older Worker Program
The Department's 7th Report to the Governor on the Older Worker
Program, Dated May 22, 1970, discusses the problem facing the older worker in
California: the growing numbers in this group, the serious economic plight of
an increasing percent of older citizens, the growing dependency ratio caused by
long-term inflation, early retirements, automation and lack of adequate dis-
semination of job information.
The report discusses the significance of its two-year "Project 60",
developed in 1964 with the San Francisco Program for Aging as the local sponsor.
The purpose was to find the reason for the large scale demand for employment
by persons over 60, and to develop a community profile of persons over 60,
analyzing their need for employment and other services as well. It concluded:
"
the serious problem of income maintenance in retire-
ment was clearly defined to us in the "Project 60" experience.
In addition, we found that in this group, 87 percent had no
chronic health conditions or impairment which limited employ-
ment; they are very reluctant to ask for assistance, either
social services or employment; they come to an employment
office when the need is for other kinds of help; the helping
persons are perceived as real people rather than the imper-
sonal, anonymous professional worker; a job which is meaning-
ful produces a rapid and positive change for the better in
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health; retirement is a tremendously stressful crisis
and preparation is essential to minimize the blow and
help the individual to adjust; loss of mastery over
one's own situation through dwindling financial
resources is their principal psychological problem;
and the most effective way to help them is to deal
with their current situation, rather than past events."
The report also describes the development of the Senior Aide Concept.
The following are excerpts from this description:
(3) Development of the Senior Aide Concept
During the years 1965-1969, the discoveries in the field of aging
brought California (and the United States) from a state of unawareness of the
condition of a majority of our elderly citizens to a dawning realization that
their plight in this period of greatest affluence is a national disgrace.
The programs and projects which developed this information are all
very recent, some ongoing into 1970, and were financed by the U.S. Office of
Economic Opportunity. In California, the Older Worker Program of the California
State Employment Service has played a participatory role in their development,
supporting and strengthening them when possible.
First came the Foster Grandparent Program, recruiting, training and
employing persons over age 60 with low incomes to serve neglected and deprived
children who lack close personal relationships with adults. This is an Older
Worker Program within the Community Action Program of OEO. The goal of this
program was to show how to raise the economic level of older people with low
incomes, and provide new roles and functions for older people including new
employment roles. They were employed 20 hours a week at $1.60 per hour. The
first project under this program in California and one of the first in the
nation was the San Francisco project beginning in 1966.
One of the most successful Foster Grandparent programs in California
in 1969 was in Pacific State Hospital. Our Pomona office screens all candidates
for these positions and Manager B. E. Sweeney has this to say:
"As we view the program, this appears to be one of
the most successful of the anti-poverty programs in this
area. It has been a 'two-way street'. The grandparents
found that they are needed and wanted and equally important
is the supplementary income which they would have found
difficulty in obtaining otherwise. The hospital staff has
been equally enthusiastic and have many success stories
of patient progress as a result of individual attention.
The average age is 67, ten are 70 and over. OEO funded
the program at 48 positions. Interestingly, this year,
the California Legislature added 12 more positions to be
paid wholly by state funds
"
Second was Operation Medicare Alert whose primary purpose was to carry
the message of Medicare to older individuals who might not otherwise know of it,
and assist them in taking the necessary steps to avail themselves of its benefits.
A secondary purpose was to ascertain the needs of the elderly population.
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3,841,027 older persons were contacted nationally, and it was from this experi-
ence that California and the nation learned of the unexpected magnitude of the
poverty of our older population.
On a statewide basis, we assisted the Social Security Administration
in recruiting, screening and referring applicants for Operation Medicare Alert
in California. Here again, elderly at or below the established poverty income
levels were hired to work in the project.
Project FIND, the third program, was developed from the reports on
Operation Medicare Alert, as an aggressive outreach program to search out
seniors, isolated and hidden from public view, and assist such individuals by
channeling help to them from available community resources which they do not
know how to obtain. The National Council on the Aging conducts this project
for OEO.
The original Project FIND location in California was in the Santa Cruz-
Watsonville area where 20 percent of the population is over 65 years of age.
The project was extended in 1969 to include San Diego, Hayward, Shasta County,
Vallejo, Long Beach, Modesto and San Bernardino. Again, older people in poverty
circumstances were hired to do the job, the oldest in California being 85 years
old.
Project FIND is the most extensive study yet made of the elderly.
The National Council on the Aging preliminary report found that 15 percent of
the elderly poor couples 65 years of age or older are living on an annual
income under $1,000 and 46 percent have incomes below $1,500. Project FIND
shows that the greatest number of California's elderly poor live in Los Angeles,
Long Beach and San Diego.
In the reports from Project FIND locations in California, the need for
employment for the senior poor is proposed as the primary solution to their
desperate economic plight. The Department of Human Resources Development has
worked very closely with these projects in the communities named above, both in
recruiting and screening the elderly applicants for employment with the project,
and accepting referrals for employment from the projects. In most instances,
staff from the field offices of the Department of Human Resources Development
are on the project board of directors or serve in an advisory capacity to the
board. The projects are continuing into 1970 and when completed, the results
will be announced by the President.
The genesis of the Senior Community Service Project was the national
interest, as expressed in a number of congressional hearings, plus the obvious
need to stimulate employment opportunities for seniors which was demonstrated
by the three programs just described.
The rationale for the Senior Community Service Project was that it
satisfy the income-producing need for part-time work and at the same time pro-
vide manpower to meet the great need for additional social and health services
which exists in each community; thus combining the need of the community with
the need of the older poor.
This project represented a more sophisticated approach to a senior
manpower problem by developing the job of Aide, complete with job descriptions,
specialized training, and background requisites.
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Although the age criteria for this project was a minimum of 55 years,
most Aides were in the sixties and seventies. They met poverty income criteria
and were either retired or chronically unemployed. Working on a 20-hour-a-week
basis, enrollees were assigned to public or nonprofit private agencies. Their
gross annual income from the project could not exceed $1,976.00. The funds for
the project were provided by the U.S. Department of Labor. All administrative
and training costs were absorbed by the local sponsors.
The California State Employment Service offices served as the employ-
ment component of these projects in 1969 in California in recruiting, screening,
testing, and in some cases employing these Senior Aides. Although the sponsor-
ing agencies used the skills of our offices in varying degree, we were able to
assist in promoting public understanding of the projects, provide information
to project staff about applicant needs and characteristics; make available pre-
vailing wage information and extend various industrial services pertinent to
establishment of new jobs. The projects which were most successful were the
ones which fully used our services in this way.
Each project in California had a local sponsoring agency in addition
to the prime contractor, a national organization active in the field of aging.
These projects were as follows:
National Council on the Aging, Washington, D.C., prime
contractor for projects in San Francisco sponsored by
the Economic Opportunity Council; and in Los Angeles,
sponsored by the Economic and Youth Opportunities
Agency.
National Council of Senior Citizens, Washington, D.C.
prime contractor for projects in Oakland, sponsored by
the Social Service Bureau of the Council of Churches;
and in San Diego, sponsored by the Community Welfare
Council.
American Association of Retired Persons and the
National Retired Teachers Association, Washington,
D.C., prime contractor for a project in Long Beach,
sponsored by the Long Beach Commission on Economic
Opportunities.
These projects are funded into 1970.
The report to the Governor also described projects conducted in
California by the National Council on Aging, the National Council of Senior
Citizens, and the American Association of Retired Persons with the National
Retired Teachers Association.
The report ends with the following conclusion and projection:
The elderly are no longer a passive group and the aged population is
growing very rapidly, in fact, at such a rate that many leading social scientists
view it as the making of a national crisis.
Workers who reach old age in the future will undoubtedly have higher
educational achievements and can be expected to have better health; a higher
proportion will be skilled workers. We question whether there is grounds for
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belief that they will accept patterns of early retirement or even retirement
at all. In other words, work and retirement patterns that have characterized
the past few decades will not automatically be extended into the future.
There has to be a better role for these people. To make the Seventies
worth living will take the talent, brains and experience of all the people
living in California.
7. State Teachers' Retirement System
Michael N. Thome, Chief Executive Officer of the State Teachers'
Retirement System reports that 312,563 active and 40,159 retired (and benefi-
ciaries of retired) persons are covered by the program. Essentially, the pro-
gram provides retirement, disability and survivor's death benefits for teachers
in public supported schools in California. In Fiscal Year 1970-71 state
participation equaled $83,450,884 and local (school districts) equaled $58,136,840.
The provisions of state law establishing the system and setting forth
such matters as eligibility, benefits, contribution scales and retirement
formulas are formed in California Education Code Sections 13801 et. seq.
Normal retirement eligibility requires 60 years of age and at least
five years of service. Early retirement at 55 and later retirement are per-
missible (with at least five years of service) with corresponding actuarial
reductions or improvement in the retirement allowances. Disability retirement
eligibility also requires at least five years of service. The standard benefit
formula is 1-2/3% of the final compensation for each year of service credit.
Final compensation is the average earnable salary for the highest three con-
secutive years of California service. The law also sets forth the death bene-
fits both before and after retirement.
Full details of this program may be obtained by writing the State
Teachers' Retirement System, Sacramento, California.
8. Department of Rehabilitation
The State Department of Rehabilitation reports as follows:
Since our work is almost entirely related to providing vocational
rehabilitation services to enable physically and mentally handicapped people
to enter employment, we do not have much contact with people over 65. During
the Fiscal Year 1969-70, out of the 14,358 clients rehabilitated, 77 were over
65; 42 of the 77 were alcoholics and 35 had other physical or mental disabilities.
Although we do not consider them "aged", as far as the labor market is
concerned anyone over 45 tends to have difficulty in obtaining employment due
to age. Our records indicate that during 1969-70, 3,592 or 25% of the persons
rehabilitated were between 45 and 65 years of age. While overall this group
comprises 25% of the rehabilitations, if the group is separated between the
individuals handicapped by alcoholics' problems and all others, we find that
1,105 or 49% of the alcoholics rehabilitated were over 45, while 2,487 or 20%
of persons with other types of handicapping conditions were in this age group.
One small program operated by this Department involves people over 65
to a substantial degree. This 1S our Teacher-Counselor Program for the Blind.
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Since blindness is largely a disability of old age, there are many newly blinded
people over 65 who need the kind of service we offer. The service provides
counselor-teachers who go into the homes of older blind people and assist them
in any way possible to learn how to live in spite of their blindness. This can
involve all types of training which may assist them to get around without assist-
ance, keep house, read Braille, type or almost any other thing which will make
them more comfortable and independent. On September 30, 1970 approximately 300
blind people over 65 were being served in this program. This is 34% of the total.
It is estimated that $132,000 were devoted to this particular effort in regard
to the aged.
9. Franchise Tax Board
The Franchise Tax Board reports as follows:
The State of California has developed a program whereby eligible indi-
viduals are relieved of a portion of the property tax burden. The Senior
Citizens Property Tax Law, (Sections 19501 et. seq., of the California Revenue
and Taxation Code), administered by the Franchise Tax Board, is designed to
offer financial assistance to individuals who own their homes, have low income,
and are 65 years of age or older. The law requires that the individual pay the
current year's property taxes and then file a claim for refund. The individual
reports the amount of money received during the year and furnishes a copy of
the current year's tax bill with proof of payment of the taxes. The first claim
filed by the individual must be accompanied by a document which proves that he
or she is over 65 years of age.
During 1969 we refunded approximately $8,000,000 to approximately
60,000 individuals. The average refund was $133. The 1970 program year has
not yet been completed, but the number of claimants being paid and the total
of the payments will be slightly higher this year. We believe the number of
claimants could be increased if we were able to contact all of the eligible indi-
viduals or receive the information from them after contact has been made. Our
program, is relatively new so it is not as well known as, for example, the Social
Security program and the individuals will not furnish the necessary information
as readily as they do to the Social Security representative.
10. Public Employees' Retirement System
Mr. William E. Payne, Executive Officer of the Public Employees'
Retirement System reports as follows:
The California Public Employees' Retirement System administers two
programs of direct interest to the aging. One is through the State Employees'
Medical and Hospital Care Act which, from its very beginning, provided for
health insurance for retired State employees with benefits and premiums equated
to active employees even though the utilization of the retired was substantially
greater than that of the active. We anticipated the advent of Medicare by obtain-
ing legislation which permitted us to develop supplemental plans to Medicare for
those over age 65, so that concurrent with the initiation of the Medicare pro-
gram we had provided our retired group, who qualified, with a benefit which sup-
plemented and generally filled in the gaps of Medicare.
Currently, we have 17,107 retired persons enrolled under our several
health insurance programs at a cost to the State of $1,689,052 for the preceding
fiscal year. At the end of the past fiscal year we had 57,086 retired members
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and beneficiaries of retired members on our retirement rolls and through the
year some $115 million paid to these retired persons through monthly benefit
payments. A somewhat equal amount of State and local government employees were
contained in this retired group with the local government employees exceeding
the retired State employees by some five and six thousand. In general terms,
the benefit costs result in the employer paying in the area of 70% of the total
cost, with the employee's contribution in the area of some 30%.
The health insurance programs have been highly effective for the aged
group. The retirement program is effective only in terms of the years of
service which the individuals have accumulated as credited years under the
Retirement System, since with a guaranteed formula, retirement allowances are
in terms of years of service as well as final salary. Through the efforts of
the Governor and the State Legislature, we have been able to install a 2%
annual compounding cost of living program in order to offset some of the ravages
created by inflation affecting fixed incomes.
11. Department of Veterans Affairs
The Department of Veterans Affairs reports two distinct programs af-
fecting 221,320 veterans: Veterans Home - 1320; Veterans Claims - 220,000.
Fiscal involvement is as follows:
Federal $4,000,000; State $5,000,000; Local (54 counties); $2,450,000.
The Department describes the two programs in the following manner:
The Veterans Service Division administers the Claims and Rights
Program for the Department of Veterans Affairs. Veteran representatives of the
Department assist veterans in presenting and pursuing claims against the
United States Veterans Administration. They also assist veterans in obtaining
hospital care in Veterans Administration Hospitals.
The Veterans Home at Yountville, California, accepts as members any
honorably discharged veteran who has been a resident of California for at least
five years, and is unable to support himself in a competitive environment.
Three levels of membership exist: domiciliary care - when a member can ambulate
freely and does not need extensive medical treatment; nursing care - when the
member's ambulation is limited or if he requires a special medical regimen;
hospital care - when conditions so warrant. Member's average age is over 70
years. Charges of $60, $90 and $120 per month are made, depending on the level
of care required. If a member is indigent, no charge is made. Charges are not
invoked that will reduce a member's income below $50 per month.
The Department's role in providing care to the aged is relatively in-
significant. Changing socio-economic conditions appear to be a limiting factor
as respects the number of those seeking membership at the Veterans Home. The
hospital and nursing care areas operate at maximum capacity; the domiciliary
units are approximately 35 percent filled. One basic assumption has been drawn:
Institutional living loses its appeal when sufficient care and assistance can
be obtained at the community level.
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12. Department of Consumer Affairs
Mr. Leighton Hatch, Director of the State Department of Consumer
Affairs, formerly the Department of Professional and Vocational Standards re-
ports programs in two important fields concerning health, nutrition and
education.
Michael R. Buzzy, R.N., Executive Secretary for the Board of Nursing
Education and Nurse Registration states that 10,000 nursing students receive
varying degrees of education concerning the elderly.
Miss Beverly C. Andre', R.N., the Board Nursing Education Consultant
in Nursing Practice, states:
"The Board of Nursing Education and Nurse Registration does
require recognition of the Older American in the prescribed cur-
riculum for accredited schools of nursing. The content area in-
cludes nutrition, physiology-anatomy, major physical and mental
health problems. A survey of curricula submitted by 48 associate
degree, 12 diploma, and 16 baccalaureate degree accredited schools
of nursing shows that only 10% of the presently accredited pro-
grams do not use convalescent or extended care facilities as
clinical experience areas. However, these programs do have clinical
experience in the care of the older adult in graduated services
of a general hospital.
"The Board's Profile of Registered Nurses identifies that
of the 68,438 full-time employed R.N.s in California, approxi-
mately 10% are geriatric nurses.
"In its adoption of a more structured program of licentiates
on probation to the Board, considerable information concerning
nursing practices in the extended care facility has been gained.
Approximately 50% of the 68 nurses on probation are employed in
extended care facilities. The new probation program includes
reports that emphasize upgrading nursing practice through con-
tinuing education. The major area of lack of knowledge among
this latter group was in psychiatric and geriatric nursing.
Since the Nursing Education Consultant responsible for the pro-
bation program is a nurse gerontologist, the imput has been one
of directing these nurses to courses, conferences, workshops and
reading material in professional magazines that would improve
their practice of nursing.
"In Section 2725 of the Nurse Practice Act, the scope of the
regulation says 'to safeguard life and health of a patient and
others'. Since July 1970, the BNENR has assigned a Nursing
Education Consultant to develop a program of services in nursing
practice.
"A recent license and licentiate violation survey of
hospitals and extended care facilities shows a need for work-
ing with these agencies in the use of criteria and guidelines
for safe and effective nursing practice. Over 50% of the agencies
responding were extended care facilities where at least 60% of
the population are Older Americans."
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Maryellen Wood, R.N., Executive Secretary of the Board of Vocational
Nurse and Psychiatric Technician Examiners reports that the state's 82 accredited
schools use extended care facilities and nursing and rest homes for clinical
experience for a high percentage of their 4,500 students.
13. State Personnel Board
Mr. John F. Fisher, Executive Officer of the State Personnel Board
reports as follows:
The only program activities of the State Personnel Board that directly
relate to the aging are those related to job opportunities. In the recruitment
of personnel for the State Civil Service, we have sought to comply fully with
the provisions of Government Code Sections 18932 and 19700 prohibiting dis-
crimination based upon age. However, this activity has been pursued within a
general policy framework and does not involve any identifiable direct cost.
With regard to maximum age limitations on employment in the State
Civil Service, we are concerned about the fact that in 1970 the California State
Legislature imposed two age limitations that, in our opinion, are unduly restric-
tive. A maximum age of 31 years was established for fire fighting positions
which normally afford entry into the Department of Forestry service (AB 305,
Chapter 138, Statutes of 1970).
Under the provisions of AB 245 (Chapter 1600, Statutes of 1970) ef-
fective July 1, 1971, an age limit of 35 was established for employment as a
Correctional Officer, Womens Correctional Supervisor I, Parole Agent I, Group
Supervisor, Youth Counselor, and other custodial and parole positions which
normally afford entry into the Department of Corrections or the Department of
the Youth Authority. In the legislative considerations of these bills in 1970,
the representatives of the State Personnel Board were the only persons who
presented testimony recommending against the establishment of these age limits.
In a report of November 10, 1970, to the Senate Committee on Finance
we made the following statement: "We note that maximum age limits for entry
into State service have been included as a feature of the retirement programs
that encourage or require retirement at age 60 or 55 for some occupations. We
do not believe assurance of an optimum retirement allowance is in itself an
adequate justification for the establishment of maximum age for entry into State
employment. We urge that entry age maximum not be set unless there is clear
and unequivocal justification based on unusual physical demand of the occupation."
14. Department of Housing and Community Development
This Department reports a modest program in the area of Housing for
the Elderly which involves a State Fund Expenditure in the amount of $4,500.
The continuous rise in housing and related costs severely affect the
elderly who live on fixed incomes. The objective of this program is to provide
advice and aid on availability of federally financed programs as well as privately
developed programs and to serve as a catalyst for seeking solutions to this
special group of senior citizens.
Upon request, the Department will assist in the application process,
determine the availability of federal aid and recommend possible solutions where
such aids are not fully available for all senior citizens.
-71-
The Department's legal authority is found in Health and Safety Code
Section 37104 through 37113; Labor Code Sections 1460 through 1468. At the
request of a government agency or private quasi-public or private, nonprofit
group, the Department will stimulate action in providing the quantity of varied
types of housing and related services required to meet the needs of the elderly.
15. Department of Fish and Game
The State Department of Fish and Game reports a unique program which
involves $150,000 in state funds, and benefits 35,000 senior Californians:
free fishing licenses.
Under recently adopted state laws, women over 62 and men over 65 may
obtain free sport fishing licenses for ocean fishing and frogging if they have
been residents of California at least five years and their income does not
exceed $140 per month for single persons and $280 for married persons.
By purchasing one current license stamp, the license is extended to
include all species of fish other than trout, (but including steel head trout).
The license is further extended to trout if a second current license stamp is
purchased.
Licenses may be obtained by filing of a simple application form with
the State Department in Sacramento.
16. Department of Youth Authority
The Department of Youth Authority reports its participation in the
Federal-Local sponsored foster grandparents program.
Forty-one senior Californians are involved in this program which in-
volves the expenditure of $135,940 in Federal Funds and $19,351 in local funds.
Sixteen of the 41 grandparents were on Public Assistance before becoming in-
volved in the program. Due to this added income and other benefits derived from
the program, 11 have discontinued Public Assistance and five are receiving
decreased payments.
Material submitted by the Department contains the following description
of the program:
Benefits to Foster Grandparents
The Foster Grandparent Program serves an extremely important purpose
for the retired senior citizen living on an inadequate income, that allows few
opportunities for meaningful social experiences.
The most obvious benefit is the additional income earned by working
as a Foster Grandparent. The $1.60 per hour for 20 hours' work a week ($32.00)
supplements their meager incomes and allows them to live a life of greater
dignity.
Of equal importance is the sense of purpose -- the increase in self-
esteem they derive from again feeling useful and needed by someone. Many of our
senior citizens have known only loneliness and rejection since their own child-
ren moved away from home. In time, they acquire the feeling that no one cares
for them or needs them, and that they are of little value to anyone.
-72-
Working as Foster Grandparents with boys that desperately need their
help changes their self concept from useless and unwanted, to being a person
who is making a valuable contribution to the lives of others. For many, it is
like a miracle drug that rejuvenates them both physically and emotionally.
Our senior citizens are uniquely qualified to provide the constructive
adult relationships needed for the emotional development of their grandsons.
They have the experience, understanding and compassion acquired through years
of living. They are motivated by the need to again feel useful and wanted.
Working with boys whose home life lacked positive adult relationships needed to
provide a feeling of security, of being loved, being wanted, being worthwhile,
is a perfect match. The grandparents have so much they want to give and the
boys have many emotional needs to be filled. Each complements and reinforces
the other, resulting in benefits for both grandparents and their grandsons.
The physical and emotional benefits resulting from again having a purpose in
life, or performing a task that is important to the future of others, would be
hard to measure. The beneficial results of their work with the boys is well
documented.
Our particular program has been operating at the Northern California
Youth Center since July 1967. It is unique in that it is the only program of
this type that is presently operating within an all correctional institution.
Senior citizens of low income groups, from various community environ-
ments and ethnic origins, were interviewed resulting in 38 taking two weeks'
basic training to orient them to an institutional setting involving boys, aged
13 to 16 years, in confinement for various infractions of the law.
The performance of this group since July 1967 has proved that the
low income senior citizen can provide a major new reource of responsible workers
for community and social agencies. The Foster Grandparents have not only been
helped financially (many have been released from Welfare rolls) but have demon-
strated an ability to meet the emotional challenge of the job by giving boys the
social and psychological support so necessary for their development.
The Orientation and Indoctrination of Foster Grandparents consists of:
(1) Orientation to the Foster Grandparents Program.
(2) Role of Foster Grandparents in Youth Authority Program.
(3) Youth Authority philosophy and organization.
(4) Referral process and background of Youth Authority wards.
(5) The Therapeutic Community concept in use in Youth Authority
institutions.
(6) Causation factors of delinquency.
(7) Techniques of treatment.
(8) Minority group problems.
(9) Working with Youth Authority staff.
(10) Observation of our institutional programs.
Upon completion of orientation and indoctrination the Foster Grandparents
are assigned to work with an experienced grandparent on a living unit.
Through in-service training, the program staff expose the Foster
Grandparents to subjects relating to the needs of the institutions and the
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children they serve. In addition, outside resource people give instruction on
nutrition, arts and crafts, Social Security, medical coverages, recreation,
and opportunities available for social involvement.
In-Service Education Meetings:
The California Youth Authority allocates several hours a week to
meetings that are designed to increase the proficiency of staff involved in the
treatment process. The sophisticated treatment concept in use in both institu-
tions make ongoing in-service education a necessity if staff are to remain
knowledgeable on new developments in treatment.
Working in this type of a setting is a new role for the Grandparents.
In order to be effective in their role, it is essential that they have a basic
understanding of the treatment strategy being used by their treatment teams.
Members of the Treatment Teams and other treatment specialists will help Grand-
parents acquire the "new skills" and knowledge by means of monthly scheduled
in-service education meetings. The scheduled in-service education meetings
will be supplemented by daily private orientation and education meetings with
Treatment Team members in order to coordinate the efforts of all staff working
directly with the children. Further in-service education will be provided for
Grandparents in meetings which specifically spell out the treatment strategy
and goals for their grandsons.
The Foster Grandparent Program recruits, trains, and employs persons
over age 60, with low incomes, to serve neglected and deprived children who
lack close personal relationships with adults.
Foster Grandparents May Serve:
Neglected infants and very young children living in institutions.
Normal older children, 6-16, in institutions.
Mentally retarded or emotionally disturbed children in institutions.
Children not in institutions, but in clinics, special classes,
sheltered workshops, or other settings.
This is an Older Worker program, which was transferred from the Office
of Economic Opportunity to the Department of Health, Education and Welfare on
September 17, 1969. It is now funded by the Department of Health, Education
and Welfare. Administration on Aging, Foster Grandparent Program, Washington, D.C.
The Goals
The Foster Grandparent Program provides new roles and functions for
Older Americans, creates new employment opportunities, stimulates innovations
in the field of child care and institutional administration demonstrates a
major new resource of responsible workers for communities and social agencies,
leads to new patterns of cooperation among agencies and professions, and gives
children meaningful lives with tender love and care.
The Older People
Several million men and women, aged 60 and over, need additional in-
come from employment to maintain a minimum standard of living. Some of them
have always known financial deprivation, others have greatly reduced incomes
-74-
because of retirement. A large number of these persons make good grandparents.
They have a generous supply of love and understanding which grows from their
years of experience. They love children. These men and women can contribute
significantly to children who are starved for emotional warmth. As such they
represent a largely untapped resource in their communities.
Employment as Foster Grandparents provides needed income and gives
new meaning to older persons who frequently welcome the opportunity to demon-
strate that they are still useful by fulfilling a need that may otherwise go
unmet.
Of the 29.7 million impoverished Americans, seven million are aged 65
and over. An additional 2.7 million are 55 to 64 years of age and also living
on incomes under the poverty level. About half of them live alone.
For youth, the major goal is to break the cycle of poverty from
generation to generation. For youth, measures sought may be long range,
starting in infancy. For the old, however, efforts must be directed toward
results in the immediate or near future. Many will have to continue to live
on very limited incomes, but they should be able to live out their lives in
greater decency and dignity than most of them do at present.
17. Department of Corrections
The State Department of Corrections reports that one of its 13 cor-
rectional institutions, California Mens Colony West in San Luis Obispo County,
is designed and operated primarily for older inmates and persons with physical
disabilities.
Two percent of the state's 25,000 male prisoners are 60 years and over.
Such men pose special problems, particularly at the time of release. The parole
division attempts to make use of various public and private service agencies in
meeting the needs of older individuals who are being returned to the community.
The Department points out that this effort involves all the problems
faced by any other aging persons, and urges that any future programs for the
aging should not exclude ex-convicts from eligibility. In some cases in the
past, federal programs to help disadvantaged people have not included parolees.
Material submitted by the Department describes Mens Colony West in
some detail.
The West Facility, a minimum security institution, was established in
1954 and now houses 1,400 older offenders. It employs various rehabilitative
programs in an effort to retrain them for their safe return to society. Planned
as a specialized institution for the older offender, the West Facility has estab-
lished the rehabilitative process in a physical and custodial setting apart from
the more secure and expensive restraint necessary for younger, more aggressive
offenders.
The facility probably houses the largest group of elderly and handi-
capped offenders in any one penal institution. The median age of West Facility
inmates is approximately 54 years, and this factor proves in some ways to be an
asset. Competing within their peer group, many of these men are able to produce
as effectively as many younger men. Older inmates know what is expected of them
-75-
in product and conduct, and normally they proceed in a deliberate manner to
meet the expectancy.
The educational program at the Mens Colony, both East and West
Facilities, operates with the guiding philosophy that education is a function
most effectively accomplished by professionally trained and accredited educa-
tors. All our academic instructors are fully credentialed by the State Depart-
ment of Education. We contract, utilizing funds appropriated in our state
budget for this purpose, with the San Luis Coastal Unified School District to
furnish us our teachers. The teachers are a part of the staff of the local
school district and are paid prevailing district salaries. Our academic pro-
gram is subject to all the state laws and district requirements, and diplomas
earned by students are awarded by the district and are not identified as being
received at a prison.
Academic programs are designed to provide upgrading for the inmates
to the fullest extent possible, commensurate with their interest. Training is
available for all men from illiteracy level up to the completion of high school,
with some correspondence work at the university level. Approximately 120
elementary diplomas are earned each year along with 100 high school diplomas.
Graduation Day at the Mens Colony is conducted in the same manner as in the
local high schools, with outside speakers, utilization of caps and gowns, and
attendance by the inmates' families. In addition to the regular day school
program, over 100 inmates are enrolled in night classes. During the 1969-70
school year, we expect to use 25 academic teachers, with five of these to be
assigned to the West Facility.
Vocational training is available in 12 major trades. An annual Art
Show is held at the Institution each year during the first week of August. Dur-
ing this display, inmates of both the East and West Facilities enter their work
for review and judging. These items of art and handicraft work are then sold,
with many inmates reaping a substantial monetary return as well as prizes and
awards for their efforts. In addition to the Art Show, hundreds of inmates,
through Arts and Crafts training, have become involved in painting, leather work,
ceramics, lapidary and other skills. This training enables men to make good
and healthy use of otherwise wasted time.
The West Facility hospital is geared primarily to geriatrics and
physical rehabilitation. The hospital has 231 beds for acutely and chronically
ill patients. There are six wards and an outpatient clinic staffed by four
full-time physicians including a psychiatrist. Two full-time dentists, a super-
vising nurse, an X-ray technician, a laboratory technician, a registered pharma-
cist, ten medical technical assistants and two medical secretaries complete the
medical staff. The adaptive physical education program provides motivation and
treatment so that residents may learn to live within the limits of their handi-
caps and capabilities, and directs them toward suitable occupations and social
reintegration.
Utilization of board certified consultants is a daily practice at the
Mens Colony. These carefully chosen contract consultants are specialists in
their fields which include among them that ophthalmology, otolaryngology,
urology, radiology, dermatology and orthopedic surgery. Periodic clinics are
conducted by these specialists who give treatment as needed to the problem cases
referred to them.
=76=
The California Mens Colony also offers a religious program to the
residents that is varied and diversified. An ecumenical setting is the basic
design in which the program functions. A more broad scope of religious experi-
ences is thus available to each individual according to his needs and beliefs.
Four full-time chaplains are on the institution staff, with both a Protestant
and Catholic chaplain assigned at each of the two facilities. Also, a part of
the staff, a Jewish Rabbi serves each facility one day each week.
Regularly scheduled Protestant Chapel Worship Services are held each
Sunday morning and a Vesper Service is conducted in the evening. The residents
participating are given ample opportunity to gain insights into the emotional
and psychological drama contained within the actual service of worship. With
such an experience, it is possible for individual concepts to be broadened and
expanded in a positive way.
A Music Staff is maintained, which makes it possible for appropriate
music to be available for all the worship services. This staff includes pianists,
organists, choir leaders, quartet and vocal soloists as well as choirs. The
deacons and musicians select the music for each worship service, thereby main-
taining a consistent theme.
Protestant libraries are maintained which offer to the resident a wide
selection of study, research and reading materials. Pamphlets, tracts, magazines
and newspapers are supplied from various sources and are distributed through the
Chaplain's offices.
The Protestant chaplains maintain contact with many religious groups
in the larger community. From these sources, our program is continuously up-
dated in theological, philosophical and psychological areas, thereby sustaining
a "feel" for current trends and change. With a program of this diversity and
magnitude, it is believed that each man who so desires, has an opportunity for
involvement in spiritual experiences, study and growth.
The Catholic Chapel program offers weekly religious instruction classes.
Religious correspondence courses are available from five different sources and
are augmented by individual instruction where necessary. In addition to the
regular Sunday services, the Catholic Chaplain conducts a daily Mass on each day
that he is in the institution.
A Catholic library is available at each of the facilities having in ex-
cess of 1,000 books covering the entire spectrum of religion: philosophy,
theology and ascetics. These books are available for check-out to all residents
of the institution. There are also large supplies of pamphlets and magazines on
hand for use of men seeking religious information.
Acolyte and choir rehearsals are held twice weekly, and are open to
those who wish to participate more fully in the religious services. Chapters of
two international Catholic organizations, the Apostles of Prayer and the Cordeliers,
are open to those men at the East Facility who wish to, and are capable of bene-
fiting from closer contact with the Chaplain and with other Catholics in inter-
personal group relationships. At the West Facility, similar benefits are available
for the men by joining the Holy Name Society.
A priest is available on twenty-four hour call in case of emergency.
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Correctional Industries at C.M.C. had a total revenue of $1₂ million
for the 1968-69 Fiscal Year. Consisting of a shoe factory, knitting mill,
clothing factory, a specialty printing plant and laundry at the East Facility,
and a tocacco processing plant at the West Facility, plus warehousing opera-
tions, the Mens Colony Industries operation employs over 600 inmates. The pro-
gram is administered by a staff of 30 industrial specialists.
The first factory activated at this institution was the tobacco factory
which was transferred from San Quentin State Prison. Last year's tobacco sales
were $135,400. This represents 11/4 million pouches of cigarette, pipe and chewing
tobacco.
Last year's sales of shoes were a little under one-half million dollars
and we sold over 60,000 pairs.
The Knitting mill sales last year were one-half million dollars as
over one million items were produced. Over one-half million pairs of hosiery,
almost one-half million tee shirts and 77,000 pairs of gloves were manufactured.
The laundry processed over 6,000,000 pounds of laundry, one third of
which was our East Facility laundry and the remaining two thirds, Camarillo
State Hospital laundry.
Small amounts of laundry were processed for California Polytechnic
State College and the San Luis Obispo County Sheriff's Department.
The specialty printing plant, when completely activated, should pro-
duce revenue in the vicinity of $500,000. This factory will print and process
license plate validation stickers for autos, trucks, trailers and motorcycles
in addition to Highway Patrol inspection stickers, Fire Marshal cargo tank
stickers and D.M.V. parking stickers.
The California Mens Colony strives continually to cultivate good com-
munity relations by being a part of local activities. For some time, West
Facility residents have contributed financial support to the Chris Jesperson
School, which is conducted for retarded and handicapped children in San Luis
Obispo. Residents have prepared slow-learner textbooks for the children and
have constructed a walker-trainer and other items for the disabled pupils.
In cooperation with the San Luis Obispo Fire Department, West Facility
residents have repaired approximately 550 large toys which were distributed to
underprivileged children during the past two years. Bicycles, tricycles,
wagons, scooters, tables, chairs and small toys have been renovated to a like-
new condition by the patient hands of these men.
Residents of both the East and West Facilities have conducted drives
for the Salvation Army and make periodic donations to the Tri-County Blood Bank.
This blood is not only available for our local facility hospitals, but is also
utilized for the relatives of inmates and for other carefully selected cases.
West Facility residents have a full-time "Books for the Blind" project
under way. Inmates record special textbooks and other teaching materials to be
utilized in the instruction of blind students under the direction of the State
Department of Rehabilitation. Between 25 and 30 texts are completed each month
by the inmate readers who have prepared 16,229,400 feet of tape, representing
750 texts since this worthwhile program began at the West Facility in 1965.
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4. SERVICES TO THE AGING - - INCORPORATED CITIES OF CALIFORNIA
A. In General:
The League of California Cities is working in close harmony
with the California Commission on Aging and the Institute for Local
Self Government in the stimulation and development of locally based
programs for the aging. Implementation of this policy was delegated
to the League's Human Resources Committee, whose first assignment was
to inventory existing programs and recommend methods of direct city
involvement. The Committee held two meetings with representatives
of the Commission and the Institute conducted extensive studies of
its own. It presented the following recommendation to the Board of
Directors of the League:
"By cooperating with the Commission on Aging
and with the assistance of the Institute, we will be
able to combine all of the efforts, and out of it
develop a basic direction for the Committee on Human
Resources and the League in the field of the aged."
The Committee further recommended that the League encourage a survey
to be conducted by the aging themselves to identify their own problems,
and recommend that cities throughout California convene community
meetings of the aged with public officials to survey problems of the
aging. The results of these two surveys are to be analyzed and will
serve as the basis of the sub-committee's recommendations as to
the role of cities and the League in dealing with these problems.
As further impetus the following resolution was presented to and
adopted by the general assembly of the League of Cities at its annual
conference in San Diego:
"WHEREAS, the problems of older Americans are of basic
concern to all cities in California; and
WHEREAS, the President's White House Conference on the
Aging will develop major national, state and local re-
commendations affecting programs for the aging; and
WHEREAS, cities in California will be asked by the
State Commission on the Aging to participate in the
White House program by sponsoring local community forums
to discuss the problems of the aging in our cities; now,
therefore, be it
RESOLVED, by the General Assembly of the League of
California Cities, assembled in the Annual Conference in
San Diego, October 28, 1970, that the League declares its
support of the Mayor's Forums scheduled for January through
March, 1971, as part of the State and National White House
Conferences on the Aging, to assist in identifying the
problems of our senior citizens and programs to meet their
needs."
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B. Results of City Questionnaire:
405 California cities received questionnaires,
191 responded and 35 indicated they spent some funds on aging
programs. The amount of money spent by cities for recreation
and/or facilities for senior citizens ranged from $300.00 (Arcata)
to $54,500.00 (Chula Vista). In general, the cities reporting
tend to give more emphasis to the recreational side of service
delivery, than to the physical, e.g., health care, transportation,
second careers, or income development. Following is a breakdown
of Aging Program cost estimates for the Fiscal Year 1969-70:
CITY
ESTIMATE
ACTUAL
Arcadia
1,500
1,500
Arcata
300
300
Antioch
6,000
6,000
Belmont
7,000
6,875
Chula Vista
53,000
54,000
Coalinga
5,500
5,500
Crescent City
15,000
15,000
Davis
1,500
1,500
Dinuba
2,128
2,150 (2,909 Fed.
Grant)
El Segundo
5,940
5,940
Escondido
25,000
25,000
Fairfield
6,865
11,177 (1970-71)
Glendora
1,000
1,000
Garden Grove
10,000
3,000
Lomita
500
500
Los Angeles
Large expenditure, but details
not available
Modesto
10,965
10,911
Montebello
6,466
6,466
Novato
4,000
4,000
Palo Alto
6,258
2,438
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CITY
ESTIMATE
ACTUAL
Pasadena
36,600
Palm Springs
14,500
14,783
Pleasanton
3,000
2,600
Red Bluff
600
600
San Diego
15,000
15,000
San Carlos
2,500
2,500
San Jose
1,200
1,200
Santa Barbara
41,500
South San Francisco
7,500
7,500
San Bernardino
20,000
20,000
Sebastopol
1,500
Santa Clara
1,500
Santa Maria
6,500
6,500
Tracy
5,000
5,000
Visalia
23,000
22,750
NOTE: Expenditure figures cannot be considered accurate as
most cities do not maintain exact cost accounting
of program expenditures and have no records of costs
of many services provided the aging.
C. Synopsis of Individual Programs Reported:
In addition to the questionnaire, the Institute for Local
Self Government staff visited 16 cities, interviewing public officials
and senior citizen participants. A summary of program highlights
from both the visits and questionnaires follows:
ANAHEIM: No special programs for the aging are identified as
such. Activities and services for this group are integrated
with recreation program and staff provided by department.
BURBANK: Recreation and park department staff provide facilities
and services in its regular program and works with organized
senior citizens clubs.
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EL SEGUNDO: Developed Senior Citizens Center with established
Senior Citizens Club that is administered through an executive
board of senior citizens. This executive board determines the
programs and coordinates the scheduling of their facility.
FAIRFIELD: Senior citizens program includes element for elderly
housing. The city contributes $7,000 for the Reach Out
Programs for Model Cities.
FRESNO: No special facilities provided for senior citizens.
Aging groups are encouraged to participate in regular recreation
programs with certain periods reserved for their use. One
recreation staff person acts as coordinator and works with a
private organization named Older Americans.
GLENDALE: In 1950, the city constructed a complete recreation
center with both indoor and outdoor recreation facilities,
designed specifically for senior citizens. Present membership 400.
LOS ANGELES: The city conducts an extensive program which is discussed
in "E" below.
LA MESA: Senior citizens center constructed specifically for aged
with program conducted by seniors with consultation from staff
of recreation department.
MENLO PARK: The city participates in a unique arrangement with a
private group, discussed in "E" below.
MONTEBELLO: The city has established senior citizens center with
primary use to preserve and promote the health and general
well-being of the older persons of the city. This is a public
facility dedicated to the primary use of senior citizens and is
operated by the Department of Parks and Recreation. This
department cooperates with the Montebello Citizens Affairs
Committee in the development of a total program at the facility
while in keeping with the established policies of the Montebello
City Council.
OXNARD: The city has helped organize the "50 Plus" Club with crafts,
luncheons, trips and a variety of activities conducted by
Recreation Department. The senior social center with the same
program supervised by the department. Liaison with Community
Action Commission on Aging Program.
PALO ALTO: This city's program is described in "E" below.
PORTERVILLE: A special telephone contact program for aged
is conducted by the fire department.
PASADENA: Several years ago the city constructed a building
to house special activities for senior citizens. The building
and grounds are maintained by the city for senior citizens.
The salary of the director is paid by a local women's service
group and an annual contribution of $2,100 from the Recreation
Department. The department sponsors scheduled activities of
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interest to senior citizens. Similarly, city facilities are
made available to them for meetings and other activities at
no charge. Approximately $25,000 was spent by the city's
welfare bureau in providing direct protective services and
assistance to elderly persons.
PALM SPRINGS: The City supports a paid senior citizens coordinator
36 hours a week, 9 months a year. He assists in the planning
and conduct of such activities as excursion trips, talent
shown, pot luck dinners, craft instruction and chess.
RIVERSIDE: Complete schedule of activities provided with re-
creation and park department staff working with organized
senior citizen clubs. Complete protective service consult-
ation provided by this staff as well as leisure time program.
SACRAMENTO: This program is described in "E" below.
SANTA BARBARA: Three senior centers are provided for various
independent groups with staff assigned, working with
senior citizens councils.
SAN JOSE: This program is described in "E" below.
SALINAS: This city has no special program. Aging groups are
given access to general recreation facilities.
SAN DIEGO: This program is described in "E" below.
SANTA FE SPRINGS: This program is described in "E" below.
SUTTER CREEK: City benches for aged who use lines through town.
In process of providing public restrooms for charter busses
and visiting older people on their travels through the area.
SEBASTOPOL: City provides city-owned house and pays all utility
and repair costs for Senior Activity Center operated by
non-profit corporation. Initially sponsored by city and
local ministers.
SOUTH SAN FRANCISCO: Senior Citizens Club and drop-in center
operated two days per week from 10 AM to 4 PM and two
nights per month. Employed recreation leadership is provided
to coordinate with groups on all activities. Office in
cooperation with the State Commission on Aging is provided
for five days per week from 9 AM to 1 PM to provide counseling,
referrals, etc. to all seniors in area.
D. Summary of Additional Services:
Number
Activities
49
Had special staffing for senior citizens/aging activities.
5
Education program for city employees to be aware of the
problems of aging.
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Number
Activities
38
Adapted public facilities to the needs of the aged.
16
Provide transportation services especially for aging.
8
Developed special employment programs.
10
Sponsored special health services.
5
Developed programs to assist in income maintenance.
10
Sponsored or developed nutrition education or programs.
21
Assisted in providing special housing for the aging.
8
Provided programs for assistance in their spiritual
well-being.
8
Developed programs of "second careers" to utilize
the aging in the public service or to assist in
city programs.
16
Gathered census data or other demographic information
specifically concerning the aging in your city to
provide "profile information" (number of OASI and
other recipients, financial status, income sources,
health care expenditures, etc.)
8
Developed statistical material on aging including
such things as sex, marital status, living arrange-
ments, educational attainment, labor force partici-
pation, life expectancy, percentage of senior citizens
in total population, etc.
E. Details of Selected City Programs:
1. LOS ANGELES: Under the direction of a Senior Citizens section
of the Special Services Division in the Recreation and
Park Department, a most extensive program is provided
for the aged. A professional recreation supervisor
directs the activities assisted by full-time assistants
from the department.
With a population estimated at 365,000 over age 65,
18 senior centers are in operation, each under the
direction of a full-time professional director. Both
city facilities and rental units are in use as centers
with plans under way for erection of a number of pre-
fabricated buildings to add to these facilities.
Each center has its established Senior Citizens Club with
elections of their own officers annually, all combined
in a Federation of Senior Citizens Clubs with a total
membership of 60,000. Each district schedules regular
monthly meetings and a general meeting of the Federation
is scheduled every four months.
Through experience the department has found that the
recreational programs and facilities in addition to pro-
viding desired social and leisure-time activities, also
provide the means of getting the senior citizens together
for discussion of their many other problems in the health
and welfare fields. With the cooperation and assistance
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of the professionals in the health, safety and govern-
ment programs, regularly scheduled seminars are presented
in each district by doctors, dentists, police, housing
authorities, etc.; each directed to specific programs or
interest and need to the age population.
Working with the University of Southern California, an
educational program is provided for prefessionals in the
field of aging as well as for volunteer workers. Under
the direction of a Recreation Senior Citizens Association,
courses are available to everyone with recognition given
by the awarding of "diplomas" at the completion of each
course.
Through the Federation, special group insurance programs
are offered all members in the accident and injury occurring
during traveling to and from events and while participating
in activities. Also reduced rates for seniors have been
secured from food establishments, theaters, various
amusement attractions and transit systems. Some of the
local theaters have found this program so successful they
have established special showings of feature events during
off day times, specifically for the senior groups.
Local newspapers have provided space for a weekly "What's
Doing" column prepared by department staff and publish a
full schedule of activities and program each week. Staff
consults regularly with church and fraternal organizations
to encourage participation in the program and have developed
extensive use of the facilities of churches and lodges for
activities.
While emphasis is placed in recruiting membership for the
organized clubs, no restriction is placed on activities
or services offered and non-club members are not only
welcome, but are invited to take part in any part of all
of the program. This has provided a needed service to the
many who hesitate to formally join in a club.
In addition to the extensive program of the department,
the Mayor's office has established a staff position, a
Coordinator of Senior Citizen Affairs. The activity report
for 1970-71 presented to the Mayor by this Coordinator
indicates that 13 committees, comprised of approximately
450 members, are meeting monthly with their efforts directed
to problems of consumer protection, education, health,
education, employment, housing, legislation, music and
arts, recreation and transportation. The advisory and
executive committees are made up mainly of representatives
of the Senior Citizens Clubs with commissioners and city
officials participating on the Inter-Department Committee.
Some of the activities and program of the committees include:
Pre-retirement planning, working with representatives of
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business and industry; Model Cities Program; developing
programs for Senior Citizens, such as The Friendly
Visitors, Foster Grandparents, and Hot Meals for the
Elderly; Nutritional lectures regarding healthful and
economical food planning, housing and referral service; etc.
The Master Calendar Committee meets monthly with city and
county departments, County Affairs on Aging, Senior Citizens
Association and Allied Senior Citizen Clubs, Inc., to
coordinate and avoid any overlapping of dates and
activities throughout the county. A monthly newspaper
"The Senior Citizens News" written in both English and
Spanish is distributed widely.
2. MENLO PARK: Probably one of the most successful and unique
senior citizens facilities, "Little House," celebrated
its 20th anniversary last year. Established by the
Peninsula Volunteers, a women's service organization,
in cooperation with the city of Menlo Park, the facility
and program have grown from a very modest beginning to
its present position of outstanding service to senior
citizens.
When the Peninsula Volunteers determined to enter the field
of service to the aged 20 years ago, they prevailed upon
the city of Menlo Park to make available a small building
and recreation playground area for their use. Through the
years the facilities have been expanded to its modest but
complete size, including meeting rooms, library, gift shop,
game rooms, craft rooms, offices for staff, a modern equipped
kitchen with dining room, all enclosing a patio area with
shuffleboard games and garden.
Grassed play area surround the outside, providing space for
various outdoor recreation activities with ample parking
area provided. The city provides maintenance of the grounds
with the building maintenance taken care of by the Little
House organization.
The grounds and facilities are used by Little House on a
$1.00 a year lease with the city, providing for tax exemption.
Operation costs are met through an annual benefit conducted
by the Peninsula Volunteers along with minor funds developed
through memberships and activities in the facility. The
planning and operation works under the direction of Peninsula
Volunteers, Little House members and staff working together.
A yearly change occurs on the Little House Board of Directors
composed of members of Peninsula Volunteers and each six
months they elect the Little House Council from the
membership.
Near the end of 1969 the membership totaled 1, 787 with an
interesting breakdown of 449 male and 1, 338 female, about
1/3 to 2/3 ratio. While located in the city of Menlo Park,
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the acquisition of a small bus last year, appropriately
named "Minnie the Bus", enabled them to establish a
regular transportation route through neighboring Palo Alto
and Atherton, thus making possible the participation of
those, and from them other areas.
Little House provides an almost bewildering array of
activities for its membership. Some of these are ceramics,
weaving, sewing, tin-craft, wood-work, and knitting.
Most of the activities fall into three categories, but
a fourth is emerging. Classes in a variety of subjects
are both educational and recreational. Most of the classes
are in cooperation with the Menlo-Atherton Adult School.
The second category is the workshops which are taught and
run by Little House members. These tend to produce interest-
oriented groups and these members often have parties,
birthday celebrations, field trips and other social benefits.
These workshops provide most of the handcrafted articles
for an annual Bazaar and help keep the shelves of Little
House Shop filled.
The third category involves the member-directed events such
as rummage sales, dances, tournaments, special programs and
dinners, pancake breakfasts and holiday celebrations. One
newsletter listed such variety of programs as Interior
Decorating, Spanish Conversation, History of Western Europe,
Nature Study, Driver Improvement, Lipreading and Related
Areas, Retirement Planning, Learn to Sing, Band, Braille,
Place and World Affairs, Clothing Alteration, Ceramics
for Blind, games, and numerous other special activities.
The fourth developing unit involves the Little House member-
ship in community volunteer work. The present Friendly
Visiting Committee has been most active and successful and
has added the Little House Singsters who entertain once
or twice monthly at nearby convalescent homes, as does the
Kitchen Band and T.N.T. Orchestra. It has made a special
effort to seek out older persons in the community who are
isolated and members assist with bringing groceries and
prescriptions to the ailing.
The Little House Braille Duplication group, working in two-
somes, has turned out hundreds of books for the blind.
Community Service projects not only fulfill an important
need to many, but give the members the opportunity to
take part in worthy projects, thus giving them the satis-
faction of making a contribution to others.
Planned for 1970 is a corps of five Little House members to
serve one afternoon a week each as problem solvers, complaint
takers, interpreters, "friends" and referral experts. With
a direct link to the Council and reporting to them they are
to be called "Councils Counselors". This operation seems
only to prove that much talent exists among our aging popu-
lation and is eager to contribute as they are doing here
with the proper leadership.
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3. PALO ALTO: A Senior Coordinating Council, comprised of
organized club representatives, prominent citizens and
city officials, coordinates the activities of the various
senior clubs in the city. The Recreation Department
provides a professional recreation supervisor to super-
vise and direct a variety of activities and program now
being conducted in city recreation and library buildings.
A senior Adult Library and Recreation Center, now under
construction, will provide special conference rooms for
counseling and in conjunction with various city depart-
ments, counseling and referral services will be initiated
in the fields of health, welfare, housing, employment, etc.
4. SACRAMENTO: When the city determined in 1950 to establish
a facility for Senior Citizens a very sound approach was
made to the planning. A committee composed of city
councilmen, recreation and park staff, representatives
of senior citizens groups and an architect, visited several
California cities having established facilities and noted
their advantages and deficiences. Full consideration was
given to construction to meet the needs of the elderly,
location to meet the problems of transportation and design
to meet the needs of the desired programs. The result was
a most practical facility that has proven worth the effort
by the use it has developed.
Approximately 4,000 members of various clubs are now en-
rolled in the many activities conducted every day and
evening throughout the year. The Recreation and Park
Department have two full-time supervisors directing and
coordinating the activities in cooperation with the
Senior Citizens Council elected by the membership. In
addition to this central facility, two satellite operations
are provided, one in a recreation building that was re-
modeled to provide for special areas and the other in a
housing project where the Housing Authority provides space
and contributes toward the costs of operation.
5. SAN JOSE: The constant changes in our complex society demand
that we do more thorough job of helping citizens prepare
for their retirement years and this city entered a new
concept in achieving this objective through State, City,
and College cooperation in the Senior Californian Education
Center Project which is co-sponsored by the City of San Jose
Recreation and Parks Department and the Department of
Recreation of San Jose State College with support of the
California Commission on Aging.
It is imperative that we continue to develop leaders with
knowledge and understanding of the physiological, psycho-
logical, sociological and economic needs of the elderly.
Through formal education, practical training and the pro-
vision of opportunities to acquire experience in working
with older adults, greater understanding can be disseminated
throughout the community.
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Some examples of new, unique and different programs for
the greater San Jose area are: Gold Card for seniors
offered by San Jose State College that provides free
admission to all athletic, dramatic and cultural events;
free registration for seniors for Adult Education classes
which are held in Senior housing projects and senior
centers; a directory of services and activities for the
aged available in three geographical areas, printed in
English and Spanish; a Senior Adult Newsletter distributed
to Seniors and Professionals; Senior Adult Information
mailed with monthly utility bills.
Aging as a subject for high school students and an oppor-
tunity for students to visit with seniors in the centers
as well as interact with them; planning, researching and
coordinating the efforts of Aging through a county-wide
committee established by the Social Planning Agency;
utilizing the Chamber of Commerce as a major referral
service to the senior program; utilizing Senior Aides
trained to seek out elderly in their homes, apartments, etc.
Self-help work projects for seniors in the center: They
are reimbursed for work accomplished through a contract
with a toy manufacturer for assembling plastic toys;
establishment of evening senior activity program for
those living in downtown hotels in cooperation with City
Library. Activities and services are important and
continually need to be upgraded, but one service that
cannot be emphasized enough is the coordination on an
area-wide basis.
6. SAN DIEGO: The Recreation Department sponsors 47 clubs
that meet at least once each week. These Senior Citizens
Clubs conduct all types of activities from socials, dances,
dinners, trips, etc.; to protective service programs that
involve the combined efforts of various agencies of the
city.
Public Health educators offer programs in health and
safety, seminars for senior citizens are conducted on
Social Security, education, volunteerism, legal problems,
health and welfare and even the generation gap.
Four Senior Citizens Centers are operated and facilitated
by the seniors themselves. Available are cards, roque,
shuffleboard, lawn bowling, table games and meeting rooms
for social activities. The Recreation Department conducts
city-wide programs such as talent shows, hobby and craft
shows, self-improvement courses, fashion shows, day camps,
weekend mountain retreat, picnics and rally days.
Sponsored by the Recreation Department, the Gadabout Club
conducts trips from one day sightseeing to extensive
out-of-country travel. This club has a present membership
of 3,000 and last year took groups to Alaska, Mexico, Hawaii,
New England and Europe.
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Also established by Recreation Department is an Information
and Referral Center with three more being planned for this
year. In addition, the senior citizens under the direction
of the department, staff and maintain a downtown information
booth, providing general community information.
5. PROGRAMS FOR THE AGING - COUNTIES of CALIFORNIA
Through the cooperation of the County Supervisors Association
of California, questionnaires prepared by the Institute Project
staff were mailed to Welfare Department administrators in each
county.
These questionnaires requested indication on a checklist
the services participated in by the County in the areas of need
in housing, health, job opportunities, nutrition, recreation,
transportation, education and any other services.
Also requested was descriptive material on the programs,
copies of ordinances and/or regulations by which such programs
had been implemented, annual financial participation and such
comments as could be provided as to effectiveness and recommend-
ations for future directions that should be taken in programs
designed to assist the aging.
Returns were received from 53 of the 58 counties and of
these returns, 35 indicated programs in their area.
While the annual expenditures reported are shown on the
chart it is very difficult to relate these figures as no con-
sistent method is used for keeping charges for staff specifi-
cally assigned to special programs for the aging. In a few
instances it appears the total welfare budget was reported.
Following is a summary of the comments provided followed by
a chart indicating the participation in each county in programs
for the aging in each area of need designated.
ALAMEDA: There are three organized Committees on Aging in the County.
Also, OEO is sponsoring a program for aging by serving low-income
Seniors in the South and Eastern portion of the county. Adult
Education is providing instructors for classes in various parts
of the county. Senior housing is being developed through non-
profit agencies and the Housing Authority. Jobs for Seniors
are being provided, on a limited basis, by Department of Labor
grants to Service Agencies.
CONTRA COSTA: Contra Costa is convinced that the most effective way
to implement a more adequate program for its older residents is
through a county-wide Citizens Committee on Aging which expedites
and coordinates efforts of voluntary and public agencies and groups
concerned with the needs and problems of the aging. Estimated
expenditures include costs of a Staff Coordinator for Committee
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on Aging and loan of a social worker who directs a Meals on
Wheels service in a voluntary agency.
CALAVERAS: Normal social services are available to older persons
within the county. There is some leisure time activity and
educational opportunities available on a limited basis.
DEL NORTE: Outside of the social services to the aged provided by
Welfare Department staff, the only formal programs for this
group are those sponsored by local churches and the Senior
Citizens Center.
EL DORADO: Through OEO and Title III OAA there is a multi-phase
Senior program that is reaching out to the isolated Seniors
in the smaller communities. Adult Education is providing
teachers for classes and interest to Seniors. A Council on
Aging formed with the assistance and support of various County
departments is researching the needs of older people. The
Health Department is providing nutrition instruction and ways
to attain better health to Senior groups. Housing and transpor-
tation are major problem areas.
FRESNO: The Fresno Area Commission on Aging has been dormant. A
sub-committee has been active in developing some Senior housing.
Adult Education provides instructors for classes in the various
school districts. The Council of Older Americans organization
has been active in developing leisure-time activities. The
Health Department has provided assistance in educating for
improved health standards for Seniors. The Model Cities Pro-
gram is serving Seniors within the area with nutrition, education,
leisure time activities, health services, and transportation.
Other communities are providing Information & Referral services,
education, health programs, leisure time activities, and various
other supportive services for the well-being of Senior residents.
GLENN: Very little service is needed in small county.
INYO: We had very good results in bettering housing for recipients
as long as we had Shelter Funds to use. We furnish transportation
for medical care and other special needs. Our Homemaker Service
has been instrumental in keeping many aged and ill persons in
their homes who would have otherwise had to be in institutions.
Supportive of community programs to provide leisure time activities
for Senior residents.
KERN: There are a number of leisure-time activities available to older
persons within the county. Many of these are based in the local
communities. Educational opportunities are available to older
residents. Categorical aid programs are available with Social
Services having a strong volunteer corps that is providing outreach
and visitation to older persons. There is no coordinated effort
in behalf of Seniors from any level of local government.
KINGS: There is a non-profit County Commission on Aging that is co-
ordinating Senior activities in the County. There is limited
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housing available for Seniors. In education, there are programs
under development to provide classes through Adult Education.
The Department of Social Welfare has provided staff to assist
in the involvement of individuals and groups to provide resources
to solve problems as they have been developed. After meeting
the need, the Department serves in the capacity of a consultant.
LAKE: The county is predominantly a retirement area of mobile homes
with heavy concentration of Seniors in the Lucerne-Nice area.
Senior Centers are in Middletown, Lucerne, Lakeport, and South
Shore. North Coast Opportunities, an OEO project, is stimulating
the planning of a community center grant in Clearlake Highlands
through the U. S. Housing and Urban Development.
LOS ANGELES: The entire expenditure indicated is for the Los Angeles
Department of Senior Citizens Affairs which is involved in all
areas of service. Promoted for the well-being and dignity of
older persons", this department primarily provides consultation,
advisory, information and promotion services to all agencies in
county involved in program for the aged. In addition, the
county participates in special programs through the Department of
Public Social Service which, in addition to administering the
Categorical Aid Programs, operates a Central Registry of Adult
Care Facilities, giving counseling, information and referral
service relative to out-of-home care facilities for adults and
maintains a current and accurate file on board and care homes,
sanitariums and convalescent homes for the aged. The Depart-
ment of Parks and Recreation sponsors a wide variety of programs
as well as assisting other agencies involved in senior citizens
work. County Health Department operates a health education
project for seniors.
MADERA: An incorporated Committee on Aging has been formed with the
cooperation of the Department of Social Welfare and the Recreation
Department. They have begun to evaluate the needs of the Seniors
in the area other than those on the categorical aid programs.
Leisure-time activities have been developed in several communities
and classes are provided through Adult Education.
MARIN: Through a Citizens Advisory Committee, a master plan for older
adults in the county was developed. At the present time this
program is being implemented through the Marin Senior Coordinating
Council, Inc. There has been a concentrated effort to develop
housing for Seniors that has provided adequate and safe housing
for many. Educational classes have been provided through the
college and the various Adult Education divisions. Leisure-time
activities are provided by cities and assisted by many from the
County. Most of the county departments cooperate in better
serving Seniors as there is an awareness of the talents and needs
of this segment. Transportation needs are being met with a
cooperative plan in conjunction with an OEO grant. A strong
attitude of self-help and how we can assist our County to be a
better place to live exists throughout the county.
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MARIPOSA: There are some leisure-time activities for older
adults which include educational and social opportunities.
Other social services are available through various county
agencies.
MENDOCINO: Our welfare department works very closely with the
local OEO organization to further improve the areas noted.
This approach has been rather effective.
MERCED: An Advisory Committee exists on the County level. Staff
is provided to develop various services needed by Seniors.
Leisure-time activities are being offered in most areas of
the County. Educational needs are being met through Adult
Education and the Community College. The various county
departments are assisting in meeting specific needs of the
older population. There is developing a strong awareness
of the Senior population and groups are being involved to
reach practical solutions.
MODOC: Only OEO films present in Welfare office for aged.
Distances are too great for most programs.
MONO: Categorical Aid program services are available to older
persons. Very limited social, educational, and leisure-
time activities are available.
NAPA: The Napa County Council on Aging established a Council on
Aging to plan and coordinate a county-wide program for
Seniors. Goals of the project include provision of direct
services such as health education, housing guidance, 50-plus
employment service, identification of existing resources for
assisting Seniors; stimulation of volunteer aid and new forms
of community support and development of community interest
and involvement. The Council develops leadership and
encourages self-help approaches to the problems that face
them. The Council also sponsors weekly meetings for Seniors
in Napa, St. Helena, and Calistoga to discuss such topics
as housing, nutrition, employment, income maintenance, and
education. A Senior center is located at 1606 Second Street
in Napa, a gift of the Napa City council. In St. Helena
a one-day a week program is held in a local church.
NEVADA: Social Service workers help in areas checked, however,
no other formal program sponsored by agency.
ORANGE: Although no special item is in county budget for services
to the aging, Department of Social Welfare provides a wide
range of services to meet the needs of older citizens, both
for those who receive aid as well as for those who have
sufficient income to meet their needs, but who need protective
services. (STATEMENT) "We are of the opinion that services
to the aging cannot be provided by regulations and county
ordinances. The community at large must be, first of all,
interested in such programs, see the need for them, and
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participate in them. It should be left to the individual
communities and community organizations to come up with sug-
gestions to meet community needs in this respect. The county
government and its branches cannot impose on the community,
programs that are supported by the community. At the same
time the county government will support by all means any
program that the community needs and asks for."
PLACER: A Committee on Aging is coordinating programs and resources
for older people. Various educational needs are being met
through Adult Education. Leisure-time activities are being
developed through various agencies and private groups. An
awareness of needs of Seniors is being generated throughout
the county by cooperative efforts of groups, county departments,
and State agencies.
PLUMAS: We have no specific programs exclusive to the aged, however,
they are covered in other programs including nutrition, housing,
health, and transportation.
RIVERSIDE: Our County participates in only two specialized programs
for the aged, although we act as a liaison agency in referring
senior citizens to other agencies. These are recruitment and
utilization of volunteers to assist aged and medi-bus program
used for transportation of aged to General Hospital. County
works in conjunction with Public Health, Parks and Recreation,
Rapid Transit, UCR Agricultural Extension Division, and
Housing Authority. There is a subsidized housing project for
eldlerly persons over 65 with a limited income. We believe
that efforts should be made in the area of additional sub-
sidized housing for the elderly. We are looking forward to
the possibility of a foster grandparent program which would
enable the elderly to become "foster grandparents" to less
fortunate youngsters.
SACRAMENTO: The County Departments of Welfare, Health and Recreation
provide regular program services to the aging. The County
contributes funds to the Family Services Agency and the Community
Services Planning Council which has an "Aging Project" committee
that studies resources, collects data and makes recommendations
on needed programs.
SAN BENITO: Services to the aging are provided by the County as
set forth in the Public Social Service Manual. There are no
special programs with special funds allocated to the aging
in this county.
SAN BERNARDINO: The Senior Citizens Club of San Bernardino County
is an association of 90 clubs, representing 35,000 Seniors,
as the official body to provide coordination and umbrella
services to the county's Senior citizens; to further the
general well-being of the aging and aged; inform and educate
Seniors and public; develop self-help, resourcefulness, and
initiative so that Seniors may remain a purposeful and
respected part of the general citizenry; engage in such
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civic and charitable work as may be practicable, and en-
courage Seniors to make this an important part of their
lives; exchange information and ideas among agencies and
organizations serving the Senior citizens.
SAN DIEGO: Present Committee with the widest county coverage is
C.O.M.P.S. which is chaired by Evelyn S. Herrmann, Senior
Citizens Coordinator, San Diego Parks and Recreation.
Hon. James Bear, a county supervisor, and former member of
the State Commission on Aging, is a member of the San Diego
County Commission on Aging Community Welfare Council. To
serve the heavy concentration of Seniors in San Diego's
central section, an Inter-Faith Community Center for
Older Persons has been opened under direction of a Board
of Directors whose members represent seven churches as well
as Senior resident homes, the San Diego State College Center
on Aging, the National Council of Senior Citizens, the
Community Welfare Council, and one member of the Board of
Supervisors.
SAN FRANCISCO: Through the Office of Aging, coordination of
services to the aged population is provided. The various
departments of the county are being involved in meeting
special needs of older persons. Priorities are being set
for needs-meeting programs to provide better standards of
living, better housing, more leisure-time activities, better
health, income supplementation, and transportation.
SAN JOAQUIN: No county-wide Commission on Aging exists. Various
county agencies provide services on an as-needed basis but
they are not coordinated. The Department of Social Services
has provided staff time to assist new programs get organized.
The Housing Authority has a real interest in providing housing
for the elderly. The Health Department provides educational
opportunities and makes the services available. Educational
opportunities are provided through Adult Education in classes
located in areas of convenience to Seniors. Leisure-time
activities are provided by City agencies and private organiza-
tions. One program is assisting in the development of jobs
(full and part-time) to supplement income.
SAN LUIS OBISPO: Nothing specific administered by County, but
staff work with other public and private agencies in program.
SAN MATEO: There is a Commission on Aging for the county that is
identifying needs and coordinating solutions. The Forum of
Senior Groups has organized programs for leisure and community
betterment projects. Housing needs are being met through
several non-profit corporations. The various County agencies
are aware of and meet the needs of Seniors as they develop.
Several employment projects exist to supplement income through
jobs. Transportation needs are met on a limited basis in
some areas (Little House). Health and nutrition programs
are provided throughout the County.
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SANTA BARBARA: The greatest need in our community right now is
for a "Meals on Wheels" program and we cannot implement this
program unless we have Federal funding. The Community Action
Commission of Santa Barbara County is in overall charge of
the county program. There is a county policy advisory
committee working for senior citizens and a council of social
services serving as a professional agency for Seniors. There
is a North Santa Barbara County Senior Citizens Program
office at Lompoc. To reach special minority groups, bulletins
and certain news articles are written in Spanish.
SANTA CRUZ: There is a Commission on Aging that is set up to identify
the needs of the older population and develop resources to
meet these needs. Various County departments assist in meeting
needs as they develop. Leisure-time activities are provided
by various groups throughout the County. Adult Education is
providing educational opportunities to Seniors. OEO has
provided some programs to assist the elderly - - Project Find
and Project Scout. They also provide some Friendly Visiting
for homebound and institutionalized persons. A food program
is being developed and nutritional classes are being held.
There is an employment program in existence.
SHASTA: The Shasta County Council on Aging was established through
the efforts of Seniors in the county, assisted by the staff
of the California Commission on Aging. The council was
instrumental in developing the Golden Umbrella Senior Center
in downtown Redding. The activities have increased as a
result of excellent leadership and the dedication of untold
volunteers in the community. The Council is composed of
seniors, businessmen, and other interested persons. The
group comprising the Council consists of broad citizen re-
presentation. An active senior organization in Redding is
the Senior Citizens of Shasta County, Inc., with a membership
of close to 2,000.
SONOMA: The Sonoma County Council on Aging has developed Senior
programs in Sebastopol where the city has donated a Senior
Center, also a senior center is operated in Monte Rio and
Guerneyville. The Council operates a Senior Center in
downtown Santa Rosa and has developed friendly visiting,
information and referral services, senior programs, as well
as various educational and training programs. The Council
works closely with the 30 Senior clubs in Santa Rosa and
other communities in Sonoma county, the County Department of
Social Welfare, Social Security office, City-County Library,
Catholic Social Service and Santa Rosa Junior College in
the development of pre-retirement programs.
STANISLAUS: In orienting its service programs around the needs of
clients, the County has identified a number of problem areas
to which it has assigned a cluster of social workers who
specialize in providing services to clients. Service units
are: Housing Service, In-home Care, Out-of-Home Care, and
Adult General Services. They also have a Volunteer Services
coordinator who works with community groups. Several Housing
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programs are under way. Institutional care is also provided
by non-profit corporation. There is a NESE grant for a
Project Find that is providing referral services to Seniors
and reaching out to those isolated individuals. Educational
opportunities are provided by Adult Education in leisure-time
activity center along with other informational programs,
such as health, nutrition, employment, and volunteer
opportunities.
TULARE: Social Services are provided through the various agencies
serving the older residents. There is a large variety of
leisure-time activities, educational opportunities, and
service-to-others opportunities. The local communities
are developing programs and services for their older residents.
Categorical Aid programs are available to the older residents
of the county.
TUOLUMNE: Social services are provided by the various agencies
of the County. There are limited social, recreational and
educational opportunities available.
VENTURA: Ventura County Community Council's Committee on Aging
was recently organized. Coordination of activities in the
City of Ventura is at the Senior Services Center for Senior
Citizens. Oxnard organized a Senior Citizen Council and
set up 13 working committees.
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Counties -- Services provided in fields, indicated by X
(Housing, Health, Job Opportunity, Nutrition, Recreation, Transportation, Education)
Annual
Hsng Hlth Jobs Nutr Recr Tran Educ Othr
Expenditures
Alameda
X
X
X
X
X
20,603,667
Amador
Alpine
Butte
Calaveras
Colusa
Contra Costa
X
X
X
X
X
X
X
25,000
Del Norte
X
El Dorado
X
x
2,000
Fresno
X
X
X
X
Glenn
X
X
X
Humboldt
Imperial
X
9,905
Inyo
X
X
X
X
22,056
Kern
Kings
X
X
X
X
X
X
X
Lake
X
X
X
X
Lassen
Los Angeles
X
X
x
X
X
X
X
X
289,649
Madera
X
X
Marin
X
X
X
X
X
X
X
X
128,000
Mariposa
Mendocino
X
X
X
X
1,000
Merced
X
X
X
X
X
X
18,484
Modoc
X
Mono
Monterey
X
X
X
Napa
X
X
X
X
X
X
X
X
22,061
Nevada
X
X
X
X
X
4
Orange
X
X
X
X
X
X
X
Placer
Plumas
Riverside
X
Sacramento
X
X
X
San Benito
San Bernardino
X
X
X
X
X
X
X
X
San Diego
X
X
X
18,480
San Francisco
X
X
X
X
X
X
X
X
45,406
San Joaquin
X
X
X
X
San Luis Obispo
x
X
x
X
X
16,807
San Mateo
X
X
X
X
X
X
X
X
3,308
Santa Barbara
X
X
x
X
x
X
Santa Clara
Santa Cruz
X
X
x
X
X
21,750
Shasta
X
X
X
X
X
X
Sierra
Siskiyou
Solano
Sonoma
Stanislaus
X
X
X
x
Sutter
Tehama
Trinity
Tulare
Tuolumne
Ventura
X
X
X
X
X
X
Yolo
Yuba
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6. For Perspective - A European Master Plan for Old Age
As in the United States, the problem of the aging population in
Europe is becoming more serious, receiving more public attention, and is
no longer capable of being brushed aside as in the past.
Medical advancement, avoidance of war, and general prosperity in
some countries have resulted in populations retiring earlier and living
longer. The European countries, with varying degrees of energy -- and
success -- are tackling the problems with a plethora of social programs
pension programs and housing plans to rival the scope and diversity
of those found in the United States. To combat loneliness, boredom, and
economic deprivation -- key problems of the aged -- programs of home helpers,
senior centers, recreational activities, hot meals served at home, trans-
portation and the like are being tested and implemented throughout Europe.
European officials, however, admit they are just beginning to grapple with
the problem and make progress towards a workable and realistic solution.
Despite the lack of the unifying force supplied by a central
government such as that enjoyed in the United States, a resolution on the
social and medico-social policy for old age has been adopted by the
Council of Europe for its seventeen member states. It is a unique, com-
prehensive approach to solving the problems of the aging. In view of its
close parallel to the objectives of the White House Conference on Aging 1971
to establish a national policy on aging, the Public Information release
on the Council's policy is reprinted herein in its entirety.
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INFORMATION
PRESSE ET INFORMATION
CONSEIL DE L'EUROPE
67-STRASBOURG-FRANCE
-
TELEX
87943
EMBARGO: NOT TO BE
TEL. 35.92.22.
SOCIAL NEWS
PUBLISHED BEFORE 1.6.70
B (70) 31
26.5.70
DM
A EUROPEAN SOCIAL AND MEDICO-SOCIAL POLICY FOR OLD AGE
A European social and medico-social policy for old age has been drawn up
by the Council of Europe. The full text, adopted by representatives of the
17-member States on the Council's Committee of Ministers, is attached.
The aim of the policy is to permit old people to occupy a suitable place
in the society of today and tomorrow, and to avoid their segregation. It covers
chapter by chapter, resources and income, employment, housing, medical and
social services, and scientific research into ageing. There is also a special
chapter on the protection of old people against road accidents. Governments
are urged to apply the outlined policy not only to their nationals but also to
aged foreigners residing on their territory.
*
*
*
The principles embodied in this text take into account the provisions of
the Council of Europe's Social Charter and Social Security Code, and the work of
two of the Council's groups of goverment experts: the Social Committee and the
Public Health Committee. They also draw on the work of other international
organizations like ILO and OECD.
RESOLUTION
on social and medico-social policy for old age
Considering that the aim of the Council of Europe is to achieve greater
unity between its members for the purpose of safeguarding and realising the
ideals and principles which are their common heritage and facilitating their
economic and social progress.
Having regard to the principles governing social progress embodied in the
European Social Charter and the European Code of Social Security and protocol.
Pursuant to the providions of the Programme of Work of the Council of
Europe relating to the drawing up of a social and medico-social policy for old
age.
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Having regard to the conclusions of the report submitted by the experts
appointed to prepare this study on the proposal of the Social Committee and the
European Public Health Committee.
Considering that it is desirable to define the principles of a social and
medico-social policy for old age
THE COMMITTEE OF MINISTERS
(i) Considering that owing to the two-fold effect of the fall in the
birth rate and greater longevity during the last generations, the
proportion of old people among the populations of the various
European countries has risen considerably and continues to rise.
(ii) Considering that technical progress and changing working condi-
tions make it often more difficult to keep older people employed
or provide them with work suited to their abilities.
(iii) Considering that as a result of economic and social progress and
particularly the development of an industrial civilisation, the
changes in family life and housing conditions in urban areas, old
people may tend to become isolated and to count less and less on
the practical and moral support formerly provided by their next-
of-kin under traditional civilisations.
(iv) Considering that the combined effect of these many developments
lead too often to a more or less deliberate rejection of the aged
by present-day society.
(v) Considering that the attitude of old people has changed and that
they now tend to seek greater autonomy and independence.
(vi) Considering that it is therefore imperative to define and apply
an overall old age policy aimed at permitting old people to occupy
a suitable place in the society of today and tommorow, that such
a policy must provide for the co-ordination of measures taken in
many closely interdependent fields.
RECOMMENDS
the governments of member states to take into account in formulating
their policy for old age, the following principles which should also be applied
to the aged foreigners residing on their territory, subject to a residence
qualification where applicable.
INTRODUCTION
1. The aim of an old age policy should be to ensure a better distribution of
the burden of inactive old people among the active population and lead to the
achievement of a healthy society based on an economic, psychological and social
coexistence of members of different age groups.
2. In the distribution of the national income, an adequate share should be
allocated to old people corresponding to their particular needs. Appropriate
machinery should be devised to ensure that this share is allocated according
to simple and sound criteria.
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3. Apart from the question of material support, the definition of old people's
place in society calls for the continuous education and information of the
active population, the aged themselves and public opinion as a whole on problems
connected with old age and their solutions. This is a prerequisite for a better
mutual understanding between the different generations.
4. Segregation of the elderly is generally to be deplored, and their inte-
gration within the wider community promotes a more balanced society.
5. The various measures called for by a rational old age policy are closely
interdependent and cannot be fully effective unless applied jointly.
6. The social action for old people should be harmonised so as to preclude
disparities in situations leading to economic and social imbalance which may
become greater in the future owing to growing migration facilities.
RESOURCES AND INCOME
7. Old age protection should be extended to the whole population as far as
necessary.
8. The age of entitlement to the old age pension should be determined, inter
alia, in the light of the population situation and the financial implications.
9. The old age pension rates should be as high as possible, bearing in mind
the standards laid down in international social security instruments, notably
the European Code of Social Security and protocol, the ILO Social Security
Convention (minimum standards) of 1952 and the ILO Convention of 1967 on in-
validity, old age and survivors' benefits.
10. The minimum old age pension rate secured to persons who have completed,
prior to the contingency, the qualifying period required for the entitlement
to a full pension (in the sense of paragraph 1 of Article 29 of the European
Code of Social Security) should be adequate to guarantee the beneficiary a
decent standard of living.
11. In the absence of an old age pension, as referred to in paragraph 10
above, needy old people should receive sufficient means to maintain a decent
standard of living.
12. Both pensions and subsistence allowances should be adjusted at appropriate
intervals to any variations in the cost of living or the general income trend
arising from the increase in productivity.
13. There should be adequate co-ordination between statutory pension schemes
so as to prevent changes in occupation from entailing loss of pension rights
and to eliminate impediments to occupational mobility.
14. Similarly with a view to avoiding all discrimination between old people
living in the same community it would be desirable to maintain and apply the
principle of equality of treatment of nationals of other member states with
the nationals of the state in question and to ensure the maintenance of acquired
rights or rights in course of acquisition so far as old age pensions are con-
cerned, by the ratification of international instruments concerning the social
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security of migrant workers; it being understood that the grant of non-
contributory benefits could be made subject to certain conditions.
15. Measures should also be taken to harmonise the methods of protecting old
people; both by the ratification of international instruments and by joint
steps taken within the Council of Europe framework.
EMPLOYMENT
16. In general, any policy governing the employment of the aged should be
based on the principles established by the Manpower and Social Affairs Committee
of OECD (Conclusions of 5 January 1967).
17. Measures to provide suitable employment opportunities for older people
should be considered within the framework of an overall employment policy.
18. Measures should be taken to encourage and facilitate retention by the aged
of an occupation suited to their capabilities so as to minimise the consequences
and also one cause of individual aging and to prevent the economic difficulties
due to the presence of too large a group of inactive persons.
19. To enable the fullest possible adjustment of man to his work and vice
versa, more particularly in the case of old people, measures should be taken
to encourage and support adaptation of jobs to enable older people to continue
working.
Where this adaptation is not desirable or possible it will be advisable
to encourage the transfer of older workers.
In order to ensure that such a transfer is not too radical for workers
approaching old age, the work they do during their whole working life should
be continually adjusted to physiological and psychological changes all through
life.
20. Measures should be taken to offer facilities for both education and
training:
(a) educational steps should be taken in time to enable old
people to maintain their powers of adjustment and to
keep abreast of technical developments.
(b) training should be provided so as to facilitate a change
of occupation to one more suited to the workers' preference
and changing ability.
21. In order to provide quantitatively and qualitatively suitable jobs for
older workers, efforts should be made to create jobs adapted to their needs and
to encourage the flexible distribution of the various kinds of jobs among age
groups by all appropriate means according to the circumstances of the country
concerned.
22. Retirement schemes should be so adjusted as to promote both prolongation
of active life and occupational mobility by making appropriate provisions where-
by pensions may be combined with paid employment.
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23. Steps should be taken to adapt the employment exchange services and the
methods used by them so as to facilitate the transfer and employment of old
people.
24. Measures, such as adaptation allowances and training grants, should be
taken to prevent unemployment of old people.
HOUSING
25. Steps should be taken to enable old people to remain in their own homes
as long as possible.
26. A special effort should be made to adapt accommodation occupied by old
people to meet their changing needs as well as their wishes.
27. Where it has not been proved possible for old people to remain in their
homes, if need be after adapting them, and where they are consequently obliged
to leave their homes (tied houses, ill-adapted or unadaptable accommodation,
remoteness), public authorities should endeavour to provide new accommodation
sufficiently large and especially designed for them in order to avoid their
transfer to collective establishments.
28. The new accommodation should be situated either in population centers, or
in their immediate vicinity, provided there are easy means of communication,
and where the occupants can receive appropriate social and medical services.
In addition, account should be taken of old people's desire to live near
their family.
29. Old persons should be able to select accommodation either interspersed
with ordinary family dwellings or in special blocks of flats, with the avail-
ability of communal services in either case, a high density of the elderly
population should, however, be avoided.
30. When new dwellings are built, account should be taken of the need to pre-
vent those accidents to which old people are prone.
31. Resource should be had to collective accommodation only when all the
aforementioned measures are insufficient to enable old people to remain in
their own homes.
32. Old people whose state of health is such that they require care which can-
not be given at home should be able to receive it in establishments catering
for their needs, namely:
- residential homes for those who are no longer able to care
for themselves in their own homes even with the help which
the social services can give them, but who do not need
continuous nursing care
- nursing homes for old people suffering from serious infirmi-
ties or chronic illnesses who need constant medical and
nursing care.
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33. It would be advisable to have available in each country the number of
beds corresponding to the need, bearing in mind the steps taken to enable old
people to remain at home.
34. The number of beds in an old people's home should ideally be small enough
for the establishment to keep a homelike atmosphere(1).
35. In an old people's home, each resident or couple should have a separate
bedroon with its own washbasin and, if possible, its own toilet. It is desir-
able that the couples should have two beds and one extra room.
36. Installations and fitments in all old people's homes should be designed
for easy use. Establishments with several floors should have lifts.
37. Where applicable, a doctor should be attached to each old people's home
with responsibility for the general health requirements of the establishment,
for giving residents the opportunity of regular medical examinations, and for
treating those who do not have their own doctor. The presence of this doctor
should never prevent residents from calling their own doctor if they wish.
The services of a social worker should also be available to each home.
38. To reduce difficulties encountered in the recruitment of staff for old
people's homes, establishments should also be fitted with labour-saving devices,
and the employment of part-time staff should be considered.
39. It would be desirable to organise special training for all staff for old
people's homes and organisations and to supply all categories of staff speciali-
sing in the care of the elderly with appropriate information.
40. Obsolete old people's homes should be progressively abandoned in favour
of modern homes suitable to the needs of elderly people and the premises of
adaptable existing old institutions should, where possible, be converted into
nursing homes for old people suffering from serious infirmities or chronic
illnesses, if new nursing homes cannot be provided.
41. Establishments for the aged, whether medical or not, should be supervised
by the public authorities to ensure that they comply with specified standards
and are properly run administratively and technically.
PROTECTION AGAINST ROAD ACCIDENTS
42. Special measures should be taken to protect old people in the streets.
To this end:
(1) Drivers of motor vehicles should be made aware of the special risks to
which old people are exposed in the streets and should realise the following
points:
- old people often step off the pavement without looking
(1) While 80 to 100 beds is considered the best number by some, others
consider that the number may be higher, provided that architectural
and functional provisions are adequate.
-105-
- they can often only manage to get across a road at all by walking
slowly and watching every step
- they sometimes lose their nerve in the middle of the road and turn
back without warning
- many old people have poor eyesight and are hard of hearing
- they often have a preference for dark clothes and so are
difficult to see at night
(2) Local authorities should provide special facilities for old people cross-
ing the road.
MEDICAL PROBLEMS
43. It would be desirable, on the one hand, for all future doctors to undergo
appropriate training in geriatrics and gerontology and on the other hand, for
postgraduate courses to be provided to enable doctors to supplement their
knowledge and bring it up to date.
44. Medical schools should have a Chair of Geriatrics which would make it
possible to co-ordinate the various geriatric activities within a school and
to promote research.
45. Adequate theoretical information and practical experience should be in-
cluded in the training courses for nurses, physiotherapists, occupational
therapists and social workers as well as in postgraduate geriatric training
courses.
46. Preventive care and treatment should aim at helping old people to preserve
their physical and mental powers in the greatest measure possible.
47. Industrial medicine should provide advice on regular medical examinations,
on prevention of accidents in work places, on planning employment adapted to
elderly workers, as well as on preparation for retirement. It should pay
special attention to the problems of workers over the age of 40.
48. The public should be informed regarding the advantages for elderly people
of regular medical examinations, which might be organised on a voluntary basis,
by the public authorities.
49. The public authorities and voluntary organisations concerned with the care
of the aged should give special thought to health education.
50. Priority should be given to the care of old people who continue to live at
home: such care should be given through normal home care services or specialised
schemes such as mobile services.
51. Establishments for chronic patients and special functional rehabilitation
centers should be provided for old people where possible in addition to the
geriatric departments of teaching hospitals. Services provided in other
hospitals should be co-ordinated with those provided in the teaching hospitals.
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52. Hospitals for old people in need of continuous nursing and medical care
may have more beds than residential homes; they should not however have more
than 250 beds, divided into wards of 25 to 30 beds, where the construction of
larger establishments is not required for medical reasons.
53. Such establishments must have a homely atmosphere and appropriate facili-
ties not only for treating the sick but also for rehabilitation. These latter
facilities must be available to out-patients.
54. These establishments, which are real nursing establishments must have:
(a) an adequate number of specialised medical staff
(b) an adequate number of specialised nursing staff
(c) a social service.
55. Old people suffering from minor mental disturbances need not normally be
treated in specialised establishments. Those with more serious mental dis-
orders should be admitted to smaller special establishments rather than be
placed in psychiatric hospitals.
56. The medical care facilities for the aged at local level should be co-
ordinated, as appropriate, without prejudice, to liaison with social services.
57. All necessary measures should be taken to provide for the care of the aged
to be financed either out of public funds or under the social security scheme.
SOCIAL SERVICES
58. Social service arrangements should, as a general rule, correspond with
the wishes of the elderly.
59. Special measures should be taken to provide the common social services
designed for the population as a whole with facilities enabling them to avoid
segregating the aged from the young generation.
60. When dealing with the elderly, the social services should collaborate with
as large a section of the local population as possible, in particular close
relations and neighbours.
Those services should aim at attenuating, and, if possible, eliminating,
the feeling of isolation, uselessness or dependence due to advancing age and
at creating, on the contrary, such conditions as will enable the various
generations to live together in an atmosphere of friendliness and mutual
assistance.
61. The social services should pursue, inter alia, the following objectives:
(a) old people should play an active part in the community
(b) basic services designed for the aged should be maintained at
the same level as those for other age groups
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(c) services should be available free for every elderly person apart
from a contribution from those concerned according to their means
(d) the best possible use should be made of the capabilities of the
elderly, taking into account individual circumstances
(e) close association between generations in cultural, occupational
and recreational matters.
62. In view of the need to secure for all old persons, whatever their physical
or mental condition, maximum care, as appropriate and the best conditions for
a decent way of life, the principle of nonsegregation should be applied as far
as possible, even in the case of persons unable to adapt themselves to social
conditions.
63. Special steps should be taken to see that social service staff are capable
of understanding the old persons concerned and of handling their problems and
treating their needs without any distinction necessarily being made between
different generations.
64. Social services, which vary according to whether they are applied to
able-bodied people living alone or able-bodied people living with their families,
should be classified in accordance with priorities which should take into
account the traditions, the political and social systems and the economic situ-
ation of each country. The general aim should be to reconcile, on the one hand,
the wishes of the elderly to retain their independence and the opportunity to
lead a purposeful life and, on the other hand, measures which make the best use
of the national resources.
Once basic individual needs in the matter of income, general health, treat-
ment, and care in case of illness or declining capacity have been met, the
following social services should be provided, according to the economic, social
and demographic situation of each country concerned:
(a) housing services
(b) service for the partially or totally incapacitated living alone or
with their families, supervised accommodation, meals on wheels,
transport arrangements
(c) services for the able-bodied living alone or with their families
(d) services for the able-bodied living in communal establishments
(e) comprehensive service centers for the elderly providing facilities
in the social, medical and cultural fields
Special attention should be paid to the creation of leisure-time facilities
(study groups, clubs, meeting rooms, social centers, etc.), the organisation of
holidays and the provision of libraries.
65. Aid, including possibly financial aid, should be given if need be, to the
family which continues to look after an old person.
66. In order to preserve the self-respect of elderly persons, social services
should be presented in a form acceptable to them.
108
67. Old persons should be informed as fully and as precisely as possible of
the services to which they are entitled or of which they may avail themselves.
Proper planning should enable mass communication media to be used for that
purpose.
68. Through the establishment of local advisory centers and the training of
qualified personnel, old persons should be encouraged to seek for themselves
information which is relevant to their circumstances and to make full use of
the available advice and help which should be given to them free and in an
impartial and tactful manner.
69. The information campaign designed to reach old persons, and indeed public
opinion as a whole, should draw particular attention to the need to prepare
them properly for their approaching retirement without overlooking the possi-
bility of training them to practice a hobby.
70. In countries where private relief activities play a significant part in
assistance for old people, special encouragement might be given to private
organisations which should, in a spirit of good co-operation with the public
services, be assisted financially and otherwise by the authorities who,
naturally, should continue to assume full responsibility for social assistance.
Regular two-way consultation between private and public services is
essential to ensure efficient aid to old persons, and this requires, moreover,
the support of all sectors of the population.
71. Besides the steps recommended for local co-ordination of the various
medical and social services, social policy for the elderly and, in particular,
the social services made available to them in both the public and private
sectors, should be co-ordinated nationally.
SCIENTIFIC RESEARCH
72. Research work, whose findings would throw light on the phenomenon of
premature ageing and subsequently enable it to be prevented or halted should
be undertaken in the social, medical biological, psychological, demographic
and economic fields.
Emphasis should be laid specifically:
(a) on a study of the physiological and psychophysiological
mechanisms of senescence with special reference to problems
of nutrition and mental health
(b) on a critical evaluation of routine medical examinations
(c) on fundamental research into molecular biology
(d) on ecological factors of all kinds which may affect the
processes of senescence
(e) on sociological and psychological research in connections
with ageing and old people, their interaction with younger
groups, public opinion and the attitude of society towards
ageing and towards old people
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(f) on all the economic and technical problems raised by the
employment of the elderly.
73. Research work already being undertaken in a number of different countries
must be pursued and intensified with a view to securing improvement in the
organisation of social and medical services for old persons.
74. An effort should be made to co-ordinate research work at European level
by effecting liaison between existing organisations.
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C. What can be done - Community Models
(1) In General
The White House Conference of 1971 will point the way for whatever
national action is required to solve the escalating problems of our aging
population, both present and future. State and local governments are
expected to follow this leadership, hopefully with progams and funding,
but assuredly with a new awareness of the problems of the aging, and an
increasing willingness to cooperate. Accordingly, every community should
establish the type of organizational structure that can best operate the
programs, deliver the services and meet the needs of our aging. The or-
ganization that can best perform these functions is one created at the
local level, committed to its local purposes, aware of local problems,
responsive in local needs, and aware of local resources. Such an organi-
zation is best equipped to inspire the necessary community conviction that
the cause is right and that need exists that must be served. It is also
generally the most effective in securing local government participation
and local financial support.
The purpose of this section is to discuss the forms that such local
organizations might take and to supply suggested models which may serve
as guidelines to those individuals and organizations who are willing to
commit themselves to the solution of the problem of the aging citizens of
their communities.
Many communities already have voluntary organizations committed to
serving particular geographical areas or particular items of need. Few
communities exist that do not require an expansion of the services of
existing organizations or establishment of new organization. Also needed
in most communities is an organization to coordinate the activities of the
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various programs devoted to the aging and serve as a bridge between the
private groups and local government. Such a coordinating organization can
not only keep the elected officials aware of the interests and needs of their
constituents over 65, but can also keep the service organizations informed
as to the programs and activities of government which are of special interest
to them.
The two types of organizations are discussed separately.
(2) The local coordinating organization.
Experience has shown that the most effective Community Coordinating
organization is one established by the local governing body. Such an or-
ganization can be created by ordinance or by resolution.
(a) Model Ordinance
The following is a model ordinance by which a City and/or County can
create a Commission on Aging.
ORDINANCE NO.
ESTABLISHING A COMMISSION ON AGING, PROVIDING FOR THE APPOINTMENT OF
MEMBERS THEREOF, AND DEFINING THE DUTIES OF SAID COMMISSION.
BE IT ORDAINED by the Council of the City as follows:
(THE BOARD OF SUPERVISORS OF THE COUNTY OF
DO ORDAIN AS
FOLLOWS:)
Section 1. CREATION OF A COMMISSION ON AGING.
A Commission on Aging of the City (County) of
is hereby
established. Said Commission shall consist of twenty (20) members. All
members shall be residents of the City (County) of
and shall serve
without compensation.
Section 2. MEMBERSHIP OF COMMISSION.
The members of said Commission shall be appointed by a major-
ity vote of the City Council (Board of Supervisors) and shall be representative
of the economic, cultural, ethnic and racial groups which comprise the popula-
tion of the City (County).
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Section 3. TERMS OF OFFICE OF MEMBERS.
The term of office of each member shall be four (4) years;
provided, however, that the terms of office of members first appointed shall
commence upon the date this Ordinance becomes effective, and the members so
appointed shall so classify themselves by lot that five (5) shall go out of
office on the first Monday of July,
, five (5) on the first Monday of
July,
, five (5) on the first Monday of July,
, and five (5) on the
first Monday of July,
.
Section 4. VACANCIES AND REMOVALS.
Vacancies on said Commission, from whatever cause, except
temporary vacancies as hereinafter provided, shall be filled by the Council
(Board) for the unexpired term. Any member of the Commission may be removed
from said Commission prior to the expiration of his term by a six-ninths
(6/9) vote of the Council (3/5 vote of the Board).
Section 5. TEMPORARY VACANCIES.
A member of the Commission may be granted a leave of ab-
sence by the Council (Board), and a temporary vacancy shall thereupon exist
for the period of such leave of absence.
During the period of such temporary vacancy, the Council,
(Board) may fill such vacancy by a temporary appointment to said Commission;
provided, however, that the period of such temporary appointment shall not
exceed the period of his appointed term.
Section 6. AUTOMATIC TERMINATION OF APPOINTMENT.
The appointment of any member of the Commission who has
been absent from three (3) consecutive regular or special meetings without
the approval of said Commission shall automatically terminate as hereinafter
set forth.
The Secretary of the Commission shall report the atten-
dance record of each member of said Commission to the City Clerk (Clerk of
the Board) at the end of each six (6) month's period, the first report to
be made on the first day of the month that follows the effective date of
this Ordinance by six (6) months. The appointment of any member who was
absent from three (3) consecutive regular or special meetings without the
approval of said Commission, as shown on said report, shall be terminated
on the date said report is filed with the City Clerk (Clerk of the Board).
The City Clerk (Clerk of the Board) shall notify any mem-
ber whose appointment has automatically terminated and report to the Council
(Board) that a vacancy exists on said Commission and that an appointment
should be made for the unexpired term.
Section 7. COUNCIL (BOARD) LIAISON REPRESENTATIVE.
The Council (Board) shall appoint one (1) of its members
to act as a liaison representative to the Commission. The functions of
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such liaison representative are: to attend the meetings of said Commission;
to advise the Council (Board) of the background, attitudes and reasons be-
hind decisions and recommendations of said Commission; and on request of any
member of said Commission to advise the Commission of policies, procedures
and decisions of the Council (Board) that may bear on matters under discus-
sion by the Commission. The liaison representative shall have no power
to vote and shall receive no additional compensation.
Section 8. BOARD, COMMISSION AND COMMITTEE LIAISON REPRESENTATIVES.
Subject to the approval of the Council (Board) in each
case, the Commission may designate one (1) of its members to act as a liaison
representative to any other board, commission or committee of the City (County).
The function of such liaison representatives are to attend meetings of such
other board, commission or committee; advise this Commission of the back-
ground; attitudes and reasons behind the actions of such other board, commis-
sion or committee; and on request of any member of such other board, commis-
sion or committee of policy, procedures and decisions of this commission
that may bear upon matters under discussion by such other board, commission
or committee. Such liaison representatives shall have no power to vote.
Section 9. OFFICERS, MEETINGS AND PROCEDURES.
The Commission shall elect one (1) of its members President
and one (1) of its members Vice-President, who shall hold office for one (1)
year and until their successors are elected unless their terms as a member
of the Commission expire sooner. The President and Vice-President shall be
elected at the first meeting of the Commission after July 1 of each year.
An officer or employee of the City (County) designated by
the City Manager (County Administrative Officer) shall serve as Secretary
of the Commission.
The Commission shall establish a regular time and place
of meeting and shall hold at least one (1) regular meeting each month.
Special meetings may be called by the President, or by any eleven (11) mem-
bers of the Commission, upon written notice, being delivered personally or
by mail to each member at least twenty-four (24) hours prior to such
meeting.
The Commission may make and alter rules governing its
organization and procedures which are not inconsistent with this or any
other applicable ordinance of the City.
Eleven (11) of the twenty (20) members shall constitute
a quorum and the affirmative vote of eleven (11) members is required to
take any action. The Commission shall keep an accurate record of its
proceedings and transactions and shall submit an annual report to the Coun-
cil (Board) with a copy to the City Manager. (County Administrative Officer)
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Section 10. FUNCTIONS OF COMMISSION.
The functions of the Commission shall be to:
a. Identify the needs of the aging of the community and
create a citizen awareness of these needs.
b. Encourage improved standards of services to the aging
and encourage establishment of needed new services for the aging, both
public and private, and in so doing, encourage coordination among organiza-
tions providing services to the aging in the community and provide advice
and assistance thereto; in cooperation with other agencies collect, main-
tain and interpret information and statistics on the aging for the use of
citizens and organizations in the City (County); encourage preparation of
publication and results of study and research pertaining to the aging.
c. Advise the Council (Board) on all matters affecting
the aging in the community.
d. Render advice and assistance to other City (County)
boards and commissions, to City (County) departments and to private agencies
on matters affecting the aging.
e. Perform such other functions and duties as may be
directed by the Council (Board).
In prescribing the above duties and functions of the
Commission it is not the intent of this Council (Board) to duplicate or
overlap the functions, duties, or responsibilities heretofore or hereafter
assigned to any other City (County) board or commission or to a City (County)
department. As to such functions or responsibilities above set forth which
are partially or wholly the responsibilities of another board or commission
or of a department of the City, (County), the Commission will render assis-
tance and advice to such board, commission or department as may be requested.
Section 11. (Recitation of appropriate posting and/or publishing
requirements).
Recordation of Vote
Date:
Attestation
(b) Such an organization may also be created by resolution of the
governing board. The following is a model resolution by which this may be
done.
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Resolution
Before the City Council (Board of Supervisors) of the City
of
(County of
), State of California.
Resolution Establishing a
Commission on Aging as Advisory to
this Council (Board).
WHEREAS, the Congress of the United States is enacting the
Older Americans Act of 1965 found and declared that, in keeping with the
traditional American concept of the inherent dignity of the individual in
a democratic society, the older people of our nation are entitled to the
full and free enjoyment of the opportunity to achieve an adequate income
in retirement, the best possible physical and mental health, suitable
housing, full rest or active services for those requiring institutional
care, opportunity for employment, pursuit of meaningful activity within the
widest range of civic, cultural, and recreational opportunities, freedom,
independence and the free exercise of individual initiative in planning
and managing their own lives and, efficient community services which pro-
vide assistance in achieving these goals in a coordinated manner, and
WHEREAS, the Congress of the United States further found that
it is the joint and several duty of the governments of the United States and
of the several states and their political subdivisions to assist our older
citizens to achieve these goals, and
WHEREAS, this Council (Board) is aware of the multiplicity of
pressing problems facing many of the older citizens in this City (County)
and believes that it would be to the best interests of both the City (County)
and its older citizens to establish an Advisory Commission to keep this
Council (Board) apprised of these problems and to also serve as a direct
communication line with both its older citizens and with the local organiza-
tions formed to render services thereto,
NOW, THEREFORE, BE IT RESOLVED as follows:
1. Creation. A "Senior Citizens Commission", hereinafter
referred to as the "Commission" is hereby created.
2. Number of Members. The Commission shall consist of eleven
(11) members.
3. Eligibility of Members. All of the members of the Commission
shall be residents of the City (County).
4. Terms of Office. Four of the first eleven members shall be
appointed for terms expiring at the end of June 19 , four for terms expiring
at the end of June 19_, and three for terms expiring at the end of June
19_
Each person thereafter appointed to a seat on the Commission
shall be appointed for a term expiring three (3) years from and after the
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date of expiration of the term of the former incumbent of the seat to which
he is appointed.
5. Powers, Functions, and Duties. The Commission shall have
the following powers, functions and duties:
(a) Study, review, evaluate and make recommendations to
this Council (Board) relative to any and all matters affecting elderly
people in the City of
(County of
), including
without being limited thereto, health, education, employment, housing,
transportation and recreation.
(b) Inventory the nature and extent of the unmet needs of
the elderly people in this City (County).
(c) Identify the various services made available to elderly
people in this City (County) by both governmental and nongovernmental agen-
cies, and, to the extent feasible, act as a voluntary coordinating body for
such agencies.
(d) Make such studies and submit to this Council (Board)
such reports or recommendations respecting matters affecting elderly people,
including without limitation those hereinabove provided, as the Council
(Board) may from time to time request.
PASSED AND ADOPTED this
day of
, 1970, by
the following vote:
AYES:
NOES:
ABSENT:
Chairman
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(c) Technical Advisory Committee
The city or county that establishes a commission on aging may
also wish to consider the establishment of a technical advisory committee
on aging. Such a committee could be comprised of representatives from the
various governmental agencies and departments that conduct programs or
offer services to the aging. This membership need not be limited to mem-
bers of the departments in the governmental agency forming the commission
on aging, although participation from other agencies would, of course, be
voluntary. Representatives from recreation and parks departments, public
health departments, welfare departments, department of social security,
planning departments and others, including representatives from private
agencies would offer broad expertise for the commission. The commission
should be provided with a full-time salaried executive to work with both
the commission and the technical advisory committee. The salary of such
executive and the costs of any staff work provided to the commission or
the committee, would generally be the obligation of the city or county
which establishes the commission on aging. Form job specifications for
such executive are set forth in footnote
.
3. The Voluntary Service Organization.
(a) Preliminary Considerations
Any group desiring to organize itself for the purpose of
rendering services to senior citizens may form either a voluntary organiza-
tions or a nonprofit corporation. In either event, if it is to function
effectively its purposes, functions, and procedures should be clearly
spelled out in a document that will enable the members to avoid misunder-
standings, fully comprehend the scope of their efforts, and become aware
of the limitations on such efforts. Accordingly, a constitution and
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by-laws or articles of incorporation and by-laws should be prepared. Forms
for each may be found later in this section. Prior to the determination,
however, of the form the organization should take, certain preliminary steps
should be taken to determine the functions it plans to fulfill, consider
what sponsorship it should seek, staff it will require, financial assis-
tance it can anticipate and the like. The following are suggested as
preliminary procedures that might be carried out in advance of the organiza-
tion effort itself.
(1) Pre-First Meeting
Prior to the first meeting, persons interested in forming a commit-
tee should meet to discuss the problems of the community with respect to
the aged and the procedures which could be used to form the community agency.
An open meeting to discuss the formation of a committee could then be
planned. Invitations should be sent to appropriate representatives of local
groups and agencies and notice of the meeting should be given to the public.
(2) First Meeting
In addition to having representatives from local groups and agencies
at this meeting, a representative from an existing local committee on aging
or a member of the State Commission on Aging would be valuable to insure
the success of the meeting. At that meeting the following subjects could
be discussed:
a. The purpose of the meeting.
b. How a committee on aging will benefit the community.
c. The duties and functions of such a committee.
d. Whether the committee should seek sponsorship from a
local agency or proceed to incorporate.
e. The names of other persons who would be helpful as
committee members.
f. The appointment of a constitution and bylaws committee.
(A date should be set for the committee to report).
g. The number of members.
h. The appointment of temporary officers.
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(3) Second Meeting
The following could take place at a second meeting:
a. A discussion of existing local programs designed to
meet the needs of the aging.
b. A discussion of specific projects that could be taken
under consideration.
c. The appointment of a nomination committee to select
officers.
d. A review of qualifications of committee members.
(4) Third Meeting
The following could be on the agenda for the third meeting:
a. The nomination and election of officers.
b. The selection of committee members
C. The formation of subcommittees.
(5) Fourth Meeting
Once the committee has established some degree of organization, it
should proceed to discuss the needs of the senior citizens of the community
and the action that can be taken to meet those needs. Reports should also
be received at this or later meetings from any committees previously formed.
The above outline is only an example of a possible procedure. In
the final analysis, the individual community must determine the specific
form and content of the meetings as well as the procedures for overall
committee formation and functioning.
The following are additional matters of importance for consideration
by a group contemplating the formation of a local service organization:
(1) Financing
While financing can be a problem for any committee, funds may be
raised in a number of ways: dues from members, contributions from agencies,
contributions from service clubs, united campaigns, local subscriptions,
and grants from a variety of sources (private and public, such as the State
Commission on Aging). Fund raising events and programs sponsored by the
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committee can also be sources of funds. While it is possible that some
programs can be implemented with little or no funds, financial support is
a basic ingredient to allow the committee to expand and meet the needs of
the community.
(2) Sponsorship
Wherever possible, it is recommended that the committee attempt to
gain sponsorship from an agency or organization which has strong community
relations. That agency or organization should represent the total community
and be able to effect overall community planning. In some communities
the community welfare council, the city council, the recreation department,
the county board of supervisors, the social agency, or some other branch
of government could become the sponsoring organization which backs the
committee. The importance of such sponsorship is that the committee auto-
matically benefits from the legal influence and status of the sponsoring
agency.
If there is no governmental agency to sponsor the committee, spon-
sorship should be sought from private organizations or foundations within
the community which are legally constituted and have public support.
But in either case the agency from which the committee seeks support
should be strong and influential and one which can provide the committee
the legal base and authority it will need to carry out its plans.
(3) Staff
A professional staff can do much to provide the committee with con-
tinuing effectiveness, coordination with other agencies and valuable access
to government. Financial limitations frequently make it difficult to secure a
staff on a full-time basis. On occasion, however, staff members can be
borrowed, can be hired part time, or can be made up of a volunteer "consulting
staff". The sponsoring organization may also be persuaded to provide staff.
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(4) Leadership
Persons chosen for leadership positions must be dedicated to the
program and possess proven ability and knowledge in the area of community
organization. In addition, it is helpful if such persons are well-known
and have already earned the respect and confidence of the community.
(5) Membership
Since the committee is designed to plan for a total community pro-
gram, the committee must be truly representative of the community. It should
represent citizen groups, lay and professional leaders, both public and
private agencies, and, older residents. There also should be members who
are representative of business and industry, veterans groups, labor unions,
churches, and schools. Individuals from all groups and agencies in the
community which have programs or responsibility for the aging should also
be represented.
(b) Constitution and Bylaws - The Unincorporated Association
The constitution and bylaws should be drafted to perform the
following functions: (1) establish the name of the organization; (2) state
its purposes; (3) regulate the internal practices and procedures of the
organization; (4) specify the relations, the rights and duties of members
not only with respect to themselves but also with respect to the organi-
zation; (5) define the powers, duties and limitations of the officers and
other agents of the organization.
In general, they should be as flexible as possible to allow
the organization to carry out its public purposes, but sufficiently specific
as to its internal functions to avoid any misunderstanding among the members.
The following constitution and bylaws are offered as guidelines with
the suggestion that any organization seeking to form itself into an
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unincorporated association employ the services of an attorney to draw the
final documents on its behalf:
CONSTITUTION AND BYLAWS
ARTICLE I - NAME AND MEETINGS
Section 1. The name of this organization shall be
Club.
The club membership will meet in regular session at
p.m. on (day)
of each week.
ARTICLE II - PURPOSES
Section 1. The purposes of this organization shall be to: (Here insert
appropriate purposes. See note, P.
for suggestions.)
Section 2. The purposes of this organization will be carried out through
its officers under policy guidelines established by the Board of Directors.
ARTICLE III - BOARD OF DIRECTORS
Section 1. Composition: The
Board of Directors shall be
composed of nine persons, representative members of the community who have
demonstrated interest in the elderly people and qualities of leadership in
the community.
Section 2. Term of Office: The Board shall be elected for terms of three
(3) years each, EXCEPT THAT the initial Board shall be divided into three (3)
classes by lot:
Three for one year terms ending (date)
Three for two year terms ending (date)
Three for three year terms ending (date)
Thereafter three vacancies shall occur annually on the Board.
a. Members may be reelected at the end of their service
on the Board.
Section 3. In June of each year the Board shall appoint a nominating commit-
tee to consist of three members of the
Club who are not members of
the Board. At least six weeks before the annual meeting in September, such
committee shall advise the secretary of its nominations of candidates for the
vacancies in the Board to be filled at the next annual meeting, and those
nominations shall likewise be distributed by the secretary to the full mem-
bership of the organization. Elections to the Board shall be by ballot of
the membership of the organization. A plurality of votes cast at the annual
meeting shall be required to elect. Vacancies occurring in the Board shall
be filled, until the next annual election, by vote of the remaining members
of the Board.
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Section 4. The Board shall hold at least one regular meeting each month.
Special meetings may be called by the President or upon written petition
of any two members of the Board. Five members of the Board shall constitute
a quorum for the transaction of business.
Section 5. Any member of the Board who shall absent himself from three
consecutive meetings, thereof, unless he shall present satisfactory excuse,
shall be deemed to have resigned as a member of the Board and shall cease
to be a member thereof. He may, however, be reinstated by a majority of
the Board. Vacancies shall be filled by a majority vote of the Board members.
ARTICLE IV - OFFICERS AND DUTIES
Section 1. The officers of the
Club shall be a President, a
Vice-President and a Secretary-Treasurer with duties that usually pertain to
their respective offices. The President and Vice-President shall be elected
annually by the Board from among its elected members and shall hold office
until their successors shall have been elected as specified in Article IX.
The Secretary-Treasurer shall be appointed by, hold office during the tenure
of, and subject to, the Board.
Section 2. The President, or in his absence the Vice-President, shall preside
over all meetings of the organization and the Board. In case of the absence
of both, a temporary presiding officer shall be elected from among the mem-
bers present. The President shall appoint all committee members and committee
chairmen. He shall exercise a general supervision over all affairs of the
organization.
Section 3. The President shall be a member, ex officio, of all committees,
but he shall not be counted in determining a quorum.
a. In the absence of the President, the Vice-President shall
serve in his stead.
Section 4. The secretary shall keep a complete record of all proceedings
and correspondence of the organization and Board; shall notify members of
the organization or Board of meetings; shall keep a complete and up-to-date
roll of the members, and shall perform other duties appertaining to the
office of secretary.
Section 5. The treasurer shall have responsibilities for the finances of
the
Club, will perform the duties usually assigned to this
office, and shall give bond, in an amount required by the Board; shall make
payments only for bills properly approved by the Board. All checks shall
bear the signature of the President or Vice-President and Treasurer. In
the absence or incapacity of the treasurer, his power to sign checks may
be delegated by the Board to one of its members. No debt or liability shall
be incurred in excess of the net assets of the organization. There shall
be an audit by a qualified accountant at the end of August each year.
Section 6. Contracts and formal documents shall be approved by the Board
and signed by two officers thereof, or by two of its members designated by
it.
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ARTICLE V - EXECUTIVE COMMITTEE
Section 1. There shall be an executive committee composed of the officers
of the Board. The members of the Executive Committee shall serve for the
duration of their terms as officers and shall meet as called by the President.
The President shall be chairman of the Executive Committee.
ARTICLE VI - OTHER COMMITTEES
Section 1. These shall be:
Nominating Committee: See Article III, Section 3, Paragraph 1.
Section 2. The Board may create other committees as are required for the
adequate functioning of the organization. Such committees shall function
during the term of office of the officer who appoints them, but may be re-
appointed upon review by the newly elected officers following the annual
meeting.
Section 3. All appointments of committees and committee chairmen by the
President (as specified in Article IV, Sec. 2) shall be confirmed and
approved by the majority of the Board.
ARTICLE VII - MEMBERSHIP
Section 1. A candidate for membership in the
Club must be
(60) sixty years of age or older.
ARTICLE VIII - ANNUAL MEMBERSHIP FEE
Section 1. The annual membership fee shall be $1.00 payable on a fiscal
year basis, the fiscal year of the
Club being September 1 to
August 31.
Section 2. A member joining the organization after the first day of March
in any fiscal year shall pay one-half of the membership fee for that fiscal
year.
Section 3. Fees may be reduced in part or totally, by the Board if, in its
judgment, such would create a financial hardship.
ARTICLE IX - ANNUAL MEETING
Section 1. There shall be an annual meeting of the members of the organization
held on the first Wednesday of September at which time the preceding year's
activities shall be reviewed. Election of new Board members by vote will
take place at the annual meeting. Election of Board officers shall take
place the first monthly meeting of the Board following the annual meeting.
Section 2. Twenty-five members shall constitute a quorum for the transaction
of business at the annual meeting.
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ARTICLE X - ORDER OF BUSINESS
Section 1. At the annual meetings of the
Club the follow-
ing shall be the Order of Business:
1. Report of the nominating committee
2. Report of the President
3. Report of the Treasurer
4. Voting for new Board Members
Section 2. At the meetings of the Board and the meetings of the
Club, the following shall be the Order of Business:
1. Roll Call
2. Introduction of visitors
3. Minutes of preceding meeting and action thereon
4. Report of officers and committees
5. Unfinished business
6. New business
ARTICLE XI - AMENDMENTS
Section 1. These bylaws may be amended by the affirmative vote of a majority
of members voting at the regular annual meeting of the organization, provided
notice of such amendment or amendments, and the nature thereof, shall have
been given to all members of the organization at least one month prior to
the date of the meeting at which said amendment or amendments are to be
considered.
Section 2. Members not present at such meetings may vote by letter addressed
to the secretary.
NOTE: Suggestions as to language describing purposes of an unincorporated
association organized to serve the aging (more than one can be used):
1. Promote the general well-being of senior citizens in
(name of community).
2. Cooperate with communities and organizations, both public
and private, to promote the general well-being of senior
citizens in (name of community).
3. Disseminate information pointing to the social and
economic advantages accruing to a community from a program
of interest and activities for and in behalf of senior
citizens.
4. Provide consultant services, resource material and library
facilities to communities and organizations desiring to
initiate or develop services for senior citizens.
5. Study, analyze and evaluate the adequacy and/or effective-
ness of existing or proposed services for senior citizens.
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6. Suggest, initiate and develop specific demonstration
projects in the field of Gerontology and Geriatrics.
7. Assist communities and groups with the organization
of clubs, centers and other activities for senior citizens.
8. Cooperate with educational institutions in the field of
Gerontology and Geriatrics in such activities as student
training, institutes, conferences, etc.
9. Develop job opportunities and increased placement of
senior citizens in full and part-time employment.
10. Encourage senior citizens to embrace an avocational
interest and activity.
11. Recruit and train volunteers to work in the field of
Gerontology and Geriatrics.
12. Provide individual counseling and group discussion to
senior citizens.
(c) Nonprofit Corporations
(1) In General
Any group desiring to organize to render aid and assistance to the
aging, or any existing unincorporated association, can form itself into a
nonprofit corporation.
A nonprofit corporation is in many ways similar to a business
corporation, except for the fact that it is formed for purposes other than
the realization of profit and issues no stock. More specifically, such
corporations can be formed by three or more persons for any lawful purpose
which does not contemplate the distribution of gains, profits, or dividends
to the members of the corporation and for which individuals lawfully may
associate themselves. An organization formed to meet the needs of the aged
falls within the above classification.
(2) Formation
The following are suggested steps that should be followed in the
formation of a nonprofit corporation:
1. Employ an attorney.
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2. Select a suitable corporate name, acceptable to the
Secretary of State. For the name to be acceptable, it must not be mislead-
ing or deceptive nor must it conflict with several other less important
requirements.
3. Choose the incorporators. This step is necessary be-
cause the articles of incorporation must not only include the names and
addresses of three or more persons who are to act in the capacity of first
directors but also must be signed by those persons. The above requirement
does not limit the number of persons who may be named in the articles, but
since each signature must be acknowledged, having a large number of persons
sign the document only serves to make the execution of the articles a time
consuming procedure. A slightly different procedure with respect to the
execution of the articles is authorized when an unincorporated association
is incorporated. (See California Corporations Code Section 9304 (b)).
4. Prepare the articles of incorporation. If the corpora-
tion is seeking exemption from state or federal taxes, this step would be
accompanied by appropriate procedures designed to gain those tax exemptions.
The articles of incorporation are required by law to
include the following matters: (a) name of the corporation, (b) the specific
and primary purposes for which the corporation is to be formed, (c) the
authority for organization, (d) the county wherein the principal office
for the transaction of the business of the corporation is located, (e) the
names and addresses of three or more persons who are to act as directors.
If an existing unincorporated association is being incorporated, then the
name of that association must also be included.
Other matters which are not required may also be included.
For example, if the corporation is seeking exemption from state and federal
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income and/or property taxes, the articles of incorporation may include a
clause dedicating the property of the corporation to tax exempt purposes.
Such a clause would include statements to the effect that the property of
the corporation is irrevocably dedicated to tax exempt purposes, that upon
dissolution of the corporation, such property will continue to be dedicated
to such purposes, and that none of the income or assets of the corporation
would ever inure to the benefit of any of the directors, officers, or members
of the corporation.
Matters dealing with corporate memberships, directors, and
officers might also be included in the articles, although such subjects are
covered in the bylaws.
5. Have the articles of incorporation signed, acknowledged
before a notary, and submitted to the Secretary of State for filing. If the
articles conform to law, the Secretary of State will file them in his office.
At that point the existence of the corporation begins. A copy of the articles
certified by the Secretary of State and bearing the endorsement of his office
must also be filed in the office of the county clerk in the county in which
the corporation is to have its principal office and in the county clerk's
office in each county where the corporation acquires ownership of any real
property.
(3) Management
Except as otherwise provided by the articles of incorporation or the
bylaws, the powers of a nonprofit corporation are to be exercised, its pro-
perty controlled, and its affairs conducted by a board of not less than
three directors. The directors are not personally liable for the debts,
liabilities, or obligations of the corporation, and unless otherwise specified
in the articles or bylaws, any vacancy in the board caused by death, resignation,
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or any disability is to filled by a majority of the remaining members thereof,
though less than a quorum. Unless otherwise provided in the articles or by-
laws, meetings of directors are to be called and held as may be ordered by
the directors.
The number, qualifications, terms of office, powers, duties and com-
pensation of and methods of selection for directors are generally provided
for in the bylaws.
(4) Powers
The powers of the corporation are to be exercised by the board. The
law provides a nonprofit corporation with a wide range of powers, including
the powers to: (1) sue and be sued; (2) make contracts; (3) receive property
by devise or bequest, and otherwise acquire and hold all property, real or
personal, including shares of stock bonds, and securities of other corpora-
tions; (4) act as a trustee under any trust incidental to the principal
objects of the corporation, and receive, hold, administer and expend funds
and property subject to such trust; (5) convey, exchange, lease, mortgage,
encumber, transfer upon trust, or otherwise dispose of all property, real or
personal; (6) borrow money, contract debts, and issue bonds, notes and de-
bentures, and secure the payment or performance of its obligations; and
(7) do all other acts necessary or expedient for the administration of the
affairs and attainment of the purposes of the corporation.
(5) Membership
The powers, rights and duties of the members of a nonprofit corpora-
tion are usually specified in the bylaws, although the law prohibits any
member from holding more than one membership. Furthermore, unless the
articles or bylaws set forth rules for fixing the respective voting, property
and other rights and interests of each member or class of members, the rights
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and interests of the members are to be considered equal. Memberships or
any right arising therefrom are generally not transferable unless the
articles or bylaws provide otherwise.
(6) Sample Articles of Incorporation for a Nonprofit Corporation
ARTICLES OF INCORPORATION
OF
I
The name of this corporation is
.
II
The purposes for which this corporation is formed are: (a) The
specific and primary purposes are (see note on p.
for possible choices);
(b) The general purposes and powers are to have and exercise all rights and
powers conferred on nonprofit corporations under the laws of California, in-
cluding the power to contract, rent, buy or sell personal or real property;
provided, however, that this corporation shall not, except to an insubstantial
degree, engage in any activities or exercise any powers that are not in fur-
therance of the primary purposes of this corporation.
III
This corporation is organized pursuant to the General Nonprofit
Corporation Law of the State of California.
IV
The county in this state where the principal office for the transac-
tion of the business of this corporation is
County.
V
a) The number of Directors of this corporation shall be
(not
less than 3).
b) The names and addresses of the persons who are to act in the
capacity of directors until the selection of their successors are:
Name
Address
John Doe
(Street, City and State)
Richard Roe
(Street, City and State)
Sarah Moe
(Street, City and State)
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VI
a) The authorized number and qualifications of members of the cor-
poration, the different classes of membership, if any, the property, voting
and other rights and privileges of members, and their liability to dues and
assessments and the method of collection thereof, shall be as set forth in
the bylaws.
b) Members of this corporation are not personally liable for the
debts, liabilities, or obligations of this corporation.
VII
a) The property of this corporation is irrevocably dedicated to
charitable purposes and no part of the net income or assets of this organiza-
tion shall ever inure to the benefit of any director, officer, or member
thereof or to the benefit of any private persons.
b) Upon the dissolution or winding up of the corporation its assets,
remaining after payment, or provision for payment, of all debts and lia-
abilities of this corporation, shall be distributed to a nonprofit fund,
foundation or coporation which is organized and operated exclusively for
charitable purposes and which has established its tax exempt status under
Section 501 (c) (3) of the Internal Revenue Code.
c) If this corporation holds any assets in trust, or the corpora-
tion is formed for charitable purposes, such assets shall be disposed of in
such manner as may be directed by decree of the superior court of the county
in which the corporation has its principal office, upon petition therefor
by the Attorney General or by any persons concerned in the liquidation, in
a proceeding to which the Attorney General is a party.
VIII
These articles may, except as hereinafter provided and except as
otherwise provided by law imposing more stringent requirements, be amended
as follows:
a) Before any members, other than the incorporators, have been ad-
mitted to the corporation, by a writing signed by two-thirds of the
incorporators.
b) After members, other than the incorporators, have been admitted
to the corporation, by resolution of the Board of Directors and two-thirds
or more of a quorum of the members given either before or after the adoption
of the resolution by the Board, provided, however, that if the voting power
shall be unequal, any amendment shall be approved by the vote or written
consent of members holding not less than a majority of the voting power.
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IN WITNESS WHEREOF, the undersigned, being the persons hereinabove
named as the first directors, have executed these Articles of Incorporation,
this
day of
, 19 .
John Doe, Incorporator
Richard Roe, Incorporator
Sarah Moe, Incorporator
STATE OF CALIFORNIA
COUNTY OF
On this day
day of
, 19 , before me,
,
a Notary Public for the State of California, personally appeared JOHN DOE,
RICHARD ROE AND SARAH MOE, known to me to be the persons whose names are
subscribed to the within Articles of Incorporation, and acknowledged to me
that they executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my
official seal on the day and year first above written.
Notary Public
(Notarial Seal)
(Note: This form is presented as an illustration of the type of form which
may be used in this state. However, for a particular organization, not
only should the articles be drafted by the attorney for the incorporators
but they should also be prepared so as to fit the specific purposes and
needs of the organization.)
(7) Bylaws
As in the case of the unincorporated association, the bylaws for a
nonprofit corporation perform the functions of regulating the internal affairs
of the corporation; of defining the relations, rights and duties of the mem-
bers; and of specifying the powers, duties and limitations of the directors,
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officers, or other agents of the corporation. Among others, the bylaws may
be concerned with the following matters:
(1) The authorized number and qualifications of members.
(2) The different classes of membership, if any.
(3) The property, voting and other rights and privileges
of members.
(4) The liability of the membership to dues or assessments
and the method of collection thereof.
(5) Procedure for the adoption, amendment, or repeal of the
bylaws.
(6) The time, place, and manner of calling, giving notice of,
and conducting regular and special meetings of members or
directors. (Note: the bylaws may dispense with notice of
all regular members' and directors' meetings.)
(7) The requirement of a quorum of directors or members.
(Note: this may be greater or less than a majority.)
(8) The number, time and manner of choosing or removing,
qualifications, terms of office, official designations,
powers, duties, and compensation of the directors and
other officers.
(9) The appointment and authority of executive or other
committees of the board.
(10) The admission, election, appointment, withdrawal, suspension,
and expulsion of members.
(11) The transfer, forfeiture, and termination of memberships.
(12) The manner of voting by members and whether cumulative
voting and proxy voting will be allowed.
(13) The making of annual reports and financial statements
to the members.
(14) The filling of vacancies in the membership and on the board
of directors.
(15) The principal business office of the corporation and the
right of the directors to change the location of the office.
(16) The exemption of the membership from liability for corpora-
tion debts, liabilities and obligations.
(17) The approval of board action taken without a meeting. (Note:
all members of the board must consent in writing to such action.)
(Note: Since some of the above items are pursuant to specific statu-
tory requirements the advice of an attorney is essential to insure that the
bylaws comply with all legal requirements.)
(8) Other Applicable Laws
a) Federal income tax exemption provisions are contained in the
Internal Revenue Code Sections 501 (c) (3) and (4).
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b) California Government Code Sections 12580-12596 relating to
the supervision of trustees for charitable purposes provides that the
state Attorney General be supplied annually with certain information to
enable him to determine whether an organization subject to the law is
being property administered. This applies to nonprofit corporations or-
ganized for charitable purposes and has been interpreted to include non-
charitable nonprofit corporations whose articles provide that their assets
upon dissolution will continue to be devoted to charitable purposes.
c) County and Municipal ordinances frequently regulate charitable
solicitations and should be checked before any fund-raising efforts are
undertaken.
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D. Working for a Prosthetic Environment
(1) Definition
By technical definition "prosthetic" means "of prothesis" - in
medicine - the replacement of a missing part of a body, such as a limb, a
tooth, or an eye. In other words, prosthetic is a substitute. When one
thinks of prosthetic devices one normally contemplates the artificial arm,
leg or hand, although they do include crutches, wheelchairs and strollers.
The current mounting concern over establishing a "prosthetic
environment" has concentrated primarily on the design and construction of
public and private facilities to take into consideration the physical handi-
caps of persons equipped with or compelled to rely upon prosthetic devices.
While this concern for a prosthetic environment relates to all
persons so afflicted or physically burdened, it is deemed appropriately in-
cluded in this report since so many of such persons are in our over-65
category.
(2) The problem
To the 90% of our citizens who are non-handicapped, such matters as
a flight of stairs, a curb, the use of a public restroom, public telephone,
a revolving door, drinking fountain, or even getting on or off a bus or
airplane are so routine as to go almost unnoticed in one's daily activities.
To the active person who seeks to enjoy his life to the fullest extent -
from a wheelchair, for example - such items form insurmountable barriers.
Not only are they physical barriers, but they also constitute barriers to
his enjoyment of the many economic and social opportunities of his community.
While it has been estimated that 10% of today's population is handicapped,
projections indicate that this percentage will increase in future years.
Every year 100,000 babies are born with the kind of defects that will force
them to use crutches, braces, or wheelchairs most of their lives. In
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addition, hundreds of thousands are crippled in traffic accidents, by combat
injuries and by the normal disabilities of advancing age. Accordingly, a
program established now to create a barrier-free environment for the handi-
capped will benefit not only today's handicapped but will make life more
meaningful and more normal for many future generations of handicapped.
(3) Progress
Although much must be done, progress has been made in the last dozen
years. In 1958 the President's Committee on Employment of the Handicapped
and the National Easter Seal Society for Crippled Children and Adults co-
sponsored a project to eliminate barriers to the handicapped in public build-
ings and facilities. Early in his administration, Governor Ronald Reagan of
California propelled the nation's largest state into the forefront of states
who were doing something constructive about the problem. On June 6, 1968 he
signed legislation adding Sections 4450, 4451, 4452 and 4453 to the
Government Code of the State of California. This legislation required that
buildings and facilities constructed in the state by the use of state, county
or municipal funds or the funds of any political subdivision of the state
comply with the provisions of the America Standards Association specifications
to make buildings accessible to and useable by the physically handicapped.
By its language the standards were made applicable to all facilities under
construction and those thereafter constructed. In 1969 Governor Reagan
signed legislation extending similar requirements to all structures built for
"public accommodation purposes" with private funds. (Health and Safety Code
Section 19955 et seq.) In August of 1970, the Governor signed legislation to
enhance the enforcement of these prior provisions, and in September of 1970
signed further legislation broadening the applicability of such regulations
through amendments to the Uniform Housing Code, Building Code, Plumbing Code,
and Electrical Codes to additional facilities.
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In August of 1968, President Johnson signed the Public Law 90-480
which required that all federal structures, as well as those financially
assisted with federal funds, be made accessible to the handicapped. The law
also stipulated that when public structures undergo extensive alterations,
elimination of barriers to the handicapped shall be included as part of the
contract. Since that time over 44 states have followed the California and
national pattern by establishing similar legal requirements on state-owned
buildings.
In 1967, the National League of Cities made a study of comparative
costs of public buildings with and without design factors necessary to
eliminate structural barriers to the handicapped. The study revealed that
the cost of constructing a barrier free city hall, civic center or hotel
would only be 1/10th of one (1) per cent more than conventionally designed
structures. Cost studies of seven additional building types indicated that
costs for these would be increased by less than one-half (1/2) of one (1%) per
cent to accomplish barrier-free design.
At the request of the National Commission on Architectural Barriers
to Rehabilitation of the Handicapped, the League also surveyed counties and
cities as to the activities in this field. It found (in 1967) that:
(a) The elderly and handicapped people have found very little im-
provement in most cities and metropolitan counties where the problem of
accessibility is most acute.
(b) Of the 95 cities with population of 50,000 or more that reported
some type of program, 39 had failed to take any official action. In 284 cities
of this size, there was no program at all. Similarly, while 42 metropolitan
counties reported a program, 230 of the nation's most populous counties
indicated that they had no program.
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(c) Only nine (9) cities and five (5) counties had adopted or
amended Building Codes or Ordinances to take account of the standard specifi-
cations for eliminating architectural barriers. A study of state activity by
the League showed similar lack of action by the states.
The situation, however, is improving rapidly. While detailed
statistics as to the number of cities and counties and states which have
moved aggressively forward, it is known that much activity has been taken in
this area. The Federal Government also has done much.
Under mandate from Congress, the National Commission on Architectural
Barriers completed and published in 1968, a report on barrier-free public
buildings. The United States Department of Housing and Urban Development and
the United States Department of Transportation have developed comprehensive
information and recommendations on the housing and transportation aspects of
the problem. The United States Department of the Interior has issued a
report on "Outdoor Recreation Planning for the Handicapped". The United States
Department of Health, Education and Welfare and the President's Committee on
Employment of the Handicapped have financed studies of specific barriers and
have widely disseminated key information on developments.
(4) New Directions.
Californians aware of the problem and interested in the progress
that is being made, can see many tangible results of these efforts. Through-
out our state, we have new ramps constructed to parallel staircases, asphalt
ramped curves in most cities, special parking stalls wide enough to accommodate
the wheelchair-bound driver, special stalls in public telephone booths and
public restrooms.
Much of this is a voluntary response to a recognized need. Much of
this is prompted by aggressive public information programs sponsored by the
State Department of Rehabilitation. Much more, however, can be attributed
to the impetus of State legislation.
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The real success that is and may be accomplished in this field, how-
ever, rests on the shoulders of local goverment. Local government constructs,
operates, controls and maintains a majority of public streets, thoroughfares
and public buildings. Local government adopts and enforces the various
Building Codes, issues building permits and inspects for compliance. Local
government approves subdivision design, special housing projects, community
planning and development. It is in these areas where the greaters progress
is needed and can be accomplished. Are the limitations of the physically
handicapped and particularly the handicapped aged taken into consideration
when these functions are performed? For example: is public transportation
adequate? Are there adequate provisions for personal security of the aging
in the areas of the local community most frequently utilized by them? Are
the physical distances between the places of residence and places of work
and recreation reasonable or unduly extended? Are parks and subdivisions
designed to facilitate social interaction and minimize walking distances
between the areas? Are directional signs adequate and easily readable? These
are but some of the added factors that should be considered by those currently
employed in designing and supervising community development.
(5) Conclusion and Recommendations.
Much progress has been made in the last decade, but much more
needs to be done. The Federal, State and local governments each have op-
portunities and obligations to adopt and enforce building standards on public
buildings that eliminate physical barriers for the handicapped. Such require-
ments may also be imposed upon existing public buildings undergoing sub-
stantial remodeling. Similar regulations can also be logically imposed upon
some privately constructed facilities. The real enforcement arm, however,
is with local government. Not only does local government approve building
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plans, issue building permits and inspect building construction for con-
formity, it also has effective means to control the design of subdivisions
parks and recreational areas, streets, highways, and to some extent, public
transportation facilities. And local governments' role in establishing a
prosthetic environment can be greatly enhanced if it but takes the following
modest steps:
(a) Assign to its Commission on Aging the responsibility of evaluat-
ing the need and recommending a course of action. Its technical advisory
committee discussed in Section C.2. (c) could be extremely helpful in this
area.
(b) Adopt the recommended amendments to the Uniform Buildings Codes
to require barrier-free design in private construction.
(c) Establish and conduct special orientation programs for members
of the local planning staff and building inspection staff to create an aware-
ness of the problems and the avenues of solution.
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E. SECOND CAREERS
1. In General
Whatever the reasons--and there are many--more persons over 65 are
today seeking employment than at any previous time in our history.
Inflation, of course, is the prime cause. The purchasing power of
retirement income has so seriously dwindled that many older workers must
either seek employment to supplement their income or face drastically altered
life patterns. The California results of the community forum questionnaire
(discussed in A. above) provides convincing evidence of this situation. While
approximately 1.7 percent of the persons over 65 (and 7.4 percent of those over
55) are working full time, over 3 percent (9.4 percent over 55) would like to
be; while approximately 8 percent of those over 65 (10.4 percent over 55) are
working part time, a substantially larger number (26.2 percent over 55 and
12 percent over 65), would like to work part time. An answer to another
question gives further verification of these conclusions. In response to the
question "do you always have enough to make ends meet", over 30 percent
responded "no"!
Another reason for this increasing desire for employment is the
changing characteristics of the "new" over-65 class, Generally, they are
healthier, better educated, and have a greater life expectancy than their
counterparts of only a dozen years ago. Many still want, and need, the chal-
lenge of work, the satisfaction of accomplishment, a reason for being.
Desiring employment, however, and getting it, are two different mat-
ters for the over-65 citizen. Steadily mounting unemployment across the nation
increases the intensity of competition for all jobs. Thousands of returning
veterans are entering the job market for the first time. While the Federal
Government is currently investing about two billion dollars a year in various
types of training and retraining programs, the older workers are receiving a
disproportionately small amount of these benefits. Furthermore, industry and
government alike have pension programs that discourage the employment of those
over 65 and in many cases, prohibit the employment of those over 70.
In the paragraphs that follow are selected illustrations of what has
been done, and what might be done, to provide job opportunities to the over-65
senior who wants to, or must, continue to work and earn.
2. The Senior Service Corporation
Seniors with marketable talents are forming themselves into profit
or nonprofit corporations and associations to facilitate their employment.
This is done by drawing upon a combination of volunteer, part-time, and full-
time workers over 65. Such organizations can obtain optimum competitive
advantage in the fees they charge for their services. In Marin County,
California, for example, the Senior Coordinating Council, a tax exempt non-
profit self-help charitable corporation, has taken over the operation of the
Greyhound Bus Depot in San Anselmo. When the Council learned that Greyhound
intended to close the depot due to high overhead and salary costs, it offered
to take over the entire operation through the use of "senior power". Greyhound
agreed and the entire operation is now continuing at less cost, with all
services being provided by over-65 workers.
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Another outstanding example of this approach is the work of Experience
Incorporated in Riverside County, California. Experience Incorporated is a
nonprofit corporation formed to provide research, consulting and advisory
services to the Hemet-San Jacinto Valley-Sun City communities of California
through the use of senior citizens, experienced and talented in various spe-
cialized fields of work. The corporation was organized in 1968 through the
efforts of business leaders, city and county officials and industrialists, who
were determined to do something about the great reservoir of retired talent
that was going to waste in Riverside County. This waste was represented by
the many retired persons of the area who possessed high professional levels
of industrial and commercial skills, but who were then idle insofar as employ-
ing these skills was concerned.
The plan was to match the skills of the seniors interested in work-
ing with the needs of businesses, industries, and all of the government entities
in the county. It was to be a two-way approach to assist those seniors who
wished to remain active, as well as those businesses and government organiza-
tion that too often had searched far afield for talent that was available
among retired seniors in the community.
At the present time, Experience Incorporated has a contract with the
County of Riverside to develop a master plan for airports. It has recently
completed phase one of a large real estate development in which its services
included the preparation of preliminary engineering data and the obtaining of
necessary zoning changes. Public relations and advertising material is being
prepared for the local Chamber of Commerce. Contracts have been negotiated for
a complete study of the County and State fire services. Some of the ladies are
employed to participate in the contract by which Experience Incorporated pro-
vides bulk mailing services for the county. An economic survey of the Hemet-
San Jacinto Valley has been completed and several other sizable ventures are
in the making.
The initial success of Experience Incorporated has led to an expansion
of its objectives into other related fields. In addition to consulting and
research services, it is now involved in the placement of seniors in part-time
or occasional jobs on a referral basis in which no fee is accepted from either
the employer or the employee. As a result of this expanded activity, seniors
have been placed in such varied assignments as purchasing agent, bookkeeper,
chemical engineer, athletic commissioner, sales representative, transportation
supervisor, travel agent, machinist and mill operator, typist, automobile
service instructor, teacher, draftsman, script reader and many others.
Experience Incorporated also found that many retirees had rendered
impressive services in the field of civic and cultural activities. As a
result, the corporation takes an interest in community affairs and encourages
its membership to participate, although on a strictly voluntary basis. Thus,
Experience Incorporated is involved in three separate phases of senior citizen
activities. First, contracting with business and government to render services
in the area of research and consultation; secondly, acting as a clearinghouse
for the placement of individual seniors in part-time or occasional jobs, and
thirdly, adding its support and the support of its members to voluntary civic
or cultural projects.
Experience Incorporated offers positive proof that senior citizens can, with
proper organization, get back into the "mainstream". Following a one-day
seminar recently sponsored by Experience Incorporated with the theme "Adding
More Life to Years", John B. Martin, U.S. Commissioner on Aging, sent a tele-
gram to the organization which read in part "I should like to see seminars
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like yours and organizations like yours repeated in communities throughout
the nation. America is wasting its finest resources by denying to so many
older Americans the opportunity to serve. It may be that this wastage will
not end until senior citizens everywhere organize as you have done to make
your skills and your experience available to your community".
3. Government Service
(a) Full time. The senior seeking placement in a new hire" full-
time civil service job in government faces the same barriers found in private
corporate employment. Generally, the over-70 worker is barred by the terms
of the applicable pension plan that requires retirement at 70, if not earlier.
The under compulsory retirement age applicant faces the bias--and the now
proven unfounded bias--of the selecting authority that the younger applicant
offers the employer more years of service and is thus preferred. Recent
studies indicate that the potential longevity of the younger employee is
seldom realized and that the older worker actually works more years for the
employing agency than does the younger applicant.
There are, of course, in every governmental agency a select few
"exempt" positions that are subject to no age or talent requirements and which
are filled by appointment of the reigning political authority. These positions,
however, are so limited in number as to have no measurable effect on employ-
ment of the aging even though seniors are by no means barred from such
appointments.
(b) Part time. The public employees retirement system in California
which covers 441, employees of the State of California and 2,610 other
employing public agencies that contract with the system, currently provides for
a mandatory retirement at the age of 70. However, it offers the applicant for
part-time work an intriguing exception to the grim situation applicable of
seekers of full-time employment. Excluded from the mandatory participation
in the retirement system--and thus from the mandatory retirement provisions--
are part-time employees who either work less than half-time, or work part time
but more than half-time for less than one year. This exclusion opens a
tremendous field for qualified seniors who wish to work. It also opens to
government the available resources of senior talent in many fields. Government,
like industry, experiences seasonal work loads which can and in some cases are,
handled by qualified seniors. Examples of seasonal work loads include, at the
State level, the Department of Motor Vehicles, Department of Agriculture,
Franchise Tax Board, and at the local level the County Tax Collector and City
and County Recreation Departments. Furthermore, a potential area of part-time
employment by seniors may develop as the government becomes more heavily in-
volved in the sponsoring of day care centers for children. The success of the
use of mature experienced part-time help in the care of children is demonstra-
ted in the "latch key program" discussed in Section 4. below.
The extent to which seniors will be provided part-time job opportuni-
ties in government is limited only by the commitment of the governing bodies
of the various public agencies to this concept. Accordingly, it becomes in-
cumbent upon the local commissions on aging in each community to conceive a
realistic program in which seniors can be employed part time and "sell" such
program to their governing body.
(c) Government Services by Contract
The success of Experience Incorporated discussed above also opens
many potentials for incorporated groups of seniors to contract with local and
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state government for the purpose of providing limited governmental services
outside of normal Civil Service requirement. Until recently Article XXIV of
the California Constitution strictly limited the authority of State and local
governments to contract governmental or quasi governmental services out to
private agencies. A recent decision, however, in the case of California State
Employees Association vs. Spencer Williams, (7 CA 3rd, 390), has somewhat
relaxed the former rule, the Court holding that "a new state function not
previously conducted by any state agency and performed by contract under
legislative direction and authority" may be contracted out without violating
the Constitutional provision. Accordingly, if in the future the state or any
local governmental agency embarks upon some new function, the governing body
could authorize its performance by contract with private or public individuals
or corporations. Here again, it would be encumbent upon the Commission on
Aging at either the state or local level to be alert to any proposed new
governmental functions and be prepared, where appropriate, to encourage the
governing body to provide for the performance of such function by contract
with an organization composed of seniors.
(d) Special Government Projects
A number of special research and development projects in programs
for the aging have been sponsored by the Federal Government, by state govern-
ment, and by local governments. As the success of these programs become estab-
lished, consideration may be given to their adoption as a permanent program of
governmental service. The following are several examples of experimental pro-
grams which may have sufficient merit to warrant their continuation on a
permanent basis.
(1) The "Adult Aid" program of Orange County.
Orange County has established a procedure to facilitate the rendering
of in-home services to the aging. A Welfare supervisor is assigned the duty
on a weekly basis to match-up needs for services with persons able to serve.
The County reports "we actually help hundreds of elderly persons in Orange
County each month from being institutionalized by finding someone to provide
the services they need to enable them to stay in their own homes such as help
with meal preparation, heavy house cleaning, yard work and even personal care
such as help with baths, taking medicine, etc.". The County indicated two
examples of how the program worked. In one example, a social worker reported
to the supervisor the need of an elderly man for some household help so that
he could stay in his home rather than be institutionalized. At the same time,
an intake worker in the Welfare Department reported to the supervisor that an
older able-bodied widow, skilled as a housewife, had applied for Welfare
assistance because she could not obtain employment due to lack of marketable
skills. The supervisor arranged the assignment of the widow to a job as house-
keeper for the elderly man. In this way, his institutionalization was avoided
and her employment avoided the necessity of her receiving Welfare aid. The
second example also concerned the referral of an applicant for Welfare aid to
serve as attendant to an older man not receiving aid. The woman was hired as
an attendant and later married the man. In the optimistic words of Orange
County "there will be no need for her to ever apply for public assistance".
(2) Love to Share.
A federally sponsored program in the State of Arkansas called "Love
to Share" has great potential as a continuing government project. The program
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matches older people who need part-time employment with youngsters who need
love and supervision. It is specifically directed at "latch key children":
those youngsters whose parents are not at home during after school afternoon
hours due to employment. The seniors, most of whom are between 63 and 65,
staff the centers where the children are supervised. The centers are equipped
with study rooms and kitchen facilities and offer games, music and other
activities for the children. The seniors are first required to complete a
three-week orientation program. Thereafter, they are employed at the rate of
$1.60 per hour, partly contributed by the Federal Government and partly by the
United Fund of the community. A survey of the community in question showed
that there were 70,000 persons over the age of 55 living on incomes of less
than $1,500.00 a year. It also indicated that there were 1,500 children in
the community who did not have a parent at home after they were let out of
school, and that many of these children were developing severe disciplinary
problems. The project thus serves two worthwhile ends. It provides love and
attention for these children during the afternoon hours and it provides part-
time employment opportunity for the older citizens of the community.
(3) Green Thumb and Green Light
Green Thumb is a work program for older men sponsored by the National
Farmers Union. It operates under a grant from the Department of Labor as a
part of its "Mainstream" program.
To be eligible for participation in the program, a person must:
(1) be at least 55 years old, (2) have a farming or rural background, and
(3) be below the poverty income level. The average annual income for parti-
cipants is $900 but the program permits them to earn up to $1,500 per year.
Workers under this program have improved or built more than 350 roadside parks
in rural America; planted more than one million trees, flowers and shrubbery;
and helped to restore and develop many historic sites.
Now operating in 17 states, the most obvious fact about Green Thumb
is the quality and quantity of work that is performed. Green Thumbers put
something special into their work and the cooperating agencies notice it im-
mediately. That "something special" is pride. Workers who had come to believe
that life was over for them join a Green Thumb crew and discover long-forgotten
or new talents in themselves. One of the most heartening results of the pro-
ject is that doctors report that the health of the workers usually improves
after working for Green Thumb.
Local communities appreciate their work because they see the results
as parks are improved, trails constructed for the benefit of visitors and
vacationers and roadsides cleared for beauty and safety. The total jobs they
accomplish are too numerous to mention.
The Green Light program was established to provide employment oppor-
tunities primarily for low income women 55 or older, operated as a component
of the Green Thumb program. Workers can earn up to $1,500 annually by working
three days a week like the Green Thumb participants at a salary scale of $1.60
per hour. Workers provide community services as aides for teachers, nurses,
librarians, senior citizens, school lunch programs and food stamp programs.
These programs provide employment opportunities for more than 3,000
low-income people in rural America and have helped to remove more than 10,000
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people from the poverty category as well as giving the older, seemingly for-
gotten aged person a sense of accomplishment and the feeling of again being
a part of, and contributor to community life.
(4) Community Representatives
At the request of the California Commission on Aging, the State
Personnel Board established a special job classification of "community
representative". This is a part-time job with the maximum monthly salary at
$140.00. Experience indicated, however, that many persons working in this
classification worked on a voluntary basis far in excess of the maximum 50 hours
allowed for compensation. The $140.00 per month maximum was set so as not to
conflict with Social Security regulations which would require a reduction in
the employee's Social Security allowance for earnings in excess of $140.00. The
typical task of such an employee is to work with trained individuals in their
assigned community to assist in identifying community needs and resources
related to aging persons and to assist in stimulating the interest of influen-
tial members of the community and community organizations in programs for the
aging. Minimum qualifications were set forth in the job specification (See
footnote
) and although no age "exclusion" was established, the require-
ment of one year of experience with senior citizen groups in a leadership
capacity tended to limit those employed to the over 65 classification.
The above are only a few examples of many government oriented pro-
grams that lend themselves to continuation under government sponsorship. Per-
sons interested in stimulating job opportunities for senior citizens will find
many other similar programs described in reports issued by the Special Com-
mittee on Aging of the United States Senate.
4. Part-Time Employment Opportunities Through Special Referral
Services Established for This Purpose.
In recognition of the special need for seniors to secure part-time
employment, a number of special employment referral services have been devel-
oped in many communities in California. Some of these operate on a volunteer
basis, others are funded by public and private contributions. The following
is a compilation of such services in California that have come to the attention
of the California Commission on Aging.
(1) Job Mart
3101 Cottage Way
Sacramento, California 95825
Mrs. Frances Austin
To secure full- or part-time jobs for seniors.
*
(2) SCORE
Small Business Administration
450 Golden Gate Avenue
San Francisco, California 94102
To assist small business by referring retired executives to serve
in an advisory capacity. Fees are arranged between the company and the
referred person.
***
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(3) Marin Senior Coordinating Council, Inc.
914 - 5th Avenue
San Rafael, California 94901
Mr. Ed Ryken
To assist seniors to supplement their incomes by part-time work.
***
(4) Senior Employment Service
2466 - 8th Street
Livermore, California 94550
Mrs. Lillian Snorf
To provide part-time jobs for older people and serve the needs of
the community, this is in the same facility as a teen employment program.
***
(5) Service Center for Senior Citizens
1435 Grove Way
Hayward, California
Mrs. Emma Vargas
To provide part-time jobs for seniors in the community.
***
(6) Project Hire
106 West Sixth Street
San Bernardino, California 92401
Mr. Verne Pomeroy
To find gainful employment for proverty stricken seniors and lift
the morale and give them an understanding of their importance as individuals.
They are informing business and industry that older citizens can be productive.
***
(7) Jobs for Seniors
1539 Euclid
Santa Monica, California 90404
Mr. Earl Brainard
To obtain jobs for seniors in full- or part-time situations. They
utilize volunteers to conduct their program.
***
(8) Careers for Retired Military, Inc.
P. 0. Box 9068
Presidio of San Francisco, California 94129
Mr. William F. Train
To assist retired and retiring military find new careers in the
civilian community. They provide counseling and referral services.
***
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(9) Careers for Women, Inc
Fairmont Hotel
San Francisco, California 94109
Mrs. Mildred Stern
To provide assistance, counseling and referral to older women.
They utilize volunteers to operate the program.
***
(10) Project Work
215 Long Beach Boulevard
Long Beach, California 90802
Mr. Samuel K. Bell
Provides information and referral services to older people looking
for jobs. Does job development and placement in conjunction with HRD Center.
*
(11) Experience, Incorporated
26951 Cawston Avenue
Hemet, California 92343
Mr. C. Harold Holmes
Solving problems of industrial corporations, small businesses,
government agencies and municipalities on a contract basis, utilizing the
various skills possessed by the retired segment of our community.
***
(12) Leisure World STARS
23561 Paseo de Valencia
Laguna Hills, California 92653
Mr. Alfred H. Foxcroft
To assist Leisure World residents to find gainful employment. They
use Volunteers to conduct the program.
***
(13) Mature Temps
215 Long Beach Boulevard
Long Beach, California 90802
Mr. S. J. Porter
To secure placement of older persons in temporary jobs. Persons are
paid by Mature Temps rather than the employer. The employer pays only on an
hourly basis.
***
(14) Mature Temps
3636 West 6th Street
Los Angeles, California 90005
To secure placement of older persons in temporary jobs. Persons are
paid by Mature Temps rather than the employer. The employer pays only on an
hourly basis.
***
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(15) Mature Temps
11 - 3rd Street
Hearst Building
San Francisco, California 94103
To secure placement of older persons in temporary jobs. Persons are
paid by Mature Temps rather than the employer. The employer pays only on an
hourly basis.
***
(16) Retirement Jobs, Inc.
161 No. First Street
San Jose, California 95112
Mr. Jules Eshner
To assist retired persons to keep active and supplement their
incomes through full- or part-time employment and serve the community needs.
They have five branch offices serving three counties. Offices are
in San Jose, Los Gatos, Palo Alto, San Mateo, and San Francisco.
***
(17) Careers for Fifty Plus, Inc.
114 So. Sutter Street
Stockton, California 95202
Mrs. Kathryn Higgins
To provide counseling and job placement for persons over 50. To
illustrate to employers that older people can be valuable in their business
operation.
***
(18) Continued Employment & Activity for the Retired
610 So. Kingsley Drive
Los Angeles, California 90005
Mr. Arthur Daneman, Project Director
To assist retirees' search for full- or part-time employment and to
encourage employers to utilize senior talent.
C E A R offices are as follows: Main office 601 South Kingsley
Drive; Branches, 2512 South Central Avenue, Los Angeles; 5301 Tujunga,
North Hollywood; 11308 Weddington, North Hollywood; 119 North Fairfax,
Los Angeles; 828 Mesa, San Pedro; and 11338 Santa Monica, West Los Angeles.
***
(19) Experience Unlimited
235 - 12th Street
Oakland, California 94607
Mr. Paul E. Herman
A cooperative group of executives, administrators, scientists,
engineers and experts in various fields, who contribute to and benefit from
weekly group discussions concerning how to seek work and current labor market
information. Primarily all are from middle management and above.
***
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(20) Partime
1044 No. Waterman Avenue
San Bernardino, California 92410
Mr. R. S. Parker, Director
To secure gainful part-time employment for retirees by utilizing
counseling and testing for new careers.
(21) Senior Activities & Employment
210 Park Avenue
Escondido, California 92025
Mrs. Dee Furnal
To secure part-time employment for older persons. Counseling pro-
vided to utilize all skills and abilities.
(22) Senior Placement Services
1685 Commercial Way
Santa Cruz, California 95060
Mr. Marshall Cheney
To obtain part-time work for older people and to serve older people
when they need jobs done.
5. Other Programs
(a) In General
In addition to the programs discussed above, a number of other pro-
grams for the aging are currently under way in California. Some are sponsored
and funded by private agencies, others are funded by a combination of private
and public funds, and still others are fully funded by the Federal Government.
While it would be difficult to identify all of the many worthwhile activities
in this field, the material in (b) and (c) below is indicative of the total
scope of these efforts.
(b) OEO Founded Projects
(1) Greater East Los Angeles Senior Citizens Foundation
3864 Whittier Boulevard, Los Angeles 90023
In one component Los Angeles has developed an employment and train-
ing program. Over the course of a year, the project trains 120 older poor
persons, mostly Mexican-American and Negro. The trainees are counseled,
given 200 hours of instruction as nursing aides, and placed in jobs at
hospitals, nursing homes, and community agencies. The project works through
target areas in East Los Angeles. South Central Los Angeles also assists
older poor persons to become involved in their communities.
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Another component gives staff to EYOA to monitor aging programs in
Los Angeles, including an NCOA, Senior Service Corps program, an East
Los Angeles multi-lingual vocational training center, and a Foster Grand-
parents program funded by HEW.
***
(2) Community Planning Council
939 North Fair Oaks, Pasadena 91103
Pasadena operates a FIND-type outreach program. The staff of eight,
which includes a social worker and four community aides, locates, counsels
and identifies the unmet needs of elderly people in the Altadena-Pasadena area.
The staff uses existing community agencies to assist in resolving special
problems of the elderly. Ongoing program planning includes involvement in
special housing needs for the elderly, food stamps, "getting the most" for
the shopping dollar, demonstration of low cost preparation and serving of
meals, and block social activities.
***
(3) NRTA and AARP
215 Long Beach Boulevard, Andrus Building, Long Beach 90802
This is a project of the National Retired Teachers Association and
the American Association of Retired Persons. Project W.O.R.K. has a diversi-
fied program using 23 personnel in agencies and 16 as community aides. It has
four specialist component areas: (1) job referral, counseling, and placement
in cooperation with the local Human Resources Development Center; (2) informa-
tion and referral services; (3) friendly visiting outreach program; (4) con-
sumer education and protection services.
* * *
(4) Sonoma County People for Economic Opportunity
1617 Terrace Way, Santa Rosa
This program will be co-sponsored by four agencies: OEO, HEW,
United Crusade and the Council on Aging. The funds from OEO will be used for
outreach, health, and unemployment. Proposed funds from HEW will be used for
transportation services of the elderly poor to wherever the aged must be
transported. Council on Aging will provide for recreational activities and
United Crusade will pay the salary for the overall coordinator and for rec-
reational activities. The program will deal with: (1) loneliness, social
and economic isolation; (2) untreated health problems or failing health;
(3) unemployment, decreasing or inadequate income; and (4) immobility/lack
of transportation.
Objectives: To raise the level of concern for the elderly poor by
both the social and the legislative community; to link older people with
various services available through existing service agencies; to enhance the
community's utilization of untapped human resources and design and develop
a five-year master plan for the continuing benefit of the older poor.
***
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(5) North Coast Opportunities, Inc.
P. 0. Box 488, Ukiah
North Coast originally developed this program as a training project
for nonprofessional welfare workers. Four aides were trained and have been
working in relation to the Lake County Welfare Department. The staff helps
locate aging poor persons, assess their needs and identify resources to meet
those needs. They have helped organize several senior groups. They have
arranged for limited bus services and for a nutritional program. They are
working to have the surplus food program extended to Mendocino County, and a
housing authority established for both counties.
(6) Senior Opportunity Development Outreach
476 Park Avenue, San Jose 95110
Outreach program based on FIND concept. Information and referral
through seven established neighborhood service centers. Program is very much
oriented to minority groups.
(7) Solano County Economic Opportunity Council
1027 Alabama Street, Vallejo 94590
The Senior Opportunity Service project in Solano County is a follow-
up of a project FIND that interviewed 12,000 older adults, identified major
areas of need, and made referrals to existing agencies. This Solano project
developed a discount card program, which enables impoverished old adults to
buy from some 200 Vallejo merchants at about a 20% discount. The project
continues its outreach activities, utilizing a number of volunteers; has
initiated classes in diet and pre-retirement planning; and is developing
repair co-op clubs. The project has helped to create a county-wide senior
citizens council.
(8) EOC of Berkeley Area
2054 San Pablo Avenue, Berkeley
During the past year, the Berkeley project organized the Senior
Association Group and Enterprises (SAGE), which operates through centers at
recreation grounds in West and South Berkeley. The Center program is educa-
tional and also serves to concern itself with community problems like housing.
(9) Economic Opportunity Commission of Imperial County
795 Main Street, El Centro 92243
The staff of the Senior opportunities project in Imperial County
help to operate 11 senior clubs, three Spanish-speaking and eight English-
speaking. These clubs, operated primarily by volunteers, make articles to
give to shut-ins; have knitting classes; arrange for visits to sick older
persons; and provide fellowship for isolated older persons. The clubs have
become involved in local community issues, such as lobbying for sewage systems
or for more parks.
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(10) Economic Opportunity Commission of San Diego County
861 Sixth Avenue, San Diego 92101
San Diego's Senior Citizens in Action project operates a varied
educational and informational program from a multi-purposed senior citizens
center. They have adult education classes in sewing, financial management,
consumer education and diet. They also provide information and referral
services to help older poor persons gain help in leading fuller, healthier
lives. The project hopes to develop a health education program as well as
a pre-retirement program. They are helping to merchandise articles made by
the senior citizen sewing class.
***
(11) Marin Senior Coordinating Council
914 - 5th Avenue, San Rafael
The agency has focused its efforts on community organization of
senior groups throughout the community. They have divided their program into
seven areas: Counseling, employment, housing, transportation, recreation-
education, community service, and health. A staff member and an advisory
committee are working in each area. They have sponsored two ballots for hous-
ing referendum within the community to provide additional units of low-income
housing; they have an ongoing scheduled bus service throughout the community;
and they are retraining senior citizens for paid jobs in convalescent hospitals
as recreation staff. Between 1968 and 1970 they helped expand the number of
senior organizations from six to 52.
***
(12) South Alameda County Economic Opportunity Agency
1435 Grove Way, Hayward 94541
The agency serves seniors through: Meals-on-Wheels; general services;
recreation; and food stamp distribution.
(13) Monterey County Anti-Poverty Coordinating Council
6 West Gabilan Street, Monterey
Project New Horizons is a FIND-type outreach program designed to
discover and to help organize the elderly poor, the largest portion of whom
are Mexican-American and Filipino agricultural workers. From an initial
emphasis on identification and counseling of the needy older poor persons,
Project New Horizons has shifted towards development of senior centers, the
establishment of adult educational classes, and the starting of Foster Grand-
parents and other community action programs.
***
(14) Stanislaus County Community Action Commission
920 - 10th Street, Modesto
Information-referral program; counseling; recreational and social
activities. Nine senior aides, all over 55, call on the elderly poor through-
out the county to ascertain their health needs, living conditions, and what
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interests they have. The project makes contacts and referrals to social
service agencies, Social Security, and legal offices in their behalf; and
informs those who are sick of visiting nurses' services.
(15) Project SCOUT of Community Action Agency
128 Van Ness Avenue, Watsonville 95076
Project SCOUT is a follow-up of Project FIND. Elderly, outreach
aides seek out elderly poor persons in Watsonville and Santa Cruz areas, in-
form them of services for which they are eligible, refer them to existing
agencies, and offer friendly assistance. The staff is equipped to interpret
Spanish and Filipino. In addition to their outreach work, SCOUT has developed
educational programs on consumer problems, job opportunities, and language
skills. The staff has helped to initiate a Foster Grandparent program and a
Senior Crafts Cooperative. They have developed and funded a county-wide
Commission on Aging which will provide staff for four senior activity centers,
as well as doing community organization on a county-wide level.
(16) Self-Help for the Aging
55 Fifth Street, San Francisco 94102
This program operates in all the target areas of the poverty program
in San Francisco. The elderly community organizer aides distribute informa-
tion and help to organize senior clubs and new services catering to the elderly
poor.
(17) Dependency Prevention Commission
County of San Bernardino
106 West Sixth Street, San Bernardino 92401
The goal of this project "HIRE" is to place the older persons in
new career positions. Over the past year, this project has hired several
dozen senior aides, secured training for them, and by a process of job-
upgrading has also placed them as aides in the welfare and probation depart-
ments, in the school systems, and in senior centers. In addition, project
HIRE encourages private employers to hire older persons, works to create new
job opportunities in government and nonprofit agencies and provides an
introductory training session for persons about to re-enter the labor market.
(18) Shasta County Community Action Project
1134 Pine Street, Redding 96001
Shasta has developed an outreach program to identify and serve the
needs of the elderly poor in this rural area. In addition to this basic out-
reach program, this project is moving in three directions. One, they are
augmenting and training a volunteer corps to aid with nutritional and con-
sumer education program; two, they are establishing an umbrella center as
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focal point for activities; and three, they are establishing a gift shop
where older persons can merchandise articles.
(19) Council of Older American Organization
1259 Broadway, Fresno 93721
Fresno has developed a learning and cultural center where older
persons develop skills in various visual arts through a series of classes
staffed by older persons skilled in these arts. In addition to the learning
center and another center recently established at a Congregational Church,
the project hopes to set up several other neighborhood centers to expand
their services to more persons in minority groups. The school department
has agreed to help fund some of the staff work.
* * *
(c) Special Research and Training Projects Funded by
Administration on Aging or other Agencies
(1)
NAME:
Los Angeles Labor Retiree Research Report
ADDRESS: 2130 West Ninth Street, Los Angeles 90006
SPONSOR: Los Angeles County Federation of Labor, AFL-CIO
PURPOSE: To secure information that will produce a profile of the retired
union members, determining their economic and social status, their
educational and recreational opportunities, and their needs and
desires in respect to programming for the present and the future;
to determine the use that retirees make of existing services, the
need for informational centers on services, and the desirability
of establishing counseling service centers.
PROGRESS: Every 10th member on union member retirement lists was invited to
come to the Machinists Building for an interview of approximately
one-half hour. A total of 1,268 interviews were conducted.
With regard to retirement problems, 392 seniors cited Health,
385-Finances, 67-Having nothing to do, 33-Loneliness, 13-Other,
and 377 seniors commented that they had no major problems at all.
Reasons for retirement included: By Choice - 420, Mandatory Age
404, Health - 389, Job Abolished - 34, Illness of Spouse - 12,
and Other - 8.
After retirement, time devoted to the following activities increased:
Hobbies, television, lodge or club activity, reading, adult educa-
tion, visiting friends and civic participation.
Interest in future union sponsored activities included: Travel
Tours 48%, Retirement Club 46.7%, Retirement Meetings or Dinners
42.6%, Social or Recreational Activities 30.1%, Educational or
Cultural Activities or Events 13.3%, and No Interest in Any Such
Activities or Events 20.3%.
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Evaluation of their health: Good 48.8%, Average 33.7%, and
Poor 17.5%.
Health comparison before/after retirement: Better than it was
23.6%, About the Same 57.1%, and Poorer 19.3%.
Housing: Own home 62.1%, Pay Rent 36.8%; Other 1.1%.
Main source of transportation: Own car 71.2%; Bus 23.7%;
Dependent on others 4.5%; and Other .6%
(2)
NAME:
Techniques for Improving Nutrition in the Aged
ADDRESS:
9015 Fullbright, Chatsworth 91311
SPONSOR:
ENKI Research Institute
PURPOSE:
To assess relative costs and benefits of the different approaches
being demonstrated (in some 25 projects) to improve nutrition
among the aging; and to be supported under the Administration on
Aging's Title IV grants.
PROGRESS:
The project is management of all AOA nutrition programs, with
research on the impact of nutritional effects on older people.
Diet survey of older Americans also researched. Does not serve
senior citizens directly.
Data collected and to be analyzed concerns participants, program
techniques and procedures, and costs
(3)
NAME:
Department of Labor and National Council of Senior Citizens Grant
ADDRESS:
534 - 22nd Street, Oakland 94612
SPONSOR:
Social Service Bureau of Oakland, Inc.
PURPOSE:
To create socially useful part-time jobs in the community to be
filled by low-income elderly (over 55) and to demonstrate what can
be accomplished by retirees and the older worker and to project a
positive image of the older adult. This project is funded by the
local United Bay Area Crusade to the Social Service Bureau of
Oakland and the Department of Labor through the National Council of
Senior Citizens to the Social Service Bureau of Oakland. This is
a pilot program, one of 19 projects across the country. Oakland is
funded for 60 job positions to be utilized by nine different agencies
extended services to the older adult.
Characteristics and number of people served: 60 senior aides are
working in nine different agencies in Oakland. Approximately 1,500
to 2,000 older adults are served in this program. The senior aides
are working in such agencies as Convalescent Hospitals. The Oakland
Recreation Department Senior Citizens Program, the Social Service
Bureau's Senior Action Project, and Residental Care Homes. Services
vary from helping the people with their transportation, housing,
employment, etc.
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PROGRESS: The senior aides are able to bring a more accurate accounting of
the needs of the older adults in the community back to the various
agencies. The senior aides have become independent because of:
The income from the job; and increases in their personal worth; a
sense of belonging; an increased productivity in their retired
years; and from their contributions to the community.
Topics considered: The problems of indvidual care for the elderly
in the community. Finding the needs of elderly and helping to
secure the services for them. The needs may be companionship,
recreation, housing, employment, financial assistance, etc.
(4)
NAME:
Hot Meals for the Elderly
ADDRESS:
427 West Fifth Street, Los Angeles 90013
SPONSOR:
Senior Citizens Association of Los Angeles County
PURPOSE:
To locate and involve seniors in a program directed toward provid-
ing "specific feedings of suitable foods". To provide, at the same
time, nutrition education aimed at improving the dietary habits of
the seniors. To find and isolate factors which most influence the
eating pattern of the seniors. To test the use of the public schools
to provide nutrition education for the older adult. To dispense
information about Food Stamps and surplus foods. To act as an
information and referral center for those seniors needing additional
health and welfare services. To provide direct service and counsel-
ing. To provide the means by which the seniors affiliating with
existing senior activities could provide a "self help" service to
other seniors.
PROGRESS:
An average of 75 seniors are served a day, one meal, four days a
week.
These people are all "fringe" people, that is, they operate on a
low fixed income. Some are now operating on $500 a month, but some
during their working years earned as much as three times (or more)
per month and they are only getting by. In short, their standard of
living is much lower now than during their years of employment. None
are wealthy.
When they were funded for a three-year project, they received
$198,000. As of October 1, 1970, $136,000 had been spent.
Ethnic characteristics: They are serving in four sites. In total,
the breakdown would be: 50% Caucasian, 26% Mexican-American, and
24% Black.
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(5)
NAME:
Operation Reach-Out
ADDRESS:
427 West 5th Street, Los Angeles 90013
SPONSOR:
Allied Senior Citizens' Clubs, Inc.
PURPOSE:
To find older persons who have become inactive and socially
isolated, and in the course of this effort test methods of improv-
ing their situation through cooperative efforts of private and
government agencies, community and religious groups; to make a
special effort to reach older persons whose normal stresses of
aging are aggravated by poverty and increased social isolation.
PROGRESS:
Goal for recruitment: To start clubs for older people and to help
recruit club members. Achievement: Total of 25 clubs and 752
members, recruited mostly in 1968 in South Central and East
Los Angeles areas of the county.
Goal for types of persons reached: To recruit club members who
were aged, socially isolated, and poor residents of a poverty
area. Achievement: All of those reached were residents of three
major poverty areas; the majority were 65 years or older and
received less than $2,000 per year.
Goal for satisfaction of member needs: To bring club members a
variety of interesting programs, and to acquaint them with com-
munity services and facilities. Achievement: Members feel that
their clubs are an important social outlet, but the majority desire
some new club activities. Member knowledge of how to find community
services is low.
(6)
NAME:
Social Work Teaching Grant in Services For the Aging
ADDRESS:
349 Cedar Street, San Diego 92101
SPONSOR:
Field Center on Aging (San Diego State College)
PURPOSE:
To give graduate students a broad range of experiences in dealing
with older individuals.
PROGRESS:
The project is unusual in that it utilizes a team approach of all
field instructors working as a collaborative unit. It provides
practical experience which will contribute to (1) a mastery of pro-
fessional social work practice; (2) self-discipline in the admin-
istration of professional services; (3) the integrated use of
knowledge, attitudes, and techniques in achieving social work goals;
(4) a broad knowledge and appreciation of the functions of social
work and through the use of this knowledge the center seeks to in-
volve the students in providing an opportunity to achieve their
goals. Thus, individual, group, and community organizations
experiences are individually tailored to suit individual needs,
characteristics and number of people served.
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Students are initially assigned Old Age Security Cases with the
San Diego Department of Public Welfare, and are also delegated to
convalescent hospitals, Commission on Aging projects, Community
Welfare Councils, the OEO funded Program, Project 45 HRD, Senior
Adult Services, Ecumenical Council on Aging, Cedar Community Center,
Central Christian Church, Senior Advisory Council, San Diego City
Department of Recreation, Comprehensive Health Planning Association,
Allied Home Health Services, Jewish Community Center, and the Social
Security Office. The students attend workshops, such as Disabled
Older Workers meetings, Volunteer Workshops, and Gerontological
Society meetings. The entire senior population of San Diego is
helped directly or indirectly by the services of these students.
The project presently has 32 students enrolled at the three levels
of education, 18 graduates are employed in senior citizen projects.
(7)
NAME:
Commission on Aging of Community Welfare Council
ADDRESS:
520 E Street, San Diego 92101
SPONSOR:
Community Welfare Council
PURPOSE:
To improve conditions for San Diego senior citizens, based upon
their needs, by liaison, implementation and research in response
to a request from the Senior Citizens Advisory Committee.
PROGRESS:
Professionals and community leaders are serving on the Commission.
At their monthly meetings they:
1. Discuss and support pending bills concerning the welfare of
senior citizens.
2. Become informed on existing services such as the Department
of Public Welfare, etc.
3. Coordinate efforts of groups working for senior citizens.
4. Support and strengthen existing programs.
5. Cooperate with
a. The Mayor's Committee
b. The County Administrative Officer in establishing the
County Department of Senior Citizen Affairs.
C. Project 45 (Employment Lab) of the California Department
of Human Resources Development.
d. California Commission on Aging on local programs.
6. Disseminate information such as the State Senior Citizens'
Property Tax Assistance Law to senior citizens by soliciting
the help of local agencies both governmental and private.
7. Develop additional services such as
a. A Consumer Fair, "A Senior Citizen Happening".
b. Preliminary planning for the White House Conference on
Aging.
The San Diego Commission on Aging is the advisory committee for
Senior Aides Project, which is financed by the U.S. Department of
Labor to assist 60 seniors of low income by placing them in part-
time work with local nonprofit agencies. An important emphasis is
on the permanent placement of senior aides.
-160-
(8)
NAME:
Adult Development Research and Training Program
ADDRESS:
U of C Medical Center, 401 Parnassus, San Francisco
SPONSOR:
Langley-Porter Institute
PURPOSE:
This is a research program with several research projects within.
Some of the projects are pre- and post-doctoral training and the
training of social science students in the adult development and
aging processes.
Characteristics and number of people served: As a research pro-
ject, they have contacted several hundred individuals.
Areas or topics considered: They are mainly concerned in processes
involved in development of the adult and in transitional stages in
life cycles. Such areas are "generation-gap" relationships, cross-
cultural differences, and socio-economic differences.
PROGRESS:
Several areas have effected policy changes; some of the notable
changes are:
1. Development of the Geriatric Screening Project at the
San Francisco General Hospital.
2. Helping to find funds to establish the Geriatric Psychiatric
Outpatient Program Development (no longer funded) but frag-
ments of it are available through Dr. Elliot Feigenbaum,
University of California Hospital Out-Patient-Adult-Clinic.
(9)
NAME:
Summer Institute for Advanced Study in Gerontology
ADDRESS:
USC, University Park, Los Angeles 90007
SPONSOR:
Ross-Moor-Cortese Institute for Study of Retirement and Aging
PURPOSE:
To make it possible for professionals now engaged in a variety of
fields serving older people to increase their knowledge and skills
in behavioral, social, biological and administrative areas of aging.
The institute will enlist outstanding faculty, drawing upon authori-
ties from many other colleges and universities during their free
summer time.
PROGRESS:
The participants answered detailed questionnaires at the conclu-
sion of the session, and gave it a vote of excellence.
The first two weeks covered the Introductory material, "Concepts
and Issues in Gerontology"; the second two-week cycle ran five
concurrent courses in the fields of biology, sociology, psychology,
economics and scientific computing; and the third two-week cycle
ran four concurrent courses in the fields of physiology, urban
ecology, psychology and social policy and administration.
-161
(10)
NAME:
Educating Social Workers in Community Work With Aging
ADDRESS:
120 Haviland Hall, University of California, Berkeley
SPONSOR:
Regents of the University
PURPOSE:
To prepare professional Social workers to work in the field of
aging with special expertise in community organization and admin-
istration. This is a two-year program which includes academic
class as well as internships specifically geared with concern for
the aging population.
PROGRESS:
The Faculty assumes their own role of being active in the com-
munities. Two and a half (2) faculty members are regularly
participating in community organizations and groups concerned with
the aging. Their primary activity is restricted to the Bay Area.
The aging population and the aging process are separate from the
problems of the aging and appropriate Social Work methodology in
problem solving is the area the project considered.
Accomplishments due to the project: (1) Initiation of curriculum
concerned with aging has developed into a full two-year program.
(2) At the present time, seven students have been awarded their
MSW in Aging. Some employment has been found in aging.
Interns: A total of 20 students are in the program. They work in
agencies concerned with initiating and developing programs of
direct service to the aged.
(11)
NAME:
Regional Training of Leaders To Work With The Aged
ADDRESS:
U of Calif Extension, 106 South Hall, Davis
SPONSOR:
Regents, University of California
PURPOSE:
1. To extend knowledge of the aging processes and the biological,
psychological, personality, health, and social changes that
occur in aging.
2. To provide trainees with information about federal and state
programs and resources, with local community programs and
services for the retired and the aged in housing, recreation,
health, welfare, financial management, employment, and
transportation.
3. To inform persons designated as leaders as to their opportuni-
ties and to give guidelines for planning, using state and
community resources; to furnish basic tools for preparing
"community resource inventories" and "client summaries".
4. To begin the planning and inauguration of the University
Extension Curriculum which would prepare educational specialists
in aging.
-162-
PROGRESS:
The first year of the program was devoted to information-gathering
of resources and facilities in the region (by sub-region) and to
training individuals as counselors in community organization and
development in problems of the aging. Training was accomplished
through an intensive short course and through use of a traveling
faculty and holding follow-up conferences in sub-regions.
All services to Senior Californians were discussed by all invited
participants.
The sub-regions where training seminars were held are as follows:
Redding; Stockton; Oroville-Orland-Chico; Yuba City-Marysville;
Modesto-Turlock; Mt. Shasta-Dunsmuir-Weed; Auburn-Nevada City-
Grass Valley; Sacramento-North Sacramento-South; and Tahoe City.
Approximately 1,068 participated in these 10 regional training
seminars.
The end result was an educated and trained group of community
leaders who took back to their respective communities an aware-
ness of the needs of older adults and the know-how to start and
expand programs to benefit Senior Californians.
-163-
F. Training
The critical shortage of persons trained in the field of aging continue
to limit the progress that could be made today and to inhibit the potential
for future program expansion. It is estimated that less than 20% of all
individuals employed in programs serving the aging have had any formal train-
ing for their work. The problem will become more acute as future program
expansions double and triple the demand for qualified help.
The Federal Government, working through the Administration on Aging has
sponsored a limited number of both long-term and short-term training programs
on aging. A total of 71 Title III training projects during fiscal 1970 pro-
vided short-term training for over 15,000 persons. Title V supported training
programs were carried on in 18 universities across the country in 1970. These
latter programs, concerned primarily with career preparation, reached 370
graduate students and 850 short-term trainees. Information concerning details
of these programs can be obtained by writing the Administration on Aging.
An analysis of these training programs indicates that they are basically
designed for those working in the field of aging, about to enter employment
in the field, or otherwise already committed to a career therein. Still
critically needed are general courses at all levels of the educational process
for students who are not committed nor in fact may ever be committed to a
career in the field of aging.
Such courses would serve two beneficial purposes. The first would be to
introduce more students to aging in general and thereby stimulate more career
entries into that field. The second beneficial purpose would be to stimulate
more general awareness of the problems and needs of the aging among our student
population.
If but one generation of Americans grew up with an appreciation of the
reality of aging, long sought reforms and needed financial assistance would
be more readily obtainable.
-164-
Sensitivity to the needs of the aging can only be acquired through an
awareness of the problems that confront them, and such awareness can be
greatly enhanced through formal education. All too often our youth oriented
society's negative attitude toward the aged, and aging, are passed from one
generation to the next without thought or evaluation. Here again, the inter-
vention of the formal educational process could reverse this senseless and
self derogating phenomenon.
Every segment of society should be sensitized and educated to the facts
of the full-life cycle, to the physical and psychological processes of growing
up, of the middle years, of aging, and of the fact that every stage of life
offers equal but different challenges and rewards. It is submitted that
courses in gerontology at all levels of the educational process would make a
significant contribution to reshaping current national attitudes toward the
aging. The following suggested core curriculum, prepared with great aid and
assistance from Miss Carol Pogash of the Institute for Local Self Government
and Mrs. Bea Shiffman of the National Council on the Aging is offered as a
starting point for the development of such courses of study.
-165-
A CORE CURRICULUM IN GERONTOLOGY
HUMAN GROWTH:
A philosophical and technical course that focuses on a study of the life
cycle with emphasis on the aging process. Coverage of the physiological
and biological evolution both of the body and the mind. Special attention
given to the transitional period from middle age to old age: changes in
learning and motor skills, and intelligence. Discussions of diseases that
afflict the elderly, including that of senility and the factors which cause
it.
PSYCHOLOGY OF AGING:
A study of the attitude and behavior changes that accompany the aging process:
the critical transition from an active to a more passive existence; the pur-
suing problems of one's lessened importance in society and deflated self
perception; role ambiguity and one's diminished sense of personal worth. Use
of Eric Erickson's theory on the chain of needs to mental health as applied
to the aging individual. Analysis of the emotional fury and rage of the eld-
erly that causes such a high proportion of mental illness; loneliness and
other withdrawal symptom which afflict the elderly; the problems of maintain-
ing maximum security, dignity and independence, and coping with their absence;
the importance of allowing the individual a wide choice in determining his own
fate.
SOCIOLOGY OF AGING:
Analysis of the aging and their place in society as it now is and as it ought
to be. Focus on the factors that determine societal attitudes toward the
aging: national wealth, tradition, family patterns, etc. Attention given to
the aging individual in his environment as he relates to his peers and to the
-166-
younger community: his integration in and isolation from society; the
gradual withdrawal and inwardness that characterizes his existence; the
limited choice offered; the independence of the dependent individual vis a
vis society; the use of groups as political and social communicators; the
use of organizations, counseling services, etc. Study various life styles for
the aging including retirement practices (employment and housing), family
patterns and group relationships. Survey of demographic aspects: population
changes; and rural and urban density.
POLITICIZATION OF THE AGING:
A course that describes the potential influence of the aging as a group that
could become functional. How a political reawakening could be developed and
the benefits of such a scheme: sensitizing the elderly to their common needs;
strategies on how to have them satisfied; discovering the commonality of
problems and aligning with other groups. Learning to understand: how to be
heard; how to make allies; how to deliver votes; how those who are aging and
unemployed change their political outlook on a liberal conservative spectrum.
Consider the possibilities of education for the public at large; community
development and organization by and for the aging. Analysis of case studies
from community experiments.
HISTORICAL ANALYSIS OF THE AGING:
The course is offered to give the student a perspective by studying how the
aged in other societies have been treated. Beginning with biblical commentaries,
and focusing on more recent cultural attitudes. Providing an anthropological
view of various societies. Updating the study with analysis of the treatment
of the aging by immigrant groups, religious sects and minority populations
in America in their respective communities, including: Black, Mexican-American,
Indian, Jew, Catholic, Russian, European, Chinese, etc., (overlapping categories).
-167-
PUBLIC POLICY FOR THE AGING:
Detailed analysis of the governmental policies that affect the aging: what
are the needs; how are they met; which ones go unsatisfied; how local, state
and federal governments are functioning in the field and how they could or
should be functioning. Could be a four semester (quarter) course, devoting
each time period to one of the four study segments described below:
EMPLOYMENT-INCOME:
Study of the civil service laws and private standards that work against the
elderly: locking people out of jobs based on age and not on mental alertness;
the problems of unemployment and how the abundance of time and lack of money
affect the able and aging individual; the valuable manpower resource which the
elderly represent; possible reforms; innovative governmental projects that
utilize the manpower of the aging to satisfy other social service needs (day-
care centers, hospitals, etc.)
HOUSING:
Study the policies for public and private housing as they now exist: should
housing for the elderly be isolated or integrated into the community; retire-
ment villages -- pros and cons; how aging individuals are affected by new
surroundings, forced moves, isolation. Analysis of special problems with
housing plans for the aging: alternative types; case studies; costs of housing
and expenses for the elderly.
HEALTH:
Learn about governmental efforts at rehabilitative and preventive medicine
for the aging: what is and what could be done. Study the problems that
confront the health agencies: how to inform the aging community of the
available services (health education); how to provide them with the services
-168-
(satellite health centers, doctors aides); how to discover what needs they
have that are going unmet (survey). Concern with nutrition and the aging.
Analysis of new and pending federal legislation--medicare.
TRANSPORTATION:
The need for the elderly individual who is physically able, to remain mobile
and the problems therein: lack of funds, poor health, need for safety and
accessible transportation. How the public transportation in certain parts
of the country has improvised to meet these needs. Experimental efforts in
major cities: problems and successes.
PLANNING FOR RETIREMENT:
A nonconventional plan to prepare people from the time they are young to
understand their later years and to prepare for them. To develop self
creatively and inwardly. For those who have already arrived at that age, to
teach them how to cope with the transition and change: what to do with leisure
time; the lack of a substantial income; the lack of co-workers around; no work
to occupy the mind. Emphasis placed on life long learning so that the liberal
arts education is a continuing one. Discussion of training and retraining
people during the later years. Equalizing job opportunities for the able and
willing individual.
FIELD WORK:
This course is the backbone of the curriculum because it most deeply and
expediently sensitizes the student. Accompanied by a weekly seminar for
common and personalized discussions. Could consist of a group survey to
analyze the needs of the elderly in a specified segment of the community;
or working in an old age home; assisting in providing services, i.e., working
in a health clinic; community development; political or health education;
etc. Unlimited. Negotiate with instructor to determine the value of a
project in terms of credits. More credit if evaluation paper written.
-169-
G. Preventive and Supportive Services
1. In General. The major expense of any health care program is hospital
and nursing home care. The national average cost in the U. S. of maintaining
a hospital patient for one day leaped from $9.50 in 1946 to more than $81 in
1970. It is expected to approach $100 per day in 1971, and rise each year
thereafter. The cost of nursing home care is also on the increase. Even if
over utilization were completely eliminated, the costs of such are to the tax
supported Medicare and Medical programs would still be. aggering. Furthermore,
there is every indication that the demands for such services will escalate just
as rapidly as have the per diem costs. The increasing life span, which may
include moreyears of dependency, is one contributing factor. The current
American syndrom of institutionalizing every problem, whether for illness or
convenience, is another. The avoidance of the need for such expensive services
is thus essential if the public can be expected to continue its financial
support. A plan which helps keep a person healthy is much better than one
which only treats him after he is ill. In the field of aging, a parallel, but
interrelated program that keeps a senior active in his own environment, is better
than one that forces him into an institution. Not only is such a program likely
to be less expensive, it is generally better for the overall health and emotional
stability of the prospective patient. The development of viable alternatives
to institutionalization is thus essential.
2. An alternative to institutionalization. A person enters a hospital or
nursing home for one reason: he cannot care for himself, or be adequately cared
for by others, in his home. It may be that needed medical care is only available
at a hospital. But it may also be a matter of convenience where the patient does
not require critical treatment as much as the availability of health services
if the need therefor arises. Under our present system it is generally more
convenient to send the patient to the services than to send the services to the
patient. Recently conducted pilot programs indicate that many situations occur
where the opposite may be as satisfactory, if not preferable. A coordinated,
cooperative official and well supported community program offering assistive,
supportive, preventive, sustaining and protective services offers the best
alternative to our present institution-oriented system. Such a program should
be founded on a true partnership between the public and private sector and
should involve both general and financial assistance from all levels of government.
Such a program could result in savings of millions of dollars and also enable
a greater number of our seniors to live out their lives in decency and dignity
freed from the devastating crush of fear, insecurity and loneliness which
contributes to both the incidence and severity of their illness and incapacity.
3. Examples of preventive and supportive services. It would be impossible
to list all the services that might be provided in every community. They will
vary according to different local situations and changing needs. They should,
however, cover a wide range of health and social services that will enable the
senior to maintain as normal a life pattern as possible. The following are
typical programs which serve these needs:
-- Meals on wheels. It has been well documented that one good hot meal a
day is about the cheapest preventive 'medicine' we have.
-- Home health care. The delivery of medical and para-medical services,
including visiting nurses and home keeper services to the senior in his own
home.
-170-
-- Neighborhood diagnostic and out patient treatment services. The early
detection and control of developing illnesses will enable the avoidance of more
expensive institutional care.
-- Social programs and activities. Organizing social programs in the
neighborhood and within easy reach, is an effective way for preventing the effects
of severe loneliness and feeling of abandonment that afflicts so many seniors.
-- Adequate and useable transportation. Much progress has been made in
this field, but much more needs to be done.
-- Referral arrangements and Hot Line services. A community or volunteer
maintained telephone services that can answer inquiries as to available services
and serve as a contact point for emergencies.
-- Day care, nigh care and respite (vacation) care. Establishing facilities
for intermittent use by seniors who are living with adult children or other
family members. In this connection, thought should be given to development of
a program providing financial assistance where needed to families so they can
care for their elderly at home.
-171-
NOTE:
The footnotes and Appendices have not been completed for inclusion
in this draft. They will, however, be a part of the final document,
as will the conclusions and recommendations of the conference.
4
THE
VI:
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"ocrText": "Ronald Reagan Presidential Library\nDigital Library Collections\nThis is a PDF of a folder from our textual collections.\nCollection: Reagan, Ronald: Gubernatorial Papers,\n1966-74: Press Unit\nFolder Title: [Aging] - Aging in California 05/24/1971\nBox: P33\nTo see more digitized collections visit:\nhttps://reaganlibrary.gov/archives/digital-library\nTo see all Ronald Reagan Presidential Library inventories visit:\nhttps://reaganlibrary.gov/document-collection\nContact a reference archivist at: [email protected]\nCitation Guidelines: https://reaganlibrary.gov/citing\nNational Archives Catalogue: https://catalog.archives.gov/\nEd Gray- -\nThis is a more complete\nform of what & pent our\npremidg. I should be a good\nresome cloumunt\nACING\nfor the 5 talf.\nCALIFORNIA\nsu P 1.\n&\nP 137\nSpare\nAGING IN CALIFORNIA\nA resource document prepared for use\nat the White House Conference on Aging\nSacramento, California -- May 24, 1971\nTAXES\n$\n25%\nthe persons\nsenze 1931\nwith\nsigne\nINDEX\nPage\nIntroduction\nPreface\nA. The Aging in California\n1\n1. In General\n1\n2. Analysis of Census Date\n3\n3. Evaluation of Questionnaire\n3\n4. Profiles\n5\nB. What is Being Done\n8\n1. In General\n8\n2. Federal Programs for the Aging\n9\n(a) Administration on Aging\n9\n(b) Atomic Energy\n12\n(c) Post Office Department\n12\n(d) Department of Labor\n13\n(e) Federal Trade Commission\n15\n(f) Department of Health, Education and Welfare\n17\n(1) Food and Drug Administration\n17\n(2) National Institute of Child Health and\n19\nHuman Development\n(3) Health Services and Mental Health\n21\nAdministration\n(4) Social Security Administration\n23\n(5) Social and Rehabilitation Service\n25\n(6) Office of Education\n27\n(g) Department of Housing and Urban Development\n29\n(h) Internal Revenue Service\n34\n(i) Veteran's Administration\n35\n(j) Office of Economic Opportunity\n40\n3. State of California Services to the Aging\n46\n(1) Department of Education\n47\n(2) Department of Social Welfare\n51\n(3) Department of Health Care Services\n53\n(4) Department of Public Health\n54\n(5) Department of Mental Hygiene\n55\n(6) Department of Human Resources Development\n58\n(1) Commission on Aging\n59\n(2) Older Workers Program\n63\n(3) Development of Senior Aide Concept\n64\n(7) State Teachers Retirement System\n67\n(8) Department of Rehabilitation\n67\n(9) Franchise Tax Board\n68\n(10) Public Employees Retirement System\n68\n(11) Department of Veterans Affairs\n69\n(12) Department of Consumer Affairs\n70\n(13) State Personnel Board\n71\ni\nPage\n(14)\nDepartment of Housing and Community Development\n71\n(15)\nDepartment of Fish and Game\n72\n(16) Department of Youth Authority\n72\n(17)\nDepartment of Corrections\n75\n4.\nServices to the Aging -- Incorporated Cities of California\n79\nA.\nIn General\n79\nB.\nResults of City Questionnaire\n80\nC.\nSynopsis of Individual Programs Reported\n81\nD.\nSummary of Additional Services\n83\nE.\nDetails of Selected City Programs\n84\n(1)\nLos Angeles\n84\n(2)\nMenlo Park\n86\n(3)\nPalo Alto\n88\n(4)\nSacramento\n88\n(5)\nSan Jose\n88\n(6)\nSan Diego\n89\n5. Programs for the Aging -- Counties of California\n90\n6. Progress in Europe\n99\nC.\nWhat Can Be Done -- Community Models\n111\n1.\nIn General\n111\n2.\nThe Local Coordinating Organization\n112\n(a)\nModel Ordinance\n112\n(b)\nModel Resolution\n116\n(c)\nTechnical Advisory Committee\n118\n3.\nThe Voluntary Service Organization\n118\n(a)\nPreliminary Considerations\n118\n(b)\nConstitution and By Laws, The Unincorporated\n122\nAssociation\n(c)\nNon Profit Corporations\n127\n(1)\nIn General\n127\n(2)\nFormation\n127\n(3) Management\n129\n(4)\nPowers\n130\n(5)\nMembership\n130\n(6)\nSample Articles of Incorporation\n131\n(7)\nBy Laws\n133\n(8) Other Applicable Laws\n134\nD.\nWorking for a Prosthetic Environment\n136\n1. Definition\n136\n2.\nThe Problem\n136\n3.\nProgress\n136\n4.\nNew Directions\n139\n5.\nConclusions and Recommendations\n140\nE.\nSecond Careers\n142\n1.\nIn General\n142\n2.\nThe Senior Service Corporation\n142\n3. Government Service\n144\n(a)\nFull Time\n144\n(b)\nPart Time\n144\n(c)\nGovernment Services by Contract\n144\nii\nPage\n(d)\nSpecial Government Projects\n145\n(1) The Adult Aid Program of Orange County\n145\n(2) Love to Share\n145\n(3) Green Thumb and Green Light\n146\n(4) Community Representatives\n147\n4. Part-time Employment Through Referral Services\n147\n5.\nOther Programs\n151\n(a)\nIn General\n151\n(b)\nOEO Funded Projects\n151\n(c)\nSpecial Research and Training Projects\n156\nF. Training\n164\nG.\nPreventive and Supportive Services\n170\niii\nINTRODUCTION\nThis document has been prepared for use at the California Statewide\nConference on Aging to be held in Sacramento on May 24th, 1971.\nIt is made available to you for two purposes. First, we believe it\nwill be a helpful resource document in your deliberations. Second, we want\nyour comments and suggestions as to any changes that will correct or improve\nthis material.\nPlease send your suggestions to:\nInstitute for Local Self Government\nClaremont Hotel Building\nBerkeley, California 94705\nAttention: Mr. S. Williams\nThis material is the first compilation of its kind and will be used as\npart of a larger document that will constitute California's report to the White\nHouse Conference of 1971. It is intended that the findings and recommendations\ndeveloped at the Statewide Conference will also be included in that report.\nWe realize the information on Federal Government activities omits some\nprograms and is very brief on others. We believe, however, it amply demonstrates\nthe scope and depth of Federal involvement. The treatment of programs by\nvolunteer groups in California is not an attempt to describe all of the fine\nprograms that are being carried out. They are too numerous for that. It is only\nan effort to describe some of the typical programs which are illustrative of\nmany others, and which offer an insight into what any local group can do with\nproper organization and committment. We invite descriptive information on any\nother volunteer programs that you believe warrant inclusion herein.\nYou who are attending this conference carry both a heavy responsibility\nand great opportunity. What you here accomplish may well set a pattern for the\nWhite House Conference, and in so doing, make a significant contribution towards\nmeeting the needs of our nation's aging.\nWe wish you success in both.\nInstitute for Local Self Government\nBy:\nSpencer Williams\nProject Director\nPreface\nAll who are today old were one day young. All who are today\nyoung will one day, with good health, and good luck, be old. All belong\nto the continuum of human existence which begins with birth and ends with\ndeath. As such, all share many common interests, fears, hopes and\nfrustrations. Physical and psychological differences between young\nand old, on the other hand, tend to set them apart. It has always been\nthus. But with our penchant for classifying, categorizing and over-\nsimplifying, for accentuating the negative, looking for areas of difference\nand disagreement rather than areas of commonality and agreement, American\nsociety seems to have opened an almost unbridgable chasm between young\nand old. To the knowledgable, this chasm is more apparent than real.\nThe old have compassion, understanding, and love for the young, not only\ntheir own young, but for young people in general. And the young - -\nthose at least who take time from their daily struggle for survival and\nachievement to contemplate the problems of the older citizens - - also\npossess a reciprocal well of compassion, understanding, and affection.\nWhatever its dimensions, however, the chasm persists. While\nthe reasons are many, the excuses are few. Some of us immaturely fear\nthe implications of our own aging process and thus shun the elderly.\nOthers are merely indifferent, so imbued with our own daily concerns.\nwe cannot or will not take the time to be concerned with anyone else's\nproblems, particularly those of the aging. To some a person reaching 65\nbecomes an indistinguishable member of a faceless horde, almost of another\nspecies, somehow no longer needing love or being capable of love, no\nlonger desiring the usual amenities of life or being capable of enjoying\nthem, no longer needing the challenge of life or experiencing the pleasures\nof achievement, no longer capable of concern about illness, poor housing,\nfinances, national or world problems.\nWe have long been a youth-oriented society and properly SO.\nAs an emerging nation of the 19th and early 20th century, our great leap\ninto world prominence was accomplished to a great extent by the courage,\ndetermination and imagination of our young people. Even today we re-\ncognize that the future of our nation rests on the ability and stability\nof the \"now generation\" and their performance in the years ahead. But\ntoo many of us, young and old alike, are in danger of becoming youth\ncultists, mistaking energy for ability, education for knowledge,\ninnovatedness for judgment. We seem too ready to pawn the value of\nexperience for the excitement and adventure of change.\nFor these and other reasons, our elderly population has become\nthe single-most tragically alienated, disadvantaged, and disserviced\nsegment of American society. Thousands of vigorous, talented, experienced\npersons are forced into retirement at the peak of their productivity and\nat a time when the nation truly needs their services. The relative income\nof the over-65 population is but 50% of those under 65, and is dropping.\nWhile the percentages of all other age groups living below the poverty\nline is diminishing, the percentages of the aging who live in poverty is\nincreasing. Inflation and sky-rocketing health costs hit hardest at our\naged population living on fixed incomes and afflicted by the growing\ndisabilities of old age. The labor market is all but closed to the\nphysically active and mentally sharp senior who seeks to supplement his\nincome.\nThese are not new problems, but they affect ever-increasing\nnumbers of persons as our aging population continues to grow rapidly.\nIn 1900 there were 3 million Americans aged 65 and more, comprising 4%\nof our population. Today we have over 20 million Americans aged 65\nand over constituting 10% of the total population. To put it in\nanother perspective, since 1900 our total population has grown 300%\nand our over-65 population has grown almost 700%. This is an acceler-\nating trend which will experience even more rapid growth when medical\nresearchers solve the problems of heart disease, cancer and stroke.\nWhile in the words of John B. Martin, U. S. Commissioner\non Aging, it may not be easy to \"sell\" a comprehensive program for the\naging - - to raise it high on the list of national priorities - -\nwe should be fully aware of the consequences of our failure to do SO.\nToday's crisis will become tomorrow's national calamity if we do not.\nThe \"sale\" must be made to our entire population, particularly our\nsecurity-assuming under-40 segment. The time for the sale is now.\nThe forum for the sale is the President's White House Conference of\n1971. The terms of the sale must be clear and unequivocable:\n1) Develop a plan now that will adequately serve the\nneeds of tomorrow's aging.\n2) Fulfill a grateful nation's obligation to yesterday's\nyouth whose vigor, courage and sacrifice made today - - and tomorrow - -\npossible.\nIt is hoped that this document will be of assistance to\nCalifornia's Commission on Aging in its efforts to stimulate a public\nawareness of the problems of our aging citizens and develop local\nprograms for their solution. It is also hoped that this document may\ncontribute to the success of the White House Conference on Aging, 1971.\nSpencer Williams\nProject Director\nA. The Aging in California.\n1. In general. Californians are proud of California. Perhaps it\nis because so many have come from so many other places that \"pride of state\"\nhas developed as a simple and perhaps the only factor of commonality that\nbinds them.\nPerhaps it is because they have so much to be proud of. In addition\nto the variety and extent of its vast natural resources - beaches and\nmountains, lakes and streams, deserts and forests - California ranks first\nin more economic and social indicators than does any other state: Popula-\nlation, personal income, farm income, number of scientists, tax receipts\nand expenditures, housing construction, retail sales, motion picture theatres,\nbirths (second in deaths), marriages (and divorces), public schools.\nCalifornia's over-65 population of 1.8 million - which is second only\nto New York with almost 2 million - benefits indirectly from some and\ndirectly from other such \"firsts\". In its various Welfare programs affect-\ning aging recipients, California's payments to the blind (AB) ranks first,\nthe totally disabled (ATD) second, and Old Age Security (OAS) third\nnationally. The California law currently provides for an automatic cost of\nliving increase for old-age assistance recipients. In his Welfare Reform\nproposal, Governor Reagan is recommending a forward step long advocated by\nstudents of public assistance for truly needy adults no longer able to\nsupport themselves; take the aged, blind and totally disabled out of the\n\"Welfare\" category and allow them to live in dignity under an automated,\n\"pension\" type system. California now ranks second in the number of doctors\nand fourth in the number per 100,000 population; second in the number of\ndentists and eighth in the number per 100,000; second in the number of\nnurses, although 27th in the number per 100,000; first in the number of\n-1-\nhospitals and second in the number of hospital beds; first in the number of\nnursing homes and nursing home beds.\nDespite these glowing statistics, California's aging suffer the same\nproblems of alienation, reduced purchasing power, inadequate housing, immo-\nbility, and forced retirement that plague seniors in our other states.\nThe area of transportation is but one example of the plight of senior\nCalifornians. Californians' historical reliance on the automobile as the\nprincipal means of transportation has inhibited the growth and development\nof adequate public transportation systems in the state. Cars are expensive\nand California's crowded highways and freeways are hazards that most seniors\navoid with a passion. What public transportation is available is scattered\nand is primarily oriented to and scheduled for the journey to work require-\nments of the low income workers living close to urban centers. For most\nsenior Californians, if you don't have a car or someone to drive you, you\njust don't go. They, thus, suffer equally, if not more severally than most\nothers from the shrinking capacity for self-maintenance and the reduced\nability to maintain social contacts and social participation which forced\nimmobility brings. The same is also true of many other of the problem\nareas singled out for special consideration by the White House Conference.\nDespite its liberal property tax exemptions for seniors, California's\nproperty taxes are among the highest in the nation and are forcing many\nof its aging citizens to seek different and frequently substandard living\narrangements. Inflation and the high costs of living are also taking\ntheir toll. And high unemployment caused by slowdowns in California's\nspace industry has generated fierce competition for the few job oppor-\ntunities that were previously available to seniors.\n-2-\nIn the sections that follow, we attempt to describe with more speci-\nficity the aging population of California. We also endeavor to describe\nwhat is being done and what can be done to improve the quality of their\nlives in the golden state.\n2. Analysis of Census Data\nThe census of 1970 reveals that nationally older adults now constitute\n9.9% of the population as compared to 9.2% in 1960. There are 20 million\npeople 65 or over -- one in every 10 persons. The number is increasing at a\nrate of 900 per day, 330,000 a year. More than 70% of those over 65 have\njoined this age group since 1961. One fourth of the aged are poor, and nine\nout of every ten receive Social Security benefits-- an average of $117 a month.\nAbout 2 million are on general assistance. Private pensions provide for only\nabout five percent of older population.\nIn California, the total population has increased 27% from 15.7 million\nto 19.9 million and the 65 and over population has increased 32% from 1.37\nmillion to 1.8 million. While in 1960 the 65 and over population constitutes\n8.98% of the State's total, it is now 9.00%. In addition, while California\nhas 10% of the nation's total population, it has 9.2% of its aging. Of every\n100 Californians over 65, 59 are women and 41 are men. In the 65-74 group,\nhowever, 56 are women and 44 men, while in the 75 and over group, 62 are women\nand 38 men.\nThe California census also reveals that 587,000 seniors are heads of\nfamilies, 343,000 are wives of heads of families and 198,197 are living with\nan under 65 family member who is the head. 198,000 men and 399,000 women\nover 65 are living alone, 35,000 are boarding with non-relatives and 94,000\nreside in institutions.\nA breakdown of the distribution of the 65 and over population by counties\nand cities in California may be found in Appendix I.\n3. Evaluation of Questionnaire\nFor the purpose of finding out what older Americans believed to be their\ngreatest needs, special assistance to the President for aging, John B. Martin,\nprepared a questionnaire to be distributed nationally. Over 5,000 were completed\nin California and returned to the Administration on Aging for tabulation.\nAdditional copies were reproduced in California and 17,000 were distributed,\nfilled out, collected and analyzed locally. The results are the subjectively\nexpressed opinions of the elderly who attended the Community Forums which were\nheld concerning their needs and problems. Since those attending are generally\nalready 'involved' in senior programs and activities, they probably do not\nrepresent a true cross-section of all the elderly persons in California. For\nexample, while the census reveals 59% of California's over 65 are women and 41%\nmen, the distribution of those answering the questionnaire was 69% women and\n31% men. Furthermore, since the questionnaires were not distributed in direct\nrelationship to the distribution of the aging population throughout the state,\nthere are additional reservations as to their validity to accurately represent\n-3-\nthe thinking of our senior citizens. Despite the failure to qualify as a\n'scientifically selected sample' the questionnaires have produced some interesting\ninformation. 23.9% of the sample were college graduates; 15.5% lived in a retire-\nment or nursing home; 63% belonged to an active organization for retired persons.\nWhile 90.1% of those questioned were retired, only 39% of those not retired\nwished they were. 7.4% were working full time, and of the 92.6% not working\nfull time, only 9.4% would like to. A somewhat higher percentage (10.4%) were\nworking parttime, a much larger group (26.2%) would like to be.\nA high percentage of seniors reported they could see a Doctor (87.7%) and\na Dentist (84.6%) when they wanted to, and of those receiving such services in\nthe preceding month 72.5% had enough to pay their doctor bills, and 62.5% had\nenough to pay the dentist. 91.6% were happy in the neighborhood where they lived.\nA sample of the California-collected questionnaire was analyzed for the\nCalifornia Commission on Aging by George Jessup and Chris Johnson with particular\nreference to the variables of age, sex, income and levels of education. While\na full reading of their report is recommended, the following are some of the\nobservations drawn from their tabluation:\nAge:\nQ: Do you have a health problem you feel needs attention, but is not getting\nmedical attention? A higher percentage of people in the age categories 55-65\nyears (27.5% to 28.3%) seems to answer affirmatively. It may be that retirement\nand/or welfare benefits are not yet available to individuals in these age\ncategories, or that the younger people are having health problems associated with\naging that they have not yet become adjusted to.\nQ: Do you have trouble paying for your housing costs? There appears to be an\nage relationship in the ability to pay housing costs, the older the person, the\nless trouble he has.\nQ: Do you have trouble getting from home to places such as shopping, church\nor visiting friends? The response indicates an age relationship with this question.\nIt appears that the older a person gets, the more trouble he has in getting around.\nThis, of course, is not too surprising in view of the aging processes going on.\nQ: Do you have enough money to buy the food you like? The response indcates\nan age relationship to this question, the older the individual (93.9%), the more\nmoney he appears to have to buy the food he likes. In the age range 66-70 years,\nonly 67.2 have enough money to buy the food they like.\nQ: How far did you go in school? It appears that the older persons responded\nthat they had higher educations than younger persons. 34.2% of those over 85 years\nresponded that they were college graduates compared to only 17.5% of those persons\nunder 55 years of age. It remains for the reader to speculate upon why the great\ndifference exists.\nIncome:\nQ: Do you have a health problem you feel needs attention, but is not getting\nmedical attention? The response indicates an income relationship to this question.\nIt appears that those in the lower income classifications have a greater problem\ngetting medical attention.\nQ: Do you have trouble paying for your housing costs? The response found\nhere indicates that the more money one has, the less trouble he has in paying\nfor housing costs.\n-4-\nQ: Do you have trouble getting from home to places such as shopping,\nchurch or visiting friends? Here again, like many of the\"common sense questions\",\nthe less income a person has, the more difficult it is for him to get around.\nQ: Do you have enough money to buy the food you like? The response is\nprobably influenced by the high percentage of persons earning more than $400\n(95.6%) who have enough money to buy the food they like, compared to those who\nmake under $100 of whom only 45.6% have enough money to buy the food they like.\nQ: How far did you go in school? As would, most likely, be expected,\na significantly larger percentage of those in the lower income categories also\nwere in the \"no schooling\" and \"some grammer school\" categories. Likewise, those\npersons in the higher income categories had completed more schooling, with 49.4%\nof those earning more than $400 responding that they were college graduates.\nEducation:\nQ: Do you have a health problem you feel needs attention, but is not getting\nmedical attention? A high percentage of persons with little or no education\n(37% - none, 35.6% - some grammer school) have a health problem that is not\ngetting medical attention, than those individuals with some college (14.4%) and\ncollege graduates (6.9%) with similar problems.\nQ: Are you usually able to see a doctor when you need one? There appears\nto be a general relationship between level of education and ability to see a\ndoctor when necessary. For example, 22% of those individuals with no education\nare unable to see a doctor when they need one, compared to 14.1% of those with some\ngrammer school.\nQ: Are you usually able to see a dentist when you need one? Here again,\nthere seems to be a relationship between educational level and being able to see\na dentist when necessary. Twenty-seven percent of those with no education were\nunable to see a dentist when necessary, compared to 15.6% of those who finished\ngrammer school and 5% of those who were college graduates.\nQ: Do you have trouble getting from home to places such as shopping, church\nor visiting friends? There appears to be a significantly greater percentage of\npersons in the higher educational categories who have little or no trouble getting\naround.\nIn concluding their report, the researchers stated that any interpretation or\ninference regarding the data should be made by the Commission. The report points\nout several significant associations between variables, and provides the Commission\nwith a general picture of how the \"population\" answered each question. It is\nimportant that inferences be made only to the actual \"population\" of 16,517 question-\nnaires from which the sample was drawn and that attempt should be made to generalize\nbeyond this particular isolated \"population\".\n4. Profiles:\nThe 1970 census data has not yet been sufficiently refined to provide a\nprofile of the composit over-65 Californian. The gross figures would indicate,\nhowever, that such person is a white 69 year old widow on Social Security who\nlives alone in the Los Angeles area and does not belong to any senior citizens\norganization.\n-5-\nThe typical adult recipients of Social Welfare in California have been\ndescribed by the State Department as follows:\nTYPICAL ADULT RECIPIENTS\n(Independent Living Arrangement)\nCharacteristics\nOAS\nAB\nATD\nSocial:\n1. Age\n72\n67\n62\n2. Sex\nFemale\nFemale\nFemale\n3. Marital\nWidowed\nMarried\nMarried\n4. Live Alone\nYes\nNo\nNo\n5. Ethnic\nWhite\nWhite\nWhite\n6. Years in State\n22\n22\n20\n7. Years in Program\n5\n2\n2\n8. Age at Entrance\n67\n65\n60\n9. Property - Liquid\nSaving-amount unknown\nSaving-amount unknown\n-Θ-\nReal\n-Θ-\n-Θ-\n-Θ-\n10. Health\nGood\nGood\nDisabled\n11. Education\n?\n?\n?\nEligibility:\n1. Residence\nIn State\nIn State\nIn State\n2. Age (Minimum)\n65\n16\n18\n3. Property Limits:\nLiquid\n$1,200\n$1,500*\n$1,200\nReal (Home\nNone\nNone\nNone\n(Income)\n$5,000\nNone\n$5,000\n4. Other\nBlind\nDisabled\nNeeds Provided bv:\n1. Basic Grant\nHousing, food,\nHousing, food, clothing,\nHousing, food cloth-\nclothing, household\nand personal needs and\ning and personal\nremedies and person-\nneeds related to blind-\nneeds and needs re-\nal needs and needs\nness.\nlated to disability.\nrelated to age.\n2. Special Grant\nAttendant Care**\nAttendant Care**\nAttendant Care,\nspecial diet and\ntransportation\nIncome\nOASDI - $64\nOASDI - $35\n-8-\nPayment of Aid:\n1. Payee\nRecipient\nRecipient\nRecipient\n2. Payments per Month\nOne\nOne\nOne\n3. Expenditure Control\nNone\nNone\nNone\n4. Unmet Needs\nNone\nNone\nNone\n5. Amount\n$95\n$135\n$125\n* None if used in 36-months plan for self-support\n** Plus large variety limited only by maximum grant ceiling\n-6-\nOAS Typical Recipient\n5'\nR.I.P.\nBACKGROUND\nMR.\nJONES\n1895\nEDUCATION\n1965\nRESOURCES\nSAVINGS\nSKILLS\nHOME\n72 yrs.\nWHITE\nGOOD HEALTH\n22 YEAR STATE\nRESIDENT\nCOUNTY X\nSOC. SEC. ADM.\nJAN.1\nJAN.1\nPay-MRS. JONES $94\nPay-MRS. JONES $64\nA.Auditor\nRobt. Ball\n[NEED-GRANT]\nINCOME\n-7-\nB. What Is Being Done.\n1. In General. The search for a solution to any problem should be preceded\nby an evaluation of past efforts directed toward the same goal. Too often we\ntranslate our new awareness of a problem into a belief that the problem is\nnew. Ecology and the preservation of our enviornment had been of deep concern\nto many scholars for many years. This is not new, although the current public\nawareness and concern is new\nand welcome. Novices, will often translate\ntheir lack of knowledge of what has been done in a particular field into a\nconviction that nothing has been done. When this happens, plowed ground may be\nneedlessly re-plowed. When we start a project by \"inventing the wheel\", both\ntime and resources are wasted.\nThere are, of course, new ideas. 01d concepts must be continually tested\nas to their validity. But a knowledge of what has been tried and failed, as\nwell as what has been tried and succeeded, are essential to sound and effective\nplanning for the future.\nThe following sections are presented to show in abbreviated form some of the\nefforts that are being made today in the field of aging. Government and non-\ngovernment programs alike are being directed at the areas of greatest need. While\ntodays crisis in aging affords no time for resting on laurels, those who have\nworked so long in the vinyards are entitled to reflect with understandable\nsatisfaction on the significant advances that have been made in the past ten\nyears.\n-8-\n2. Federal Programs for the Aging\n(a) Administration on Aging.\nThe most significant development of 1969 was the enactment of the\nOlder Americans Act Amendments (Public Law, 91-69). It extended the duration\nof the grant programs of the Older Americans Act of 1965, authorized a\nnational old Americans voluntary program, provided assistance to strengthen\nthe state agencies on aging as well as community projects. It authorized\nareawide model projects. Another significant development in 1969 was the\nappointment of Commissioner Martin to serve as the President's Special\nAssistant on Aging, giving AOA's Commissioner for the first time a voice in\nthe highest council of government. 1970 saw much activity towards imple-\nmentation of the 1969 amendments and the continuation and expansion of numer-\nous programs.\nIn administering Title IV of the Older Americans Act, the AOA\nworked closely with state agencies on aging to stimulate their planning\nactivities and to evaluate delivery of services to the aging at the community\nlevel. In 1970, two Federal matching grant programs were funded for state-\nwide planning efforts and for the planning, training and delivery of commun-\nity services for the elderly.\nIn 1969, 816,000 older persons were served by 786 Title III projects;\nin 1970, 1,800,000 older persons were served by 1,000 Title III projects. For\nexample, in 1969 and 1970 over 165,000 older persons were helped to maintain\nindependent living arrangements through such items of assistance as homemaker\nand home health aid services, home delivered meals, home maintenance \"chore\"\nservices, adult day-care services and the like.\nOpportunities for participation in community life were enhanced in\n1969 and 1970 through development and support of a number of programs serving\nthe aging. These include job placements (15,400 in 1969), adult education\nactivities (103,900 in 1969 and over 100,000 in 1970), transportation services\n(76,600 in 1969, 88,059 in 1970), recreation and leisure type services (505,000\nin 1969, 528,713 in 1970), and through multipurpose senior center services\n(509,000 in 1969, 600,000 in 1970).\nThe stimulation of the aging to render volunteer services to per-\nsons in need in their own communities was also a major effort in 1969, with\n40,700 seniors involved, and in 1970 when 50,000 persons participated. These\nservices included directing leisure time activities, providing tutoring ser-\nvices for students, assisting in the operation of senior centers, providing\ntransportation services to other seniors, making home visits and telephone\ncontacts for shut-ins. In 1969 a total of 59 training projects provided\nshort-term training for 10,690 persons to serve the elderly. In 1970 a total\nof 71 such training projects provided short-time training for over 15,000 per-\nsons. Many of the projects prepared specialized personnel, professional and\nnonprofessional, to better serve the elderly.\nResearch and demonstration grants under Title IV of the Older\nAmericans Act, contributed significantly to knowledge and improved practices\nin aging. During 1969, 63 new and continuation projects were funded at a\ncost of approximately $4,155,000. In 1970, 61 new and continuation projects\n-9-\nwere funded at a cost of $3,082,000. Projects in this area are directed at\nexamining the major needs and problems of the nation's elderly population\nand to develop better ways of dealing with them. In 1969, for instance,\ndata for differentiating the needs, interests, and abilities of low and\nmiddle income elderly, between the \"younger\" and the \"older\" senior citizen,\nand the aging in varying environmental settings, was accumulated. The con-\nclusions drawn from an evaluation of these statistics will have far reaching\nsignificance for the design, thrust, and cost of efforts on behalf of older\npeople in future years.\nIn 1968 Congress earmarked $2,000,000 to initiate a special program\nto improve nutrition services for the elderly under Title IV. Under this\nprogram a number of grants were made in both 1969 and 1970, and a number have\nalready been completed. The projects are basically designed to test tech-\nniques and delivery systems for improving the diets of the elderly and for\ncombating social and psychological impediments through good dietary habits.\nSuch programs involve both metropolitan and nonmetropolitan areas and are\ngenerally carried out in existing facilities in the communities, such as\nschools, recreation centers, community centers, homes for the aging, social\nhalls, public housing, churches, and the like. While much data is still to\nbe evaluated, it appears that two major causes of malnutrition and under-\nnutrition in American are lack of income and ignorance of what constitutes an\nadequate diet. In addition, other social and psychological factors associated\nwith aging adversely effect the dietary habits of older people.\nA number of other projects were funded by AOA in studying all\naspects of retirement living, in analyzing the problem of mobility and trans-\nportation needs of the elderly, and in studying and developing a set of social\nindicators for the aging which will assist in the ongoing assessments of the\nstatus of older Americans.\nTraining programs were also conducted under Title V for the purpose\nof sending significant numbers of graduates into responsible positions serving\nthe older population. By the end of 1970 eighteen universities were conducting\nsuch programs in career training. Programs were also designed and funded for\nshort-term training of personnel to improve their skills in the field of aging.\nIn these two years, a total of 3,334 students received either short or long-\nterm training.\nThe foster grandparent program continues to be an extremely popular\nprogram for older persons.\nSince the funding of the initial twenty-one projects, in 1965, the\nprogram has expanded to include sixty-eight projects in 40 states and\nPuerto Rico. No new programs were funded in 1970. There are 187 participat-\ning institutions in which 4,300 foster grandparents serve 8,600 children on\nany one day, and about 22,000 children a year. For the past two years, how-\never, the number of projects and the number of older persons serving in the\nprogram has remained the same. The number of children served has also re-\nmained unchanged.\nThere are other areas, however, in which some changes have occurred.\nTen million dollars was allocated for this program in Fiscal Year 1968, nine\nmillion was allocated in Fiscal Year 1969, and $8.7 million in Fiscal Year 1970\n-10-\nAlso, the profile of individuals serving as foster grandparents has changed.\nInitially, recruitment of males was difficult. Today, one foster grandparent\nin every five is a grandfather. Nonwhite participation has increased from\n26 to 32 percent. Encouraging is the fact that the 70 and over age group\nhas increased from 30 to 41 percent of the total participants during this\nperiod. The younger foster grandparents, the 60 to 63-year-olds, have de-\ncreased comparably. In addition, foster grandparents today are generally\nfrom lower income groups than when the program began. The average income is\nnow $1,052 for single grandparents and $1,675 for two-member families, ex-\ncluding the stipend they receive as foster grandparents of about $1,700. In\naddition to the stipend, foster grandparents receive an allowance to help\ndefray transportation costs, an annual physical examination, and, wherever\npossible, a nutritious meal each day.\nThe attitudes of institutions have changed also. When this program\nbegan, it was difficult to locate agencies and child-care institutions will-\ning to participate. Now, literally hundreds of requests each year for\nFederal help to start new projects are turned away. The institutions also\nnow show a greater acceptance of the older person, of the nonwhite and of the\npoor.\nIn both years, community planning efforts took high priority, with\n130 planning projects in 1969, and 141 in 1970.\nAOA has stepped up its cooperative efforts in HUD and its model\ncities activities.\nSince 33 percent of all Americans aged 65 or over live in central\ncities and 27 percent of them are in the poverty status, the Administration\non Aging has devoted an increasing amount of attention to the needs of the\nelderly in model cities areas. Since these elderly often have severe trans-\nportation and mobility problems, accessible services are essential to them.\nIncreased health and welfare services are a critical need along with improved\nhousing. Too, there is an important concern for the involvement of older\npersons themselves in the model cities planning process, plus the necessity\nof acquainting model cities personnel with the problems of the elderly and\noffering them technical assistance.\nAOA activity in the model cities program has taken several direc-\ntions. AOA has its own task force on model cities. Within AOA the Title III,\nIV and V programs have given high priority to model cities. The Administration\non Aging has actively cooperated with other agencies within HEW on special\nmodel cities efforts as well as in the HEW coordinated model cities effort.\nThe Administration on Aging, through an agreement between HEW and HUD, has\nmoved ahead on programs for the elderly in direct concert with the model cities\nadministration.\nIn addition to the foregoing, the AOA undertook implementation of\nthe Retired Senior Volunteer Program (RSVP) authorized by the Amendments of\n1969. $500,000 was appropriated in early 1971 and senior volunteer programs\nare now being established in each of ten regions. An aggressive public in-\nformation program is also being carried out. Major support was directed to\nSenior Citizens Month in May of 1970. A number of publications, films and\nother documents are produced for distribution with particular emphasis on the\nWhite House Conference on Aging.\n-11-\nEarly in 1970, AOA began exploration with religious denominations\nnationally on possible involvement of churches in community services for\nolder Americans, through technical assistance from AOA. The possibilities\nof a private project are currently under study.\n(b) Atomic Energy Commission.\nThe AEC spent approximately $5.7 million in 1969 and $5.6 million\nin 1970 in research programs related to understanding of the problems of\naging. The research was conducted in 11 AEC laboratories and 23 university\nhospital research projects. One important factor in aging being studied is\nsenescence of immune system. Research with mice indicate the immune system\ncapability declines with advancing age, increasing susceptability to infec-\ntious agents. Ways to enhance immune competencies among the aging are being\nresearched. Another continuing focus of the Atomic Energy Commission's re-\nsearch on aging is in determining the mechanism whereby radiation interacts\nat the molecular and cellular level to bring about loss of functional adapta-\ntion by the individual or species with passage of time. This includes studies\nthat are directed to determining those parameters that are characteristics of\nthe aging phenomenon and accelerated by irradiation; emphasis is also placed\non identifying the physical and physiological phenomenon associated with the\naging process and on studies on molecular and attendant cellular changes that\ncan be used to predict the onset of an aging process.\n(c) Post Office Department.\nThe Postal Inspection Service is responsible for the investigation\nenforcement of the mail fraud statute, Section 1341, Title 18, United States\nCode. It is the oldest \"consumer protection law\" ever enacted by Congress.\nIt provides felony sanctions for any use of the mails in furtherance of a\nscheme to obtain money or property on the basis of fraudulent representations.\nWhile not limited to protection of the aging, the aging are partic-\nularly susceptible to this type of fraud, and thus are important beneficiaries\nof this governmental activity.\nThe following are typical fraudulent practices that have been\ndetected and successfully prosecuted:\nWin a free vacation \"contest\" in which the purported winners\nmake a modest $25.00 \"registration deposit\" to assure their\nnonexistent winnings.\nMedical frauds purporting to sell quack cures for arthritis,\ncancer, obesity, impotency, diabetes, etc.\nHome improvements, debt consolidation and mortgage rackets.\nMatrimonial schemes.\nStocks, bonds, oil and gas leases and other investment swindles.\nFunds solicitation for nonexistent charities or for worthwhile\nannounced purposes and thereafter being diverted to other uses.\n-12-\nIn addition to enforcement, the Department is engaged in a vigor-\nous prevention-through-public-information program, and in 1970 cooperated\nwith the CTC in the field of consumer protection to establish in each metro-\npolitan area of the Nation a system of channeling consumer complaints to the\nproper agency for prompt action.\n(d) Department of Labor.\nOf the programs administered by the Department of Labor, the most\nimportant to the aging are the Age Discrimination in Employment Act of 1967\nand the various job development efforts of the Manpower Administration spe-\ncifically directed at training older workers for employment in government\nand military.\nThe purpose of the Age Discrimination Act is to promote employment\nof older persons based on their ability. The administration and enforcement\nof the Age Discrimination in Employment Act of 1967 was redelegated to the\nAdministration of the Wage and House and Public Contracts Division in the\nDepartment of Labor.\nThe Manpower Administration has continued in its efforts to train\n\"older workers\" for jobs in industry and government when those jobs are within\nreach of their attainment. What has been attempted more is the use of older\ntrained, unemployed, or retired persons to fill the positions of supervisors,\ncounselors, and administrators in the manpower programs. It is found that\nolder workers, especially indigenous ones, establish a rapport with the en-\nrollee many times better than younger workers. Older workers generally estab-\nlish good relationships with older enrollees or older people in the community.\nOperation Mainstream has been the program which provided the vehicle\nfor older workers. Due to the fact that Mainstream was primarily relegated to\nrural and semirural areas, and that the exodus of younger people from those\nareas has been pronounced, we find that this program has provided a surer\navenue to jobs for older persons.\nIn Fiscal Year 1969, the Department of Labor funded 207 Operation\nMainstream programs at a cost of $31 million, in 1970 its combined OEO-Labor\nfunding exceeds $40 million. In addition, there were five national contracts\nfor older workers in 1969 and six in 1970, funded for approximately $10 mil-\nlion and $12 million, respectively. Operation Mainstream projects are admin-\nistered by the Regional Manpower Administrators. The older worker programs,\nalthough funded with Mainstream funds, are administered by the national\noffice staff.\nThe older worker projects follow the same poverty guidelines as\nother Mainstream programs do with one exception, the minimum age limit is\n55 years. These projects are listed below:\n-13-\n1969:\nAuthorized\nSponsor\nFunds\nSlots\nNat'l Council of Senior Citizens\n$3,200,000\n1,132\n(NCSC)\nNat'l Council on the Aging\n2,300,000\n500\n(NCOA)\nNat'l Ret. Teachers Assoc.\n738,000\n313\n(NRTA)\nNat'l Farmers Union\n5,200,000\n2,314\n(Green Thumb)\n(4,700,000)\n(2,044)\n(Green Light)\n(500,000)\n(270)\nVirginia State College\n320,000\n115\n1970:\nAuthorized\nSponsor\nFunds\nSlots\nNat'l Council of Senior Citizens\n$3,446,912\n1,148\n(NCSC)\nNat'l Council on the Aging\n3,582,028\n572\n(NCOA)\nNat'l Retired Teachers Assoc.\n739,011\n353\n(NRTA)\nNat'l Farmers Union\nGreen Thumb/Green Light\n6,700,160\n2,680\nVirginia State College\n479,904\n125\nTotal Action against Poverty,\nRoanoke Valley\n300,000\n70\nThe Mainstream program has the highest percentage of persons 55 years\nof age and over of any of the manpower programs. The programs include older\nworkers from approximately 15 percent in the new careers program to an average\nof about 10 percent in other programs such as the Concentrated Employment\nProgram (CEP), Work Incentive Program (WIN), Job Opportunities in the Business\nSector (JOBS); and other training programs, including MDTA institutional and\nOn-the-Job Training (OJT).\nOlder worker service units were established in 27 cities, for the\npurpose of providing specialized and intensified employment services to\nmiddle-aged and older persons who were having difficulty in obtaining employ-\nment because of their age, or factors associated with age. In addition to\nproviding intensified services, the units were able to develop innovative\nservice methods and techniques for improving services to older workers. The\ncities in which the units were located were Baltimore, Cleveland, New Orleans,\nMinneapolis-St. Paul, Washington, D.C., St. Louis, Boston, Dallas, New York\nCity, San Antonio, Detroit, Rochester, N.Y., Buffalo, Long Beach, Oakland,\nSan Diego, Houston, Chicago, Los Angeles, Pittsburgh, Van Nuys, Kansas City,\nCincinnati, Milwaukee, Philadelphia, San Francisco, and Providence.\n-14-\nThe NIIG is an applied research program focusing on the employment\nand retirement of middle-aged and older workers. It was established to help\nimprove employment services by providing specialized training in industrial\ngerontology to placement and counseling officers; encouraging, coordinating\nand applying research on this subject; and developing and distributing written\nand audiovisual material in this field.\nIndustrial gerontology is the study of the employment and retire-\nment problems of middle-aged and older workers. It begins where age \"per se\"\nbecomes a handicap to employment. Industrial gerontology is concerned with\naptitude testing and placement, job adjustment, retention, redesign, motiva-\ntion, and mobility. It is concerned with the transition from employment to\nretirement and with retirement itself, and retirement income with public and\nprivate pension programs.\nThe experimental and demonstration projects carried on by the em-\nployment service have proved extremely beneficial in developing the senior\ncommunity service program. The older worker service units have provided an\nolder worker specialist who is fully cognizant of techniques for counseling,\njob development and placement of older workers.\nThe five prime sponsors for the senior program have had the services\nof the specialist and find that they have been invaluable in the recruitment,\nselection, continuing counseling, and job placement that is necessary in pro-\ngrams of this type.\n(e) Federal Trade Commission.\nThe Federal Trade Commission enforces laws designed to protect\nagainst unfair methods of competition and to halt in interstate commerce\nunfair or deceptive acts or practices. In carrying out this charge it has\nbecome apparent to the Commission that elderly consumers are among those most\nlikely to find it hard to obtain goods and services they need and want at\ncosts they can afford -- cost in terms of money and in terms of health,\nsafety, and convenience. The Commission is aware that the elderly make up a\nhigh proportion of the poor -- the group upon which noncompetitive practices\nand unfair and deceptive practices in the marketplace are likely to have\ngreatest impact.\nProperly informed, the elderly, as individuals, can maximize their\nsatisfactions through their buying decisions.\nProperly informed, elderly consumers, particularly in groups, can\ninterfere directly with or at least blunt illegal conduct and persistent\npractices inimical to a sound market.\nIt is recognized that elderly consumers, particularly, need to\nunderstand their rights and responsibilities. They need this ammunition if\nthey are to avoid the hazards of the marketplace -- and to avoid the buyer-\nseller transaction induced by unfair and deceptive practices.\nA brief review of activities of the Commission of particular\nrelevance to the elderly follows.\n-15-\nIn recent years senior citizen groups and community organizations\nconcerned with the elderly have been among the target groups for which both\nfield and headquarters staff of the FTC have undertaken education/information\nefforts; talks and conference participation, printed consumer bulletins and\npress releases, for example.\nConsumer Education/Information\nEfforts at the local level are essential to deter unfair and decep-\ntive market practices frequently confronting elderly consumers. From one FTC\nfield office are these 1964 examples of current activities designed to meet\nneeds of older consumers:\nThe attorney-in-charge chaired the Mayor's Consumer Protection\nCommittee for S nior Citizens in Los Angeles. This committee tries to co-\nordinate and make more effective the protection and education efforts of\nlocal organizations and agents. For example, arrangements have been made for\npersonnel in the office of the mayor to receive and distribute complaints to\nthe proper agencies for handling.\nThe California Attorney General's Office and the Los Angeles FTC\nField Office have worked together for the past six years to create interest\namong the black and brown people in the poverty areas. They have published\npamphlets, prepared comic strips, made radio and television appearances, and\ndesigned inservice training components for social workers.\nFederal-State-Local Cooperation\nIn 1969-1970 the Commission pursued an aggressive program to spark\nState and local interest in halting deceptive and unfair competition. With\nlimited success thus far, it has encouraged States to adopt the model \"little\nFTC Act\" which provides weapons by which State governments can put an end to\nunfair market practices which often plague the elderly.\nThe FTC tries to enlist aid of State and local officials in the\nenforcement of acts for which FTC is responsible, such as the Fair Packaging\nand Labeling Act and the Truth in Lending Act.\nAction to Stop Unfair, Deceptive Practices\nWhile not a blueprint of the agency's total program, the Commission\nemphasizes the halt of irregular marketplace practices with particular impact\non the elderly and others unable to afford to be victimized. The case-by-\ncase approach is used in ordering individual firms to stop deceptive and\nunfair practices. However, the Commission cannot rely exclusively or even\nprimarily on this approach. Nor can it rely entirely upon guidance to the\nindustry in the form of written guides, advisory opinions or trade regula-\ntions and rules. Guidance and force both are used. Complementary education\nefforts are proposed as described above.\nThe Commission is specifically assigned responsibility for enforc-\ning the Wool, Fur, and Textile Acts.\n-16-\nOlder shoppers who must guard their clothing dollars carefully\nshould be pleased at the increased activity in the recent past in the FTC\nenforcement of laws that require truthful labeling and advertising of woolen\nand textile fiber products. Recently the FTC has proposed rules which would\nrequire manufacturers to put permanent labels in garments to show how to\ncare for them.\nThe Commission has used its power to try to stop selling practices\nwhich misrepresent income producing business offers to the elderly. For\nexample, sharp practices in the selling of franchises and other do-it-yourself\nbusiness.\nFalse and misleading advertising is continuing to receive special\nscrutiny, through the monitoring of printed and broadcast media.\nOther questionable practices in which the Commission has taken\naction include automobile warranties, magazine sales practices, unsolicited\ncredit cards, pricing of automobile tires, pricing practices of the automobile\nindustry, appliance warranties, labeling and advertising of insecticides and\npesticides, and retail food store advertising and marketing practices.\n(f) Department of Health, Education and Welfare.\n(1) Food and Drug Administration\nVirtually all of the FDA's many programs to enforce the Federal\nFood, Drug, and Cosmetic Act and related laws benefit the elderly as much,\nor more, than any other age group. It is protecting the health and pocket-\nbooks of all consumers to the extent of more than $100 billion of the Nation's\ncommerce in consumer products. Health protection naturally comes first,\nleaving a fraction of its resources for matters that involve only economics.\nBut many health problems also have an economic aspect, so there is a substan-\ntial benefit to the consumer's pocketbook in that way.\nThe following are some of its more important programs:\n(i) Corrective actions of special concern to the elderly\nconsumer.\nThese include actions to insure potency, purity, safety, and effec-\ntiveness of drugs. The FDA's authority and resources to deal with\ndefective drugs have been strengthened substantially. Manufacturers\nrecalled defective drugs from the market over 700 times during 1969\nalone.\nIn 1970 highest priority was given to the matter of drugs\neffectiveness and the removal of ineffectual drugs from the\nUnited States market.\nA monumental study was conducted by the National Academy of\nSciences - National Research Council, under contract with the FDA,\nin which 2,824 separate reports involving 10,000 therapeutic claims\nfor more than 4,300 formulations manufactured by 335 companies were\nevaluated. Orders to make labeling changes or to halt marketing\naffected 7 percent.\n-17-\nAn intensified drug inspection program is also under way in\nwhich FDA inspection teams remain in a plant until all questionable\nmanufacturing practices have been corrected. Many elderly consum-\ners, misled by lay press articles and mail order advertising about\nso-called \"youth drug\" from Europe, called KH-3, have been attempt-\ning to import it. Hundreds of shipments have been detained at\nports of entry because neither safety nor effectiveness have been\nestablished as required by U.S. law. FDA has detailed its charges\nagainst the drug in a seizure case filed in the Federal District\nCourt at Los Angeles.\nFalse and misleading claims for vitamin and mineral food sup-\nplements continue to be aimed particularly at the elderly consumer.\nA court action now underway involves mail order promotion of\n\"Golden 50\" tablets for preventing tiredness, lack of pep, worry\nand weakness, and increasing sexual interest, potency and activity.\nIllustrations and sales copy claim nutritional value of one capsule\nequal to that of larger quantities of expensive foods. Ads in\nreligious and other periodicals, and mailing lists of elderly\npeople are used to sell the product. Regulation of therapeutic\ndevices has been largely confined to court proceedings against\ndefective or misbranded products.\n(ii) Study of health practices and opinions\nThis project, suggested by the Committee on Aging, to study sus-\nceptibility of consumers to health fallacies and misrepresentations,\ninvolved the interview of more than 2,800 randomly selected con-\nsumers. Twenty-two and eight-tenths percent of the sample were\nover 65. The final report is due for early publication and is ex-\npected to shed new light on the health practices and opinions of\nthe American public in general, and of the elderly consumers in\nparticular.\n(iii) Implementation of the Fair Packaging and Labeling Act\nIt is estimated that about 85 percent of the food packages on\ngrocery shelves are now in compliance with this law.\nRegulations spelling out new labeling requirements for non-\nprescription drugs, devices, and cosmetics became effective\nDecember 31, 1969. Labeling of prescription drugs is not involved\nunder the Fair Packaging and Labeling Act, being covered in much\ngreater detail by the Federal Food, Drug, and Cosmetic Act.\nPlans are being drafted for a program to obtain State assis-\ntance in developing regulations against nonfunctional slack-filling\nof packages.\n(iv) L-Dopa cleared for Parkinson's Disease\nProbably the most important single FDA action affecting the elderly\nin 1970 was its approval of the new drug L-Dopa for the treatment\nof Parkinson's disease. There are about 1.5 million sufferers from\n-18-\nParkinson's disease in the United States, most of them in the\nover-60 age group. In view of the known hazards in its use, which\nwere deemed outweighed by the benefits, FDA issued a newsletter to\nall physicians explaining the precautions to be taken in its use,\nand also required the manufacturer to continue intensive research\non long-term effects.\n(2) National Institute of Child Health and Human Development\n(NICHD)\nAging Program\nAging may represent many biological and psychological processes;\nit may stem from changes in individual cells or it may be a by-product or\naccompaniment of disease. So many possible causes must be investigated that\nprogress in aging research is particularly vulnerable to manpower and fund\nshortages. Yet, everyone who lives to adulthood experiences some degree of\naging. Research to unravel the complexities of the aging process and to\nattempt modification of aging's effects on the human mind and body is there-\nfore of potential benefit to all people.\nThe NICHD is in the important business of providing support for\nresearch in the biological, medical, and behavioral aspects of aging, and for\ntraining scientists to carry forward this multifaceted and most imperative\nresearch.\nThe Adult Development and Aging Branch\nThis branch supports research at universities, medical schools, and\nlaboratories throughout the United States in four general areas. They are\naging and disease; cellular aging; intellectual changes with age; and life in\nthe later years. It also supports training for research in aging.\nAging and Disease\nExperiments in aging must distinguish between aging processes and\ndisease processes, although the two are often interrelated. Many cell and\nbody functions decline with age, contributing to the development of disease.\nIt takes a long time to study progressive changes with age in humans and the\neffects of varying life style and environmental factors on those changes. In\naddition, certain procedures are not suitable for human experimentation be-\ncause they may have harmful effects. For these reasons, experimental animals\nwith short-life spans are used in many aging studies. As in human studies,\nthe disease processes that affect the experimental animals must be taken into\naccount in studying their aging processes. Long-term studies in humans also\ncontinue to receive NICHD support.\nCellular Aging\nDiseases during one's lifetime eventually causes an accumulation of\ndamage to the body which represents one aspect of the aging process. However,\nthe unfortunate physical changes that occur with increasing age are not all\ndue to disease. Apparently, certain changes occur because of the way the\nbody is constructed, i.e., they are intrinsic aging processes. They occur in all\npersons and contribute to serious impairment in the functioning of the body\nwith age.\n-19-\nSome of these changes are in molecular structure, some in the cells,\nand some in the organ systems. However, molecular and cellular changes are\nprobably responsible for organ changes and are therefore the target of more\nresearch.\nNICHD is building a program of research on aging of specific cell\ntypes that can be studied by transplantation and tissue culture.\nAnother area of NICHD supported research deals with the cells of\nthe body that never divide. Most of their components are periodically de-\nstroyed and recreated, just as in a dividing cell. However, deoxyribonucleic\nacid (DNA) -- which is responsible for control of many cell activities -- is\nformed anew only during cell division. The DNA in nondividing cells, there-\nfore -- such as in brain and muscle cells -- is 80 years old in an 80-year-\nold man. It would not be surprising if changes had occurred in this complex\nmolecular structure exposed for decades to its microenvironment of thermal\nand chemical energy. Such changes might well have led to loss of cell\nefficiency.\nStudies are also being conducted on an abnormal material that\naccumulates in aging cells, particularly those of the brain and heart. This\nbrown material, often called age pigment, may occupy as much as 25 percent\nof a cell's volume. It seems likely that it may cause some of the loss of\nfunction that occurs with increasing age.\nIntellectual Changes with Age\nModern man is at least as dependent on his mental processes as on\nhis physical well-being, and he experiences profound changes in mental func-\ntion with increasing age. Understanding and perhaps learning to modify these\nchanges would be a significant contribution of research. Many investigators\nare examining the problems a person faces in performing complex tasks, many\nof them posed by technological advances requiring rapid detection, storage,\nretrieval, and processing of information by the brain. The modern air pilot\nfaces this type of problem in the safe guidance of his aircraft from takeoff\nto landing. The age of the pilot is one of the factors that affects his\nperformance, positively in some ways, negatively in others. This type of\nresearch needs to be expanded to cover a larger range of psychological\nfunctions. Research is needed on thinking, learning, remembering, and\ncreativity, with regard to the processes themselves and to the effect of\naging on each of them.\nExtensive additional research is being supported in the biological\nand psychological aspects of aging.\nStatistics on the NICHD Aging Program\nThe expenditures for research and training in aging by NICHD in\nFiscal Years 1969 and 1970 were;\n-20-\nAdult Development and Aging Branch (ADAB)\n1969\n1970\nResearch Grants\n$3,485,047\n$3,225,564\nTraining Grants\n1,976,642\n2,054,033\nFellowships\n133,527\n68,402\nResearch Career Dev. Awards\n174,819\n182,570\nContracts\n167,955\n45,064\nSubtotal ADAB\n$5,937,990\n$5,575,635\nGerontology Research Center\n1,700,000\n2,132,000\nAdult Development & Aging\nInfo.\n86,000\n92,000\nTotal\n$7,723,990\n$7,799,635\n(3) Health Services and Mental Health Administration\nThe Health Services and Mental Health Administration under the\ndirection of the administrator, is responsible for providing leadership and\ndirection to programs and activities designed to improve general health ser-\nvices and mental health programs for the total population and for achieving\nthe development of health care and maintenance systems that are adequately\nfinanced comprehensive interrelated and responsive to the needs of indi-\nviduals and families in all socioeconomical and ethnic groups. The elderly,\nof course, along with all of the rest of the population benefit from such\nprograms. However, special attention to the needs of the elderly is re-\nquired for certain facets of physical and mental health services and pro-\ngrams. The multiplicity of illness which often occurs in the same individual\nmaking treatment more complex, the lack of mobility which serves as a barrier\nto obtaining available health services, and the onset of senility, are but a\nfew problems which require special consideration in organizing health pro-\ngrams for delivering services to and preparing health personnel to deal with\nthe aged.\nTo provide a focal point for the many diverse efforts in health\nservices for the aged, the position of coordinator of health of the aging\nhas been established within one of HSMHA major components, mainly the\nCommunity Health Service. This component is the organizational unit spe-\ncifically involved in health aspects of Medicare and with particular concern\nwith the delivery of health services to the aged.\nThe Community Health Service component of HSMHA has a number of\nother specific functions. It is responsible for the comprehensive health\nplanning program enacted by Congress and carried out by the Federal Government\nin partnership with State and local governments and the private sector. It\nis also responsible for the establishment of National Standards for providers\nof services under the Medicare program. For the first time, this effort\nmoves towards the establishment of a National Standard for the delivery of all\ntypes of health care services. The Health Standards Division has instituted\nseveral ongoing programs to promote and maintain the quality of care provided\nto elderly persons. Of particular significance is the effort of upgrading\n-21-\nState licensure and certification requirements, tightening national accredi-\ntation programs, and establishing both standards for and surveillance of the\ndelivery of health care.\nThe Division of Health Care Services promotes the development and\nutilization of improved methods of health services organization delivery and\nfinancing at the community level. The Division of Health Resources encourages,\nassists and supports appropriate agencies and organizations in' developing\nneeded health care resources and increasing their capacity to provide for the\ndelivery of quality effective services. A major effort of this division in\n1970 was its concentration on the health facilities survey improvement program\nto improve and standardize the performance of State and Federal personnel en-\ngaged in surveying and certifying health facilities for licensure and parti-\ncipation in Medicare and Medicard programs. The nursing home branch continued\nduring 1970 to direct its efforts toward improvement of health and social ser-\nvices of long-term care patients in nursing homes.\nThe National Institute of Mental Health, assigned to HSMHA for\nadministrative purposes, has a section on mental health of the aging in the\nDivision of Special Mental Health Programs. This section is concerned with\nprograms of applied research concerning the mental health of aging persons.\nThe NIMH has found that while persons over age 65 are an exceedingly high\nrisk group insofar as mental health problems are concerned, they are as a\ngroup the lowest in utilization of mental health services. Accordingly,\nprograms and research projects are directed at improving this situation. For\nexample, new applied research studies funded for the first time in 1970 in-\nclude one which is assessing the effects of services and programs offered by\nan older adult program in a community center to aged individuals who have\nundergone various types and degrees of role changes. Another project provides\nan intensive case finding and service program which will yield information\nabout the life style, attitudes, and social functioning of low income urban\naged.\nThe hospital improvement program operated by NIMH since 1963 de-\nvoted 20 projects in 1970 to improvement of facilities concerned with aged\npersons. NIMH is also stimulating projects to train new types of profes-\nsional workers to help care for those aged who are already mentally impaired\nor to prevent mental illness in arising. The major portion of NIMH funds\nconcerned with aging is being used for teaching grants and trainee stipends\nat social work schools. In 1970, 17 universities had training grants\nin the field of aging. Training was also stimulated in psychiatric social\nwork, psychiatry, psychiatric nursing, and in general, directed at upgrading\nthe efficiency of mental health personnel.\nHSHMA is also responsible for the regional medical programs services\nwhich are conducted through grants and contracts in an effort to assist the\nnation's health institutions and health professions to improve the organization\nof health resources and accessibility of care and to enhance man power capability\nat community levels within the framework of voluntary cooperative relationships.\nThe purpose is to improve the quality of care to individuals, but especially\nthose threatened by or suffering from heart disease, cancer, stroke, and kidney\n-22-\ndisease. During fiscal 1970, funds were available to the 54 programs for support\nof about 600 components activities with a specific categorical disease. Two multi-\nphasic screening programs were funded in East Palo Alto and in the San Joaquin\nValley. Rehabilitation activities associated with majority of stroke patients, was\nthe subject of training and research. Home health aid projects were also stimulated\nand as of July 1st, the Hill-Burton program administered by the Health Facility\nPlanning and Construction Service, had provided assistance for the construction of\n93,749 longterm care beds in chronic disease hospitals, nursing homes, and units\nof general hospitals. Also in 1970, 63.6 million dollars was appropriated for the\nconstruction of long term care facilities which should stimulate the construction\nof approximately 8,900 longerm care beds.\n(4)\nSocial Security Administration\nSocial Security Administration\nThe Social Security Administration administers the Federal social security pro-\ngram, which is the Nation's basic method of assuring income to the worker and\nhis family when he retires, becomes disabled, or dies, and of assuring hospital\nand medical benefits to persons 65 or over. When earnings stop or are reduced\nbecause the worker retires, dies or becomes disabled, monthly cash benefits are\npaid to replace part of the earnings the family has lost.\nDevelopments in Social Security\nAbout 92 million people contributed to social security in calendar year 1969,\nand 95 million in 1970. Today, 95 out of 100 mothers and children are protected\nagainst the risk of loss of income because of the death of the family breadwinner.\nThe survivorship protectionalone, as of January 1, 1969, had a face value of about\n$960 billion, and as of January 1, 1970 $1,130 billion.\nAbout 24.9 million men, women, and children were receiving monthly social security\nbenefits as fiscal year 1969 ended, and 25.8 million in 1970. The beneficiaries\ninclude about 16.8 million retired workers and dependents of retired workers,\n2.6 million disabled workers and their dependents, and 6.3 million survivors of\ndeceased workers. About 0.6 million noninsured persons 72 and over were receiving\nspecial payments that are provided to certain aged persons getting no public\nassistance payments and little or no other governmental pensions. Virtually the\nentire cost of these special payments is borne by general revenues of the U. S.\nTreasury.\nNinety percent of those who were 65 or over at the beginning of 1970 were receiving\nbenefits or would be eligible to receive benefits when they or their spouses retire.\nOf those who reached 65 in 1970, 93 percent were eligible for social security cash\nbenefits. Projections to the year 2000 indicate that 96 to 98 percent of all aged\npersons will then be eligible for cash benefits under the program.\nBeneficiaries and Benefit Amounts\nDuring the fiscal year ended June 30, 1970, benefits paid under the old age, survivors,\nand disability insurance program totaled $29,045 million -- an increase of $3,351\nmillion over the amount paid in the preceding fiscal year, and $6,220 million over\n1968. Total benefit payments to disabled workers and their dependents in 1970 were\n$2,778 million, 14 percent higher than in fiscal year 1969. Old-age and survivors\ninsurance monthly benefits rose 11 percent to $26,267 million. Lump-sum death pay-\nments amounted to $288 million, about $2 million higher than in the previous fiscal\nyear.\n-23-\nThe number of monthly benefits in current-payment> status increased by 0.8 million\nto 25.8 million during the year, and the monthly rate rose $453 million (21 percent)\nto 2.6 billion.\nIn December, 1969, the average old-age benefit being paid to a retired worker who\nhad no dependents also receiving benefits was $117 a month. When the worker and\nhis wife were both receiving benefits, the average family benefit was $169. For\nfamilies composed of a disabled worker and a wife under 65 with one or more entitled\nchildren in her care, the average was $238; and for families consisting of a widowed\nmother and two children; the average benefit was $256. The average monthly benefit\nfor an aged widow and widower was $88. (amendments effective January, 1970, raised\nbenefits 15 percent)\nDuring the fiscal year 1969, a period of disability was established for about 347,000\nworkers, 35,000 more than the previous high set in fiscal year 1968. During 1970\nthe period of disability was established for 335,000, 12,000 leass than 1969. The\nnumber of persons determined to have been disabled since childhood totaled 26,000\nin 1969 and 25,000 in 1970.\nThe number of disabled workers receiving monthly benefits rose nine percent in fiscal\nyear 1970 and totaled 1,435,900 at the end of June. Benefits were being paid to about\n1,131,000 wives, husbands, and children of these beneficiaries. By the end of June,\n1970, child's benefits were being paid at a monthly rate of $19.2 million to 263,000\ndisabled persons 18 and over -- dependent sons or daughters of deceased, disabled, or\nretired insured workers -- whose disabilities began before they reached 18. About\n29,000 women were receiving wife's or mother's benefits solely because they were the\nmothers of persons receiving childhood disability benefits. The number of disabled\nwidows and widowers receiving monthly benefits was about 32,000 at the end of June\n1969 and 45,000 at the end of June, 1970.\nMedicare paid out $6.3 billion in 1969 and $6.8 billion in 1970 for the health-care\nexpenses of men and women age 65 and over covered by the program. About $4.7 billion\nwas paid in 1969 and $4.8 billion in 1970 for hospital care, extended care facility\ncare, and other services covered by the hospital insurance program. In addition,\n$1.6 billion was reimbursed for physicians services and various related health and\nmedical items covered by the supplementary medical insurance program in 1969 and\n$2 billion in 1970.\nThe medicare program depends for its success upon the understanding and cooperation\nof large numbers of people and a variety of institutions. Twenty million older\npeople, just bout all those over age 65, are covered automatically under the hospital\ncare portion of the program. Of these people, 96 percent have also signed up for\nthe voluntary part of medicare and pay a monthly premium to get additional coverage\nfor physicians' bills. Over 17 million hospital stays have been paid for during the\nfiscal years 1968 - 1970. Over 76 million medical bills have been paid under the\nsupplementary plan.\nThere are about 6,800 hospitals involved, 200,000 physicians and 4,650 extended\ncare facilities in addition to 2,350 home health agencies, 2,680 private laboratories\nand many other health service providers. Some 130 Blue Cross and Blue Shield and\nprivate insurance contractors help in the administration of the program and 52 State\nagencies are involved in the certification of eligibility of providers in terms of\nquality standards.\n-24-\n(5)\nSocial and Rehabilitation Service\nActivities Affecting the Aging\nThe Social and Rehabilitation Service has responsibilities to the Nation's older\npopulation which extend far beyond its obvious responsibilities to them through\nthe Administration on Aging. The Assistance Payments Administration administers\nthe old age assistance program, to provide badly needed cash benefit supplementation\nfor inadequate -- or nonexistent -- incomes in old age. The Medical Services\nAdministration administers the medicaid program which meets medical needs of the\nolder poor and near-poor beyond any protection they may have through medicare and\nother programs. The Office of Research, Demonstrations, and Training conducts\nresearch and demonstration projects which extend the frontiers of knowledge\nconcerning welfare and rehabilitation for the aged and others. The Rehabilitation\nServices Administration provides rehabilitation services for the aged who are\nhandicapped, including those whose handicaps are due solely to advanced age. The\nnewly created Community Services Administration brings together under unified\ndirection the provision of social services to individuals and families, including\nthe aged, who are or who may become clients served by public assistance.\nOld Age Assistance\nIn June 1970 SRS's Assistance Payment Administration served 2,052,000 persons aged\n65 or over through the old age assistance program. While this is a slight increase\nin number from the preceding year it represents a marked decrease from the all-time\nhigh of 2,810,000 aged persons in September 1950. This overall decline has come\nabout despite a steady increase in the number of aged people in our population.\nThe decline is due primarily to the rapid increase in the number of persons receiving\nold age survivors disability insurance and the increase of these insurance benefits.\nAll 50 States, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands\nhave old age assistance programs. The national average assistance grant in June\n1969 was $74.75. This represents an increase of approximately $2.50 over the pre-\nceding year.\nAs a means of encouraging dependent elderly people to attain either partial or full\nself-support 35 States now provide for a disregard of some portion of earned income\nin determining the amount of assistance payments. Additionally, 23 States allow for\nsome disregard of income which is incurred from sources other than earnings.\nAccording to the latest study available the medican age of old age assistance re-\ncipients is approximately 77 years and trends indicate that this median age will\nincrease in the future. The proportion of assistance recipients living alone in\ntheir own homes is approximately 35 percent.\nMedical Assistance\nAll states except Arizona and Alaska had Medicaid (Medi-Cal in California) programs\noperational as of January 1, 1970. In fiscal year 1970, total expenditures for\nmedical assistance under all federally aided public assistance programs were $5.1\nbillion, of which $2.6 billion came from the Federal Government.\nMedicaid permits the Federal Government to contribute to the cost of the care of\naged individuals in institutions for mental diseases when the State inclused this\nservice, and 34 States did so in fiscal year 1969. Over 69,000 mental patients were\nenrolled in the program. The States involved received about $150 million of Federal\nfunds to help them improve the care of the patients and to develop comprehensive\nmental health programs.\n-25-\nResearch and Demonstrations\nThe demonstration projects program in public assistance under section 1115 of the\nSocial Security Act provided grants for at least 21 different projects during the\ncalendar year 1969 and 24 in 1970, all of which were totally or partially concerned\nwith providing a variety of services to elderly recipients in public welfare. These\nprojects were carried out under the auspices of State public welfare agencies.\nRehabilitation Services\nThe major goal of the Rehabilitation Services Administration's program for the\naging is to rehabilitate as many odler handicapped individuals as possible into\ngainful employment through activities of the State-Federal rehabilitation program\nadministered by the agency.\nToday, large numbers of older people are \"existing\" at the poverty level, or below,\nand when such a predicament is compounded by a disability it is indeed tragic as\nit is more difficult for the older handicapped person to obtain employment.\nIt is estimated that there are over four million disabled people 40 years of age\nand older eligible for, and in need of, rehabilitation services.\nIn an effort to alleviate this situation, State rehabilitation agencies have been\nintensifying their efforts to serve the aged handicapped and a steady increase in\nthe number of these individuals rehabilitated has resulted. For example, in fiscal\nyear 1959, a total of 80,739 disabled persons were rehabilitated into employment,\n24,275 of whom were aged 45 and beyond, while in fiscal year 1970 a total of 266,970\nhandicapped persons were rehabilitated of which an estimated 71,2000 -- almost three\ntimes the 1959 figure -- were 45 years of age and over.\nCommunity Services\nThe Community Services Administration, established in November 1969, is the newest\ncomponent of the Social and Rehabilitation Service. The new Administration has as\none of its responsibilities providing social services to aged and handicapped in-\ndividuals in the public assistance program. A principal objective of the Community\nServices Administration is to strengthen and extend social services to the aged in\nStates and to help them toward an increased participation in family and community life.\nAt the same time, Regional Community Services Administration counterpart staff have\nbeen appointed so that a unified and comprehensive approach, at the Federal level,\nto work with States administering the service programs for aged and handicapped in-\ndividuals is underway.\nThrough its Division of Services to the Aged and Handicapped, the Community Services\nAdministration is responsible for policy and program development for services to the\naged in the public assistance program and will maintain liaison and joint planning\non the operating levels with those Federal and national agencies and organizations\nactive in the field of aging.\nAs of the quarter ending March 31, 1969, 223,000 aged individuals, approximately\n17 percent of the total aged in the program, received a variety of services which\nhelped them with such problems as meeting health needs, home maintenance, finding\nemployment, securing adequate housing and community participation in the form of\nadult education and recreation activities. Of this number, 80,000 needing protection\nwere helped to find a protective institutional placement, or were helped with problems\nof money management or daily living.\nThe Federal expenditures for the provision of social services to the aged for fiscal\nyear 1969 was $39.3 million, and in fiscal year 1970 $70,422,000.\n-26-\n(6)\nOffice of Education\nAdult Basic Education\nThe adult basic education program authorized under the Adult Education Act of 1966,\nas amended, provides instruction in basic skills -- reading, writing, speech,\ncomprehension, computation -- up to and including the twelfth grade level for per-\nsons 16 years of age and older who need and desire such skills. Adults enroll be-\ncause they want to prepare for a job or job promotion, they want to be able to\nfollow their children's progress in school, or they want to be more functioning\ncitizens. The program is administered by State education agencies according to\nState plans submitted to the U. S. Office of Education and approved by the U. S.\nCommissioner of Education. Facilities and resources of local public school sys-\ntems are utilized where available.\nDuring fiscal year 1969 and 1970, the reports of age distribution in appropriate\nadult basic education activities indicated the approximate extent to which persons\nover 45 years of age participated in the program:\n1\nState grant program\nNumber of enrollees\n1969\n1970\n45 to 54\n83,700\n77,148\n55 to 64\n41,850\n39,448\n65 and over\n20,925\n15,100\n1\nTeacher training program\nNumber of participants\nAge:\n40 to 49\n1,119\n1,239\n50 to 59\n589\n649\n60 and over 1\n241\n261\nPublic Library Services\nThe Division of Library Programs during the past year has maintained liaison with\nthe Administration on Aging. Staff have been particularly concerned with the public\nlibrary's role as part of the total community ffort in the field of aging. With\nincreased free time, older adults are now making greater use of their public libraries\n-- for informa tion, inspiration, and leisure-time reading. Many kinds of library-\nsponsored adult education programs are in evidence. These include film series,\nlectures, forums, television programs, and discussion groups.\nService Developments\nThe possibility of some Federal assistance for institutional services and general\nservices for handicapped people through public (and other) libraries supported by\ntitles IV-A and IV-B has strengthened existent programs and permitted long-needed\ninnovations in this area.\nFor example, one State agency, the Washington State Library whose institutional\nservices are directed to 12,000 institutionalized residents, is now participating\nin the State's plan to move from solely institutional residential sites to halfway\nhouses and local residential sites whose objective is to place these State dependents\ncloser to a community setting. The Washington State Library is, with assisting\nFederal funds, responding to this shift in custodial and care philosophy by establish-\ning nearby library services and by encouraging and promoting public library services\nto sustain the homebound and handicapped. In this shift, library services are becoming\nmore available and more specifically aimed at the aged both throughthe program ac-\ntivities of the State government and through the leadership offered to public libraries\nstriving to strengthen their services for senior citizens.\n-27-\nCommunity Services and Continuing Education\nCommunity service and continuing education programs, authorized by Title I of the\nHigher Education Act of 1965, have established a number of programs designed to\nassist the older American. In 1970, a total of 7,360 persons participated in\n20 programs developed for the older American in 12 States.\nRecognizing that early retirement and advances in medical science have afforded\nthe senior citizen many years for useful activities, the Title I program is\nattempting to find solutions to the problems which confront the older adult and\nto increase the possibilities for effective utilization of this potential reservoir\nof knowledge, manpower, and experience.\nManpower Development and Training Program\n(Public Law 87-415, as amended)\nAlthought the Manpower Development and Training Act (MDTA) since its inception has\nafforded opportunities for training to persons 45 years of age and older, the 1966\namendments recognized the special training and employment needs of this age group\nand gave impetus to programs meeting these special needs.\nIn fiscal year 1970, the participation of older workers in the program continued\nat about the same level as the previous year, with persons 45 years of age and older\nrepresenting about 10 percent of the enrollments both in institutional and on-the-\njob training. Cumulatively (fiscal years 1963-1970), however, the participation is\nslightly higher, at 11 percent of the total enrollment. Following is the participa-\ntion for both institutional training and on-the-job training for fiscal years 1969\nand 1970.\nTotal MDTA\nInstitutional\nOJT\n1969\nTotal enrolled\n220,000\n135,000\n85,000\n45 and older\n22,000\n13,500 (10%)\n8,500 (10%)\n1970\nTotal enrolled\n226,000\n135,000\n91,000\n45 years or older\n22,000\n13,100 (9%)\n9,100 (10%)\nA number of training programs have been developed which meet the special training\nneeds of the older group.\nMDTA has also provided training in new and emerging occupations particularly suited\nto the older worker.\nThe AMIDS (Area Manpower Institutes for the Development of Staff) are providing\ntraining, staff development and technical assistance to all manpower personnel\nworking with the disadvantaged (and by definition, this includes persons 45 years\nof age and older). AMIDS were developed by the Office of Education in response\nto the need for counselors and instructional personnel in MDTA programs who possessed\na unique understanding of the special learning and human needs of persons enrolled\nin MDTA programs. The AMIDS programs have been extended to all manpower personnel\nworking with the disadvantaged whether in the MDTA program, State agencies such\nas the employment service and private industry.\n-28-\n(g)\nDepartment of Housing and Urban Development\nThe Department of Housing and Urban Development now administers 21 different pro-\ngrams which provide some form of assistance (directly or indirectly) to our elderly\npopulation. Housing programs directed specifically and exclusively to the elderly\npopulation (such as low-rent public housing projects designed for the elderly and\nnonprofit and limited-profit sponsored housing under section 202) have been in operat-\ntion for more than a decade. These latter programs account for the sharp rise in\nfederally subsidized independent living accommodations designed for the elderly, from\n1,100 units in 1960 to 180,000 in 1970.\n\"Designed for the elderly\" tells only part of the story, for the elderly have occupied\nlow-rent public housing from its inception, and their participation in the program,\nbefore the provision of housing specifically designed for the elderly, had reached\n77,000 general purpose units in 1960, and 156,000 by 1970. Thus, by mid-1970, federally\nassisted programs have produced over 336,000 subsidized independent living accommodations\noccupied by the elderly.\nThe steady rise observed in the number of general purpose low-rent public housing\nunits occupied by elderly households probably will continue as a result of normal\noperations in both tenant intake and the aging process At the same time, the\npresent pipeline of units under construction, awaiting construction, and in appli-\ncations awaiting approval indicate a continued high rate of participation by the\nelderly, in spite of the phasing out of the section 202 program, which is a direct\nloan program being converted to an interest subsidy program under section 236.\nThe older population also benefited from significant progress in 1970 in HUD programs\nnot specifically identified as for the elderly. Recognition of their particular\nneeds due to static and limited incomes was most starkly revealed in the model cities\nprogram. The aged population in these depressed neighborhoods ranged from 10 percent\nof the areas' population to 50 percent in some cities Special programs for the\nsenior citizens clearly were indicated and HUD instituted a series of actions to meet\nthese needs.\nHUD small town, new communities, and breakthrough also focused attention on the\nparticular requirements of the elderly as a normal part of the general population\nin these emerging programs. About 60 percent of home rehabilitation grants in urban\nrenewal and code enforcement areas continued in 1970 to be made to couples or individual\nhomeowners aged 62 and over.\nInteragency and cross-disciplinary teams have worked together in 1970 to assure\nservices that would result not only in improved shelter but, so far as possible,\na total living environment and the services needed by the elderly to sustain their\nindependence and freedom from institutionalization. Programs on nutrition, education,\nhealth maintenance, transportation, and home aids have marked the year's effort to\nbring services within housing complexes or within easy access of the residents.\nServices emanating from housing centers have stressed the neef for a neighborhood\napproach rather than community space and services restricted to the fortunate few\nin housing developments - thus housing becomes a community resource for the older\npopulation.\nHUD health-related programs also increased in number in the past year. The FHA\nsection 232 nursing home beds under insurance increased from 52439 at December 31,\n1968, to 70,739 at August 31, 1970, with another 12,738 beds committed but not yet\ninsured. A large percentage of the occupants were elderly.\n-29-\nThe first year of the intermediate care facilities program saw the completion\nof HUD-HEW criteria for construction and operation.\nHUD participated in an increasing number of conferences, seminars, and uni-\nversity gerontological center activities.\nResearch and Technology and the Elderly\nResearch on the transportation needs of the elderly population was included\nin studies undertaken in 1970. These studies were jointly funded in cooperation\nwith the Department of Health, Education, and Welfare and with the Department of\nTransportation and focused on the mobility patterns of the older population. A\ntwo-day workshop on early findings was held in May 1970. Another study, funded\nby HEW and HUD, covered the selection of tenants for housing for the elderly and\nhandicapped and the services required to permit this group to live independently.\nIn addition, formulation of a study on the effectiveness of current housing pro-\ngrams for the elderly should be ready for activation early in 1971.\nOperation Breakthrough\nThe special needs of the aging are also served in HUD's breakthrough program.\nIn 1970 all nine of the breakthrough sites broke ground. Housing units specifi-\ncally designed for the elderly will be available on the sites. Of the approximate\ntotal of 2800 housing units, about 1700 are assisted, about 200 are public housing\nfor the elderly, and about 1500 are supported by the 236 and 235 FHA programs, a\nlimited number of which will be available to the elderly.\nMetropolitan Planning and Development -- Resources for the Elderly\nThe Office of Metropolitan planning and Development, HUD, embraces a series\nof programs designed to improve the quality of life for persons of all ages.\nSeveral of these programs have particular significance for the older population,\nthe majority of whom reside in metropolitan areas or small towns. Thus, programs\nfor neighborhood facilities, open space land (including small city parks), small\ntown assistance, and new community assistance reflect concern for the elderly\npopulation and their special need for environmental improvements. The following\nare highlights of some of these programs:\nNeighborhood facilities program\nThe neighborhood facilities program provides two-thirds grants (three quarters\nin Economic Development Administration (EDA)-designated redevelopment areas) to local\npublic bodies to assist in the construction of multiservice neighborhood centers\nfor low-income neighborhoods. Funds cover the acquisition of land, demoliton, new\nconstruction, rehabilitation of existing structures, landscaping, architectural/\nengineering fees, parking lots and other minor outdoor development. Funds for the\noperation of services and activities that will take place in the facility must be\nobtained from sources other than HUD. Grants are made only to public bodies;\nhowever, nonprofit organizations having the legal, financial and technical capacity\nmay subcontract with the public body to own and/or operate the facility.\nAs of June 30, 1970, 440 neighborhood facilities projects had been approved by\nHUD. Of these, 49 percent offer some type of service or activity designed specifi-\ncally for senior citizens. (In projects approved during the first half of fiscal\nyear 1971, 54 percent included senior citizens activities.)\n-30-\nOpen space and small city parks\nThe open space program encourages local communities to be aware of the unde-\nveloped needs of any park service area. With grants from this program, various\ncommunities have developed specialized parks, for example, tot lots, active rec-\nreation areas, and parks for older citizens. Parks developed in areas where senior\ncitizens reside should be developed to meet their needs.\nSmall towns\nThe department recognizes the advantages of the \"small town way of life\" and\nis continually seeking to improve its services and programs to smaller communities.\nA basic objective is to preserve and improve both the small and large community--\nso that citizens will have meaningful opportunities to choose either option. The\npotential of the small town and new community development is an alternative to\nmetropolitan congestion and suburban sprawl, and the problem of accommodating a\npopulation which will double in the next 50 years is receving new emphasis and\nattention.\nThis effort has significant impact on the population over age 65 since two-\nthirds of them live in nonmetropolitan areas or small communities outside central\ncities.\nHealth programs serving the elderly\nA number of HUD administered programs have a direct bearing on serving the\nhealth needs of the elderly.\nSection 232 of the National Housing Act authorizes FHA to provide mortgage\ninsurance for proprietary and private non-profit nursing homes. Joint financing\nwith Federal Hill-Burton grants is permissible. As of December 1970, there were\n11 FHA-insured nursing home projects which had received Hill-Burton grants. These\nrepresent 1,287 beds and $11,612,500 in mortgage amounts. In addition, there are\nanother 14 FHA insured homes withour Hill-Burton monies representing 1625 beds and\n$14,864,800 in mortgage amounts. As of August 1970, FHA has insured 716 nursing\nhome projects which contain 70,739 beds and $529,089,609 in mortgage amounts.\nIntermediate care facilities\nOf direct importance to the elderly was the expansion in 1969 of the FHA\nsection 232 nursing home program to include funding for intermediate care\nfacilities. Before this, the major resources of the Department in behalf of\nthe elderly had been for dwellings for the well elderly who are capable of in-\ndependent living and self-management, and at the other extreme, for nursing homes.\nA number of older people fall between these poles who cannot live independently\nand yet do not need skilled nursing home care. Vendor payments under the 1967\nSocial Security Amendment will make intermediate care facilities usable by re-\ncipients of old-age assistance, aid to the blind, and aid to the disabled.\nTo help finance facilities for this in-between group, section 111 of the 1969\nHousing Act authorizes FHA insurance to finance new or rehabilitated intermediate\ncare facilities, or combined nursing homes and intermediate care facilities. These\ncan be financed under the same terms and conditions as provided for a nursing home,\nand the program is administered by the nursing home branch.\nThe mortgage is limited to a principal obligation not exceeding $12,500,000\nor 90 percent of the estimated value of the property or project including major\nmovable equipment. The Secretary must require certification by the State agency\ndesignated by the Public Health Service Act as to the need of such facilities\nand that there are appropriate standards for their operations.\n-31-\nDuring 1970, HUD in consultation with the Department of Health, Education,\nand Welfare completed joint directives relating to the health and medical aspects\nof intermediate care facilities. Some 24 projects now are in process with seven\ncompleted and in operation and six under construction.\nNonprofit hospitals\nThe 1968 Housing Act authorized FHA to insure mortgage loans on nonprofit\nhospitals for construction or rehabilitation, including equipment to be used in\nthe operation, under section 242.\nThe maximum interest rate on these loans is 8 percent, plus one-half of 1\npercent mortgage insurance premium and the maximum term is 25 years. The maxi-\nmum insurable loan is 9U percent of the estimated replacement cost of the building\nand major equipment, with the limit of $25 million for any one loan. Before\ninsuring any mortgage under section 242, a certification of need must be obtained\nfrom the appropriate State agency certifying that there is a need for the hospital.\nA memorandum of agreement has been signed between HEW and HUD under which HEW\nprocesses hospital facility proposals under the mortgage insurance program, through\nits regional office, using Hill-Burton procedures and construction and design stand-\nards. A Hill-Burton grant may be combined with an FHA-insured loan.\nThis program became operational in May 1969. As of November 1970, 11 hospital\nloans had been insured, and firm commitments have been given on 13 additional pro-\nposals. A number of additional hospital proposals are being processed by HEW and FHA.\nGroup practice facilities program\nThe Demonstration Cities and Metropolitan Development Act of 1966 authorizes\nHUD, under title XI of the National Housing Act, to insure mortgage loans financing\nthe construction or rehabilitation of, and the purchase of equipment or facilities\nfor the group practice of medicine, dentistry, or optometry. The program is ad-\nministered by the FHA which receives technical guidance and assistance covering\nmedical and health aspects of the program from the Public Health Service of the De-\npartment of Health, Education, and Welfare.\nGroup practice makes possible more efficient use of scarce manpower and costly\nhealth care facilities and equipment. It can be particularly beneficial to small\ncommunities and low-income urban areas where adequate health facilities of a com-\nprehensive nature may not otherwise be conveniently available, particularly to\nthe elderly.\nHUD Housing for the Elderly\nDemand for housing for the elderly remained high in 1970. The Department of\nHousing and Urban Development continued to give housing for the elderly close\nattention through a variety of financial tools using both public and private sponsors.\nHousing units specifically designed for the elderly approved or committed for\nmortgage insurance or annual contributions in public housing during the first 8 months\nof calendar year 1970 showed an increase in excess of 15,000 units over the same\nmonths of 1969. The comparison by major programs for this period follows:\nPROGRAMS APPROVED OR COMMITTED (First 8 months both calendar years) 1970\n1969\nLow-rent public housing\n33,481\n23,666\n202 direct loan program\n398\n3,032\nFHA 236 insurance program (interest subsidy)\n7,739\n0\nFHA 231 program\n88\n0\n-32-\nThe cumulative number of approved units from program inception through\nAugust 31, 1970 is:\nLow rent public housing\n282,757\n202 direct loan program\n45,106\nFHA 236 program\n9,883\nFHA 231 and 207 programs\n43,657\nThe department also administers a housing subsidy program under private\nauspices (sec 202 (d) (3) \"Below market interest rate, a rent supplement program\nfor low income families (sec 202 and 231 affecting 4200 elderly persons in 1970\nand $3.7 million) urban renewal home rehabilitation loans and grants (Sec 312 of\nthe Housing Act of 1949 and affecting loans for 25,700 dwelling units amounting\nto $100 million, and direct grants for 25,300 cases in the amount of $53 million),\nand others.\nSeveral items of legislation in 1970 were also of special significance to the\nelderly:\n1970 Uniform Relocation Act\nWith the vast increase in public programs in densely populated urban areas,\nthe dislocation from homes and businesses has caused the affected citizens, in-\ncluding the elderly, to bear the burden of meeting these public needs. To alle-\nviate this situation, the Uniform Relocation Assistance and Real Property Acqui-\nsition Act of 1970 was signed by the President on January 2, 1971. This act\nresponds to the fact that relocation is a serious and growing problem in the\nUnited States and that the pace of displacement will accelerate in the years\nimmediately ahead. The committee report states that it \"recognizes that advisory\nassistance is of special importance in the relocation process especially for the\npoor, nonwhite, the elderly, and people engaged in small business.\"\nSeveral features of this act may well benefit the older population who must\nleave their homes and seek new housing arrangements. Fixed payment limitations\nfor moving expenses have been increased for individuals and families from $200\nto $500. Additional relocation payments to rent housing or make a down payment have\nbeen increased from $1,000 to a maximum or $4,000 based on an assistance period\nextended from 2 to 4 years; replacement housing payments and the amountis increased\nfrom $5,000 up to a maximum of $15,000. This may include giving up owner-occupied\nhousing, financial assistance will be available to cover the differential in the\naggregate interest and other debt service.\nSince many elderly owner occupants find difficulty in finding replacement\nhousing they can afford, this liberalization of funds for defraying at least the\nfinancial difficulty is significant. In addition, a relocation advisory service is\nestablished to minimize hardships in adjusting to relocation. This service can be\nvaluable to the elderly, particularly to the lone woman not experienced in real\nestate transactions or in finding housing resources.\n1970 Housing Act\nThe Housing Act of 1970, signed by the President on December 31, 1970, fills\nthe gap in housing programs for the elderly by recognizing the needs of the frail\nbut not ill older persons. Rental congregate housing with both public and private\nsponsors is expressly endorsed. Such housing should alleviate the necessity for\npremature residence in medically oriented institutions.\n-33-\nThe Secretary is authorized to insure mortgages covering rent supplements and\nsection 236 rental assistance projects designed to be occupied by displaced,\nelderly or handicapped persons. Those projects may contain community kitchens,\ncommon dining areas, and other shared facilities. Up to 10 percent of section 236\ninterest reduction payments and 10 percent of the contracts to make rent supplemtn\npayments may be made with respect to such congregate facilities.\nCongregate public housing also is included. In the provision of housing pre-\ndominantly for displaced, elderly, or handicapped families, the Secretary of HUD\nis directed to encourage public housing agencies to develop such housing wherever\npracticable, for use in whole or in part as congregate housing. Congregate hous-\ning is defined to mean projects with central dining facilities where some or all\nof the units do not have kitchen facilities. Up to 10 percent of the newly\nauthorized annual comtribution contract authority can be set aside for this con-\ngregate program for the low-income elderly, displaced, or handicapped persons.\nThrough these enactments HUD will be in a better position in the years ahead\nto provide residential facilities and services needed by millions of older people\ncaught between inability to live independently but not needing the costly and\nsocially less desirable medical facility. It is foreseen that residents of such\ncongregate facilities will be as self-sustaining as their capacity will permit, will\nhave \"their own front door key\" and services, such as nutrition programs, will be\ndeveloped to sustain an independent environment as long as health permits. It also\nmay mean, as the program is developed, that many older people in nursing homes may\nnow be accommodated in congregate housing projects.\nThe act also makes clear that tenants may serve on boards of local hosuing\nauthorities. This reinforces the President's expressed desire to involve older\npeople in the planning and operation ofprograms established in their behalf.\n(h) Internal Revenue Service\nThe Internal Revenue Service reports that it has prepared and distributed two\npublications for elderly taxpayers to assist them in preparing their tax returns.\nThey also report that there are two areas in which the revenue service has attempted\nto improve its service to elderly taxpayers during 1970. They are (1) improvements\nin the form 1040; and (2) increases in the amounts and types of taxpayer assistance\ntraining provided.\nThe consolidated form 1040 introduced in 1969 extends the level of income from\n$5,000.00 to $20,000.00 of those persons who can have their income computed by the\nInternal Revenue Service by taking the short form. The new rules included pension\nand annuity income for the first time so that the elderly can take advantage of\nthe short form. In computation of the tax, IRS will take into consideration the\nannuity and retirement income aspects of the taxpayers income as well as the retire-\nment income credit to which the taxpayer is entitled. The procedure for those who\nprefer to compute their own tax has also been simplified.\nThe IRS has also begun and expanded a nationwide program to provide taxpayer\nassistance training for the elderly. Through this program representatives of the\nvarious retirement and elderly organizations receive specialized training from the\nIRS in completing tax forms. These trainees can then go back to their organizations\nand assist in the preparation of tax forms.\n-34-\n(i)\nVeterans Administration\nThe Veterans Administration reports there are 1.96 million veterans over 65\ntoday, and that this will increase to 5.10 million by 1985. They further report\nby 1985 almost one-half (49%) of the total male population will be veterans.\nAccordingly, the VA programs are concerned not only with caring for the current\nneeds of veterans of all ages, but in anticipating future needs and improved ways\nof dealing with and preventing such problems, particularly among the aging. The VA\nhas reported the following programs:\n(1) VA hospitalization\nAs of November 26, 1968, there were 23,940 patients 65 years and\nolder remaining in VA hospitals. They represented 26.3 percent\nof all patients in VA hospitals on that date. Within that group,\n9,655 were 75 or older. During calendar year 1968, 23.8 percent\nof all discharges from VA hospitals were represented by the\n65-and-older group.\nSince many of the conditions affecting older individuals tend to\nbe chronic, the older veterans represent a high percentage of the\npopulation in long-term facilities, and special programs to meet\ntheir needs have been developed.\n(2) Extended care service\n(a) Inpatients. -- Within the VA Department of Medicine and\nSurgery, the Extended Care Service operates a system of\nfacilities for long-term care. These serve not only the\naging veteran, but all those requiring such long-term\ncare. However, well over one-half of all patients cared\nfor in these facilities are aged 65 and over.\nSpecifically, the Extended Care Service consists of\nintermediate care for patients who are chronically ill\nbut still require more or less daily medical services\nin a ward, nursing home care for those who require con-\ntinued or protracted nursing care but do not require\ndaily medical supervision; domiciliary care for veterans\nwho are ambulatory and able to perform activities of\ndaily living despite chronic medical or psychiatric dis-\nabilities; restoration programs for those who may be\nexpected to be able to return to community living after\na period of rehabilitation; and hospital-based home care\nfor those who are bedridden, but can be cared for at\nhome with professional support by the hospital staff.\nSome of these programs are paralleled by similar facil-\nities operated by the several States and by individual\ncommunity enterprises.\nThroughout the Extended Care Service, emphasis is placed\non encouraging the patient to make maximum use of his\nremaining facilities and on preventing further deteri-\noration. The goal is always to reduce institutional-\nization to a minimum, and to treat the individual patient\nat the lowest level of institutional care consistent with\nhis well-being.\n35_\n(b) Outpatients. -- In the outpatient treatment program as well,\nthe older age group -- 65 and over -- continued to represent\na sizable percentage of the total load. In fiscal year 1969,\npatients in this age group made over 908,000 visits to staff\nand fee basis physicians for outpatient treatment, represent-\ning about 14 percent of the total outpatient treatment load.\n(3) Social work service\nSocial workers do assist each older person in the VA Health Care\nSystem to utilize his remaining abilities to the fullest extent\npossible. Every effort is made to encourage movement from a sick\ndependent role which implies prolonged institutionalization to a\nmore healthy independent role in a private family setting located\nin the mainstream of community life. For some, continued care\nin an institution of some type is necessary and the VA offers\nlong-term nursing care in VA hospitals and in private nursing\nhomes in the community. Some ambulatory self-care patients are\ntransferred to VA domiciliaries where many rehabilitation services\nare available to assist in the restoration process. Others,\nwithout families, who are able to live more independently are\nassisted in moving into a well-developed foster home program where\nthey can enjoy the full benefits of private family life. Social\nworkers offer necessary supporting services to ensure continuous\nsuccessful living in the community. Most older patients prefer\nto return to their own families and special attention is given to\nproviding services to reestablish and maintain the integrity of\nthese family groups.\nIn addition to offering direct services to patients and their\nfamilies, VA social workers organize and direct the activities\nof volunteers who are interested in helping patients in readjust-\ning to all facets of community life. Social workers also parti-\ncipate with other public and private health and welfare organ-\nizations on both a local and national level in identifying needs\nof the older person and developing programs to meet these needs.\n(4) Voluntary service\nRetired and elderly citizens serving as volunteers have become\nthe backbone of the VA voluntary service program and their ser-\nvices are considered indispensable in the care and treatment of\npatients in the hospital and those patients returning to their\nhomes and communities.\nThe older volunteers have demonstrated they have the time,\npatience, and the capacity to win the confidence of patients\nthrough the development of personal relationships. This so-\ncalled friendship or companionship therapy is getting mar-\nvelous results in motivating and stimulating patients, many\nof whom are elderly, to regain the limits of their potential\nfor restoration and return to community living.\nThe elderly volunteers in supplementing the efforts of hospital\nstaff have made it possible to expand and extend many services\n-36-\nand programs for patients and to improve the quality of the care\nand treatment activities.\nThrough voluntary service retired and elderly volunteers have\nfound and made new lives of their own. They are the pride and\njoy of their families because they have discovered that they\ncan be just as essential to society in their later years as in\nthe earlier years of their lives.\n(5) Psychology service\nThe psychological facets of the elderly have assumed increasing\nimportance. The appropriate care, treatment, and rehabilitation\nof the aging veterans is in a large part determined by their\nmental outlook and their mental status. To meet the problems\npresented by these patients, psychologists in the Veterans'\nAdministration now work in the nursing home units, intermediate\ncare services and domiciliaries as well as in the psychiatric\nhospitals where there are large numbers of aged veteran bene-\nficiaries. These veterans post the broadest diversity of psycho-\nlogical problems. For instance, efforts have been ongoing to\nassist nursing home supervisors in establishment of psycholog-\nically harmonious environments in the VA nursing home units.\nThis has included both the mental and physical aspects. The aim\nis to assist the elderly patients to maintain their spatial and\ntemporal orientations, thus keeping confusion, memory loss and\nanxiety at minimal levels. Psychology trainees are encouraged\nto work in these areas with preference for appointment being\ngiven to psychology students who have major interests in the\nproblems of the aged and to universities which are engaged in\npsychology programs in gerontology.\nSpecial programs based upon principles developed from learning\ntheory are currently being utilized to assist the aged veteran\npatient. Classlike sessions are held to teach and to help retain\nsuch things as the date, where they are (hospital location), the\nnames of people who care for them, etc. These orientation classes\nhave significantly reduced the development of confusion and re-\ngression in many elderly patients, as well as helping aged vet-\nerans to regain lost faculties. On an individual patient basis\n\"reinforcement therapy\" techniques, instituted by psychology, are\nbeing used to assist in the development of appropriate behaviors\nwhich are needed in order to allow the psychiatrically aged\npatients to maintain themselves in noninstitutional settings.\nSuch things as neatness, eating habits, and control of bodily\nfunctions are especially helped by these psychological treatment\ntechniques. This particular therapeutic approach is readily\nadapted to the types of problems encountered with the elderly\npsychiatric patients.\nNew automated equipment for the measurement of psychological\ndeficits in the aged has been developed by VA psychology.\nStudies using this equipment will become one of the main compo-\nnents of a Psychological Aging Study Center being developed by\nthe VA in conjunction with a major university in Florida.\n-37-\n(6) The research program on aging\nTo meet its responsibilities to our increasing number of aging\ncitizens and older patients, the Veterans' Administration sponsors\nbasic and clinical research programs on a broad front. Aging\nstudies include investigations in the mechanisms of aging from\nthe standpoint of current concepts in biology, heredity, bio-\nchemistry, disease processes, and the environment with emphasis\non the changes that occur with age. Thus, just as fundamental\nresearch was important to broadening and strengthening our\nknowledge of disease processes, fundamental research is of vital\nimportance for advancing our understanding of aging or of mech-\nanisms bearing on the aging process.\nDepartment of Veterans Benefits\n(1) Guardianship program\nThere have been three areas of development in the guardianship\nprogram which affect aging incompetent VA beneficiaries. There\nhas been a policy change, concerning the type of court-appointed\nfiduciary preferred. Previously, corporate guardians were pre-\nferred over individual guardians. This policy has been reversed.\nThe cases in which it is necessary, in the best interests of the\nbeneficiary, to obtain a court-appointed fiduciary have increas-\ningly involved veterans and other adults who live alone in room-\ning or boarding homes without relatives to look after them. In\nsuch cases, an individual guardian is usually in a better position\nto give more personal attention to the beneficiary and to take\nmore immediate action in emergency situations than a corporate\nguardian would be able to do.\nThe Federal fiduciary concept has been expanded in an effort to\nprovide more alternatives to a court-appointed fiduciary. The\nappointment of a State court fiduciary, with the attendant costs,\nfees, and commissions, decreases the amount of money available\nfor the care of the beneficiary. Also, the stigma of incom-\npetency still exists when an individual has a court-appointed\nfiduciary. These factors can be avoided if a suitable fiduciary\nrelationship can be established with a Federal fiduciary.\nThe timing and frequency of personal contacts with beneficiaries\nhas been tailored to each individual case in order to give neces-\nsary service within available resources. Experience has shown\nthat where an incompetent beneficiary is living with relatives,\nfriends, or in other types of sheltered environment, personal con-\ntacts by our field personnel need not be as frequent as in situa-\ntions where the beneficiary is living alone without anyone to\nlook after him. Scheduling contacts in accordance with each sit-\nuation assures that our attention is focused where the need is the\ngreatest.\n-38-\n(2) Compensation and pension programs\nThe Veterans' Administration, through the various programs admin-\nstered by the Department of Veterans Benefits (compensation, pen-\nsion, and dependency and indemnity compensation), provides all or\npart of the income for over 1,700,000 persons age 65, or older.\nThis total is broken down to: 986,972 veterans, 607,402 widows,\n148,296 mothers and 56,393 fathers of veterans.\n(3) Educational assistance\nPublic Law 90-631, enacted October 23, 1968, and effective\nDecember 1, 1968, extends eligibility for a maximum of 36 months\nentitlement to educational benefits under the provisions and at\nthe rates of chapter 35 of title 38, United States Code, to widows\nof veterans who died of service-connected causes or wives of\nveterans who are permanently and totally disabled from service-\nconnected disabilities. Counseling under this law is optional but\nnot mandatory. This portion of the law is primarily intended to\nassist the wives and widows of the younger veterans of the\nVietnam era. However, the law contains no age limit so that the\nbenefit would be equally available to wives and widows over age 65\nwho are otherwise qualified. It is not presently possible to\ndetermine whether many in this older category will choose to take\nadvantage of the benefit.\n-39-\n(j) The Office of Economic Opportunity\nThe efforts of the Office of Economic Opportunity are increasingly concerned\nwith the elderly because their numbers are increasing, and their poverty status is\nalso on the rise. The 65 and over population accounted for 15% of the poor people\nin 1959, 18% in 1968 and 20% in 1970. One of the reasons for this phenomenon is\nthe increasing average, life span of persons who reach 65. While once people were\nexpected to live but a few years past retirement, today a man reaching 65 can ex-\npect to live an additional 14 years, and a woman, an additional 16 years past 65.\nThe aged poor have all the problems of other poor, plus the multiple handicaps\nof age itself. Furthermore, many of the aged poor lived comfortable middle class\nlives only to find that their carefully saved retirement funds are inadequate to\nsustain themselves. Thus the OEO is concerned with both the elderly who have been\npoor all their lives, and the new poor, who only achieved that status upon reaching\nold age.\nAdequate income is the first line against poverty and OEO is concerned with\nnew and innovative programs which will provide employment income for the elderly\npoor. These include services as foster grandparents, senior aids of Mainstream,\ngreen thumbers, green lighters, child day care centers aides, and a host of others.\nIncreased income is not the only benefit of such programs, however, and the in-\ncreased sense of worth that derives from it appears to have a direct link to better\nhealth, and in many cases, a lessening of the use of such tax-supported facilities\nas nursing homes.\nIncome is not the only need of the elderly, and thus the OEO is concerned with\nprograms concerned with housing for the elderly, health, transportation, nutrition\nand socialization. Also underway are pilot OEO funded programs such as SOS (Senior\nOpportunities for Service) and FIND, an outreach and referral program that has\nproven of significant value informing seniors of the benefits to which they are\nentitled.\nOEO estimates that it presently serves 1,500,000 to 1,750,000 of the elderly\npoor including the 700,000 reached by the SOS programs, and that $69.7 million is\nthe approximate cost of serving this group of the poverty population.\nOEO is represented on all cabinet and sub-cabinet interdepartmental committees\nof the Federal Government concerned with the elderly. It has also been involved in\nthe preliminary activities of the White House Conference on Aging and is represented\non several of the 14 task force secretariats which are treating such topics as\nincome, health, housing, nutrition, employment-retirement, and transportation.\nThere is a continuing exchange between OEO, AOA, HEW, Labor and other agencies\non both the policy planning and program operating levels. It has worked very closely\nwith HUD in the model cities programs and has entered into mutual funding arrangements\nwith HUD and a number of other agencies carrying out programs of benefit to the aging.\nOlder Persons Advisory Committee\nThe Office of Economic Opportunity in 1970 reestablished an Older Persons\nAdvisory Committee to help assure that all OEO programs, whenever feasible, addressed\nthemselves to the needs of the elderly poor. The committee was appointed to advise\nthe agency director of the nature and extent of specific problems faced by the\nelderly poor, the impact of OEO and other antipoverty efforts on the plight of\nolder persons at the local level, and the consolidation, simplification, and the\nstrengthening of local, State and national programs affecting the elderly. In\naddition, it is intended that the committee will encourage the establishment of\nlocal programs involving private groups and State and local governments to assist\nthe older poor.\n-40-\nRegional Aging Coordinators\nDuring 1970, a coordinator on aging was appointed in each of the 10 OEO\nregional offices to provide assistance to the regional directors, the State eco-\nnomic opportunity offices, and the community action agencies in insuring more\ninvolvement of the elderly poor in all programs of OEO, and the better us of\nservices provided by State and other community agencies.\nManpower Programs\n(EOA - Title I)\nOEO funds three manpower programs that serve the elderly---the concentrated\nemployment program (CEP), new careers, and Operation Mainstream. The adminis-\ntration and operation of all three have been delegated to the Department of Labor,\nOperation Mainstream has by far the most significant impact on the elderly of any\nof OEO's manpower programs for that age group.\nThe most recent guidelines published by the Department of Labor state Opera-\ntion Mainsteam's purpose to be the provision of work-training and employment pro-\njects, augmented by necessary supportive services designed to provide pemanent\njobs at decent wages for adults with a history of chronic unemployment. Designed\nfor rural areas and towns, projects concentrate on work experience and training\nactivities that will improve communities and those low-income areas where the\nprojects may take place. Such projects may seek to decrease air and water pollu-\ntion, improve parks, protect wildlife, rehabilitate slum housing, or extend edu-\ncation, health, and social services.\nPriority enrollment is given to those who have been chronically unemployed\n(defined as unemployed for more than 15 consecutive weeks, repeatedly unem-\nployed during the past 2 years, or employed less than 20 hours a week for more\nthan 26 consecutive weeks); have completed some training but remain unemployed;\nlack current orospects for training or employment because of age of some other\nfactor. In fiscal 1970, the obligation for Mainstream was $51 million, compared\nwith $41 million in fiscal 1969, and enrollment as of June 1970 totalled 12,687\ncompared with 10,261 in June 1969.\nOperation Mainstream includes several projects that concentrate exclusively\non people over 55 who meet the previously stated qualifications. In June 1970,\nenrollment opportunities in these older worker projects totaled 4,628 compared\nwith 4,373 slots in June 1969. Actual enrollment in these older worker projects\ntotaled 4,315 in June 1970. Outside of the older persons project, an additional\n900 enrollment slots were provided for workers 45 and over in the regular Main-\nstream program.\nThe largest of the older worker programs is the Green Thumb program, spon-\nsored by the National Farmers Union (under national contract) and now operating\nin 15 States. Subsidiary to the Green Thumb is the Green Light program, directed\nat serving unemployed older women and operating in 10 States. These two programs\nwere funded at $5.4 million in fiscal year 1970 compared with $5.2 million in\nfiscal year 1969, with enrollment opportunities of 2,435 in fiscal year 1970,\nand 2,313 in fiscal year 1969. At the end of June 1970, there were 2046 enrollees\nin the Green Light program.\n-41-\nThere were for other older persons programs funded during 1970. A contract\nwith the National Council of Senior Citizens was expanded from 1,132 authorized\nslots in 1969, to 1,148 slots in 1970. Similarly, a contract with the National\nRetired Teachers' Association was expanded from 313 slots to 433 slots. Con-\ntracts with Virginia State College, 115 slots, and the National Council on Aging,\n500 slots, were renewed at the same level. These programs involve enrollees in\na variety of social, health, and educational services to their communities.\nSenior Opportunities and Services\n(EOA - Title II, Section 222 (a)7)\nThe Senior Opportunities and Services program authorized by the 1967 amend-\nments to the Economic Opportunity Act, is designed to identify and meet the\nspecial economic, health, employment, welfare, and other needs of persons above\nthe age of 60 in projects which serve and/or employ older persons as the exclusive\nor predominant participant or employee group. The projects deal with specific\nproblems of the older poor that cannot practically be met by more general pro-\ngrams designed to serve all or younger age groups.\nThese projects provide maximum opportunity for older poor persons to develop,\ndirect, and/or administer such programs while utilizing existing services and\nother programs to the maximum extent feasible.\nIn fiscal year 1970, a total of $6.8 million was allocated from senior opportun-\nities and services funds, of which $400,000 was used for migrant and Indian projects\nand a special project conducted by VISTA. The total of SOS rograms increased from\n194 to 208 and served more than 700,000 elderly poor.\nEmployment\nA major and lasting benefit of many SOS programs is their extensive training\nand use of elderly poor persons to assist others and the extent to which other\nlocal, State, and Federal as well as private agencies are recognizing the useful-\nness of this service and adding elderly poor nonprofessional and paraprofessional\naides to their own staffs. The institutional change already effected in health,\neducational, and welfare institutions is significant. Many SOS programs start\nwith a commitment from other public agencies to give full- or part-time employ-\nment to seniors once they have received training.\nOther SOS programs are attacking difficult transportation problems of the aged\npoor, providing consumer education (training the elderly poor in areas of food buy-\ning, budgeting, home management), helping form discount clubs and co-ops to enhance\npurchasing power; training older persons to recognize fraudulent insurance and\nother confidence schemes.\nOutreach and referral services\nAn almost universal service of OEO's aging programs is the use of trained\nlow-income aides to inform and assist the elderly poor to better utilize the other\nprograms and services for which they are eligible. An early nationwide OEO pro-\ngram---medicare alert--and subsequently project FIND, disclosed that large\nnumbers of the elderly poor because of ignorance, language barriers, shyness,\nor other reasons were failing to register for medicare, food programs, and other\nservices for which they are eligible. A major service to this poorest and most\nhelpless segment of the older poor is that of finding and connecting them with\nexisting services.\n.42-\nIt is well established that older poor persons, trained as aides and\npossessing language qualifications, are able to reach this group more effec-\ntively than anyone else, including professional social workers.\nFiscal year 1971 findings and plans\nIn fiscal year 1971, a minimum $7.8 million will be used to continue the fund-\ning of local senior opportunities and services projects and, for the first time,\nassume the costs of training and technical assistance services in the older persons\nprogram area.\nA continued strong training and technical assistance effort, conducted by the\nNational Council on the Aging, is considered essential to focus local projects on\ntheir prime goals of resource mobilization and institutional change. With the\nassumption of the cost of this contract, the fiscal year 1971 budget will provide\nfor a small increase in funds for operating field programs.\nServing the Older Poor Through A11-Age Programs\nThe newly created Office of Special Programs coordinating function has in-\ncreased the agency's emphasis on meeting the needs of the elderly in and through\nsuch all-age programs as neighborhood health centers, legal services, community\naction agencies, programs for Indians and mirgrants, and VISTA. Special pro-\ngrams maintains liaison with all operational segments of the agency, serving\nwithin OEO as an advocate for the elderly poor.\nHealth affairs programs\nThe Office of Health Affairs makes funds available, especially through the\ncomprehensive health services program and emergency food and medical services\nprogram, to provide assistance to the elderly poor. About $7.4 million is spent\nto serve the elderly in 50 comprehensive health services demonstration projects\nbeing developed across the country. Approximately $16.2 million is channeled\nthrough the emergency food and medical services programs to meet the nutrition\nneeds of the elderly poor in projects aimed specifically at the aged and those\ndesigned for all age groups including the elderly. Special pilot projects have\nincluded meals-on-wheels and hot lunch programs. The Office of Special Pro-\ngrams is pulling together the experience of EFM, as well as SOS programs to\ndevelop improved and better coordinated programming in the area of nutrition for\nthe elderly. The problem here is not just to provide nutritious meals for the\nolder poor, but to build that feature into a comprehensive service and income\nprogram accompanied with adequate research and evaluation to assure effectiveness\nand replicability.\nLegal services programs\nThe 265 neighborhood legal services projects handle the legal problems of all\nwho are within the OEO poverty guidelines. No breakdown by age groups is avail-\nable, but clearly a number of the elderly are being served by the local projects\nat present and more will be in the future as their needs and problems are focused\nupon.\nVISTA\nVolunteers in Service to America (VISTA) has always sought older persons as\nvolunteers and the percentage serving at a given time has fluctuated between 6 per\ncent and 16 percent. A total of 2,700 older persons, or 12 percent of the overall\nVISTA enrollment since the program's inception, are or have been in the age 50 group.\n-43-\nResearch and Demonstration Projects\nOEO has planned its research and demonstration projects so that the knowledge\nand experience gained from them could be channeled not only to local community\naction agencies, but to many other public, private, and volunteer agencies which\nincreasingly are concerning themselves with the problems of the older poor. Among\nsuch projects specifically designed to aid the aged poor are:\nProject Late Start\nThe National Retired Teachers Association and the American Association of\nRetired Persons received in 1970 a second-year grant of $252,000 to continue a\nresearch project to test, in four diverse geographic and ethnic locations, the\nthesis that low-income elderly people can have their life pattern altered and\ntheir problems ameliorated by a concentrated group experience which seeks to be\neducational and informative.\nRural housing repair\nA pilot program to repair the substandard homes of elderly poor persons.\nThe program trains older poor persons as construction workers to repair homes\nowned by elderly, blind, or disabled recipients of public assistance.\nThe project has a double focus: To solve substandard housing problems and\nto reduce unemployment, especially among the elderly poor.\nHousing assistance and social service project\nA research and demonstration project conducted by the Cambridge (Mass)\nEconomic Opportunity Committee has mobilized the elderly poor into an effective\naction group around a common issue affecting their lives: Critical housing\nproblems and solutions to their need for related social services required for their\nwell-being. The project was refunded in 1970 for a second year for $229,651.\nCommunity development rural programs\nNine OEO rural projects seek to overcome the complex problems of bringing\nservices to and economically developing sparsely populated areas. The programs\nare experimenting with self-supporting transportation systems, leadership training,\nsaturation use of outreach centers, development of small business enterprises, and\na communications system to increase awareness of opportunities and services avail-\nable to the rural poor. Although these projects are not aimed exclusively at the\nolder poor, they reach substantial numbers of such people.\nConsumer programs\nOEO's consumer research and demonstration programs reach the elderly poor,\nalthough this is not the only target group. An estimated $0.1 million was aimed\nat older poor citizens in fiscal year 1970.\nLegal research and services for the elderly\nLegal Research and Services for the Elderly (LRSE), a national demonstration\nproject, was initiated in fiscal year 1968. Its latest funding, in the amount of\n$414,735, was announced in December 1970. The grantee is the Washington-based\nNational Council of Senior Citizens\nLRSE was funded to research and identify the particular problems facing the\nelderly poor; to examine the law and the major legally sanctioned institutions\nthat affect the elderly; to devise models and methodologies to meet their needs;\nto provide new systems for eliminating the negative impact to our social, economic,\nand administrative institutions on their lives; and to devise methods for educating\nthe elderly poor community as to their rights.\n-44-\nA study of the use of older persons in child care\nUrban Systems Research and Engineering, Inc., of Cambridge, Mass, recently\ncompleted a study for OEO on \"Meeting the Needs of the Elderly Poor: A Study of\nthe Use of Older Persons in Child Care.\" Excerpts from their report condlude:\n\"We have conducted an in-depth study of the ways in which the Government\ncan assist the elderly by intervening in a particular market the market for child-\ncare workers. This market appears for several reasons to be on the verge of a\nsubstantial expansion, and the area of child care is one for which older persons\nare in many ways, well suited. In carrying out this analysis, we emphasize that\nthe objective of the effort is not to use funds Intended for the elderly as a method\nof subsidizing child-care services, but rather to achieve a mutual compatibility\nof interest in which the quality of child care available for a given cost is\nincreased by drawing on the resources which older persons can provide and in\nwhich the welfare of older persons is increased through greater involvement in\npaid employment of a rewarding nature.\"\n-45-\n3. STATE OF CALIFORNIA SERVICES TO THE AGING\nThe following questionnaire was mailed to 42 Departments and Agencies\nof the State:\nQUESTIONNAIRE\nTo: Mr. Spencer Williams\n455 Capitol Mall, Suite 700\nSacramento, California 95814\n1. We are participating in programs for the aging affecting the following\nareas of need:\n( ) Housing\n( ) Recreation\n( ) Health\n( ) Transportation\n( ) Job opportunities\n( ) Education\n( ) Nutrition\n( ) Other (please attach\ndescription)\n( ) None\n2. Attached is descriptive material concerning the above program(s).\n3. Attached are copies of laws and/or regulations by which such programs are\nbeing implemented.\n4a. Our annual financial participation equals:\n$ Federal\nState\nLocal\nb. The number of persons affected totals\n.\n5. (Optional) The following are our comments as to the effectiveness of these\nefforts and our recommendations as to the future directions that should be\ntaken in programs designed for the aging (please attach).\nVery truly yours,\n(Name)\n(Office/Department/Board)\nResponses were received from 42 of the 42. Of these, 251 indicated\nthey have no programs directly relating to the aging. The Department of Public\nWorks, however, pointed out that its program of relocating persons whose homes\nare acquired for highways or other public purposes benefited a number of per-\nsons in the over-65 category. The Department of Parks and Recreation stated\n-46-\nthat several of their desert parks were particularly attractive to persons\nover 65, and that a current survey underway on the use of trailers and campers\nindicated a high incidence of use by older Californians. In addition, its\ncurrent program of adding ramps to park entrances and making doorways wider\nfor wheelchairs has proven of particular convenience to senior Californians.\nSeventeen departments reported direct services to the aging. These\nincluded 21 separate programs affecting from 14 aged persons in the smallest\nprogram, to over 1,951,180 aged persons in the largest. Total identifiable\nexpenditures reported are $722,719,000 federal, $743,814,000 state, and\n$313,206,000 local. These programs are summarized below.\n1. Department of Education\nThe Education Code of the State of California (Sections 5553 and 5701)\nspecifically authorize the establishment of adult education programs in high\nschools and community colleges. During the 1969-1970 school year, there were\napproximately 1,000,000 adults enrolled in the high school and unified school\ndistricts of California. Approximately 100,000 of these adults were 50 years\nof age or over. Discretion to establish such classes is vested in the Govern-\ning Board of the School District (5702) although, if established, classes must\nconform to normal study and graduation requirements (5705) and standards\nprescribed by the State Board of Education (5708).\nPublic School Adult Education in California (including the adult edu-\ncation offered in the community colleges) is financed partly by State appor-\ntionment (2 percent of the State educational dollar which equaled $28.9 million\nin the 1969-70 Fiscal Year) and local district tax funds. Limited financial\nreimbursement is available for certain vocational classes.\nA 1967 Review of Educational Opportunities Available to Older Adults\n(over 50 years of age) in California's Public Adult Education Programs reported\nas follows: 3\nFor the purpose of obtaining current information on the educational\nopportunities available to our older adults through California's public school\nadult education program, the Bureau of Adult Education in May, 1967, mailed a\nquestionnaire on the education of the aging to administrators of adult educa-\ntion programs in adult schools and junior colleges. Specifically the question-\nnaire sought information as to the ways the adult education program is serving\nthe educational needs of older adults. Ages 50 years and over were chosen as\nfalling within the area of \"aging\". Information was sought on the nature of\nthe organization and the responsibilities of local committees working with the\nproblems of the aging. Administrators were asked to state the major problems\ninvolved in planning and organizing educational programs for older adults and\nto indicate any plans for the future. Approximately 50 percent (156) of the\nadministrators responded to the questionnaire. A summary of the information\ngathered from the questionnaire is presented in the following paragraphs.\nThe administrators were asked to check on a form provided the areas\nof study in the regular program in which there was a fair concentration of\nolder adults. The following areas and the frequency of their listings are\nindicated below:\n1. Fine Arts - 74\n2. Crafts - 69\n3. Homemaking - 68\n-47-\n4. Business Education - 57\n5. Americanization - 47\n6. Civic Education and Special Fields - 43\n7. Industrial Education - Vocational and Industrial Arts - 40\n8. English, Foreign Languages, and Speech Arts - 36\nApproximately one-half of the schools reporting indicated that\nspecific classes were organized for older adults. The titles of some of the\nclasses primarily organized for older adults are as follows:\n1. Arts and Crafts\n2. Retirement Planning\n3. Leadership Training for Mature Adults\n4. Lip Reading\n5. Dactylology\n6. Gerontology\n7. Choral Instruction (Senior Citizens' Chorus)\n8. Spanish for Older Adults\n9. Driver Improvement for Senior Citizens\n10. Clothing Construction\n11. Citizenship and Elementary English\n12. Physical Exercises for Older People\n13. Public Affairs and World Affairs (Current Events)\n14. Music Appreciation\n15. Practical Gardening\n16. Understanding the Older Adult\n17. Painting\n18. Investment and Securities\n19. Consumer Education for Homemakers\n20. Applied Psychology\n21. New Horizons for Mature Workers\n22. Home Health Aides\nInformation was also sought as to lecture series that were specifically\nconcerned with the problems of aging. Quite a number of our adult educators\nreported lecture series specifically planned for the older adult. Examples of\ntitles of lecture series reported are as follows:\n1. Retirement Planning\n2. Psychological Aspects of Aging\n3. Health for Senior Citizens\n4. World Religions\n5. Personal Improvement\n6. Health Education for Diabetics\n7. Financial Planning and Tax Benefits\n8. Estate Planning\n9. Medicare and What It Means To You\n10. Services to Older Adults\n11. Nutrition and Food Preparation\n12. Fraud and Medical Quackery\n13. California's Diminishing Resources\n14. Social Security Benefits\n15. Consumer Education for Limited Budgets\n16. Preparing a Will\n-48-\n17. Give Your Heart a Fighting Chance\n18. Trends in Modern Literature\n19. Living in Later Life\n20. Role of the Aged from Primitive Society to Modern Times\nMost of the adult educators reported that the older adults are\nserved through the school's regular counseling program. The adults over fifty\nwho are interested in elementary certificates and high school diplomas are\ngiven special encouragement and counseling time. Older adults avail themselves\nof the testing services and individual counseling. The nature of the counsel-\ning includes the encouragement of adults to develop interests and skills in new\nfields through a planned educational program. Group guidance opportunities are\nprovided through gerontology and psychology classes. Gathering information on\njob opportunities in the community for older adults was listed as guidance\nactivity. One school reported a full-time state employment representative on\ncampus to provide current employment information. The guidance staff in a\nnumber of instances work closely with senior citizen groups, the older age\nspecialist in the Department of Employment, the Social Security offices, social\nwelfare agencies, and boarding and convalescent home operators. The Los Angeles\nCity Schools report a gerontology specialist for their adult education program.\nIn rating the tasks of major concern to adult schools and junior\ncolleges in the field of aging, the administrators listed the following in the\norder of their importance:\n1. Developing skills and interests appropriate to advancing years\n2. Planning for retirement\n3. Developing a better understanding of the physiological and\npsychological changes incident to aging\n4. Developing the attitudes and outlooks appropriate to a changing\nfamily life\n5. Developing mental hygiene practices and increased mental health\nand emotional security\n6. Planning through consumer education for a more economical way\nof living\n7. Training to overcome physical handicaps such as hard of hearing,\nheart disease, and so forth\n8. Training of older citizens for more active participation in\npublic affairs\n9. Training people to work with older adults\n10. Improving the level of community understanding about the aging\nprocess\n11. Vocational and educational guidance for older adults\n12. Retraining for full-time or part-time jobs\nApproximately 50 percent of the adult educators reporting indicated\nthat there is a local committee working with the problems of the aging.\nNumerous agencies are represented on the local committee. The ones most\nfrequently mentioned are the Community Welfare Council, social welfare, recrea-\ntion department, senior citizen groups, church groups, public library, Red Cross,\nChamber of Commerce, mental health associations, Salvation Army, service clubs,\nsocial security, employment, and city and county health departments. In most\nevery instance the local adult administrator is either a member or serves as a\nconsultant or advisor to the group. The administrator works cooperatively with\nthe groups and leaders of the community in determining the educational needs of\nadults.\n-49-\nThere are some excellent examples of the cooperative efforts of\nseveral agencies in organizing the educational programs for older adults. A\ncourse in \"Understanding the Older Adults\" for use in adult education classes\nwas prepared under the auspices of the Office of the Los Angeles County Super-\nintendent of Schools and the California State Department of Social Welfare.\nThe impetus for this course of study came through requests from the nonprofit\nand proprietary homes for the aged in Southern California, licensed by the\nCalifornia State Department of Social Welfare. The course is intended to\nassist operators, administrators, and staff of homes for the aged in a better\nunderstanding of the older adult through an increased awareness of his psycho-\nlogical and physical needs and the ways of meeting these needs. The course was\nformulated in a trial draft in 1963 and tested in three different teaching\nsituations in the adult education programs of Long Beach and Los Angeles City\nand revised in 1966 in accordance with the outcome of these pilot projects.\nAnother example of the cooperative efforts of several agencies in the\ncommunity is the pre-retirement program offered by the Los Rios Junior College\nDistrict and the adult education division of the Sacramento Unified School\nDistrict. The Community Welfare Council was responsible for organizing an\nadult education committee within the committee on aging, which included rep-\nresentation from the adult education divisions of the schools in Sacramento\nCounty. This committee was responsible for organizing a pre-retirement lecture\nseries, which has been presented twice a year for the last several years. The\ntopics included in the lecture series are as follows: viewing retirement,\nnature of work and leisure, insurance planning, wills and property management,\ninvestments, government retirement plans, social security and medicare, budget-\ning, employment, frauds, physical health and nutrition, mental health, philosophy\nof life, and living arrangements. The schools offering these series have re-\nported excellent attendance. The significant part of this effort is the fact\nthat the schools are continuously evaluating and improving their programs in\nclose cooperation with other agencies represented on the committee.\nIn the field of driver education for older adults, meetings have been\nheld in Long Beach, Menlo Park, Santa Cruz, and Paradise to consider the problems\nof the older driver. These meetings were held in senior citizen centers.\nRepresentatives of the State Department of Motor Vehicles, California Commission\non Aging, State Department of Education, as well as local adult school people\nparticipated in the deliberations. One of the specific outcomes of these meet-\nings was the organization of a driver improvement class (behind the wheel and\nclassroom instruction) at Paradise High School. Among the other outcomes from\nthese meetings was the realization that such a program to be successful must\navail itself of all possible communication media, including television, as well\nas the preparation of written materials for distribution. It was suggested\nthat classes in driver improvement could be conducted informally in senior\ncenters under the leadership of older adults and as preparation for this role,\nan adult education class in training volunteer leaders could be offered.\nA review of the questionnaire indicated that the following problems\nare of major concern to adult educators in the planning and organizing of\neducational programs for older adults:\n1. Transportation to and from school\n2. Finding suitable meeting places for classes\n3. The need for more day classes and with it the problem of\nfinding adequate facilities and teachers\n-50-\n4. Budget limitations of the school district to provide\neducational programs for older adults\n5. Lack of motivation and interest on the part of older adults\nfor planned types of educational experiences\n6. Identifying the real educational needs of older adults\n7. Finding well-qualified teachers with specific training and\nappreciation of the problems on aging\n8. Securing community cooperation and support for educational\nprograms.\n9. Maintaining satisfactory and consistent attendance\n10. Lack of good lay leaders\n2. Department of Social Welfare\nThe State Department of Social Welfare reports that in addition to\nsocial casework services, they are involved in a number of programs affecting\nthe over-65 population in areas of housing, nutrition, transportation, income\nmaintenance, payments for public and private institutional care and licensing\nof facilities for the aging.\nFiscal participation (for the 1969-70 fiscal year) is as follows:\nFederal $207,807,200, State $178,939,900, Local $29,960,500. 313,734\naged persons are involved in these programs.\nDetails of these programs are set forth below:\nOld Age Security (OAS)\nThis is a public assistance program for needy persons 65 years of age\nor older who reside in California. Money payments including other income may\nnot be less than the statutory minimum standard of $129 (effective December 1,\n1969). Payments to aged persons including other income may not exceed $194\n(effective December 1, 1969) unless he has a special need for attendant care\nservices to enable him to remain in his own home.\nAs of July 1970, there were about 313,700 aged persons receiving money\npayments through this program, with the average statewide payment being $105.63.\nThis group represents about 17 percent of the people 65 or over in California.\nRecipients had an average monthly income from all sources of approximately $54\nwith over 72 percent of them receiving federal social security benefits. About\n30 percent of the recipients own their own home; 5 percent own income-producing\nproperty; and about 73 percent have property reserves, mostly in savings, cash,\ninterment plots, or life insurance. The typical recipient of Old Age Security\nin California is 76 years old, widowed, has resided in the state about 30 years\nand has received OAS for six years. Seventy percent of the recipients are\nwomen. Eighty-four percent of the aged recipients live in a house or apartment,\nwith almost one-half of these living alone. About 10 percent have other indepen-\ndent living arrangements, with the balance in some type of out-of-home care\nsituation.\nThere is no limitation on the value of any property which is being\nused by the recipient as a home. Real property, other than the home, may be\nretained as long as the county assessed value does not exceed $5,000.00 and the\nproperty is producing a reasonable income to help meet the person's needs.\n-51-\nAn individual may have personal property such as savings, bank\naccounts, deeds of trust, cash value of life insurance, and stocks and bonds.\nThe total value of such property may not be more than $1,200.00 or $2,000.00\nif both husband and wife are receiving public assistance.\nThere are no property limitations on such items as personal effects,\nclothing, personal jewelry, household furniture and equipment, foodstuffs, fuel,\nmusical instruments, items used for recreation, an automobile needed for trans-\nportation, and certain burial reserves.\nIn some instances, money or other proceeds such as deeds of trust\nreceived from the sale of real property are not considered when such money and\nother proceeds are to be used to purchase a home.\nFood Stamp Program\nThe Food Stamp Program is a voluntary program for all OAS recipients\nand for certain nonrecipients over 65 who meet the eligibility requirements.\nThose determined to be eligible by the County Welfare Department are permitted\nto purchase food stamps from a stamp issuing office (a bank or other) at a\nsubstantial discount, thus increasing their monthly food purchasing power. For\nexample, a family of one can pay $18.00 and obtain $28.00 worth of food stamps.\nA family of two can pay $36.00 and acquire $56.00 worth of food stamps.\nFood stamps may be used at local approved markets, and may be used to\npurchase most foods except imported foods, liquor, tobacco and such nonfood\nitems as soap, dog food, or vitamins. They cannot be exchanged for cash.\nLicensing\nThe Department of Social Welfare is concerned with the licensing of\nresidential care and extended care facilities, as distinguished from hospitals\nand nursing or convalescent homes, licensed by the Department of Public Health,\nand psychiatric care facilities, licensed by the Department of Mental Hygiene.\nA \"residential care home\" is one designed to care for the aged who do\nnot wish or are unable to live alone but who do not need hospital or nursing\nhome care. It is a substitute for living in their own home.\nThere are more than 3,700 residential care homes in California, serv-\ning about 45,000 aged persons. They include about 378 larger homes accommodat-\ning some 26,000 persons, operated under auspicies of both proprietary and\nnonprofit organizations. About 3,500 smaller group care and family homes oper-\nated by individual and corporated owners serve about 19,000 persons.\nLicenses for homes offering residential care to less than 16 persons\nare issued by county welfare departments under the delegated authority of the\nState Department of Social Welfare.\nThe Department also has jurisdiction in the licensing of the newly\nestablished classification of Extended Care Facilities. These are designed for\nthose who require more individual care than is available in a residential care\nhome but who do not require the professional medical and nursing services pro-\nvided in nursing homes. As of December 1970 no facilities have been licensed\nunder this new classification.\n-52-\nLegal Services\nThe Federal Government has authorized the establishment of Statewide\nlegal services for the poor (including OAS recipients) to be administered by\nthe Department of Social Welfare. California has not elected to institute this\nprogram. Limited legal services are available under various OEO programs dis-\ncussed elsewhere in this appendix.\n3. Department of Health Care Services\nThe California Medical Assistance Program, known as Medi-Cal, is\nCalifornia's implementation of Title XIX of the Social Security Act. One of\nthe first state plans approved by the U.S. Department of Health, Education, and\nWelfare, it has been in operation since March 1, 1966. It offers a broad pro-\ngram of comprehensive health care for over 1,951,000 public assistance recipients\nof whom 313,700 were over 65 and under the OAS program, and about 200,000\nmedically indigent individuals of whom 32,000 are aged. Some aged persons are\nalso included in the Aid to the Blind and Aid to the Totally Disabled programs.\nMedi-Cal services 4 are available on a free choice, fee-for-service\nbasis. Claims for payment are processed by three fiscal intermediaries respon-\nsible for determining their validity and correctness, and for making payments.\nOverall administration is provided by the Health and Welfare Agency, Office of\nHealth Care Services.\nThe Department reports that financial participation for Fiscal Year\n1969-70 equals Federal $509,826,000, State $392,917,016, Local $216,260,843.\nFigures are not available for costs of services to only those over 65.\nUnder the Medi-Cal program there are two groups of beneficiaries\ndesignated as Group I and Group II. Group I beneficiaries are persons who are\neligible for a public assistance grant. (AFDC, AB, AID, OAS). This includes\npersons who are actually receiving the grant and also persons who would be\neligible to receive the grant on the basis of resources and needs but preferred\nnot to take the cash grant. The individual who is a Group I beneficiary has no\nresponsibility for paying any part of the cost of his medical care.\nGroup II beneficiaries are persons who are like public assistance\nrecipients in every respect except that their income and resources are more\nthan will enable them to receive a cash grant under one of the categorical aid\nprograms. In other words, the individual to be covered under Medi-Cal Group II\nor \"Medically needy\" has to be blind, permanently and totally disabled, sixty-\nfive years of age or older, or be in a family with dependent children. Group II\nbeneficaries have recently been granted the same scope of medical services\navailable to Group I.\nThe individual who is covered under Group II may have to share the\ncost to the extent that his income in excess of the amount that is allowed for\nhis maintenance and the amount of resources is in excess of the amount allowed\nby law. Under the present circumstances, a single individual is allowed $162 a\nmonth for his maintenance. A single person is also entitled to a reserve amount\nin cash or other assets of up to $1,200 plus $100 for each additional person to\na maximum of $2,000.\n-53-\n4. Department of Public Health\nDr. Louis Taylor, Director of the State Department of Public Health\nreports as follows:\nThe Department of Public Health is currently participating in programs\nfor the aging affecting the following areas of need: health, nutrition, and\neducation.\nThe Department participates in the Mecicare and Medi-Cal programs,\nboth of which are concerned with the delivery of health care services to elderly\npatients. Responsibility for licensing and certifying providers of the care\nrests with the Department under the provisions of the California Hospital Act.\nThe Department is also concerned with the quality of care and the development\nof adequate home care and certain other facilities.\nDepartmental staff organize and foster development of short-term\ntraining programs designed to provide staff operating in new areas of health\ncare with the requisite knowledge to furnish satisfactory care (e.g., renal\ndialysis and emphysema). Staff are also engaged in assisting in the develop-\nment of local programs of a very diverse nature, such as:\nDay care centers for the elderly\nProtective services\nHomemaker services\nNutritional counseling services\nMeals-on-wheels programs\nHealth education for senior citizens\nAll of California's approximate 1,900,000 citizens 65 of age and over are af-\nfected in one way or another by the various departmental programs. Thus we do\nnot have presently available the total cost of the Department's activities in\nsupport of the aged. We do have, however, cost data on a program which has a\nmajor impact on this segment of the population. I am referring to expenditures\nfor local health services for the chronically ill and aged. For Fiscal Year\n1970-71, such expenditures were estimated as follows: Federal $392,000, State\n$575,000; Local $6,379.000.\nThe Department Program Budget for Fiscal Year July 1, 1970 to June 30,\n1971 contains more detailed descriptive material in regard to these activities.\nYour attention is invited to the descriptions of the Preventive Medical Program\nand the Community Health Services and Resources Program found in Pages 627-657\nof the budget.\nThere are two major problems affecting the health and well-being of\nthe elderly today.\nThe first problem area is concerned with the need of obtaining -- out-\nside of an institution -- the help, largely supplied by nonprofessionals, in\npersonal care and housekeeping. This need is brought on by the infirmities and\nchronic diseases which so frequently accompany advancing age. Homes could be\npreserved and life made far more tolerable for many of the elderly, if such\nservice were available.\n-54-\nThe other problem is that of obtaining the preventive and the simple\nrehabilitative or restorative care which is so vital to those in the latter\nyears of life if one is to avoid the deterioration that leads to a bedfast and\ntotally dependent state. Much of the misery of old age, both to the person and\nto his family, could be avoided if such care were generally received.\nStudies to evaluate the actual needs of the elderly poor, the resources\nnow being expended to satisfy those needs, and what it would take to meet the\nneeds if they were handled on an organized basis, are presently underway in the\nDepartment.\n5. Department of Mental Hygiene\nThe Department of Mental Hygiene reports on four separate programs\ndirectly affecting the over-65 population. The first, the Community Geriatric\nScreening Project, described below has full Federal Financing ($38,758.00) and\naffects 15,000 persons. The other three, also described below, are in-hospital\nprograms for which direct costs cannot be ascertained.\nThe Community Geriatric Screening Project is a statewide program to\nencourage counties to develop more appropriate screening methods for the elderly\nmentally disturbed. This project is the outgrowth of the Department of Mental\nHygiene Geriatric Screening Program carried on in San Francisco from 1964 to\n1968 and which is described in the following material.\nIn 1966 the Geriatric Screening Project received an award for out-\nstanding achievement from the American Psychiatric Association.\nIn 1969 the Geriatric Screening Project was selected by the U.S.\nSenate Special Committee on Aging as a model for screening and treatment of the\nelderly mentally disturbed. A report on the program, \"Complexities and Rewards\nof Prevention\", appears in \"Mental Health and the Elderly: Action Programs to\nPrevent, Reduce or Improve Institutionalization\", published in December 1970 by\nthe U.S. Senate Special Committee on Aging.\nThe program is more specifically described as follows:\nCommunity Geriatric Screening Project\nIn 1964 the Department of Mental Hygiene established a Geriatric\nScreening Project in San Francisco with its primary objectives to reduce in-\nappropriate admissions of the elderly to state hospitals and to provide alter-\nnate plans by developing a utilizing community resources and services that would\nmore appropriately meet the needs of this group. San Francisco was selected for\nthe demonstration project because of its high rate of admissions of the aged to\nstate hospitals. Approximately some 500 persons were committed from that county\neach year. Many had medical illnesses that produced temporary mental disturb-\nances. A significant number were in need of care and supervision only and did\nnot require skilled psychiatric treatment in a hospital.\nThe staff, all employees of the California Department of Mental Hygiene,\nwas composed of an internist, psychiatrist, a psychiatric social worker, a super-\nvising psychiatric social worker who functioned as coordinator and a senior\nstenographer.\n-55-\nThe project staff evaluated all persons over 65 in San Francisco for\nwhom a petition of mental illness had been requested. In addition, requests\nfor evaluations and recommendations were accepted from the local County Welfare\nDepartment, private physicians, community social agencies, landlords and friends.\nA high percentage of the persons screened by the project staff were considered\ncrisis situations and therefore decisions had to be made and recommendations\nimplemented with little delay.\nIn providing direct services the emphasis was on screening persons\nin their own home setting and thus prior to hospital admission. Examination\nin the home provided for a more complete assessment and evaluation. A psychi-\natric social worker and physician made the home visit together which afforded\na coordinated clinical and social approach to the patient. The function of the\nstaff was to diagnose, to evaluate, to make recommendations, and to offer con-\nsultation; staff members were not involved in any continuing, active treatment\nprogram.\nAlternatives to state hospitalization included maintaining the person\nin his own home with community supportive services, such as, Homemaker's Service,\nhome health aids, attendant care, Meals-on-Wheels and Friendly Visitors. For\nthose requiring care and supervision not possible to be received in his own home,\nboarding home, residential hotel and nursing home placements were utilized.\nSome persons whose needs related primarily to counseling or social recreation\nwere referred to Senior Citizens Centers, social casework agencies and church\ngroups.\nIn the first three calendar years of the project, 1,290 persons were\ndirectly served by the Geriatric Screening Project and commitments of the elderly\nfrom San Francisco County to the state hospitals dropped from approximately 500\na year to 40 the first year; 12 the second year and 3 the third year. Concur-\nrently, there was a marked reduction in the number of total yearly admissions of\nthis elderly group to the San Francisco County Hospital psychiatric ward. Prior\nto the screening program, admissions averaged approximately 750 a year. In\n1967, the third calendar year of the project, that figure had dropped to 262\nadmissions.\nOf those 1,290 persons screened; 45% remained in their own homes with\nsupportive services; 10% were admitted to both county and private medical\nhospitals; 33% were placed in nursing homes; 8% went to boarding homes or\nresidential hotels and 4% were committed to state mental hospitals. The number\nof persons screened did not reflect the several hundred requests from physicians,\nsocial workers and others for assistance in recommending suitable plans for an\nelderly person.\nIn 1968 the operation of the project was terminated by the Department\nof Mental Hygiene and transferred to San Francisco County as a unit of the\nCommunity Mental Health Services.\nIn 1968 the Department of Mental Hygiene utilized Federal grant-in-aid\nfunds to support a statewide project to encourage counties to develop programs\nsimilar to the Geriatric Screening Project. The objectives of the Community\nGeriatric Screening Project are to assist counties in developing geriatric\nscreening units for the purpose of utilizing full community resources for the\ncare and treatment of the mentally disturbed aged person. Although methods and\nprocedures vary with each county, the general approach has been for the project\n-56-\ndirector to; (a) meet with appropriate persons in the Division of Local\nPrograms of the county for information and briefing, (b) meet with the County\nLocal Program Chief to describe how a geriatric screening unit might operate\nand to assess his interest, (c) review clinical files of patients admitted to\nthe state hospitals over a two- or three-month period to determine the appropri-\nateness of the admission, (e) meet with those community agencies involved in\nproviding services to the aged mentally disturbed, and, (f) assist in the develop-\nment of an ongoing local program.\nComments\nThe effectiveness of the method of screening developed by the Geriatric\nScreening Project was clearly demonstrated by its accomplishments. Not only was\nunnecessary and costly hospitalization prevented but patients received care\nappropriate to their individual needs. In urging local counties to develop\nsimilar programs, one of the major problems encountered has been uninterest by\nprofessional staffs in working with the aged. With this in mind, future programs\nconcerned with the aging should emphasize education in the field of aging at\nall levels of professional care, as well as training ancillary personnel.\nAs states continue to move from the placement of the elderly in state\nhospitals to community placement, screening will become increasingly more im-\nportant. Regardless of where the screening takes place, at the state hospital\nor in the community, both levels of screening must require emphasis on a thorough\nand careful evaluation of each patient's needs and both must include a knowledge\nof the suitability and appropriateness of the various resources to which patients\nmay be referred.\nThe Department points out that while the population of California has\ncontinued to expand during the last decade, and the general population in the\nState Hospitals has shown marked decline, the number of aged persons has de-\ncreased by a dramatic 84%. A large share of the credit for this accomplishment\ngoes to the Geriatric Screening Program, described above, and by the in-hospital\nprogram described as follows:\nState Hospital Geriatric Programs\nThe following are examples of the geriatric programs in the state\nhospitals. There are some \"typical\" features among all of the programs, but\neach of them is individualistic, reflecting that particular creative atmosphere\nwhich has been established by the particular hospital staff.\nNapa State Hospital Geriatric Resocialization Program\nThe program is designed to improve social skills, motivate the patient\nto leave the hospital, and remove feelings of fearfulness, loneliness, depres-\nsion, and feelings of isolation. This therapeutic program is divided into four\nsteps.\n1. The first is to get the patient to develop a relationship with\none other person, a technician or other staff member.\n2. When he is capable of being a \"buddy\" he is ready to join a small\ndiscussion group.\n-57-\n3. When he is able to hold his own in group discussions, he is\nready for the last step.\n4. Becoming acquainted with community life.\nThe whole process usually takes from six to eight months. Since the\ninception of the program in 1963, 800 patients have been in the program. Five\nhundred of these have been able to leave the hospital and almost all of them\nhave remained out of the hospital. The return rate is between eight and nine\npercent as compared with the entire hospital return rate of 33 percent.\nPatton State Hospital Geriatric Program\nOver 1,500 patients have been returned to live in the community from\nthe program since its inception in 1964. Less than five percent of these have\nrequired rehospitalization at Patton. The goals of this program are through\nmedical and psychiatric care to ameliorate the patient's illness so that\n(1) those who can be returned to community living can be placed at the earliest\ndate possible and (2) to provide an optimum sheltered hospital living situation\nfor those persons too debilitated to leave the hospital.\nThe present program located in six units has facilities for 225\npatients. It is the intent of the staff to expedite program so that patients\nare returned to the community from 60 to 90 days after admission. In many in-\nstances placement is accomplished even faster. The program consists of three\nphases: I Diagnostic Phase; II Intensive Treatment; and III Leave Planning.\nThroughout this continuum the full resources of the treatment team are utilized\nin order to maximize the treatment impact and expedite the program.\nStockton State Hospital Geriatric Program\nThe Stockton program is an intensive treatment program which focuses\non specific treatment goals for each patient. The goal is rapid emotional and\nphysical healing and shorter term hospitalization.\nOn the basis of information provided by the Stockton Geriatric Rating Scale,\na program is designed that incorporates seven special treatment subprograms.\nThis diminishes the fragmentation of staff attention between the largely\nphysical care problem and pronounced psychiatric disability. The factors are\ndeemed adequate for both research and clinical uses and are valid in predict-\ning outcome and in being sensitive to changes in patients' level of impairment.\n6. Human Resources Development\nThe Department of Human Resources Development reports a number of\nareas in which it is directly involved with senior Califorians.\nIt is charged with implementing the State law known as the \"California\nLaw on Age Discrimination in Employment\" (California Unemployment Insurance Code\nSections 2070-2078).\nIt has responsibility in carrying out Public Law 90-202 of the 90th\nCongress, known as the Age Discrimination Act of 1967.\n-58-\nIt administers the Older Worker Program in California, and is the\nadministrative agency for the California Commission on Aging. These two\nprograms are discussed in detail below:\n(1) Commission on Aging Program\nOver 1,800,000 people over the age of 65 now live in California. Al-\nthough different levels of income, education, health and background are\nrepresented, the same physiological and social processes of growing old are\nshared by all. The social process, rather than the physiological process, is\nthe primary concern of the California Commission on Aging.\nAs the average age of our population decreases (52 percent is esti-\nmated to be under the age 25), the pressure mounts to force the older members\nof society to withdraw and thus create vacancies for younger individuals. At\nthe same time that the younger population is increasing, however, the popula-\ntion of those who have reached an arbitrary retirement age but are still capable\nof working and contributing to society is also increasing. As younger people\nenter adult society in larger numbers, there is a greater need for the trained,\nmature, experienced leadership which can be provided only by the senior members\nof society.\nEach community should utilize the full range of experience and knowl-\nedge possessed by its senior citizens, and meaningful activity must be avail-\nable for the mental and physical health of those same senior citizens. By\nmatching their knowledge and skills to the needs of the community, the commun-\nity gains in terms of an experienced work force, use of knowledge and skill\nacquired during years of activity, increased income from taxes, decreased\nreliance of senior citizens on public assistance and vigor and energy of those\nwho have something to give. By continuing to serve their community, the indi-\nvidual gains by having meaningful activity, being able to retain control of his\nincome, savings and property, and the dignity of determining his own scope of\nlife, plus knowing that he is still useful.\nWelfare and Institutions Code Sections 18300 through 18356 authorizes\nthe establishment and formation of the Commission on Aging.\nThe California Commission on Aging has many responsibilities but,\nif any one goal of the Commission encompasses both its philosophy and its func-\ntions, it is this: to work with other public and private organizations and\nwith the individual to provide the maximum opportunity for self-fulfillment\nduring the mature years.\nIn order to most effectively meet the total needs of California's\nolder residents, the Commission has assumed specific functions and objectives.\nThese include:\n-- To review, evaluate, approve and supervise projects under\nTitle III of the Older Americans Act of 1965.\n-- To assist and guide the communities of the State, through\nconsultation, in developing programs to meet the needs of\ntheir senior residents.\n-- To work closely with pertinent departments and agencies of\nthe state government in order that state resources shall be\nused as effectively and efficiently as possible in behalf of\nSenior Californians.\n-59-\n--To act as a clearinghouse and information center on all aspects\nof aging.\n--To hold hearings on, and in other ways to study, all aspects\nof the problems of aging and to advise the Governor of action\nneeded to solve these problems.\n--To provide ready access to health education, preventive health\nservices, prompt medical treatment and restorative resources\nbased on the most advanced knowledge and techniques available,\nfor all older people.\n--To assist in providing a wide range of housing and living\narrangements located, designed and priced in keeping with the\nchanging health and social characteristics, needs and interests\nof the aging.\n--To encourage services to protect all older people from exploita-\ntion through false claims, frauds, quackeries, unnecessary services\nand unreasonable charges, and to provide special assistance to\nthose unable to manage their own affairs.\n--To promote educational opportunities for older persons and those\nwho work with them.\n--To encourage full cooperation on the part of the family, community\nand society in helping older people fulfill significant roles in\nthe post-parental and retirement years.\n--To create opportunities for paid and voluntary services in\ncommunity agencies and to people of any or all age groups.\n--To assure provision of institutional and medical care, community\nand protective services and care and attention for the home-bound\nby people sympathetic to the aged and trained to work with them.\n--To involve older adults in planning and conducting programs\nand services for seniors and for others in their communities.\nAdded Responsibilities of the Commission Under the 1969\nAmendments of the Older Americans Act\nIn addition to administration, responsibilities now include planning\nevaluation, and coordination. The State plan shall provide that effective\nstatewide planning will be carried out on an ongoing basis on behalf of all\nolder persons in the State, with emphasis being placed on assuring the conduct\nof: (1) Special studies, including issue analyses and data gathering;\n(2) review and evaluation of all major programs and services for the elderly\nin the State; and (3) establishment of linkages with all other State planning\nefforts and service programs that affect the elderly of the State.\nPrimarily responsible for studying the needs, problems and opportu-\nnities of the Senior Californian are the twelve members of the Commission --\neight private citizens appointed by the Governor; and four legislative members,\ntwo appointed by the Speaker of the Assembly and two by the President Pro Tem\nof the Senate. Heading the Commission are the Chairman, appointed by the\n-60-\nGovernor for an indefinite term, and the Executive Director, appointed by the\nmembers of the Commission. Completing the Commission staff are some seven\nspecial consultants and clerks.\nFinancing the Commission's wide variety of service programs in aging\nis primarily through Title III funds made available through the Older Americans\nAct of 1965. Under the provisions of this act, maximum federal funds for the\nfirst year of a project may constitute 75% of the cost, 60% of the cost in the\nsecond and 50% of the cost in the third year. Nonfederal, funds complete the\nfinancing of the Commission projects. These funds may come in part or whole\nfrom the following sources:\n-- State appropriation to the California Commission on Aging\n-- County, municipal and local public governmental agencies\n-- Nonprofit private agencies and organizations\nThe matching share on the part of the state, communities or other\nnonfederal sources may be in the form of monies, facilities or services for\ncarrying out the activity or project approved by the Commission.\nSince 1955, when it was established by statute, the Commission on\nAging has been sole coordinator for all state departments having programs for\nthe aging. Cooperative working arrangements between departments provides\nspecialized professional support as the need arises.\nThe Senior Californian newsletter is the official publication of the\nCalifornia Commission on Aging. Published quarterly and distributed to all\ninterested individuals, groups and organizations throughout the state and\nnation, the Senior Californian features news of Commission projects and their\nactivities; spotlights outstanding programs and the work being done in them by\nSenior Californians; reports on opportunities for senior volunteers, and carries\narticles of general interest to persons concerned with the older Californian.\nIn addition, the Commission periodically publishes brochures and\npamphlets featuring individual projects and the important work being done by\nthem.\nAmong its countless activities, the California Commission on Aging can\nclaim several \"firsts\". Two of these \"firsts\" include the establishment of the\nTraining Institutes for California's senior leaders. These institutes were\nsponsored by the University of Southern California Gerontology Center in\n1968-69 and by San Jose State College in 1969-70.\nPresently, there are two such Centers in operation: in San Jose,\nthrough the Recreation Department of the City of San Jose in cooperation with\nthe Department of Recreation and Leisure Studies at San Jose State College;\nand in Los Angeles, through the Recreation Department of the City of\nLos Angeles and the University of Southern California. Each center serves the\nregion in which it is located. Training programs can be offered in any part\nof the region to meet the convenience of the workshop participants.\nGerontology Training Institutes: Three-day meetings held three times\na year to provide basic knowledge in gerontology as well as supplementary\ninformation and skills for Title III project staffs, OEO staff personnel work-\ning in programs for the elderly and interested community members.\nAlthough each institute includes some time for sharing specific pro-\ngram ideas, the primary focus of these sessions is on the presentation and\n-61-\ndiscussion of general material which might apply to all who work with older\npeople regardless of specific job or geographical location. This background\ninformation can then be discussed and applied on a more specialized basis at\nthe regional workshops. These programs offer to Californians in the field of\naging curriculum, material similar to that presented to students in gerontology\ncourses. Participation in the institutes is by invitation.\nAs the response to each of the component parts of this education net-\nwork increased, it became evident that a statewide focus could serve to minimize\npiecemeal or duplicated efforts by providing a coordinated approach. A state-\nwide education and training program was initiated to integrate these various\nlevels of programs which were already in existence; to foster innovative educa-\ntional concepts in the field of aging; and to stimulate the development of\nservices based on broader perceptions of basic problems and approaches.\nThe Commission has also established the first State civil service\nclassification in the United States designed for part-time employment of seniors.\nIn California, as demonstrated in these examples, older people are\nassuming new roles -- those of volunteers, of helpers whose expenses are paid,\nand of aides who receive some remuneration for their work. They are providing\nleadership that has a great deal of meaning to their group, and is helping it\nto become an important part of the community.\nThese programs are only a few examples of our total California pro-\ngram. They are the ones which are indicating methods that are proving effec-\ntive in a variety of local areas. We are hopeful that they may be used by our\nlarge state agencies as part of a continuing program after they have been\ntested through the three-year period of the Older Americans Act, or that other\ncommunities may set up similar programs as they become ready to do so.\nSince the enactment of the Older Americans Act of 1965, there has\nbeen a growing concern about the problems confronting the elderly. An educated\ncommunity and trained personnel are paramount in formulating and implementing\nsocial policies to insure the well-being of older persons. A community needs\ninformation on which to base thoughtful approaches; professional personnel need\ncontinuous access to current data to provide effective leadership and older\npersons need information and ongoing training for self-help, for self-\ndevelopment, for service to others and for communication with the total\ncommunity.\nBeginning in 1967 the California Commission on Aging, through its\nstaff consultants and through its allocation of Older Americans Act Title III\nfunds, introduced a newwork of informational and educational programs through-\nout California in order that all communities might be made aware of the needs\nof their senior citizens and of ways in which resources can be mobilized for\nimproved services to meet these needs. Four different types of programs were\ndeveloped to provide education and training at the local, regional and state-\nwide levels: Information Days, Regional Workshops, Senior Education Centers,\nand Gerontology Training Institutes. Each has a specific purpose. Each pro-\nvides basic information needed to further programs of service.\nInformation Days: One-day sessions focusing on programs and services\nfor the aging at the county level, sponsored cooperatively with local organiza-\ntions and agencies.\nA broad spectrum of services for the elderly, or one particular\ntopic in-depth may be explored through speakers and group discussions. Booths\n-62-\nor tables offering informational material are made available by local agencies\nto service the older person. These meetings are widely publicized to attract\nas many senior Californians as possible and are attended by 200-500 persons,\ndepending on the locale. The primary purpose is to inform seniors about what\nservices are available in their local communities.\nRegional Workshops: One-day symposia for those who work with older\npersons either as professionals or volunteer leaders. The attendance of civic\nleaders, educators, the ministry, public agency personnel and representatives\nof the private sector is encouraged to broaden the total community's awareness\nof everyone's need to identify with the aging process.\nThese meetings are designed to involve the participants in discuss-\nions of specific issues of concern which could then lead to community action.\nThere were three such workshops held during this past year in each of the five\nCalifornia Commission on Aging Regions which are multi-county in scope.\nSenior Education Centers: A comprehensive program of ongoing year-\nround educational programs for professionals, community groups, volunteers,\nstudents and senior Californians.\nThrough the cooperative efforts of a local government and a neighbor-\ning college or university, a training program in the field of aging is offered\nto foster more creative and more comprehensive involvement in the community for\nand by seniors.\nContent depends on the needs of the specific group and the programs\nvary from one-day workshops, panel discussion meetings, series of workshop\nsessions and lecture presentations to practical demonstrations. Subjects in-\nclude psychological, sociological and biological aspects of aging, nutrition,\nhealth, recreation for nursing and residential care homes, volunteer orienta-\ntion, and other similar topics.\n(2) Older Worker Program\nThe Department's 7th Report to the Governor on the Older Worker\nProgram, Dated May 22, 1970, discusses the problem facing the older worker in\nCalifornia: the growing numbers in this group, the serious economic plight of\nan increasing percent of older citizens, the growing dependency ratio caused by\nlong-term inflation, early retirements, automation and lack of adequate dis-\nsemination of job information.\nThe report discusses the significance of its two-year \"Project 60\",\ndeveloped in 1964 with the San Francisco Program for Aging as the local sponsor.\nThe purpose was to find the reason for the large scale demand for employment\nby persons over 60, and to develop a community profile of persons over 60,\nanalyzing their need for employment and other services as well. It concluded:\n\"\nthe serious problem of income maintenance in retire-\nment was clearly defined to us in the \"Project 60\" experience.\nIn addition, we found that in this group, 87 percent had no\nchronic health conditions or impairment which limited employ-\nment; they are very reluctant to ask for assistance, either\nsocial services or employment; they come to an employment\noffice when the need is for other kinds of help; the helping\npersons are perceived as real people rather than the imper-\nsonal, anonymous professional worker; a job which is meaning-\nful produces a rapid and positive change for the better in\n-63-\nhealth; retirement is a tremendously stressful crisis\nand preparation is essential to minimize the blow and\nhelp the individual to adjust; loss of mastery over\none's own situation through dwindling financial\nresources is their principal psychological problem;\nand the most effective way to help them is to deal\nwith their current situation, rather than past events.\"\nThe report also describes the development of the Senior Aide Concept.\nThe following are excerpts from this description:\n(3) Development of the Senior Aide Concept\nDuring the years 1965-1969, the discoveries in the field of aging\nbrought California (and the United States) from a state of unawareness of the\ncondition of a majority of our elderly citizens to a dawning realization that\ntheir plight in this period of greatest affluence is a national disgrace.\nThe programs and projects which developed this information are all\nvery recent, some ongoing into 1970, and were financed by the U.S. Office of\nEconomic Opportunity. In California, the Older Worker Program of the California\nState Employment Service has played a participatory role in their development,\nsupporting and strengthening them when possible.\nFirst came the Foster Grandparent Program, recruiting, training and\nemploying persons over age 60 with low incomes to serve neglected and deprived\nchildren who lack close personal relationships with adults. This is an Older\nWorker Program within the Community Action Program of OEO. The goal of this\nprogram was to show how to raise the economic level of older people with low\nincomes, and provide new roles and functions for older people including new\nemployment roles. They were employed 20 hours a week at $1.60 per hour. The\nfirst project under this program in California and one of the first in the\nnation was the San Francisco project beginning in 1966.\nOne of the most successful Foster Grandparent programs in California\nin 1969 was in Pacific State Hospital. Our Pomona office screens all candidates\nfor these positions and Manager B. E. Sweeney has this to say:\n\"As we view the program, this appears to be one of\nthe most successful of the anti-poverty programs in this\narea. It has been a 'two-way street'. The grandparents\nfound that they are needed and wanted and equally important\nis the supplementary income which they would have found\ndifficulty in obtaining otherwise. The hospital staff has\nbeen equally enthusiastic and have many success stories\nof patient progress as a result of individual attention.\nThe average age is 67, ten are 70 and over. OEO funded\nthe program at 48 positions. Interestingly, this year,\nthe California Legislature added 12 more positions to be\npaid wholly by state funds\n\"\nSecond was Operation Medicare Alert whose primary purpose was to carry\nthe message of Medicare to older individuals who might not otherwise know of it,\nand assist them in taking the necessary steps to avail themselves of its benefits.\nA secondary purpose was to ascertain the needs of the elderly population.\n-64-\n3,841,027 older persons were contacted nationally, and it was from this experi-\nence that California and the nation learned of the unexpected magnitude of the\npoverty of our older population.\nOn a statewide basis, we assisted the Social Security Administration\nin recruiting, screening and referring applicants for Operation Medicare Alert\nin California. Here again, elderly at or below the established poverty income\nlevels were hired to work in the project.\nProject FIND, the third program, was developed from the reports on\nOperation Medicare Alert, as an aggressive outreach program to search out\nseniors, isolated and hidden from public view, and assist such individuals by\nchanneling help to them from available community resources which they do not\nknow how to obtain. The National Council on the Aging conducts this project\nfor OEO.\nThe original Project FIND location in California was in the Santa Cruz-\nWatsonville area where 20 percent of the population is over 65 years of age.\nThe project was extended in 1969 to include San Diego, Hayward, Shasta County,\nVallejo, Long Beach, Modesto and San Bernardino. Again, older people in poverty\ncircumstances were hired to do the job, the oldest in California being 85 years\nold.\nProject FIND is the most extensive study yet made of the elderly.\nThe National Council on the Aging preliminary report found that 15 percent of\nthe elderly poor couples 65 years of age or older are living on an annual\nincome under $1,000 and 46 percent have incomes below $1,500. Project FIND\nshows that the greatest number of California's elderly poor live in Los Angeles,\nLong Beach and San Diego.\nIn the reports from Project FIND locations in California, the need for\nemployment for the senior poor is proposed as the primary solution to their\ndesperate economic plight. The Department of Human Resources Development has\nworked very closely with these projects in the communities named above, both in\nrecruiting and screening the elderly applicants for employment with the project,\nand accepting referrals for employment from the projects. In most instances,\nstaff from the field offices of the Department of Human Resources Development\nare on the project board of directors or serve in an advisory capacity to the\nboard. The projects are continuing into 1970 and when completed, the results\nwill be announced by the President.\nThe genesis of the Senior Community Service Project was the national\ninterest, as expressed in a number of congressional hearings, plus the obvious\nneed to stimulate employment opportunities for seniors which was demonstrated\nby the three programs just described.\nThe rationale for the Senior Community Service Project was that it\nsatisfy the income-producing need for part-time work and at the same time pro-\nvide manpower to meet the great need for additional social and health services\nwhich exists in each community; thus combining the need of the community with\nthe need of the older poor.\nThis project represented a more sophisticated approach to a senior\nmanpower problem by developing the job of Aide, complete with job descriptions,\nspecialized training, and background requisites.\n-65-\nAlthough the age criteria for this project was a minimum of 55 years,\nmost Aides were in the sixties and seventies. They met poverty income criteria\nand were either retired or chronically unemployed. Working on a 20-hour-a-week\nbasis, enrollees were assigned to public or nonprofit private agencies. Their\ngross annual income from the project could not exceed $1,976.00. The funds for\nthe project were provided by the U.S. Department of Labor. All administrative\nand training costs were absorbed by the local sponsors.\nThe California State Employment Service offices served as the employ-\nment component of these projects in 1969 in California in recruiting, screening,\ntesting, and in some cases employing these Senior Aides. Although the sponsor-\ning agencies used the skills of our offices in varying degree, we were able to\nassist in promoting public understanding of the projects, provide information\nto project staff about applicant needs and characteristics; make available pre-\nvailing wage information and extend various industrial services pertinent to\nestablishment of new jobs. The projects which were most successful were the\nones which fully used our services in this way.\nEach project in California had a local sponsoring agency in addition\nto the prime contractor, a national organization active in the field of aging.\nThese projects were as follows:\nNational Council on the Aging, Washington, D.C., prime\ncontractor for projects in San Francisco sponsored by\nthe Economic Opportunity Council; and in Los Angeles,\nsponsored by the Economic and Youth Opportunities\nAgency.\nNational Council of Senior Citizens, Washington, D.C.\nprime contractor for projects in Oakland, sponsored by\nthe Social Service Bureau of the Council of Churches;\nand in San Diego, sponsored by the Community Welfare\nCouncil.\nAmerican Association of Retired Persons and the\nNational Retired Teachers Association, Washington,\nD.C., prime contractor for a project in Long Beach,\nsponsored by the Long Beach Commission on Economic\nOpportunities.\nThese projects are funded into 1970.\nThe report to the Governor also described projects conducted in\nCalifornia by the National Council on Aging, the National Council of Senior\nCitizens, and the American Association of Retired Persons with the National\nRetired Teachers Association.\nThe report ends with the following conclusion and projection:\nThe elderly are no longer a passive group and the aged population is\ngrowing very rapidly, in fact, at such a rate that many leading social scientists\nview it as the making of a national crisis.\nWorkers who reach old age in the future will undoubtedly have higher\neducational achievements and can be expected to have better health; a higher\nproportion will be skilled workers. We question whether there is grounds for\n-66-\nbelief that they will accept patterns of early retirement or even retirement\nat all. In other words, work and retirement patterns that have characterized\nthe past few decades will not automatically be extended into the future.\nThere has to be a better role for these people. To make the Seventies\nworth living will take the talent, brains and experience of all the people\nliving in California.\n7. State Teachers' Retirement System\nMichael N. Thome, Chief Executive Officer of the State Teachers'\nRetirement System reports that 312,563 active and 40,159 retired (and benefi-\nciaries of retired) persons are covered by the program. Essentially, the pro-\ngram provides retirement, disability and survivor's death benefits for teachers\nin public supported schools in California. In Fiscal Year 1970-71 state\nparticipation equaled $83,450,884 and local (school districts) equaled $58,136,840.\nThe provisions of state law establishing the system and setting forth\nsuch matters as eligibility, benefits, contribution scales and retirement\nformulas are formed in California Education Code Sections 13801 et. seq.\nNormal retirement eligibility requires 60 years of age and at least\nfive years of service. Early retirement at 55 and later retirement are per-\nmissible (with at least five years of service) with corresponding actuarial\nreductions or improvement in the retirement allowances. Disability retirement\neligibility also requires at least five years of service. The standard benefit\nformula is 1-2/3% of the final compensation for each year of service credit.\nFinal compensation is the average earnable salary for the highest three con-\nsecutive years of California service. The law also sets forth the death bene-\nfits both before and after retirement.\nFull details of this program may be obtained by writing the State\nTeachers' Retirement System, Sacramento, California.\n8. Department of Rehabilitation\nThe State Department of Rehabilitation reports as follows:\nSince our work is almost entirely related to providing vocational\nrehabilitation services to enable physically and mentally handicapped people\nto enter employment, we do not have much contact with people over 65. During\nthe Fiscal Year 1969-70, out of the 14,358 clients rehabilitated, 77 were over\n65; 42 of the 77 were alcoholics and 35 had other physical or mental disabilities.\nAlthough we do not consider them \"aged\", as far as the labor market is\nconcerned anyone over 45 tends to have difficulty in obtaining employment due\nto age. Our records indicate that during 1969-70, 3,592 or 25% of the persons\nrehabilitated were between 45 and 65 years of age. While overall this group\ncomprises 25% of the rehabilitations, if the group is separated between the\nindividuals handicapped by alcoholics' problems and all others, we find that\n1,105 or 49% of the alcoholics rehabilitated were over 45, while 2,487 or 20%\nof persons with other types of handicapping conditions were in this age group.\nOne small program operated by this Department involves people over 65\nto a substantial degree. This 1S our Teacher-Counselor Program for the Blind.\n-67-\nSince blindness is largely a disability of old age, there are many newly blinded\npeople over 65 who need the kind of service we offer. The service provides\ncounselor-teachers who go into the homes of older blind people and assist them\nin any way possible to learn how to live in spite of their blindness. This can\ninvolve all types of training which may assist them to get around without assist-\nance, keep house, read Braille, type or almost any other thing which will make\nthem more comfortable and independent. On September 30, 1970 approximately 300\nblind people over 65 were being served in this program. This is 34% of the total.\nIt is estimated that $132,000 were devoted to this particular effort in regard\nto the aged.\n9. Franchise Tax Board\nThe Franchise Tax Board reports as follows:\nThe State of California has developed a program whereby eligible indi-\nviduals are relieved of a portion of the property tax burden. The Senior\nCitizens Property Tax Law, (Sections 19501 et. seq., of the California Revenue\nand Taxation Code), administered by the Franchise Tax Board, is designed to\noffer financial assistance to individuals who own their homes, have low income,\nand are 65 years of age or older. The law requires that the individual pay the\ncurrent year's property taxes and then file a claim for refund. The individual\nreports the amount of money received during the year and furnishes a copy of\nthe current year's tax bill with proof of payment of the taxes. The first claim\nfiled by the individual must be accompanied by a document which proves that he\nor she is over 65 years of age.\nDuring 1969 we refunded approximately $8,000,000 to approximately\n60,000 individuals. The average refund was $133. The 1970 program year has\nnot yet been completed, but the number of claimants being paid and the total\nof the payments will be slightly higher this year. We believe the number of\nclaimants could be increased if we were able to contact all of the eligible indi-\nviduals or receive the information from them after contact has been made. Our\nprogram, is relatively new so it is not as well known as, for example, the Social\nSecurity program and the individuals will not furnish the necessary information\nas readily as they do to the Social Security representative.\n10. Public Employees' Retirement System\nMr. William E. Payne, Executive Officer of the Public Employees'\nRetirement System reports as follows:\nThe California Public Employees' Retirement System administers two\nprograms of direct interest to the aging. One is through the State Employees'\nMedical and Hospital Care Act which, from its very beginning, provided for\nhealth insurance for retired State employees with benefits and premiums equated\nto active employees even though the utilization of the retired was substantially\ngreater than that of the active. We anticipated the advent of Medicare by obtain-\ning legislation which permitted us to develop supplemental plans to Medicare for\nthose over age 65, so that concurrent with the initiation of the Medicare pro-\ngram we had provided our retired group, who qualified, with a benefit which sup-\nplemented and generally filled in the gaps of Medicare.\nCurrently, we have 17,107 retired persons enrolled under our several\nhealth insurance programs at a cost to the State of $1,689,052 for the preceding\nfiscal year. At the end of the past fiscal year we had 57,086 retired members\n-68-\nand beneficiaries of retired members on our retirement rolls and through the\nyear some $115 million paid to these retired persons through monthly benefit\npayments. A somewhat equal amount of State and local government employees were\ncontained in this retired group with the local government employees exceeding\nthe retired State employees by some five and six thousand. In general terms,\nthe benefit costs result in the employer paying in the area of 70% of the total\ncost, with the employee's contribution in the area of some 30%.\nThe health insurance programs have been highly effective for the aged\ngroup. The retirement program is effective only in terms of the years of\nservice which the individuals have accumulated as credited years under the\nRetirement System, since with a guaranteed formula, retirement allowances are\nin terms of years of service as well as final salary. Through the efforts of\nthe Governor and the State Legislature, we have been able to install a 2%\nannual compounding cost of living program in order to offset some of the ravages\ncreated by inflation affecting fixed incomes.\n11. Department of Veterans Affairs\nThe Department of Veterans Affairs reports two distinct programs af-\nfecting 221,320 veterans: Veterans Home - 1320; Veterans Claims - 220,000.\nFiscal involvement is as follows:\nFederal $4,000,000; State $5,000,000; Local (54 counties); $2,450,000.\nThe Department describes the two programs in the following manner:\nThe Veterans Service Division administers the Claims and Rights\nProgram for the Department of Veterans Affairs. Veteran representatives of the\nDepartment assist veterans in presenting and pursuing claims against the\nUnited States Veterans Administration. They also assist veterans in obtaining\nhospital care in Veterans Administration Hospitals.\nThe Veterans Home at Yountville, California, accepts as members any\nhonorably discharged veteran who has been a resident of California for at least\nfive years, and is unable to support himself in a competitive environment.\nThree levels of membership exist: domiciliary care - when a member can ambulate\nfreely and does not need extensive medical treatment; nursing care - when the\nmember's ambulation is limited or if he requires a special medical regimen;\nhospital care - when conditions so warrant. Member's average age is over 70\nyears. Charges of $60, $90 and $120 per month are made, depending on the level\nof care required. If a member is indigent, no charge is made. Charges are not\ninvoked that will reduce a member's income below $50 per month.\nThe Department's role in providing care to the aged is relatively in-\nsignificant. Changing socio-economic conditions appear to be a limiting factor\nas respects the number of those seeking membership at the Veterans Home. The\nhospital and nursing care areas operate at maximum capacity; the domiciliary\nunits are approximately 35 percent filled. One basic assumption has been drawn:\nInstitutional living loses its appeal when sufficient care and assistance can\nbe obtained at the community level.\n-69.-\n12. Department of Consumer Affairs\nMr. Leighton Hatch, Director of the State Department of Consumer\nAffairs, formerly the Department of Professional and Vocational Standards re-\nports programs in two important fields concerning health, nutrition and\neducation.\nMichael R. Buzzy, R.N., Executive Secretary for the Board of Nursing\nEducation and Nurse Registration states that 10,000 nursing students receive\nvarying degrees of education concerning the elderly.\nMiss Beverly C. Andre', R.N., the Board Nursing Education Consultant\nin Nursing Practice, states:\n\"The Board of Nursing Education and Nurse Registration does\nrequire recognition of the Older American in the prescribed cur-\nriculum for accredited schools of nursing. The content area in-\ncludes nutrition, physiology-anatomy, major physical and mental\nhealth problems. A survey of curricula submitted by 48 associate\ndegree, 12 diploma, and 16 baccalaureate degree accredited schools\nof nursing shows that only 10% of the presently accredited pro-\ngrams do not use convalescent or extended care facilities as\nclinical experience areas. However, these programs do have clinical\nexperience in the care of the older adult in graduated services\nof a general hospital.\n\"The Board's Profile of Registered Nurses identifies that\nof the 68,438 full-time employed R.N.s in California, approxi-\nmately 10% are geriatric nurses.\n\"In its adoption of a more structured program of licentiates\non probation to the Board, considerable information concerning\nnursing practices in the extended care facility has been gained.\nApproximately 50% of the 68 nurses on probation are employed in\nextended care facilities. The new probation program includes\nreports that emphasize upgrading nursing practice through con-\ntinuing education. The major area of lack of knowledge among\nthis latter group was in psychiatric and geriatric nursing.\nSince the Nursing Education Consultant responsible for the pro-\nbation program is a nurse gerontologist, the imput has been one\nof directing these nurses to courses, conferences, workshops and\nreading material in professional magazines that would improve\ntheir practice of nursing.\n\"In Section 2725 of the Nurse Practice Act, the scope of the\nregulation says 'to safeguard life and health of a patient and\nothers'. Since July 1970, the BNENR has assigned a Nursing\nEducation Consultant to develop a program of services in nursing\npractice.\n\"A recent license and licentiate violation survey of\nhospitals and extended care facilities shows a need for work-\ning with these agencies in the use of criteria and guidelines\nfor safe and effective nursing practice. Over 50% of the agencies\nresponding were extended care facilities where at least 60% of\nthe population are Older Americans.\"\n-70-\nMaryellen Wood, R.N., Executive Secretary of the Board of Vocational\nNurse and Psychiatric Technician Examiners reports that the state's 82 accredited\nschools use extended care facilities and nursing and rest homes for clinical\nexperience for a high percentage of their 4,500 students.\n13. State Personnel Board\nMr. John F. Fisher, Executive Officer of the State Personnel Board\nreports as follows:\nThe only program activities of the State Personnel Board that directly\nrelate to the aging are those related to job opportunities. In the recruitment\nof personnel for the State Civil Service, we have sought to comply fully with\nthe provisions of Government Code Sections 18932 and 19700 prohibiting dis-\ncrimination based upon age. However, this activity has been pursued within a\ngeneral policy framework and does not involve any identifiable direct cost.\nWith regard to maximum age limitations on employment in the State\nCivil Service, we are concerned about the fact that in 1970 the California State\nLegislature imposed two age limitations that, in our opinion, are unduly restric-\ntive. A maximum age of 31 years was established for fire fighting positions\nwhich normally afford entry into the Department of Forestry service (AB 305,\nChapter 138, Statutes of 1970).\nUnder the provisions of AB 245 (Chapter 1600, Statutes of 1970) ef-\nfective July 1, 1971, an age limit of 35 was established for employment as a\nCorrectional Officer, Womens Correctional Supervisor I, Parole Agent I, Group\nSupervisor, Youth Counselor, and other custodial and parole positions which\nnormally afford entry into the Department of Corrections or the Department of\nthe Youth Authority. In the legislative considerations of these bills in 1970,\nthe representatives of the State Personnel Board were the only persons who\npresented testimony recommending against the establishment of these age limits.\nIn a report of November 10, 1970, to the Senate Committee on Finance\nwe made the following statement: \"We note that maximum age limits for entry\ninto State service have been included as a feature of the retirement programs\nthat encourage or require retirement at age 60 or 55 for some occupations. We\ndo not believe assurance of an optimum retirement allowance is in itself an\nadequate justification for the establishment of maximum age for entry into State\nemployment. We urge that entry age maximum not be set unless there is clear\nand unequivocal justification based on unusual physical demand of the occupation.\"\n14. Department of Housing and Community Development\nThis Department reports a modest program in the area of Housing for\nthe Elderly which involves a State Fund Expenditure in the amount of $4,500.\nThe continuous rise in housing and related costs severely affect the\nelderly who live on fixed incomes. The objective of this program is to provide\nadvice and aid on availability of federally financed programs as well as privately\ndeveloped programs and to serve as a catalyst for seeking solutions to this\nspecial group of senior citizens.\nUpon request, the Department will assist in the application process,\ndetermine the availability of federal aid and recommend possible solutions where\nsuch aids are not fully available for all senior citizens.\n-71-\nThe Department's legal authority is found in Health and Safety Code\nSection 37104 through 37113; Labor Code Sections 1460 through 1468. At the\nrequest of a government agency or private quasi-public or private, nonprofit\ngroup, the Department will stimulate action in providing the quantity of varied\ntypes of housing and related services required to meet the needs of the elderly.\n15. Department of Fish and Game\nThe State Department of Fish and Game reports a unique program which\ninvolves $150,000 in state funds, and benefits 35,000 senior Californians:\nfree fishing licenses.\nUnder recently adopted state laws, women over 62 and men over 65 may\nobtain free sport fishing licenses for ocean fishing and frogging if they have\nbeen residents of California at least five years and their income does not\nexceed $140 per month for single persons and $280 for married persons.\nBy purchasing one current license stamp, the license is extended to\ninclude all species of fish other than trout, (but including steel head trout).\nThe license is further extended to trout if a second current license stamp is\npurchased.\nLicenses may be obtained by filing of a simple application form with\nthe State Department in Sacramento.\n16. Department of Youth Authority\nThe Department of Youth Authority reports its participation in the\nFederal-Local sponsored foster grandparents program.\nForty-one senior Californians are involved in this program which in-\nvolves the expenditure of $135,940 in Federal Funds and $19,351 in local funds.\nSixteen of the 41 grandparents were on Public Assistance before becoming in-\nvolved in the program. Due to this added income and other benefits derived from\nthe program, 11 have discontinued Public Assistance and five are receiving\ndecreased payments.\nMaterial submitted by the Department contains the following description\nof the program:\nBenefits to Foster Grandparents\nThe Foster Grandparent Program serves an extremely important purpose\nfor the retired senior citizen living on an inadequate income, that allows few\nopportunities for meaningful social experiences.\nThe most obvious benefit is the additional income earned by working\nas a Foster Grandparent. The $1.60 per hour for 20 hours' work a week ($32.00)\nsupplements their meager incomes and allows them to live a life of greater\ndignity.\nOf equal importance is the sense of purpose -- the increase in self-\nesteem they derive from again feeling useful and needed by someone. Many of our\nsenior citizens have known only loneliness and rejection since their own child-\nren moved away from home. In time, they acquire the feeling that no one cares\nfor them or needs them, and that they are of little value to anyone.\n-72-\nWorking as Foster Grandparents with boys that desperately need their\nhelp changes their self concept from useless and unwanted, to being a person\nwho is making a valuable contribution to the lives of others. For many, it is\nlike a miracle drug that rejuvenates them both physically and emotionally.\nOur senior citizens are uniquely qualified to provide the constructive\nadult relationships needed for the emotional development of their grandsons.\nThey have the experience, understanding and compassion acquired through years\nof living. They are motivated by the need to again feel useful and wanted.\nWorking with boys whose home life lacked positive adult relationships needed to\nprovide a feeling of security, of being loved, being wanted, being worthwhile,\nis a perfect match. The grandparents have so much they want to give and the\nboys have many emotional needs to be filled. Each complements and reinforces\nthe other, resulting in benefits for both grandparents and their grandsons.\nThe physical and emotional benefits resulting from again having a purpose in\nlife, or performing a task that is important to the future of others, would be\nhard to measure. The beneficial results of their work with the boys is well\ndocumented.\nOur particular program has been operating at the Northern California\nYouth Center since July 1967. It is unique in that it is the only program of\nthis type that is presently operating within an all correctional institution.\nSenior citizens of low income groups, from various community environ-\nments and ethnic origins, were interviewed resulting in 38 taking two weeks'\nbasic training to orient them to an institutional setting involving boys, aged\n13 to 16 years, in confinement for various infractions of the law.\nThe performance of this group since July 1967 has proved that the\nlow income senior citizen can provide a major new reource of responsible workers\nfor community and social agencies. The Foster Grandparents have not only been\nhelped financially (many have been released from Welfare rolls) but have demon-\nstrated an ability to meet the emotional challenge of the job by giving boys the\nsocial and psychological support so necessary for their development.\nThe Orientation and Indoctrination of Foster Grandparents consists of:\n(1) Orientation to the Foster Grandparents Program.\n(2) Role of Foster Grandparents in Youth Authority Program.\n(3) Youth Authority philosophy and organization.\n(4) Referral process and background of Youth Authority wards.\n(5) The Therapeutic Community concept in use in Youth Authority\ninstitutions.\n(6) Causation factors of delinquency.\n(7) Techniques of treatment.\n(8) Minority group problems.\n(9) Working with Youth Authority staff.\n(10) Observation of our institutional programs.\nUpon completion of orientation and indoctrination the Foster Grandparents\nare assigned to work with an experienced grandparent on a living unit.\nThrough in-service training, the program staff expose the Foster\nGrandparents to subjects relating to the needs of the institutions and the\n-73-\nchildren they serve. In addition, outside resource people give instruction on\nnutrition, arts and crafts, Social Security, medical coverages, recreation,\nand opportunities available for social involvement.\nIn-Service Education Meetings:\nThe California Youth Authority allocates several hours a week to\nmeetings that are designed to increase the proficiency of staff involved in the\ntreatment process. The sophisticated treatment concept in use in both institu-\ntions make ongoing in-service education a necessity if staff are to remain\nknowledgeable on new developments in treatment.\nWorking in this type of a setting is a new role for the Grandparents.\nIn order to be effective in their role, it is essential that they have a basic\nunderstanding of the treatment strategy being used by their treatment teams.\nMembers of the Treatment Teams and other treatment specialists will help Grand-\nparents acquire the \"new skills\" and knowledge by means of monthly scheduled\nin-service education meetings. The scheduled in-service education meetings\nwill be supplemented by daily private orientation and education meetings with\nTreatment Team members in order to coordinate the efforts of all staff working\ndirectly with the children. Further in-service education will be provided for\nGrandparents in meetings which specifically spell out the treatment strategy\nand goals for their grandsons.\nThe Foster Grandparent Program recruits, trains, and employs persons\nover age 60, with low incomes, to serve neglected and deprived children who\nlack close personal relationships with adults.\nFoster Grandparents May Serve:\nNeglected infants and very young children living in institutions.\nNormal older children, 6-16, in institutions.\nMentally retarded or emotionally disturbed children in institutions.\nChildren not in institutions, but in clinics, special classes,\nsheltered workshops, or other settings.\nThis is an Older Worker program, which was transferred from the Office\nof Economic Opportunity to the Department of Health, Education and Welfare on\nSeptember 17, 1969. It is now funded by the Department of Health, Education\nand Welfare. Administration on Aging, Foster Grandparent Program, Washington, D.C.\nThe Goals\nThe Foster Grandparent Program provides new roles and functions for\nOlder Americans, creates new employment opportunities, stimulates innovations\nin the field of child care and institutional administration demonstrates a\nmajor new resource of responsible workers for communities and social agencies,\nleads to new patterns of cooperation among agencies and professions, and gives\nchildren meaningful lives with tender love and care.\nThe Older People\nSeveral million men and women, aged 60 and over, need additional in-\ncome from employment to maintain a minimum standard of living. Some of them\nhave always known financial deprivation, others have greatly reduced incomes\n-74-\nbecause of retirement. A large number of these persons make good grandparents.\nThey have a generous supply of love and understanding which grows from their\nyears of experience. They love children. These men and women can contribute\nsignificantly to children who are starved for emotional warmth. As such they\nrepresent a largely untapped resource in their communities.\nEmployment as Foster Grandparents provides needed income and gives\nnew meaning to older persons who frequently welcome the opportunity to demon-\nstrate that they are still useful by fulfilling a need that may otherwise go\nunmet.\nOf the 29.7 million impoverished Americans, seven million are aged 65\nand over. An additional 2.7 million are 55 to 64 years of age and also living\non incomes under the poverty level. About half of them live alone.\nFor youth, the major goal is to break the cycle of poverty from\ngeneration to generation. For youth, measures sought may be long range,\nstarting in infancy. For the old, however, efforts must be directed toward\nresults in the immediate or near future. Many will have to continue to live\non very limited incomes, but they should be able to live out their lives in\ngreater decency and dignity than most of them do at present.\n17. Department of Corrections\nThe State Department of Corrections reports that one of its 13 cor-\nrectional institutions, California Mens Colony West in San Luis Obispo County,\nis designed and operated primarily for older inmates and persons with physical\ndisabilities.\nTwo percent of the state's 25,000 male prisoners are 60 years and over.\nSuch men pose special problems, particularly at the time of release. The parole\ndivision attempts to make use of various public and private service agencies in\nmeeting the needs of older individuals who are being returned to the community.\nThe Department points out that this effort involves all the problems\nfaced by any other aging persons, and urges that any future programs for the\naging should not exclude ex-convicts from eligibility. In some cases in the\npast, federal programs to help disadvantaged people have not included parolees.\nMaterial submitted by the Department describes Mens Colony West in\nsome detail.\nThe West Facility, a minimum security institution, was established in\n1954 and now houses 1,400 older offenders. It employs various rehabilitative\nprograms in an effort to retrain them for their safe return to society. Planned\nas a specialized institution for the older offender, the West Facility has estab-\nlished the rehabilitative process in a physical and custodial setting apart from\nthe more secure and expensive restraint necessary for younger, more aggressive\noffenders.\nThe facility probably houses the largest group of elderly and handi-\ncapped offenders in any one penal institution. The median age of West Facility\ninmates is approximately 54 years, and this factor proves in some ways to be an\nasset. Competing within their peer group, many of these men are able to produce\nas effectively as many younger men. Older inmates know what is expected of them\n-75-\nin product and conduct, and normally they proceed in a deliberate manner to\nmeet the expectancy.\nThe educational program at the Mens Colony, both East and West\nFacilities, operates with the guiding philosophy that education is a function\nmost effectively accomplished by professionally trained and accredited educa-\ntors. All our academic instructors are fully credentialed by the State Depart-\nment of Education. We contract, utilizing funds appropriated in our state\nbudget for this purpose, with the San Luis Coastal Unified School District to\nfurnish us our teachers. The teachers are a part of the staff of the local\nschool district and are paid prevailing district salaries. Our academic pro-\ngram is subject to all the state laws and district requirements, and diplomas\nearned by students are awarded by the district and are not identified as being\nreceived at a prison.\nAcademic programs are designed to provide upgrading for the inmates\nto the fullest extent possible, commensurate with their interest. Training is\navailable for all men from illiteracy level up to the completion of high school,\nwith some correspondence work at the university level. Approximately 120\nelementary diplomas are earned each year along with 100 high school diplomas.\nGraduation Day at the Mens Colony is conducted in the same manner as in the\nlocal high schools, with outside speakers, utilization of caps and gowns, and\nattendance by the inmates' families. In addition to the regular day school\nprogram, over 100 inmates are enrolled in night classes. During the 1969-70\nschool year, we expect to use 25 academic teachers, with five of these to be\nassigned to the West Facility.\nVocational training is available in 12 major trades. An annual Art\nShow is held at the Institution each year during the first week of August. Dur-\ning this display, inmates of both the East and West Facilities enter their work\nfor review and judging. These items of art and handicraft work are then sold,\nwith many inmates reaping a substantial monetary return as well as prizes and\nawards for their efforts. In addition to the Art Show, hundreds of inmates,\nthrough Arts and Crafts training, have become involved in painting, leather work,\nceramics, lapidary and other skills. This training enables men to make good\nand healthy use of otherwise wasted time.\nThe West Facility hospital is geared primarily to geriatrics and\nphysical rehabilitation. The hospital has 231 beds for acutely and chronically\nill patients. There are six wards and an outpatient clinic staffed by four\nfull-time physicians including a psychiatrist. Two full-time dentists, a super-\nvising nurse, an X-ray technician, a laboratory technician, a registered pharma-\ncist, ten medical technical assistants and two medical secretaries complete the\nmedical staff. The adaptive physical education program provides motivation and\ntreatment so that residents may learn to live within the limits of their handi-\ncaps and capabilities, and directs them toward suitable occupations and social\nreintegration.\nUtilization of board certified consultants is a daily practice at the\nMens Colony. These carefully chosen contract consultants are specialists in\ntheir fields which include among them that ophthalmology, otolaryngology,\nurology, radiology, dermatology and orthopedic surgery. Periodic clinics are\nconducted by these specialists who give treatment as needed to the problem cases\nreferred to them.\n=76=\nThe California Mens Colony also offers a religious program to the\nresidents that is varied and diversified. An ecumenical setting is the basic\ndesign in which the program functions. A more broad scope of religious experi-\nences is thus available to each individual according to his needs and beliefs.\nFour full-time chaplains are on the institution staff, with both a Protestant\nand Catholic chaplain assigned at each of the two facilities. Also, a part of\nthe staff, a Jewish Rabbi serves each facility one day each week.\nRegularly scheduled Protestant Chapel Worship Services are held each\nSunday morning and a Vesper Service is conducted in the evening. The residents\nparticipating are given ample opportunity to gain insights into the emotional\nand psychological drama contained within the actual service of worship. With\nsuch an experience, it is possible for individual concepts to be broadened and\nexpanded in a positive way.\nA Music Staff is maintained, which makes it possible for appropriate\nmusic to be available for all the worship services. This staff includes pianists,\norganists, choir leaders, quartet and vocal soloists as well as choirs. The\ndeacons and musicians select the music for each worship service, thereby main-\ntaining a consistent theme.\nProtestant libraries are maintained which offer to the resident a wide\nselection of study, research and reading materials. Pamphlets, tracts, magazines\nand newspapers are supplied from various sources and are distributed through the\nChaplain's offices.\nThe Protestant chaplains maintain contact with many religious groups\nin the larger community. From these sources, our program is continuously up-\ndated in theological, philosophical and psychological areas, thereby sustaining\na \"feel\" for current trends and change. With a program of this diversity and\nmagnitude, it is believed that each man who so desires, has an opportunity for\ninvolvement in spiritual experiences, study and growth.\nThe Catholic Chapel program offers weekly religious instruction classes.\nReligious correspondence courses are available from five different sources and\nare augmented by individual instruction where necessary. In addition to the\nregular Sunday services, the Catholic Chaplain conducts a daily Mass on each day\nthat he is in the institution.\nA Catholic library is available at each of the facilities having in ex-\ncess of 1,000 books covering the entire spectrum of religion: philosophy,\ntheology and ascetics. These books are available for check-out to all residents\nof the institution. There are also large supplies of pamphlets and magazines on\nhand for use of men seeking religious information.\nAcolyte and choir rehearsals are held twice weekly, and are open to\nthose who wish to participate more fully in the religious services. Chapters of\ntwo international Catholic organizations, the Apostles of Prayer and the Cordeliers,\nare open to those men at the East Facility who wish to, and are capable of bene-\nfiting from closer contact with the Chaplain and with other Catholics in inter-\npersonal group relationships. At the West Facility, similar benefits are available\nfor the men by joining the Holy Name Society.\nA priest is available on twenty-four hour call in case of emergency.\n-77-\nCorrectional Industries at C.M.C. had a total revenue of $1₂ million\nfor the 1968-69 Fiscal Year. Consisting of a shoe factory, knitting mill,\nclothing factory, a specialty printing plant and laundry at the East Facility,\nand a tocacco processing plant at the West Facility, plus warehousing opera-\ntions, the Mens Colony Industries operation employs over 600 inmates. The pro-\ngram is administered by a staff of 30 industrial specialists.\nThe first factory activated at this institution was the tobacco factory\nwhich was transferred from San Quentin State Prison. Last year's tobacco sales\nwere $135,400. This represents 11/4 million pouches of cigarette, pipe and chewing\ntobacco.\nLast year's sales of shoes were a little under one-half million dollars\nand we sold over 60,000 pairs.\nThe Knitting mill sales last year were one-half million dollars as\nover one million items were produced. Over one-half million pairs of hosiery,\nalmost one-half million tee shirts and 77,000 pairs of gloves were manufactured.\nThe laundry processed over 6,000,000 pounds of laundry, one third of\nwhich was our East Facility laundry and the remaining two thirds, Camarillo\nState Hospital laundry.\nSmall amounts of laundry were processed for California Polytechnic\nState College and the San Luis Obispo County Sheriff's Department.\nThe specialty printing plant, when completely activated, should pro-\nduce revenue in the vicinity of $500,000. This factory will print and process\nlicense plate validation stickers for autos, trucks, trailers and motorcycles\nin addition to Highway Patrol inspection stickers, Fire Marshal cargo tank\nstickers and D.M.V. parking stickers.\nThe California Mens Colony strives continually to cultivate good com-\nmunity relations by being a part of local activities. For some time, West\nFacility residents have contributed financial support to the Chris Jesperson\nSchool, which is conducted for retarded and handicapped children in San Luis\nObispo. Residents have prepared slow-learner textbooks for the children and\nhave constructed a walker-trainer and other items for the disabled pupils.\nIn cooperation with the San Luis Obispo Fire Department, West Facility\nresidents have repaired approximately 550 large toys which were distributed to\nunderprivileged children during the past two years. Bicycles, tricycles,\nwagons, scooters, tables, chairs and small toys have been renovated to a like-\nnew condition by the patient hands of these men.\nResidents of both the East and West Facilities have conducted drives\nfor the Salvation Army and make periodic donations to the Tri-County Blood Bank.\nThis blood is not only available for our local facility hospitals, but is also\nutilized for the relatives of inmates and for other carefully selected cases.\nWest Facility residents have a full-time \"Books for the Blind\" project\nunder way. Inmates record special textbooks and other teaching materials to be\nutilized in the instruction of blind students under the direction of the State\nDepartment of Rehabilitation. Between 25 and 30 texts are completed each month\nby the inmate readers who have prepared 16,229,400 feet of tape, representing\n750 texts since this worthwhile program began at the West Facility in 1965.\n-78-\n4. SERVICES TO THE AGING - - INCORPORATED CITIES OF CALIFORNIA\nA. In General:\nThe League of California Cities is working in close harmony\nwith the California Commission on Aging and the Institute for Local\nSelf Government in the stimulation and development of locally based\nprograms for the aging. Implementation of this policy was delegated\nto the League's Human Resources Committee, whose first assignment was\nto inventory existing programs and recommend methods of direct city\ninvolvement. The Committee held two meetings with representatives\nof the Commission and the Institute conducted extensive studies of\nits own. It presented the following recommendation to the Board of\nDirectors of the League:\n\"By cooperating with the Commission on Aging\nand with the assistance of the Institute, we will be\nable to combine all of the efforts, and out of it\ndevelop a basic direction for the Committee on Human\nResources and the League in the field of the aged.\"\nThe Committee further recommended that the League encourage a survey\nto be conducted by the aging themselves to identify their own problems,\nand recommend that cities throughout California convene community\nmeetings of the aged with public officials to survey problems of the\naging. The results of these two surveys are to be analyzed and will\nserve as the basis of the sub-committee's recommendations as to\nthe role of cities and the League in dealing with these problems.\nAs further impetus the following resolution was presented to and\nadopted by the general assembly of the League of Cities at its annual\nconference in San Diego:\n\"WHEREAS, the problems of older Americans are of basic\nconcern to all cities in California; and\nWHEREAS, the President's White House Conference on the\nAging will develop major national, state and local re-\ncommendations affecting programs for the aging; and\nWHEREAS, cities in California will be asked by the\nState Commission on the Aging to participate in the\nWhite House program by sponsoring local community forums\nto discuss the problems of the aging in our cities; now,\ntherefore, be it\nRESOLVED, by the General Assembly of the League of\nCalifornia Cities, assembled in the Annual Conference in\nSan Diego, October 28, 1970, that the League declares its\nsupport of the Mayor's Forums scheduled for January through\nMarch, 1971, as part of the State and National White House\nConferences on the Aging, to assist in identifying the\nproblems of our senior citizens and programs to meet their\nneeds.\"\n-79-\nB. Results of City Questionnaire:\n405 California cities received questionnaires,\n191 responded and 35 indicated they spent some funds on aging\nprograms. The amount of money spent by cities for recreation\nand/or facilities for senior citizens ranged from $300.00 (Arcata)\nto $54,500.00 (Chula Vista). In general, the cities reporting\ntend to give more emphasis to the recreational side of service\ndelivery, than to the physical, e.g., health care, transportation,\nsecond careers, or income development. Following is a breakdown\nof Aging Program cost estimates for the Fiscal Year 1969-70:\nCITY\nESTIMATE\nACTUAL\nArcadia\n1,500\n1,500\nArcata\n300\n300\nAntioch\n6,000\n6,000\nBelmont\n7,000\n6,875\nChula Vista\n53,000\n54,000\nCoalinga\n5,500\n5,500\nCrescent City\n15,000\n15,000\nDavis\n1,500\n1,500\nDinuba\n2,128\n2,150 (2,909 Fed.\nGrant)\nEl Segundo\n5,940\n5,940\nEscondido\n25,000\n25,000\nFairfield\n6,865\n11,177 (1970-71)\nGlendora\n1,000\n1,000\nGarden Grove\n10,000\n3,000\nLomita\n500\n500\nLos Angeles\nLarge expenditure, but details\nnot available\nModesto\n10,965\n10,911\nMontebello\n6,466\n6,466\nNovato\n4,000\n4,000\nPalo Alto\n6,258\n2,438\n-80_\nCITY\nESTIMATE\nACTUAL\nPasadena\n36,600\nPalm Springs\n14,500\n14,783\nPleasanton\n3,000\n2,600\nRed Bluff\n600\n600\nSan Diego\n15,000\n15,000\nSan Carlos\n2,500\n2,500\nSan Jose\n1,200\n1,200\nSanta Barbara\n41,500\nSouth San Francisco\n7,500\n7,500\nSan Bernardino\n20,000\n20,000\nSebastopol\n1,500\nSanta Clara\n1,500\nSanta Maria\n6,500\n6,500\nTracy\n5,000\n5,000\nVisalia\n23,000\n22,750\nNOTE: Expenditure figures cannot be considered accurate as\nmost cities do not maintain exact cost accounting\nof program expenditures and have no records of costs\nof many services provided the aging.\nC. Synopsis of Individual Programs Reported:\nIn addition to the questionnaire, the Institute for Local\nSelf Government staff visited 16 cities, interviewing public officials\nand senior citizen participants. A summary of program highlights\nfrom both the visits and questionnaires follows:\nANAHEIM: No special programs for the aging are identified as\nsuch. Activities and services for this group are integrated\nwith recreation program and staff provided by department.\nBURBANK: Recreation and park department staff provide facilities\nand services in its regular program and works with organized\nsenior citizens clubs.\n-81-\nEL SEGUNDO: Developed Senior Citizens Center with established\nSenior Citizens Club that is administered through an executive\nboard of senior citizens. This executive board determines the\nprograms and coordinates the scheduling of their facility.\nFAIRFIELD: Senior citizens program includes element for elderly\nhousing. The city contributes $7,000 for the Reach Out\nPrograms for Model Cities.\nFRESNO: No special facilities provided for senior citizens.\nAging groups are encouraged to participate in regular recreation\nprograms with certain periods reserved for their use. One\nrecreation staff person acts as coordinator and works with a\nprivate organization named Older Americans.\nGLENDALE: In 1950, the city constructed a complete recreation\ncenter with both indoor and outdoor recreation facilities,\ndesigned specifically for senior citizens. Present membership 400.\nLOS ANGELES: The city conducts an extensive program which is discussed\nin \"E\" below.\nLA MESA: Senior citizens center constructed specifically for aged\nwith program conducted by seniors with consultation from staff\nof recreation department.\nMENLO PARK: The city participates in a unique arrangement with a\nprivate group, discussed in \"E\" below.\nMONTEBELLO: The city has established senior citizens center with\nprimary use to preserve and promote the health and general\nwell-being of the older persons of the city. This is a public\nfacility dedicated to the primary use of senior citizens and is\noperated by the Department of Parks and Recreation. This\ndepartment cooperates with the Montebello Citizens Affairs\nCommittee in the development of a total program at the facility\nwhile in keeping with the established policies of the Montebello\nCity Council.\nOXNARD: The city has helped organize the \"50 Plus\" Club with crafts,\nluncheons, trips and a variety of activities conducted by\nRecreation Department. The senior social center with the same\nprogram supervised by the department. Liaison with Community\nAction Commission on Aging Program.\nPALO ALTO: This city's program is described in \"E\" below.\nPORTERVILLE: A special telephone contact program for aged\nis conducted by the fire department.\nPASADENA: Several years ago the city constructed a building\nto house special activities for senior citizens. The building\nand grounds are maintained by the city for senior citizens.\nThe salary of the director is paid by a local women's service\ngroup and an annual contribution of $2,100 from the Recreation\nDepartment. The department sponsors scheduled activities of\n-82-\ninterest to senior citizens. Similarly, city facilities are\nmade available to them for meetings and other activities at\nno charge. Approximately $25,000 was spent by the city's\nwelfare bureau in providing direct protective services and\nassistance to elderly persons.\nPALM SPRINGS: The City supports a paid senior citizens coordinator\n36 hours a week, 9 months a year. He assists in the planning\nand conduct of such activities as excursion trips, talent\nshown, pot luck dinners, craft instruction and chess.\nRIVERSIDE: Complete schedule of activities provided with re-\ncreation and park department staff working with organized\nsenior citizen clubs. Complete protective service consult-\nation provided by this staff as well as leisure time program.\nSACRAMENTO: This program is described in \"E\" below.\nSANTA BARBARA: Three senior centers are provided for various\nindependent groups with staff assigned, working with\nsenior citizens councils.\nSAN JOSE: This program is described in \"E\" below.\nSALINAS: This city has no special program. Aging groups are\ngiven access to general recreation facilities.\nSAN DIEGO: This program is described in \"E\" below.\nSANTA FE SPRINGS: This program is described in \"E\" below.\nSUTTER CREEK: City benches for aged who use lines through town.\nIn process of providing public restrooms for charter busses\nand visiting older people on their travels through the area.\nSEBASTOPOL: City provides city-owned house and pays all utility\nand repair costs for Senior Activity Center operated by\nnon-profit corporation. Initially sponsored by city and\nlocal ministers.\nSOUTH SAN FRANCISCO: Senior Citizens Club and drop-in center\noperated two days per week from 10 AM to 4 PM and two\nnights per month. Employed recreation leadership is provided\nto coordinate with groups on all activities. Office in\ncooperation with the State Commission on Aging is provided\nfor five days per week from 9 AM to 1 PM to provide counseling,\nreferrals, etc. to all seniors in area.\nD. Summary of Additional Services:\nNumber\nActivities\n49\nHad special staffing for senior citizens/aging activities.\n5\nEducation program for city employees to be aware of the\nproblems of aging.\n-83-\nNumber\nActivities\n38\nAdapted public facilities to the needs of the aged.\n16\nProvide transportation services especially for aging.\n8\nDeveloped special employment programs.\n10\nSponsored special health services.\n5\nDeveloped programs to assist in income maintenance.\n10\nSponsored or developed nutrition education or programs.\n21\nAssisted in providing special housing for the aging.\n8\nProvided programs for assistance in their spiritual\nwell-being.\n8\nDeveloped programs of \"second careers\" to utilize\nthe aging in the public service or to assist in\ncity programs.\n16\nGathered census data or other demographic information\nspecifically concerning the aging in your city to\nprovide \"profile information\" (number of OASI and\nother recipients, financial status, income sources,\nhealth care expenditures, etc.)\n8\nDeveloped statistical material on aging including\nsuch things as sex, marital status, living arrange-\nments, educational attainment, labor force partici-\npation, life expectancy, percentage of senior citizens\nin total population, etc.\nE. Details of Selected City Programs:\n1. LOS ANGELES: Under the direction of a Senior Citizens section\nof the Special Services Division in the Recreation and\nPark Department, a most extensive program is provided\nfor the aged. A professional recreation supervisor\ndirects the activities assisted by full-time assistants\nfrom the department.\nWith a population estimated at 365,000 over age 65,\n18 senior centers are in operation, each under the\ndirection of a full-time professional director. Both\ncity facilities and rental units are in use as centers\nwith plans under way for erection of a number of pre-\nfabricated buildings to add to these facilities.\nEach center has its established Senior Citizens Club with\nelections of their own officers annually, all combined\nin a Federation of Senior Citizens Clubs with a total\nmembership of 60,000. Each district schedules regular\nmonthly meetings and a general meeting of the Federation\nis scheduled every four months.\nThrough experience the department has found that the\nrecreational programs and facilities in addition to pro-\nviding desired social and leisure-time activities, also\nprovide the means of getting the senior citizens together\nfor discussion of their many other problems in the health\nand welfare fields. With the cooperation and assistance\n-84-\nof the professionals in the health, safety and govern-\nment programs, regularly scheduled seminars are presented\nin each district by doctors, dentists, police, housing\nauthorities, etc.; each directed to specific programs or\ninterest and need to the age population.\nWorking with the University of Southern California, an\neducational program is provided for prefessionals in the\nfield of aging as well as for volunteer workers. Under\nthe direction of a Recreation Senior Citizens Association,\ncourses are available to everyone with recognition given\nby the awarding of \"diplomas\" at the completion of each\ncourse.\nThrough the Federation, special group insurance programs\nare offered all members in the accident and injury occurring\nduring traveling to and from events and while participating\nin activities. Also reduced rates for seniors have been\nsecured from food establishments, theaters, various\namusement attractions and transit systems. Some of the\nlocal theaters have found this program so successful they\nhave established special showings of feature events during\noff day times, specifically for the senior groups.\nLocal newspapers have provided space for a weekly \"What's\nDoing\" column prepared by department staff and publish a\nfull schedule of activities and program each week. Staff\nconsults regularly with church and fraternal organizations\nto encourage participation in the program and have developed\nextensive use of the facilities of churches and lodges for\nactivities.\nWhile emphasis is placed in recruiting membership for the\norganized clubs, no restriction is placed on activities\nor services offered and non-club members are not only\nwelcome, but are invited to take part in any part of all\nof the program. This has provided a needed service to the\nmany who hesitate to formally join in a club.\nIn addition to the extensive program of the department,\nthe Mayor's office has established a staff position, a\nCoordinator of Senior Citizen Affairs. The activity report\nfor 1970-71 presented to the Mayor by this Coordinator\nindicates that 13 committees, comprised of approximately\n450 members, are meeting monthly with their efforts directed\nto problems of consumer protection, education, health,\neducation, employment, housing, legislation, music and\narts, recreation and transportation. The advisory and\nexecutive committees are made up mainly of representatives\nof the Senior Citizens Clubs with commissioners and city\nofficials participating on the Inter-Department Committee.\nSome of the activities and program of the committees include:\nPre-retirement planning, working with representatives of\n-85-\nbusiness and industry; Model Cities Program; developing\nprograms for Senior Citizens, such as The Friendly\nVisitors, Foster Grandparents, and Hot Meals for the\nElderly; Nutritional lectures regarding healthful and\neconomical food planning, housing and referral service; etc.\nThe Master Calendar Committee meets monthly with city and\ncounty departments, County Affairs on Aging, Senior Citizens\nAssociation and Allied Senior Citizen Clubs, Inc., to\ncoordinate and avoid any overlapping of dates and\nactivities throughout the county. A monthly newspaper\n\"The Senior Citizens News\" written in both English and\nSpanish is distributed widely.\n2. MENLO PARK: Probably one of the most successful and unique\nsenior citizens facilities, \"Little House,\" celebrated\nits 20th anniversary last year. Established by the\nPeninsula Volunteers, a women's service organization,\nin cooperation with the city of Menlo Park, the facility\nand program have grown from a very modest beginning to\nits present position of outstanding service to senior\ncitizens.\nWhen the Peninsula Volunteers determined to enter the field\nof service to the aged 20 years ago, they prevailed upon\nthe city of Menlo Park to make available a small building\nand recreation playground area for their use. Through the\nyears the facilities have been expanded to its modest but\ncomplete size, including meeting rooms, library, gift shop,\ngame rooms, craft rooms, offices for staff, a modern equipped\nkitchen with dining room, all enclosing a patio area with\nshuffleboard games and garden.\nGrassed play area surround the outside, providing space for\nvarious outdoor recreation activities with ample parking\narea provided. The city provides maintenance of the grounds\nwith the building maintenance taken care of by the Little\nHouse organization.\nThe grounds and facilities are used by Little House on a\n$1.00 a year lease with the city, providing for tax exemption.\nOperation costs are met through an annual benefit conducted\nby the Peninsula Volunteers along with minor funds developed\nthrough memberships and activities in the facility. The\nplanning and operation works under the direction of Peninsula\nVolunteers, Little House members and staff working together.\nA yearly change occurs on the Little House Board of Directors\ncomposed of members of Peninsula Volunteers and each six\nmonths they elect the Little House Council from the\nmembership.\nNear the end of 1969 the membership totaled 1, 787 with an\ninteresting breakdown of 449 male and 1, 338 female, about\n1/3 to 2/3 ratio. While located in the city of Menlo Park,\n-86-\nthe acquisition of a small bus last year, appropriately\nnamed \"Minnie the Bus\", enabled them to establish a\nregular transportation route through neighboring Palo Alto\nand Atherton, thus making possible the participation of\nthose, and from them other areas.\nLittle House provides an almost bewildering array of\nactivities for its membership. Some of these are ceramics,\nweaving, sewing, tin-craft, wood-work, and knitting.\nMost of the activities fall into three categories, but\na fourth is emerging. Classes in a variety of subjects\nare both educational and recreational. Most of the classes\nare in cooperation with the Menlo-Atherton Adult School.\nThe second category is the workshops which are taught and\nrun by Little House members. These tend to produce interest-\noriented groups and these members often have parties,\nbirthday celebrations, field trips and other social benefits.\nThese workshops provide most of the handcrafted articles\nfor an annual Bazaar and help keep the shelves of Little\nHouse Shop filled.\nThe third category involves the member-directed events such\nas rummage sales, dances, tournaments, special programs and\ndinners, pancake breakfasts and holiday celebrations. One\nnewsletter listed such variety of programs as Interior\nDecorating, Spanish Conversation, History of Western Europe,\nNature Study, Driver Improvement, Lipreading and Related\nAreas, Retirement Planning, Learn to Sing, Band, Braille,\nPlace and World Affairs, Clothing Alteration, Ceramics\nfor Blind, games, and numerous other special activities.\nThe fourth developing unit involves the Little House member-\nship in community volunteer work. The present Friendly\nVisiting Committee has been most active and successful and\nhas added the Little House Singsters who entertain once\nor twice monthly at nearby convalescent homes, as does the\nKitchen Band and T.N.T. Orchestra. It has made a special\neffort to seek out older persons in the community who are\nisolated and members assist with bringing groceries and\nprescriptions to the ailing.\nThe Little House Braille Duplication group, working in two-\nsomes, has turned out hundreds of books for the blind.\nCommunity Service projects not only fulfill an important\nneed to many, but give the members the opportunity to\ntake part in worthy projects, thus giving them the satis-\nfaction of making a contribution to others.\nPlanned for 1970 is a corps of five Little House members to\nserve one afternoon a week each as problem solvers, complaint\ntakers, interpreters, \"friends\" and referral experts. With\na direct link to the Council and reporting to them they are\nto be called \"Councils Counselors\". This operation seems\nonly to prove that much talent exists among our aging popu-\nlation and is eager to contribute as they are doing here\nwith the proper leadership.\n-87-\n3. PALO ALTO: A Senior Coordinating Council, comprised of\norganized club representatives, prominent citizens and\ncity officials, coordinates the activities of the various\nsenior clubs in the city. The Recreation Department\nprovides a professional recreation supervisor to super-\nvise and direct a variety of activities and program now\nbeing conducted in city recreation and library buildings.\nA senior Adult Library and Recreation Center, now under\nconstruction, will provide special conference rooms for\ncounseling and in conjunction with various city depart-\nments, counseling and referral services will be initiated\nin the fields of health, welfare, housing, employment, etc.\n4. SACRAMENTO: When the city determined in 1950 to establish\na facility for Senior Citizens a very sound approach was\nmade to the planning. A committee composed of city\ncouncilmen, recreation and park staff, representatives\nof senior citizens groups and an architect, visited several\nCalifornia cities having established facilities and noted\ntheir advantages and deficiences. Full consideration was\ngiven to construction to meet the needs of the elderly,\nlocation to meet the problems of transportation and design\nto meet the needs of the desired programs. The result was\na most practical facility that has proven worth the effort\nby the use it has developed.\nApproximately 4,000 members of various clubs are now en-\nrolled in the many activities conducted every day and\nevening throughout the year. The Recreation and Park\nDepartment have two full-time supervisors directing and\ncoordinating the activities in cooperation with the\nSenior Citizens Council elected by the membership. In\naddition to this central facility, two satellite operations\nare provided, one in a recreation building that was re-\nmodeled to provide for special areas and the other in a\nhousing project where the Housing Authority provides space\nand contributes toward the costs of operation.\n5. SAN JOSE: The constant changes in our complex society demand\nthat we do more thorough job of helping citizens prepare\nfor their retirement years and this city entered a new\nconcept in achieving this objective through State, City,\nand College cooperation in the Senior Californian Education\nCenter Project which is co-sponsored by the City of San Jose\nRecreation and Parks Department and the Department of\nRecreation of San Jose State College with support of the\nCalifornia Commission on Aging.\nIt is imperative that we continue to develop leaders with\nknowledge and understanding of the physiological, psycho-\nlogical, sociological and economic needs of the elderly.\nThrough formal education, practical training and the pro-\nvision of opportunities to acquire experience in working\nwith older adults, greater understanding can be disseminated\nthroughout the community.\n-88-\nSome examples of new, unique and different programs for\nthe greater San Jose area are: Gold Card for seniors\noffered by San Jose State College that provides free\nadmission to all athletic, dramatic and cultural events;\nfree registration for seniors for Adult Education classes\nwhich are held in Senior housing projects and senior\ncenters; a directory of services and activities for the\naged available in three geographical areas, printed in\nEnglish and Spanish; a Senior Adult Newsletter distributed\nto Seniors and Professionals; Senior Adult Information\nmailed with monthly utility bills.\nAging as a subject for high school students and an oppor-\ntunity for students to visit with seniors in the centers\nas well as interact with them; planning, researching and\ncoordinating the efforts of Aging through a county-wide\ncommittee established by the Social Planning Agency;\nutilizing the Chamber of Commerce as a major referral\nservice to the senior program; utilizing Senior Aides\ntrained to seek out elderly in their homes, apartments, etc.\nSelf-help work projects for seniors in the center: They\nare reimbursed for work accomplished through a contract\nwith a toy manufacturer for assembling plastic toys;\nestablishment of evening senior activity program for\nthose living in downtown hotels in cooperation with City\nLibrary. Activities and services are important and\ncontinually need to be upgraded, but one service that\ncannot be emphasized enough is the coordination on an\narea-wide basis.\n6. SAN DIEGO: The Recreation Department sponsors 47 clubs\nthat meet at least once each week. These Senior Citizens\nClubs conduct all types of activities from socials, dances,\ndinners, trips, etc.; to protective service programs that\ninvolve the combined efforts of various agencies of the\ncity.\nPublic Health educators offer programs in health and\nsafety, seminars for senior citizens are conducted on\nSocial Security, education, volunteerism, legal problems,\nhealth and welfare and even the generation gap.\nFour Senior Citizens Centers are operated and facilitated\nby the seniors themselves. Available are cards, roque,\nshuffleboard, lawn bowling, table games and meeting rooms\nfor social activities. The Recreation Department conducts\ncity-wide programs such as talent shows, hobby and craft\nshows, self-improvement courses, fashion shows, day camps,\nweekend mountain retreat, picnics and rally days.\nSponsored by the Recreation Department, the Gadabout Club\nconducts trips from one day sightseeing to extensive\nout-of-country travel. This club has a present membership\nof 3,000 and last year took groups to Alaska, Mexico, Hawaii,\nNew England and Europe.\n-89-\nAlso established by Recreation Department is an Information\nand Referral Center with three more being planned for this\nyear. In addition, the senior citizens under the direction\nof the department, staff and maintain a downtown information\nbooth, providing general community information.\n5. PROGRAMS FOR THE AGING - COUNTIES of CALIFORNIA\nThrough the cooperation of the County Supervisors Association\nof California, questionnaires prepared by the Institute Project\nstaff were mailed to Welfare Department administrators in each\ncounty.\nThese questionnaires requested indication on a checklist\nthe services participated in by the County in the areas of need\nin housing, health, job opportunities, nutrition, recreation,\ntransportation, education and any other services.\nAlso requested was descriptive material on the programs,\ncopies of ordinances and/or regulations by which such programs\nhad been implemented, annual financial participation and such\ncomments as could be provided as to effectiveness and recommend-\nations for future directions that should be taken in programs\ndesigned to assist the aging.\nReturns were received from 53 of the 58 counties and of\nthese returns, 35 indicated programs in their area.\nWhile the annual expenditures reported are shown on the\nchart it is very difficult to relate these figures as no con-\nsistent method is used for keeping charges for staff specifi-\ncally assigned to special programs for the aging. In a few\ninstances it appears the total welfare budget was reported.\nFollowing is a summary of the comments provided followed by\na chart indicating the participation in each county in programs\nfor the aging in each area of need designated.\nALAMEDA: There are three organized Committees on Aging in the County.\nAlso, OEO is sponsoring a program for aging by serving low-income\nSeniors in the South and Eastern portion of the county. Adult\nEducation is providing instructors for classes in various parts\nof the county. Senior housing is being developed through non-\nprofit agencies and the Housing Authority. Jobs for Seniors\nare being provided, on a limited basis, by Department of Labor\ngrants to Service Agencies.\nCONTRA COSTA: Contra Costa is convinced that the most effective way\nto implement a more adequate program for its older residents is\nthrough a county-wide Citizens Committee on Aging which expedites\nand coordinates efforts of voluntary and public agencies and groups\nconcerned with the needs and problems of the aging. Estimated\nexpenditures include costs of a Staff Coordinator for Committee\n-90-\non Aging and loan of a social worker who directs a Meals on\nWheels service in a voluntary agency.\nCALAVERAS: Normal social services are available to older persons\nwithin the county. There is some leisure time activity and\neducational opportunities available on a limited basis.\nDEL NORTE: Outside of the social services to the aged provided by\nWelfare Department staff, the only formal programs for this\ngroup are those sponsored by local churches and the Senior\nCitizens Center.\nEL DORADO: Through OEO and Title III OAA there is a multi-phase\nSenior program that is reaching out to the isolated Seniors\nin the smaller communities. Adult Education is providing\nteachers for classes and interest to Seniors. A Council on\nAging formed with the assistance and support of various County\ndepartments is researching the needs of older people. The\nHealth Department is providing nutrition instruction and ways\nto attain better health to Senior groups. Housing and transpor-\ntation are major problem areas.\nFRESNO: The Fresno Area Commission on Aging has been dormant. A\nsub-committee has been active in developing some Senior housing.\nAdult Education provides instructors for classes in the various\nschool districts. The Council of Older Americans organization\nhas been active in developing leisure-time activities. The\nHealth Department has provided assistance in educating for\nimproved health standards for Seniors. The Model Cities Pro-\ngram is serving Seniors within the area with nutrition, education,\nleisure time activities, health services, and transportation.\nOther communities are providing Information & Referral services,\neducation, health programs, leisure time activities, and various\nother supportive services for the well-being of Senior residents.\nGLENN: Very little service is needed in small county.\nINYO: We had very good results in bettering housing for recipients\nas long as we had Shelter Funds to use. We furnish transportation\nfor medical care and other special needs. Our Homemaker Service\nhas been instrumental in keeping many aged and ill persons in\ntheir homes who would have otherwise had to be in institutions.\nSupportive of community programs to provide leisure time activities\nfor Senior residents.\nKERN: There are a number of leisure-time activities available to older\npersons within the county. Many of these are based in the local\ncommunities. Educational opportunities are available to older\nresidents. Categorical aid programs are available with Social\nServices having a strong volunteer corps that is providing outreach\nand visitation to older persons. There is no coordinated effort\nin behalf of Seniors from any level of local government.\nKINGS: There is a non-profit County Commission on Aging that is co-\nordinating Senior activities in the County. There is limited\n-91-\nhousing available for Seniors. In education, there are programs\nunder development to provide classes through Adult Education.\nThe Department of Social Welfare has provided staff to assist\nin the involvement of individuals and groups to provide resources\nto solve problems as they have been developed. After meeting\nthe need, the Department serves in the capacity of a consultant.\nLAKE: The county is predominantly a retirement area of mobile homes\nwith heavy concentration of Seniors in the Lucerne-Nice area.\nSenior Centers are in Middletown, Lucerne, Lakeport, and South\nShore. North Coast Opportunities, an OEO project, is stimulating\nthe planning of a community center grant in Clearlake Highlands\nthrough the U. S. Housing and Urban Development.\nLOS ANGELES: The entire expenditure indicated is for the Los Angeles\nDepartment of Senior Citizens Affairs which is involved in all\nareas of service. Promoted for the well-being and dignity of\nolder persons\", this department primarily provides consultation,\nadvisory, information and promotion services to all agencies in\ncounty involved in program for the aged. In addition, the\ncounty participates in special programs through the Department of\nPublic Social Service which, in addition to administering the\nCategorical Aid Programs, operates a Central Registry of Adult\nCare Facilities, giving counseling, information and referral\nservice relative to out-of-home care facilities for adults and\nmaintains a current and accurate file on board and care homes,\nsanitariums and convalescent homes for the aged. The Depart-\nment of Parks and Recreation sponsors a wide variety of programs\nas well as assisting other agencies involved in senior citizens\nwork. County Health Department operates a health education\nproject for seniors.\nMADERA: An incorporated Committee on Aging has been formed with the\ncooperation of the Department of Social Welfare and the Recreation\nDepartment. They have begun to evaluate the needs of the Seniors\nin the area other than those on the categorical aid programs.\nLeisure-time activities have been developed in several communities\nand classes are provided through Adult Education.\nMARIN: Through a Citizens Advisory Committee, a master plan for older\nadults in the county was developed. At the present time this\nprogram is being implemented through the Marin Senior Coordinating\nCouncil, Inc. There has been a concentrated effort to develop\nhousing for Seniors that has provided adequate and safe housing\nfor many. Educational classes have been provided through the\ncollege and the various Adult Education divisions. Leisure-time\nactivities are provided by cities and assisted by many from the\nCounty. Most of the county departments cooperate in better\nserving Seniors as there is an awareness of the talents and needs\nof this segment. Transportation needs are being met with a\ncooperative plan in conjunction with an OEO grant. A strong\nattitude of self-help and how we can assist our County to be a\nbetter place to live exists throughout the county.\n-92-\nMARIPOSA: There are some leisure-time activities for older\nadults which include educational and social opportunities.\nOther social services are available through various county\nagencies.\nMENDOCINO: Our welfare department works very closely with the\nlocal OEO organization to further improve the areas noted.\nThis approach has been rather effective.\nMERCED: An Advisory Committee exists on the County level. Staff\nis provided to develop various services needed by Seniors.\nLeisure-time activities are being offered in most areas of\nthe County. Educational needs are being met through Adult\nEducation and the Community College. The various county\ndepartments are assisting in meeting specific needs of the\nolder population. There is developing a strong awareness\nof the Senior population and groups are being involved to\nreach practical solutions.\nMODOC: Only OEO films present in Welfare office for aged.\nDistances are too great for most programs.\nMONO: Categorical Aid program services are available to older\npersons. Very limited social, educational, and leisure-\ntime activities are available.\nNAPA: The Napa County Council on Aging established a Council on\nAging to plan and coordinate a county-wide program for\nSeniors. Goals of the project include provision of direct\nservices such as health education, housing guidance, 50-plus\nemployment service, identification of existing resources for\nassisting Seniors; stimulation of volunteer aid and new forms\nof community support and development of community interest\nand involvement. The Council develops leadership and\nencourages self-help approaches to the problems that face\nthem. The Council also sponsors weekly meetings for Seniors\nin Napa, St. Helena, and Calistoga to discuss such topics\nas housing, nutrition, employment, income maintenance, and\neducation. A Senior center is located at 1606 Second Street\nin Napa, a gift of the Napa City council. In St. Helena\na one-day a week program is held in a local church.\nNEVADA: Social Service workers help in areas checked, however,\nno other formal program sponsored by agency.\nORANGE: Although no special item is in county budget for services\nto the aging, Department of Social Welfare provides a wide\nrange of services to meet the needs of older citizens, both\nfor those who receive aid as well as for those who have\nsufficient income to meet their needs, but who need protective\nservices. (STATEMENT) \"We are of the opinion that services\nto the aging cannot be provided by regulations and county\nordinances. The community at large must be, first of all,\ninterested in such programs, see the need for them, and\n-93-\nparticipate in them. It should be left to the individual\ncommunities and community organizations to come up with sug-\ngestions to meet community needs in this respect. The county\ngovernment and its branches cannot impose on the community,\nprograms that are supported by the community. At the same\ntime the county government will support by all means any\nprogram that the community needs and asks for.\"\nPLACER: A Committee on Aging is coordinating programs and resources\nfor older people. Various educational needs are being met\nthrough Adult Education. Leisure-time activities are being\ndeveloped through various agencies and private groups. An\nawareness of needs of Seniors is being generated throughout\nthe county by cooperative efforts of groups, county departments,\nand State agencies.\nPLUMAS: We have no specific programs exclusive to the aged, however,\nthey are covered in other programs including nutrition, housing,\nhealth, and transportation.\nRIVERSIDE: Our County participates in only two specialized programs\nfor the aged, although we act as a liaison agency in referring\nsenior citizens to other agencies. These are recruitment and\nutilization of volunteers to assist aged and medi-bus program\nused for transportation of aged to General Hospital. County\nworks in conjunction with Public Health, Parks and Recreation,\nRapid Transit, UCR Agricultural Extension Division, and\nHousing Authority. There is a subsidized housing project for\neldlerly persons over 65 with a limited income. We believe\nthat efforts should be made in the area of additional sub-\nsidized housing for the elderly. We are looking forward to\nthe possibility of a foster grandparent program which would\nenable the elderly to become \"foster grandparents\" to less\nfortunate youngsters.\nSACRAMENTO: The County Departments of Welfare, Health and Recreation\nprovide regular program services to the aging. The County\ncontributes funds to the Family Services Agency and the Community\nServices Planning Council which has an \"Aging Project\" committee\nthat studies resources, collects data and makes recommendations\non needed programs.\nSAN BENITO: Services to the aging are provided by the County as\nset forth in the Public Social Service Manual. There are no\nspecial programs with special funds allocated to the aging\nin this county.\nSAN BERNARDINO: The Senior Citizens Club of San Bernardino County\nis an association of 90 clubs, representing 35,000 Seniors,\nas the official body to provide coordination and umbrella\nservices to the county's Senior citizens; to further the\ngeneral well-being of the aging and aged; inform and educate\nSeniors and public; develop self-help, resourcefulness, and\ninitiative so that Seniors may remain a purposeful and\nrespected part of the general citizenry; engage in such\n-94-\ncivic and charitable work as may be practicable, and en-\ncourage Seniors to make this an important part of their\nlives; exchange information and ideas among agencies and\norganizations serving the Senior citizens.\nSAN DIEGO: Present Committee with the widest county coverage is\nC.O.M.P.S. which is chaired by Evelyn S. Herrmann, Senior\nCitizens Coordinator, San Diego Parks and Recreation.\nHon. James Bear, a county supervisor, and former member of\nthe State Commission on Aging, is a member of the San Diego\nCounty Commission on Aging Community Welfare Council. To\nserve the heavy concentration of Seniors in San Diego's\ncentral section, an Inter-Faith Community Center for\nOlder Persons has been opened under direction of a Board\nof Directors whose members represent seven churches as well\nas Senior resident homes, the San Diego State College Center\non Aging, the National Council of Senior Citizens, the\nCommunity Welfare Council, and one member of the Board of\nSupervisors.\nSAN FRANCISCO: Through the Office of Aging, coordination of\nservices to the aged population is provided. The various\ndepartments of the county are being involved in meeting\nspecial needs of older persons. Priorities are being set\nfor needs-meeting programs to provide better standards of\nliving, better housing, more leisure-time activities, better\nhealth, income supplementation, and transportation.\nSAN JOAQUIN: No county-wide Commission on Aging exists. Various\ncounty agencies provide services on an as-needed basis but\nthey are not coordinated. The Department of Social Services\nhas provided staff time to assist new programs get organized.\nThe Housing Authority has a real interest in providing housing\nfor the elderly. The Health Department provides educational\nopportunities and makes the services available. Educational\nopportunities are provided through Adult Education in classes\nlocated in areas of convenience to Seniors. Leisure-time\nactivities are provided by City agencies and private organiza-\ntions. One program is assisting in the development of jobs\n(full and part-time) to supplement income.\nSAN LUIS OBISPO: Nothing specific administered by County, but\nstaff work with other public and private agencies in program.\nSAN MATEO: There is a Commission on Aging for the county that is\nidentifying needs and coordinating solutions. The Forum of\nSenior Groups has organized programs for leisure and community\nbetterment projects. Housing needs are being met through\nseveral non-profit corporations. The various County agencies\nare aware of and meet the needs of Seniors as they develop.\nSeveral employment projects exist to supplement income through\njobs. Transportation needs are met on a limited basis in\nsome areas (Little House). Health and nutrition programs\nare provided throughout the County.\n-95-\nSANTA BARBARA: The greatest need in our community right now is\nfor a \"Meals on Wheels\" program and we cannot implement this\nprogram unless we have Federal funding. The Community Action\nCommission of Santa Barbara County is in overall charge of\nthe county program. There is a county policy advisory\ncommittee working for senior citizens and a council of social\nservices serving as a professional agency for Seniors. There\nis a North Santa Barbara County Senior Citizens Program\noffice at Lompoc. To reach special minority groups, bulletins\nand certain news articles are written in Spanish.\nSANTA CRUZ: There is a Commission on Aging that is set up to identify\nthe needs of the older population and develop resources to\nmeet these needs. Various County departments assist in meeting\nneeds as they develop. Leisure-time activities are provided\nby various groups throughout the County. Adult Education is\nproviding educational opportunities to Seniors. OEO has\nprovided some programs to assist the elderly - - Project Find\nand Project Scout. They also provide some Friendly Visiting\nfor homebound and institutionalized persons. A food program\nis being developed and nutritional classes are being held.\nThere is an employment program in existence.\nSHASTA: The Shasta County Council on Aging was established through\nthe efforts of Seniors in the county, assisted by the staff\nof the California Commission on Aging. The council was\ninstrumental in developing the Golden Umbrella Senior Center\nin downtown Redding. The activities have increased as a\nresult of excellent leadership and the dedication of untold\nvolunteers in the community. The Council is composed of\nseniors, businessmen, and other interested persons. The\ngroup comprising the Council consists of broad citizen re-\npresentation. An active senior organization in Redding is\nthe Senior Citizens of Shasta County, Inc., with a membership\nof close to 2,000.\nSONOMA: The Sonoma County Council on Aging has developed Senior\nprograms in Sebastopol where the city has donated a Senior\nCenter, also a senior center is operated in Monte Rio and\nGuerneyville. The Council operates a Senior Center in\ndowntown Santa Rosa and has developed friendly visiting,\ninformation and referral services, senior programs, as well\nas various educational and training programs. The Council\nworks closely with the 30 Senior clubs in Santa Rosa and\nother communities in Sonoma county, the County Department of\nSocial Welfare, Social Security office, City-County Library,\nCatholic Social Service and Santa Rosa Junior College in\nthe development of pre-retirement programs.\nSTANISLAUS: In orienting its service programs around the needs of\nclients, the County has identified a number of problem areas\nto which it has assigned a cluster of social workers who\nspecialize in providing services to clients. Service units\nare: Housing Service, In-home Care, Out-of-Home Care, and\nAdult General Services. They also have a Volunteer Services\ncoordinator who works with community groups. Several Housing\n-96-\nprograms are under way. Institutional care is also provided\nby non-profit corporation. There is a NESE grant for a\nProject Find that is providing referral services to Seniors\nand reaching out to those isolated individuals. Educational\nopportunities are provided by Adult Education in leisure-time\nactivity center along with other informational programs,\nsuch as health, nutrition, employment, and volunteer\nopportunities.\nTULARE: Social Services are provided through the various agencies\nserving the older residents. There is a large variety of\nleisure-time activities, educational opportunities, and\nservice-to-others opportunities. The local communities\nare developing programs and services for their older residents.\nCategorical Aid programs are available to the older residents\nof the county.\nTUOLUMNE: Social services are provided by the various agencies\nof the County. There are limited social, recreational and\neducational opportunities available.\nVENTURA: Ventura County Community Council's Committee on Aging\nwas recently organized. Coordination of activities in the\nCity of Ventura is at the Senior Services Center for Senior\nCitizens. Oxnard organized a Senior Citizen Council and\nset up 13 working committees.\n-97-\nCounties -- Services provided in fields, indicated by X\n(Housing, Health, Job Opportunity, Nutrition, Recreation, Transportation, Education)\nAnnual\nHsng Hlth Jobs Nutr Recr Tran Educ Othr\nExpenditures\nAlameda\nX\nX\nX\nX\nX\n20,603,667\nAmador\nAlpine\nButte\nCalaveras\nColusa\nContra Costa\nX\nX\nX\nX\nX\nX\nX\n25,000\nDel Norte\nX\nEl Dorado\nX\nx\n2,000\nFresno\nX\nX\nX\nX\nGlenn\nX\nX\nX\nHumboldt\nImperial\nX\n9,905\nInyo\nX\nX\nX\nX\n22,056\nKern\nKings\nX\nX\nX\nX\nX\nX\nX\nLake\nX\nX\nX\nX\nLassen\nLos Angeles\nX\nX\nx\nX\nX\nX\nX\nX\n289,649\nMadera\nX\nX\nMarin\nX\nX\nX\nX\nX\nX\nX\nX\n128,000\nMariposa\nMendocino\nX\nX\nX\nX\n1,000\nMerced\nX\nX\nX\nX\nX\nX\n18,484\nModoc\nX\nMono\nMonterey\nX\nX\nX\nNapa\nX\nX\nX\nX\nX\nX\nX\nX\n22,061\nNevada\nX\nX\nX\nX\nX\n4\nOrange\nX\nX\nX\nX\nX\nX\nX\nPlacer\nPlumas\nRiverside\nX\nSacramento\nX\nX\nX\nSan Benito\nSan Bernardino\nX\nX\nX\nX\nX\nX\nX\nX\nSan Diego\nX\nX\nX\n18,480\nSan Francisco\nX\nX\nX\nX\nX\nX\nX\nX\n45,406\nSan Joaquin\nX\nX\nX\nX\nSan Luis Obispo\nx\nX\nx\nX\nX\n16,807\nSan Mateo\nX\nX\nX\nX\nX\nX\nX\nX\n3,308\nSanta Barbara\nX\nX\nx\nX\nx\nX\nSanta Clara\nSanta Cruz\nX\nX\nx\nX\nX\n21,750\nShasta\nX\nX\nX\nX\nX\nX\nSierra\nSiskiyou\nSolano\nSonoma\nStanislaus\nX\nX\nX\nx\nSutter\nTehama\nTrinity\nTulare\nTuolumne\nVentura\nX\nX\nX\nX\nX\nX\nYolo\nYuba\n-98-\n6. For Perspective - A European Master Plan for Old Age\nAs in the United States, the problem of the aging population in\nEurope is becoming more serious, receiving more public attention, and is\nno longer capable of being brushed aside as in the past.\nMedical advancement, avoidance of war, and general prosperity in\nsome countries have resulted in populations retiring earlier and living\nlonger. The European countries, with varying degrees of energy -- and\nsuccess -- are tackling the problems with a plethora of social programs\npension programs and housing plans to rival the scope and diversity\nof those found in the United States. To combat loneliness, boredom, and\neconomic deprivation -- key problems of the aged -- programs of home helpers,\nsenior centers, recreational activities, hot meals served at home, trans-\nportation and the like are being tested and implemented throughout Europe.\nEuropean officials, however, admit they are just beginning to grapple with\nthe problem and make progress towards a workable and realistic solution.\nDespite the lack of the unifying force supplied by a central\ngovernment such as that enjoyed in the United States, a resolution on the\nsocial and medico-social policy for old age has been adopted by the\nCouncil of Europe for its seventeen member states. It is a unique, com-\nprehensive approach to solving the problems of the aging. In view of its\nclose parallel to the objectives of the White House Conference on Aging 1971\nto establish a national policy on aging, the Public Information release\non the Council's policy is reprinted herein in its entirety.\n-99-\nINFORMATION\nPRESSE ET INFORMATION\nCONSEIL DE L'EUROPE\n67-STRASBOURG-FRANCE\n-\nTELEX\n87943\nEMBARGO: NOT TO BE\nTEL. 35.92.22.\nSOCIAL NEWS\nPUBLISHED BEFORE 1.6.70\nB (70) 31\n26.5.70\nDM\nA EUROPEAN SOCIAL AND MEDICO-SOCIAL POLICY FOR OLD AGE\nA European social and medico-social policy for old age has been drawn up\nby the Council of Europe. The full text, adopted by representatives of the\n17-member States on the Council's Committee of Ministers, is attached.\nThe aim of the policy is to permit old people to occupy a suitable place\nin the society of today and tomorrow, and to avoid their segregation. It covers\nchapter by chapter, resources and income, employment, housing, medical and\nsocial services, and scientific research into ageing. There is also a special\nchapter on the protection of old people against road accidents. Governments\nare urged to apply the outlined policy not only to their nationals but also to\naged foreigners residing on their territory.\n*\n*\n*\nThe principles embodied in this text take into account the provisions of\nthe Council of Europe's Social Charter and Social Security Code, and the work of\ntwo of the Council's groups of goverment experts: the Social Committee and the\nPublic Health Committee. They also draw on the work of other international\norganizations like ILO and OECD.\nRESOLUTION\non social and medico-social policy for old age\nConsidering that the aim of the Council of Europe is to achieve greater\nunity between its members for the purpose of safeguarding and realising the\nideals and principles which are their common heritage and facilitating their\neconomic and social progress.\nHaving regard to the principles governing social progress embodied in the\nEuropean Social Charter and the European Code of Social Security and protocol.\nPursuant to the providions of the Programme of Work of the Council of\nEurope relating to the drawing up of a social and medico-social policy for old\nage.\n-100-\nHaving regard to the conclusions of the report submitted by the experts\nappointed to prepare this study on the proposal of the Social Committee and the\nEuropean Public Health Committee.\nConsidering that it is desirable to define the principles of a social and\nmedico-social policy for old age\nTHE COMMITTEE OF MINISTERS\n(i) Considering that owing to the two-fold effect of the fall in the\nbirth rate and greater longevity during the last generations, the\nproportion of old people among the populations of the various\nEuropean countries has risen considerably and continues to rise.\n(ii) Considering that technical progress and changing working condi-\ntions make it often more difficult to keep older people employed\nor provide them with work suited to their abilities.\n(iii) Considering that as a result of economic and social progress and\nparticularly the development of an industrial civilisation, the\nchanges in family life and housing conditions in urban areas, old\npeople may tend to become isolated and to count less and less on\nthe practical and moral support formerly provided by their next-\nof-kin under traditional civilisations.\n(iv) Considering that the combined effect of these many developments\nlead too often to a more or less deliberate rejection of the aged\nby present-day society.\n(v) Considering that the attitude of old people has changed and that\nthey now tend to seek greater autonomy and independence.\n(vi) Considering that it is therefore imperative to define and apply\nan overall old age policy aimed at permitting old people to occupy\na suitable place in the society of today and tommorow, that such\na policy must provide for the co-ordination of measures taken in\nmany closely interdependent fields.\nRECOMMENDS\nthe governments of member states to take into account in formulating\ntheir policy for old age, the following principles which should also be applied\nto the aged foreigners residing on their territory, subject to a residence\nqualification where applicable.\nINTRODUCTION\n1. The aim of an old age policy should be to ensure a better distribution of\nthe burden of inactive old people among the active population and lead to the\nachievement of a healthy society based on an economic, psychological and social\ncoexistence of members of different age groups.\n2. In the distribution of the national income, an adequate share should be\nallocated to old people corresponding to their particular needs. Appropriate\nmachinery should be devised to ensure that this share is allocated according\nto simple and sound criteria.\n-101-\n3. Apart from the question of material support, the definition of old people's\nplace in society calls for the continuous education and information of the\nactive population, the aged themselves and public opinion as a whole on problems\nconnected with old age and their solutions. This is a prerequisite for a better\nmutual understanding between the different generations.\n4. Segregation of the elderly is generally to be deplored, and their inte-\ngration within the wider community promotes a more balanced society.\n5. The various measures called for by a rational old age policy are closely\ninterdependent and cannot be fully effective unless applied jointly.\n6. The social action for old people should be harmonised so as to preclude\ndisparities in situations leading to economic and social imbalance which may\nbecome greater in the future owing to growing migration facilities.\nRESOURCES AND INCOME\n7. Old age protection should be extended to the whole population as far as\nnecessary.\n8. The age of entitlement to the old age pension should be determined, inter\nalia, in the light of the population situation and the financial implications.\n9. The old age pension rates should be as high as possible, bearing in mind\nthe standards laid down in international social security instruments, notably\nthe European Code of Social Security and protocol, the ILO Social Security\nConvention (minimum standards) of 1952 and the ILO Convention of 1967 on in-\nvalidity, old age and survivors' benefits.\n10. The minimum old age pension rate secured to persons who have completed,\nprior to the contingency, the qualifying period required for the entitlement\nto a full pension (in the sense of paragraph 1 of Article 29 of the European\nCode of Social Security) should be adequate to guarantee the beneficiary a\ndecent standard of living.\n11. In the absence of an old age pension, as referred to in paragraph 10\nabove, needy old people should receive sufficient means to maintain a decent\nstandard of living.\n12. Both pensions and subsistence allowances should be adjusted at appropriate\nintervals to any variations in the cost of living or the general income trend\narising from the increase in productivity.\n13. There should be adequate co-ordination between statutory pension schemes\nso as to prevent changes in occupation from entailing loss of pension rights\nand to eliminate impediments to occupational mobility.\n14. Similarly with a view to avoiding all discrimination between old people\nliving in the same community it would be desirable to maintain and apply the\nprinciple of equality of treatment of nationals of other member states with\nthe nationals of the state in question and to ensure the maintenance of acquired\nrights or rights in course of acquisition so far as old age pensions are con-\ncerned, by the ratification of international instruments concerning the social\n-102-\nsecurity of migrant workers; it being understood that the grant of non-\ncontributory benefits could be made subject to certain conditions.\n15. Measures should also be taken to harmonise the methods of protecting old\npeople; both by the ratification of international instruments and by joint\nsteps taken within the Council of Europe framework.\nEMPLOYMENT\n16. In general, any policy governing the employment of the aged should be\nbased on the principles established by the Manpower and Social Affairs Committee\nof OECD (Conclusions of 5 January 1967).\n17. Measures to provide suitable employment opportunities for older people\nshould be considered within the framework of an overall employment policy.\n18. Measures should be taken to encourage and facilitate retention by the aged\nof an occupation suited to their capabilities so as to minimise the consequences\nand also one cause of individual aging and to prevent the economic difficulties\ndue to the presence of too large a group of inactive persons.\n19. To enable the fullest possible adjustment of man to his work and vice\nversa, more particularly in the case of old people, measures should be taken\nto encourage and support adaptation of jobs to enable older people to continue\nworking.\nWhere this adaptation is not desirable or possible it will be advisable\nto encourage the transfer of older workers.\nIn order to ensure that such a transfer is not too radical for workers\napproaching old age, the work they do during their whole working life should\nbe continually adjusted to physiological and psychological changes all through\nlife.\n20. Measures should be taken to offer facilities for both education and\ntraining:\n(a) educational steps should be taken in time to enable old\npeople to maintain their powers of adjustment and to\nkeep abreast of technical developments.\n(b) training should be provided so as to facilitate a change\nof occupation to one more suited to the workers' preference\nand changing ability.\n21. In order to provide quantitatively and qualitatively suitable jobs for\nolder workers, efforts should be made to create jobs adapted to their needs and\nto encourage the flexible distribution of the various kinds of jobs among age\ngroups by all appropriate means according to the circumstances of the country\nconcerned.\n22. Retirement schemes should be so adjusted as to promote both prolongation\nof active life and occupational mobility by making appropriate provisions where-\nby pensions may be combined with paid employment.\n-103-\n23. Steps should be taken to adapt the employment exchange services and the\nmethods used by them so as to facilitate the transfer and employment of old\npeople.\n24. Measures, such as adaptation allowances and training grants, should be\ntaken to prevent unemployment of old people.\nHOUSING\n25. Steps should be taken to enable old people to remain in their own homes\nas long as possible.\n26. A special effort should be made to adapt accommodation occupied by old\npeople to meet their changing needs as well as their wishes.\n27. Where it has not been proved possible for old people to remain in their\nhomes, if need be after adapting them, and where they are consequently obliged\nto leave their homes (tied houses, ill-adapted or unadaptable accommodation,\nremoteness), public authorities should endeavour to provide new accommodation\nsufficiently large and especially designed for them in order to avoid their\ntransfer to collective establishments.\n28. The new accommodation should be situated either in population centers, or\nin their immediate vicinity, provided there are easy means of communication,\nand where the occupants can receive appropriate social and medical services.\nIn addition, account should be taken of old people's desire to live near\ntheir family.\n29. Old persons should be able to select accommodation either interspersed\nwith ordinary family dwellings or in special blocks of flats, with the avail-\nability of communal services in either case, a high density of the elderly\npopulation should, however, be avoided.\n30. When new dwellings are built, account should be taken of the need to pre-\nvent those accidents to which old people are prone.\n31. Resource should be had to collective accommodation only when all the\naforementioned measures are insufficient to enable old people to remain in\ntheir own homes.\n32. Old people whose state of health is such that they require care which can-\nnot be given at home should be able to receive it in establishments catering\nfor their needs, namely:\n- residential homes for those who are no longer able to care\nfor themselves in their own homes even with the help which\nthe social services can give them, but who do not need\ncontinuous nursing care\n- nursing homes for old people suffering from serious infirmi-\nties or chronic illnesses who need constant medical and\nnursing care.\n-104-\n33. It would be advisable to have available in each country the number of\nbeds corresponding to the need, bearing in mind the steps taken to enable old\npeople to remain at home.\n34. The number of beds in an old people's home should ideally be small enough\nfor the establishment to keep a homelike atmosphere(1).\n35. In an old people's home, each resident or couple should have a separate\nbedroon with its own washbasin and, if possible, its own toilet. It is desir-\nable that the couples should have two beds and one extra room.\n36. Installations and fitments in all old people's homes should be designed\nfor easy use. Establishments with several floors should have lifts.\n37. Where applicable, a doctor should be attached to each old people's home\nwith responsibility for the general health requirements of the establishment,\nfor giving residents the opportunity of regular medical examinations, and for\ntreating those who do not have their own doctor. The presence of this doctor\nshould never prevent residents from calling their own doctor if they wish.\nThe services of a social worker should also be available to each home.\n38. To reduce difficulties encountered in the recruitment of staff for old\npeople's homes, establishments should also be fitted with labour-saving devices,\nand the employment of part-time staff should be considered.\n39. It would be desirable to organise special training for all staff for old\npeople's homes and organisations and to supply all categories of staff speciali-\nsing in the care of the elderly with appropriate information.\n40. Obsolete old people's homes should be progressively abandoned in favour\nof modern homes suitable to the needs of elderly people and the premises of\nadaptable existing old institutions should, where possible, be converted into\nnursing homes for old people suffering from serious infirmities or chronic\nillnesses, if new nursing homes cannot be provided.\n41. Establishments for the aged, whether medical or not, should be supervised\nby the public authorities to ensure that they comply with specified standards\nand are properly run administratively and technically.\nPROTECTION AGAINST ROAD ACCIDENTS\n42. Special measures should be taken to protect old people in the streets.\nTo this end:\n(1) Drivers of motor vehicles should be made aware of the special risks to\nwhich old people are exposed in the streets and should realise the following\npoints:\n- old people often step off the pavement without looking\n(1) While 80 to 100 beds is considered the best number by some, others\nconsider that the number may be higher, provided that architectural\nand functional provisions are adequate.\n-105-\n- they can often only manage to get across a road at all by walking\nslowly and watching every step\n- they sometimes lose their nerve in the middle of the road and turn\nback without warning\n- many old people have poor eyesight and are hard of hearing\n- they often have a preference for dark clothes and so are\ndifficult to see at night\n(2) Local authorities should provide special facilities for old people cross-\ning the road.\nMEDICAL PROBLEMS\n43. It would be desirable, on the one hand, for all future doctors to undergo\nappropriate training in geriatrics and gerontology and on the other hand, for\npostgraduate courses to be provided to enable doctors to supplement their\nknowledge and bring it up to date.\n44. Medical schools should have a Chair of Geriatrics which would make it\npossible to co-ordinate the various geriatric activities within a school and\nto promote research.\n45. Adequate theoretical information and practical experience should be in-\ncluded in the training courses for nurses, physiotherapists, occupational\ntherapists and social workers as well as in postgraduate geriatric training\ncourses.\n46. Preventive care and treatment should aim at helping old people to preserve\ntheir physical and mental powers in the greatest measure possible.\n47. Industrial medicine should provide advice on regular medical examinations,\non prevention of accidents in work places, on planning employment adapted to\nelderly workers, as well as on preparation for retirement. It should pay\nspecial attention to the problems of workers over the age of 40.\n48. The public should be informed regarding the advantages for elderly people\nof regular medical examinations, which might be organised on a voluntary basis,\nby the public authorities.\n49. The public authorities and voluntary organisations concerned with the care\nof the aged should give special thought to health education.\n50. Priority should be given to the care of old people who continue to live at\nhome: such care should be given through normal home care services or specialised\nschemes such as mobile services.\n51. Establishments for chronic patients and special functional rehabilitation\ncenters should be provided for old people where possible in addition to the\ngeriatric departments of teaching hospitals. Services provided in other\nhospitals should be co-ordinated with those provided in the teaching hospitals.\n-106-\n52. Hospitals for old people in need of continuous nursing and medical care\nmay have more beds than residential homes; they should not however have more\nthan 250 beds, divided into wards of 25 to 30 beds, where the construction of\nlarger establishments is not required for medical reasons.\n53. Such establishments must have a homely atmosphere and appropriate facili-\nties not only for treating the sick but also for rehabilitation. These latter\nfacilities must be available to out-patients.\n54. These establishments, which are real nursing establishments must have:\n(a) an adequate number of specialised medical staff\n(b) an adequate number of specialised nursing staff\n(c) a social service.\n55. Old people suffering from minor mental disturbances need not normally be\ntreated in specialised establishments. Those with more serious mental dis-\norders should be admitted to smaller special establishments rather than be\nplaced in psychiatric hospitals.\n56. The medical care facilities for the aged at local level should be co-\nordinated, as appropriate, without prejudice, to liaison with social services.\n57. All necessary measures should be taken to provide for the care of the aged\nto be financed either out of public funds or under the social security scheme.\nSOCIAL SERVICES\n58. Social service arrangements should, as a general rule, correspond with\nthe wishes of the elderly.\n59. Special measures should be taken to provide the common social services\ndesigned for the population as a whole with facilities enabling them to avoid\nsegregating the aged from the young generation.\n60. When dealing with the elderly, the social services should collaborate with\nas large a section of the local population as possible, in particular close\nrelations and neighbours.\nThose services should aim at attenuating, and, if possible, eliminating,\nthe feeling of isolation, uselessness or dependence due to advancing age and\nat creating, on the contrary, such conditions as will enable the various\ngenerations to live together in an atmosphere of friendliness and mutual\nassistance.\n61. The social services should pursue, inter alia, the following objectives:\n(a) old people should play an active part in the community\n(b) basic services designed for the aged should be maintained at\nthe same level as those for other age groups\n-107-\n(c) services should be available free for every elderly person apart\nfrom a contribution from those concerned according to their means\n(d) the best possible use should be made of the capabilities of the\nelderly, taking into account individual circumstances\n(e) close association between generations in cultural, occupational\nand recreational matters.\n62. In view of the need to secure for all old persons, whatever their physical\nor mental condition, maximum care, as appropriate and the best conditions for\na decent way of life, the principle of nonsegregation should be applied as far\nas possible, even in the case of persons unable to adapt themselves to social\nconditions.\n63. Special steps should be taken to see that social service staff are capable\nof understanding the old persons concerned and of handling their problems and\ntreating their needs without any distinction necessarily being made between\ndifferent generations.\n64. Social services, which vary according to whether they are applied to\nable-bodied people living alone or able-bodied people living with their families,\nshould be classified in accordance with priorities which should take into\naccount the traditions, the political and social systems and the economic situ-\nation of each country. The general aim should be to reconcile, on the one hand,\nthe wishes of the elderly to retain their independence and the opportunity to\nlead a purposeful life and, on the other hand, measures which make the best use\nof the national resources.\nOnce basic individual needs in the matter of income, general health, treat-\nment, and care in case of illness or declining capacity have been met, the\nfollowing social services should be provided, according to the economic, social\nand demographic situation of each country concerned:\n(a) housing services\n(b) service for the partially or totally incapacitated living alone or\nwith their families, supervised accommodation, meals on wheels,\ntransport arrangements\n(c) services for the able-bodied living alone or with their families\n(d) services for the able-bodied living in communal establishments\n(e) comprehensive service centers for the elderly providing facilities\nin the social, medical and cultural fields\nSpecial attention should be paid to the creation of leisure-time facilities\n(study groups, clubs, meeting rooms, social centers, etc.), the organisation of\nholidays and the provision of libraries.\n65. Aid, including possibly financial aid, should be given if need be, to the\nfamily which continues to look after an old person.\n66. In order to preserve the self-respect of elderly persons, social services\nshould be presented in a form acceptable to them.\n108\n67. Old persons should be informed as fully and as precisely as possible of\nthe services to which they are entitled or of which they may avail themselves.\nProper planning should enable mass communication media to be used for that\npurpose.\n68. Through the establishment of local advisory centers and the training of\nqualified personnel, old persons should be encouraged to seek for themselves\ninformation which is relevant to their circumstances and to make full use of\nthe available advice and help which should be given to them free and in an\nimpartial and tactful manner.\n69. The information campaign designed to reach old persons, and indeed public\nopinion as a whole, should draw particular attention to the need to prepare\nthem properly for their approaching retirement without overlooking the possi-\nbility of training them to practice a hobby.\n70. In countries where private relief activities play a significant part in\nassistance for old people, special encouragement might be given to private\norganisations which should, in a spirit of good co-operation with the public\nservices, be assisted financially and otherwise by the authorities who,\nnaturally, should continue to assume full responsibility for social assistance.\nRegular two-way consultation between private and public services is\nessential to ensure efficient aid to old persons, and this requires, moreover,\nthe support of all sectors of the population.\n71. Besides the steps recommended for local co-ordination of the various\nmedical and social services, social policy for the elderly and, in particular,\nthe social services made available to them in both the public and private\nsectors, should be co-ordinated nationally.\nSCIENTIFIC RESEARCH\n72. Research work, whose findings would throw light on the phenomenon of\npremature ageing and subsequently enable it to be prevented or halted should\nbe undertaken in the social, medical biological, psychological, demographic\nand economic fields.\nEmphasis should be laid specifically:\n(a) on a study of the physiological and psychophysiological\nmechanisms of senescence with special reference to problems\nof nutrition and mental health\n(b) on a critical evaluation of routine medical examinations\n(c) on fundamental research into molecular biology\n(d) on ecological factors of all kinds which may affect the\nprocesses of senescence\n(e) on sociological and psychological research in connections\nwith ageing and old people, their interaction with younger\ngroups, public opinion and the attitude of society towards\nageing and towards old people\n-109-\n(f) on all the economic and technical problems raised by the\nemployment of the elderly.\n73. Research work already being undertaken in a number of different countries\nmust be pursued and intensified with a view to securing improvement in the\norganisation of social and medical services for old persons.\n74. An effort should be made to co-ordinate research work at European level\nby effecting liaison between existing organisations.\n-110-\nC. What can be done - Community Models\n(1) In General\nThe White House Conference of 1971 will point the way for whatever\nnational action is required to solve the escalating problems of our aging\npopulation, both present and future. State and local governments are\nexpected to follow this leadership, hopefully with progams and funding,\nbut assuredly with a new awareness of the problems of the aging, and an\nincreasing willingness to cooperate. Accordingly, every community should\nestablish the type of organizational structure that can best operate the\nprograms, deliver the services and meet the needs of our aging. The or-\nganization that can best perform these functions is one created at the\nlocal level, committed to its local purposes, aware of local problems,\nresponsive in local needs, and aware of local resources. Such an organi-\nzation is best equipped to inspire the necessary community conviction that\nthe cause is right and that need exists that must be served. It is also\ngenerally the most effective in securing local government participation\nand local financial support.\nThe purpose of this section is to discuss the forms that such local\norganizations might take and to supply suggested models which may serve\nas guidelines to those individuals and organizations who are willing to\ncommit themselves to the solution of the problem of the aging citizens of\ntheir communities.\nMany communities already have voluntary organizations committed to\nserving particular geographical areas or particular items of need. Few\ncommunities exist that do not require an expansion of the services of\nexisting organizations or establishment of new organization. Also needed\nin most communities is an organization to coordinate the activities of the\n-111-\nvarious programs devoted to the aging and serve as a bridge between the\nprivate groups and local government. Such a coordinating organization can\nnot only keep the elected officials aware of the interests and needs of their\nconstituents over 65, but can also keep the service organizations informed\nas to the programs and activities of government which are of special interest\nto them.\nThe two types of organizations are discussed separately.\n(2) The local coordinating organization.\nExperience has shown that the most effective Community Coordinating\norganization is one established by the local governing body. Such an or-\nganization can be created by ordinance or by resolution.\n(a) Model Ordinance\nThe following is a model ordinance by which a City and/or County can\ncreate a Commission on Aging.\nORDINANCE NO.\nESTABLISHING A COMMISSION ON AGING, PROVIDING FOR THE APPOINTMENT OF\nMEMBERS THEREOF, AND DEFINING THE DUTIES OF SAID COMMISSION.\nBE IT ORDAINED by the Council of the City as follows:\n(THE BOARD OF SUPERVISORS OF THE COUNTY OF\nDO ORDAIN AS\nFOLLOWS:)\nSection 1. CREATION OF A COMMISSION ON AGING.\nA Commission on Aging of the City (County) of\nis hereby\nestablished. Said Commission shall consist of twenty (20) members. All\nmembers shall be residents of the City (County) of\nand shall serve\nwithout compensation.\nSection 2. MEMBERSHIP OF COMMISSION.\nThe members of said Commission shall be appointed by a major-\nity vote of the City Council (Board of Supervisors) and shall be representative\nof the economic, cultural, ethnic and racial groups which comprise the popula-\ntion of the City (County).\n-112-\nSection 3. TERMS OF OFFICE OF MEMBERS.\nThe term of office of each member shall be four (4) years;\nprovided, however, that the terms of office of members first appointed shall\ncommence upon the date this Ordinance becomes effective, and the members so\nappointed shall so classify themselves by lot that five (5) shall go out of\noffice on the first Monday of July,\n, five (5) on the first Monday of\nJuly,\n, five (5) on the first Monday of July,\n, and five (5) on the\nfirst Monday of July,\n.\nSection 4. VACANCIES AND REMOVALS.\nVacancies on said Commission, from whatever cause, except\ntemporary vacancies as hereinafter provided, shall be filled by the Council\n(Board) for the unexpired term. Any member of the Commission may be removed\nfrom said Commission prior to the expiration of his term by a six-ninths\n(6/9) vote of the Council (3/5 vote of the Board).\nSection 5. TEMPORARY VACANCIES.\nA member of the Commission may be granted a leave of ab-\nsence by the Council (Board), and a temporary vacancy shall thereupon exist\nfor the period of such leave of absence.\nDuring the period of such temporary vacancy, the Council,\n(Board) may fill such vacancy by a temporary appointment to said Commission;\nprovided, however, that the period of such temporary appointment shall not\nexceed the period of his appointed term.\nSection 6. AUTOMATIC TERMINATION OF APPOINTMENT.\nThe appointment of any member of the Commission who has\nbeen absent from three (3) consecutive regular or special meetings without\nthe approval of said Commission shall automatically terminate as hereinafter\nset forth.\nThe Secretary of the Commission shall report the atten-\ndance record of each member of said Commission to the City Clerk (Clerk of\nthe Board) at the end of each six (6) month's period, the first report to\nbe made on the first day of the month that follows the effective date of\nthis Ordinance by six (6) months. The appointment of any member who was\nabsent from three (3) consecutive regular or special meetings without the\napproval of said Commission, as shown on said report, shall be terminated\non the date said report is filed with the City Clerk (Clerk of the Board).\nThe City Clerk (Clerk of the Board) shall notify any mem-\nber whose appointment has automatically terminated and report to the Council\n(Board) that a vacancy exists on said Commission and that an appointment\nshould be made for the unexpired term.\nSection 7. COUNCIL (BOARD) LIAISON REPRESENTATIVE.\nThe Council (Board) shall appoint one (1) of its members\nto act as a liaison representative to the Commission. The functions of\n-113-\nsuch liaison representative are: to attend the meetings of said Commission;\nto advise the Council (Board) of the background, attitudes and reasons be-\nhind decisions and recommendations of said Commission; and on request of any\nmember of said Commission to advise the Commission of policies, procedures\nand decisions of the Council (Board) that may bear on matters under discus-\nsion by the Commission. The liaison representative shall have no power\nto vote and shall receive no additional compensation.\nSection 8. BOARD, COMMISSION AND COMMITTEE LIAISON REPRESENTATIVES.\nSubject to the approval of the Council (Board) in each\ncase, the Commission may designate one (1) of its members to act as a liaison\nrepresentative to any other board, commission or committee of the City (County).\nThe function of such liaison representatives are to attend meetings of such\nother board, commission or committee; advise this Commission of the back-\nground; attitudes and reasons behind the actions of such other board, commis-\nsion or committee; and on request of any member of such other board, commis-\nsion or committee of policy, procedures and decisions of this commission\nthat may bear upon matters under discussion by such other board, commission\nor committee. Such liaison representatives shall have no power to vote.\nSection 9. OFFICERS, MEETINGS AND PROCEDURES.\nThe Commission shall elect one (1) of its members President\nand one (1) of its members Vice-President, who shall hold office for one (1)\nyear and until their successors are elected unless their terms as a member\nof the Commission expire sooner. The President and Vice-President shall be\nelected at the first meeting of the Commission after July 1 of each year.\nAn officer or employee of the City (County) designated by\nthe City Manager (County Administrative Officer) shall serve as Secretary\nof the Commission.\nThe Commission shall establish a regular time and place\nof meeting and shall hold at least one (1) regular meeting each month.\nSpecial meetings may be called by the President, or by any eleven (11) mem-\nbers of the Commission, upon written notice, being delivered personally or\nby mail to each member at least twenty-four (24) hours prior to such\nmeeting.\nThe Commission may make and alter rules governing its\norganization and procedures which are not inconsistent with this or any\nother applicable ordinance of the City.\nEleven (11) of the twenty (20) members shall constitute\na quorum and the affirmative vote of eleven (11) members is required to\ntake any action. The Commission shall keep an accurate record of its\nproceedings and transactions and shall submit an annual report to the Coun-\ncil (Board) with a copy to the City Manager. (County Administrative Officer)\n-114-\nSection 10. FUNCTIONS OF COMMISSION.\nThe functions of the Commission shall be to:\na. Identify the needs of the aging of the community and\ncreate a citizen awareness of these needs.\nb. Encourage improved standards of services to the aging\nand encourage establishment of needed new services for the aging, both\npublic and private, and in so doing, encourage coordination among organiza-\ntions providing services to the aging in the community and provide advice\nand assistance thereto; in cooperation with other agencies collect, main-\ntain and interpret information and statistics on the aging for the use of\ncitizens and organizations in the City (County); encourage preparation of\npublication and results of study and research pertaining to the aging.\nc. Advise the Council (Board) on all matters affecting\nthe aging in the community.\nd. Render advice and assistance to other City (County)\nboards and commissions, to City (County) departments and to private agencies\non matters affecting the aging.\ne. Perform such other functions and duties as may be\ndirected by the Council (Board).\nIn prescribing the above duties and functions of the\nCommission it is not the intent of this Council (Board) to duplicate or\noverlap the functions, duties, or responsibilities heretofore or hereafter\nassigned to any other City (County) board or commission or to a City (County)\ndepartment. As to such functions or responsibilities above set forth which\nare partially or wholly the responsibilities of another board or commission\nor of a department of the City, (County), the Commission will render assis-\ntance and advice to such board, commission or department as may be requested.\nSection 11. (Recitation of appropriate posting and/or publishing\nrequirements).\nRecordation of Vote\nDate:\nAttestation\n(b) Such an organization may also be created by resolution of the\ngoverning board. The following is a model resolution by which this may be\ndone.\n-115-\nResolution\nBefore the City Council (Board of Supervisors) of the City\nof\n(County of\n), State of California.\nResolution Establishing a\nCommission on Aging as Advisory to\nthis Council (Board).\nWHEREAS, the Congress of the United States is enacting the\nOlder Americans Act of 1965 found and declared that, in keeping with the\ntraditional American concept of the inherent dignity of the individual in\na democratic society, the older people of our nation are entitled to the\nfull and free enjoyment of the opportunity to achieve an adequate income\nin retirement, the best possible physical and mental health, suitable\nhousing, full rest or active services for those requiring institutional\ncare, opportunity for employment, pursuit of meaningful activity within the\nwidest range of civic, cultural, and recreational opportunities, freedom,\nindependence and the free exercise of individual initiative in planning\nand managing their own lives and, efficient community services which pro-\nvide assistance in achieving these goals in a coordinated manner, and\nWHEREAS, the Congress of the United States further found that\nit is the joint and several duty of the governments of the United States and\nof the several states and their political subdivisions to assist our older\ncitizens to achieve these goals, and\nWHEREAS, this Council (Board) is aware of the multiplicity of\npressing problems facing many of the older citizens in this City (County)\nand believes that it would be to the best interests of both the City (County)\nand its older citizens to establish an Advisory Commission to keep this\nCouncil (Board) apprised of these problems and to also serve as a direct\ncommunication line with both its older citizens and with the local organiza-\ntions formed to render services thereto,\nNOW, THEREFORE, BE IT RESOLVED as follows:\n1. Creation. A \"Senior Citizens Commission\", hereinafter\nreferred to as the \"Commission\" is hereby created.\n2. Number of Members. The Commission shall consist of eleven\n(11) members.\n3. Eligibility of Members. All of the members of the Commission\nshall be residents of the City (County).\n4. Terms of Office. Four of the first eleven members shall be\nappointed for terms expiring at the end of June 19 , four for terms expiring\nat the end of June 19_, and three for terms expiring at the end of June\n19_\nEach person thereafter appointed to a seat on the Commission\nshall be appointed for a term expiring three (3) years from and after the\n-116-\ndate of expiration of the term of the former incumbent of the seat to which\nhe is appointed.\n5. Powers, Functions, and Duties. The Commission shall have\nthe following powers, functions and duties:\n(a) Study, review, evaluate and make recommendations to\nthis Council (Board) relative to any and all matters affecting elderly\npeople in the City of\n(County of\n), including\nwithout being limited thereto, health, education, employment, housing,\ntransportation and recreation.\n(b) Inventory the nature and extent of the unmet needs of\nthe elderly people in this City (County).\n(c) Identify the various services made available to elderly\npeople in this City (County) by both governmental and nongovernmental agen-\ncies, and, to the extent feasible, act as a voluntary coordinating body for\nsuch agencies.\n(d) Make such studies and submit to this Council (Board)\nsuch reports or recommendations respecting matters affecting elderly people,\nincluding without limitation those hereinabove provided, as the Council\n(Board) may from time to time request.\nPASSED AND ADOPTED this\nday of\n, 1970, by\nthe following vote:\nAYES:\nNOES:\nABSENT:\nChairman\n-117-\n(c) Technical Advisory Committee\nThe city or county that establishes a commission on aging may\nalso wish to consider the establishment of a technical advisory committee\non aging. Such a committee could be comprised of representatives from the\nvarious governmental agencies and departments that conduct programs or\noffer services to the aging. This membership need not be limited to mem-\nbers of the departments in the governmental agency forming the commission\non aging, although participation from other agencies would, of course, be\nvoluntary. Representatives from recreation and parks departments, public\nhealth departments, welfare departments, department of social security,\nplanning departments and others, including representatives from private\nagencies would offer broad expertise for the commission. The commission\nshould be provided with a full-time salaried executive to work with both\nthe commission and the technical advisory committee. The salary of such\nexecutive and the costs of any staff work provided to the commission or\nthe committee, would generally be the obligation of the city or county\nwhich establishes the commission on aging. Form job specifications for\nsuch executive are set forth in footnote\n.\n3. The Voluntary Service Organization.\n(a) Preliminary Considerations\nAny group desiring to organize itself for the purpose of\nrendering services to senior citizens may form either a voluntary organiza-\ntions or a nonprofit corporation. In either event, if it is to function\neffectively its purposes, functions, and procedures should be clearly\nspelled out in a document that will enable the members to avoid misunder-\nstandings, fully comprehend the scope of their efforts, and become aware\nof the limitations on such efforts. Accordingly, a constitution and\n-118-\nby-laws or articles of incorporation and by-laws should be prepared. Forms\nfor each may be found later in this section. Prior to the determination,\nhowever, of the form the organization should take, certain preliminary steps\nshould be taken to determine the functions it plans to fulfill, consider\nwhat sponsorship it should seek, staff it will require, financial assis-\ntance it can anticipate and the like. The following are suggested as\npreliminary procedures that might be carried out in advance of the organiza-\ntion effort itself.\n(1) Pre-First Meeting\nPrior to the first meeting, persons interested in forming a commit-\ntee should meet to discuss the problems of the community with respect to\nthe aged and the procedures which could be used to form the community agency.\nAn open meeting to discuss the formation of a committee could then be\nplanned. Invitations should be sent to appropriate representatives of local\ngroups and agencies and notice of the meeting should be given to the public.\n(2) First Meeting\nIn addition to having representatives from local groups and agencies\nat this meeting, a representative from an existing local committee on aging\nor a member of the State Commission on Aging would be valuable to insure\nthe success of the meeting. At that meeting the following subjects could\nbe discussed:\na. The purpose of the meeting.\nb. How a committee on aging will benefit the community.\nc. The duties and functions of such a committee.\nd. Whether the committee should seek sponsorship from a\nlocal agency or proceed to incorporate.\ne. The names of other persons who would be helpful as\ncommittee members.\nf. The appointment of a constitution and bylaws committee.\n(A date should be set for the committee to report).\ng. The number of members.\nh. The appointment of temporary officers.\n-119-\n(3) Second Meeting\nThe following could take place at a second meeting:\na. A discussion of existing local programs designed to\nmeet the needs of the aging.\nb. A discussion of specific projects that could be taken\nunder consideration.\nc. The appointment of a nomination committee to select\nofficers.\nd. A review of qualifications of committee members.\n(4) Third Meeting\nThe following could be on the agenda for the third meeting:\na. The nomination and election of officers.\nb. The selection of committee members\nC. The formation of subcommittees.\n(5) Fourth Meeting\nOnce the committee has established some degree of organization, it\nshould proceed to discuss the needs of the senior citizens of the community\nand the action that can be taken to meet those needs. Reports should also\nbe received at this or later meetings from any committees previously formed.\nThe above outline is only an example of a possible procedure. In\nthe final analysis, the individual community must determine the specific\nform and content of the meetings as well as the procedures for overall\ncommittee formation and functioning.\nThe following are additional matters of importance for consideration\nby a group contemplating the formation of a local service organization:\n(1) Financing\nWhile financing can be a problem for any committee, funds may be\nraised in a number of ways: dues from members, contributions from agencies,\ncontributions from service clubs, united campaigns, local subscriptions,\nand grants from a variety of sources (private and public, such as the State\nCommission on Aging). Fund raising events and programs sponsored by the\n-120-\ncommittee can also be sources of funds. While it is possible that some\nprograms can be implemented with little or no funds, financial support is\na basic ingredient to allow the committee to expand and meet the needs of\nthe community.\n(2) Sponsorship\nWherever possible, it is recommended that the committee attempt to\ngain sponsorship from an agency or organization which has strong community\nrelations. That agency or organization should represent the total community\nand be able to effect overall community planning. In some communities\nthe community welfare council, the city council, the recreation department,\nthe county board of supervisors, the social agency, or some other branch\nof government could become the sponsoring organization which backs the\ncommittee. The importance of such sponsorship is that the committee auto-\nmatically benefits from the legal influence and status of the sponsoring\nagency.\nIf there is no governmental agency to sponsor the committee, spon-\nsorship should be sought from private organizations or foundations within\nthe community which are legally constituted and have public support.\nBut in either case the agency from which the committee seeks support\nshould be strong and influential and one which can provide the committee\nthe legal base and authority it will need to carry out its plans.\n(3) Staff\nA professional staff can do much to provide the committee with con-\ntinuing effectiveness, coordination with other agencies and valuable access\nto government. Financial limitations frequently make it difficult to secure a\nstaff on a full-time basis. On occasion, however, staff members can be\nborrowed, can be hired part time, or can be made up of a volunteer \"consulting\nstaff\". The sponsoring organization may also be persuaded to provide staff.\n-121\n(4) Leadership\nPersons chosen for leadership positions must be dedicated to the\nprogram and possess proven ability and knowledge in the area of community\norganization. In addition, it is helpful if such persons are well-known\nand have already earned the respect and confidence of the community.\n(5) Membership\nSince the committee is designed to plan for a total community pro-\ngram, the committee must be truly representative of the community. It should\nrepresent citizen groups, lay and professional leaders, both public and\nprivate agencies, and, older residents. There also should be members who\nare representative of business and industry, veterans groups, labor unions,\nchurches, and schools. Individuals from all groups and agencies in the\ncommunity which have programs or responsibility for the aging should also\nbe represented.\n(b) Constitution and Bylaws - The Unincorporated Association\nThe constitution and bylaws should be drafted to perform the\nfollowing functions: (1) establish the name of the organization; (2) state\nits purposes; (3) regulate the internal practices and procedures of the\norganization; (4) specify the relations, the rights and duties of members\nnot only with respect to themselves but also with respect to the organi-\nzation; (5) define the powers, duties and limitations of the officers and\nother agents of the organization.\nIn general, they should be as flexible as possible to allow\nthe organization to carry out its public purposes, but sufficiently specific\nas to its internal functions to avoid any misunderstanding among the members.\nThe following constitution and bylaws are offered as guidelines with\nthe suggestion that any organization seeking to form itself into an\n-122-\nunincorporated association employ the services of an attorney to draw the\nfinal documents on its behalf:\nCONSTITUTION AND BYLAWS\nARTICLE I - NAME AND MEETINGS\nSection 1. The name of this organization shall be\nClub.\nThe club membership will meet in regular session at\np.m. on (day)\nof each week.\nARTICLE II - PURPOSES\nSection 1. The purposes of this organization shall be to: (Here insert\nappropriate purposes. See note, P.\nfor suggestions.)\nSection 2. The purposes of this organization will be carried out through\nits officers under policy guidelines established by the Board of Directors.\nARTICLE III - BOARD OF DIRECTORS\nSection 1. Composition: The\nBoard of Directors shall be\ncomposed of nine persons, representative members of the community who have\ndemonstrated interest in the elderly people and qualities of leadership in\nthe community.\nSection 2. Term of Office: The Board shall be elected for terms of three\n(3) years each, EXCEPT THAT the initial Board shall be divided into three (3)\nclasses by lot:\nThree for one year terms ending (date)\nThree for two year terms ending (date)\nThree for three year terms ending (date)\nThereafter three vacancies shall occur annually on the Board.\na. Members may be reelected at the end of their service\non the Board.\nSection 3. In June of each year the Board shall appoint a nominating commit-\ntee to consist of three members of the\nClub who are not members of\nthe Board. At least six weeks before the annual meeting in September, such\ncommittee shall advise the secretary of its nominations of candidates for the\nvacancies in the Board to be filled at the next annual meeting, and those\nnominations shall likewise be distributed by the secretary to the full mem-\nbership of the organization. Elections to the Board shall be by ballot of\nthe membership of the organization. A plurality of votes cast at the annual\nmeeting shall be required to elect. Vacancies occurring in the Board shall\nbe filled, until the next annual election, by vote of the remaining members\nof the Board.\n-123-\nSection 4. The Board shall hold at least one regular meeting each month.\nSpecial meetings may be called by the President or upon written petition\nof any two members of the Board. Five members of the Board shall constitute\na quorum for the transaction of business.\nSection 5. Any member of the Board who shall absent himself from three\nconsecutive meetings, thereof, unless he shall present satisfactory excuse,\nshall be deemed to have resigned as a member of the Board and shall cease\nto be a member thereof. He may, however, be reinstated by a majority of\nthe Board. Vacancies shall be filled by a majority vote of the Board members.\nARTICLE IV - OFFICERS AND DUTIES\nSection 1. The officers of the\nClub shall be a President, a\nVice-President and a Secretary-Treasurer with duties that usually pertain to\ntheir respective offices. The President and Vice-President shall be elected\nannually by the Board from among its elected members and shall hold office\nuntil their successors shall have been elected as specified in Article IX.\nThe Secretary-Treasurer shall be appointed by, hold office during the tenure\nof, and subject to, the Board.\nSection 2. The President, or in his absence the Vice-President, shall preside\nover all meetings of the organization and the Board. In case of the absence\nof both, a temporary presiding officer shall be elected from among the mem-\nbers present. The President shall appoint all committee members and committee\nchairmen. He shall exercise a general supervision over all affairs of the\norganization.\nSection 3. The President shall be a member, ex officio, of all committees,\nbut he shall not be counted in determining a quorum.\na. In the absence of the President, the Vice-President shall\nserve in his stead.\nSection 4. The secretary shall keep a complete record of all proceedings\nand correspondence of the organization and Board; shall notify members of\nthe organization or Board of meetings; shall keep a complete and up-to-date\nroll of the members, and shall perform other duties appertaining to the\noffice of secretary.\nSection 5. The treasurer shall have responsibilities for the finances of\nthe\nClub, will perform the duties usually assigned to this\noffice, and shall give bond, in an amount required by the Board; shall make\npayments only for bills properly approved by the Board. All checks shall\nbear the signature of the President or Vice-President and Treasurer. In\nthe absence or incapacity of the treasurer, his power to sign checks may\nbe delegated by the Board to one of its members. No debt or liability shall\nbe incurred in excess of the net assets of the organization. There shall\nbe an audit by a qualified accountant at the end of August each year.\nSection 6. Contracts and formal documents shall be approved by the Board\nand signed by two officers thereof, or by two of its members designated by\nit.\n-124-\nARTICLE V - EXECUTIVE COMMITTEE\nSection 1. There shall be an executive committee composed of the officers\nof the Board. The members of the Executive Committee shall serve for the\nduration of their terms as officers and shall meet as called by the President.\nThe President shall be chairman of the Executive Committee.\nARTICLE VI - OTHER COMMITTEES\nSection 1. These shall be:\nNominating Committee: See Article III, Section 3, Paragraph 1.\nSection 2. The Board may create other committees as are required for the\nadequate functioning of the organization. Such committees shall function\nduring the term of office of the officer who appoints them, but may be re-\nappointed upon review by the newly elected officers following the annual\nmeeting.\nSection 3. All appointments of committees and committee chairmen by the\nPresident (as specified in Article IV, Sec. 2) shall be confirmed and\napproved by the majority of the Board.\nARTICLE VII - MEMBERSHIP\nSection 1. A candidate for membership in the\nClub must be\n(60) sixty years of age or older.\nARTICLE VIII - ANNUAL MEMBERSHIP FEE\nSection 1. The annual membership fee shall be $1.00 payable on a fiscal\nyear basis, the fiscal year of the\nClub being September 1 to\nAugust 31.\nSection 2. A member joining the organization after the first day of March\nin any fiscal year shall pay one-half of the membership fee for that fiscal\nyear.\nSection 3. Fees may be reduced in part or totally, by the Board if, in its\njudgment, such would create a financial hardship.\nARTICLE IX - ANNUAL MEETING\nSection 1. There shall be an annual meeting of the members of the organization\nheld on the first Wednesday of September at which time the preceding year's\nactivities shall be reviewed. Election of new Board members by vote will\ntake place at the annual meeting. Election of Board officers shall take\nplace the first monthly meeting of the Board following the annual meeting.\nSection 2. Twenty-five members shall constitute a quorum for the transaction\nof business at the annual meeting.\n-125-\nARTICLE X - ORDER OF BUSINESS\nSection 1. At the annual meetings of the\nClub the follow-\ning shall be the Order of Business:\n1. Report of the nominating committee\n2. Report of the President\n3. Report of the Treasurer\n4. Voting for new Board Members\nSection 2. At the meetings of the Board and the meetings of the\nClub, the following shall be the Order of Business:\n1. Roll Call\n2. Introduction of visitors\n3. Minutes of preceding meeting and action thereon\n4. Report of officers and committees\n5. Unfinished business\n6. New business\nARTICLE XI - AMENDMENTS\nSection 1. These bylaws may be amended by the affirmative vote of a majority\nof members voting at the regular annual meeting of the organization, provided\nnotice of such amendment or amendments, and the nature thereof, shall have\nbeen given to all members of the organization at least one month prior to\nthe date of the meeting at which said amendment or amendments are to be\nconsidered.\nSection 2. Members not present at such meetings may vote by letter addressed\nto the secretary.\nNOTE: Suggestions as to language describing purposes of an unincorporated\nassociation organized to serve the aging (more than one can be used):\n1. Promote the general well-being of senior citizens in\n(name of community).\n2. Cooperate with communities and organizations, both public\nand private, to promote the general well-being of senior\ncitizens in (name of community).\n3. Disseminate information pointing to the social and\neconomic advantages accruing to a community from a program\nof interest and activities for and in behalf of senior\ncitizens.\n4. Provide consultant services, resource material and library\nfacilities to communities and organizations desiring to\ninitiate or develop services for senior citizens.\n5. Study, analyze and evaluate the adequacy and/or effective-\nness of existing or proposed services for senior citizens.\n-126-\n6. Suggest, initiate and develop specific demonstration\nprojects in the field of Gerontology and Geriatrics.\n7. Assist communities and groups with the organization\nof clubs, centers and other activities for senior citizens.\n8. Cooperate with educational institutions in the field of\nGerontology and Geriatrics in such activities as student\ntraining, institutes, conferences, etc.\n9. Develop job opportunities and increased placement of\nsenior citizens in full and part-time employment.\n10. Encourage senior citizens to embrace an avocational\ninterest and activity.\n11. Recruit and train volunteers to work in the field of\nGerontology and Geriatrics.\n12. Provide individual counseling and group discussion to\nsenior citizens.\n(c) Nonprofit Corporations\n(1) In General\nAny group desiring to organize to render aid and assistance to the\naging, or any existing unincorporated association, can form itself into a\nnonprofit corporation.\nA nonprofit corporation is in many ways similar to a business\ncorporation, except for the fact that it is formed for purposes other than\nthe realization of profit and issues no stock. More specifically, such\ncorporations can be formed by three or more persons for any lawful purpose\nwhich does not contemplate the distribution of gains, profits, or dividends\nto the members of the corporation and for which individuals lawfully may\nassociate themselves. An organization formed to meet the needs of the aged\nfalls within the above classification.\n(2) Formation\nThe following are suggested steps that should be followed in the\nformation of a nonprofit corporation:\n1. Employ an attorney.\n-127-\n2. Select a suitable corporate name, acceptable to the\nSecretary of State. For the name to be acceptable, it must not be mislead-\ning or deceptive nor must it conflict with several other less important\nrequirements.\n3. Choose the incorporators. This step is necessary be-\ncause the articles of incorporation must not only include the names and\naddresses of three or more persons who are to act in the capacity of first\ndirectors but also must be signed by those persons. The above requirement\ndoes not limit the number of persons who may be named in the articles, but\nsince each signature must be acknowledged, having a large number of persons\nsign the document only serves to make the execution of the articles a time\nconsuming procedure. A slightly different procedure with respect to the\nexecution of the articles is authorized when an unincorporated association\nis incorporated. (See California Corporations Code Section 9304 (b)).\n4. Prepare the articles of incorporation. If the corpora-\ntion is seeking exemption from state or federal taxes, this step would be\naccompanied by appropriate procedures designed to gain those tax exemptions.\nThe articles of incorporation are required by law to\ninclude the following matters: (a) name of the corporation, (b) the specific\nand primary purposes for which the corporation is to be formed, (c) the\nauthority for organization, (d) the county wherein the principal office\nfor the transaction of the business of the corporation is located, (e) the\nnames and addresses of three or more persons who are to act as directors.\nIf an existing unincorporated association is being incorporated, then the\nname of that association must also be included.\nOther matters which are not required may also be included.\nFor example, if the corporation is seeking exemption from state and federal\n-128-\nincome and/or property taxes, the articles of incorporation may include a\nclause dedicating the property of the corporation to tax exempt purposes.\nSuch a clause would include statements to the effect that the property of\nthe corporation is irrevocably dedicated to tax exempt purposes, that upon\ndissolution of the corporation, such property will continue to be dedicated\nto such purposes, and that none of the income or assets of the corporation\nwould ever inure to the benefit of any of the directors, officers, or members\nof the corporation.\nMatters dealing with corporate memberships, directors, and\nofficers might also be included in the articles, although such subjects are\ncovered in the bylaws.\n5. Have the articles of incorporation signed, acknowledged\nbefore a notary, and submitted to the Secretary of State for filing. If the\narticles conform to law, the Secretary of State will file them in his office.\nAt that point the existence of the corporation begins. A copy of the articles\ncertified by the Secretary of State and bearing the endorsement of his office\nmust also be filed in the office of the county clerk in the county in which\nthe corporation is to have its principal office and in the county clerk's\noffice in each county where the corporation acquires ownership of any real\nproperty.\n(3) Management\nExcept as otherwise provided by the articles of incorporation or the\nbylaws, the powers of a nonprofit corporation are to be exercised, its pro-\nperty controlled, and its affairs conducted by a board of not less than\nthree directors. The directors are not personally liable for the debts,\nliabilities, or obligations of the corporation, and unless otherwise specified\nin the articles or bylaws, any vacancy in the board caused by death, resignation,\n-129-\nor any disability is to filled by a majority of the remaining members thereof,\nthough less than a quorum. Unless otherwise provided in the articles or by-\nlaws, meetings of directors are to be called and held as may be ordered by\nthe directors.\nThe number, qualifications, terms of office, powers, duties and com-\npensation of and methods of selection for directors are generally provided\nfor in the bylaws.\n(4) Powers\nThe powers of the corporation are to be exercised by the board. The\nlaw provides a nonprofit corporation with a wide range of powers, including\nthe powers to: (1) sue and be sued; (2) make contracts; (3) receive property\nby devise or bequest, and otherwise acquire and hold all property, real or\npersonal, including shares of stock bonds, and securities of other corpora-\ntions; (4) act as a trustee under any trust incidental to the principal\nobjects of the corporation, and receive, hold, administer and expend funds\nand property subject to such trust; (5) convey, exchange, lease, mortgage,\nencumber, transfer upon trust, or otherwise dispose of all property, real or\npersonal; (6) borrow money, contract debts, and issue bonds, notes and de-\nbentures, and secure the payment or performance of its obligations; and\n(7) do all other acts necessary or expedient for the administration of the\naffairs and attainment of the purposes of the corporation.\n(5) Membership\nThe powers, rights and duties of the members of a nonprofit corpora-\ntion are usually specified in the bylaws, although the law prohibits any\nmember from holding more than one membership. Furthermore, unless the\narticles or bylaws set forth rules for fixing the respective voting, property\nand other rights and interests of each member or class of members, the rights\n-130-\nand interests of the members are to be considered equal. Memberships or\nany right arising therefrom are generally not transferable unless the\narticles or bylaws provide otherwise.\n(6) Sample Articles of Incorporation for a Nonprofit Corporation\nARTICLES OF INCORPORATION\nOF\nI\nThe name of this corporation is\n.\nII\nThe purposes for which this corporation is formed are: (a) The\nspecific and primary purposes are (see note on p.\nfor possible choices);\n(b) The general purposes and powers are to have and exercise all rights and\npowers conferred on nonprofit corporations under the laws of California, in-\ncluding the power to contract, rent, buy or sell personal or real property;\nprovided, however, that this corporation shall not, except to an insubstantial\ndegree, engage in any activities or exercise any powers that are not in fur-\ntherance of the primary purposes of this corporation.\nIII\nThis corporation is organized pursuant to the General Nonprofit\nCorporation Law of the State of California.\nIV\nThe county in this state where the principal office for the transac-\ntion of the business of this corporation is\nCounty.\nV\na) The number of Directors of this corporation shall be\n(not\nless than 3).\nb) The names and addresses of the persons who are to act in the\ncapacity of directors until the selection of their successors are:\nName\nAddress\nJohn Doe\n(Street, City and State)\nRichard Roe\n(Street, City and State)\nSarah Moe\n(Street, City and State)\n-131-\nVI\na) The authorized number and qualifications of members of the cor-\nporation, the different classes of membership, if any, the property, voting\nand other rights and privileges of members, and their liability to dues and\nassessments and the method of collection thereof, shall be as set forth in\nthe bylaws.\nb) Members of this corporation are not personally liable for the\ndebts, liabilities, or obligations of this corporation.\nVII\na) The property of this corporation is irrevocably dedicated to\ncharitable purposes and no part of the net income or assets of this organiza-\ntion shall ever inure to the benefit of any director, officer, or member\nthereof or to the benefit of any private persons.\nb) Upon the dissolution or winding up of the corporation its assets,\nremaining after payment, or provision for payment, of all debts and lia-\nabilities of this corporation, shall be distributed to a nonprofit fund,\nfoundation or coporation which is organized and operated exclusively for\ncharitable purposes and which has established its tax exempt status under\nSection 501 (c) (3) of the Internal Revenue Code.\nc) If this corporation holds any assets in trust, or the corpora-\ntion is formed for charitable purposes, such assets shall be disposed of in\nsuch manner as may be directed by decree of the superior court of the county\nin which the corporation has its principal office, upon petition therefor\nby the Attorney General or by any persons concerned in the liquidation, in\na proceeding to which the Attorney General is a party.\nVIII\nThese articles may, except as hereinafter provided and except as\notherwise provided by law imposing more stringent requirements, be amended\nas follows:\na) Before any members, other than the incorporators, have been ad-\nmitted to the corporation, by a writing signed by two-thirds of the\nincorporators.\nb) After members, other than the incorporators, have been admitted\nto the corporation, by resolution of the Board of Directors and two-thirds\nor more of a quorum of the members given either before or after the adoption\nof the resolution by the Board, provided, however, that if the voting power\nshall be unequal, any amendment shall be approved by the vote or written\nconsent of members holding not less than a majority of the voting power.\n-132-\nIN WITNESS WHEREOF, the undersigned, being the persons hereinabove\nnamed as the first directors, have executed these Articles of Incorporation,\nthis\nday of\n, 19 .\nJohn Doe, Incorporator\nRichard Roe, Incorporator\nSarah Moe, Incorporator\nSTATE OF CALIFORNIA\nCOUNTY OF\nOn this day\nday of\n, 19 , before me,\n,\na Notary Public for the State of California, personally appeared JOHN DOE,\nRICHARD ROE AND SARAH MOE, known to me to be the persons whose names are\nsubscribed to the within Articles of Incorporation, and acknowledged to me\nthat they executed the same.\nIN WITNESS WHEREOF, I have hereunto set my hand and affixed my\nofficial seal on the day and year first above written.\nNotary Public\n(Notarial Seal)\n(Note: This form is presented as an illustration of the type of form which\nmay be used in this state. However, for a particular organization, not\nonly should the articles be drafted by the attorney for the incorporators\nbut they should also be prepared so as to fit the specific purposes and\nneeds of the organization.)\n(7) Bylaws\nAs in the case of the unincorporated association, the bylaws for a\nnonprofit corporation perform the functions of regulating the internal affairs\nof the corporation; of defining the relations, rights and duties of the mem-\nbers; and of specifying the powers, duties and limitations of the directors,\n-133-\nofficers, or other agents of the corporation. Among others, the bylaws may\nbe concerned with the following matters:\n(1) The authorized number and qualifications of members.\n(2) The different classes of membership, if any.\n(3) The property, voting and other rights and privileges\nof members.\n(4) The liability of the membership to dues or assessments\nand the method of collection thereof.\n(5) Procedure for the adoption, amendment, or repeal of the\nbylaws.\n(6) The time, place, and manner of calling, giving notice of,\nand conducting regular and special meetings of members or\ndirectors. (Note: the bylaws may dispense with notice of\nall regular members' and directors' meetings.)\n(7) The requirement of a quorum of directors or members.\n(Note: this may be greater or less than a majority.)\n(8) The number, time and manner of choosing or removing,\nqualifications, terms of office, official designations,\npowers, duties, and compensation of the directors and\nother officers.\n(9) The appointment and authority of executive or other\ncommittees of the board.\n(10) The admission, election, appointment, withdrawal, suspension,\nand expulsion of members.\n(11) The transfer, forfeiture, and termination of memberships.\n(12) The manner of voting by members and whether cumulative\nvoting and proxy voting will be allowed.\n(13) The making of annual reports and financial statements\nto the members.\n(14) The filling of vacancies in the membership and on the board\nof directors.\n(15) The principal business office of the corporation and the\nright of the directors to change the location of the office.\n(16) The exemption of the membership from liability for corpora-\ntion debts, liabilities and obligations.\n(17) The approval of board action taken without a meeting. (Note:\nall members of the board must consent in writing to such action.)\n(Note: Since some of the above items are pursuant to specific statu-\ntory requirements the advice of an attorney is essential to insure that the\nbylaws comply with all legal requirements.)\n(8) Other Applicable Laws\na) Federal income tax exemption provisions are contained in the\nInternal Revenue Code Sections 501 (c) (3) and (4).\n-134-\nb) California Government Code Sections 12580-12596 relating to\nthe supervision of trustees for charitable purposes provides that the\nstate Attorney General be supplied annually with certain information to\nenable him to determine whether an organization subject to the law is\nbeing property administered. This applies to nonprofit corporations or-\nganized for charitable purposes and has been interpreted to include non-\ncharitable nonprofit corporations whose articles provide that their assets\nupon dissolution will continue to be devoted to charitable purposes.\nc) County and Municipal ordinances frequently regulate charitable\nsolicitations and should be checked before any fund-raising efforts are\nundertaken.\n-135-\nD. Working for a Prosthetic Environment\n(1) Definition\nBy technical definition \"prosthetic\" means \"of prothesis\" - in\nmedicine - the replacement of a missing part of a body, such as a limb, a\ntooth, or an eye. In other words, prosthetic is a substitute. When one\nthinks of prosthetic devices one normally contemplates the artificial arm,\nleg or hand, although they do include crutches, wheelchairs and strollers.\nThe current mounting concern over establishing a \"prosthetic\nenvironment\" has concentrated primarily on the design and construction of\npublic and private facilities to take into consideration the physical handi-\ncaps of persons equipped with or compelled to rely upon prosthetic devices.\nWhile this concern for a prosthetic environment relates to all\npersons so afflicted or physically burdened, it is deemed appropriately in-\ncluded in this report since so many of such persons are in our over-65\ncategory.\n(2) The problem\nTo the 90% of our citizens who are non-handicapped, such matters as\na flight of stairs, a curb, the use of a public restroom, public telephone,\na revolving door, drinking fountain, or even getting on or off a bus or\nairplane are so routine as to go almost unnoticed in one's daily activities.\nTo the active person who seeks to enjoy his life to the fullest extent -\nfrom a wheelchair, for example - such items form insurmountable barriers.\nNot only are they physical barriers, but they also constitute barriers to\nhis enjoyment of the many economic and social opportunities of his community.\nWhile it has been estimated that 10% of today's population is handicapped,\nprojections indicate that this percentage will increase in future years.\nEvery year 100,000 babies are born with the kind of defects that will force\nthem to use crutches, braces, or wheelchairs most of their lives. In\n-136-\naddition, hundreds of thousands are crippled in traffic accidents, by combat\ninjuries and by the normal disabilities of advancing age. Accordingly, a\nprogram established now to create a barrier-free environment for the handi-\ncapped will benefit not only today's handicapped but will make life more\nmeaningful and more normal for many future generations of handicapped.\n(3) Progress\nAlthough much must be done, progress has been made in the last dozen\nyears. In 1958 the President's Committee on Employment of the Handicapped\nand the National Easter Seal Society for Crippled Children and Adults co-\nsponsored a project to eliminate barriers to the handicapped in public build-\nings and facilities. Early in his administration, Governor Ronald Reagan of\nCalifornia propelled the nation's largest state into the forefront of states\nwho were doing something constructive about the problem. On June 6, 1968 he\nsigned legislation adding Sections 4450, 4451, 4452 and 4453 to the\nGovernment Code of the State of California. This legislation required that\nbuildings and facilities constructed in the state by the use of state, county\nor municipal funds or the funds of any political subdivision of the state\ncomply with the provisions of the America Standards Association specifications\nto make buildings accessible to and useable by the physically handicapped.\nBy its language the standards were made applicable to all facilities under\nconstruction and those thereafter constructed. In 1969 Governor Reagan\nsigned legislation extending similar requirements to all structures built for\n\"public accommodation purposes\" with private funds. (Health and Safety Code\nSection 19955 et seq.) In August of 1970, the Governor signed legislation to\nenhance the enforcement of these prior provisions, and in September of 1970\nsigned further legislation broadening the applicability of such regulations\nthrough amendments to the Uniform Housing Code, Building Code, Plumbing Code,\nand Electrical Codes to additional facilities.\n-137-\nIn August of 1968, President Johnson signed the Public Law 90-480\nwhich required that all federal structures, as well as those financially\nassisted with federal funds, be made accessible to the handicapped. The law\nalso stipulated that when public structures undergo extensive alterations,\nelimination of barriers to the handicapped shall be included as part of the\ncontract. Since that time over 44 states have followed the California and\nnational pattern by establishing similar legal requirements on state-owned\nbuildings.\nIn 1967, the National League of Cities made a study of comparative\ncosts of public buildings with and without design factors necessary to\neliminate structural barriers to the handicapped. The study revealed that\nthe cost of constructing a barrier free city hall, civic center or hotel\nwould only be 1/10th of one (1) per cent more than conventionally designed\nstructures. Cost studies of seven additional building types indicated that\ncosts for these would be increased by less than one-half (1/2) of one (1%) per\ncent to accomplish barrier-free design.\nAt the request of the National Commission on Architectural Barriers\nto Rehabilitation of the Handicapped, the League also surveyed counties and\ncities as to the activities in this field. It found (in 1967) that:\n(a) The elderly and handicapped people have found very little im-\nprovement in most cities and metropolitan counties where the problem of\naccessibility is most acute.\n(b) Of the 95 cities with population of 50,000 or more that reported\nsome type of program, 39 had failed to take any official action. In 284 cities\nof this size, there was no program at all. Similarly, while 42 metropolitan\ncounties reported a program, 230 of the nation's most populous counties\nindicated that they had no program.\n-138-\n(c) Only nine (9) cities and five (5) counties had adopted or\namended Building Codes or Ordinances to take account of the standard specifi-\ncations for eliminating architectural barriers. A study of state activity by\nthe League showed similar lack of action by the states.\nThe situation, however, is improving rapidly. While detailed\nstatistics as to the number of cities and counties and states which have\nmoved aggressively forward, it is known that much activity has been taken in\nthis area. The Federal Government also has done much.\nUnder mandate from Congress, the National Commission on Architectural\nBarriers completed and published in 1968, a report on barrier-free public\nbuildings. The United States Department of Housing and Urban Development and\nthe United States Department of Transportation have developed comprehensive\ninformation and recommendations on the housing and transportation aspects of\nthe problem. The United States Department of the Interior has issued a\nreport on \"Outdoor Recreation Planning for the Handicapped\". The United States\nDepartment of Health, Education and Welfare and the President's Committee on\nEmployment of the Handicapped have financed studies of specific barriers and\nhave widely disseminated key information on developments.\n(4) New Directions.\nCalifornians aware of the problem and interested in the progress\nthat is being made, can see many tangible results of these efforts. Through-\nout our state, we have new ramps constructed to parallel staircases, asphalt\nramped curves in most cities, special parking stalls wide enough to accommodate\nthe wheelchair-bound driver, special stalls in public telephone booths and\npublic restrooms.\nMuch of this is a voluntary response to a recognized need. Much of\nthis is prompted by aggressive public information programs sponsored by the\nState Department of Rehabilitation. Much more, however, can be attributed\nto the impetus of State legislation.\n-139-\nThe real success that is and may be accomplished in this field, how-\never, rests on the shoulders of local goverment. Local government constructs,\noperates, controls and maintains a majority of public streets, thoroughfares\nand public buildings. Local government adopts and enforces the various\nBuilding Codes, issues building permits and inspects for compliance. Local\ngovernment approves subdivision design, special housing projects, community\nplanning and development. It is in these areas where the greaters progress\nis needed and can be accomplished. Are the limitations of the physically\nhandicapped and particularly the handicapped aged taken into consideration\nwhen these functions are performed? For example: is public transportation\nadequate? Are there adequate provisions for personal security of the aging\nin the areas of the local community most frequently utilized by them? Are\nthe physical distances between the places of residence and places of work\nand recreation reasonable or unduly extended? Are parks and subdivisions\ndesigned to facilitate social interaction and minimize walking distances\nbetween the areas? Are directional signs adequate and easily readable? These\nare but some of the added factors that should be considered by those currently\nemployed in designing and supervising community development.\n(5) Conclusion and Recommendations.\nMuch progress has been made in the last decade, but much more\nneeds to be done. The Federal, State and local governments each have op-\nportunities and obligations to adopt and enforce building standards on public\nbuildings that eliminate physical barriers for the handicapped. Such require-\nments may also be imposed upon existing public buildings undergoing sub-\nstantial remodeling. Similar regulations can also be logically imposed upon\nsome privately constructed facilities. The real enforcement arm, however,\nis with local government. Not only does local government approve building\n-140-\nplans, issue building permits and inspect building construction for con-\nformity, it also has effective means to control the design of subdivisions\nparks and recreational areas, streets, highways, and to some extent, public\ntransportation facilities. And local governments' role in establishing a\nprosthetic environment can be greatly enhanced if it but takes the following\nmodest steps:\n(a) Assign to its Commission on Aging the responsibility of evaluat-\ning the need and recommending a course of action. Its technical advisory\ncommittee discussed in Section C.2. (c) could be extremely helpful in this\narea.\n(b) Adopt the recommended amendments to the Uniform Buildings Codes\nto require barrier-free design in private construction.\n(c) Establish and conduct special orientation programs for members\nof the local planning staff and building inspection staff to create an aware-\nness of the problems and the avenues of solution.\n-141-\nE. SECOND CAREERS\n1. In General\nWhatever the reasons--and there are many--more persons over 65 are\ntoday seeking employment than at any previous time in our history.\nInflation, of course, is the prime cause. The purchasing power of\nretirement income has so seriously dwindled that many older workers must\neither seek employment to supplement their income or face drastically altered\nlife patterns. The California results of the community forum questionnaire\n(discussed in A. above) provides convincing evidence of this situation. While\napproximately 1.7 percent of the persons over 65 (and 7.4 percent of those over\n55) are working full time, over 3 percent (9.4 percent over 55) would like to\nbe; while approximately 8 percent of those over 65 (10.4 percent over 55) are\nworking part time, a substantially larger number (26.2 percent over 55 and\n12 percent over 65), would like to work part time. An answer to another\nquestion gives further verification of these conclusions. In response to the\nquestion \"do you always have enough to make ends meet\", over 30 percent\nresponded \"no\"!\nAnother reason for this increasing desire for employment is the\nchanging characteristics of the \"new\" over-65 class, Generally, they are\nhealthier, better educated, and have a greater life expectancy than their\ncounterparts of only a dozen years ago. Many still want, and need, the chal-\nlenge of work, the satisfaction of accomplishment, a reason for being.\nDesiring employment, however, and getting it, are two different mat-\nters for the over-65 citizen. Steadily mounting unemployment across the nation\nincreases the intensity of competition for all jobs. Thousands of returning\nveterans are entering the job market for the first time. While the Federal\nGovernment is currently investing about two billion dollars a year in various\ntypes of training and retraining programs, the older workers are receiving a\ndisproportionately small amount of these benefits. Furthermore, industry and\ngovernment alike have pension programs that discourage the employment of those\nover 65 and in many cases, prohibit the employment of those over 70.\nIn the paragraphs that follow are selected illustrations of what has\nbeen done, and what might be done, to provide job opportunities to the over-65\nsenior who wants to, or must, continue to work and earn.\n2. The Senior Service Corporation\nSeniors with marketable talents are forming themselves into profit\nor nonprofit corporations and associations to facilitate their employment.\nThis is done by drawing upon a combination of volunteer, part-time, and full-\ntime workers over 65. Such organizations can obtain optimum competitive\nadvantage in the fees they charge for their services. In Marin County,\nCalifornia, for example, the Senior Coordinating Council, a tax exempt non-\nprofit self-help charitable corporation, has taken over the operation of the\nGreyhound Bus Depot in San Anselmo. When the Council learned that Greyhound\nintended to close the depot due to high overhead and salary costs, it offered\nto take over the entire operation through the use of \"senior power\". Greyhound\nagreed and the entire operation is now continuing at less cost, with all\nservices being provided by over-65 workers.\n-142-\nAnother outstanding example of this approach is the work of Experience\nIncorporated in Riverside County, California. Experience Incorporated is a\nnonprofit corporation formed to provide research, consulting and advisory\nservices to the Hemet-San Jacinto Valley-Sun City communities of California\nthrough the use of senior citizens, experienced and talented in various spe-\ncialized fields of work. The corporation was organized in 1968 through the\nefforts of business leaders, city and county officials and industrialists, who\nwere determined to do something about the great reservoir of retired talent\nthat was going to waste in Riverside County. This waste was represented by\nthe many retired persons of the area who possessed high professional levels\nof industrial and commercial skills, but who were then idle insofar as employ-\ning these skills was concerned.\nThe plan was to match the skills of the seniors interested in work-\ning with the needs of businesses, industries, and all of the government entities\nin the county. It was to be a two-way approach to assist those seniors who\nwished to remain active, as well as those businesses and government organiza-\ntion that too often had searched far afield for talent that was available\namong retired seniors in the community.\nAt the present time, Experience Incorporated has a contract with the\nCounty of Riverside to develop a master plan for airports. It has recently\ncompleted phase one of a large real estate development in which its services\nincluded the preparation of preliminary engineering data and the obtaining of\nnecessary zoning changes. Public relations and advertising material is being\nprepared for the local Chamber of Commerce. Contracts have been negotiated for\na complete study of the County and State fire services. Some of the ladies are\nemployed to participate in the contract by which Experience Incorporated pro-\nvides bulk mailing services for the county. An economic survey of the Hemet-\nSan Jacinto Valley has been completed and several other sizable ventures are\nin the making.\nThe initial success of Experience Incorporated has led to an expansion\nof its objectives into other related fields. In addition to consulting and\nresearch services, it is now involved in the placement of seniors in part-time\nor occasional jobs on a referral basis in which no fee is accepted from either\nthe employer or the employee. As a result of this expanded activity, seniors\nhave been placed in such varied assignments as purchasing agent, bookkeeper,\nchemical engineer, athletic commissioner, sales representative, transportation\nsupervisor, travel agent, machinist and mill operator, typist, automobile\nservice instructor, teacher, draftsman, script reader and many others.\nExperience Incorporated also found that many retirees had rendered\nimpressive services in the field of civic and cultural activities. As a\nresult, the corporation takes an interest in community affairs and encourages\nits membership to participate, although on a strictly voluntary basis. Thus,\nExperience Incorporated is involved in three separate phases of senior citizen\nactivities. First, contracting with business and government to render services\nin the area of research and consultation; secondly, acting as a clearinghouse\nfor the placement of individual seniors in part-time or occasional jobs, and\nthirdly, adding its support and the support of its members to voluntary civic\nor cultural projects.\nExperience Incorporated offers positive proof that senior citizens can, with\nproper organization, get back into the \"mainstream\". Following a one-day\nseminar recently sponsored by Experience Incorporated with the theme \"Adding\nMore Life to Years\", John B. Martin, U.S. Commissioner on Aging, sent a tele-\ngram to the organization which read in part \"I should like to see seminars\n-143-\nlike yours and organizations like yours repeated in communities throughout\nthe nation. America is wasting its finest resources by denying to so many\nolder Americans the opportunity to serve. It may be that this wastage will\nnot end until senior citizens everywhere organize as you have done to make\nyour skills and your experience available to your community\".\n3. Government Service\n(a) Full time. The senior seeking placement in a new hire\" full-\ntime civil service job in government faces the same barriers found in private\ncorporate employment. Generally, the over-70 worker is barred by the terms\nof the applicable pension plan that requires retirement at 70, if not earlier.\nThe under compulsory retirement age applicant faces the bias--and the now\nproven unfounded bias--of the selecting authority that the younger applicant\noffers the employer more years of service and is thus preferred. Recent\nstudies indicate that the potential longevity of the younger employee is\nseldom realized and that the older worker actually works more years for the\nemploying agency than does the younger applicant.\nThere are, of course, in every governmental agency a select few\n\"exempt\" positions that are subject to no age or talent requirements and which\nare filled by appointment of the reigning political authority. These positions,\nhowever, are so limited in number as to have no measurable effect on employ-\nment of the aging even though seniors are by no means barred from such\nappointments.\n(b) Part time. The public employees retirement system in California\nwhich covers 441, employees of the State of California and 2,610 other\nemploying public agencies that contract with the system, currently provides for\na mandatory retirement at the age of 70. However, it offers the applicant for\npart-time work an intriguing exception to the grim situation applicable of\nseekers of full-time employment. Excluded from the mandatory participation\nin the retirement system--and thus from the mandatory retirement provisions--\nare part-time employees who either work less than half-time, or work part time\nbut more than half-time for less than one year. This exclusion opens a\ntremendous field for qualified seniors who wish to work. It also opens to\ngovernment the available resources of senior talent in many fields. Government,\nlike industry, experiences seasonal work loads which can and in some cases are,\nhandled by qualified seniors. Examples of seasonal work loads include, at the\nState level, the Department of Motor Vehicles, Department of Agriculture,\nFranchise Tax Board, and at the local level the County Tax Collector and City\nand County Recreation Departments. Furthermore, a potential area of part-time\nemployment by seniors may develop as the government becomes more heavily in-\nvolved in the sponsoring of day care centers for children. The success of the\nuse of mature experienced part-time help in the care of children is demonstra-\nted in the \"latch key program\" discussed in Section 4. below.\nThe extent to which seniors will be provided part-time job opportuni-\nties in government is limited only by the commitment of the governing bodies\nof the various public agencies to this concept. Accordingly, it becomes in-\ncumbent upon the local commissions on aging in each community to conceive a\nrealistic program in which seniors can be employed part time and \"sell\" such\nprogram to their governing body.\n(c) Government Services by Contract\nThe success of Experience Incorporated discussed above also opens\nmany potentials for incorporated groups of seniors to contract with local and\n-144-\nstate government for the purpose of providing limited governmental services\noutside of normal Civil Service requirement. Until recently Article XXIV of\nthe California Constitution strictly limited the authority of State and local\ngovernments to contract governmental or quasi governmental services out to\nprivate agencies. A recent decision, however, in the case of California State\nEmployees Association vs. Spencer Williams, (7 CA 3rd, 390), has somewhat\nrelaxed the former rule, the Court holding that \"a new state function not\npreviously conducted by any state agency and performed by contract under\nlegislative direction and authority\" may be contracted out without violating\nthe Constitutional provision. Accordingly, if in the future the state or any\nlocal governmental agency embarks upon some new function, the governing body\ncould authorize its performance by contract with private or public individuals\nor corporations. Here again, it would be encumbent upon the Commission on\nAging at either the state or local level to be alert to any proposed new\ngovernmental functions and be prepared, where appropriate, to encourage the\ngoverning body to provide for the performance of such function by contract\nwith an organization composed of seniors.\n(d) Special Government Projects\nA number of special research and development projects in programs\nfor the aging have been sponsored by the Federal Government, by state govern-\nment, and by local governments. As the success of these programs become estab-\nlished, consideration may be given to their adoption as a permanent program of\ngovernmental service. The following are several examples of experimental pro-\ngrams which may have sufficient merit to warrant their continuation on a\npermanent basis.\n(1) The \"Adult Aid\" program of Orange County.\nOrange County has established a procedure to facilitate the rendering\nof in-home services to the aging. A Welfare supervisor is assigned the duty\non a weekly basis to match-up needs for services with persons able to serve.\nThe County reports \"we actually help hundreds of elderly persons in Orange\nCounty each month from being institutionalized by finding someone to provide\nthe services they need to enable them to stay in their own homes such as help\nwith meal preparation, heavy house cleaning, yard work and even personal care\nsuch as help with baths, taking medicine, etc.\". The County indicated two\nexamples of how the program worked. In one example, a social worker reported\nto the supervisor the need of an elderly man for some household help so that\nhe could stay in his home rather than be institutionalized. At the same time,\nan intake worker in the Welfare Department reported to the supervisor that an\nolder able-bodied widow, skilled as a housewife, had applied for Welfare\nassistance because she could not obtain employment due to lack of marketable\nskills. The supervisor arranged the assignment of the widow to a job as house-\nkeeper for the elderly man. In this way, his institutionalization was avoided\nand her employment avoided the necessity of her receiving Welfare aid. The\nsecond example also concerned the referral of an applicant for Welfare aid to\nserve as attendant to an older man not receiving aid. The woman was hired as\nan attendant and later married the man. In the optimistic words of Orange\nCounty \"there will be no need for her to ever apply for public assistance\".\n(2) Love to Share.\nA federally sponsored program in the State of Arkansas called \"Love\nto Share\" has great potential as a continuing government project. The program\n-145-\nmatches older people who need part-time employment with youngsters who need\nlove and supervision. It is specifically directed at \"latch key children\":\nthose youngsters whose parents are not at home during after school afternoon\nhours due to employment. The seniors, most of whom are between 63 and 65,\nstaff the centers where the children are supervised. The centers are equipped\nwith study rooms and kitchen facilities and offer games, music and other\nactivities for the children. The seniors are first required to complete a\nthree-week orientation program. Thereafter, they are employed at the rate of\n$1.60 per hour, partly contributed by the Federal Government and partly by the\nUnited Fund of the community. A survey of the community in question showed\nthat there were 70,000 persons over the age of 55 living on incomes of less\nthan $1,500.00 a year. It also indicated that there were 1,500 children in\nthe community who did not have a parent at home after they were let out of\nschool, and that many of these children were developing severe disciplinary\nproblems. The project thus serves two worthwhile ends. It provides love and\nattention for these children during the afternoon hours and it provides part-\ntime employment opportunity for the older citizens of the community.\n(3) Green Thumb and Green Light\nGreen Thumb is a work program for older men sponsored by the National\nFarmers Union. It operates under a grant from the Department of Labor as a\npart of its \"Mainstream\" program.\nTo be eligible for participation in the program, a person must:\n(1) be at least 55 years old, (2) have a farming or rural background, and\n(3) be below the poverty income level. The average annual income for parti-\ncipants is $900 but the program permits them to earn up to $1,500 per year.\nWorkers under this program have improved or built more than 350 roadside parks\nin rural America; planted more than one million trees, flowers and shrubbery;\nand helped to restore and develop many historic sites.\nNow operating in 17 states, the most obvious fact about Green Thumb\nis the quality and quantity of work that is performed. Green Thumbers put\nsomething special into their work and the cooperating agencies notice it im-\nmediately. That \"something special\" is pride. Workers who had come to believe\nthat life was over for them join a Green Thumb crew and discover long-forgotten\nor new talents in themselves. One of the most heartening results of the pro-\nject is that doctors report that the health of the workers usually improves\nafter working for Green Thumb.\nLocal communities appreciate their work because they see the results\nas parks are improved, trails constructed for the benefit of visitors and\nvacationers and roadsides cleared for beauty and safety. The total jobs they\naccomplish are too numerous to mention.\nThe Green Light program was established to provide employment oppor-\ntunities primarily for low income women 55 or older, operated as a component\nof the Green Thumb program. Workers can earn up to $1,500 annually by working\nthree days a week like the Green Thumb participants at a salary scale of $1.60\nper hour. Workers provide community services as aides for teachers, nurses,\nlibrarians, senior citizens, school lunch programs and food stamp programs.\nThese programs provide employment opportunities for more than 3,000\nlow-income people in rural America and have helped to remove more than 10,000\n-146-\npeople from the poverty category as well as giving the older, seemingly for-\ngotten aged person a sense of accomplishment and the feeling of again being\na part of, and contributor to community life.\n(4) Community Representatives\nAt the request of the California Commission on Aging, the State\nPersonnel Board established a special job classification of \"community\nrepresentative\". This is a part-time job with the maximum monthly salary at\n$140.00. Experience indicated, however, that many persons working in this\nclassification worked on a voluntary basis far in excess of the maximum 50 hours\nallowed for compensation. The $140.00 per month maximum was set so as not to\nconflict with Social Security regulations which would require a reduction in\nthe employee's Social Security allowance for earnings in excess of $140.00. The\ntypical task of such an employee is to work with trained individuals in their\nassigned community to assist in identifying community needs and resources\nrelated to aging persons and to assist in stimulating the interest of influen-\ntial members of the community and community organizations in programs for the\naging. Minimum qualifications were set forth in the job specification (See\nfootnote\n) and although no age \"exclusion\" was established, the require-\nment of one year of experience with senior citizen groups in a leadership\ncapacity tended to limit those employed to the over 65 classification.\nThe above are only a few examples of many government oriented pro-\ngrams that lend themselves to continuation under government sponsorship. Per-\nsons interested in stimulating job opportunities for senior citizens will find\nmany other similar programs described in reports issued by the Special Com-\nmittee on Aging of the United States Senate.\n4. Part-Time Employment Opportunities Through Special Referral\nServices Established for This Purpose.\nIn recognition of the special need for seniors to secure part-time\nemployment, a number of special employment referral services have been devel-\noped in many communities in California. Some of these operate on a volunteer\nbasis, others are funded by public and private contributions. The following\nis a compilation of such services in California that have come to the attention\nof the California Commission on Aging.\n(1) Job Mart\n3101 Cottage Way\nSacramento, California 95825\nMrs. Frances Austin\nTo secure full- or part-time jobs for seniors.\n*\n(2) SCORE\nSmall Business Administration\n450 Golden Gate Avenue\nSan Francisco, California 94102\nTo assist small business by referring retired executives to serve\nin an advisory capacity. Fees are arranged between the company and the\nreferred person.\n***\n-147-\n(3) Marin Senior Coordinating Council, Inc.\n914 - 5th Avenue\nSan Rafael, California 94901\nMr. Ed Ryken\nTo assist seniors to supplement their incomes by part-time work.\n***\n(4) Senior Employment Service\n2466 - 8th Street\nLivermore, California 94550\nMrs. Lillian Snorf\nTo provide part-time jobs for older people and serve the needs of\nthe community, this is in the same facility as a teen employment program.\n***\n(5) Service Center for Senior Citizens\n1435 Grove Way\nHayward, California\nMrs. Emma Vargas\nTo provide part-time jobs for seniors in the community.\n***\n(6) Project Hire\n106 West Sixth Street\nSan Bernardino, California 92401\nMr. Verne Pomeroy\nTo find gainful employment for proverty stricken seniors and lift\nthe morale and give them an understanding of their importance as individuals.\nThey are informing business and industry that older citizens can be productive.\n***\n(7) Jobs for Seniors\n1539 Euclid\nSanta Monica, California 90404\nMr. Earl Brainard\nTo obtain jobs for seniors in full- or part-time situations. They\nutilize volunteers to conduct their program.\n***\n(8) Careers for Retired Military, Inc.\nP. 0. Box 9068\nPresidio of San Francisco, California 94129\nMr. William F. Train\nTo assist retired and retiring military find new careers in the\ncivilian community. They provide counseling and referral services.\n***\n-148-\n(9) Careers for Women, Inc\nFairmont Hotel\nSan Francisco, California 94109\nMrs. Mildred Stern\nTo provide assistance, counseling and referral to older women.\nThey utilize volunteers to operate the program.\n***\n(10) Project Work\n215 Long Beach Boulevard\nLong Beach, California 90802\nMr. Samuel K. Bell\nProvides information and referral services to older people looking\nfor jobs. Does job development and placement in conjunction with HRD Center.\n*\n(11) Experience, Incorporated\n26951 Cawston Avenue\nHemet, California 92343\nMr. C. Harold Holmes\nSolving problems of industrial corporations, small businesses,\ngovernment agencies and municipalities on a contract basis, utilizing the\nvarious skills possessed by the retired segment of our community.\n***\n(12) Leisure World STARS\n23561 Paseo de Valencia\nLaguna Hills, California 92653\nMr. Alfred H. Foxcroft\nTo assist Leisure World residents to find gainful employment. They\nuse Volunteers to conduct the program.\n***\n(13) Mature Temps\n215 Long Beach Boulevard\nLong Beach, California 90802\nMr. S. J. Porter\nTo secure placement of older persons in temporary jobs. Persons are\npaid by Mature Temps rather than the employer. The employer pays only on an\nhourly basis.\n***\n(14) Mature Temps\n3636 West 6th Street\nLos Angeles, California 90005\nTo secure placement of older persons in temporary jobs. Persons are\npaid by Mature Temps rather than the employer. The employer pays only on an\nhourly basis.\n***\n-149-\n(15) Mature Temps\n11 - 3rd Street\nHearst Building\nSan Francisco, California 94103\nTo secure placement of older persons in temporary jobs. Persons are\npaid by Mature Temps rather than the employer. The employer pays only on an\nhourly basis.\n***\n(16) Retirement Jobs, Inc.\n161 No. First Street\nSan Jose, California 95112\nMr. Jules Eshner\nTo assist retired persons to keep active and supplement their\nincomes through full- or part-time employment and serve the community needs.\nThey have five branch offices serving three counties. Offices are\nin San Jose, Los Gatos, Palo Alto, San Mateo, and San Francisco.\n***\n(17) Careers for Fifty Plus, Inc.\n114 So. Sutter Street\nStockton, California 95202\nMrs. Kathryn Higgins\nTo provide counseling and job placement for persons over 50. To\nillustrate to employers that older people can be valuable in their business\noperation.\n***\n(18) Continued Employment & Activity for the Retired\n610 So. Kingsley Drive\nLos Angeles, California 90005\nMr. Arthur Daneman, Project Director\nTo assist retirees' search for full- or part-time employment and to\nencourage employers to utilize senior talent.\nC E A R offices are as follows: Main office 601 South Kingsley\nDrive; Branches, 2512 South Central Avenue, Los Angeles; 5301 Tujunga,\nNorth Hollywood; 11308 Weddington, North Hollywood; 119 North Fairfax,\nLos Angeles; 828 Mesa, San Pedro; and 11338 Santa Monica, West Los Angeles.\n***\n(19) Experience Unlimited\n235 - 12th Street\nOakland, California 94607\nMr. Paul E. Herman\nA cooperative group of executives, administrators, scientists,\nengineers and experts in various fields, who contribute to and benefit from\nweekly group discussions concerning how to seek work and current labor market\ninformation. Primarily all are from middle management and above.\n***\n-150-\n(20) Partime\n1044 No. Waterman Avenue\nSan Bernardino, California 92410\nMr. R. S. Parker, Director\nTo secure gainful part-time employment for retirees by utilizing\ncounseling and testing for new careers.\n(21) Senior Activities & Employment\n210 Park Avenue\nEscondido, California 92025\nMrs. Dee Furnal\nTo secure part-time employment for older persons. Counseling pro-\nvided to utilize all skills and abilities.\n(22) Senior Placement Services\n1685 Commercial Way\nSanta Cruz, California 95060\nMr. Marshall Cheney\nTo obtain part-time work for older people and to serve older people\nwhen they need jobs done.\n5. Other Programs\n(a) In General\nIn addition to the programs discussed above, a number of other pro-\ngrams for the aging are currently under way in California. Some are sponsored\nand funded by private agencies, others are funded by a combination of private\nand public funds, and still others are fully funded by the Federal Government.\nWhile it would be difficult to identify all of the many worthwhile activities\nin this field, the material in (b) and (c) below is indicative of the total\nscope of these efforts.\n(b) OEO Founded Projects\n(1) Greater East Los Angeles Senior Citizens Foundation\n3864 Whittier Boulevard, Los Angeles 90023\nIn one component Los Angeles has developed an employment and train-\ning program. Over the course of a year, the project trains 120 older poor\npersons, mostly Mexican-American and Negro. The trainees are counseled,\ngiven 200 hours of instruction as nursing aides, and placed in jobs at\nhospitals, nursing homes, and community agencies. The project works through\ntarget areas in East Los Angeles. South Central Los Angeles also assists\nolder poor persons to become involved in their communities.\n-151-\nAnother component gives staff to EYOA to monitor aging programs in\nLos Angeles, including an NCOA, Senior Service Corps program, an East\nLos Angeles multi-lingual vocational training center, and a Foster Grand-\nparents program funded by HEW.\n***\n(2) Community Planning Council\n939 North Fair Oaks, Pasadena 91103\nPasadena operates a FIND-type outreach program. The staff of eight,\nwhich includes a social worker and four community aides, locates, counsels\nand identifies the unmet needs of elderly people in the Altadena-Pasadena area.\nThe staff uses existing community agencies to assist in resolving special\nproblems of the elderly. Ongoing program planning includes involvement in\nspecial housing needs for the elderly, food stamps, \"getting the most\" for\nthe shopping dollar, demonstration of low cost preparation and serving of\nmeals, and block social activities.\n***\n(3) NRTA and AARP\n215 Long Beach Boulevard, Andrus Building, Long Beach 90802\nThis is a project of the National Retired Teachers Association and\nthe American Association of Retired Persons. Project W.O.R.K. has a diversi-\nfied program using 23 personnel in agencies and 16 as community aides. It has\nfour specialist component areas: (1) job referral, counseling, and placement\nin cooperation with the local Human Resources Development Center; (2) informa-\ntion and referral services; (3) friendly visiting outreach program; (4) con-\nsumer education and protection services.\n* * *\n(4) Sonoma County People for Economic Opportunity\n1617 Terrace Way, Santa Rosa\nThis program will be co-sponsored by four agencies: OEO, HEW,\nUnited Crusade and the Council on Aging. The funds from OEO will be used for\noutreach, health, and unemployment. Proposed funds from HEW will be used for\ntransportation services of the elderly poor to wherever the aged must be\ntransported. Council on Aging will provide for recreational activities and\nUnited Crusade will pay the salary for the overall coordinator and for rec-\nreational activities. The program will deal with: (1) loneliness, social\nand economic isolation; (2) untreated health problems or failing health;\n(3) unemployment, decreasing or inadequate income; and (4) immobility/lack\nof transportation.\nObjectives: To raise the level of concern for the elderly poor by\nboth the social and the legislative community; to link older people with\nvarious services available through existing service agencies; to enhance the\ncommunity's utilization of untapped human resources and design and develop\na five-year master plan for the continuing benefit of the older poor.\n***\n-152-\n(5) North Coast Opportunities, Inc.\nP. 0. Box 488, Ukiah\nNorth Coast originally developed this program as a training project\nfor nonprofessional welfare workers. Four aides were trained and have been\nworking in relation to the Lake County Welfare Department. The staff helps\nlocate aging poor persons, assess their needs and identify resources to meet\nthose needs. They have helped organize several senior groups. They have\narranged for limited bus services and for a nutritional program. They are\nworking to have the surplus food program extended to Mendocino County, and a\nhousing authority established for both counties.\n(6) Senior Opportunity Development Outreach\n476 Park Avenue, San Jose 95110\nOutreach program based on FIND concept. Information and referral\nthrough seven established neighborhood service centers. Program is very much\noriented to minority groups.\n(7) Solano County Economic Opportunity Council\n1027 Alabama Street, Vallejo 94590\nThe Senior Opportunity Service project in Solano County is a follow-\nup of a project FIND that interviewed 12,000 older adults, identified major\nareas of need, and made referrals to existing agencies. This Solano project\ndeveloped a discount card program, which enables impoverished old adults to\nbuy from some 200 Vallejo merchants at about a 20% discount. The project\ncontinues its outreach activities, utilizing a number of volunteers; has\ninitiated classes in diet and pre-retirement planning; and is developing\nrepair co-op clubs. The project has helped to create a county-wide senior\ncitizens council.\n(8) EOC of Berkeley Area\n2054 San Pablo Avenue, Berkeley\nDuring the past year, the Berkeley project organized the Senior\nAssociation Group and Enterprises (SAGE), which operates through centers at\nrecreation grounds in West and South Berkeley. The Center program is educa-\ntional and also serves to concern itself with community problems like housing.\n(9) Economic Opportunity Commission of Imperial County\n795 Main Street, El Centro 92243\nThe staff of the Senior opportunities project in Imperial County\nhelp to operate 11 senior clubs, three Spanish-speaking and eight English-\nspeaking. These clubs, operated primarily by volunteers, make articles to\ngive to shut-ins; have knitting classes; arrange for visits to sick older\npersons; and provide fellowship for isolated older persons. The clubs have\nbecome involved in local community issues, such as lobbying for sewage systems\nor for more parks.\n-153-\n(10) Economic Opportunity Commission of San Diego County\n861 Sixth Avenue, San Diego 92101\nSan Diego's Senior Citizens in Action project operates a varied\neducational and informational program from a multi-purposed senior citizens\ncenter. They have adult education classes in sewing, financial management,\nconsumer education and diet. They also provide information and referral\nservices to help older poor persons gain help in leading fuller, healthier\nlives. The project hopes to develop a health education program as well as\na pre-retirement program. They are helping to merchandise articles made by\nthe senior citizen sewing class.\n***\n(11) Marin Senior Coordinating Council\n914 - 5th Avenue, San Rafael\nThe agency has focused its efforts on community organization of\nsenior groups throughout the community. They have divided their program into\nseven areas: Counseling, employment, housing, transportation, recreation-\neducation, community service, and health. A staff member and an advisory\ncommittee are working in each area. They have sponsored two ballots for hous-\ning referendum within the community to provide additional units of low-income\nhousing; they have an ongoing scheduled bus service throughout the community;\nand they are retraining senior citizens for paid jobs in convalescent hospitals\nas recreation staff. Between 1968 and 1970 they helped expand the number of\nsenior organizations from six to 52.\n***\n(12) South Alameda County Economic Opportunity Agency\n1435 Grove Way, Hayward 94541\nThe agency serves seniors through: Meals-on-Wheels; general services;\nrecreation; and food stamp distribution.\n(13) Monterey County Anti-Poverty Coordinating Council\n6 West Gabilan Street, Monterey\nProject New Horizons is a FIND-type outreach program designed to\ndiscover and to help organize the elderly poor, the largest portion of whom\nare Mexican-American and Filipino agricultural workers. From an initial\nemphasis on identification and counseling of the needy older poor persons,\nProject New Horizons has shifted towards development of senior centers, the\nestablishment of adult educational classes, and the starting of Foster Grand-\nparents and other community action programs.\n***\n(14) Stanislaus County Community Action Commission\n920 - 10th Street, Modesto\nInformation-referral program; counseling; recreational and social\nactivities. Nine senior aides, all over 55, call on the elderly poor through-\nout the county to ascertain their health needs, living conditions, and what\n-154-\ninterests they have. The project makes contacts and referrals to social\nservice agencies, Social Security, and legal offices in their behalf; and\ninforms those who are sick of visiting nurses' services.\n(15) Project SCOUT of Community Action Agency\n128 Van Ness Avenue, Watsonville 95076\nProject SCOUT is a follow-up of Project FIND. Elderly, outreach\naides seek out elderly poor persons in Watsonville and Santa Cruz areas, in-\nform them of services for which they are eligible, refer them to existing\nagencies, and offer friendly assistance. The staff is equipped to interpret\nSpanish and Filipino. In addition to their outreach work, SCOUT has developed\neducational programs on consumer problems, job opportunities, and language\nskills. The staff has helped to initiate a Foster Grandparent program and a\nSenior Crafts Cooperative. They have developed and funded a county-wide\nCommission on Aging which will provide staff for four senior activity centers,\nas well as doing community organization on a county-wide level.\n(16) Self-Help for the Aging\n55 Fifth Street, San Francisco 94102\nThis program operates in all the target areas of the poverty program\nin San Francisco. The elderly community organizer aides distribute informa-\ntion and help to organize senior clubs and new services catering to the elderly\npoor.\n(17) Dependency Prevention Commission\nCounty of San Bernardino\n106 West Sixth Street, San Bernardino 92401\nThe goal of this project \"HIRE\" is to place the older persons in\nnew career positions. Over the past year, this project has hired several\ndozen senior aides, secured training for them, and by a process of job-\nupgrading has also placed them as aides in the welfare and probation depart-\nments, in the school systems, and in senior centers. In addition, project\nHIRE encourages private employers to hire older persons, works to create new\njob opportunities in government and nonprofit agencies and provides an\nintroductory training session for persons about to re-enter the labor market.\n(18) Shasta County Community Action Project\n1134 Pine Street, Redding 96001\nShasta has developed an outreach program to identify and serve the\nneeds of the elderly poor in this rural area. In addition to this basic out-\nreach program, this project is moving in three directions. One, they are\naugmenting and training a volunteer corps to aid with nutritional and con-\nsumer education program; two, they are establishing an umbrella center as\n-155-\nfocal point for activities; and three, they are establishing a gift shop\nwhere older persons can merchandise articles.\n(19) Council of Older American Organization\n1259 Broadway, Fresno 93721\nFresno has developed a learning and cultural center where older\npersons develop skills in various visual arts through a series of classes\nstaffed by older persons skilled in these arts. In addition to the learning\ncenter and another center recently established at a Congregational Church,\nthe project hopes to set up several other neighborhood centers to expand\ntheir services to more persons in minority groups. The school department\nhas agreed to help fund some of the staff work.\n* * *\n(c) Special Research and Training Projects Funded by\nAdministration on Aging or other Agencies\n(1)\nNAME:\nLos Angeles Labor Retiree Research Report\nADDRESS: 2130 West Ninth Street, Los Angeles 90006\nSPONSOR: Los Angeles County Federation of Labor, AFL-CIO\nPURPOSE: To secure information that will produce a profile of the retired\nunion members, determining their economic and social status, their\neducational and recreational opportunities, and their needs and\ndesires in respect to programming for the present and the future;\nto determine the use that retirees make of existing services, the\nneed for informational centers on services, and the desirability\nof establishing counseling service centers.\nPROGRESS: Every 10th member on union member retirement lists was invited to\ncome to the Machinists Building for an interview of approximately\none-half hour. A total of 1,268 interviews were conducted.\nWith regard to retirement problems, 392 seniors cited Health,\n385-Finances, 67-Having nothing to do, 33-Loneliness, 13-Other,\nand 377 seniors commented that they had no major problems at all.\nReasons for retirement included: By Choice - 420, Mandatory Age\n404, Health - 389, Job Abolished - 34, Illness of Spouse - 12,\nand Other - 8.\nAfter retirement, time devoted to the following activities increased:\nHobbies, television, lodge or club activity, reading, adult educa-\ntion, visiting friends and civic participation.\nInterest in future union sponsored activities included: Travel\nTours 48%, Retirement Club 46.7%, Retirement Meetings or Dinners\n42.6%, Social or Recreational Activities 30.1%, Educational or\nCultural Activities or Events 13.3%, and No Interest in Any Such\nActivities or Events 20.3%.\n-156-\nEvaluation of their health: Good 48.8%, Average 33.7%, and\nPoor 17.5%.\nHealth comparison before/after retirement: Better than it was\n23.6%, About the Same 57.1%, and Poorer 19.3%.\nHousing: Own home 62.1%, Pay Rent 36.8%; Other 1.1%.\nMain source of transportation: Own car 71.2%; Bus 23.7%;\nDependent on others 4.5%; and Other .6%\n(2)\nNAME:\nTechniques for Improving Nutrition in the Aged\nADDRESS:\n9015 Fullbright, Chatsworth 91311\nSPONSOR:\nENKI Research Institute\nPURPOSE:\nTo assess relative costs and benefits of the different approaches\nbeing demonstrated (in some 25 projects) to improve nutrition\namong the aging; and to be supported under the Administration on\nAging's Title IV grants.\nPROGRESS:\nThe project is management of all AOA nutrition programs, with\nresearch on the impact of nutritional effects on older people.\nDiet survey of older Americans also researched. Does not serve\nsenior citizens directly.\nData collected and to be analyzed concerns participants, program\ntechniques and procedures, and costs\n(3)\nNAME:\nDepartment of Labor and National Council of Senior Citizens Grant\nADDRESS:\n534 - 22nd Street, Oakland 94612\nSPONSOR:\nSocial Service Bureau of Oakland, Inc.\nPURPOSE:\nTo create socially useful part-time jobs in the community to be\nfilled by low-income elderly (over 55) and to demonstrate what can\nbe accomplished by retirees and the older worker and to project a\npositive image of the older adult. This project is funded by the\nlocal United Bay Area Crusade to the Social Service Bureau of\nOakland and the Department of Labor through the National Council of\nSenior Citizens to the Social Service Bureau of Oakland. This is\na pilot program, one of 19 projects across the country. Oakland is\nfunded for 60 job positions to be utilized by nine different agencies\nextended services to the older adult.\nCharacteristics and number of people served: 60 senior aides are\nworking in nine different agencies in Oakland. Approximately 1,500\nto 2,000 older adults are served in this program. The senior aides\nare working in such agencies as Convalescent Hospitals. The Oakland\nRecreation Department Senior Citizens Program, the Social Service\nBureau's Senior Action Project, and Residental Care Homes. Services\nvary from helping the people with their transportation, housing,\nemployment, etc.\n-157-\nPROGRESS: The senior aides are able to bring a more accurate accounting of\nthe needs of the older adults in the community back to the various\nagencies. The senior aides have become independent because of:\nThe income from the job; and increases in their personal worth; a\nsense of belonging; an increased productivity in their retired\nyears; and from their contributions to the community.\nTopics considered: The problems of indvidual care for the elderly\nin the community. Finding the needs of elderly and helping to\nsecure the services for them. The needs may be companionship,\nrecreation, housing, employment, financial assistance, etc.\n(4)\nNAME:\nHot Meals for the Elderly\nADDRESS:\n427 West Fifth Street, Los Angeles 90013\nSPONSOR:\nSenior Citizens Association of Los Angeles County\nPURPOSE:\nTo locate and involve seniors in a program directed toward provid-\ning \"specific feedings of suitable foods\". To provide, at the same\ntime, nutrition education aimed at improving the dietary habits of\nthe seniors. To find and isolate factors which most influence the\neating pattern of the seniors. To test the use of the public schools\nto provide nutrition education for the older adult. To dispense\ninformation about Food Stamps and surplus foods. To act as an\ninformation and referral center for those seniors needing additional\nhealth and welfare services. To provide direct service and counsel-\ning. To provide the means by which the seniors affiliating with\nexisting senior activities could provide a \"self help\" service to\nother seniors.\nPROGRESS:\nAn average of 75 seniors are served a day, one meal, four days a\nweek.\nThese people are all \"fringe\" people, that is, they operate on a\nlow fixed income. Some are now operating on $500 a month, but some\nduring their working years earned as much as three times (or more)\nper month and they are only getting by. In short, their standard of\nliving is much lower now than during their years of employment. None\nare wealthy.\nWhen they were funded for a three-year project, they received\n$198,000. As of October 1, 1970, $136,000 had been spent.\nEthnic characteristics: They are serving in four sites. In total,\nthe breakdown would be: 50% Caucasian, 26% Mexican-American, and\n24% Black.\n-158-\n(5)\nNAME:\nOperation Reach-Out\nADDRESS:\n427 West 5th Street, Los Angeles 90013\nSPONSOR:\nAllied Senior Citizens' Clubs, Inc.\nPURPOSE:\nTo find older persons who have become inactive and socially\nisolated, and in the course of this effort test methods of improv-\ning their situation through cooperative efforts of private and\ngovernment agencies, community and religious groups; to make a\nspecial effort to reach older persons whose normal stresses of\naging are aggravated by poverty and increased social isolation.\nPROGRESS:\nGoal for recruitment: To start clubs for older people and to help\nrecruit club members. Achievement: Total of 25 clubs and 752\nmembers, recruited mostly in 1968 in South Central and East\nLos Angeles areas of the county.\nGoal for types of persons reached: To recruit club members who\nwere aged, socially isolated, and poor residents of a poverty\narea. Achievement: All of those reached were residents of three\nmajor poverty areas; the majority were 65 years or older and\nreceived less than $2,000 per year.\nGoal for satisfaction of member needs: To bring club members a\nvariety of interesting programs, and to acquaint them with com-\nmunity services and facilities. Achievement: Members feel that\ntheir clubs are an important social outlet, but the majority desire\nsome new club activities. Member knowledge of how to find community\nservices is low.\n(6)\nNAME:\nSocial Work Teaching Grant in Services For the Aging\nADDRESS:\n349 Cedar Street, San Diego 92101\nSPONSOR:\nField Center on Aging (San Diego State College)\nPURPOSE:\nTo give graduate students a broad range of experiences in dealing\nwith older individuals.\nPROGRESS:\nThe project is unusual in that it utilizes a team approach of all\nfield instructors working as a collaborative unit. It provides\npractical experience which will contribute to (1) a mastery of pro-\nfessional social work practice; (2) self-discipline in the admin-\nistration of professional services; (3) the integrated use of\nknowledge, attitudes, and techniques in achieving social work goals;\n(4) a broad knowledge and appreciation of the functions of social\nwork and through the use of this knowledge the center seeks to in-\nvolve the students in providing an opportunity to achieve their\ngoals. Thus, individual, group, and community organizations\nexperiences are individually tailored to suit individual needs,\ncharacteristics and number of people served.\n-159-\nStudents are initially assigned Old Age Security Cases with the\nSan Diego Department of Public Welfare, and are also delegated to\nconvalescent hospitals, Commission on Aging projects, Community\nWelfare Councils, the OEO funded Program, Project 45 HRD, Senior\nAdult Services, Ecumenical Council on Aging, Cedar Community Center,\nCentral Christian Church, Senior Advisory Council, San Diego City\nDepartment of Recreation, Comprehensive Health Planning Association,\nAllied Home Health Services, Jewish Community Center, and the Social\nSecurity Office. The students attend workshops, such as Disabled\nOlder Workers meetings, Volunteer Workshops, and Gerontological\nSociety meetings. The entire senior population of San Diego is\nhelped directly or indirectly by the services of these students.\nThe project presently has 32 students enrolled at the three levels\nof education, 18 graduates are employed in senior citizen projects.\n(7)\nNAME:\nCommission on Aging of Community Welfare Council\nADDRESS:\n520 E Street, San Diego 92101\nSPONSOR:\nCommunity Welfare Council\nPURPOSE:\nTo improve conditions for San Diego senior citizens, based upon\ntheir needs, by liaison, implementation and research in response\nto a request from the Senior Citizens Advisory Committee.\nPROGRESS:\nProfessionals and community leaders are serving on the Commission.\nAt their monthly meetings they:\n1. Discuss and support pending bills concerning the welfare of\nsenior citizens.\n2. Become informed on existing services such as the Department\nof Public Welfare, etc.\n3. Coordinate efforts of groups working for senior citizens.\n4. Support and strengthen existing programs.\n5. Cooperate with\na. The Mayor's Committee\nb. The County Administrative Officer in establishing the\nCounty Department of Senior Citizen Affairs.\nC. Project 45 (Employment Lab) of the California Department\nof Human Resources Development.\nd. California Commission on Aging on local programs.\n6. Disseminate information such as the State Senior Citizens'\nProperty Tax Assistance Law to senior citizens by soliciting\nthe help of local agencies both governmental and private.\n7. Develop additional services such as\na. A Consumer Fair, \"A Senior Citizen Happening\".\nb. Preliminary planning for the White House Conference on\nAging.\nThe San Diego Commission on Aging is the advisory committee for\nSenior Aides Project, which is financed by the U.S. Department of\nLabor to assist 60 seniors of low income by placing them in part-\ntime work with local nonprofit agencies. An important emphasis is\non the permanent placement of senior aides.\n-160-\n(8)\nNAME:\nAdult Development Research and Training Program\nADDRESS:\nU of C Medical Center, 401 Parnassus, San Francisco\nSPONSOR:\nLangley-Porter Institute\nPURPOSE:\nThis is a research program with several research projects within.\nSome of the projects are pre- and post-doctoral training and the\ntraining of social science students in the adult development and\naging processes.\nCharacteristics and number of people served: As a research pro-\nject, they have contacted several hundred individuals.\nAreas or topics considered: They are mainly concerned in processes\ninvolved in development of the adult and in transitional stages in\nlife cycles. Such areas are \"generation-gap\" relationships, cross-\ncultural differences, and socio-economic differences.\nPROGRESS:\nSeveral areas have effected policy changes; some of the notable\nchanges are:\n1. Development of the Geriatric Screening Project at the\nSan Francisco General Hospital.\n2. Helping to find funds to establish the Geriatric Psychiatric\nOutpatient Program Development (no longer funded) but frag-\nments of it are available through Dr. Elliot Feigenbaum,\nUniversity of California Hospital Out-Patient-Adult-Clinic.\n(9)\nNAME:\nSummer Institute for Advanced Study in Gerontology\nADDRESS:\nUSC, University Park, Los Angeles 90007\nSPONSOR:\nRoss-Moor-Cortese Institute for Study of Retirement and Aging\nPURPOSE:\nTo make it possible for professionals now engaged in a variety of\nfields serving older people to increase their knowledge and skills\nin behavioral, social, biological and administrative areas of aging.\nThe institute will enlist outstanding faculty, drawing upon authori-\nties from many other colleges and universities during their free\nsummer time.\nPROGRESS:\nThe participants answered detailed questionnaires at the conclu-\nsion of the session, and gave it a vote of excellence.\nThe first two weeks covered the Introductory material, \"Concepts\nand Issues in Gerontology\"; the second two-week cycle ran five\nconcurrent courses in the fields of biology, sociology, psychology,\neconomics and scientific computing; and the third two-week cycle\nran four concurrent courses in the fields of physiology, urban\necology, psychology and social policy and administration.\n-161\n(10)\nNAME:\nEducating Social Workers in Community Work With Aging\nADDRESS:\n120 Haviland Hall, University of California, Berkeley\nSPONSOR:\nRegents of the University\nPURPOSE:\nTo prepare professional Social workers to work in the field of\naging with special expertise in community organization and admin-\nistration. This is a two-year program which includes academic\nclass as well as internships specifically geared with concern for\nthe aging population.\nPROGRESS:\nThe Faculty assumes their own role of being active in the com-\nmunities. Two and a half (2) faculty members are regularly\nparticipating in community organizations and groups concerned with\nthe aging. Their primary activity is restricted to the Bay Area.\nThe aging population and the aging process are separate from the\nproblems of the aging and appropriate Social Work methodology in\nproblem solving is the area the project considered.\nAccomplishments due to the project: (1) Initiation of curriculum\nconcerned with aging has developed into a full two-year program.\n(2) At the present time, seven students have been awarded their\nMSW in Aging. Some employment has been found in aging.\nInterns: A total of 20 students are in the program. They work in\nagencies concerned with initiating and developing programs of\ndirect service to the aged.\n(11)\nNAME:\nRegional Training of Leaders To Work With The Aged\nADDRESS:\nU of Calif Extension, 106 South Hall, Davis\nSPONSOR:\nRegents, University of California\nPURPOSE:\n1. To extend knowledge of the aging processes and the biological,\npsychological, personality, health, and social changes that\noccur in aging.\n2. To provide trainees with information about federal and state\nprograms and resources, with local community programs and\nservices for the retired and the aged in housing, recreation,\nhealth, welfare, financial management, employment, and\ntransportation.\n3. To inform persons designated as leaders as to their opportuni-\nties and to give guidelines for planning, using state and\ncommunity resources; to furnish basic tools for preparing\n\"community resource inventories\" and \"client summaries\".\n4. To begin the planning and inauguration of the University\nExtension Curriculum which would prepare educational specialists\nin aging.\n-162-\nPROGRESS:\nThe first year of the program was devoted to information-gathering\nof resources and facilities in the region (by sub-region) and to\ntraining individuals as counselors in community organization and\ndevelopment in problems of the aging. Training was accomplished\nthrough an intensive short course and through use of a traveling\nfaculty and holding follow-up conferences in sub-regions.\nAll services to Senior Californians were discussed by all invited\nparticipants.\nThe sub-regions where training seminars were held are as follows:\nRedding; Stockton; Oroville-Orland-Chico; Yuba City-Marysville;\nModesto-Turlock; Mt. Shasta-Dunsmuir-Weed; Auburn-Nevada City-\nGrass Valley; Sacramento-North Sacramento-South; and Tahoe City.\nApproximately 1,068 participated in these 10 regional training\nseminars.\nThe end result was an educated and trained group of community\nleaders who took back to their respective communities an aware-\nness of the needs of older adults and the know-how to start and\nexpand programs to benefit Senior Californians.\n-163-\nF. Training\nThe critical shortage of persons trained in the field of aging continue\nto limit the progress that could be made today and to inhibit the potential\nfor future program expansion. It is estimated that less than 20% of all\nindividuals employed in programs serving the aging have had any formal train-\ning for their work. The problem will become more acute as future program\nexpansions double and triple the demand for qualified help.\nThe Federal Government, working through the Administration on Aging has\nsponsored a limited number of both long-term and short-term training programs\non aging. A total of 71 Title III training projects during fiscal 1970 pro-\nvided short-term training for over 15,000 persons. Title V supported training\nprograms were carried on in 18 universities across the country in 1970. These\nlatter programs, concerned primarily with career preparation, reached 370\ngraduate students and 850 short-term trainees. Information concerning details\nof these programs can be obtained by writing the Administration on Aging.\nAn analysis of these training programs indicates that they are basically\ndesigned for those working in the field of aging, about to enter employment\nin the field, or otherwise already committed to a career therein. Still\ncritically needed are general courses at all levels of the educational process\nfor students who are not committed nor in fact may ever be committed to a\ncareer in the field of aging.\nSuch courses would serve two beneficial purposes. The first would be to\nintroduce more students to aging in general and thereby stimulate more career\nentries into that field. The second beneficial purpose would be to stimulate\nmore general awareness of the problems and needs of the aging among our student\npopulation.\nIf but one generation of Americans grew up with an appreciation of the\nreality of aging, long sought reforms and needed financial assistance would\nbe more readily obtainable.\n-164-\nSensitivity to the needs of the aging can only be acquired through an\nawareness of the problems that confront them, and such awareness can be\ngreatly enhanced through formal education. All too often our youth oriented\nsociety's negative attitude toward the aged, and aging, are passed from one\ngeneration to the next without thought or evaluation. Here again, the inter-\nvention of the formal educational process could reverse this senseless and\nself derogating phenomenon.\nEvery segment of society should be sensitized and educated to the facts\nof the full-life cycle, to the physical and psychological processes of growing\nup, of the middle years, of aging, and of the fact that every stage of life\noffers equal but different challenges and rewards. It is submitted that\ncourses in gerontology at all levels of the educational process would make a\nsignificant contribution to reshaping current national attitudes toward the\naging. The following suggested core curriculum, prepared with great aid and\nassistance from Miss Carol Pogash of the Institute for Local Self Government\nand Mrs. Bea Shiffman of the National Council on the Aging is offered as a\nstarting point for the development of such courses of study.\n-165-\nA CORE CURRICULUM IN GERONTOLOGY\nHUMAN GROWTH:\nA philosophical and technical course that focuses on a study of the life\ncycle with emphasis on the aging process. Coverage of the physiological\nand biological evolution both of the body and the mind. Special attention\ngiven to the transitional period from middle age to old age: changes in\nlearning and motor skills, and intelligence. Discussions of diseases that\nafflict the elderly, including that of senility and the factors which cause\nit.\nPSYCHOLOGY OF AGING:\nA study of the attitude and behavior changes that accompany the aging process:\nthe critical transition from an active to a more passive existence; the pur-\nsuing problems of one's lessened importance in society and deflated self\nperception; role ambiguity and one's diminished sense of personal worth. Use\nof Eric Erickson's theory on the chain of needs to mental health as applied\nto the aging individual. Analysis of the emotional fury and rage of the eld-\nerly that causes such a high proportion of mental illness; loneliness and\nother withdrawal symptom which afflict the elderly; the problems of maintain-\ning maximum security, dignity and independence, and coping with their absence;\nthe importance of allowing the individual a wide choice in determining his own\nfate.\nSOCIOLOGY OF AGING:\nAnalysis of the aging and their place in society as it now is and as it ought\nto be. Focus on the factors that determine societal attitudes toward the\naging: national wealth, tradition, family patterns, etc. Attention given to\nthe aging individual in his environment as he relates to his peers and to the\n-166-\nyounger community: his integration in and isolation from society; the\ngradual withdrawal and inwardness that characterizes his existence; the\nlimited choice offered; the independence of the dependent individual vis a\nvis society; the use of groups as political and social communicators; the\nuse of organizations, counseling services, etc. Study various life styles for\nthe aging including retirement practices (employment and housing), family\npatterns and group relationships. Survey of demographic aspects: population\nchanges; and rural and urban density.\nPOLITICIZATION OF THE AGING:\nA course that describes the potential influence of the aging as a group that\ncould become functional. How a political reawakening could be developed and\nthe benefits of such a scheme: sensitizing the elderly to their common needs;\nstrategies on how to have them satisfied; discovering the commonality of\nproblems and aligning with other groups. Learning to understand: how to be\nheard; how to make allies; how to deliver votes; how those who are aging and\nunemployed change their political outlook on a liberal conservative spectrum.\nConsider the possibilities of education for the public at large; community\ndevelopment and organization by and for the aging. Analysis of case studies\nfrom community experiments.\nHISTORICAL ANALYSIS OF THE AGING:\nThe course is offered to give the student a perspective by studying how the\naged in other societies have been treated. Beginning with biblical commentaries,\nand focusing on more recent cultural attitudes. Providing an anthropological\nview of various societies. Updating the study with analysis of the treatment\nof the aging by immigrant groups, religious sects and minority populations\nin America in their respective communities, including: Black, Mexican-American,\nIndian, Jew, Catholic, Russian, European, Chinese, etc., (overlapping categories).\n-167-\nPUBLIC POLICY FOR THE AGING:\nDetailed analysis of the governmental policies that affect the aging: what\nare the needs; how are they met; which ones go unsatisfied; how local, state\nand federal governments are functioning in the field and how they could or\nshould be functioning. Could be a four semester (quarter) course, devoting\neach time period to one of the four study segments described below:\nEMPLOYMENT-INCOME:\nStudy of the civil service laws and private standards that work against the\nelderly: locking people out of jobs based on age and not on mental alertness;\nthe problems of unemployment and how the abundance of time and lack of money\naffect the able and aging individual; the valuable manpower resource which the\nelderly represent; possible reforms; innovative governmental projects that\nutilize the manpower of the aging to satisfy other social service needs (day-\ncare centers, hospitals, etc.)\nHOUSING:\nStudy the policies for public and private housing as they now exist: should\nhousing for the elderly be isolated or integrated into the community; retire-\nment villages -- pros and cons; how aging individuals are affected by new\nsurroundings, forced moves, isolation. Analysis of special problems with\nhousing plans for the aging: alternative types; case studies; costs of housing\nand expenses for the elderly.\nHEALTH:\nLearn about governmental efforts at rehabilitative and preventive medicine\nfor the aging: what is and what could be done. Study the problems that\nconfront the health agencies: how to inform the aging community of the\navailable services (health education); how to provide them with the services\n-168-\n(satellite health centers, doctors aides); how to discover what needs they\nhave that are going unmet (survey). Concern with nutrition and the aging.\nAnalysis of new and pending federal legislation--medicare.\nTRANSPORTATION:\nThe need for the elderly individual who is physically able, to remain mobile\nand the problems therein: lack of funds, poor health, need for safety and\naccessible transportation. How the public transportation in certain parts\nof the country has improvised to meet these needs. Experimental efforts in\nmajor cities: problems and successes.\nPLANNING FOR RETIREMENT:\nA nonconventional plan to prepare people from the time they are young to\nunderstand their later years and to prepare for them. To develop self\ncreatively and inwardly. For those who have already arrived at that age, to\nteach them how to cope with the transition and change: what to do with leisure\ntime; the lack of a substantial income; the lack of co-workers around; no work\nto occupy the mind. Emphasis placed on life long learning so that the liberal\narts education is a continuing one. Discussion of training and retraining\npeople during the later years. Equalizing job opportunities for the able and\nwilling individual.\nFIELD WORK:\nThis course is the backbone of the curriculum because it most deeply and\nexpediently sensitizes the student. Accompanied by a weekly seminar for\ncommon and personalized discussions. Could consist of a group survey to\nanalyze the needs of the elderly in a specified segment of the community;\nor working in an old age home; assisting in providing services, i.e., working\nin a health clinic; community development; political or health education;\netc. Unlimited. Negotiate with instructor to determine the value of a\nproject in terms of credits. More credit if evaluation paper written.\n-169-\nG. Preventive and Supportive Services\n1. In General. The major expense of any health care program is hospital\nand nursing home care. The national average cost in the U. S. of maintaining\na hospital patient for one day leaped from $9.50 in 1946 to more than $81 in\n1970. It is expected to approach $100 per day in 1971, and rise each year\nthereafter. The cost of nursing home care is also on the increase. Even if\nover utilization were completely eliminated, the costs of such are to the tax\nsupported Medicare and Medical programs would still be. aggering. Furthermore,\nthere is every indication that the demands for such services will escalate just\nas rapidly as have the per diem costs. The increasing life span, which may\ninclude moreyears of dependency, is one contributing factor. The current\nAmerican syndrom of institutionalizing every problem, whether for illness or\nconvenience, is another. The avoidance of the need for such expensive services\nis thus essential if the public can be expected to continue its financial\nsupport. A plan which helps keep a person healthy is much better than one\nwhich only treats him after he is ill. In the field of aging, a parallel, but\ninterrelated program that keeps a senior active in his own environment, is better\nthan one that forces him into an institution. Not only is such a program likely\nto be less expensive, it is generally better for the overall health and emotional\nstability of the prospective patient. The development of viable alternatives\nto institutionalization is thus essential.\n2. An alternative to institutionalization. A person enters a hospital or\nnursing home for one reason: he cannot care for himself, or be adequately cared\nfor by others, in his home. It may be that needed medical care is only available\nat a hospital. But it may also be a matter of convenience where the patient does\nnot require critical treatment as much as the availability of health services\nif the need therefor arises. Under our present system it is generally more\nconvenient to send the patient to the services than to send the services to the\npatient. Recently conducted pilot programs indicate that many situations occur\nwhere the opposite may be as satisfactory, if not preferable. A coordinated,\ncooperative official and well supported community program offering assistive,\nsupportive, preventive, sustaining and protective services offers the best\nalternative to our present institution-oriented system. Such a program should\nbe founded on a true partnership between the public and private sector and\nshould involve both general and financial assistance from all levels of government.\nSuch a program could result in savings of millions of dollars and also enable\na greater number of our seniors to live out their lives in decency and dignity\nfreed from the devastating crush of fear, insecurity and loneliness which\ncontributes to both the incidence and severity of their illness and incapacity.\n3. Examples of preventive and supportive services. It would be impossible\nto list all the services that might be provided in every community. They will\nvary according to different local situations and changing needs. They should,\nhowever, cover a wide range of health and social services that will enable the\nsenior to maintain as normal a life pattern as possible. The following are\ntypical programs which serve these needs:\n-- Meals on wheels. It has been well documented that one good hot meal a\nday is about the cheapest preventive 'medicine' we have.\n-- Home health care. The delivery of medical and para-medical services,\nincluding visiting nurses and home keeper services to the senior in his own\nhome.\n-170-\n-- Neighborhood diagnostic and out patient treatment services. The early\ndetection and control of developing illnesses will enable the avoidance of more\nexpensive institutional care.\n-- Social programs and activities. Organizing social programs in the\nneighborhood and within easy reach, is an effective way for preventing the effects\nof severe loneliness and feeling of abandonment that afflicts so many seniors.\n-- Adequate and useable transportation. Much progress has been made in\nthis field, but much more needs to be done.\n-- Referral arrangements and Hot Line services. A community or volunteer\nmaintained telephone services that can answer inquiries as to available services\nand serve as a contact point for emergencies.\n-- Day care, nigh care and respite (vacation) care. Establishing facilities\nfor intermittent use by seniors who are living with adult children or other\nfamily members. In this connection, thought should be given to development of\na program providing financial assistance where needed to families so they can\ncare for their elderly at home.\n-171-\nNOTE:\nThe footnotes and Appendices have not been completed for inclusion\nin this draft. They will, however, be a part of the final document,\nas will the conclusions and recommendations of the conference.\n4\nTHE\nVI:\n-"
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