on fixed incomes have access to the maintenance drugs that are prescribed for them.

We have had many cases of elderly persons who have been in a state of depression for lengthy periods but when psychiatric counseling is made available and the person is prescribed a drug and where necessary provided the proper medication, the patient comes out of the depression and is able to again live a normal life. These kinds of experiences lead us to believe that a health plan that would encompass coverage of mental health as well as physical health would be beneficial to millions of older Americans.

There is a need for a national health plan that would insure the same quality of health services to everyone regardless of income. In the public health delivery sector, there are many instances where patients never see the same physician. There are instances where patients have three and four clinic appointments a month because of the lack of medical personnel staffing the facility. There are instances where patients wait 5 and 6 hours for clinic appointments, again, because of a lack of medical staff in specialty areas. We must have a health plan that will allow persons from all segments of our population access to a health delivery system that has the same standards for the less affluent as the affluent.

I might also point out that there should be a move to expand the curriculum of medical schools to deal more in the area of gerontology and geriatrics. We find that our doctors do not know how to deal with older people.

Many elderly persons have problems eating the proper foods because they are in need of dental care or they have had teeth extractions and can't afford dentures. Illnesses emanating from improper diet could be significantly reduced if there was a health plan that provided for dental services and dentures.

We would urge that the Older Americans Act include some language that would assure that preventive and institutionalized health care be available to older persons regardless of their socioeconomic

status.

In the area of nutrition, we are presently serving 1,400 meals per day at 23 meal sites and approximately 140 home-delivered meals in the New Orleans area. We have estimated that we could double the number of meal sites and triple the number of home-delivered meals if sufficient title VII funds were available.

Senator EAGLETON. How many home delivered meals, 140?
Mr. GATES. 1,400.

We recognize that the intent of title VII was to bring older people together, but we have found that there is a tremendous need to service the home-bound elderly.

We also feel that title VII should be an integral part of a service. delivery system for the elderly and that any effort to make it an autonomous title of the Older Americans Act should be ignored. Surveys have pointed out that older people who remain in their homes outlive those who are living in nursing homes. With the proper supportive services such as homemakers and inhome health care, our senior citizens could enjoy their golden years with dignity and respect. We estimate that the homemaker program operated under the New Orleans Council on Aging which is a title XX

funded program is meeting only 5 percent of the need. We would urge that more funds be made available for homemaker and inhome health care.

The New Orleans Council on Aging in conjunction with the Louisiana Center for Public Interest has provided legal services to the elderly.

We would urge the subcommittee that as they draft legislation for the renewal of the Older Americans Act, that they reinforce the language that stipulates that State offices on aging and area agencies on aging serve as planning and coordinating agencies and that implementation of services be provided by agencies with the expertise of service delivery. We have found this system to work very effectively and efficiently in this planning service area. As I stated previously, as you move around the country, you will be exposed to many types of delivery systems in the field of aging, but I have found that as I have traveled around talking to persons in other States and other cities who are delivering services, and as I have compared their delivery systems with what we enjoy in this immediate area, I would strongly suggest that this type of service delivery system, a working agreement with the area agency and the providing agency, that this kind of system be duplicated around the country as some type of model.

Thank you. [Applause.]

Senator EAGLETON. I have a couple of questions. I subscribe to your comment with respect to the lack of medical knowledge in the area of gerontology. It is in a sense a rather new specialty, it shouldn't be. The aging process has been around since Day One, but it has only been relatively recent that gerontology, the physiological and psychological ramifications of aging has become a specialty. I am pleased that we offered to set up a national institute on aging. You realize there is a thing in Washington called the National Institutes of Health where they do marvelous medical research and they farm out many grants to large medical universities such as Tulane here in New Orleans, and there has been an Institute on Cancer and on heart, kidney, et cetera, so they could focus on these particular diseases. They all come under the umbrella of the Institutes of Health. We now have one on aging because we found in terms of research with respect to aging, it was the bottom end of the list. It is sort of like the bottom end that I mentioned earlier with the Commissioner on Aging in HEW; he was at the bottom end of the page. Aging, as a medical research area, was at the bottom of the list, too. So in order to get it up higher and in better focus, we created the institute.

Let me ask you this hypothetical question

Mr. GATES. Before you do, one alternative to having the Administration on Aging buried in HEW, it might be that the Commis sioner could report to the Chairman of the Federal Council of Aging, who is also the President's adviser on aging problems. Senator EAGLETON. If someone walked in here today and gave you $2 million, and said, "We want you to spend it on programs help the aging in New Orleans," what would be your priorities? Mr. GATES. OK. You know, we use the term "prioritize the needs." I think that we would have to develop a system that would coordi

that

nate those four kinds of areas that we have talked about. As most of the elderly here have said, we need to have transportation first. In order to get the health service, they have got to get there. A person with a cane or in a walker who needs to get to a health facility will have to be transported. So we will have to have a combination of kinds of things that will provide the services.

With $2 million, we could start with transportation. We could start with another staff person in a neighborhood health clinic who would devote his or her time-I am talking about a medical staff person-specifically to treating the elderly so they won't have to sit and wait all day. I can tell you some horror stories of elderly persons waiting in hospitals to have blood sugar tests. They go all day without eating. We need people in the health system who will be there to serve the elderly.

I think that an elderly person has qualified over the years to demand a few special services when they go to a health clinic. Of course, we all know we go to doctors and we have to wait, but we are all not 75 or 76 years old.

We could start with the transportation; we could start with staff people who are there to provide service. We could expand the nutrition program, especially for the homebound. I am very interested in those people who cannot get out to a congregate meal site such as this, and there are many in this area.

We have a waiting list, as you know; we are allowed to serve a certain percentage of title VII meals to the homes. At first it was 10 percent and it has been relaxed over the years. Right now, we presently have a waiting list of 150 people who would like to have their meals delivered to them and I am sure that that number would be expanded many times more if people knew that that service was available.

There is presently a "Meals on Wheels" program, but it is funded under title XX, which includes a means test and which is vastly underfunded, in my estimation.

Senator EAGLETON. Where would the legal services be on your priority list?

Mr. GATES. As I say, as we try to prioritize, we have to weigh all of the factors, and if we would attempt to serve the total elderly population, we have found play legal services a very important part in the lives of older people. First of all, we have found over the last 3 years that people don't know they have legal problems. They say, "Well, I don't have any legal problems," but they are not aware of estate planning; they are not aware of writing wills; they are not aware of their insurance benefits.

We have a lot of problems with social security and SSI. Those are the kinds of things that the legal services program have brought to light, that the ordinary person does have legal problems. So legal services are in that sphere of things that we would try to coordinate in the whole ball game.

Senator EAGLETON. But certainly not as keen in priority as nutrition, health, and transportation?

Mr. GATES. It would have to be given a little lower priority than that, but I don't know if it should be at the bottom of the list.

31-8130-79-17

Senator EAGLETON. What about my question that I asked earlier this morning of one or more of the witnesses? Should we do fewer things better or continue to do many things not so hot?

Mr. GATES. If you are thinking in terms of lumping funds together to do things, I would say do fewer things better. Senator EAGLETON. Senator Johnston.

Senator JOHNSTON. Thank you very much, Mr. Gates. Your testimony has been excellent. Let me say, first of all, that on this question of SSI and social security problems, and that sort of thing, don't forget that your Senator and your Congressman have offices here in New Orleans that specifically can help on those items. Two or three of you have asked me about specific problems, so let me give you my telephone number here in New Orleans. I have got full-time people who are very good on those problems and I am going to give you this number and invite you all to call.

Specifically, ask for Mrs. Barras, B-a-r-r-a-s, but my number here is 589-2427.

I am going to repeat that: 589-2427, Mrs. Barras, B-a-r-r-a-s.

We have got an office down in the Federal Building, so those of you who can't get down there call, otherwise, go down and see her. Lindy Boggs has an office in the same building and I am sure she would be glad to see you as well.

Mr. McGOVERN. That would be the old Federal Building across from the old Post Office; right?

Senator JOHNSTON. That is that new Federal Building, the Hale Boggs Building. It is down in the Hale Boggs Building.

So don't forget about us and I know Mr. Gates will refer us some folks, too, if they need some help.

Mr. GATES. They can always call the Council on Aging, 586-1221, for any kind of assistance.

Senator JOHNSTON. Good. So much for that. My folks will be busy, I hope, later this afternoon and tomorrow.

I would like to ask you on another subject here, the question of housing. I am interested in housing patterns for the elderly, specifically in New Orleans. Could you describe for me, I know you probably don't have the exact figures, but can you describe to me what percentage of the elderly live in their own homes, what percent are renters, how important the section 8 program is. Tell me something about housing patterns.

Mr. GATES. To the best of my knowledge right now, there is about 48 to 50 percent of the elderly who own their own homes.

Senator JOHNSTON. Forty-eight to fifty percent?

Mr. GATES. Right. But one of the things that is happening in New Orleans is that a lot of younger people are buying up property that older people had been living in for 20 or 25, 30 years as renters, and they are renovating the property for their own personal use, which there is nothing wrong with, but it does present a problem in dis placing older people because they do have to find other housing. We do have a housing assistance component at the New Orleans Council on Aging, whereas we physically go out and assist older persons in finding adequate housing. We were very instrumental in getting the section 8 program up off the ground as it relates to the elderly population.

Senator JOHNSTON. Section 8 coordinates with your office?

Mr. GATES. Yes; section 8 is handled by the housing authority here, but we have a very good working relationship with them. In fact, it was a joint effort that got the section 8 program into the Delta Towers.

Section 202: Housing, has run into some problems here, but we are still working on that. Section 8 itself is much better now than it was a year or a year and a half ago, primarily because we went into the neighborhoods and contacted the landlords. It was a problem with the section 8 program, to convince the landlords to participate. For some reason or another they were reluctant in the beginning. I think they are coming around.

I would hope that landlords would recognize the fact that renting their property to an elderly person is a much better investment than renting it to other people.

Senator JOHNSTON. Do you have any advice to us on how we might put our Federal money into housing for the elderly? Would you recommend section 8, 202, or some other program or just what would you recommend?

Mr. GATES. I think after we work the bugs out of the section 8 program, Senator, and really get the confidence of the landlords and keep putting forth the effort and keep educating them that the section 8 program is the immediate answer to housing for the elderly. The 202, section 8 program, is good for long-range solutions, and I think we should continue those, but right now for the immediate solution, and we are almost going through a crisis kind of thing now with people being displaced because of the flight back into the city because of properties skyrocketing outside of the parish, so I would say we would have to go with both programs, but I would certainly urge that more funding be put into the section 8 program, and as a long range plan, the 202, section 8 program.

The reason I say that is because we have a 202, section 8 program that we have been trying to get started for 32 years and I understand that they are going to turn the first spade of ground next month.

Mr. GEORGE. I would like to ask a question.

Mr. GATES. I wanted to tell the gentleman that the people from Desire did get paid Friday.

Mr. GEORGE. I am going to speak concerning this housing business. Now, first, the CIA, Community Improvement Agency, that's under HUD. Now, I know people downtown, I live at 3045 Feliciano, ZIP code 70126. That is near the Desire housing project.

We are homeowners. The problem is some people have had their housing fixed under the CIA program and are experiencing difficulty with the contractors. Now, one of the requirements of the CIA people is that you get a bonded contractor. You sign a contract at 3 percent, but these contractors don't seem to be fulfilling the obligation.

They have gone off and stuck to people with houses that aren't complete. They want them to sign a release so they can get their money and still the man's work isn't done. The question is, Being an elderly person living on a fixed income, you have put your investment in a home, the city comes along and says it's substandard.