BLIC ALTH RARY OFFICIAL STATE GROUPS ON AGING: ELEMENl‘S OF ORGANIZATION AND PROGRAM / ‘7‘ “gm; (I! w ’ ,7 J ,, (1,9 7. A» r. ,7 Regort of The Conference of State Commiesions on Aging and. Federal Agencies f" Washington 25 , D.C \ September 8-10 , 1952 mus DEPARTMENT‘ DOGU MAR 1 1954 museum mweasm 0? Third Printing Committee on Aging and Geriatrics Department of Health, Education, and. Welfare ( January _ 1951+ OFFICIAL STATE GROUPS ON AGING: EIEMENTS OF ORGANIZATION AND PROGRAM Report of The Conference of State Commissions on Aging and Federal Agencies September 8-10 , 1952 Third Printing Committee on Aging and Geriatrics , Department of Ly. '» ggalth, Education, and Welfaril / Washington 25, D. C. January l95h i m m «umiummakn ' ' HW/57 62M; Mia/31%, ri- géf 2 ,3 This report is based upon a. transcript of the proceedings d the caersl sessions of the Conference of State Commissions on Aging and Federal Agencies and on the summaries prepared by the planning committees of the various work group sessions. A preliminary draft V was submitted for review to all participants. l The report does not attempt to describe the day-by-day proceedings of each panel or worfigroup g§$§§1°n° Rather, it is organized under such headings as seem to offer the best opportunity to summarize the totel content of the discussion. The close inter;- relstionship of the problems involved tended to break through the neat orderliness of the agenda. Not only were discussions, initiated during the panel sessions, carried on in the work group sessions but, in may instances, the very nature of One work group's interest led it into extended comment on matters officially allocated to another. This was perhaps inevitable in a field where these interests tend so constantly to overlap one another. Some of the tOpics, it will be noted, were not dealt with as fun; as others. This was largely because the representation from 029 iii [ many of the States was not sufficiently well—balanced, in terms of the interests or special competenCe of the individual delegates, to cover the entifie range of the aging problem. Public welfare, for instance, was heavily represented, whereas there who'only a handful of conferees to speak authoritatively on matters of public health, employment or housinga However, it was evident that the great majority of the delegates were clearly conscious of the multi-faceted nature of the problem and recognized that for a State commission or committee to be fully effective its membership must reflect all areas of ‘ interest. It should also be emphasized that the Conference made no over- all recommendations of any sort. Following the pattern established by the National Conference on Aging in 1950, several of the individual work groups suggested concrete lines of action that, in their opinion, could profitably be taken, but none was presented to the Conference as a whole for formal adOptiona ‘Finally, the report can in no way be regarded as a definitive statement on the part of the State commissions or committees. A large number of the delegates taking part in the Conference were present as representatives of Governors of States in which no such groups had been officially established. Others were from States in which the commission or committee had come so recently into existence that they had little active working experience to draw upon. what appears in this report, therefore, must be regarded as a summary of the congregate "thinking out loud" by a number of individuals actively conCerned with the problem of aging as it affected their own State. In general, they .V 1v ,1: discussed those matters which were on their minds or on which they wanted information, without attempting to arrive at a. well-rounded exposition of the entire subject. In presenting this report, the Committee acknowledges the help of Merrill Rogers of the Federal Security Agency in organizing the material and undertaking the actual writing. It also wishes to pay special tribute to Miss Ann H. McCorry of the Agency for her work in helping to organize the Conference and. in preparing much of the background. material fer it. Committee on A31? ‘;and Geriatrics Federal Security Agency inwwil "7 The Conference of State Canmissions on Aging and Federal Agencies California - Inter-departmental Coordinating Cormnittee on the Problems of the Aging Connecticut - Commission on the Care and Treatment of the Chronically Ill, Aged and Infirm ~ Florida - State Improvement Commission - Citizens' Committee on Retirement in Florida Illinois - Committee on Aging Massachusetts - Subcamnittee on Problem of the Aging, Recess Commission of the State Legislature on Revision of Public Welfare Laws Michigan - Governor's Commission to Study Problem of Aging - Interdepartmental Canmittee on Problems of the Aging Minnesota. - Commission on Aging New Maxi-1,0 - Governor's Conference on the Aging New York - State Joint legislative Ccmmittee on PrOblam of the Aging North Carolina - Special Committee on Aging Pennsylvania .- Joint State Government Commission of the General Assembly Rhode Island - Governor's Commission to Study Problems of the Aged Washington - State Council for the Aging Pepuletion West Virginia - Governor's Committee on Aging Wisconsin - Committee on the Problems of the Aged to the legislative Council Participating Federal Agencies Department of Agriculture Housing and Home Finance Agency Department of Ctmmerce Department of Labor Federal Security Agency Veterans Administration The Governors of the following States and Territories which have no official comissions or committees sent delegates: Alabama, Arizona, Delaware, Georgia, Hawaii, Kentucky, Louisiana, Maine, Maryland, Mississippi, Montana, Ohio, Oklahoma, Oregon, South Carolina, Tennessee, Texas and Virginia. Also represented was the Council of State Governments. Conference Objectives , 1. To provide opportunity for State Commissions to review and consider developments in their work methods and pregrams through learning what other Commissions are doing, and through mutual *tliscussion of their problems and plans. i , 2. To provide opportunity for State Commission members and staff to become acquainted with personnel, resources, and programs of the Federal Departments and Agencies, and to determine their relationship to State and community action on needs of the aging. .41 > 3. To provide opportunity for program personnel of the Federal agencies ‘concerned to meet State Commission members and staff and to become acquainted with Commission programs so that they can anticipate the impact of Commission activities on established Federal, and State-Federal programs. h. 'To provide opportunity for States interested in establishing *fimissions on aging to obtain guidance from the experience of Commissions—now operating in other States. vii 7 mom. ii. iii; 2.. II. III. IV. VII. VIII. Table of Contents Foreword ....... . ........................ . .............. Preface and Summary.................................... Origin and Purpose of the Conference................ Contrasting Forms of Cummission Organization..........~ How Can Conmissiona Best Function?................ .... Public Assistance and Income maintenance............... Health, Medical Care and Rehabilitation................ Living Arrangements....... ...... ....................... Education and Guidance........................... ..... Employment of Older Persons............................ Fact-Finding, Reporting and Research................... How the Community Functions............................ Conclusionooe-eooeeonoctu-oouetoooeeeooeoooeeneueercoco . Appendix A Introducing the State Commissions 'Appendix B List of Delegates ‘Appendix C Agenda viii ll 25 35 #5 56 71 I PREFACE-Am) SUMMARY In an excellentzsummary of the "things learned," during the final session of the ConfereDCe of State Commissions on Aging and Federal Agencies that was held in Washington, D. 0., September 8 to 10, 1952, one of the delegates made the following points: It was apparent, she said, that there were two main stimuli which lead to the recognition of State responsibility towards the prdblem of aging and to the establishment of State commissions or committees. The first was the increasing number of dependent old people and the consee quent financial burden on the State. The second was the problems of social and physical dependency which were now, only in part, being met rthrough voluntary groups or special programs developed by the public health and welfare agencies. In ganeral, these State commissions or committees have been set up primarily to study the over-all problem and to make recommendations for further action. For the most part, they have been appointed for limited terms (one or two years) and the question of permanent organi- zation is still in abeyance. Only a few have so far moved into a third phase of activity, namely, the actual promotion and implementation of plans already approved. The initial interim organization of these commissions or com- mittees, she pointed out, follows no single pattern. Approximately half have been created by legislative enactment, the other half thriugh appointment by the State Governors. In some cases, it is primarily an inter-departmental affair, that is, membership made up of the heads of, - 2 .. or representatives from, the various State agencies whose field of operation in any way touches on the aging problem. In other instances, it is an appointed citizen group or a combination of the two. In analyzing the trends in organization, the speaker reported a. seemingly slight preference in fevor of the legislative commission with citizens or advisory groups, or with lay members included in its member- ship. Some of these commissions or committees have small appropriations to work vith. Others are provided for by the State departments. With one or two possible exceptions, she pointed out, none can be said to have "abundant financing." V In dealing with the problem of eging vithin their respective State borders, the majority of the emissions or committees seem to take 3 broad approach. There ere four cetegories in which they appear to be primarily interested. mess ere: 1, economic maintenence; 2, homing end living arrangemnts; 3, heelth end rehabilitetion; h, per- sonal adjustment, including activities programs. Some emissions, hovever, have facussed on more limited trees such as public essistence, chronic illness or some particular need thet is the concern of the State Department of Welfare. ' . ‘ , Exeept in one state, direct services to people heve not been in.-~ clnded in the responsibilities laid on the Stste emissions or salinit- tees. In general, the speaker slid, the two principal operating func— tions appear to be the coordination and improvemnt of stete-vide pror- grems in the field of aging as well as of the ectivities of those State depertments whose work touches this field. The importance of encom'eg- ing local 'cdmmnity services, 11mm, res heevily stressed and much or - 3 - the discussion revolved around ways and means by which this could be accomplished. Throughout the Conference, the relationship between the State departments and State commissions or committees was a topic to which the delegates continually reverted. Again and again, in group discussions, the need or care in delineating their respective responsibilities was clearly indicated. At times, fear was expressed that the State com- missions vouLd take over the functions of the departments; at other times, it was the other way around. All, however, were in agreement as to the necessity of the two forking together in the closest collaboration and of making full utilizatibn of all the resources of all the agencies, government or voluntary, within the State, as well as those which the Federal Government has to offer. Origin and Purpose of the Conference The above summary will give something of the scope of the inquiry to which the Conference addressed itself.r With a few exceptions, all these State commissions or committees on Aging have come into existence' during the past two years. The impetus for their organization derived largely from the National Conference on Aging which met in Washington, D. C., in August 1950, under the sponsorship of the Federal Security Aggnnyy fffiia conference, the first of its kind ever to be held, did much to focus nationpvide attention on the many and difficult problems which flowed from the rapidly increasing number and preportion of older peeple in our population. And its report emphasized that primary re- sponsibility for any real solution of these problems must rest upon the States and local communities. ‘ when”. ‘Till - h. _ At the time the present conference met, comissions or committees of this sort had been established in 15 States whose aggregate popula- tions were almost one—half of the total for the entire United States. In several of the other States efforts were being made to follow suit. And many of the larger cities in the non-commission States were pushing programs on their own initiative. In addition, since the Washington gathering of 1950, there had been at least 50 major Conferences throughout the Nation devoted en- tirely to the problem of aging or some specific aspect of it. Some of these had been State or regional affairs, sponsored by local government. Others had been called by universities, foundations, or other private ' groups. And there had been perhaps an equal number dealing primarily.‘ with other mtters which, for the first time, included in their agenda 8 session on the aging problem. '7 In other words, there was every indication that the "ball was rolling.‘. Despite the tremendous and increasing amount of State activity in the aging field, however, there was little integrated knowledge of its scope and direction. In February of 1952, the Committee on Aging and Geriatrics of the Federal Security Agency_beggnjagsnrreywot.thoseycommis- sions or committees which were already in existence in order to determine how they were organized, the authority under which they Operated, their specific objectives and the way in which they were functioning. _l_/ This ' survey was conducted with the aid of the regional offices of the Agency. 1/ This Survey, under the title, Introducing the State Commissions and brought up to date as of November lfii appears as Appendix A 05 this report. - 5 - , In the process, the Comittee chairman received requests from some of the State officials for the Agency to undertake the organization of a. Conference of State Commissions on Aging. Such a Conference held at this time, they said, might prove highly valuable as a. forum for the mutual exchange of experience, ideas and techniques of procedure. It vould provide an opportunity to take stock of the progress in this new and vital field of social welfare. And it might also enable State and local groups to iron out some of the difficulties that inevitably arise in the handling of new programs. These suggestions were checked informally by the Committee with Officials of other State commissions and the decision use made to go ahead; . In order to provich the broadest possible base i’or such- a'Con. ference, a planning cosmittee the set up vith membership drawn from all the Federal agencies obese activities in my In: touched on the aging ‘ problem. In addition to the Federal Security Agency, these included the Department of Labor, the Department of Agriculture, the Housing .na' Hans Finance Agency. the Bureau of the Census and the Veterem Administration. letters were sent to the Governors of all of the 15 States having State commissions or committees explaining the purpose of the prOposed conference and. inviting them to send delegates. Similar letters were sent to the Governors there no such organizations had been established on the essumption that the underlying impel-moo oi’ the problem would bring a. response. Acceptences were received from theGovernors of 33 of the States and refinance, 18 or which had no officinl sumo _ 6 _ activities in the aging field. By the time the Conference met, the total number of delegates appointed tOpped the hundred mark.§/ The Agenda Since this was the first time such a conference had been held, its organization presented several problems, particularly in the matter of the agenda. The important thing was to determine those precise ques- tions with which the delegates were mbst concerned and to afford appor- tunity for the fullest interplay of discussion. Because of the limited amount of time it was found impracticable to bring any representative group of the State commissions together officially to make decisions, though informal contact was established with a number of State peOple attending the University of Michigan Conference on Housing the Aging in July. Instead, a checklist of possible tOpics was sent to all coup mission chairmen to discover their order of importance, and at least two subsequent questionnaires vere employed to determine the general eon- sensus on several specific points., The agenda, as finally agreed upon g/ placed heavy emphasis on problems of organization and procedure, but on program content only as it ablated to ways and means of making the Operation of the program more effective. Most of the returns on the check list stressed the importance of having representatives of various Federal agencies eveileble as re- source peeple. The agenda were purposely made as flexible as possible. Inny of the delegates, it should be noted, came from States which were still in the preliminary stages of fact—finding and recommendation. Others were 2/ A list of the delegates appears in Appendix B. 3/ See Appendix c. - 1 - from States in which the emission or committee '83 a f‘going concern.‘ Still others were from States whose interest lay chiefly in exploring the need {Bran official commission or in finding out how best to go about establishing one. for this reason, every effort was made to enable all the delegates to engage in the discussions from their on particular Isngle of- interest or: experience. i t In his welcomim address, Federal Security Administrator Oscar R. Ewing emphasized the subordinate role of the Federal agencies and de- scribed the Conference-e one “of, for and by the States." Summing up _ its purpose, he acid, "This is to be strictly e shirt-sleeve forum. Us are not here to read set speeches or to make reports. We are here to take up I. variety or questions which will be tossed out on the floor for consideretion—-and to thresh out the pros and cons until we arrive it g what we nape will be a senblanco of some of the answers." At the close of the fife-dry session, it was the general conviction that the Conference had eccawlishod its purpose. I! no hard end fast solutions to all the prgblems were advanced (and none vss expected), the debates had at least been given the Opportunity to "thrash out the pros nnd‘conse" {he majority was in agreement that the discussion bed clarified for than many important matters in the trees of Operation in which they were concerned, and had helped immeasurably to project a. sharper focus on the mole prdblem. Furthermore,“ it had enabled. reprev sentetives from the various States to become acquainted rith one another in the friendly contact of small discussiongroups and thus establish the best possible basis for further cooperation. II CONTRAgTING FORMS OF COMMISSION ORGANIZATION Prior to the Conference each delegate had been supplied with the pamphlet Introducing the State Commissions (reproduced in Appendix A) which summarized the salient facts relating to the operation of each emission or committee. But in order to create a more informal back- ground for discussion on "How the other fellow works" representatives fro. five of the States, whose commissions or committees more or less typified some of the contrasting forms of organization, vere asked to speak briefly on the "whys and wherefores“ of their own particular groups. masochusetts for instance, it was explained, operates through a sub-camittee of the already established Public Welfare Commission , and consists of the members of the Legislature-mas a mpublican, the other a Delnoeratutogether with four resource people who are authorities in the field of nedical care and social welfare° It is a statutory body which came into being as a result of several bills introduced into the legislature asking for a study of the problems of aging. I . In Minnesota there is a special Commission created by legislative act with a broad charter to study a wide range of problems relating to the aging situation. The drive behind its creation came from several members of the Welfare Connnittee of the legislature who were concerned «over the increasing load of public assistance cases. The coum'lllsion has 25 theaters-o5 State Senators, 5 RepresentatiVes and 15 laymen. It finc- tions through It major subject sub-committees, to serve on which it has - 9 _ enlisted the services of some 150 citizens throughout the State who have a special interest in the problems involved. In Florida, it was stated, the immediate impetus for an organized. effort in the aging field was the fear that an increasing influx into the~ State of retired workers on small or inadequate pensions would entail many new welfare and socio-economic prdblems. This fear had been engen- dered by the widespread expansion of retirment benefits for union members throughout the country in the settlement of a series of major strikes ;" which had occurred in l9h7. To meet the problem a Retirement Research Division of the State Improvement Commission was established. Authority was derived from a 1932 law giving the Commission fblanket authority "to do any development or research on any subject field for the general wel-I fare of the citizens of the State of Florida." The Commission is headed by the Governor who appoints three other members; the chairman of the State Road Development is a member 35 ' officio. It has.a paid staff which includes statisticians, architects, hospital specialists and economists, all of whom are available for re- search in the aging field. It also has the support of related agencies in the State that are working in highly specialized fields. In addition, '3 there is a l5-member Citizens Committee, established by the Governor by proclamation, to act in an advisory capacity to the Retirement Research, Division and which functions entirely at its own expense. In Illinois the problem of aging is dealt-with through a Citizens Committee appointed by the Governor. Originally, according to the Com- mittee chairman, this had been an interdepartmental committee of the State, but had been changed by the Governor who felt that the problem was one that should be handled on a local basis as a local responsibility. _ 10 - The Committee, it was stated, is wholly non—partisan and is composed of individuals with specific interest in the problem, including representa- tives from related State agencies. The group operates as a planning committee, with sub-committees' dealing with specific problems. Several State departments contribute to its staff and finances and otherwise work in close cooperation with it. No specific limitations have been put on the size of the committee or restrictions on its functioning. "It is our responsibility," the spokesman said, "to determine in what fields we can be most useful,“ Connecticut's effort in the field of aging is concentrated on chronic illness and rehabilitation. There is a 7-man commission, ap- pointed by the Governor, which includes the Commissioners of Health and Welfare serving ex officio, and usually two members of the Legis- lature. The Commission was created in l9h5 by legislative action with wide authority to "plan, survey, recommend, own, buy, lease or rent plants, operate them . a a and to recommend changes in legislation." The Commission, it was stated, is free to consider all aspects of aging, but stresses chronic illness because "it seems to be the main handicap which reduces old people from independence to dependence." Pressure for the original legislation originated with the State Wel- fare Department because of the need for additional and less expensive hospitalization following the rapid rise, since 19h3, in the costs of medical and hospital care when these costs were added to public as- sistance benefits. It is the only State commission providing direct services. - 11 _ III HOW CAN COMMISSIONS BEST FUNCTION? In the light of the responses to the questionnaires sent by the Conference Planning Committees to the vardons State commnssdnns or com- mittees, there seem to be three functions, it was stated, that are common to all, viz, -- they all make studies; -- they all publicly report their findings; they all recommend action, either to the Governor or to the Legislature.&/ In addition, there are commissions or committees which function in one or more of the following areas of activity: g -- some are chiefly concerned with coordinating States agencies; fl -- some act primarily as a clearing-house for information and distribute literature and reports; -- some provide consultative services to local committees; -- some maintain liaison with commissions in other States and with the Federal government; -- only one, as noted above, provides direct services. It is obvious that, in most instances, each State has worked out its own modus operandi and established its own definition of responsi- bility and area of activity. E/ An Illinois delegate, however, later pointed out that, with her State committee, "we have purposely avoided the function of recommending action . . . to enable us to accept private financing." - 12 _ As a Coordinator and Stimulator of Activity There is little doubt that the majority of the delegates con- sidered the primary function of a State commission or committee, once it was past the initial "paper state," to be that of a coordinator of present activities in the aging field, and of a stimulator of new ac- tivities.' Again and again, the term "catalyzer" cropped up in the discussions saggesting that these States bodies could, and should, provide the essential ingredient which, in chemical terms, would bring about the desired "reaction"--or, in simpler language, help channel and make the most effective use of all the resources that can be marshalled towards the over-all objective. As one delegate phrased it, the primary task is to "get State departments more interested in the problem, and also to stimulate ac- tivity on the part of universities and non-professional organizations." In nearly all instances, it was made clear, the closest tie-up of these commissions and committees is with the State departments dealing with the problems of public welfare-—public assistance, health, mental hospitals, employment and the like. Since each of these is con— cerned with some vital factor of the aging problem, the Job is to dem- onstrate how the area of activity of one is related to the areas of activity of the others, and how a common assault on the problem will lighten the burden on all the departments. This is particularly true in those States where concern over the mounting cost of old-age assistance was the main impetus whic} led to the creation of the commissions or committees. As an adjunct to the department of welfare administering relief, it was recognized, such a body could obviously have a limited effectiveness. Only as it reached - 13 _ out to enlist the cooperation of every State department which might con- tribute to the over-all effort--to establish some manner of effective teamwork-~could it hope for any successful accomplishment. This point was underscored by one of the delegates whose State program is still in the very early stages of development. It had been set up, he said, more or less under the guidance of the Public Welfare Department, but the Conference had convinced him of the need of "bring- ing all the State departments into the picture." It was apparent, however, that many of the States have taken the measure of this difficulty by including in their commission or committee memberships the executive heads, or representatives from, those depart- . ments whose work involves any aspect of the aging problem. Even so, it was acknowledged that many difficulties remained to be unravelled. Uhder any system of bureaucracy the individual departments or bureaus are understandably concerned.with their own sphere of operations. And jealousies arise when one department is suspected of impinging on the "rights and responsibilities" of another; This essential difficulty was~emphasized by theeexperience=of mem- bers of some.of,;he commissions whose activities, it was alleged, had seemed to suggest an intention to “take over" some of the specialized services of the State agencies, particularly~in the field of health. The utmost tact, it HaS‘said; was necessary to avoid such entanglements and to irOn but any misunderstandings that might arise. Or, as one delegate phrased it, "So long as a commission confines its functions to studying, investigating and coordinating present activities, it gets alOng very well. But as soon as it steps over into the field of - 12, - operation it becomes a competitor with established state departments or private agencies." I I The Case for Direct Services _ 0n the other hand, a'delegate from Connecticut statéd flatly that in his State all initial efforts to coordinate the efforts of the various State agencies had resulted in failure. The situation, he agreed, was admittedly different from that in other States since his Commission was organized for the express purpose of supplying direct services in the field of chronic illness and rehabilitation. Without question, he said, the Commission as an Operating agency was compet- ing with some of the State agencies in their own special fields of activity, and that some of the proprietary units feared they would be put out of business if the State moved into the field. But it was, in his 'Judgment, the most effective way to get results. The delegate further underscored his conviction that the ap- ‘ proach of his own State Commission to the problem was essentially the ‘right one. "Uhless you are Operating directly to the benefit of in— dividuals, you lose the soul and spirit of the services." He also made the point, to which some delegates appeared to listen rather thought- fully, that "it is easier to get money for help to people than it is to get it for study and research." Despite this vigorously expressed belief, it was the general con- sensus that State commissions or committees should not undertake to pro- vide Special services in any area of need relating to the agicg prdb— lem. To some extent, undoubtedly, the delegates were wary of becoming involved in activities which would place them in a position of attempts ing to take over functions that came within the bailiwick of - 15 - established State departments-or-agencies, But from a more positive angle, one of the delegates decried such involvement on the ground_ that it is "so easy to become mired down in the immediate problems . .-. and details that pretty soon we lose our desired scope and breadth of analysis and study and recommendations} helping State Departments . ._ Some of the ways in which coordinated effort can be made ef- fective were discussed by the delegates. AA good State commission or committee, it was pointed out, can be immeasurably useful in helping the State departments overcome some of the difficulties with which they are beset. For the most part, as one delegate said, these State departments or agencies function under specific legislation and are therefore "fenced in" in respect to their activities, Many clearly see the need for certain kinds of work to be done, but have no legal author- ity to undertake it. The commission, however, is not bound down by any such restriction and is therefore much freer to "get the most out of the research, planning and development in the (aging) field." Most of the agencies, he found, were grateful that the commission was "thus able to take care of many phases of the work in which they themselves are not constituted to serve." Such a relationship, he said, encourages the commission to "reach out and do everything we can that they are not, already doing." .An even more effegtive form of coordination, it was suggested, . occurs when the commission or one of its sub-committees can york with a State department on some specific problem. This is true especially when legislation is needed to enable the department to move into a new or expanded field of operation. Committee members can be highly useful _ 16 - in doing the "leg-work" necessary to help get the necessary bill through the Legislature and give to the arguments advanced, perhaps, a broader definition of State interest. Working with Voluntary Agencies No less important, it was stated, is the need of integrating the efforts of the State commissions or committees with those of voluntary agencies concerned with any aspect of the problem. Repeated reference, for instance, was made by the delegates from Massachusetts to the close working association that had been established between the committee (a legislative body) and the United Community Services-~an association which, it was stated, had served in large part to overcome the antipathy which private citizens often have for dealing with “politicians." The point also was made that in Massachusetts, through the work of the commission, the public had for the first time become conscious that aging was a "whole community problem" and not Just a specialized problem of welfare or medical care. And one representative of the private agencies expressed her gratitude for a chance to work with her State commission and to do things "we couldn't possibly do by ourselves without legislative backing." Coordination is Not the Whole Answer However much the emphasis was placed upon coordinating the func- tions of the various agencies, there was also the strongly expressed conviction on the part of many of the delegates that it was the respon— sibility of a State commission to "step in where these functicis are not being properly discharged." An instance of this was given by a Florida delegate in relation to the problem, above noted, engendered by the migration into the State of retired individuals with marginal _ 17 - rescurces. An extensive information program as well as a study and re- search program was needed, he said, and since no State agency was authorized to do either of these Jobs, it was up to the Commission to undertake the responsibility. Beyond this, at least one delegate warned against regarding co- ordination as an end result in itsegf. While agreeing at all times on its urgent necessity, he argued there was danger in being too easily satisfied with the "talk and paper" stage. Coordinating, evaluating and the making of reports are essential, he said, but they are only the be- ginning. It is a frustrating experience to realize how much preliminary effort is necessary "to even get the thing started to roll and to whip a few problems." To do the Job well takes "an awful lot oi work and a lot of time and a lot of education," and unless a commission recognizes this thoroughly it is only “building up a beautiful bunch of reports to kid itself." State-Community Relationship For the majority of the delegates, however, there seemed to be no strict dividing line between coordination and stimulation-~the effort to get the job going. Even those commissions or committees whose official assignment are limited to making "a study of the problem together with appropriate recommendations" saw themselves in the role of missionaries. Mbst of them, it was apparent, were in close contact with all the con- crete programs that were being developed in local communities. And many reported on the part they had played in providing "advice and :onsulta- tion" and in other ways giving active assistance. In exploring this topic, the question of the most aesirable re— lationship between the State commission or committee and the local - 18 - community programs came in for considerable discussion. Though many of the delegates admittedly were still groping towards a solution, there was general agreement that the primary responsibility for meeting the needs of an aging pOpulation rested upon the community, and that without an intensive local effort the reports and the recommendations would in- deed for the most part, remain a "bunch of words." One of the delegates explained that his own State Committee was directing its chief efforts towards "trying to get the local committees off the groun ." There was also general agreement that all local committees, or—‘ ganized to develop specific programs, should be wholly autonomous. The idea that the State commission or committee should exercise any control over their activities--or that, in fact, it should take responsibility for their organization--seemed wholly alien to the Conferenceo The best results, it was emphasized, are obtained through effective teamwork be— tween the State and local committees. To some extent this point of view may have been based on the fact that, as now constituted, none of the commissions or committees has the personnel necessary to undertake a State-wide organization of community services. But an even more fundamental reason, perhaps, was the recog- nition that action initiated "from the bottom" can be, as usually is, more effective than that "from the top," And precisely as the Federal Government can "help and encourage" the States to organize activity in this field, the State in turn should limit its own role, vis a vis the community, to help and encouragement. ' This however, it was made clear in the discussions, should in no sense be regarded as an "escape clause" for responsibility on the part of‘the State commissions or committees. It is their job not only to - 19 _ spell out the over-all needs but to give their findings the widest pos- sible publicity. Beyond that, there are endless Opportunities, as some delegates pointed out, to bring in private citizens from all parts of the State to serve on subcommittees or special fact-finding boards. In Florida, it was reported, the voluntary Citizens Committee, working with the State commission, made a point of holding its bi-monthly meetings in different sections of the State in order to arouse local interest. In this and other ways it is possible to "indoctrinate" community leaders in the many angles of the problem, and to spur them to organize com- mittees within their own community which will deveIOp concrete programs geared to local needs. In dealing with this relationship, as another delegate suggested, it was essential that a good information service should be provided by the State commissions or committees. This service should have a two-way function: acquiring information on community activities and relaying it to other communities that can profit by it. Stress also was laid on utilizing and making available the basic professional research that has been done on the various problems with which the community must cope. This is important, the delegate remarked, so that the local committee members will not "Jump to conclusions the way a layman like myself is apt to do", and may thus avoid many of the headaches of trial and error. I How Functions are Carried Out In the course of the general discussion, there was a number of interesting sidelights on the way in which some of the State tcmmdssions or committees carry on their functions. A delegate from New Yerk, for instance, explained that his Com- mittee placed great emphasis on public hearings which were held annually J; g - 20 - in New York City. These hearings, he said, are open to anyone who wishes to attend, and leading State and national authorities on all phaSes of the aging prdblem are brought in to participate. There is an unusually high attendance for these hearings. Verbatim reports are made of the proceedings and distributed as part of the committee's annual re- port. The material collected is studied by the Committee and staff members for suggestions which can be used for recommendations to the legislature. The delegate also emphasized that the Committee makes every effort to stimulate community action and, at the request of the community, pro- videSuspecific guidance and advice. This is an activity which the Com- mittee has undertaken on its own initiative, he said, though no such responsibility was spelled out in the enacting legislation on which its authority rested. Other delegates who had attended some of the Committee hearings gave a high rating to their value, and praised the manner in which New York State was conducting its programs. Special mention was made of the successful way a housing study conducted among the recipients of old-age assistance in Rochester had been integrated with the work done in the community in the field of chronic disease. The Florida Commission laid emphasis on its research activities conducted in cooperation with Florida universities. Several community studies have been completed, and a report has been issued by the Citizens Committee on problems of retirement. All these documents, it was stated, are available for use by local communities. It also stressed its infor— mation service, noted above, directed towards out-of—State retired indi- f” viduals planning to move to the State. - 21 _ The California Commission reported an extensive information serv- ice that was being developed as a means of stimulating community activity. It called special attention to the publication of‘a directory of State departments describing all the services available to local communities from these-sources. HBntion was made also of other forms of activities common to many of the State commissions or committees; These included the issu- ing of information bulletins and other publications, conferences held in local communities and, of courca, the official reports made to either the Legislature or the Governor. Legislative vs Executive Appointed Commissions One of the topics in which the delegates took an unusually keen interest was the relative merits of the State commissions or committees established by action of the Legislature and those of the voluntary group appointed by the Governor. Both alternatives had their staunch advocates, though most of the delegates who spoke on the subject were quite willing to agree that the method which seems to work best in one State might be less effective in another. On behalf of the statutory body, it was pointed out that it is the Legislature which has final authority to determine appropriations for State departments, and that all programs relating to the aging field a? must be passed on by the law-making body. A commission or cowmittee set up by statutory authority, it was argued, is likely to have far greater prestige among the legislators who created it than an "outsidn" body, and its recommendations are likely to be listened to with greater attention. Furthermore, it was stated, the Legislature is a continuing body, and once committed to the need of studying the aging problem can be 3‘ mm «v .. “a" i,» - 22 - relied on better to I'carry through." In contrast, where the initiative depends wholly on the Executive, there is less certainty in this res’ spect. A Governor who has an active interest in the prdblem, it was claimed, might well be succeeded by one who has little or none, and who would either fail to reappoint a commission or give it so little support as to render it valueless. Furthermore, the argument ran, in appointing a commission it was more than probable that a Governor would name only, or at least chiefly, people of his own party affiliation, and would otherwise tend to give it; a strictly politiCal coloration which might impair its usefulness. In statutory bodies, membership is usually bi-partisan and support for the measure comes from both parties. Beyond that, the belief was expressed that legislators, as a rule, are sensitive to the desires and needs of their own constituencies and are therefore much more keenly aware of the problem of the "old folks." Some fear was expressed that, at times, a member of a legislative commission might use it as a platform to advance his own political in- ‘ terests, though the general attitude of the delegates appeared to be that any one who "talks of aging“, for whatever purpose, is "helping the cause." The contention that an Executive-appointed commission is necessar- ily partisan was denied by the chairman of one of the commissions, He himself, he said, was a Republican appointed by a Democratic Governbr, and there was no evidence that political considerations had entered into the selection of any of the other members. Others who supported this approach to the problem seemed to bane the feeling that party affilia- tion is a matter of minor consequence and that, in prettically all fiv'“F5 F - 23 - States, a genuine effort had been made to secure people for membership on a commission or committee who had some definite interest or qualified experience in the field. One delegate spoke of the greater freedom of action which a vol- untary committee permitted. Two—fifths of those appointed to his own group, he explained, were members of the Legislature, and the rest were lay people. Under this set—up, he said, legislators and lay people work side by side to do a jab without in any way being bound by legis— lative action. Others gave their opinion that a "free-wheeling" committee can often establish more effective coordination among the various State agencies and stimulate greater activity among the various communities than a statutory body. One representative of a State Commission was high in his praise of the voluntary Citizens Committee appointed by the Governor to work with it. This Committee, he said, "makes it easier for us bureaucrats to do a job," since citizens groups "can do many things that a State agency can't do (and) can say things to the public that it is not good business for a State agency to say." importance of Legislative Participation All delegates, however, were in agreement as to the need of "deal— ing in" members of the Legislature for any group that expected to function effectively in the aging field. Wherever possible, it was contended, legislators from both parties should be included as members of a volun— tary or Executive-appointed committee. Where this was not feasible, their services should be enlisted as advisors who would, in this way, ob-~ tain a working knowledge of the group's activities and its point of vies; This held true, it was stated, even when a Governor is appointing an is z - ah - exploratory committee to advise him on what initial legislation to ask for; it is important to "have somebody in the Legislature who can speak up and be a friend in court to you." Another delegate asserted that the best way to secure coordina- tion between the legislators and a voluntary commission is to invite members of the legislature to take part in local meetings in their own constituencies. By this means, he said, a large number of them can be brought into the picture and their interest enlisted in terms of their own neighbors as individuals and voters. The importance of legislative participation was underscored by several delegates who recited experiences in which its lack had resulted in failure to get necessary legislation enacted. One case was cited (though in another field of activity) of a bill that had been crippled by hostile amendments "simply because there was no member of the legis- lature who knew about the bill to prevent the attack." -25- IV PUBLIC ASSISTANCE AND INCOME MAINTENANCE One of the mjor stimuli to the creation of State commissions or committees on.Aging has come, as noted above, from the increasing number of old pe0ple dependent on public assistance and the consequent finan- cial burden on the States. Significantly, the program area with the largest representation at the conference was public assistance. It was asserted that income maintenance, which is of basic imp portance in the solution of all other problems, is too often seen by the public as something to be promoted "for the poor." Actually, it was pointed out, the States” concern in this area must extend to all aging persons, since health care, housing and other needs are related to the problem of "making ends meet." It is the task of a State commission, in coordinating the activities of the various State departments and agencies, to underscore this point of View. Need for Better Data One delegate—~a State legislator—~made the point that, although a good Job has been done in his own State by the Welfare Department, the Legislature has not been able to get close enough to the actual facts regarding the total aging population. One useful function of a commission on the aging, he said, can be the conduct of surveys to pro— vide the information needed by legislatures concerning all the aged peeple in the State, particularly that portion not known to the oldpage assistance program. Such information is needed in planning for the entire aging pepulation of the State. ,s - 26 - Furthermore, it was stated, there has not been enough effort to promote public understanding of income maintenance programs and to inter— pret present trends. It is highly important for the public at large to have the whole picture of these programs: what they accomplish; what they fail to accomplish; and where the emphasis should be placed in future\deve10pments. Attention was called in this connection, to the family and indi- vidual income data issued annually by the Bureau of the Census and de- rived from its monthly population sample. Such data are very useful but have their limitations. Income as defined by the Census Bureau includes earnings (wages or salary and net income from self-employment in a busi- ness or professional practice) as well as current income frOm such sources as pensions, rent, interest, dividends, etc.2/ Information on receipts from the following sources essential for any appraisal of the .iell-being of peeple is excluded from Census data: proceeds from the sale of prOperty; incdme in kind; withdrawal of savings or conversion of assets; gifts; and lump sum inheritances or insurance payments. Another shortcoming of these data is that they are on a national basis only, i.e., no details by States are given. There is a definite need for more intensive State studies of income. For the decennial census year of 2950, the Bureau of the Census plans to publish in the 3second series, State bulletins. a simple distribution of families and individuals by income levels for States, counties, and smaller areas. Age detail, however, will not be shown in these tables, though a distri- bution of persons by age and income for each State, and for metrOpolitan :2/ A complete description of the income concept used by the Census Bureau appears in the Census Report, "Income of Families and Persons in the United States: 1950," Series Pu60, No. 9. - 27 _ areas of 250,000 or more, will appear in the third series, State bulletins. I How Better Data Can Be Obtained There are various ways, it was pointed out, in which the State commissions can use the facilities of the Federal Government to obtain more adequate statistics for the older pepulation. For example, one such body, it was reported, is in the process of commissioning the Census Bureau to select a representative sample of elderly peeple in that State for the purpose of interviewing them with respect to their work experi— ence, income, housing, health, savings, and recreation. 'This is done on a cost basis. The Bureau can be asked to conduct similar surveys in other States.. In addition, early in 1953, it will be able to provide States with summary cards, or with special tabulations of Census data, on a cost basis. For States needing data for reports to their Governor or to the Legislature; it was suggested that help might also be found in the Bureau of Agricultural Economics data on the rural pepulation of a State in farm studies made by land-grant colleges, and in the consumption studies conducted by the Bureau of Human Nutrition and Home Economics. It was suggested, further, that data on how older peeple are liv- ing and what resources are available to them can be gleaned in part from periodic reports issued by the Social Security Administration, State and 10cal retirement systems, the Railroad Retirement Board, and the Veterans Administration. It is known, for instance, thfit at the end or 1951, one- fourth of the population 65 years or over were receiving old-age and survivor's insurance, one-fifth were receiving public assistance, and that a little less than one-third were receiving income as earners or as M 'V ",A‘fi M." p? '-28- wives of earners. Similar estimates for the size of some of these groups can be develoPed within each State. A recent study of the resources of the group receiving benefits under old—age and survivors insurance, and a study about to be made of the group receiving old-age assistance, will yield data, it was said, that is valid on a State basis. State commissions, it was emphasized, need to know what statistics are already available in the field of income and what the statistics mean. They also need to know whether or not they can get money for studies of their own and what help is available from Federal agencies. Who Applies for OldrAge Assistance? Great interest was expressed in a study made by the Social Secu— rity Administration, in c00peration with the States, to determine the characteristics of new applicants for old-age assistance. It was found, as of April 1949, that a very substantial number of these applicants were farmers or farm workers, or were engaged in some other occupation that, at the time, was not covered under old-age and survivors insurance.~ In 3 States--all agricultura1--over ho percent of the population 65 years and over were receiving old-age assistance last June. In 8 other States, however—-nearly all industrial, where there was a comparatively high old-age and survivors insurance coverage--fewer than 10 percent were re— ceiving assistance; and in 3 of these, 30 percent or more were drawing /insurance benefits. 7' In 1950, it was pointed out, coverage under old-age and survivors insurance was expanded to include regularly employed farm workers and various other groups, and benefit payments were increased. The result was that in 1951, for the first time, the number of persons 65 years of age or older receiving insurance benefits exceeded those receiving public _ 29 - assistance. This, it was believed, would be a continuing trend and should be taken into consideration by all State agencies dealing with problems of income maintenance for older persons. More Information for Rural Communities Further discussiou on this point indicated that, in many rural communities, there was little knowledge or understanding of old-age and survivors insurance. Some farmers, it was said, are not articulate about their own stake in retirement. In other areas, sentiment is growing rapidly among farmers who want coverage for themselves and who feel resentment at "discrimination" in non-coverage. Only the "regular hired hand" is now covered. There was agreement that further informa- tion should be channeled to rural areas. Also, it was pointed out that in all States, but particularly those with large urban populations and wide oldrage and survivors in, surance coverage, there is value in relating the size of the old-age assistance program to coverage under old-age and survivors insurance with a view to determining the effect of one on the other. There is still need, it was stated, for understanding that both these programs are part of the over-all program, and that the deficiencies in one in- fluence the size and character of the other. What Kind of Living? In addition to studies of income maintenance and the distribu- tion of income, there is need for study within the State of what kind of living the income buys. For example, a study made in Kentucky showed that about 80 percent of the recipients of oldyage assistance live in homes with no running water and no toilet facilities. - 3o - In Minnesota, the problem of the chronically ill receiving old— age assistance was cited. It was pointed out that, because the medical care cost can go above the State's maximum on income plus assistance, two groups are relatively well cared for: those in convalescent homes; and those receiving care in their own homes. But for the grOup living in boarding homes, the State's legal maximum of $60 monthly on income plus assistance does not meet cost, and hardship results. On the basis of this finding, it was stated, the Minnesota commission will recommend that the Legislature change its present maximum. In a Connecticut study, it was found that pe0ple fared beet if . living with relatives or within a lO—mile radius of them, so that in case of illness they either could move to their relatives' home or their relatives could come to their home to give the care needed. The discussion was further extended to the experience of various communities in the use of supervised home-maker services to supply the care needed by aged pe0ple, and with which they can continue to remain in their own homes. In some cities, it was reported, experi- ments have been made with a part-time home—maker service given to an aged couple for one day or one-half day a week. Detroit, it was stated, began its service by limiting the cost to the amount which would be en- tailed in the alternative of institutional living. Now, even if the cost exceeds that of institutional living, it is allowed under old-age assistance, providing the need for such service is temporary. Since the cost of the home—maker's salary can be considered an administrative expenditure, the Federal Government shares in the cost of the service on a matching basis, outside the sharing arrangements for the cost of the assistance program. Furthermore it is recognized that once the _ 31 _ home is broken up, and the individual placed in an institution, it is difficult to reverse the process. Comment was made on the present meagre knowledge of the kind of living, or the standard of living and consumption patterns, of the ag— ing population. The Bureau of Human Nutrition and Home Economics in the Department of Agriculture, it was stated, makes consumption studies which include some data on aging groups. The Budget for an Elderly Cou le, develOped by the Federal Security Agency and adjusted periodi— cally in selected cities by the Department of Labor, reflects the needs of aged peOple in an urban but not necessarily a rural setting. Supplementing Assistance Income Through Employment Many of the delegates expressed themselves in favor of encour- aging elderly persons receiving old-age assistance to supplement their income, if they so wish, by taking advantage of any employment oppor- tunities that are offered. In those States where these assistance grants are obviously inadequate, the recipients often have to turn to occasional employment to meet the greater portion of their needs. It was the general assumption that the restrictions which make it diffi— cult for a recipient to undertake such employment, and also the long delays in restoring an individual to the assistance rolls after he has voluntarily gone off, are due to Federal legislation or regulations. This assumption, it was asserted, is by no means valid. The States, it was pointed out, have rather wide latitude in budgeting earned income and also supplemental income in the form of gi‘ts. The purpose of oldrage assistance is to bring an individual's total income up to the point which each State determines is the minimum income essential for maintaining a standard of decency and health for its - 32 - -citinens. ‘Earned income and gifts, therefore, have to be taken into, account by the welfare units administering assistance grants to the aged, but need not necessarily lead to loss of eligibility or to a reduced grant if special needs exist which the additional income can be budgeted to meet. It was emphasized that State regulations and local administrative meChanics account for most of the long delays in restoring the assistance grants of persons who conscientiously go off relief when they can, for a time, meet their own needs without assistance from public funds. It was suggested that groups concerned with these matters should study their State welfare laws, and the local administratiou of welfare funds, to see what changes can be made to secure greater administrative flexi- bility and better understanding of individual needs. Extending Social Insurance There was some discussion of proposals to extend the old-age and survivors insurance program to cover groups at present without protec— tion.l It was recognized that even universal coverage would still leave several million currently aged persons outside the system. These are persons who retired too tong ago touearn benefit rights, and the aged wives and widows of such persons. One proposal to meet the needs of this group is to blanket them all in under old-age and survivors insur- ‘ance for a minimum benefit, the sole conditions being age and retirement. Even at so low a rate as $25 this would cost several billion dollars a year. The propasai for blanketing-ifi is; therefore usually tripled with the withdrawal or the Federal Government from public assistance. The consequences for present recipients of old-age assistance and for the -States would vary. In States with low assistance payments, it was m 33 _ pointed out, most recipients would be at-least as well off as they are now; some would be better off, some worse off, depending upon the size of the minimum benefit. ,In States with-high payments, most recipients would undoubtedly be worse off, unless, that is, the State supplemented the Federal benefit. As far as the States are concerned, the savings in present State—local expenditures for oldmage assistance would vary, depending upon the level of present assistance payments and the size of the proposed Federal minimum benefit. Most, if not all States, would be under pressure to supplement the benefit. If the latter were $25 or less, quite a few high-payment States would have to spend more for sup- plementation than they do now on their share of old-age assistance. At present, it was pointed out, there are rather widely differ- ent standards in effect in old-age assistance in different States. In California the standard is now $75 monthly for basic needs. For pe0ple without other income, old—age and survivors insurance with a "blanket- in" provision, it was said, would hardly be acceptable. The disabled were seen by the Conference delegates as a grOup particularly in need of insurance protection. The acceptance of this principle is reflected in recent oldpage and survivors insurance legis- lation providing for the "freezing" of the benefit rights of perma- nently and totally disabled workers, although for all practical purposes this legislation can not become effective until further action is taken by the Congress. It is sometimes suggested, as a method of saving money, to limit permanent and total disability insurance to workers in late middlenage. If eligibility for disability benefits were to be limited to persons 50 years or over, half or more of the disabled group, now without protection, would be taken care of. -31.- The Work Group on Income Maintenance concluded its discussion by agreeing on the following recommendations: 1. That the State commissions ask the Federal Government to provide information on kinds of income data available in Federal Agencies, and on resources for assisting the States to deve10p data of their own. That commissions study the use of community home—maker services as one method for helping maintain aging peOple in‘their own homes, and explore costs of such service and ways of financing it. That oldaage and survivors insurance be extended as the basic government program for income maintenance, and that the desirability of disability insurance as part of this program be explored. - 35 - V Health, Medical Care and Rehabilitation There is little doubt that problems involving the health and re- habilitation of older people Vere also very much on the minds of the del- egates, though in many respects the discussion was handicapped by the fact, as noted above, that there was on1y_a comparatively small repre- sentation at the Conference from the field of public health. The Connecticut Experience Without question, the most positive impression on the Conference was made by the Connecticut delegation. Its detailed description of I the methods employed by its own State Commission in providing direct medical and rehabilitation services for the chronically 111 was listened to with tremendous interest by the other delegates. The Connecticut State Commission was organized in l9h5 to find some way (as noted above) to reduce the heavy burden of the cost of medical and hospital care which had recently been added to the benefits of public assistance. And its attack on the problem was based on the conviction that chronic illness was the major cause of dependency among the aged and the aging. V In discussing this program, one of the delegates explained that the Commission had started on a purely demonstration level. "We asked for a study unit first," he said, "to see if what we thought was true EEE true. And after five years, we have drawn a few deductions that bear out some of the things we contended originally, and have changed our minds about others." In l9h7, the Commission was given permission to operate a study unit in a wing of the State veterans hospital. Since then, some 500 to 600 old age assistance cases have been sent there for _ 35 - rehabilitation. At the present time, the Commission operates similar wards in b general private hospitals. Experience has shown, the delegate said, that the next step is to provide low—cost domiciles for those who have been rehabilitated, but can not live by themselves and who have no family to take care of them. At the moment, he said, he was uncertain whether these would be estab- lished and operated.by the Commission or through some other agency. But he made it clear that the Commission intended to get action by one means orxanother; Though admittedly the Commission still has a long way to go before arriving at a solution of all the problems, the delegate was vigorously of the opinion that its approach was the one best calculated to achieve real results. As previously stated, however, it was the consensus that, gener- ally speaking, a State commission should avoid asking for authority to direct services, This holds true particularly where there is reason to believe that the health needs of older people can be met by utilizing and expanding the present health and welfareservices0 The chief responi? -~smbility of a commission, it was felt, lies in calling public attention to these needs, and in working with existing agencies to see that the needs are more effectively met. At the same time, it was agreed that its role must necessarily vary in different States, depending on the adequacy of the State and local resources in the health field. And where there are no programs of sufficient calibre to do the Job, it is clearly up to the State commission to initiate action to make up the deficiency. _ 37 _ Special Health Services for the Aging? There was general recognition that the health needs of older people are greater than for any other age group. Chronic disease, it was pointed out, is four times as preva-ent after the age of 65-and, on any given day, there are some 3/h of a million older people with chronic disabilities being cared for in institutions, Then, too, older people are, for the most part, financially unable to secure the specialized medical services they should have, And the heavy burden of a hospital~ . ized illness is underscored by the fact that only 2 percent of Blue Cross membership are men and women 65 years or over, Despite these considerations, it was the belief of most of the delegates that there should be no compartmentalizing of health services for the aging. What was necessary, it was pointed out, was a greater understanding of the special health needs of older peOple on the part of physicians and pdblic health officials, If this could be achieved the basic health services would be capable of carrying the load, Some dissent to this opinion was expressed by a delegate who sug- gested that the ”pinpoint approach" which has been effective in other health problems-—as, for instance, tuberculosis-~could be equally well applied to the aging preblem, Attention, however, was drawn to the fact that many of the health prchlems of old age have their roots in middle age, and that programs'directed towards the middle-age group offer the best opportunity to prevent many of the disabilities of old age. Since nearly half the adult population of the country is on the "other side of #5," it is essential that the approach have the widest possible base, and, that all factors in the earlier years which make for old age dependency should be taken into consideration and made a part of health planning“ - 38 . It can here be noted that, fer the most part, the delegates sup- ported this approach in reapect to all cemmunity services which in any way come into the aging picture. In fact, grave concern was expressed ' over the danger of setting the aged apart as a separate group. It was generally agreed that the older citizens themselves do not want to be so treated. As several delegates pointed out, creation of separate agencies and facilities for the aging runs counter to the general philosophy of American government. It also creates administrative and financing prob- lems. The soundest psychology and the wisest public policy, it was felt, is to think of the disabilities of the aged as those found in varying degrees in other elements of the community and not at all peculiar to the aged. Prevention of Illness The importance of health measures aimed at the prevention of disa- bility was also given considerable attention. It was pointed out that chronic disease, if caught in its early stages, can often either be cured or its progress arrested before it becomes a disabling illness. Much emphasis was placed on the value of multiple screening as a means of de- tecting symptoms of disease in a mass population. By means of X-ray, ' blood tests, etc., it was explained, incipient cases of tuberculosis, dia- betes, anemia, cancer and certain types of heart ailments can often be uncovered. The Public Health Service of the Federal Security Agency is coop- erating with a number of States in conducting mass screenings in selected communities and is providing both financial and personnel assistance. There are still many "bugs" in the procedure, it was said, and many - 39 . administrative problems still to be worked out. But the method, it was felt, has very great potentialities. Emphasis vas placed on the need for medical schools to train physicians toward a better understanding of the problems of aging and enable them to recognize their social and community responsibilities in this area. Discussion also revolved around the difficulty in obtaining counseling services from the general practitioner for the patient re- ferred to medical, surgical or other specialists. Rehabilitation A The importance of helping older peOple, who are disabled because of chronic illness, to "get back on their feet" came in for further discussion. Much effective work, it was pointed out, is already being done in this field by State agencies. And comment was made on the grow- ing tendency of old-age homes to concentrate on the care of the chroni- cally ill, and to provide occupational therapy and rehabilitation services. In most States, it was reported, great difficulty is experienced in getting older people accepted by the rehabilitation agencies. This is due to the fact that the potential employability of the individual is the determining factor in certifying a person for rehabilitation services. Because of the prejudice of many employers against hiring older workers, it was said, these agencies tend to give their major attention to younger men and women. As one of the delegates pointed out "58 percent of our 'disabled load (on public aSSistance) are over 60 years of age.“ A sta- tistical analysis of this load in terms of those individuals who could be rehabilitated (providing serv1ces were available) and thus eventually re- moved from the assistance rolls would, it was suggested, be immensely -I+o- valuable to the welfare people in spelling out their problems in this area of need. A representative of the Office of Vocational Rehabilitation re- ported that, in the past half decade, the average age of rehabilitants" had increased by 8 years. At present, some 8 percent of those receiving State-Federal services are #5 years or older. Because of the limited funds available, it was pointed out, some States seem chiefly to reha- bilitate those who have a potential production capacity over a long period. However, it was asserted, there is a growing understanding of the need of rehabilitation services for older workers. And the recent joint conference of the University of Michigan and the Michigan State _ Vocational Rehabilitation authorities, devoted entirely to the subject, was given as an example of this new emphasis. Health Services in Nursing Homes Standards of care in nursing homes, and the question of how to im- prove health services in these homes, evoked considerable discussion which reflected the multitude of problems in this area onfronting the States. What to do about closing homes that did not meet s andards; about homes that would not accept welfare patients; where to place patients when homes were closed--these were some of the questions asked, without specific solutions being advanced. And a discussion of Joint responsibility of public health and welfare,departments for the care ren- dered to patients in nursing homes and similar facilities, seemed to center chiefly around the difficult matter of equitable rates and the basis for such rates. Out-Patient and Home-Care Services Much interest was shown in the availability of out-patient and _ hl - other types of clinics, especially in non—urban areas, as well as in the programs for home care that are under way throughout the country. Pro- vision of more nursing services in the home for rehabilitants was de- scribed as a vital need, though no suggestions were offered as to how these services could be expanded in view of the alarming shortage of nursing personnel. Emphasis was placed on the need for education of the patient's family in simple nursing procedures, and also in rehabilitation procedures. Much of the importance of home-care programs sprang from a rec- ognition of the heavy pressures, which many general hospitals are under, in caring for the chronically ill. In the absence of effective reha- bilitation services, it was asserted, many of the patients are returned again and again to the hospital for care and treatment. And it was sug- gested that some research agency might well make a study of the load im- posed on our general hospitals by these repeated admissions. At the same time, it was pointed out that, in order to make a home-care program fully effective, it is necessary to have adequate laboratory and diagnostic facilities. The already heavy load that the hospitals are carrying makes it virtually impossible for the hospital authorities to take on the additional responsibilities which such an extra-mural program requires. The answer lay, it was acknowledged, in the coordination and utilization of all existing resources, and it was to this end that State and community effort should be directed. Caring for the Mentally Ill The problem of mental illness also precipitated a prolonged dis- cussion. There is an alarming increase in the number of aging and aged persons admitted to our mental institutions, many of whom might be better _ kg - cared for elsewhere by utilizing community medical or domiciliary serv- ices. This is putting a terrific strain on both our existing facilities and our economic resources. Emphasis was placed on the urgentneed for adequate preventive programs. Experiences in Massachusetts, it was stated, prove the value of such preventive service programs, and are confirmed by reports of the efficacy of the rehabilitation programs in various centers in New York City. These reports have demonstrated *hat senile psychosis—-one of the most frequent diagnoses among aged patients--can, in large measure, be preventedo Based on results obtained in these rehabilita- tive programs and demonstration projects, it was stated that perhaps one of the most economical approaches to the problem of senile psychoses might well be the development of preventive programs on a wide scale. These would incorporate occupational, recreational and social contacts to help meet the needs of th older person. Many indications of illness have been demonstrated to be emotional traumas, caused by loss of status,‘ feeling pushed aside, etc. These health prdblems, it was stated, can in many instances be prevented. The need for facilities for the mentally ill in the general hos- pital was underscor~ as a major need° If general hospitals would pro- vide facilities for short-term stays f mentally ill patients, many of them could return to the ommunity within a fev days and would, it is estimated, reduce the admissions to State mental hospitals by some 60 percent. The "day-care center" for mental cases in Massachusetts, it was stated, has stimulated a great deal of 'nterest in the whole problem of mental health, and the establishment of ”night-care centers" for similar - h3 - patients in the community-is being actively considered. One difficulty that lies in the path of all these programs, of course, is the lack of a sufficient number of trained psychiatric nurses. The American Hos- pital Association and the Catholic Hospital Association, it was said, are currently concerning themselves with this problem. A proposed project of the American Psychiatric Association was described as a possible solution in other cases° The APA, it was re- ported, is developing plans for a special type of hospital geared to the needs of older age persons with mental disorders. So far as pas» sible the atmosphere of the ordinary mental institution would be erad- icated. A husband and wife, for instance, would'be permitted to remain together in an efficiency apartment° A sheltered workshop would enable the patients to engage in rehabilitative activities under medical superm vision. Opportunities would be afforded the patients to do small Jobs for the manufacturers in the area,and to manufacture articles of their own for sale. In addition to the curative value ofgthese activities, they would serve partially to help the patients contribute to the up- keep cost of the institutiono Great concern was also expressed over the large number of elderly persons committed to State mental hospitals, during periods of extreme disturbance. who can not then be returned to the community after they have achieved a substantial recovery. In Massachusetts, it was stated, there are probably more than 3,000 such patients at present who could live outside an institution, provided the right living arrangements were worked outo The same problem exists in other States. In this connection, it was pointed out that, in large part, the prolonged confinement of elderly persons in State hospitals, and the - hh - many instances of recommitment,after a short period back home, are due to the lach of proper community planning to meet the needs of the aging population. Much of the problem, it was said, centers around the tragic plight of single old persons who have no one to take an interest in their well-being. In many instances, bad food habits, irregular schedules, and lack of social intercourse. have been.shown to be the direct causes for their commitment to an institution. Some sort of community service to provide individualized care and concern is needed when the patient is ready to return to his home community after a.period of care and treatment in a hospital. Unfortunately, it was asserted, there has been little effort to provide services of this nature, al- though the problem is within the competency of voluntary health and welfare agencies and groups concerned with community organization for the aged. ’ ,' -15.. VI LIVING ARRANGEMENES Living arrangements for older people offered a fertile field for discussion which covered both independent housing and institutional living. It was pointed out that mch of the housing problem for those in their later years derives from the sharp curtailment of income after retirement. An elderly couple, for instance, trying to live on a small pension, may . have great difficulty in maintaining their former home. What they 'L'erl'ily want is" some place to live that is geared to their special needs and particularly to their pocketbook. This applies, it was asserted, not only. to the "needy" with whom the public welfare people are concerned and to those who require nursing-home or institutional accomodations; it is some— thing that affects a very great proportion of all old people. 'And any solution to the problem, therefore, must embrace a. variety of approaches. Essentially, it was asserted, this is a. question for which each individual connmmity must find its own answer. The business of a State ' commission is to help focus attention on the problem and to marshal, for this purpose, all available resources. The Federal Govermnént, especially the Housing and Home Finance Agency, it was pointed out, stands prepared to offer technical assistance, and can often give valuable help to the community either in general planning or in working out specific projects. Housing Developments Much of the discussion centered armlnd specific projects already under way or contemlated. . A plan for a sponsored neighborhood village, under consideration by the Retirement Research Division of the Florida State Improvement Commission, was presented in some detail. Under this - #6 .. plan, retired workers from industrial concerns would. establish small new communities, ranging in population from 500 families upward. Such com- munities would be operated on a non-profit basis by companies or labor unions. Living units would be designed with special needs of older people in mind; a well—rounded, special activities program would be provided; and machinery to insure continuity of the commity would be established. It is the hope of the Commission to provide housing at a cost not greater than $35 a month. Industrial companies, it was said, have indicated substantial interest in the plan, both as an incentive device in employee relations and from a public relations point of view. Employees are likewise inter- ested because they see in it the potentialities of quality housing in a mild climate at a. reasonable cost. As an example of labor union interest, it was reported that the Upholsterers' International Union is taking steps to establish a sponsored small community for its retired employees, under the Florida plan, at a cost of 351% million. The Union contemplates using the housing and facilities for vacation as well as retirement purposes, > both to acquaint members. with the new community and to insure maximum use. In discussing the plan, the question was raised as to whether the sponsored neighborhood village would result in the segregation of older persons from the range of on-going activities usually found in the more heterogeneous type of commity. This was recogniz d as a. problem by the Florida Commission, though it was hoped that the various types of com- nity facilities to be provided would overcome this obstacle to a greater or lesser extent. A number of surveys to acquire such data, it was - A7 .. stated, have been completed; others are underway, and still other studies are contemplated. _ V , Provision for the housing of single persons, or the residual mem- ber of a family unit, was also discussed. Reference was made to the Methodist Village in Virginia where dormitory accommodations and the planning of apartments are among the approaches under consideration, by the Virginia Department of Welfare} and Institutions, to meet specific problems of this kind. The develpment-oi' Penney Farms in Florida, where efficiency apartments are now being added as an attempt to meet such hous- ing needs, was further cited as an approach to this problem. In this conu- nection, it was observed that housing costs can sometime be reduced by permitting occupancy of a unit by two persons not related by blood or marriage. Attention was also called to the fact that, while Federal public housing regulations do not permit single individual admissions to projects, the surviving husband or wife is permitted to remain after the death of the spouse. ‘ Consideration was given to the broad problem of that is being done in the "average" community to provide suitable living arrangements for older persons. Emphasis was placed on the necessity of providing shop- ping, recreational, medical and social facilities and, in particular, of making it possible for older people to continue to identify themselves with the community as a whole. As one delegate put it, all older per- sons are not interested in living out their later years in a setting of . "trees and grass." Some want to‘be "where, life is moving-snot necess eerily to‘be a part Or it, but at least to be able to sit on the side- lines at watch it." 4 each people, he said, still have "a need for in- dependence and choose familiar ‘surrotmdings every tine. I .. 1&8 - Park Forest in Illinois was Cited as a new development in which a deliberate effort is being nmde to secure variation in family type and size as a means of dealing with this problem. Here, a number of small apartment—type units, near the center of town, are projected which will be particularly suitable for occupancy by older persons. Such planning, it was pointed out, avoids some ofthe drawbacks that exist in housing developments which concentrate on a single family type and size. It also makes possible certain social benefits that accrue to the more heterogeneous kind of community. As was emphasized repeatedly during the discussion, older persons resist being segregated from the normal on-going activities of a community, and wish above all to be a part of active commity life. In this connection, the experience of the Brit- ish was cited as demonstrating how successfully the problem of living arrangements for older people can be dealt with by providing "separation without segregation . " Public Housing and Slum Clearance Matters relating to low-rent public housing came in for general consideration. It was reported that the mblic Housing Administration of the Housing and Home Finance Agency is currently giving general guidance to local housing authorities with respect to the housing of J aging persons. "l‘here was also discussion as to whether State commissions should concern themselves more actively with slum clearance legislation in order to get rid of some of the undesirable slum houses frequently Occupied by older persons. This, it was pointed out, raises two questions: first, who will be displaced by such slum clearance? and secondly, in planning for the re-use of cleared areas, what opportunities will accrue for .. #9 - housing aged people? In exploring some of the aspects of this problem, it was emphasized that housing needs of aged persons is basically no different from those of all other persons. It is essential that a. com- munity attempt to achieve good housing on all fronts. . The major problem is cost; and as housing costs are reduced for everybody, the task of pro- viding suitable housing for aged persons will be made easier. Subdividing the Home In general, it was eased that the basic question is "how the housing cost problem can be attacked so that the aged can afford to live in a house that meets their needs." 'Ilhe discussion brought out the fact that surveys conducted by the Bureau of Old—Age and Survivors Insurance show that may aged people own homes that are too large for their needs, and often attempt to supplement th=::ir limited incomes by subdivuiing older large homes. The suggestion was made that State comissions might usefully develop an advisory service which mld enable older peeple to become aware of the effective means and resources for such subdivision. However, it was urged that, in providing such technical assistance, the remodeling and subdivision of larger homes should be evaluated in terms of the psychological and other prozalems of the aging person, rather than as a business venture. The experience of the Rederal Housing Administra— tion has shown that many cases of subdivision do not pay from an economic point of view. 0n the other hand, it was agreed that subdivision often contributes a genuine measure of family security, even though it may not give any substantial relief to"the economic plight of older persons. There was also comment on the fact that zoning regulations fre‘ quently limit the extent to which older homes can be subdivided and that, in some commities, a new attitude tOVard 2-family houses would have to .. 50 .. be developed. This is especially important if any progress is to be made with the promotion of the "three-generation" house, or the so- called mther-in-law annex, as a means of meeting the needs of persons who seek some degree of privacy but yet not complete separation from their kin. It was suggested that this is an area to which State com- missions might well give increasing attention. Boarding and Nursing Homes |l'here was some discussion of the boarding-room program of the Public Welfare Department of North Carolina. which is one means by. which the State is attempting to provide satisfactory. living arrangements for a number of older persons. The program is not limited to persons receiv- ing public assistance or to those with particular social and economic problems, but has been developed to meet the needs of all strata of soci- ety. As a result of this program, the Departmnt is receiving requests for assistance in locating suitable living arrangements from a large number of older persons of widely varying economic resources. The De- partment ismaking use of the program as an educational medium to enlist as many community resources as possible in an effort to meet the housing needs of all the aged. During the discussion it was suggested that every community should undertake a survey of facilities available for aged and single persons who need nursing care or a place to live. In fact, it was asserted, ' there is greater need for such facilities among persons who are finan— cially independent than there is among the needy. As one delegate phrased it, "Just because a person has some money in his old age is no assurance that he will not have a hard time finding the right place to live . " .. 51 .. In general, the confer es agreed that boarding— and nursing-home programs are a. vital sector ‘ any approach to the aging problem, and that it is the business of a ttate commission to explore and evaluate these programs to the fullest extent possible.‘ Particular attention was directed to the urgent necessity of developing adequate standards to govern the operation of such homes. In Florida, it was reported, the Citizens Committee on Retirement, the State Welfare Department and the State Health Department are proposing legislation to provide standard I procedures to govern the operation of nursing homes, It was the con- sensus that similar action should. be taken by all State commissions, and that they should seek the cooperation of other appropriate State agencies or interests or segnents in the development of adequate standards. mortive Community Services I Supportive programs, involving a variety of home~care commity services that make it possible for a greater number of older persons to live in their own homes, also came in for a share or the discussion. Two or three experiences where private organizations had made use of this approach were reported, The discussion revealed that State commissions were definitely interested in making wider use of the supportive programs but that, for the most part, limited staff resources prevented. them from taking such steps» The delegates, however, agreed that programs of this nature constitute a useful device for meeting some of the housing needs of the aging, and their ,ydétfentialities should be explored by all gtate commissionsa I V Cooperative Housing Major consideration was given by the delegates to the whole ques- tion of cooperative housing in relation to the housing needs of aging .. 52 _ persons. Section 9.13 of the Federal Housing Administration insurance prog'am, providing for cooperative projects, was mentioned. as offering a practical device that might be adapted to meet some of these needs. The Florida. Commission, it was reported, is currently exploring coopera- tive housing possibilities under the provision of this section, but is finding it difficult to bring together the minimzm number of people re- quired to undertake a. cooperative project It was suggested that efforts of this sort would have a greater chance of success if cooperative youps were encouraged to recruit a reasonable proportion of older persons into their membership, rather than attempt to organize cooperatively a. member- ship comprised solely of older persons° Financing of Housing Progects In discussing the various means that might be employed in housing the aged, the importance of exploring all untapped financial resources was underscored; An example was given of the activity going forward under the Comonwealth Housing Rind in Bostone Here, with leadership provided by the Housing Association of Metropolitan Boston, plans are under way to utilize a long existent , but practically unused, charitable fund to provide an apartment—type development for the aging“ Careful canvassing of all such :mstitutional funds was urged with the view of bringing their usefulness into step with current needs. lehgwd Design of Institutions Attention was also directed by the delegates to the need for rais- ing the general level of planning and design with respect to institutions. In this connection, it was reported, that the National Lutheran Council has suggested to the American Institute of Architects that groups should be brought together to bring about general improvement in this fieldo ’. 53 - Major Basic Principles Out of the discussion on living, arrangements certain basic prin- ciples concerning a valid approach to the problem emerged These in- eluded: l. The provision of adequate living arrangements and housing for aging persons calls for the fullest possible exploration and utilization of all the various means, both from the point of view of independent liv- ing and institutional living. At best, no one device meets the housing needs of more than a portion of older persons. All feasible resources and devices must be utilized in meeting the problem. 2. The planning of housing for aging persons is essentially a. broad commnity problem. Emphasis was given to the fact that, if the housing opportunities for the aging are to be improved, housing oppor- tunities for all persons must likewise be improved. Thus the total housing supply is battered and benefits accrue to older persons along with others. 3. Older persons indicate definite preference for housing that is located and properly related to the on-going activities: in the come munity. Not only do they want to be in the center of things,but they want to feel that they are an active part of community life. it. Wide flexibility in planning both as to methods and types of accommodatiOna; must. be employed if suitable living arrangemnts are to be provided for our aging population. 5. The sound planning of living arrangements for aging persons must take into consideration the mam social, economic, and psychologiCal factors affecting aging per-sens. « The‘necessity of providing shopping, . - 51‘ ~ recreational, medical, and social facilities, within practical proximity, was recognized throughout the discussion. The Role of the State Commission Mom the discussion, also,_.came several concrete suggestions as to the type of activities which a State comission can profitably undertake at this time: 1. Each State commission should establish a subcommittee on hous— ing and living arrangements for the aged whose major concern would be to encourage and promote services and programs to achieve more adequate liv- ing arrangements for our older citizens. 2. State commissions must, without fail, concern themselves with the development of adequate standards to govern the operation of nursing- homes, boarding-homes, and the many various types of institutions for aging persons. 3. State commissions might also well give more attention to the many facets and effects of local zoning regulations, as related to the housing of aging persons. Discussion of this area of activity during the Conference was focused chiefly on the subdividing and remodeling of larger homes, a device often engaged in by older persons for reasons of economic necessity or sometimes because of family preference or security. However, it often affects the location of institutions, the building of annex-type apartments for aging parents, and other forms of housing arrangements for older people. It was felt that the field of zoning regulations may well prove to be an area calling for community study and action, if our aging population is to be well housed. 1+. State commissions should explore the potentialities in the cooperative housing device whereby housing cost can often be reduced, .. 55 - and suitable living manganents made available, to a substantial segnent of the aging. 5. State missions should be on the alert with respect to untapped financial resources, such as endowments, foundation mas, etc., and. take steps to ensure the full usefulness of such hands in terms of current housing needs of aged persons. 6. State commissions should. encourage supportive programs that mad. enable many older people to live in their own homes or avail them- selves of other similar suitable living arrangements. 7. State connnissions should familiarize themselves with all local, State, and Feaeral resources, including those of both public and private organizations, and make full use of such resources in achieving adequate housing for older people. - 56“.. VII ,_ NATION AND GUIDANCE lJIhe importance of education and guidance activities in any approach to the problem of aging was clearly recognized by the conferees. Empha- sis was placed on the concept of life-long education, or more. specifically adult education, as a "powerful force . . . in the preparation of an en- riched, personally satisfying and. socially'usef‘ul old age." Effective adult education, it was said, must deal not only with cultural values but also with practical matters of preper nutrition and the care of one's health during the middle and later years. of life. Adult courses in thepublic schools, together with university ex- tension courses, were identified as offering the most effective channels for community educational effort among older people. Libraries also provide excellent facilities. And programs sponsored by civic, buéiness and professional associations, religious groups, labor unions and farm organizations have proved highly successm. Strong emphasis was placed on the use of mass mediaupress, motion pictures, radio and television. Attitudes “Tm-lands --7 Older: 'Pers ons One of the questions raised early in the discussion was whether "Older people wanted to learn." Recent surveys were mentioned which indicated that older people are not interested in further education. It was suggested that this attitude is probably due to a "built-in" cultural I. pattern. Adult education, ,it.was pointed out, is associated with "school- ing," and schooling is associated with chidren. Adults hesitate, there- fore, to identify themselves with children going back to school. Mare- over, they are reluctant to place themselves in a position of competing - 57 .. with youngsters. Furthemre, no effort is usually made to adapt either the instructional methods and materials to adult needs and interests. This has been a deterrent factor in the promotion of adult education. The most important dravback, however, it was stated, is the fal- laoious idea that old people cannot learn. An organized effort to get rid. of this concept constitutes one of the great- :eeds in the-"whole i. field of education for aging. The immediate Job is to try to change the attitudes of the older people themselves. After that, 1.7:";2haps, it will be easier to break down the prejudices of the school administrators and the teachers. I Discussion on these points raised the question: whether, for educa- tional purposes, it is better to segregate older. people from the other age groups. In general, as noted above, it we; felt that older people do not wish to be set apart or to be considered as‘na special group. From the democratic point of view, and that of the social welfare, it was the belief that integration is the wisest policy to pursue. However, it was recognized that certain situations may call for a limited amount of segregation. This is true if older people are to make their maximm contribution to the group, and are not to be frustrated and discouraged by the competition of younger pers'ons'_before they have a chance to achieve the necessary self-confidence. Older people, it was pointed out, come to class with both strengths antiweamesses, as is true of younger persons. A qualified teacher 'will be able to utilize these strengths to the learning advantage of both the individual and the class. He will also knew how to treat the weaknesses so as not to em;- barrass morons . 358.- The attitude of the younger age groups towards older people was discussed in terms of intergroup education. Recent advances in psychol- ogy, biology, and anthropology, it was pointed out, have made pos— _ Bible a scientific approach to this problem. Reference was made to a list of materials for teachers on the subject that has been developed jointly by the Office of Education of the federal Security Agency, the American Teachers Association and the National Education Association. A similar list, it was stated, is being developed for the use of com- munity leaders dealing with the fundamental principles and techniques at adult intergroup education. Value of Correspondence Courses _The delegates apparently placed little value on correspondence courses, either as an instrument of adult education for older people or as a means of providing training in the field for teachers and leaders, These courses were criticized mainly for the lack of Opportunity they afford for vital group discussion’ This is partly because of the diffi- culty in finding competent persons to handle the courses, and partly be- cause of the excessive time required to answer satisfactorily and con- siderately the great number of letters likely to be received. However, it was agreed that the nature of the course and character- istics of the student might modify this Judgment, and that it would be possible to adapt such courses for the use of older people in isolated places or those who do not wish to Join a formal class. It was reported that the University of Chicago and a few other institutions already have established, or are contemplating ‘thea establishment cg correspondence courses in the aging field. The National Home Study Council is also ex- ploring the matter, and may soon have some answers to many of the questions involved. - 59 _ Filmsz Radio and TV No small amount of interest was expressed in the use of films and transcriptions in education for the aging. Few films, it was stated, are available on the specific subject of aging, and most of these are not very satisfactory. Attention was called to the Director of 16 mm. Film Libraries and the catalogue of U. S» Government films, issued by the Of- fice of Education. The Office of Education, it was stated, is cooperat- ing with the Library of Congress in cataloguing all Government motion pictures, with appropriate subject headings and annotations. The cata- logue cards are now being distributed to libraries throughout the country and to other institutions. Interested groups, it was said, may find some of the listed subjects useful in a program of education and guidance for the aging. i I The value of radio recordings as educational media was also ex- plored. Attention was called to the series of recordings made by WEAL; of Baltimore; and those of the National Institutes of Health, the Bureau of Old Age and Survivors Insurance, the university of Maryland, and the University of Michigan. The Transcription Ex hange of the Office of Ed- ucation was also mentioned as a source of recordings that might be a- dapted for use in the education and guidance of older people.' The great potentialities of television for educational purposes was emphasized, together with the importance of taking prompt action in securing the television channels allocated by the Federal Communications Commission for educational purposes. In this connection, it was sug- gested that groups interested in problems of aging might do uell to Jain with other community agencies to establish a local TV educational station. Colleges and universities, local and State public school systems, - 6o _ religious, social and civic organizations, and governmental agencies were named as having a direct.interest in such a venture. It was pointed out, however, that such research, planning, and organization must be done before effective educational use can be made of these _channels, Resources and Services of the Federal Government Particular attention was directed to the wide variety of educa- tional and guidance resources and services developed by a number of agencies of the-Federal Government. Some of these services, it was said, were especially designed for older people; the others were of value for adult education programs in general. Special mention was made of Department of Agriculture publications dealing with the nutri- tion and housing problems of older peOple, and also of various films on these subjects. State and county extension agents, it was noted, have organized clubs for older people under the leadership of, and with materials furnished by, the Department. It was the conviction of one delegate, however, that much more- could be done to develop these Federal services, in terms of the spas. cific problems engendered by the rapidly increasing number and propor- tion of o der peOple in our population. Government agencies, it was felt, should be urged to take such steps as might seem feasible to as- :Trsist the States and communities in dealing with the aginggg;oblemn Re~training of Older Workers - Much of the discussion on re-trainingeand the rehabilitation of the older worker also revolved around the resources and services offered the States by the Federal agencies. Public employment offices assay the potentiality of the individual seeking~a-Job, and offer counseling and ,6. _ placement service. They do net, however, undertake any training function. The Office of VocatiOnal Rehabilitation, on the other hand, provides re- training as part of the rehabilitation process, regardless of age, but only for those who have a medically established disability and where a reasonable hope exists that a rehabilitant may secure a Job. There is, of‘course, a Nation-wide c00perative system of State-Federal vocational training in the public schools administered by the State Boards for Vo- cational Education. But Federal aid to this program is limited to workers vho already have Jobs or are preparing to enter the labor market.§/ I I In other words, as you pointed out, there are no State Federal services available where an older, unemployed or retired person can re- ceive training for a Job for which his physical limitations would not prove a handicap, or the age factor count against him. Whatever is done lin this category must be financed out of State or local funds. General discussion of these matters brought out the fact that many of the supposed limitations in Services of this nature are only partially rooted in Federal statutes, and that many are derived from State laws and local regulations. In the field of vocational training, it was indicated that certain States have taken steps to remOVe some of these limitations, and to apply State and local funds to meet an area of need for which Federal funds are not authorized. ‘fi §/ Almost every School system has vocational training available to adults regardless of their employment status. Free courses in typing and short- hand are generally.available in all major cities to all women interested in taking such courses. Since almost 80 percent of vocational education is paid for by State or local funds, there are no general limitations on the way such funds are used except those imposed by each State or cOmmun- ity. Those courses which depend upon Federal funds are generally limited to training persons for occupations in which they reasonably can be ex- pected to find employment. ‘f.62 - State commissions were urged to explore all these aspects of this problem with a view of obtaining State and community action. At the same time, it was felt, the States should ask“ the Federal Government to liberalize its laws so that Federal funds would be available to help deal with the problem. A practical demonstration of what can be done by a specific com- munity interested in re-training older workers was described by one of the representatives of the Department of Labor. In 1951 and l9§?, the Women's Bureau of the Department, in cooperation with ten national women's organizations, the Bureau of Employment Security, and a number of State Employment Services, decided to determine the asSistance that could be given by women's organizations toward solving a shortage of women of— fice workers in a specific community. It was thought that there were probably many middle-aged women who, when they were younger, had been em- ployed in such Jobs and who now, with their children reared and their domestic responsibilities lightened, could undoubtedly be brought back into the labor market. Basic parts of the test program in some cities included an intensive publicity campaign urging employers to hire older women. In two of the four cities which tested the over-all program, special refresher training courses were develOped for women over 35 years nest age. or the 7k women taking this training in one city, approximately =‘6O were over k0 years of age. In another city, arrangements were made to establish a separate class for 50 such women who had been referred to the Employment Service by the women's organizations cooperating in the pro- gram in that community. The need for overcoming employer resistance to employing older persons, and the need for training of older women seeking 'n 63 c to re-enter employment, were amply shown by this test program which had been developed with the basic objective. of solving a labor shortage. - The Problem of Illiteracy One major factor was emphasized as affecting the problem of re- training and rehabilitation of older workers. And that was the factor of illiteracy. It was pointed out that there are some 10 million adults in this country who have received no education beyond that of the fourth grade. Thie educational handicap weighs heavily on older workers who grew up at a period when far fewer bays and girls finished grade school than do today. These functionally illiterate older workers do not pos- sess the basic educational background that would enable them to receive training for specialized Jobs in our modern, highly mechanized industry. And they are,therefore, either left 0n the "scrap heap" or forced to scramble for the meanest sort of Jobs for which no particular training is required. in“ ”[51, _ VIII“ EMPLOYMENT OF OLDER PERSONS Discussion under this heading focused chiefly upon two main as- pects of the subject: first, the significant employment problems which confront older men and women; and, second, the role of the State com-, mission in solving these problems. It was generally agreed that the major employment problem affect- ing older persons is the loss of one's gob during the two decades or so before the so-called retirement age, and the difficulty of getting an- other. The great majority of workers, it was pointed out, are not firmly attached to any one Job during their working years. This means that, frequently, they have to seek employment when they are middle- aged or elderly. It is samewhere in these middle years that employer‘ prejudice begins to develop against hiring men or women because of age. In addition, there are the special problems of middle-aged and older women who seek employment either for the first time or after a lapse in their work experience, On the average, age barriers to employment arise some 10 years earlier for women than for men, and many employers seeking office workers will not accept women over the age of 35. In other words, it was made clear that age becomes a barrier to employment much earlier than at 65 years, and that the problem is accentuated as the age of the worker increases. Much interest was shown in the way the Minnesota Commissiou is attacking this area. A sub-committee on employment, it was reported, has initiated studies in what it considers the four principal divisions of the problem: 1, hiring restrictions by employers; 2, restrictions - 65 - created by union or employer pension plans; 3, compulsory employer med- ical examinations; and h, job adjustment and re-training. Research on these topics, it was stated, is concentrated on the h5-65 age brackets with the problems of the over 65 worker left temporarily in abeyance. Similar studies, it is understood, are being conducted at Cornell University, Pennsylvania State College, the university of Min- nesota and by the Industrial Relations Center of the university of Chicago. In this connection, it was pointed out that the value of many studies carried on by universities and other institutions in the general aging field is severely limited because of the omission of the employ- ment and economic aspects of the problem.‘ What State Commissions Can Do In general, it was felt that State commissions should try to edu- cate the employer on the need of alteringlpresent restrictive hiring practices, and to change community attitudes towards the employment of older people. Many delegates, however, were of the opinion that a com— mission should also undertake to find new‘Job opportunities for the ag- ing and the aged. This point of view was opposed by those.who felt that it was more practicable, at least during the initial stage of the com- mission's development, to "remain behind the scenes," that is, to focus on research and the stimulation of interest in the general problem. The discussion also brought out a difference of opinion as to how much fact is needed before action can be taken. Some delegates felt that, until there are more c0ncrete data available on the employ- ability of older workers, little or no effective action is possible. Others, however, were convinced of the importance of doing whatever is possible now, on the basis of present knowledge, to relieve the situation. - 66 _. An outstandingly successful project in Schenectad , Neerork, was cited as an example of this latter contentiono Here, with the help and guidance of the_State JOint Legislative Committee oanroblems of the Aging, a local city committee on employment has been established with a Special counseling service which.has resulted in a 30 to to percent increase in placement of older workers by the local office of the New York State Employment Servicep The Committee maintains an information service and has established contact with employers throughout the areao It works in clOSe relationship with the local employment officeo th amples were given similar programs, in other communities, which have been successful in reutraining older people and providing them with a means of self-supporta The whole area of Federal and State cooperation in developing counseling and jobmplacement services for the older_worker was explored in some detail by a representative of the Department of Laboro The De- partment of Labor, he explained, had become interested in trying to work out a solution to the increasing percentage of older workers in the active files of the State employment serviceso It was convinced that the considerable experience it had had with special counseling and placement services for.handicapped workers could be applied to the problems of the older worker» As a result, a series of demonstration research projects was set up, in cooperation with the local State employment services, in New York, Pennsylvania, Ohio, California and Texas-o "We discovered," he said, "that by making more effective use of the techniques, personnel and resources at our command we could signifi— cantly.improve the placement possibilities for older peopleo" Based on - 67 - a sample of h,657 cases, it was found that "those applicants given in- tensive counseling and placement services had actually twice as good a chance of a Job as those who were simply permitted to go through the routine service of the office." I Since these studies were made, he said, the Bureau of Employment Security has issued a special section on services to older workers, and every State has done something about the problem--some more than others. But those States in which the demonstration projects had been conducted, and in which there is an active community interest in the problem, have made far greater progress than those in which such interest and support have not'been developed. .- Maximum Age Restrictions in Government Another area where it was felt that a State commission can, and should, function is in trying to persuade State and local governments to remove maximum age restrictions for their own employees. Some States, it was reported, have already taken this step; others have done so only for Specific positions. A forthright position on this matter by govern- ment, it was believed, would help in no small degree to break down some of the age restrictions which now operate in business and industry. In this connection, it was pointed out that the Federal Govern- ment has already taken action. Previously, the maximum age for Job ap- plications under Civil Service had been set at 62 years. Except for certain 50b categories, this maximum has new been abolished by the Con- gress, with the single stipulation that_a person who has reached his 70th birthday can be appointed to the competitive service only on a temporary basis. this action, he said, opens up the possibility that many Federal employees will be able to retain their Jobs beyond the age of 70. -’.68 ‘. . Business men on State Commissions I In.(dis¢ussing the composition of a State commission, it was stressed that prominent business men should be included as members of any group or subcommittee dealing with employment. The importance of this, it was felt, can not be over-estimated. ,Among the many advantages fre- quently cited for haying a State cemmission on aging is that it is easier to persuade employers to alter their present hiring practices if there is strong community backing for a program to provide empIOyment for older people. The more representative business executives are identi~ fieduwith~the program, it was said, the more likely it is to achieve results. ‘ :This suggestion tied in rather closely with a cemment, made at an— other point in the discussion, to the effect that many business men are~ complaining about high taxes to support the relief rolls while, at the same time, large numbers of older workers are forced on these rolls be— cause of their inability to get Jobs under a hiring system which imposes rigid age discriminations. V The Retired Worker in the "Sunshine States“ I Considerable attention was given to the problems of those States which have a large influx of retired persons every year. All too fre- quently, it was asserted, retired men and women who migrate to the so- called "Sunshine States" find their retirement incomes insufficient to maintain an adequate standard of living and are forced to seek either em- ployment or relief. In many cases, they.are unable to find suitable em- ployment and are added to the public assistance rolls. Stress was laid upon the need for realistic employment information for use in guiding the migration of retired people. It was felt that, - 69 . _ largely because of the popularity of the subject of the aging, there has been a great deal of ill-advised counseling of older people on~mwhere to retire", and much unscrupulous advice is being circulated by spurious bureaus and publications. It was agreed there was need for effective services to provide sound counsel for older people on this matter, and that some fiethod should be devised to bring about the exposure of qus . 2‘ Discussion also revolved around the need to attract industry to the States which have large numbers of retired residents. In Arizona, it was pointed out "87 percent of the retired people would like to be working." But, with little large-scale industry in the State, there is a Very limited number of Job opportunities, especially for older people. It was suggested that an inventory 'e made of -he special skills and abilities possessed by these older residents. Such an inVentory might serve to persuade outside industrial interests to move into the State and provide needed employment. Something similar could also be done, it was pointed out, in depressed econOmic areas suffering from unemployment where the Job problems of older persons are more acute because of the surplus of Qualified young workers. What Kind of Jobs for Older Workers? The types of Jobs on which older workers can be employed and their adaptability to these new Jobs came in far general consideration. Some of the delegates were of the opinion that the service trades provide more employment opportunities than the mass production industries; others held the opposite view. In the course of the discussion, numerous ex- amples were given which showed that many skills held by older workers are 1‘ transferable from one occupation and industry to another. In this . 7o . connection, it was urged that-greater efforts be made to appraise the capacities of older people in order to determine to what extent they can make a direct contribution to the economy of the State or Nation by marketing their skills. Surveys made in Utica and other cities of New York, it was stated, have shown that older people have many abilities and work potentialities which can be used to the economic advantage of _ themselves and the community. Criteria "for Retirement Another sepect of the employment prdblems of older persons which was dealt with at some length is the impact of industrial medicine and the role of the industrial physician. The need for a set of criteria to serve as a physiological yardstick was stressed, particularly for its value in dealing with the question of compulsory retirement based on chronolOgical age. Some delegates, however, were of the opinion that such a yardstick is not the whole answer to the compulsory retirement problem. The decision whether or not a worker is to be retired should, it was felt, in each instance be based on individual considerations in- volving a variety of social, economic and psychological factors. - 71 - IX FACT-FINDING, REPORTING AND RESEARCH The immediate question posed in the discussion around this topic was what kind of facts a State commission should be interested in. It was agreed the answer depends to a large extent upon how the commis- sion is organized, what interests motivated its establishment, and-- importantly--what resources it has in staff and money. Good fact-finding was described as something more than the col- lection of statistical data; it should have a qualitative character and try to create a picture of the aged population as human beings. The best results of course, are obtained from as broad a cross section as possible. However, it was admitted that, at times, the approach must necessarily be opportunistic. In Chicago for instance, it was pointed out, an impbrtant study was made of people known to public and private agencies, not because it was more necessary to know about this type of older person than any other, but because the basic data for such a study were more readily available. Ideally, it was felt that a major function of the commissions I should be the assembling of available data relating to their activities and the collection of pertwnent data when they are not already available. It was indicated, however, that the authorization for most of the com- missions is temporary, that their paid staff, if any, is extremely small and, that therefore, they are not in a posiSition to engage in any large scale fact—finding enterprises. It was agreed that, for the present, ggheir role was one of coordinating and making effective use of already éiisting materials, and that specific fact-finding proaects could 0an be - 72 . undertaken when the commissions had a full-time paid staff to work in this field. The Florida Improvement Commission, it was pointed out is in such a fortunate position, and has made a number of studies relating to the older population, present and potential, in the State. Delegates from Kentucky and Illinois, however, indicated that there were real resources for obtaining pertinent statistical information within their respective States, and that effective use was being made of them. And the Rhode Island Commission was reported as planning a survey of a sample of the whole aged pOpulation of its State, in cooperation with the Bureau of the Census, to provide a solid underpinning for information gathered from many sources. ‘ In any event, there was general agreement that the first duty of a commission is to see what informatioa is available to the community it- selfe—that is, data already collected by variOus local agencies, State agencies or by the Federal Government. The commission should also know where general studies, made by the various agencies, have stopped short of including significant data on aging, and how these gaps can be filled. In respect to mental hospitals, for instance, it was pointed out that the importance of assembling data in this field lay in the use made of them in working out the problem of the relationship between older persons and mental institutious. Various examples were given of the way such studies have been utilized.‘ In some instances, it was stated, the community has been enabled to see what alternate arrangements might be made for older persons who had been "dumped in mental institutions" by children or relatives, as a way of escaping responsibility. ~73? Recurrent reference was made, during the discussion, to the various data or services that the commission can obtain from the Fed- eral Government. Cited as an example was the recent study by the Bureau of OldQAge and Survivors Insurance of the economic resources of 18,000 recipients of Insurance benefits. The Bureau of Labor Statistics, the Bureau of Employment Security, the Women's Bureau, all in the Labor Department, and the Social Security Administration also gave examples. Making Reports In discussing the business of making official reports, great em- phasis was laid on what a delegate termed the decision-making function,,y and the need to see that these reports are geared to "operating realities". Every day, he pointed out, decisions are being made which relate to the problems of the aged in mental institutions, housing problems, re- tirement problems, employment problems, The first job, he said, is to see that the people who make these decisions get the right kind of in- formation. To do this it is necessary to know how and where decisions- are made—-whether by administrative officials, legislative groups, par- ticularly committees in the legislature, or, as so often happens, by individuals who have no official designation. Next, he said, it is important to ask how the information can be brought to these persons who make the actual decisions; and, also, how much information is necessary and what type of information is necessary. On this point, the delegate asserted, it is not essential to have " [100 percent data on any problem, Correct decisions can usually be made on the basis of information that is much less complete,providedthe‘signif— icantihctors are intelligently covered. The way in which the engineering -74- term "bit" is today being employed in making sound social studies was also described in some detail. However, it is highly important, the delegate said, to examine all material that goes into the making of a report and to strip it down to the hard core that is immediately relevant. The specific questions to be asked of each report are: How long should it be? What should it con— tain? How should it be formulated? Most legislators, he pointed out, are buried under the material they are supposed to read. To get at- tention or action, it is essential to produce as brief and compact a re— port as possible, with supplementary material attached for anyone who is interested. These admonitions should be taken to heart, he warned, since sooner or later every c0mmission is faced with the necessity of produc- ing some sort of a report or written document which, it is hoped, will be read by somebody with power to make decisions. The important thing is to get the decisions-~and the right decisions. Reporting To The Public There was also a brief discussion on how a State Commission should report its findings to the public--or in other words, the whole area of public relations. This, it was agreed, involved much more than the making of press releases or sponsoring radio programs, etc., however important these things are. Emphasis was placed on the quality of public relations--the need to make sure that the material supplied to columnists, etc., is the sort worth publicizing and not trashy space-fillers. Too many wrong impressions, it was said, are given as to what constitutes the aging problem, and it is of vital importance to see that the basic facts are given full and continuous presentation. _ 75 _ IA delegate from Mississippi emphasized the need for clarity and readability in reporting. Too many statistics, he said, scare away most potential readers. As an example, he cited the experience of the Missis- sippi State Department of Public Welfare which had abandoned the custom- ary type of statistical report and replaced it with a report presented in cartoon form. This new style of presentation, while containing essentially the same information as previous reports, was much more widely read by both State legislators and the public, and received a large amount of favorable comment. It was also emphasized that reporting to State and local agencies is an essential part of the work of State c0mmissions. It was agreed that the commissions should provide available data wherever they are needed and serve as consultants to other State and local agencies. Sim- ilarly, the work and findings of the individual State commissions should be available for all other commissions. This exchange of information, it was suggested, should go below the State level and include local agencies and commissions. Certainly, it was felt, a clearing—house for data on the aged is needed, andiit.was indicated that the Federal Securu ity Agency's Committee on Aging and Geriatrics is now serving somewhat in that capacity. Resources A considerable amount of time was spent discussing the resources for fact—finding which could be exploited by the State commissions, State agencies. Frequently State and municipal commissions on the Aging or similar bodies, it was said, include as members officials from various State departments. It was also pointed out that, although Ohio has no State commission, there are working committees in the larger ‘ “My“ - 76 _ metropolitan areas of this State which have been able to provide a good deal of useful information. Several of the State departments in Ken— tucky, it was asserted, have a real interest in the problem of aging and, with clerical and tabulating facilities, are in a position to make substantial contributions. This is true also in Illinois. A delegate from Minnesota reported that cost-of-living data were compiled by the State Department of Labor in all counties within the State for the use of the Department of Public Welfare. This was avail- able to local areas in considering the budgetary problems of older' people. In Maine, it was reported, efforts to establish a State commis- sion had encountered some resistance on the part of State agencies to the release of data which might have been effectively used in further- ing a program for the aged. A delegate from Massachusetts suggested that this was a matter of establishing working relations with personnel. Other delegates pointed to the advantages of formal legislative or gubernatorial sanction in obtaining the c00peration of State agencies. Universities. These can often make the fact—finding task of State commissions less difficult, it was asserted. An example was cited of the work done by the University of Louisville and the University of Kentucky. Other universities mentioned as having provided useful data on the aging are Ohio State, Chicago, Connecticut, Cornell, Harvard, and those located in Florida. A delegate from Florida pointed out that universities can fre- quently provide pertinent facts on the aging and conduct studies at the suggestion of commissions. However, he warned that basic differences may exist between the type of facts sought by commissions and facts which - 77 - are found by university projects. Commissions are likely to need ex- tensive fact-gathering done in a short period of time. On‘the other hand, universities are pretty much limited to projects suitable for theses and dissertations, many of which involve extensive analysis of small bodies of data over fairly long periods of timeo Private resourceso Many private organizations are able to pro» vide facts or services in factofinding to the State cemmissions° Among such organizations, the following were mentioned: National Council for Economic Research, the Survey Research Center at the university of Michigan, the Social Science Research Council, the Industrial Relations 'Research Association, labor unions, welfare oeuncils, private industrial 'concerns, and the Red Crosso The centributions of labor unions and em- plOyers in the field of retirement and pension systems were specially stressedo Studies made in Montana, illinois, and Wisconsin were cited as exampleso Research, Demonstration and Evaluationo Generally speaking, there is a great lack of knowledge of the later part of the age cycle in con- trast to what is known about other age groups, In recent years, for instance, a tremendous amOunt of research has been devoted to exploring all facets of the problems of children and youtho If any substantial progress is to be made in exploring the problem of the aging an equally intensive research effort must be madea During the past few years, it was recognized, considerable progress had been made in this direction, but the effort as a whole has only barely got under way° Securing Useful Data _ ? It was pointed out that, if a commission can formulate the ques» tions, the State and Federal departments can-often find the answers° " These questions, however, it was emphasized, must be specific and g ‘- 4:, ,fl v _ 78 _ definitive if the staffs of other agencies are to assist in the col- lection and analysis of data. In compiling such material, it was asserted that State legisla- tors are usually more influenced by State-oriented facts and data than those gathered on a national basis. An excellent program proposal may run the risk of being turned down because it is not based on factual data which can be applied to local conditions. Some modification or reinterpretation of the "confidentiality of reports" may be necessary, it was said, if certain types of social data on various aSpects of aging are to be collected. The rules on what in- formation is confidential, and therefore inaccessible to researchers, vary from State to State. Federad.regulationsalso make some informa- tion inaccessible. It was urged that Government departments modify these regulations so that certain kinds of studies, concerned with general trends, may be conducted so long as the rights of the individual are not infringed. This would include access to privileged communica- tions. Broadening the Base for Sampling Emphasis was also placed on the need for random sampling of the general population, outside of institutions and clinics, to establish control groups for comparison with the population groups ordinarily studied by agencies. Too much of present research, it was claimed, is being done on the 5 percent of older people who are in institutions and clinics, and too little on the 95 percent who are part of t?‘ general community. State commissions have an important role, it was said, in working to break down the prpjudices of the general public against acting wn - 79 - as guinea-pigs for such samplings and, in general, to stimulate a favor- able climate of opinion in this matter. in making these samplings, attention was called to procedures developed in connectiOn with child studies: '1, Adding a service func— tion to the research agency to draw people in, as for instance, baby clinics; 2, house-to-house canvassing to secure cooperation; and 3, in- ' tensive studies of an entire population within a given area. To develop successful research programs on aging, it was asserted,, access to the population as early as 45 years of age is necessary. And efforts to correlate the activities of the State commissions should be encouraged with an exchange of fact-finding and current analysis of data in various areas. Pilot Progects Considerable interest was expressed in practical pilot projects which have an action program. Far too many current projects, it was asserted, raise the question, "What do they prove?" It is important to see that a demonstration project provides concrete figures and data that can be applied to solving aspecificproblem. Otherwise it may be Open to ridicule. Also noted was the fact that good follow-up studies are usually lacking--particularly the long-term follow-up. It is easy enough, as one delegate pointed out, to get an assessment in terms of immediate effects, but difficult in terms of long-term effects. Furthermore, in making a cost study of a program, it is not sufficient merely to get the immediate; costs to the State. Such a study should not only determine direct and”: "hidden costs; it should also evaluate alternative kinds of treatment or assistance in order to measure both the direct and indirect savings that might result from different types of programs. - 80 _ X .HOW THE COMMUNITY FUNCTIONS Throughout the Conference, there was hardly a phase of the discus- sion of the problem of aging which did not involve the role of the com- munity. And many of the important aspects of this role were explored in work groups dealing with program content. How Local Groups Get Started Much interest was shown in how and why a local group in the aging field comes into existence. It was evident there is a variety of motiva~ tions. Some are started in response to a need for recreation facilities, for nursing-homes, for greater employment Opportunities, and so on. Others are the result of some general concern originating in a mayor's office, or the efforts of the voluntary agencies. On the whole, it was felt, the business of getting a local group started does not present a major problem. Also, while it is desirable for it to have as broad a representation as possible in the community, this is not an essential factor at the outset. Once in operation, it was asserted, State leaders can feel fairly comfortable in the assurance that most groups will broaden their membership and objectives as a result of their own dynamic impulses. In other words, it makes little difference what aspect of the problem is first focused upon. The important thing is 3 ttgiicourage local groups and individuals to "get something going." However, it was pointed out that, after their first burst of enthusiasm, many local groups need help if they are to move ahead to do an effective Job. At such times, it is of great importance to have the assistance of staff members of a Community Council or Council of Social - 81 - Agencies, or a consultant made available through a State commission. This is especially true where the group is dealing with complex community relationship problems, such as providing nursing-home care for the aging or the modification of those union and industrial policies which now pre- vent employment of older workers. Use of Existing Organizations In order to "get going," however, it is not always necessary to form new grOups. Often the impulse and the first steps can come from organizations already functioning in the field of social welfare. Through an enlargement of services, these can move directly to meet a need for which no adequate provision has been made. The role that a local Council of Social Agencies can serve in defining such needs, and stimulating community developments to deal with them, was illustrated by the account of the work done by the Seattle Council. In this instance, initial interest was roused by the increasing number of more or less isolated elderly peOple who had moved to the city from other communities and, in consequence, were without friends and personal contacts. By helping to organize a series of "Evergreen Club" social centers for older people, the Council successfully met what was recognized as a deep and widespread need. Its efforts in this field, however, brought into clearer focus a number of other related problems. As a result, the Council began to ex— ( plore the matter of more adequate nursing care for personalwho do not \ require hospitalization. This, in turn, led to a study of standa;%§!;or nursing-homes. At no time did the Council try to solve these problems directly. Instead, it concentrated on calling attention to the existence of a problem, and on acting as a mediating agency in getting action _ 82 - started under the pr0per auspices. In this way, step by step, the work- ing groups of the Seattle Council have covered many areas of need of Spe— cial importance to the aging, and the Council itself has achieved seme— thing of national reputation for what it is accomplishing. Another example of the way a community aging program can be devel- 0ped was given by a delegate from Hawaii. Here the impetus came from the Honolulu Parks and Recreation Board working with two citizens' committees. With primary emphasis 0n "creative old age," and directed to those over 50, an effort is being made to help the individual make a smoother tran— sition into the later years, and thus avoid some of the problems that are ordinarily aSSOCiated with old age. I Throughout the discussion, however, great emphasis was placed on the role of the local welfare department and what it can do in planning for the aged. Minnesota, in particular, was cited as an example of a State where county welfare authorities show considerable imagination and initiative in providing needed services for the aged. It was pointed out that welfare departments must have organized community support if they are to adept a creative attitude toward the need; of underprivileged groups in the community, since "they are frequently under pressure and attack from groups who feel they are too tolerant and too generous." In self defense, it was stated, the local relief offices tend to over— ‘emphasize financial eligibility rather than need, including social need. hafiithat reason, welfare departments should be represented on all commit- .i tees piggning for the aged. In this connection, the point was again underscored that the goal of old-age assistance is not merely financial independence, but personal independence as well. State welfare agencies, it was emphasized, can and - 83 _ should help elderly persons achieve this independence. In other words, people should be left free in their personal lives, even if they are on the assistance rolls. Unless citizen groups realize that broad social planning is a part of a progressive public welfare program, it was as— serted, welfare people in the States cannot give effective aid to planning for the aged.‘ Reference was also made to the active role played by many of the Field Offices of the Bureau of Old-Age and Survivors Insurance of the Federal Security Agency in helping local communities to establish and conduct aging programs. It was suggested that these Offices are an invaluable source of information about older people in the community, and an excellent channel through which certain kinds of information can be made available to them. Community Attitudes A discussion of negative community attitudes towards older people, and how these attitudes can be modified, brought forth a variety of Opin- ions. Some delegates felt that one of the chief difficulties lay in the fact that young peeple today are not taught proper respect for older peOple. Obviously, education to eradicate this attitude must begin in the home and the grade schools. However, it was pointed out that this attitude is just as firmly rooted in nest adults. A re-education pro» gram, therefore, must be community-wide to make peeple grasp more fully the problems of the old folks, and to "see themselves as they may be— i“ . come." All this, it was acknowledged, is a slow process since lewd volves many deep-rooted prejudices. Not all peeple have the capacity to cast off these prejudices; and even when theyfldo, it may take years - 8h _ of effort before there can be a genuine change of climate-~so far as these attitudes are concerned--within the entire community. Probably the best way to make a dent in the problem, it was agreed, is through greater participation on the part of older peOple in activities that are now more or less the particular province of younger adults. This includes all manner of social, recreational, civic and religious activities which go to make up the community life, and in which older people can, and should, be persuaded to make a substantial contribution. In this way, it was believed, younger peOple-—both chil- dren and adults--will begin to appreciate the talents and capacity of their elders. And they, in turn, will have a tangible demonstration of their own worth to the community. However, it was not wholly agreed that this is what the old peOple themselves want. Some felt there is a natural tendency of older pe0ple to "flock by themselves" because of the interests they share in common. Others, including some of the older delegates attending the Conference, admitted this was to some degree true. At the same time, they pointed out that mutual interests among individuals are by no means limited by the age factor, and that very often it is "more fun to engage in activities where there were people of all ages involved." Much of the discussion deveIOped around concrete methods of come munity education that can be employed to meet this problem. Mention was made of some of the techniques used by the extension groups of the De- partmeit of Agriculture to help peeple overcome the emotional blocks which prevent the acceptance of new ideas. A given problem was pro— Jected, it was explainedLfilnd the members of the group are asked to tell what they already knew about it. ZOut of the various and sometimes - 85 - contradictOry answers, it becomes possible for the participants to realize their own areas of confusion in the matter, and to come, through ydiscussion, to some rational understanding of it. A variant of this approach, it was pointed out, has been used by some State commissions to help create more positive attitudes towards older people. Basic problems which confront the State in the aging field are spelled out to local groups which are then asked to outline their own community needs. In the give and take of trying to find the solutions, a better grasp of the problem as a whole is arrived at, and many of the "emotional blocks" which prevent the acceptance of new ideas are dispelled. It was also observed that those discussions in which the older peOple themselves took an active part were likely to provide the most common-sense answers. Utilization of Older People Closely allied to this was the question of the extent to which the older people themselves can make an active contribution to the solution of these problems. Volunteer services, it was pointed out, are within the ability of many vigorous and intelligent elderly men who have retired, or wives whose lessened domestic responsibilities (after their children have married and left home) leave them eager to "find something to do." And community welfare departments can well make use of retired professional people, as voluntary visitors, to supplement the services provided by the paid staff. An effort of this sort, it was pointed out, would strike directly at the feeling of being laid on the shelf which many older people bit- . fl terly resent. It would also provide a way of endgrging community servu ices for the aged who need individualizedrattention which, because of _ 86 _ personnel and budget limitations, can not be met by public or private health and welfare agenc1es. Community Education Throughout the Conference, the need to develop a public awareness of the meaning of an aging pOpulation was recognized as basic to all States. And community efforts in this field impinged on the discussion ’of every phase of the total problem. In projecting ways and means by which such public awareness can be brought about within the community, the importance of promoting a well—rounded program was underscored, and emphasis was placed on public responsibility for securing action.. There was general agreement that the program should not be di- rected solely to the plight of the "old folkS." Rather, it should make clear that aging begins with the middle years, and that the true focus of the program is to develop a "climate" in which the transition from middle age to old age can be accomplished with a minimum of frustration, unhappiness and economic insecurity. Furthermore, as a matter of method, there was agreement that the generalized approach is less effective than the particular. In planning a campaign, the total population of the community should be broken down into segments, much as a pie is cut into pieces, and the appeal directed to the needs and interests of individual groups. In other words, the public should be approached as community leaders, legislators, tax- payers, church people, employers, workers, etc. In all these groups, it was pointed out, there will be a prOportion of aging or aged persons, or individuals closely associated with such persons. All these are likely to interpret the problemgin terms of their own experience. _ 87 _ The important thing, it was emphasized, is to personalize the problem for as many people as possible. Thus an individual who has a chronically ill person in his family can be induced to give his support to the program. And one who is concerned over the rising cest of old- age assistance and institutional care will be able to see the value of the preventive measures which the program sets forth. Leadership training The need of training for leadership in this comparatively new field of social science also came in for its full share of attention. Great interest was expressed in the program deve10ped by the Division of Gerontology, Institute for Human Adjustment of the University of Michigan. WOrking in c00peration with the Extension Service, the Division has established an adult education program whose purpose is to encourage older individuals to concentrate on aging as a means of "being socially useful," and to provide the necessary training to enable them to express themselves effectively. The University has initiated a spe- cial project in one of the larger Michigan cities in which older peeple are getting first hand experience in organizing a friendly visiting service, a job placement project, and a program of community education. The University is offering, through its School of Social Work, special courses for the training of professional workers in the field of aging. Other colleges and universities, it was indicated, also give similar training. And postgraduate courses in leadership are offered at New York University, the Universities of Syracuse, North Carolina, California (at Los Angeles), Teachers College, Columbia University, and The University of Chicago. - 88 _ The provision of scholarships to pay the fees of students taking adult leadership training courses was urged. In Michigan, it was re- ported, various private agencies have made such scholarships available. Among other things, it was pointed out, the idea has proved highly use- ful in giving publicity to the courses, and in giving the agencies a stake in the effort. -89.. XI CONCLUSION With the close of the 3-day session, it was the general consensus, as indicated above, that the Conference had served well the purpose for which it had been called. Much of the discussion, as it slid from one topic to another, was undoubtedly a reflection of the uncertainties and lack of positive attitudes which most of the delegates brought with them. As one of the conferees remarked, "We are all groping." And it was evi- dent that many ~of the delegates found a degree of comfort in the fact that other States seemed to have some of the same difficulties in coping with the problems that their own have, Several of the delegates testified as to what they personally had derived from the gathering, One asserted his belief that the Conference had. ”converted all those from the nonr-comission States to the need of having a State commission or committee" Another pointed out that, though the various States were in different stages of development in respect to the aging problem, the Conference had "revealed certain basic trends and made clear that what happens in one State is related to what happens in another." Others ageed that one of its chief values lay in showing "what sources of information were available, and what resource people could be counted on for help in working out specific problemsc" It was felt that a positive contribution had been made by under- scoring the "importance of expanding services now in existence to meet the needs of older people and of integrating older people in the normal life of theeonmmity by the use of all these resources." The Conference also, it was stated, had created a "greater sense of the waya State - 90 - commission can work with the various agencies in the field, and of the extent to which many of these agencies were really eager for outside help and support." It constituted, as one delegate phrased it, a challenge "to go back and work for a balanced program and to see that no one phase of it was given geater importance than another." Certainly, it was clear that, in general, the delegates were con- vinced that the problem can be solved only by a broad frontal attack; and that those States whose initial approach had been concern over the rising cost of old-age assistance would come closer to finding an answer in such an attack than in any other way. Towards A Permanent Organization It was also the conviction of the majority of the delegates that the Conference had laid the foundation for a further and more active collaboration among the States in dealing with the problem of aging. Most were in agreement with the delegate who urged that "some lines of comication be established which would enable the States to keep close touch with each other for an exchange of experience, results of research, etc.," This idea was taken up by a delegate from Arizona who stated his belief that a. national organization of State commissions or committees was a. logical outcome of the Conference, However, he thought it would be better to include all of the 158 States in order to get the "picture from all angles." It was particularly important, he said, to avoid giving the impression that this would represent a new Federal program; otherwise the people in the States might not take proper initiative. Following this, a formal motion was made by a Florida delegate to establish such a national organization. He also suggested that the .. 91 _ gentleman from Arizona be appointed interim president, with "responsi- bility for working out a program and a set of by-laws for a formal organ- ization in our next annual meeting if and when we have it." An alternate suggestion, though not in the form of a motion, was made by an Illinois delegate, that the American Public Welfare Association be requested to provide staff facilities for an interim organization. It was clearly evident, however, from the debate that the delea v gates were of the opinion that any step towards permanent organization at the present time was premature. Such a step, it was felt, might well be taken a year from now when, it was hoped, a considerably larger num- ber of States could be represented with official commissions or commit- tes. As a result, the Florida motion failed to carry any substantial support, There was more general agreement with the suggestion of a Minnesota delegate that the present sponsorship of the Eederal Secu- rity Agency, and other Federal agencies, be continued until such time as the State commissions felt they were ready for formal organization, In closing the session, Mr. John L. Thurston, Deputy Administra— tor' of the. Federal Security Agencyn-and in behalf of the other Frederal agencies involved-«emressed his pleasure at the opportunity to partici- pate in the Conference. It was, he felt, the responsibility of the Faderal Government to serve as a catalyzer or stimulator in new expand» ing areas of social welfare like aging, Healso said that, for him, the Conference represented an "orchestration of resources-oFlederal, State and local. "We are all of us in this aging‘business," and "one of our ' larger tasks is to. . ~.thld together our resources so that we come reasonably well toward hitting the target we are aiming a ." ’18 .. _ 92 .. . He- expreSsedl-a hope that there would. be some sort of continuation of ah exchange of ideas aaong the State groups; and said that if another ‘ conference oext year 'éeemed desirable the Federal Security Agency and. the other Federal; 2mm would be "delighted to welcome you back here at any time.." 4 I I A motion that a report of the Conferenoe: be made available to all participants by the Federal, Security Agenéy was adapted. Amino vote of thanks, wasexténdefi to 'FEderal Security Administrator, Oscpzffi. Ewing, and tijarticipatihg severnment.agénc1es,,f0r their hospitality. APPENDIX A Introducing -- THE STATE COMMISSIONS AND COMMEES ON AGING This was originally prepared as a pamphlet at the suggestion of several of the State Commissions and distributed as background material for use at the Conference. It is designed to describe briefly the organization, membership and general program of the lit official State Connniss ions or Committees on Ming. The information included was originally summarized from reports made in the early spring of 1952 by the Regional Offices of the Federal Security Agency. Since the Conference, the material has been re-submitted to the State Commissions and Committees for review and to permit them to incorporate any new developments that may have taken place. CALIFORNIA Inter-Departmental Coordinating Committee on the Problems of the Aging .616, K. asexecramento 11+ I General Structure Authorization and Assignment Establist by the Governor, January 1952, as a continuation, under different name and with expanded assignment, of the Staff Com- mittee established by hecutive Order of the Governor, February 1951, to develop plans for the State-wide Conference on the Problems of Aging held October 1951. The following are among the duties of the Inter-Departmental Com— mittee: (l) coordinate all State activities with aid for the aging; (2) ,ensure efficient and effective use of State resources in development of needed program; (3) act as consultants and. advisors for, and to, local commities in developing local programs; (1+) stinnJlate and encourage local communities in developing needed programs; (5) assist communities in planning institutes; (6) act as clearinghouse for technical infnems— tion and activities throughout State and Nation; (7) act "as consultants to Citizens' Committee on Aging to be appointed in near future. Membership and General Organization manganese)“: . Membership includes: Secretary to the Governor; Directors of the State Departments of Education, Employment, Industrial Relations, Manta]. Ergiene, Public Health, Recreation, Social Welfare, Veterans' Affairs, Personnel Board, and Chief of the Division of Old-Age Security. Mr. Charles I. Schottland, Director of the Department of Social Welfare, is Chairman of the Committee and Mr. Louis Kuplan, Chief, Divi- sion of Old—Age Security, is Executive Secretary Staff Committee itself has no staff. Proyam work and facilitating services, such as duplication of materials, are shared among the State ’ agencies. M , Appropriation to the established State agencies. II II Activities 1.. Recommendations of the Governor's Conference attended by 2,500 persons have been taken for action by the appropriate State agen- cies or group of agencies; Executive Secretary makes a monthly check on action progress, and other new developments in aging work of each depart- ment. 2. Executive Secretary and other Connnittee members are furnishing consultation services, materials, etc.) , to more than 30 commity commit- tees established since or revitalized by the Governor“s Conference. Com» ‘ mittee also distributed the Background Material and Proceedings, 2 widely used reports on the Conference" 3. Committee has compiled and released an "Information Brochure" describing resources and services of the State agencies in aging work, and how local groups may request and use such services. This brochure is available to all persons who attended the Conference, all local com- munities, and to anyone who requests. Some 3,000 copies have already been given State-wide distribution. 1+. Connnittee publishes a quarterly "News letter" describing new activities and services in commities in California, and programs of Stateawide agencieso 5. Committee is meeting with local committees for discussion of local programs and action which the local groups suggest the State agen- cies take. . a. Twelve representatives from the Intera-Departmental Committee and field representatives of those State agencies met recently in all—day session with 35 members of the San Diego County Committee9 the mayor , and other local officials. bo In September Mr. Louis Kuplan, the Committee“s Executive Secretary, met with the Committee on Aging of San Diegoo He gave the group a report on the Conference on Housing for the Aging held at the University of Michigan last July. The dis— cussion was then centered on relating the conference findings to the local situation, The outcome was agreement to present the problem to the San Diego Community Chest and ask for im— mediate action in developing a housing program for San Diego's senior citizens“ c. In September representatives of the State Department of Em- ‘f ployment‘9 Industrial Relations, the Chairman and the Executive Secretary of the Committee met with the Committee on Employ- ment for the Aging of the Welfare Council of Metropolitan Los Angeles. Represented on the local committee were business executives, labor, public agencies, social welfare agencies, education, churches? etc. Discussion was centered «around the problem of employment for older persons and how the local community could meet thema As an outcome of this meeting the III local group agreed to establish a subcommittee with responsi- bility for preparing a program to be presented to the entire committee for action. d. A county-wide conference on the problems of the aging was held November 15 by the Welfare Council of Santa Clara County. The Committee was represented on the planning com- mittee for this conference and members of the State Committee participated in it. 6. Committee is.sponsoring --field staff conferences of the field representatives of the several State agencies and furnishing all representatives with cemmon materials and information. --Joint discussion of all legislative proposals recommended by the several State agencies with regard to their own pro- grams in the aging field. ' 7. Committee is facilitating teamrplay among the State agencies in develOping demonstration programs in the aging field. --Departments of Employment and Social Welfare are Jointly pushing the development of employment Opportunities for recipients of Old—Age Security. This project is being carried Out through local welfare and employment offices and involves team consultation and services by the staff of those offices to each recipient. 8. Committee is developing a plan for an annual "Senior Citizens Week." ‘ 9. Committee is making recommendations to the Governor regarding need for membership, functions, staffing, financing, and organizational location within the structure of the State government of a Citizens Committee on Aging to function concurrently with the Inter-Departmental Committee. 10. The California Federation of Labor (AFofL), at its annual convention last August adapted a resolution asking Governor Warren to call another state-wide conference on the problems of the aging. This resolution asked that the Governor give consideration to having such a gponference every two years. ,~ #5» CONNECTICUT >Commission on Care and Treatment of Chronically Ill, Aged and Infirm Rocky Hill, Connecticut I General StrUcture Authorization and Assignment In l9hl a Commission was appointed to study the "care and treat- ment of people afflicted with physical or mental disabilities." (See attached statement of Statutory Authorization.) This Commission recom- mended a study and Creation of new facilities. Therefore, the l9h3 General Assembly directed the Public Welfare Council to continue this study and report how great the numbers were and recommend the type of State infirmary required. This report recommended the establishment of three major institutions. Apparently that program was too great for the State to assume at that time. (Such building of State custodial insti- tutions was not contemplated.) A second commission, the present "Commission on the Care and Treatment of the Chronically Ill, Aged and Infirm," was created in l9h5 by the General Assembly. This Commission was authorized to study, es- tablish a program, coordinate existing resources, plan, construct, pur- chase, lease, staff and operate such institutions as met its requirements. In l9h7, the General Assembly created the central study unit in conjunction with the State Veterans Home and HOSpital at Rocky Hill which has 600 completely equipped beds ( and domiciliary quarters for veterans), where the Veterans Commission had numbers of patients who required ident- ical services which the patients of this Commission needed. Here doc- tors, nurses, physiotherapists and administrative staff are being trained to undertake this type of work in other institutions of this COmmission around the State. This study unit has shown what long-term diseases can be handled, how much rehabilitation can accomplish with all age groups, especially with the mentally alert young handicapped for whom there are no other State facilities, and the causes and treatment of conditions discovered. In l9h7, funds were apprOpriated, with additions in every succeed- ing session of the General Assembly, to the CommissiOn to be used as g grants in aid to general State-aided hospitals and municipal hospitals 16 who obligate themselves to meet the requirements set up by the Commission, preference being given to those in the areas where the patient load is heaviest. The grants are used for various purposes in the different hos- pitals depending on the need to make a complete unit. In some instances structures are needed; in others, personnel and equipment. In return this Commission is allotted a certain percent of beds to which they m§§Vrecom- mend welfare patients. Staff Seven member Commission. Five electors-serve for overlapping terms of four years° The Com- missioner of Health and the Commissioner of Welfare serve as ex officio membersc The Commission is authorized to employ and fix the compensa- tion of a director and such other employees as it may require. Dr. J0hn C. Leonard is Chairman,-and Dro A. N. Creadick is Medi- Cal Directorc . The staff is as folldws: Commission: (h) MEdical Director, Deputy Director, Busi- ness Manager and Administrative Assistant Hospital staff (at Rocky Hill): Departments of Adminis- (Sh) ' tration, MEdicine, Surgery, Education, Physical Medicine and Rehabilitation, Social Service and Laboratory° Financing State appropriationo $15,063.5h Commission Expenses 1951-52 $271,197.31 Hospital Expenses at Rocky Hill 1951-52 $105,000.00 Grants in Aid 1951-52 Members of the Commission receive no compensation for their serv-' ices as such, but shall be reimbursed for expenses incurred in the per— formance of their duties. II Activities 10 The Commission reports its findings, activities and recommenda- tions biennially to the Governor and the General Assembly, and annually to the GovernOro ‘ 2. At the central study unit in Rocky Hill9 as of Ju1y.l, 1952, 4 where the Commission has been operating for five yearsy h9h welfare pa- fetients had been processed through its servicesa Patients of the Veterans Commission were also treated and the results studied. The operatiou of ‘this unit has taught the Commission many lessons in regard to the care of these patients and has demonstrated areas of benefit and limitationso 3. Since l9k8 the Commission has administered grants in aid to two municipal hospitals, at new Britain, the Neerritain Memorial Hospital, VI and at Bridgeport, the Hillside Home and Hospital; also to three general State—aided hospitals, at New Haven, the Grace-New Haven Community Hos- pital, at Bristol, the Bristol Hospital, Inc., and at Stamford, the Stamford Hospital. h. This Commission has specified that beneficiaries of the State of Connecticut are urgently in need of 2,100 beds, and that these beds should provide: a. Complete nursing care for those people who are unable to care for themselves due to their handicaps . . . . . 700 beds Patients for whom some medical rehabilitation is possible (a general hospital) . . . . . . . . . . . 700 beds Domiciliary beds for people who have been rehabilitated and better able to care for themselves, but have no homes of their own and need boarding facilities shaded to their needs . . . . . . . . . . . . . . . . . . . 700 beds Ve have recommended three centers containing each of the afore- mentioned categories, the first to be established in New Britain at the New Britain Memorial Hospital, the second in New Haven, and the third in Bridgeport, at the Hillside Home and Hospital. ' as New Britain — New Britain Memorial Hospital was given a $75,000 grant in aid. under the supervision of the Commission a 12- bed wing was put into operation in September 1950. Two ad- ditional grants of $25,000 and $h5,000, respectively, have been given for the continuation and improvement of the pres- ent program. Also, in 1950 and 1951, funds to the amount of $3,300,000 were allocated for the New Britain Project by vote of the Humane and Welfare Institutions Building Program Com- mission and the Legislatureo Contracts were let to provide a 60-bed infirmary for terminal care and essential services such as heat, laundry, kitchen for these beds. The Commission is anxiously awaiting completion of this unit. Further building to include family and home units on this site is contemplated in the future. New Haven - Plans are now being worked out to make use of a hos- pital already built which the State of Connecticut has recently purchased. There are 130 beds in this facility with ample room on the property for building accommodations for domicilary care. ' VII c. Bridgeport — The City of Bridgeport Operates a home and hospital of both a remedial and custodial nature. With the assistance of grants in aid from this Commission, the institution is staffed by a full-time medical director, a department of physical med— icine and medical and laboratory aides. Plans are presently being formulated to increase the present facilities, and it is planned that, ultimately, hous- ing facilities will be incorporated in the whole program. 5. Summary This Commission has envisioned three needs: Housing for the healthy aged. Nursing and medical care for the terminal cases in all age groups. Research and study of every avenue to improve knowledge about and care of the incapacitating chronic diseases, and use of all the modern techniques for rehabilitating those afflicted. And desires to provide a service to all welfare cases of the State to see that they are evaluated, treated, and rehabilitated with a recom- mendation as to their disposition into prOper quarters either - :1 d9 To domiciles, if they are able to take care of themselves. To a ward for confused mental cases requiring consider- able nursing supervision and some medical treatment. To domiciliary beds or sheltered villages if they have no home, or need mild supervision or guidance, where they might have a sheltered workshop, a common meeting room, and central dining facilities. To a ward where they may receive terminal care and their last days made as comfortable as possible. It is ultimately planned that the above facilities may be opened to pay and part-pay patients as well as welfare patients. III Statutory Authorization STATE OF CONNECTICUT PUBLIC ACT N0. #37 An Act Creating A Commission on the Care and Treatment of the Chronically Ill, Aged and Infirm. VIII Be it enacted by the Senate and House of Representatives in General As- sembly convened: Section 1. On or before July 1, 19h5, the governor shall appoint five electors of this state to serve as a commission on the care and treatment of the chronically ill, aged and infirm. Two of such members shall serve for a term of four years, from said date; and bienniall; thereafter the governor shall appoint for a term of four years a succes- sor to each member whose term expires. The governor shall fill any vacancy for the unexpired portion of the term and may remove any member for cause. The members shall receive no compensation for their services as such but shall be reimbursed for expenses incurred in the performance of their duties. The commissioner of health and the commissioner of welfare shall be ex—officio members of said commission. The members shall elect a chairman and a secretary from among their number. Section 2. The commission shall study the problems of the care and treatment of the chronically ill, aged and infirm persons in this state; shall initiate a program, with the c00peration and aid of state agencies concerned, to coordinate and develOp existing resources for such care and treatment, and shall plan and, subject to the approval of the general assembly, construct or purchase, lease or otherwise acquire, sub— ject to the provisions of sections 30g and 59g of the l9h3 supplement to the general statutes, and staff and Operate, such buildings as it deems necessary for the care of such persons; provided the governor shall ap- prove the purchase of or option to purchase land for such purpose. Said commission shall fix rates for care at such institutions and shall de— termine policies and adopt regulations necessary to carry out the pro- visions of this act. Section 3. Subject to the provisions of chapter 105a of the gen- eral statutes, said commission is authorized to employ and fix the com- pensation of a director and such other employees as it may require. Section 1+. The commission shall report its findings, activities and recommendations biennially to the governor and the general assembly and shall draft legislation necessary to carry its recommendations into effect. Section 5. The sum of twenty-five thousand dollars is appropriated for the purpose of activating the most urgently needed components of the commission's program. Section 6. This act shall take effect from its passage. FLORIDA Florida State Improvement Commission -~ Tallahassee Citizens Committee on Retirement in Florida I General Structure AuthorizatiOn and Assignment Governor's proclamation, October 1950, designated Florida State Improvement Commission as State agency with primary responsibility in field of studying, investigating, making plans for and assisting in move- ment of retired persons in Florida, and established "the Citizens' Com- mittee on Retirement in Florida to advise the Commission." (See attached copy of Governor“s Proclamationo) The Improvement Commission is to "give assistance to and coordinate the work of State, local and private agencies in this field.” The Citizen's Committee is to report progress to the Governor and the public. All State Agencies, Boards, Bureaus and Depart- ments are directed to assist and cooperate with the Commission and Com- mitteea Membership and General Organization The Improvement Commission is the established State planning agency with a full time Executive Director and 7 program Divisions. The Commission established a new Division, the Retirement Research Division, to carry out its responsibilities in the aging field, Mr° Walter E. Keyes is Director of the Commission, the Governor is Chairman, and there are k other members. The Citizens' Committee has 15 members appointed by the Governoro Membership includes; a newspaper editor, an airline official, trust officer of a bank, president of an insurance company, an agriculturist, an industrialist, an educator, a savings and homealoan banker, a real estate broker, a representative of organized labor, an investment broker, the executive secretary of a resources development board, a retired business executive, a radio station official, a housewife, The Committee elected its Chairman and Vice-Chairman, respectively, M'ro John L. Morris, Vice President, National Air Lines, Miami, and Mr. Nelson Poynter, Editor and Publisher of the Stn Petersburg Times, The Committee has conducted much of its business through 4 subcommitteeso Staff Mr. Irving L. Webber, a sociologist, is Supervisor of Commis- sion's Retirement Research Division which has a small professional and clerical staffo Social science staff and graduate students of Florida State University, University of Florida, and Florida Agricultural.and X Mechanicalzfioirlegeztboperaftéd‘ in fdbingfi’aldmand analysésf'or com- mimityiatudies. Citizen Committee is served by Commission staff. Financ ing State appropriation to Commission. Citizen Committee members serve without pay and defray own expenses. Committee members financed First and Second. Annual Southern Conferences on Gerontology held at the University of Florida in 1951 and 1952. II Activities 7 This information was abstracted from the "First "Annual Report of the Citizens Committee on Retirement in Florida" dated January 21 , 1952. 1. Citizens Committee met 6 times in first year in different communities in State; its subcommittees met more often. Committee prepared and issued a statement of its "Policies and Objectives." 2. Committee financed Southern Conference on Gerontology to stimilate interest, study and research in aging field. 3. Retirement Research Division conducted 3 community surveys of retirees living in St; Petersburg, Orlando, West Palm Beach, and cooper- ated with Florida State University in studies of older people at Winter Park and. St. Cloud. Purpose of these surveys is to obtain information which will help Florida communities to prepare for prospective retired citizens. Reports of surveys'o'f retired people living in Orlando and West Palm Beach. are in preparation. The West Palm Beach material is supplemented by a sample survey of approximately 100 negroes aged 60 and over which was carried out in cooperation with Florida A & M College. 1+. Retirement Research Division assembled and distributed infer.- mation about retirement in Florida to thousands of retirees and prospec- tive retirees throughout the United States. The Committee has directed the Omission to attempt to work out an employer-education program relating to the older worker in cooperation with the Florida State Cham- ber of Commerce and the Florida State Enployment Service. 5. Retirement Research Division has carried out studies of special housing needs of older people, including a sampling survey using questionnaires to obtain views of retirees and. prospective retirees on type of accommodations they desired, physical location, etc. This in- formation was used by the Citizens Committee in negotiations with private housing interests investigating location and architectural design for neighborhood villages. "Planning Housing for the Aged," a bulletin in- tended to be of use to builders, architects and others interested in the special housing needs of older people, is in preparation: 6. other activities included "studies of self-help and part-tine employment and. investigation of proposed Rederal legislation providing for upward revision in amount of earnings permitted Old-Age and Survi-L ' imrs' Insurance beneficiaries." XI 7. Published reports include "The Retired Population of St. Petersburg: Its Characteristics and Social Situation," "Florida's Older Population." Reports on St° Cloud, Winter Park, West Palm Beach, and Orlando are in preparation. 8. Part of the field work involved in a State-wide survey of rec- reational facilities for older peOple has been finishedo The Commission is making plans for the preparation of a fact book on Florida‘s older people which it hopes will be ready for publication by the end of the year. Future studies will be directed toward cost-of-living factors, housing, recreation, employment, adult educatiou. 9. The Citizens Committee's major activities include: a. Sponsorship of two proposed bills: one to provide for the licensing of nursing homes, the other for the regula- tion of institutions which contract to give life care to older people in consideration of a lump-sum payment. These bills have been deve10ped by the Citizens Committee and the Retirement Research Division in consultation with the affected State agencies. bo Encouragement of builders to provide low-cost housing for older peopleo c. Sponsorship of the Annual Southern Conference on Gerontol- ogy. dn Investigation of the feasibility of establishing local area citizen committees on retirement” III Underlying Authority Proclamation State of Florida Executive Department Tallahassee, Florida _Whereas, Florida has long been the vacation and retirement goal of millions of citizens of this country, and Whereas, recently adopted industry pension plans and the broaden- ing of the NatiOnal Social Security Program will make it possible for hundreds of thousands of retired workers to spend their declining years in a place of their own choosing, and Whereas, large numbers of these retired workers will come to Florida, where they may find warmth, comfort, and the kind of recrea- tional and social activities which make for good health and long life, and . XII ' 4: Whereas, the coming to Florida of large numbers of retired persons will have a profound effect upon the economic and social life of ilorids and will create many problems for the retired workers themselves, and Whereas} in the interest of the happiness and welfare of these new citizens of Florida, and the general social and economic Well4béing of our entire state, careful study and organized assistance should.be given to this movement: How, therefore, I; Fuller warren, by virtue of the authority vested in me as Governor of the State of Florida, do hereby: 1‘ Designate the Florida State Improvement Commission as the state agency with primary responsibility in the field of studyingy'inu yestigating, making plans for and assisting in the movement of retired persons to Florida. Inquiries in this field addressed to other state agencies may be referred to the Improvement Commission for official re- sponse. The Improvement Commission shall give assistance to and coordi~ hate the work of state, local and private agencies in this field. 2. Establish the Citizens Committee on Retirement in Florida to advise the Ilorida State Improvement Commission with respect to the movement of retired persons to Florida. The Citizens Committee on Re- tirement in Florida shall consist of not more then 15 members to be named by the Governor; The members of the Citizens Committee on Retiree ment in Florida shall serve without pay; shall elect one of their number as Chairman; and shall report progress from time to time to the Governor and the publicc 3. Authorize and direct all state agencies, boards, bureaus and departments to assist and cooperate with the Citizens Committee on Rea tirement in Florida and the Florida State Improvement Commission in this movement. IN WITNESS WHEREOFj I have hereby set my hand and caused to be affixed the great seal of the State of Florida at Tallahassee, the Capital, this 6th day of October, (SEAL) AoD. 1.950: /e/ Fuller Warren Governor Attest: /s/ R. A. Gray Secretary of State XIII ILLINOIS Illinois Committee on Aging Room 1500, 160 North La Salle Street, Chicago I General Structure Authorization and Assignment A nonpartisan citizens group established on invitation of the Governor, July 1950, to review the situation of older people in Illinois and the adequacy of services to meet their needso During 1950-1951, the committee was headed by the Chairman of the Board of Welfare COmmission— ers and the Chairman of the Illinois Public Aid Commission. The three other members were drawn from these two commissions, with certain staff representatives serving ex officio. Preliminary surveys indicated the problems of aging required a permanent organizatiou for long—range plan- ning. Consequently, in January 1952, the ICA was substantially enlarged and set about crystallizing its responsibilities and future areas of action, An Executive Secretary was employed February 1, 19520 ' The committee is assigned responsibility for determining the needs of older people in Illinois, for devising ways to meet these needs, and for stimulating the development of necessary services in the various communities of the State as well as coordinating and improving the serv- ices now being extended by a wide variety of State and voluntary agencies“ Committee goals include the prevention of dependency in old age and the rehabilitation of those already dependent. Mmeership and General Organization Present membership consists of 19 persons - ll lay members and 8 persons on the staffs of State agencies. Fields represented include welfare, health and public aid, management and labor, extension service, industrial relations, social service, housing, education, etcr Sub- committee structure includes an Executive Committee; committees on budget and finance, public relations, and cammunity development; and h subject committees on (a) employment and retirement, (b) physical and mental health, (c) housing, and (d) education and recreation. Mr. William Rutherford of Peoria is Chairmano Staff An Executive Secretary, Mrs. Elizabeth Breckinridge, 160 North La Salle Street, Chicago. XIV Financing At present financing is shared by the Department of Public Welfare and the Public Aid Commission. II Activities It is expected that the actual program of the committee will change from year to year as work progresseso The general areas of work may be classified as follows: lo Research center and information bureau on all problems and programs pertaining to aging in Illinois. 20 Coordination of State activities. 30 Community education through institutes, publications, radio, television, and the local presso A; Community organization in stimulating local groups to develop their own serviceso 5. Direct services to local communities and groups through con- sultation, conducting conferences, recreation and education programs, and other demonstration programs° 60 Development of standards and professional training° The committee has sponsored a series of workshops at the Illinois Welfare Conference and has acted as the organizer of the Illinois As- sociation of Hemes for the Aged° It is currently initiating a non-profit A independent Retirement Counseling Bureauo fl MASSACHUSETTS Sub-Committee on Problems of the Aging, Massachusetts Recess Commission on Revision of Public Welfare_Laws State House, Boston I General Structure Authorization and Assignment Statutory authorization for Recess Commission, begun in l9h7, has been biannually continued by the Legislature since that time. Present authorization lapses with convening of the Legislature in 1953. The Sub-Committee on Problems of the Aging was created by the Commission in 1951. The Commission is established to survey and study laws relating to public welfare, for purposes of revision, codificatiOn, and recom- mending such changes and additions as seem desirable. The Commission is directed to report to the Legislature the results of its study and recom- mendations, if any, together with draft legislation necessary to effect the recommendation. Membership and General Organization Six members of the Legislature are members of the Recess Commis- sion. The Sub-Committee on Problems of the Aging is one of several sub- committees of the Commission and consists of two Legislators who are members of the Recess Commission. Representative (Mrs. B, A.) Irene K. Thresher is Chairman of the Sub-Committee. Staff One Secretary to the Sub-Committee. Sub-Committee has had con- sultant assistance from the State Mantel Health Commission, the State De- partment of Welfare, a private family agency, and the Geriatrics Clinic of Peter Bent-Brigham Hospital, Boston. Financing State appropriation for work of the Recess Commission. II Activities 1. Submitted a report to the Legislature. The Sub-Committee‘s re- port to the Legislature (Massachusetts House of Representatives, No. 24h0, April 1952) recommended that the Commission be continued to engage in further study, submit findings, and draft legislation by March 19530 The report (a) points out the inadequacy in policy and provision for adminis— tration of existing legislation of special interest to aging persons: XVI (b) rec0mmends that the Legislature consider the development of new services by the State public welfare, employment, and housing agencies-- that the public assistance agencies offer counseling services and train and supervise, volunteer friendly visitor services--that employment serv- ices be geared to study the problems and possibilities of older workers and to educate the public to these needs-—that public housing projects be open to individual older persons and that private housing projects be assisted in every way possible: and (c) outlines a program to be under- taken by the Recess Commission, if continued, with the aim of "develop- ing a better system of handling the problems of aging." 2. Proposed that Recess Commission undertake the following pro- gram: A survey of public and private facilities for the aged...com- munity facilities, such as chronic hospitals, nursing and boarding homes, agencies promoting the rehabilitation and retraining of the aged, volun- tary recreation programs, and geriatric clinics. "A cross-section of recipients must be asked what they think of the care provided for the elderly. "Basic statistics must be centralized and studies made of preposals for housing, financial aid of other types, out-patient clinics, mental health clinics, rehabilitation and employment. "The financial resources of the Commonwealth and municipalities must be studied to work out a program which includes as much federal financial participation as possible. The possibility of extending Old Age Assistance grants to reduce the cost of the aged in institutions must be thoroughly explored." "Pilot" projects "introducing new concepts" which can be started easily under both private and public sponsorship, such as: conversion and use for "home type" care of an unused building at a State mental hospital, and "development of treatment teams with an ever-expanding cadre of trained personnel as basis for changing type of treatment for elderly at all State mental hospitals; cooperative participation with a municipality in develOpment of a self—liquidating housing project for the elderly; encouraging develOpment of geriatric clinics in general teaching hospitals. Guidance and encouragement to community committees and groups in their efforts to "promote a better climate for those growing old." Encouragement ofand.garticipation in regional conferences on problems of the aging which bring together the public and the experts. Organization of "all-day institutes" in cities and towns in various sections of the State to discuss: (a) health and rehabilitation services, (b) employment opportunities, (c) housing, (d) educational, recreational and social senters forileisure‘time,,(é)}economicv XVII security, (f) counseling services to individuals on personal problems, (g) responsibility of each community for its aging populationo III Statutory Authorization RESOLVE ESTABLISHING AN UNPAID SPECIAL COMMISSION TO STUDY AND REVISE THE LAWS RELATING TO PUBLIC WELFARE. Resolved, That a special unpaid commission, to consist of one member of the senate to be designated by the president thereof, two members of the house of representatives to be designated by the speaker thereof, and three persons to be appointed by the governor, is hereby established to make a survey and study of the laws of the commonwealth relating to public welfare, with a view to the revision and codification of said laws and to the recommending of such changes therein and addi- tions thereto as may appear necessary or desirableo In making said survey and study, said commission shall consider the subject matter of so much of the governor‘s address, printed as current senate document numbered one, as relates to a complete recodification of the public welfare laws to clarify the responsibilities of the commonwealth and cities and towns, and so much thereof as relates to an amendment of ex- isting statutes to provide more adequate safeguards surrounding the or— ganization of charitable corporations, and the subject matter of current senate document numbered four hundred and thirty and of current house documents numbered three hundred and fifty-four, nine hundred and seventyofive and sixteen hundred and fifteen. Said commission shall hold hearings, shall be provided with quarters in the state house or elsewhere and may expend for expenses and legal, clerical and other as- sistance such sums as may be appropriated therefor. Said commission shall report to the general court the results of its study, and its recommendations, if any, together with drafts of legislation necessary to carry said recommendations into effect, by filing the same with the ‘clerk of the house of representatives not later than the first Wednesday of December in the current year, Approved June 25, 1947 XVIII MICHIGAN Commission to Study Problems of Aging I General Structure Authorization and Assignment Established by Governor, March 1951, under authority of general statute authorizing creation of study commissions, to study the mental and physical health, employment, living arrangements, recreation, and education problems of persons from middle age to advanced age and to recommend programs and legislation beneficial to these persons and to the State. Commission was asked to file report with Governor by Decem— ber 31 , 1952. Report has been submitted this summer. Membership and General Organization Thirty-six members appointed by Governor. Approximately half of membership chosen for special knowledge and demonstrated interest in problems of aging; the balance, informed citizens and civic leaders, ehosen from all parts of State so that geographic representation was effected. Governor appointed Chairman,"ms.i.ZHa.rold S. Patton, Assistant Professor of Economics, Western Michigan College of Education, Kalamazoo. Commission members elected 2 Vice—Chairmen, the Secretary, and mmbership of the 6 member Executive Committees. Executive Committee met biweekly, Commission monthly. Commission functioned through 7 Committees: Employ- ment, Economic Support, Health, Education, Activities in Retirement, Liv- ing Arrangements and Housing, and Community Planning. Each Committee responsible for assembling and evaluating data, and drafting a section of the report including recommendations and legislative proposals, for review and acceptance by full Commission. An Inter-departmental Com- mittee on Problems of the Aging, represent the executive agencies of the State Government met with the Commission as needed, furnished factual information and analyses of legislative proposals. Mr. Frank Blackford, Aide to the Governor, is Chairman of the Inter-departmental Comittee. Staff Commission had no staff but received assistance from State and Federal agencies and Inter-departmental Committee. State Department of Social Welfare circularized all county departments of social welfare operating infirmaries and hospital units and all licensed private homes for aged getting data on residents of those institutions, their medical care needs, and services available to them. ' "FEW Financ ing Financed from appropriation of $5,000 to the Governor's innd for all "study commissions." Note: An mter-departmental Committee on Problems of Aging was estab- lished by Governor in spring of 1950. Its membership represents State agencies concerned with welfare, public health including mental health, education, unemployment compensation, workmen's compensation, labor, libraries, insurance, public administration, and the University of Michigan Institut for Human Adjustment. The Committee's original as- signment was to define the problems of aging as outline for working com- mittees of the Commission on Aging, appointed later; suggest individuals and groups to be considered in making appointments to the Commission; and review work being done throughout the country in the field of aging. The Committee published several reports. Its "Stnmnary Report," dated Septem- ber 26, 1950, was the basic information guide furnished the Commission. The Inter-departmental Committee was reactivated at the request of the Commission to help it in its work. II Activities 1. The Commission has completed and submitted its report to the Governor. 2. The Commission sponsored a State-wide Conference on Aging in May 195;}. The section reports and Commission findings were used as back- ground material for the Conference. The Conference agenda set forth the basic propositions with which the Commission was concerned in making its recomendations for program and legislation. The Conference informed the public of the work of the Commission, and enabled the Commission to get a cross section of public Opinion with regard to action on its find- ings and therefore to pretest, in part, public understanding and support for its recommendation. ' 3. The Commission encouraged the formation of commanity commit- tees° Commission members from localities were asked to make their serv- ices available to local groups, and the Chairman of the Committee on Community Planning met with local groups on request. ’4. Commission members participated in national and regional meet» ings in the aging field. 5. Teams of Commission members visited in commities in the State to observe program activities in aging, and familiarize the Com- mission with attitudes and aspirations of local groups and problems peculiar to those commnmities. 1%. MINNESOTA Commission on Aging Room 13 Court House, Minneapolis I General Structure Authorization and Assignment Statutory authorization, April 1951, to act from time members appointed until commencement of 1953 regular session of legislature. (See attached copy of legislation») Created "to study the problems of the aging papulation (defined by Commission to be persons 15 and over) in Minnesota with respect to their social and economic welfare, rehabil- itation, health, recreation, and family relationships, and to recommend methods of effectively meeting the problems of aging in a constructive manner." Directed to file by January 15, 1953, a report to the Governor of findings and reconmendations. Membershigand General Organization Twenty—five members. Five State Senators, appointed by the Senate Committee on Committees; 5 State Representatives, appointed by the Speaker of the House; and 15 "leaders in medical, employment, recrea- tional and social welfare fields," appointed by the Governor. Chairman, Vice—Chairman, Secretary, and. Chairmen of working com- mittees selected by Commissmn from among its members. Commission functions through 1+ committees, each of which sub- divided its assignment as follows; gloyment with 2 subcommittees on dimensions of problem, causes and answers; Living Arrggements with subcomittees on medical care and rehabilitation, aged in rural areas, aged in urban areas, congregate living centers, family relations and attitudes, desirable housing, public housing, care in mental hospitals; Recreation with 5 subcomittees on community clubs, boarding homes, homes for aged, nursing and convalescent homes, adult education; Economic Wel- fare with each member assigied to l of 15 areas of study -- Old—Age and Survivors’ Insurance, Railroad Retirement, Old-Age Assistance, Aid to Blind, Veterans' benefits, investments-income-resources, annuities-life insurance-disability insurance, general relief, Unemployment Comensa— tion, Compensation Insurance, private charities, medical-health—hospital insurance, liability benefits, private pensions, responsibility of rela- tives. Each Committee may invite outside eXperts to serve with then. Commission Chairman and Secretary are "ex-officio” members of each Com- mittee. Staff No paid staff. Legislation authorized employment of professional and clerical aid, and use of "facilities of the Legislative Research Com- mitteeo" The Secretary of the Commission is Mr. Jerome Kaplan, Group Work Counsultant, Hennepin County Welfare Board, 13h Court House, Minne— apolis. The Minnesota Division of Social Welfare is tabulating returns from questionnairesa University of Minnesota was asked to assign grad- uate students for research projects° Financing Legislation authorized appropriation of $1,000; Legislative Advisory Council granted additional $1,500. Funds used for travel ex- penses of Commission membera stationery, and publishing of final report. Commission members serve without compensationo Additional funds needed to publish reporto II Activities Commission activities are primarily geared to the gathering and evaluation of information necessary for its report and recommendations to the Governoro. The report will be ready for publication sometime in October 1952” . At the same time, through inviting individuals and groups to par- ticipate in Committee meetings and assignment, through questionnaires and news releases, the Commission is striving to interest many persons and organizations to understand the need and to undertake actitities in the aging field° The Commission as a whole has met a number of times, the commit- tees frequently. The Committees collaborated in the design of a 6-page question- naire sent to 87 county welfare boards asking for factual information and opinion on the unmet needs of older personso The questionnaire seeks data on existing programs, community resources in the way of personnel, organizations and facilities, both used and unused, with regard to leisure needs, old-age assistance and living arrangementso Other questionnaires are in use seeking collaborative information from agencies, institutions and individuals affected by County Welfare Board programs. Mbre than 150 indiv1duals and groups have participated in the Commission's worko At the present time the Commission is actively engaged in com- pleting recommendations to be made to the Governor and a preparation of a final report. Additional consideration by the Commission must be given in the area of legislation in order to effectively promote the program undertaken by the Commission. The Commission does not feel that its work is completed with the publishing of a report but is of XXII \ the opinion that its members should continue to serve as a focal point for promoting a program of benefit to the aged in this State. The Com- mission is also considering the advisability of a State-wide conference on aging in 1953. III Statutory Authorization CHAPTER 6A3 -- 1951 SESSION AN ACT CREATING A COMMISSION TO STUDY THE PROBLEMS OF THE AGING POPULATION IN MINNESOTA WITH RESPECT TO THEIR H SOCIAL.AND ECONOMIC WELFARE, REHABILITATION, HEALTH, RECREATION AND FAMILY RELATIONSHIPS, AND TO RECOMMEND METHODS OF EFFECTIVELY MEETING THE PROBLEMS OF AGING IN A CONSTRUCTIVE MANNER, AND MAKING AN APPROPRIATION THEREFOR. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: Section 1. A commission is hereby created to study the problems of the aging pOpulation in Minnesota with respect to their social and economic welfare, rehabilitation, health, recreation, and family rela- tionships, and to recommend methods of effectively meeting the problems of aging in a constructive mannero Section 2a The commission shall consist of not more than 25 mem- bers, five of whom shall be members of the house of representatives to be appointed by the speaker and five who are members of the senate to be appointed by the committee on committees of the senate, the remaining members to be appointed by the governoro They shall serve without com- pensation and shall include leaders in the medical, employment, recre- ational and social welfare fieldso Appointments to such commission % shall be made upon the passage of this act, Vacancies occurring or 3 existing in the membership cf the commission shall be filled by the appointing powera Section 3b The commission is authorized to act from the time its members are appointed until the commencement of the next regular session of the State Legislature and shall make and file a report of its findings and recommendations to the governor not later than January 15, 19530 Section he The commission shall have the authority and power to hold meetings and hearings at such times and places as it may designate to accomplish the purposes set forth in this act“ The commission shall select a chairman, viceachairman, and such other officers from the mem- bership as it may deem necessaryq Section 5. Members of the commission, while serving without pay, shall be allowed and paid their actual traveling and other expenses nec- essarily incurred in the performance of their dutieso The commission may emp10y clerical and professional aid and assistance; and may purchase stationery and other supplies; and do all things reasonably necessary and convenient in carrying out the purposes of this acto XXIII / Section 6. There is hereby appropriated out of any monieg’in the State treasury, not otherwise appropriated, $1,000, or so much thereof as may be necessary to pay expenses incurred by the commission._ Fbr the payment of such expenses the commission shall draw its warrants'upon the State treasurer, which warrants shall be signed by the chairman and at least two other members of the commission and the State auditor shall then approve and the State treasurer pay such warrants as and when presented. A general summary or statement of expenses incurred by the commission and paid shall be included with the commission's report. Section 7. The facilities of the legislative Research Committee are hereby made available to the commission. Filed: April 23, 1951 Signed: Mike Hblm Secretary of State XXIV NEWYCRK Joint Legislative Committee on Problems of the Aging 91L Broadway, Newburgh, New York I General Structure Authorization and Ass ignnent Statutory atthorization originating in 19h? (see attached resolu~ tion) which has been continued by the Legislature each year since that time "to proceed." with a study of the problems of the aging." Committee has all powers of a standing legislative committee, including power of subpoena. , Membership and General Organization Eight members. In addition, 7 "Ex-Officio Members ," 3 "General Advisers," 5 member "Advisory Committee on longevity." Eight member "Advisory Comittee on Employment Problems of the Elderly," and 5 member "Advisory Committee on Recreationfor the Elderly." Fbur Senators, appointed by the President Pro Tem of the Senate, and 1+ Assemblyman appointed, by the Speaker of the Assembly are mem- bers of the Committee. Chairman, Vice-Chairman, and Secretary are selected by members. Four members have continued as members through- out the 5-year life of the Committee, among them the Chairman, Senator Thomas C. Desmond, The President Pro Tem of the Senate, the Speaker of the House, Minority leaders of the Senate and the Assembly, and Chair- men of the Senate Finance Committee and the Assembly Committee on Ways and Means are the "Ex-Officio Members." Staff Committee has a staff including a Director, Associate Director, Consultant, and an office staff of 5 persons, Mr. Albert J. Abrams, 94 Broadway, Newburgh, is Director. Statute provides that the Committee "shall receive from all public officers, departments and agencies of the State and its political subdivisions, such assistance and data as will enable it properly to consummate its investigations; . ." Pinanc ing ' State appropriation. Committee requested $25,000 and unexpended balance from last fiscal year as its appropriation for the current fiscal year. II Activities 1. Committee conducts public hearings each year, inviting na-'-' tional authorities in the aging field to prepare and present papers. These papers together with a summary of the Committee's "findings and recommendations to the Governor and the legislature," research papers prepared by the Comittee's staff, and bills in aging field drafted by the Committee staff and introduced by members are published annually in ' a source book volume of at least 200 pages. While the supply lasts, these reports are available free of charge and are coveted documents both in this country and broad. --Birthdays Don't Count, l9h8, contains papers on all aspects of aging. "Never Too Old, 199, concerned with employment difficulties of the aged. --You.ng At _A_ny Age, 1950, concerned with role of local communi- ties in dealing with the aging. --No Time To Grow Old, 1951, reporting evidence of the revolu- tion in our attitudes toward older persons. 2. legislation drafted by the Committee and introduced in the 1951 legislature were concerned with many topics including the following: —-creation of an advisory council on employment of older workers --creating a counseling service for older workers -- authorizing municipalities to establish sheltered workshops -- amending civil service law in relation to suspension of pensions -- appropriation to health department for experiments in multi- phasic screening --creating a State council on the elderly --establishment by private nonprofit corporation of low rent housing facilities for elderly; nursing, boarding homes, apartments, and establishing a State loan fund for this purpose "establishment of community recreation programs —-appropriation to health department for pilot study in rehabil- itation —-appropriation for physical and vocational rehabilitation of workers over 65 for work in defense industries XXVI —-establishing a geriatric clinic Committee was instrumental in financing staff for State Education Department which has developed curriculum and consultation services for an adult education program on planning for retirement now being widely offered in the public schools. Committee was instrumental in effecting recent regulation of State Housing Commissioner that at least 5% of the dwelling units in State financed public housing projects shall be avail- able to elderly persons. 3. Committee has encouraged and participated in conmmnity eon- ferences on employment, housing, health, etc. , and offers consultation services to local groups in establishing local councils on aging and. programs. Committee functions as a clearinghouse of information on commnity activities and unusual program development throughout the Nation. 11-. Committee staff participates in National and. International conferences on aging and are widely sought for consultant services. III Statutory Authorization RESOIUJJION CREATING THE Joml‘ IEGISLATIVE COMETI'EE ON PROBLEMS OF THE AGING WHEREAS, The proportion of aged people in the population of our Nation is increasing rapidly, a factor bringing in its wake a great mam new, intricate problems which will confront our State in the near future, and ' WIIEREAS, It is important that studies be made to foresee what impact the aging of our people will have on our State, now therefore, be it Resolved (if the Assembly concur), That a Joint legislative Com— mittee is hereby created to consist of four members of the Senate to be appointed by the Temporary President of the Senate aid four members of the Assembly to be appointed by the Speaker of the Assembly with full power and authority to proceed with a study of the problems of the aging; and be it further Resolved (if the Assembly concur), That such committee shall organize by the selection from its number of a chairman, a vice—chair- man and a secretary, and shall employ and may at pleasure remove a re- search director and other employees and assistants as may be necessary, and fix their compensation within the amounts made available therefor herein. Any vacancy in the committee shall be filled by the officer authorized to make the original appointment. The members of the compt- tee shall serve without compensation for their services but shall be 'en- titled to their actual expenses incurred in the performance of their duties hereunder. Such Committee may sit at any place within the State as it may determine to conduct its labors, and may hold either public or private hearings. Such committee or any member thereof shall have the XXVII power to subpoena witnesses, administer oaths, take testimomr and compel . the production of books, papers, documents and other evidence and it shall have generally all the powers of a legislative committee as provided by the legislative law. Such committee may request and shall receive from all public officers and departments and agencies of the State and its political subdivisions, such assistance and data as will enable it prop— erly to consmmnate pits investigations; and be it further Resolved\(if the Assembly concur), That the committee shall report to the legislature on or before March first, nineteen hundred and forty- eight the results of its studies and investigations; and submit with its report such legislative proposals as it deems necessary to make its rec- onnnendat'iOns : effective; and be it further Resolved (if the Assembly concur), That the sum of fifteen thou- sand dollars I$15,000) or so much thereof as may be necessary, is hereby appropriated from the legislative contingent fund and made imediately available to pay the expenses of the committee, including personal serv- ice, in carrying out the provisions of this resolution. Such moneys shall be payable after audit by and upon the warrant of the comptroller on vouchers certified or approved by the chairman of the committee in the manner provided by law. Introduced March 12, 191.7. To Finance Com. Mar. 18 Rept. Adopted in both houses. XXVIII NORTH CAROLINA Special Committee on Aging I General Structure Authorization and Assignment Establishment by Governor, October 1951 (See attached letter) "to review recommendations made by several sections of the Governor‘s Confer- ence on Aging of June 1951 and to further in such ways as appear practi- cal and feasible the attainment of those objectives," The Committee is to file a report on its work and recommendations with the Governor by December 1952o Mbmbership and General Organization Twenty-five members appointed by the Governor, membership in- cludes: President of a large textile mill; Personnel Director of an— other such mill; Superintendent, nonprofit home for aged under religious auspices; Director, nonprofit health publishing house; President, State Federation of Women‘s Clubs; President, State Federation of Business and Professional Women's Clubs; President, State Medical Society; Executive Secretary, State Nurses Association; a County Commissioner; Clerk, Supe- rior Court; a County Superintendent of Public Welfare; President, North Carolina College(Negro); professor, Duke university School of Nursing; Physician representative of a Negro medical school; 5 professors from De- partment of Sociology, School of Public Health, Business Foundation and Extension Service, State University; Commissioner, State Board of Public Welfare; Director of Public Assistance and Supervisor, Services for Aged, State Board of Public Welfare; State Health Officer; member, State Hos- pitals Board of Control; manager, OldaAge and Survivors Insurance Field Officeo The Governor appointed Committee Chairman, Mr, Edwin Brower, Brower Mills, Inca, Hope Mills, North Carolina° Committee Chairman desig- nated Mrs. Annie May Pemberton, Supervisor, Services to the Aged, State Board of Public Welfare, Raleigh, a member of the Committee and formerly ‘ Secretary to the Governor‘s Conference, as Secretary to the Committee. Chairman established a 5-member steering group composed of Committee mem- bers who had worked as Section Chairmen and Officers for the Governor's Conference, Staff No staff exclusively assigned to Committee work. Members use own organizations and are aided by State Board of Public Welfare staff. a" ,XXIX Financing No provision reportedo Expenses of the Governor's Conference and the publication of the Conference Report financed through contributions of life insurance companies with home offices in North Carolina° Note: 19h9 General Assembly of North Carolina authorized the Governor to appoint a Commission to study problems of aging and report findings to 1951 General Assemblyo Members of this Commission, together with delegates from North Carolina who attended the 1950 National Conference on Aging, constituted Planning Committee for the Governor's Conference of June 1951. Membership of Special Committee includes 3 members of l9h9-‘50 Commission, the Conference Section Chairmen, Co—Chairnen and Recorders, and several additional persons, II Activities 1, The steering group developed the plan for the Committee's ‘worka This plan includes following steps: (a) Determination by the steering group of which of the Con- ference recommendations it was feasible for the Committee to try to get activated, The Governor‘s Conference at- tended by 200 persons had 6 sections which made recom- mendations as follows: Research and Population -- 8 recommendations Employment, Employability and Income Maintenance -- 5 study recommendations; 5 action recommendations Education, Recreation, Religion -- 20 recommendations Health Maintenance and Rehabilitation -- 6 recom- mendations . Family Life, Housing and Social Service -~ 9 recom- mendations. Professional Personnel -~ 7 recommendations (b) Determination of the kind of additional information needed, if any, for action on each recommendationo (c) Determination of agencies, organizations, individuals in “ State which should be involved in getting information needed, and effecting the recommendations. (d) Assignment of work on each recommendation to one or more members of the Committee who, in terms of personal knowl- edge, business associations, and other capacities, are considered best equipped to deal with the organizations and individuals who could furnish the necessary informa- tion or take the action, Each Committee member plots his own course on how to get his assignments completed -- letters, interviews, speechmaking, group conferences are involvedo For example: the State Health Officer, 3 member of the COmmittee is to report what action he can XXX and will take on the recommendation "nutritional studies of the aged should be extended and one of the most urgent needs is study of institutional diets"; the Committee Chairman is asking the State Superintendent of Public Ins struction what he intends to do about the recommendation _ "the State Legislature makes appropriations to the Depart- ment of Public Instruction for implementation of the adult education program," and is asking the State Farm Bureau and Grange what action they are taking toward coverage of farm groups under Old-Age and Survivor's Insuranceo 2, The Committee report to the Governor will state what action has been taken on the recommendations, present obstacles to action and further executive, legislative, and other action necessary to achieve the conference objectives. III Underlying Authority STATE OF NORTH CAROLINA Governor's Office Raleigh October 9, 1951 W. Kerr Scott Governor Dear On the call of this office, a State-wide Conference on Aging was held here in Raleigh at the Sir Walter Hotel on June 28-29, 1951. I was highly pleased by the interest in this Conference and the splendid work which was done during the two days of discussiou by experts in various aspects of the needs of older people from throughout the Stateo You will recall that at the closing session a resolution was adopted by the perSOn— nel of the Conference requesting that I appoint a special Committee on Aging to follow up on the work of the Conference. I am requesting that you serve On this special committee. The particular assignment of the Committee will be to review the recommenda- tions made by the several sections of the Conference and to further in such ways as appear practical and feasible the attainment of those ob- jectives. A report to me on the work of this follow—up Committee not later than December 1, 1952, is requested. I am appointing Mr. Edwin Brower, Hope Mills, as Chairman of the Committee. Sincerely, WKS:dc (s) W. Kerr Scott XXXI PENNSYLVANIA Joint State Government Commission of the General Assembly Room h50, Capitol Building, Harrisburg I General Structure Authorization and Assignment Statutory authorization, December 1951, "to make a comprehensive and intensive study of the state—wide needs and problems of the aging and the aged and to develop in cooperation with other governmental and volun- »tary groups ways and means to assist the Commonwealth in meeting these needs and problems." "Such study shall concentrate on": (1) employment opportunities; (2) facilities and services for aged-acounseling and per- sonal services, employment guidance and placement, medical care, insti- tutional services, treatment and rehabilitation for chronically ill, care and rehabilitation for disabled and handicapped, recreation, educa;“ tion, and related community services; (3) analysis of problems of Old- Age Assistance recipients with special reference to adequaCy of grants and standards of living, boarding homes and other sheltered care; (h) problems of care and treatment of senile aged° The Commission is to report results of its investigations and it recommendations to the General Assembly by February 1953. ' Membership and General Organization The Joint State Government Commission is an established Committee and staff of the Pennsylvania Legislature which makes studies pertaining to public policy requested by the Assembly: Thirteen Senators and thir- teen Representatives are members of the Commission, Representative Baker Boyer, Chairman of the House Committee on Committees, is Chairman of the Commission, Senator Paul L, Wagner is Vice-Chairman, and Represent- ative Stuart Helm is Secretary-Treasurero Authorizing legislation pro~ vides that "the Commission may appoint and consult with a Citizens Ad— visory Committee of competent lay and professional citizens who have' demonstrated interests in and knowledge of the aging and aged." It is not known whether the Commission has appointed this Committeeo Staff The Commission has a permanent staff which is augmented as needed for particular assignments. Staff reported to be working on problems of aging include Dr, Paul H. Wueller, Associate Director in charge of Re- search and Statistics, 2 statisticians, l institution inspector, and clerical assistanceo The State Department of Public Assistance is re- ported to be assisting the staff in review of information schedules, etc, XXXII Financing > State appropriation for general Commission work. Amount allo- cated for aging study and development work is unknown. II Activities ' l. Organizing statistical data on age groups-~changes since 1900 of proportion of population age 60 and over. 2. Gathering information on income maintenance--amounts from earnings, OldeAge and Survivors Insurance, Railroad Retirement, Old-Age Assistance, Federal Civil Service Retirement, private pension plans, union benefits. 30 Gathering information on employer and union requirements which restrict employment opportunities of older workers. #0 Summarizing medical information on provision for health maintenance and medical care. XXXIII RHODE ISLAND The Governor's Commission to Study Problems of the Aged 2h Mason Street, Providence I General Structure Authorization and Assignment Statutory authorization, April 1951 (See attached copy of Ass sembly Resolution), "to make a complete, overall study regarding the economics, employment, medical, recreational and social problems of the older citizens of the State" and to "recommend a coordinated State pro- gram for improving general welfare of citizens so that opportunities shall be provided.for aging persons to contine as full participating members of community, to enable families, communities, and society to adjust to aging population under modern conditions," ~ Membership and General Organization Twenty-five members appointed by the Governor, Membership includes: District Court Judge; State Directors of Social Welfare and Employment Security Chief; Division of Women and Children, State Department of Labor; Director of a local public welfare agency; Supervisor, Americanization and Adult Education; Manager, Old- Age and Survivors' Insurance field office; Director, Office of Price Stabilization; Director, home for aged under Jewish auspices; Secretary, State Council of Churches; Director and Secretary of two Diocesan Bureaus of Social Service; Secretary, Urban League; Director, District Nursing Association; two physicians in private practice; lay leader of women's work in civic affairs; General Agent, mutual life insurance company; Business Agent, labor union; industrial Relations Director of large industry; Professors in economics and other fields from three colleges; a Senator and a Representative, Rhode Island Legislature. Chairman and Vice~Chairman, and Work Committee Chairman elected by Commission from among its members. Judge JOhn P. Cooney, Sixth District Court, is Chairman of the Commission. Commission is doing its planning and program development work through five committees on health, housing, recreation, economics, and researcho Staff _An Executive Secretary° Commission appointed Director of State vocational rehabilitation program to this assignment. One Technical Director (part-time); 1 Research Assistant. XXXIV Financing State appropriation. Statute authorized an appropriation of $10,000. Commission members serve without campensation but receive necessary travel expenses. Commission staff is housed in space pro- .vided by the State Department of Employment Security. II Activities General The Commission is now holding a monthly meeting. The subcom- mittees are meeting somewhat more frequentlyo The work is now pointing toward recommendations for legislative action which will be presented at the January session of the legislature. Economic and Income Maintenance 1. Through State Department of Employment Security getting data on employment "quits” and layoffs of older workers, and canvassing major industries for information on their employment policies and practices. 2. Organizing study of private pension plans involving queries to 9,000 employers regarding any plans they have, how financed, kind and number of workers covered, and c0mpulsory retirement requirements. 3. Assembling data on coverage of Railroad Retirement, Civil Servica, Veterans Administration, city and county retirement programs, and retirement plans of voluntary social agencies. h. Through Old-Age and Survivors Insurance Field Office getting analysis of workers, aged 65 to 75, Whose benefits are discontinued be— cause of employment income. 5. Through Department of Social Welfare getting analysis of characteristics, particularly reasons for dependency, of new applicants for Old-Age Assistance. Housing 6. Conducting a series of meetings with representatives of public and private nonprofit homes for aged; have advisory group analyzing data on nonprofit homes. 7. Obtaining detailed information on commercially operated homes. 8. Surveyed public housing projects with regard to number of older persons accommodated, waiting lists, rents, recreation facilities, and management‘s attitude toward older tenants; noted exclusion of single older persons from projects and that no particular consideration is given to architectural features serving convenience and safety of older persons. Health 9. Health Committee notes large number of older persons housed in State Infirmary and State Hospital for MEntal Diseases; questions whether persons are living in these institutions andhtn bursa flgriaged do so because they need housing, or because they need medical attention. 10. Health Committee visited rehabilitation services of the Hospital for Chronic Illness, Rocky Hill, Connecticut, operated by the Connecticut Commission for the Care and Treatment of the Chronically Ill, Aged and Infirm. Committee is promoting opening of a ward at State Infirmary for rehabilitation of aged handicapped. ll. Gathered information from general hospitals on services to aged persons. Made special study of admissions, length of stay, etc., of older persons in an urban and a rural hospital. 12. Through State Departments of Social Welfare and Employment Security getting analysis of medical care grants now being made and morbidity reports on workers over 65 who are eligible for cash sickness benefits. 13. Recommends study on extent of chronic illness, and its rela- tionship to other factors in lives of aged. Recreation 1%. Mbeting with public and voluntary recreation program leaders to stimulate programs. 15. Gathering information on clubs for publication to promote establishment of clubs in more communities. 16. Members of a "Forever Young Club" are reporting on their own attitudes and opinions regarding recreational activities. . Research and Other Community Organization 17. Undertaking a basic study involving interviews with older persons on a sampling basis to obtain information on existing conditions, attitudes, needs and wishes of such persons with regard to health, hous- ing, recreation, and economic circumstances. l8. Canvassing church congregations on health, housing, recrea- tional, and economic conditions of older persons. Two-thirds of popu- lation of Rhode Island are church members. 19. A survey of a sample of the old population 65 years and over, with cooperation of the U. S. Census Bureau, has been approved. This will prdbably be conducted in January 1953. XXXVI III Statutory Authorization STATE OF RHODE ISLAND, &c. In General Assembly January Session, A.D. 1951 RESOLUTION CREATING A SPECIAL COMMISSION TO INVESTIGATE AND STUDY THE PROBLEMS OF THE AGEDO VHEREAS, His Excellency, Governor Dennis J. Roberts, did in his inaugural message on January 2, 1951, state that "the time has come for us to take steps to correct a maladjustment in our economic and social machinery which has been doing a great injustice to our citizens over 65;" WHEREAS, His Excellency did further state that "their position in the labor force has been growing proportionately smaller; those older persons who can make a contribution to the ecouomy of our state must be given an opportunity to do so; if we insist upon supporting them in idle- ness they do not want, we are going to expend the public funds on relief and other non-productive measures;" and WHEREAS, It appears that these problems extend to persons younger than 65 years; now, therefore, be it RESOLVED, That a special commission be and the same is hereby created to consist of not more than 25 members to be appointed by, and who shall serve at the pleasure of, the governor. It shall be the purpose of such commission to make a complete, overall study regarding the economic, employment, medical, recreational and social problems of the older citizens of the state° In the perform- ance of its duties said commission shall survey, evaluate, plan and recommend a coordinated state program for improving the general welfare of said citizens so that opportunities shall be provided for aging per- sons to continue as fully participating members of the community, to enable families, communities and society to adjust to the aging popula- tiOn under modern conditions,- Vacancies occurring on said commission shall be filled in the same manner as the original appointments were made. Forthwith upon the passage of this resolution the commission shall meet and organize and elect from among its members a chairman, vice chairman and such other officers and subcommittees as it shall deem necessary. The members of said commission shall serve without compensation, but shall be allowed their necessary and actual traveling expenses. XXXVII The commission shall be allowed to engage an executive secretary and such clerical and expert assistants and technicians as it shall deem necessary for its purposes. The sum of $10,000 or so much thereof as may be necessary, is hereby appropriated, out of any money in the treasury not otherwise appropriated, for the purpose of carrying out the provisions of this resolution; and the state controller is hereby authorized and directed to draw his orders upon the general treasurer for the payment of such sum, or so much thereof as may be required from time to time, upon the receipt by him of properly authenticated vouchers. Said commission shall report to the governor from time to time, provided it shall make its first report on or before February 1, 1952. XXXVIII WASHINGTON washington Council for Aging Population I General Structure Authorization and Assignment Established by Governor, April 1952. No executive order was issued to establish the State Council for the Aging Pepulation. The Governor addressed letters to certain promi— nent citizens, requesting their participation on the Council, and these letters served as the initiating action toward the establishment of this Council. Membership and General Organization Approximately 20 members. The Governor invited the following organizations to designate representatives to serve on the Council; 2 representatives each from State Federation of Labor, Washington Association of Industry, the Townsend State Council; 1 representative each from the Senior Citizens League, Fraternal Order of Eagles, State Hospital Association, State Nurses Association, State Council of Churches, Catholic Welfare Associa- tion, State Medical Association, and Spanish American War Veterans. The directors of the State Departments of Social Security, Health, Labor and Industries are working with the Council. Staff No staff has been established for the Council, and Assistant Director of the State of washington, Department of Social Security, George M. V. Brown, has taken principal responsibility for coordinating the activities of the Council. Miss Mary Lou Everson of that Department was designated as secretary of the Council, and handles all correspond— ence. Staff work done this far has been of a voluntary nature. ' ' Financing No funds have been provided for the operation of the Council. The members of the Council have suggested that some provision be made in the forthcoming budget for an executive secretary for the Council, and to provide additional operating funds. - ‘ XXXIX . “9‘" - --._ II Activities 1. The objectives of the committee are primarily to provide guidance to local communities in their attempt to meet the problems of the Aging population, whether thoae problems be economic, psychological, physiological, pr recreational. The only activities in which the Council has engaged so far have been the three meetings, but there should be an early attempt made by the Council to stimulate more com- munity effort. Very possibly one community will be selected as a pilot project with subsequent action in other communities to be determined by the results of the experimental project. 2. To date three meetings of the Council have been held. 3. No program conferences are scheduled for the near future. WEST VIRGINIA Governor's Committee on Aging I General Structure Authorization-am}. Assignment Established by the Governor, December 1951, to determine what other States are doing in the areas of education, health, welfare projects for aging persons, and to review policies of business corporations in this regard. The Committee is to report its findings to the Governor. Membership and General Organization Four members appointed by the Cmvernor. Ibmbership includes: a. physician in private practice; the State Direc- tor of Health; Administrative Assistant, State Department of Public Assistance; and a Professor of Sociolog, Marshall College. The Governor designated Dr. J. r. Richardson, Department of Sociolog, Marshall College, Huntington, Chairman of the Connnittee. Staff Committee has no staff. Sociology Dewrtment at Marshall College carried on a preliminary survey. _ Financing ‘ No funds. II Activities No inromation . WISCONSIN Connnittee on the Problems of the Aged to the legislative Council State Capitol, Madison I General Structure Authorization and Assignment Statutory authorization July 1, 1951 (see attached) with annual appro- priation through June 30, 1953. Statute directs the. JOint Legislative Council "to conduct a study of the problem of our aged population and to develop such information as will enable the legislature to enact a long range program geared to provide adequately for those who have devoted most of their years to the development of this State." . . . "Such study should give emphasis to Ea) adequate old-age assistance, (b) problems of institutional care, c) partial or extended employment, (d) leisure time." . . . "Council is further directed to conduct a study of all welfare costs, to make recommendations thereon and to determine if a pattern fixing a maximm percentage county tax levy from real estate tax for welfare purposes can be developed." Membership and General‘Organization ' Nine members. Statute provides that an "Advisory Connnittee" of 3 Senators, 3 Assembly- men, and 3 citizens at large, with a knowledge of an interest in the problem of the aged shall direct the study. Senators and Assemblyman were appointed by their respective Houses, and the .Citizens at large" were selected by the-legislative Council. The Council is a continuing Joint (Senate-Assembly) study and planning Committee of the legislature. Members of the Committee on the Problems of the Aged elected their Chairman, Vice—Chairman, and Secretary. Senator Foster 13. Porter, Bloomington, Wisconsin, is Committee Chairman. Staff Committee appointed a Project Director, Mr. Ieo E. Boebel, room 202 South, State Capitol, Madison. ~Statute directs Director of Public Wel- fare to release employees for maximum periods of 3 months each to partic- ipate in study, and to furnish information as requested by Project Director. ‘ Financ ' State appropriation of $15,000 annually, 1951 and 1952, for conduct of study and preparation of report. Appropriation available for compensation m1 for‘personal services, except staff services of Department of Public Welfare. II Activities 1. lbs Committee held series of open hearings of two kinds in different cities in the State: (a) State agency representatives and other organizations reported on their activities, and (b) representatives of local organizations, institutions and agencies, old-age assistance recipients, their relatives and the general public attended hearings and expressed their views. The following programs have been discussed in ' these hearings: employment services, especially counseling and placement of applicants vocational and adult education for occupational training, recreational and educational interests care of aged in public and private institutions, county homes and nursing home operations, nursing home standards under licensing law ’ county infirmaries recreation programs in Milwaukee and Madison Old-Age and Survivors' Insurance and OldnAge Assistance program and report of the University of Wisconsin Committee on Problems of Aging medical aspects of agingm-presented by panel sponsored by State Medical Society programs of county welfare departments, boarding and nursing home operators. 2. Research projects under way include the following: (a) operation of the lien law (b) survey of shift of medical payments from vendor payments to payments included in assistance grants (c) survey by Wisconsin Employment Service of placement of workers over 65 years of age, by sex and type of work, for period December 1951 - May 1952 (d) compilation and review of statutes relating to care of , aged and infirm , (e) informational survey of old-age assistance recipients with respect to support by relatives (f) characteristics of old-age assistance recipients with respect to housing and living arrangements, location of residence, and physical condition (g) compilation of welfare and other costs and mill tax levy for welfare purposes in 20 counties (h) survey of other States with respect to general character- istics of their Old-Age Assistance programs n11: Projects outlined include: (a) survey by visit of approximately 15 proprietary voluntary homes for aged (b) survey of records of Old-Age Assistance applicants wheee applications were denied (c) compilation of information from other States relative to sharing of grants and administrative costs of Old—Age Aesistance by State and county units. 3. Committee meets monthly and publishes "Progress Reports." III Legislative Authorization Eublished July 7, 1951. No. 139, 8.] c has 'AN ACT to create 20;015 (3) of the statutes, relating to a study of the prOblems of the aged by the legislative council and making an appropri~ ation° The people of the state of Wisconsin, represented in senate and assembly, do enact as follows: Section 1. Modern scientific developments have extended the life span of our citizens. This has resulted in a need for a re-evaluation of our public assistance program, our instiumttondlfprogramycourspmogram of manpower utilization and our recreational program. The need for an exhaustive study of the prdblem of our aged citizens is not only dictated by humanitarian considerations, but is necessary in order to utilize our state facilities most effectively. , Section 2. The Joint legislative council is directed to conduct a study of the problem of our aged population and to develop such infor- mation as will enable the legislature to enact a long-range program geared to provide adequately for those who have devoted most of their years to the development of this state. Such study should give special emphasis to : (a) The problem of adequate old-age assistance. (b) The problem of institutional careo EC c) The problem of partial or extended employment. d) The problem of leisure time. Section 2a. The joint legislative council is further directed to conduct a study, working co—operatively with state agencies, of all welfare costs, to make recommendations thereon and to determine if a pattern fixing a maximum percentage county tax levy from real estate tax for welfare purposes can be developed. Section 3. An advisory committee shall be appointed to direct the study. The committee shall consist of 3 senators and 3 assemblymen XLIV to be appointed as are standing committees in their respective houses, and 3 citizens at large, with a knowledge of an interest in the problem of the aged, selected by the council, The advisory committee shall select a project director who shall devote at least half time to this job. Section h. The director of public welfare is directed to re- lease employees for periods not to exceed 3 months to participate in this study, and to provide such information as may be requested by the project director. Section 5. 20,015 (3) of the statutes is created to read: 20,015 (3) sum OF THE AGED. (a) There is appropriated from the general fund annually for the years beginning July 1, 1951, and July 1, 1952, $15,000 to the Joint legislative council for the conduct of a study of the aged and the preparation of a report thereon. (b) Payments from this appropriation for reimbursement of ex- penses and compensation for services shall be made to persons not em- ployed by the public welfare department and shall be made by voucher signed by the chairman and secretary'of the council. Approved June 26, 1951. XL? APPENDIX B PARTICIPANTS IN THE ICONFERENCE OF STATE COMMISSIONS 0N AGING AND FEDERAL AGENCIES September 8 - 10, 1952 A. MERRILL ANDERSON. member of the Employment Committee, Minnesota Com- mission on Aging. Assistant Director, Employment Service, State of Minnesota, 369 Cedar Street, St. Paul. DR. JOHN E. ANDERSON. Chairman, Committee on Living Arrangement, Minne- sota Commission on Aging. Director, Institute of Child Welfare, Uni- versity of Minnesota, Minneapolis. E. EVERETT ASHLEY III. Economic Research, Office of the Administrator, Housing & Home Finance Agency. KITTYE CLYDE AUSTIN. Administrative Assistant, State Department of Public Welfare, h21 South Uhion Street, Montgomery, Alabama. ROBERT M. BALL. Old Age & Survivors Insurance, Program Analysis Research, Bureau of Old Age & Survivors Insurance, Social Security Administration, Federal Security Agency. DR. ROSWELL P. BATES. Member of the Maine Legislature and House Chair- h; man of Legislative Committee on Public Health, 72 Main Street, Orono, Maine. EDWARD R. BELKNAP. Physical Medicine Rehabilitation Division, Veterans Administration. SENATOR JAMES S. BERGER. JOint State Government Commission of the General Assembly, P. O. Box 61, Harrisburg, Pennsylvania. LUCILLE BETTMAN. Member, Illinois Committee on Aging. Executive Secre- tary, Board of Welfare Commissioners,l60 N. LaSalle Street, Chicago. EILEEN BLACKEY. Social Service, Veterans Administration. LAWRENCE N. BLOOMBERG. Public Housing Operations Research, Public Housing Administration,Housing & Home Finance Agency. ANNA M. BOGGS. Associate State Leader, Home Demonstration Work, Coopera— tive Extension Work, West Virginia university, Mergantown. XLYI W. F. BOND. Director of Public Relations, State Department of Public Wel- fare, Jackson, Mississippi. ELIZABETH BRECKINRIDGE. Executive Secretary, Illinois Committee on Aging, 160 N. LaSalle Street, Chicago. DR. I. J. BRIGHTMAN. Assistant Commissioner for Welfare Medical Services, New York State Department of Social Welfare (on assignment from State Department of Health), Albany. DR. STANLEY T. BROOKS. Public Health Analyst, Bureau of State Services, Public Health Service, Federal Security Agency. EDWIN BROWER. Chairman, Special Committee on Aging, Brewer Mills, Inc., Hope Mills, North Carolina. DR. L. GUY BROWN. University of Rhode Island, Chairman, Department of Sociology, Kingston. Chairman, Research Committee, Governor's COm- mission to Study Problems of the Aged. JOHN BRUNER. Chief, Bureau of Adult Institutions, Virginia Department of Welfare and Institutions, Richmond. ELIZABETH BRYAN. Director, Bureau of Public Assistance, State Department of Public Welfare, #21 South Union Street, Montgomery, Alabama. GEORGE E. BURDICK. Senior Research Assistant, Joint State Government Commission of the General Assembly, P.O. Box 61, Harrisburg, Pennsylvania, FLORA E. BURTON. Member, Subcommittee on Problems of Aging, Recess Cem- mission of the State Legislature on Revision of Public Welfare Laws, 173 Newbury Street, Boston, Massachusetts. AMBROSE CALIVER. Adult Education, Office of Education, Federal Security Agency. DR. DALE C. CAMERON. Occupational Health Physician—Psychiatrist, Bureau of State Services, Public Health Service, Federal Security Agency. ROBERT CANARY. Chief, Division of Social Administration, Ohio Department of Public Welfare, Columbus. TED CHRISTIANSENo Member of the Economic Welfare Committee, Minnesota Commission on Aging. Executive Secretary, Kanabec County Welfare Board, Mora. DOUGLAS COLMAN. Vice President, thns Hopkins Hospital, Johns Hopkins University, 15 West Mt. Vernon Place, Baltimore, Maryland. DR. NILA COVALT. Chief of Physical Medicine, Commission on the Care and Treatment of the Chronically Ill, Aged and Infirm, Hospital for Chronic Illness, Rocky Hill, Connecticut. XLVII LEMONT CRANDALL. Chairman, Economic Welfare Committee, Minnesota Com- mission on Aging. Division of Social Welfare, 117 university Avenue, St. Paul. ' DR. A. NOWELL CREADICK. Medical Director, Commission On the Care and Treatment of the Chronically Ill, Aged and Infirm, Hospital for Chronic Illness, Rocky Hill, Connecticut. ESTHER CURTIS. ,(Representing the Governor of Montana) 227 Parkdale, Great Falls, Montana. DR. WILMA DONAHUE. meber, Interdepartmental Committee on Problems of the Aging. Chairman, Division of Gerontology, Institute for Human Adjustment, University of Michigan, Ann Arbor. MRS. JOHN WHINHAM DOSS. 2hll North Charles Street, Baltimore, Maryland. RALPH M. DUNBAR. Library Services, Office of Education, Federal Security Agency. CORNELIA DUNPHY. Bureau of Public Assistance, Social Security Adminis- tration, Federal Security Agency. EDGAR H. ELAM. Demographer, Bureau of the Census, Department of Commerce. DR. V. L. ELLICOTT. Deputy State Health Officer of Montgomery County, ROckville, Maryland. EDITH EPLER. Director, Social Welfare, Commission on the Care and Treat- ment of the Chronically Ill, Aged and Infirm, Hospital for Chronic Illness, Rocky Hill, Connecticut. DR. JACK R. EWADT. bknber, Subcommittee on Problems of Aging, Recess Commission of the State Legislature on Revision of Public Welfare Laws. Commissioner of Mental Health, 15 Ashburton Place, Boston. OSCAR R. EWING. Administrator, Federal Security Agency. CANON EDWARD FERGUSON. Farmer Foundation, Dallas, Texas. JACOB FISHER. Social Security Research, Social Security AdministratiOn, Federal Security Agency. ROBERT w. FLEISCHER. Citizens 00mmittee on Retirement in Florida. 1888 North Atlantic Avenue, Daytona-Beach, Florida. WILMER FROISTAD. Social Work Training, Bureau of Public Assistance, Social Security Administration, Federal Security Agency. DR. FRANK GAINES. Commissioner of Mental Health, Commonwealth of Ken- tucky, 620 South Third Street, Louisville. THOMAS P. GALBRAITH. Architect, MEdical Care Facilities, Bureau of Modical Services, Publianealth Service, Federal Security Agency. XLVIII Am.» DR. JAMES F. GARRETT, Rehabilitation Psychologist, Office of Vocational Rehabilitation, Federal Security Agency. DR. JOSEPH H. GERBER. Office of Vocational Rehabilitation, Federal Se- curity Agency. CLAUDE GILKXSON. Advance Research Assistant, Joint State Government Com- mission of the General Assembly, P. O. Box 61, Harrisburg, Pennsylvania. CURRY W. GILLMORE. OASI Specialist, OASI. CHESTER GRAUPMANN, Vice-Chairman, Minnesota Commission on Aging. Chair- man, McLeod County Welfare Board, Glencoe. FELIX A. GRISETTE. Member, Special Committee on Aging. Executive Di- rector, Health Publications Institute, Raleigh, North Carolina. MARY GUINEY; Abumer, Interdepartmental Committee on Problems of the Aging. Assistant Supervisor, Wayne County Bureau of Social Aid, A707 Rivard Avenue, Detroit. S. E. HAISTY. Department of Public Welfare (State of Tennessee), Nash- ville. DR. HEBER HARPER. Federal Security Agency. FLORA HATCHER. Liaison with Public Interest Groups and Organizations, Office of the Administrator, Housing & Home Finance Agency. DR. ROBERT HAVIGHURST. Committee for Human Development; university of Chicago, Chicago. ' JANE M. HOEY. Public Assistance Policy, Bureau of Public Assistance, Social Security Administration, Federal Security Agency. LOLA HOWARD. Administrator, State Public Welfare Commission, Salem, Oregon. CHARLES W. INGLER. Council of State Governments, 1737 K Street, N. W. Washington, D. C. MURIEL IVANOV-RINOV. Department of Social Relations of the Episopal Diocese in Washington, 1702 Rhode Island Avenue, N. W., Washington, D. C. DR. JOHN H. JANNEY. 1211 Cathedral Street, Baltimore, Maryland. FRANCES JEFFERS. Member, Special Committee on Aging. Services to the Aged, State Board of Public Welfare, Raleigh, North Carolina. RALPH J. JOHNSON. Hygiene of Housing, Bureau of State Services, Public Health Service, Federal Security Agency. XLIX "RV"- DR. LEROY JONES. Chairman, Executive Committee, Governor's Conference on Aging in New Mexico. P.O. Box 37, Old Albuquerque, New Mexico. JANET KAHLERT. Member, Illinois Committee on Aging. Director, Division of Services, Illinois Public Aid Commission, 160 N. LaSalle Street, Chicago. JEROME KAPLAN. Secretary, Minnesota Commission on Aging. Consultant on Services for the Aging, Hennepin County Welfare Board, Minneapolis. HOMER KEMPFER. Adult Educator, Office of Education, Federal Security Agency. ' WALTER E. KEYES. Director, State Improvement Commission, P.0. Box 930. Tallahassee, Florida. DR. CLETUS L. KRAG. Hygiene of Aging, Bureau of State Services, Public Health Service, Federal Security Agency. DR. LOUIS A. M. KRAUBE. Professor of Clinical_MEdicine, university of Maryland Medical School, Baltimore. IRVING LADIMER. Assistant Director of'Research Planning Branch, National Institute of Health, Public Health Service, Federal Security Agency. JUDGE JOHN H. LAMMECK. Director, Ohio Department of Public Welfare, Columbus. GEORGE LEIBOWITZ. Old-Age and Survivors Insurance, Coverage Analysis, Bureau of Old-Age & Survivors Insurance, Social Security Administra- tion, Federal Security Agency. HECTOR J. LE MAIEE. Education Director, Commission on Care and Treatment of Chronically Ill, Aged and Infirm, Hospital for Chronic Illness, Rocky Hill, Connecticut. DANIEL LITTLEY. District Manager, Pennsylvania Employment Service, Philadelphia. T. WIISON LONGMORE. Agricultural Socio—Economic Research, Bureau of Ag- ricultural Economics, Department of Agriculture. HARALD LUND. Technical Director, Governor's Commission to Study Problems ct Aged, 2h Mason Street, Providence, Rhode Island. LYDIA LYNDE. Adult Education Through Extension Service, Department of Ag- riculture. BELVERA MACK. Medical and Hospital ReSources, Research Analyst, Bureau of Medical Services, Public Health Service, Federal Security Agency. DR. J. A. MCCALLUM. Superintendent, Montebello Hospital, Hartford Road and Herring Run, Baltimore, Maryland. L RICHARD MCCAMANT. Rehabilitation Specialist. Civil Service Commission. ANN MCCORRY. Committee on Aging and Geriatrics, Federal Security Agency. DR. JOHN R. MCGIBONY. bbdical and Hospital Resources, Bureau of Medical Services, Public Health Services, Federal Security Agency. ROSE McHUGH° Welfare Services, Bureau of Public Assistance, Social Se- curity Administration, Federal Security Agency. MRS. GLENN McIN'I‘IRE° 9 Page Street, Brunswick, Maine. MARION McINTYRE. Chief, Division of Aid for the Aged, Ohio Department of Public Welfare, Columbus. NELL McKEEVER. Health Educator, Office of-the Surgeon General, Public Health Service, Federal Security Agency. C. F. McNEIL. Dean, School of Social Administration, Ohio State univer- sity, Columbus. SENATOR DONALD P. MCPHERSON. Pennsylvania General Assembly, 250 Carlisle Street, Gettysburg. SLATOR M. MILLER. Assistant Vice President, Hawaiian Sugar Planters Association 731 Investment Building, Washington, D. C. WILLIAM L. MITCHELL. Deputy Commissioner for Social Security, Social Security Administration, Federal Security Agency. ROBERT H. MONTGOMERY. Staff Supervisor, Applicant Services, Field Pro- gram Section,1025 P Street, Sacramento 1%. DR. J. EARL MOORE. Johns Hopkins Hospital, Baltimore, maryland. ETHEL T. MORI. Assistant Director, Parks Board of Recreation City and County of Honolulu, Hawaii. JOHN L MORRIS. Chairman, Citizen' 5 Committee on Retirement in Florida. Vice President, National Air Lines, 32h0 N. W. 27th Avenue, Miami. ROBERT J MEERS, Actuary, Office of the Commissioner, Social Security Ad- ministration, Federal Security Agency. . CHARLES E. ODELL. Employment Counseling and Placement, Bureau of Employ- ment Security, Department of Labor. JOHN PARKER° Past President of the Three-Quarter Club, Bangor, Maine. J. MILTON PATTERSON. Director, State Department of Public Welfare, 120 W. Redwood Street, Baltimore, Maryland. LI MARGUERITE PATTON. Chairman, Governor's Commission to Study Problems of Aging. Assistant Professor of Economics, Western Michigan College of Education, Kalamazoo. AARON PAUL. Director, DivisiOn of Public Assistance, Department of Economic Security, CommOnwealth of Kentucky, Frankfort. ANNIE MAY PEMBERTON. Secretary, Special Committee on Aging. Supervisor, Services of the Aged, State Board of Public Welfare, Raleigh, North Carolina. OSCAR C. POGGE. Old-Age & Survivors Insurance Policy, Bureau of Old-Age and Survivors Insurance, Social Security Administration, Federal Se- curity Agency. AME POWELL. Member, Subcommittee on Problems of Aging, Recess Commis- sion of State Legislature on Revision of Public Welfare Laws. Direc- tor, Department for Older Peeple, Family Society of Greater Boston, 603 Boylston Street, Boston. DR. PERRY F. PRATHER. Deputy Director, State Department of Health, 2u11 North Charles Street, Baltimore, Maryland. DR. CLARENCE J. PRICKETT. Superintendent, State Welfare Home, Smyrna, Delaware. ' ’ LOUIS RAVIN. Employment Counseling & Placement, Bureau of Employment Se- curity, Department of Labor. PEARL RAVNER. Employment of Women, Women‘s Bureau, Department of Labor. GUY RICE. Georgia State Department of Public Health, Health Conserva- tion Services, Atlanta, Georgia. DRth. N. RICHARDSONELNChairman, Governor's Committee on Aging, Depart- ment of Sociology, Marshall College, Huntington, West Virginia. HELEN RINGE. Bureau of Labor Statistics, Research and Statistics, De- partment of Labor. ARTHUR B. RIVERS, State Director, State Department of Public Welfare, P. 0. Box 1108, Columbia, South Carolina. DR. GEORGE ROBERTSON. Director of the Clinic on Geriatrics, Thayer Hospital, Waterville, Maine. JUDGE HENRY J. ROBISON. Assistant Director, Ohio Department of Public Welfare, Columbus. MERRILL ROGERS. Assistant to Chairman, COmmittee on Aging, Federal Secue~ rity.Agency. LII . ”psi EDITH G. ROSS. Director of Local Welfare Services, Louisiana Department of Public Welfare. REP. RICHARD A. RUETHER. Member, Subcommittee on Problems of Aging, Re- cess CommiSSion of State Legislature on Revision of Public Welfare Laws. Mamber, State Legislature, 1 Spring Street, Williamstown, Massachusetts. JOHN A. RUSKOWSKI. Joint Legislative Committee on Problems of the Aging, New York. WILLIAM RUTHERFORD, Chairman. Illinois Committee on Aging, 160 N. LaSalle Street, Chicago. ' GERARD M. SHEA Director of Public Welfare, 3016 Municipal Center, 300 Indiana Avanue, N.W., Washington, D. C. DR. HENRY D. SHELDON. Demographer, Bureau of the Census, Department of Commerce. DR. NATHAN W. SHOCK. Chief, Gerontology Section, U. S. Public Health Service, Federal Security Agency, Baltimore City Hospitals, Baltimore, Maryland. MRS. CLARA SIMERVILLE. Oregon State College, Education, Corvallis, Oregon. S. H. SINGLETON. Attorney, Department of Public Welfare, Oklahoma City, Oklahoma. ‘ SISTER HELEN THERESA. Tacoma Washington Ozmam Home. SISTER JOHN OF THE CROSS. Member, State Council for the Aging Population, Providence Hospital, 17th & East Jefferson, Seattle, Washington. ANYA F. SMITH. Housing and Home Finance Agency. PAUL SMITH. Chief of Technical Services, Pennsylvania Employment Services, Harrisburg. PAULINE A. SMITH. Department of Health and Welfare, Augusta, Maine. ELLIS SPILLANE.‘ Public Health Educator, National Institute of Mental. Health, Public Health Service, Federal Security Agency. AUGUSTUS SYLNESTER. Assistant to the Chairman, Committee on Aging and Geriatrics, Federal Security Agency. ~J. A. THIGPEN. Director. State Department of Public Welfare, Jacksonyi Mississippi. REP. TEMAN THOMPSON. Chairman, Minnesota Commission on Aging, Member, State Legislative, Lanesboro.‘ LIII REP. IRENE K. THRESHER. Chairman, subcommittee on Problems of Aging, Re- cess Commission of State Legislature on Revision of Public Welfare Laws. Member State Legislature, 667 Chestnut Street, Waban (Newton), Massachusetts. . JOHN L. THURSTON. Deputy Administrator, Federal Security Agency. CLARK TIBBITTS. Chairman, Cammittee on Aging and Geriatrics, Federal Security Agency. PATRICK TOMPKINS. Massachusetts Dept. of Public Welfare, Boston, Massachusetts. ROBERT E. TUMELTY. Public Health Educator, DivisiOn of Public Health Education, Public Health Service, Federal Security Agency. J. SHELDON TURNER. Public Assistance Standard & Client Services, Bureau of Public Assistance, Social Security Administration, Federal Security Agency. DEREK VAN om. Member of Arizona. legislature, 1838 Palmcroft Way, N. w., Phoenix. W. B. VAN HORN. Mamber, Governor's Committee on Aging. Administrative Assistant, Department of Public Assistance, Charleston, West Virginia. REID WALL. Member, Special Committee on Aging. Superintendent, Methodist Home for the Aged, Charlotte, North Carolina. REVEREND ANDREW WARNER. Chairman of_the Committee on Education and Leisure Tine Activities, State Council for the Aging Population. Counseling Pastor, Mason Methodist Churéh, Route 3, Box 7h9—C, Tacoma, Washington. JUDGE T. J. S. WAXTER. Director, City Department of Welfare, 327 St. Paul Place, Baltimore, maryland. IRVING L. WEBBER. Supervisor, Retirement Research Division State Improve- » ment Commission, P.O. Box 930, TallahaSsee, Florida. REP. LEROY A. WEIDNER. Pennsylvania General Assembly, 512 No. Ninth Street, Reading. EDNA C. WENTWORTH. Studies of OASI Beneficiaries, Bureau of OldeAge & Survivors Insurance, Social Security Administration, Federal Security Agency. MARGARET WIESMAN. hbmber of Legislative Committee concerned with employ- ment of persons over ho, 36 Hancock Street, Boston. DR. HUNTINGTON WIIIJJECS. Commissioner of_Health of Baltimore, Baltimore, Maryland. ' LIV £3 , i x; ‘, yd: :, ‘ DR. WILSON WING. Associate Professor, Public Health Administration, Johns Hopkins School of Hygiene and Public Health. 615 N. Wolfe Street, Baltimore, Maryland. ERNEST E, WITTE. Social Work Training, Bureau of Public Assistance, Federal Security Agency. OLIVE E. YOUNG. Employment Counseling Specialist, Bureau of Employ- ment Security, Department of Labor. DR. MARK V. ZIEGLER. Chief, Bureau of Medical Services and Hespitals, 2207 North Charles Street, Baltimore, Maryland. LV ){v. .» 5?? APPENDIX C CONFERENCE OF STATE COMMISSIONS 0N AGING AND FEDERAL AGENCIES Program Monday, September 8 8:15 a.m. REGISTRATION 9:30 aom. INTRODUCTION OF STATE COMMISSIONS Oscar R. Ewing 9:55 aom¢ THE CONFERENCE PLAN John L. Thurston 10:10 a.m. SECTION I. STATE COMMISSIONS: What Are They? How Do They Work? Hindsights and Foresights A Panel representing types of existing State Commissions. Dr° A. Nowell Creadick William Rutherford Representative Irene K° Thresher Representative Teman Thompson Walter E. Keyes Interviewed by William L, Mitchell 11:5 a.m. LUNCH PERIOD 1:00 p.m. SECTION In RESUMPTION OF STATE COMMISSIONS PANEL 2: 30 p.m. SECTION II. METHODS WORK GROUPS A. in COMMUNITY EDUCATION Discussion leader - Anna M. Boggs Recorder-Observer - J. T. Richardson Organizer - Homer H. Kempfer B. in COMMUNITY ORGANIZATION Discussion leader - Jack Ewalt Recorder-Observer — Ethel T. Mori Organizer — Ernest F. Witte IQ“ Co in FACT-FINDING AND REPORTING Discussion leader - Felix A. Grisette Recorder-Observer - Harold H. Lund Organizer - Henry Sheldon Do in RESEARCH, DEMONSTRATION, EVALUATION Discussion leader - John E. Anderson Organizer - James F. Garrett 7:00 p.m. GET ACQUAINTED BUFFET DINNER Crystal Room, The Willard Hotel Tuesday, September 9 9:00 a.m. SECTION II" METHODS WORK GROUPS RESUMED A0 in COMMUNITY EDUCATION B0 in COMMUNITY ORGANIZATION Ca in FACT-FINDING AND REPORTING Do in RESEARCH, DEMONSTRATION, EVALUATION 12:00 Noon LUNCH PERIOD 1:15 p.m° SECTION II: THUMBNAIL REPORTS OF METHODS WORK GROUPS Edith Go Ross for Community Education Jack Ro Ewalt for Community Organization Harold Lund for Fact-Finding and Reporting John E° Anderson for Research, Demonstration and Evaluation Interviewed by Robert Montgomery 2:30 p.m. SECTION III‘ RESOURCES OF THE FEDERAL GOVERNMENT IN PROGRAM AREAS Chairman: John L. Thurston Health, Medical Care, Rehabilitation — John R. McGibony Employment - Charles Eo Odell Education and Guidance - Ambrose Caliver Community Participation — Dean Snyder Living Arrangements - E. Everett Ashley, III Income Maintenance - Wilbur J. Cohen Panel and floor discussion conducted by Clark Tibbitts . ' .5” Evening Open a Wednesday, September 10 9:00 a.m. SECTION III. WORK IN PROGRAM AREAS A. HEALTH, MEDICAL CARE, REHABILITATION Discussion leader - Douglas Colman Recorder—Observer - Edith Epler Organizer — Vane M. Hoge B. EMPLOYMENT Discussion leader - Elizabeth Breckinridge Recorder-Observer - Merrill Anderson Organizer - Charles E. Odell C. EDUCATION AND GUIDANCE Discussion and leader — Wilma Donahue Recorder-Observer - Hector J. Le Maire Organizer » Ambrose Caliver Do COMMUNITY PARTICIPATION Discussion leader ~ Andrew Warner Recorder-Observer - Kittye Clyde Austin Organizer - Dean Snyder E. LIVING ARRANGEMENTS Discussion leader - Irene K. Thresher Recorder-Observer — Frances Jeffers Organizers — Everett Ashley, III Arthur Gernand F. INCOME MAINTENANCE Discussion leader - Mary K. Guiney Recorder-Observer - George E. Burdick Organizers — Rose J“ McHugh, George Leibowitz 12:00 NOON LUNCH PERIOD THUMBNAIL REPORTS OF WORK GROUPS IN PROGRAM AREAS Conducted by Wilma Donahue 1:30 p.m. FINAL CONFERENCE SESSION Douglas Colman for Health, Medical Care, and Rehabilitation Ac Merrill Anderson for Employment - Hector J° Le Maire for Education and Guidance Kittye Clyde Austin for Living Arrangements Frances Jeffers for Community Participation Mary K. Guiney for Income Maintenanlg Mme: DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Oveta Culp Hobby, Secretary ******* Agency Membership in The Committee on Aging and Geriatrics is drawn from The Public Health Service Bureau of State Services Bureau of Medical Services National Institutes of Health The Office of Education The Social Security Administration Office of the Commissioner Bureau of Old-Age and Survivors Insurance Bureau of Public Assistance Office of Vocational Rehabilitation ******* Other participants in The Committee's work are drawn from The Department of Agriculture The Department of Labor The Housing and Home Finance Agency The Bureau of the Census The Veterans Administration ******* Clark Tibbitts, Chairman Ccumuttee on Aging and Geriatrics