December 1, 1971
Page 43750
By Mr. MUSKIE:
S. 2922. A bill to establish a Commission on Mental Health and Illness of the Elderly, and for other purposes. Referred to the Committee on Labor and Public Welfare.
COMMISSION ON MENTAL HEALTH AND ILLNESS OF THE ELDERLY
Mr. MUSKIE. Mr. President, I am introducing today a bill to establish a Commission on Mental Health and Illness of the Elderly. This bill represents one of the steps we must take to deal adequately with the problems of the elderly.
When I was first named to the Senate Committee on Aging in 1961, I said that "our democracy may well be judged on the contributions it makes to those who have given so much during their active life in building the strength of our communities, States, and Nation."
This bill confronts one of the most neglected problems in the field of aging.
Geriatric patients now occupy one of every five beds in our mental hospitals. And from 15 to 25 percent of elderly persons living in their own homes have some degree of mental impairment.
Our public policy today is confused where the mental health of the elderly is concerned. In far too many cases, aged persons are "warehoused" in institutions. They could return to their own communities if proper services were available there.
Mental health conditions today are exacting a heavy cost, in suffering and in money, for the elderly patient, his children, and the country.
The mental health problems of the aged are made worse by misplaced negative attitudes. Too often there is a stereotype of the elderly patient and the patient gets a cursory diagnosis, which is simply that treatment will not work.
We know better. The November 1971 report of the Senate Committee on Aging, Mental Health Care and the Elderly: Shortcomings in Public Policy," which was prepared at the direction of Senator CHURCH and myself, documents that these mental health problems can often be substantially helped.
One survey of 49 psychiatric hospitals showed 75 percent of all elderly mental patients improved enough to go home within 2 months.
My new bill will provide the framework for making certain this type of help will be made available. It would create a Commission, appointed by the President, and including psychiatrists, psychologists, social workers, nurses, and other experts, which would formulate a unified national policy for the mental health of the elderly.
This legislation provides more than just another study. The Commission would outline future policy as its first responsibility. It would then:
Study the future needs for mental health facilities, manpower, and research and training to meet the mental health needs of the elderly;
Describe every year what had been done and what are the top priorities in mental health care for the elderly;
Evaluate present mental health programs to see if they are responsive to the needs of aged persons;
Develop priorities among research programs that will increase our knowledge of mental illness and the aged;
Work with the other branches of government to implement the policy recommendations of the 1971 White House Conference on Aging.
The need for this high level Commission is compelling. But we all know it is not the only need that is compelling right now. Conditions of life for many older Americans are very cruel and in some instances worsening.
The worst problem facing many older Americans is inadequate income.
One of every four people over 65 lives in poverty. The number living in poverty has actually increased in the last 2 years.
No one has been hit harder by recession and inflation than the elderly. Many older workers are being eased into an early retirement they do not want, and at lower social security benefits than if they worked until age 65.
And every elderly person knows what inflation has done to fixed incomes and to social security.
We must end inflation and restore price stability.
But what will happen when we experience the next inflation? The plain fact is that unless we protect those on fixed incomes now, they will pay for the next inflation, as they paid before.
We can and should now increase social security benefits, so that the incomes of older Americans can catch up with higher prices in the economy.
But benefit increases alone are no safeguard for the future. I believe that the Federal Government must enact legislation to insure social security benefits will increase automatically as the cost of living goes up. Only then can we finally secure what America pledged over three decades ago – a truly decent life for older Americans.
And we must do more. We must liberalize the social security retirement test. Too often those who deserve assistance are denied benefits because of legal technicalities. We must provide full payments for needy widows and widowers at age 65. Why should the emotional emptiness left by the loss of a loved one be matched by material deprivation?
Just as serious as the economic situation is the health care problem. The sad truth is that Government has let the resources of the aged fall while health care costs continue to climb at a faster rate than any other price in the whole economy.
I know how the health care crisis hurts. My Subcommittee on the Health Care of the Elderly has held extensive hearings in Los Angeles and other cities. We have heard the testimony of aged persons on what cutbacks in Medicare and Medicaid mean to them. We have listened to them tell us what it means to have many needs completely uncovered by medicare.
The costs the elderly pay to cover doctor bills under Medicare have doubled since the program started. If the trend continues, senior citizens will soon be paying as much of their strained resources for medical care as they did when a health care program for the elderly was only a distant dream.
Already medicare pays less than half the costs of care. Out-of-pocket expenses are over $225 a year, double the health costs of those under 65.
These statistics do not convey the true meaning of the crisis – the pain of arthritis, the tedious days of waiting for treatment.
The only fair solution is to take the dollar sign once and for all out of the elderly's decisions. We must guarantee comprehensive medical care for all Americans.
We also need new systems to deliver health care. The Senate has already adopted a bill I proposed to build new medical schools and train doctors for the special treatment required for senior citizens.
As chairman of the Subcommittee on Health Care of the Elderly, I have also proposed: The construction of special clinics in areas heavily populated by the elderly; the use of health care teams to bring aid to shut-ins; new transportation systems to take the elderly to and from distant medical facilities.
We have to learn more and do more about the problems aged people face in America. Ten percent of us are now over 65. In 50 years, 15 percent will be over 65 and 5 percent over 75 years of age.
The Commission on Mental Health and Illness of the Elderly that I propose today is a vital step. For far too long we have turned our back on the serious mental health problems of the aged. With this proposal, we will finally face the issue squarely.
The time has come for action on this and the other problems of aged Americans.
I ask unanimous consent that the text of this bill be printed at this point in the
CONGRESSIONAL RECORD.
There being no abjection, the bill was ordered to be printed in the RECORD, as follows
S. 2922
A bill to establish a commission on Mental Health and Illness of the Elderly, and for other purposes
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Commission on Mental Health and Illness of the Elderly Act."
ESTABLISHMENT OF COMMISSION
SEC. 2. There is hereby established a temporary commission to be known as the Commission on Mental Health and Illness of the Elderly (hereinafter called the "Commission"). Such Commission shall exist for a period not to exceed 5 years.
DUTIES OF THE COMMISSION
SEC. 3. It shall be the duty of the Commission to–
(1) develop a national policy for the proper maintenance of mental health for aged and aging persons and the care and treatment of mental illness for such persons;
(2) undertake studies to assess future needs for mental health facilities, manpower, research, and training to meet the mental health care needs of aged and aging persons;
(3) submit to the President for transmittal to Congress an annual report describing major developments concerning the treatment and care of elderly persons suffering from mental illness, identify priority issues, and propose recommendations for solving these problems;
(4) recognizing that proper physical health and proper mental health are inseparable, evaluate present mental health programs to determine whether such programs are responsive to the needs of aged and aging persons;
(5) develop priorities for programs designed to increase knowledge about various aspects of mental illness among aged and aging persons; and
(6) cooperate with the executive and legislative branches for the purpose of implementing the policy proposals recommended at the 1971 White House Conference on Aging.
ORGANIZATION OF THE COMMISSION
SEC. 4. (a) The Commission shall be composed of nine members to be appointed by the President, by and with the advice and consent of the Senate. The Commission shall include at least one member from each of the fields of psychology, psychiatry, social science, social work, and nursing. Each person so appointed shall, as a result of his training, experience, and attainments, be exceptionally qualified to formulate and appraise programs and activities related to aging.
(b) The President shall designate one of the members of the Commission to serve as Chairman and one to serve as Vice Chairman. Vacancies shall be filled in the same manner in which the original appointments were made. Any vacancy in the Commission shall not affect its powers, and five members of the Commission shall constitute a quorum.
POWERS OF THE COMMISSION
SEC. 5. To carry out the purposes of this Act, the Commission shall have the authority to–
(1) prescribe such rules and regulations as it deems necessary governing the manner of its operations and its organization and personnel;
(2) obtain from any department, agency, or instrumentality of the United States, with the consent of the head thereof, such facilities, services, supplies, advice, and information as the Commission may determine to be required by it to carry out its duties;
(3) acquire by lease, loan, or gift, and to hold and dispose of by sale, lease, or loan, real and personal property of all kinds necessary for, or resulting from, the exercise of authority under this Act;
(4) enter into contracts or other arrangements, or modifications thereof, with State and local governments, and institutions and individuals in the United States, to conduct programs the Commission deems necessary to carry out the purposes of this Act, and such contracts or other arrangements, or modifications thereof, may be entered into without legal consideration, without performance or other bonds, and without regard to section 3709 of the Revised Statutes;
(5) make advance, progress, and other payments which the Commission deems necessary under this Act without regard to the provisions of section 3648 of the Revised Statutes;
(6) receive money and other property donated, bequeathed, or devised to the Commission, without condition or restriction other than that it be used for the purposes of the Commission;
(7) accept and utilize the services of voluntary and uncompensated personnel and reimburse them for travel expenses, including per diem, as authorized by section 5703 of title 5, United States Code;
(8) employ such officers and employees as may be necessary to carry out its functions under this Act; and
(9) obtain services of consultants in accordance with the provisions of section 3109 of title 5, United States Code, at rates for individuals not to exceed $100 per day for each day they are engaged in the performance of their duties to the Commission.
COMPENSATION OF COMMISSION MEMBERS
SEC. 6. (a) Section 5313 of title 5, United States Code, is amended by adding at the end thereof the following new paragraph:
"(21) Chairman, Commission on Mental Health and Illness of the Elderly.".
(b) Section 5315 of title 5, United States Code, is amended by adding at the end thereof the following new paragraph:
"(95) Members, Commission on Mental Health and Illness of the Elderly (8).".
ADVISORY COUNCIL
SEC. 7. (a) There is hereby established an Advisory Council on Mental Health and Illness of the Elderly (hereinafter referred to as the "Council") to be composed of nine members appointed by the President for terms of two years without regard to the provisions of title 5, United States Code.
(b) The council shall select its own Chairman and Vice Chairman and shall meet at the call of the Chairman, but not less than four times a year. Members shall be appointed for two-year terms, except that of the members first appointed, five shall be appointed for a term of one year and four shall be appointed for a term of two years as designated by the President at the time of appointment. Any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall serve only for the remainder of such term. Members shall be eligible for reappointment and may serve after the expiration of their terms until their successors have taken office. A vacancy in the Council shall not affect its activities, and five members thereof shall constitute a quorum.
(c) The Commission shall make available to the Council such staff, information, and other assistance as it may require to carry out its activities.
FUNCTIONS OF THE COUNCIL
SEC. 8. The Council shall advise the Commissioner on policy matters relating to mental health and illness.
COMPENSATION OF COUNCIL MEMBERS
SEC. 9. Each member of the Council appointed pursuant to section 7 shall receive $50 a day, including travel time, for each day he is engaged in the actual performance of his duties as a member of the Council. Each such member shall also be reimbursed for travel, subsistence, and other necessary expenses incurred in the performance of his duties.
TERMINATION
SEC. 10. The Commission shall cease to exist sixty days after the submission of its final report.
AUTHORIZATION OF APPROPRIATIONS
SEC. 11. There are authorized to be appropriated such sums as may be necessary to carry out the purposes of this Act.