[Senate Hearing 110-597] [From the U.S. Government Publishing Office] S. Hrg. 110-597 SENIORS GOING HUNGRY IN AMERICA: A CALL TO ACTION AND WARNING FOR THE FUTURE ======================================================================= HEARING before the SPECIAL COMMITTEE ON AGING UNITED STATES SENATE ONE HUNDRED TENTH CONGRESS SECOND SESSION __________ WASHINGTON, DC __________ MARCH 5, 2008 __________ Serial No. 110-23 Printed for the use of the Special Committee on Aging Available via the World Wide Web: http://www.gpoaccess.gov/congress/ index.html ---------- U.S. GOVERNMENT PRINTING OFFICE 45-090 PDF WASHINGTON : 2008 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; DC area (202) 512-1800 Fax: (202) 512-2104 Mail: Stop IDCC, Washington, DC 20402-0001 SPECIAL COMMITTEE ON AGING HERB KOHL, Wisconsin, Chairman RON WYDEN, Oregon GORDON H. SMITH, Oregon BLANCHE L. LINCOLN, Arkansas RICHARD SHELBY, Alabama EVAN BAYH, Indiana SUSAN COLLINS, Maine THOMAS R. CARPER, Delaware MEL MARTINEZ, Florida BILL NELSON, Florida LARRY E. CRAIG, Idaho HILLARY RODHAM CLINTON, New York ELIZABETH DOLE, North Carolina KEN SALAZAR, Colorado NORM COLEMAN, Minnesota ROBERT P. CASEY, Jr., Pennsylvania DAVID VITTER, Louisiana CLAIRE McCASKILL, Missouri BOB CORKER, Tennessee SHELDON WHITEHOUSE, Rhode Island ARLEN SPECTER, Pennsylvania Debra Whitman, Majority Staff Director Catherine Finley, Ranking Member Staff Director (ii) C O N T E N T S ---------- Page Opening Statement of Senator Gordon Smith........................ 1 Opening Statement of Senator Ron Wyden........................... 3 Opening Statement of Senator Elizabeth Dole...................... 4 Opening Statement of Senator Ken Salazar......................... 5 Opening Statement of Senator Claire McCaskill.................... 91 Panel I Edwin Walker, deputy assistant secretary, Administration on Aging, U.S. Department of Health and Human Services, Washington, DC................................................. 7 Kate Hudson, deputy under secretary, Food Nutrition and Consumer Services, U.S. Department of Agriculture, Washington, DC....... 21 Panel II Marcus Lampros, president, Lampros Steel, Inc., Portland, OR..... 46 James Ziliak, director, Center for Poverty Research, Department of Economics, University of Kentucky, Lexington, KY............ 50 James Weill, president, Food Research and Action Center, Washington, DC................................................. 63 Robert Blancato, executive director, National Association of Nutrition and Aging Services Programs, Washington, DC.......... 73 Jan Jones, senior vice president, Communications and Government Relations, Harrah's Entertainment, Inc., Las Vegas, NV......... 82 APPENDIX Statement by Stacy Dean, director of Food Assistance Policy, Center on Budget and Policy Priorities......................... 99 Information booklet on the Causes, Consequences, and Future of Senior Hunger in America by James P. Ziliak, Craig Gunderson, and Margaret Haist............................................. 104 (iii) SENIORS GOING HUNGRY IN AMERICA: A CALL TO ACTION AND WARNING FOR THE FUTURE ---------- -- WEDNESDAY, MARCH 5, 2008 United States Senate, Special Committee on Aging, Washington, DC The Committee met, pursuant to notice, at 10:34 a.m., in Room SD-562, Dirksen Senate Office Building, Hon. Gordon H. Smith, Ranking Member, presiding. Present: Senators Wyden, Salazar, McCaskill, Smith, and Dole. OPENING STATEMENT OF SENATOR GORDON H. SMITH, RANKING MEMBER Senator Smith. Good morning, ladies and gentlemen, we thank you all for being here. I want you to know that this Committee has a very special tradition of working in a bipartisan way, and Senator Kohl and I have long had that kind of relation. So with his permission, we will proceed and then welcome some more of my colleagues. My colleague, Senator Wyden and the gentleman from Colorado, we welcome you as well, Senator Dole. I want to extend also a personal welcome to Mr. Marcus Lampros, who will testify about the wonderful volunteer work that he does on behalf of the Loaves and Fishes Centers in my home State of Oregon. I look forward to hearing Mr. Lampros' testimony later this morning. Bottom line, ladies and gentlemen, food is the most basic of human building blocks. You can't have sustained life without it. Yet in this country, millions of Americans do go hungry. As hard as that may sound to some ears, it is in fact the truth. In fact, more than 35 million Americans are food insecure, meaning their access to food is limited by a lack of money and a lack of resources. They are some of our most vulnerable citizens, and many of them are seniors. Hence, the focus of this Committee. In my home State of Oregon, hunger affects many seniors. Although the trend of hunger is improving in my State, there remain far too many who are on the brink of hunger or are receiving inadequate aid. However, even with recent improvements in outreach and increased enrollment in programs to combat hunger, more than one in 10 Oregonians experience difficulty in purchasing food each year. The problem of hunger in our Nation is one that I have long been concerned about and one that has led me, along with Senator Dole and Senator Lincoln, to Chair the Senate Hunger Caucus. I look forward to working again with these, my colleagues that I have mentioned, to ensure that seniors have better availability to the nutrition programs in the Older Americans Act. Senator Lincoln and I and Senator Dole and others will work with the appropriators to raise funding levels for the congregate and home delivered meals that we will be talking about today. We were successful in seeing a small increase in funding for these programs last year, but after many years of stagnant funding, there is much more that needs to be done. I also want to thank the Meals on Wheels Association of America. This foundation does remarkable work that they have been doing to gather the funding and research to create the great report they are releasing today. This report will help me and my colleagues to finally have a much better understanding of the specific causes, impacts and future trends of senior hunger in America. As the report mentions, since 2000, more than 11 percent, or roughly 5 million seniors, have experienced some form of food insecurity, with more than 750,000 persons actually suffering from hunger due to financial constraints. We will learn today that there are certain risk factors for food insecurity, such as living with a grandchild, never married individuals, social isolation and persons who rent their housing. Surprising, seniors who are the on younger age range, between ages 60 and 64, are more likely than those who are 80 years and older to suffer from food insecurity. Unfortunately, we know that while there are programs available to seniors, they are not always utilized. For instance, only a small percentage of seniors who are eligible for food stamps actually for and receive them. The U.S. Department of Agriculture has done work to increase these numbers, and I look forward to hearing more from them today on their efforts. Taken as a whole, the statistics I have discussed this morning are staggering and they show us that more must be done. The health consequences from lack of access to this most basic need are grave. Most importantly, they are preventable. Unfortunately, without change, we can expect this problem only to worsen. As we will learn more about today the number of seniors expected to be food insecure by 2025 is estimated to be 9.5 million seniors, which is about 75 percent higher than the 2005 estimates. However, I believe we won't have to wait that long to notice that hunger will quickly become an even greater problem in our Nation. So that with rising prices of grain, corn and gas, in the U.S. prices for food are also on the rise. These rising prices make the balance of life that much more difficult and fragile for those seniors who want to stay in their homes and communities as they age. Our own U.S. Capitol is adorned with displays and images of fields of plenty, of harvests of wheat. This remains a Nation of bounty, and we must ensure that our hungry seniors can and do have access to the food and nutrition programs available to them. Again, I look forward to learning more from our panelists about these issues and what options we as a government have in order to turn the current trend around. We must continue to work together to ensure our most vulnerable citizens are lifted from the threat of hunger and are able to thrive as healthy individuals. I believe Senator Kohl will be joining us later, and so with the permission of my colleagues, why don't we go Democrat, Republican, and Democrat. Senator Wyden. OPENING STATEMENT OF SENATOR RON WYDEN Senator Wyden. Thank you, Mr. Chairman, and congratulations to you and Senator Kohl for scheduling this important hearing and all the advocacy that you are doing for this particular issue. It is my view that it is a moral blot on our country, a Nation so strong and good and wealthy, that we have so many older people going to bed at night hungry. Back in my youth, when I was co-director of the Oregon Gray Panthers, I served on the board of Loaves and Fishes, and I am very pleased that Senator Smith has invited Marcus Lampros to be here. The Lampros family in Portland is involved in just about every good cause in our community, and we are very pleased that they are here. The fact of the matter is, that this program is enormously important as it relates to nutrition, but also extremely important as it relates to the socialization needs of older people as well. I was struck this past winter when my wife Nancy and I delivered meals for Loaves and Fishes. We got a chance to talk to a lot of the folks who get the meals that Loaves and Fishes delivers. The programs that we are going to hear about today very often are the only visitors that a lot of older people have, particularly on a holiday. That was the case this year when Nancy and I visited. We were the only persons who were going to be in contact with these older people. So the point made by Senator Smith today about the benefits of these programs as they relate to hunger is absolutely right. But it is also clear that these programs perform a great need in terms of keeping older people connected to the community. The only other point I want to mention is my sense that these programs are also vitally needed to prevent older people from eventually needing institutional care. Because just as sure as the night follows the day, if you don't have adequate nutrition, along with heat and other essentials, you are going to get sick. So what we have is an opportunity here with a modest amount of help in areas like nutrition to keep older people from needlessly having to go into institutional facilities where there are a lot less happy, and it is much more expensive for the taxpayers. So this is a cause that is morally right, but I would also offer up the judgment that it is economically right as well. So we congratulate all of our witnesses, particularly pleased to have Oregonians here, and look forward to working with you, Senator Smith, Senator Dole and Senator Salazar on this issue. If ever there was a bipartisan cause in America, rooting out hunger among our seniors is it. So I look forward to working with our colleagues. Senator Smith. Thank you, Senator Wyden. Senator Dole. OPENING STATEMENT OF SENATOR ELIZABETH DOLE Senator Dole. Thank you so much, Senator Smith, for holding this hearing today. This takes me back to my days when I was assistant to the president for consumer affairs years and years ago, and this was one of the issues that we were terribly concerned about then. When I came to the Senate, my maiden speech was on this very issue, the problem of hunger in the United States and around he world. I often paraphrased David Broder of the Washington Post, because I think what he said is so appropriate. Some issues just seem impossible to resolve, but this is not one of them. All we need is caring people and a caring government, and we can eliminate hunger in our lifetime. So joining the Hunger Caucus, helping to set that up has certainly been a privilege for me and this remains a top priority. I want to thank Meals on Wheels Association of America for your passion, your commitment to feeding our seniors. You are indeed doing the Lord's work. It has been a privilege to visit a number of your organizations in North Carolina and to see the good work that you folks are doing. In addition, I want to thank all of those who will be testifying. In America, the land of prosperity and plenty, as my colleagues have mentioned, some people have the misconception that hunger plagues only far away, undeveloped nations. The reality is that hunger is a silent enemy lurking within one in 10 U.S. households. In fact, in North Carolina alone, nearly 1 million of our 8.8 million residents are struggling with food insecurity issues. So again, one of my top priorities is addressing this far too prevalent problem that affects people of all ages and certainly including our seniors. Millions of seniors are living on fixed incomes, as we have already heard. They don't have the means to purchase nutritious foods and other basic necessities. They have no choice but to buy what they can afford. Far too often, these are unhealthy choices. It is a sad fact that many of our senior citizens slip through the cracks with their nutritional needs going unmet and unnoticed. I am very pleased that the proposed versions of the Farm Bill includes strong nutrition titles that go to great lengths to address hunger in America. In particular, I am encouraged to see the inclusion of funding for the Senior Farmers Market Nutrition Program that enables seniors to purchase fruits, vegetables and other nutritious foods at farmers markets. I also welcome significant increase in funding for the Emergency Food Assistance Program, which benefits food banks the provide critical nutritional assistance to many disadvantaged Americans, and proposed changes to the Commodities Supplemental Food Program, again, which provides nutritious USDA commodity foods for the elderly and other vulnerable populations. Of course, caring for seniors and other needy citizens should not fall solely on the shoulders of the Federal Government. Instead, we welcome and encourage public/private partnerships through programs such as Meals on Wheels and numerous food banks across the United States. In North Carolina, I visited a number of our food assistance organizations around the State, and I am always impressed with the mission feel that they are on, the tremendous job they do to meet the needs of our less fortunate citizens. One area I have been focused on is promoting food donations and incentivizing volunteers to participate in these charitable and necessary ventures. In fact, my food donation amendment was included in the Farm Bill that addresses four tax issues that will encourage food donations and volunteering to help the hungry. For example, the amendment allows volunteers to receive a tax deduction for mileage incurred while transporting food donations. As a former president of the American Red Cross, I know firsthand the importance of volunteers. There would be no Red Cross without the 1.3 million volunteers, and I understand that many charities like Meals on Wheels depend on volunteers using their personal vehicles to deliver food to countless tables across the country. In addition, volunteers who glean and transport food could benefit from this tax deduction measure. Excess crops that would otherwise be plowed under or thrown out are taken from farms and other entities and distributed to the needy. Each year in this country, 96 billion pounds of good, nutritious food is left over or thrown away. Gleaning helps eliminate this waste. I have gleaned with a number of organizations, and really most recently with the Society of St. Andrew in Harnett County, gleaning sweet potatoes back on October. It is a great thing to do. So again, thank you, Senator Smith, for holding this hearing. I look forward to working with my colleagues to fight the battle against hunger. I feel fervently about this and regard you as partners and look forward to working with you. It is a campaign, as I have said, that can't be won in months or even a few years. But with a caring government and a caring people working together, ending hunger in America is certainly a victory within reach. Thank you very much, Mr. Chairman. Senator Smith. Thank you. Senator Salazar. OPENING STATEMENT OF SENATOR KEN SALAZAR Senator Salazar. Thank you very much, Senator Smith, and I also want to thank Chairman Kohl for putting a focus on this issue, which is so important from my point of view. Having worked as attorney general for my State for 6 years, I try to put a focus on issues relating to the elderly. I always felt that the principal value that impelled me to do my work as attorney general, protecting our seniors, had to do with respecting our elders. I think that the respect for elders is an American value that is timely and priceless and transcends generations. I know that in my State, we have about 700,000 elder Americans. I also know that many of those 700,000 people are not well nutritioned. We have, based on a 2005 study which was conducted by the Department of Health and Human Services, a finding that 56,857 of them are not able to eat two or more complete meals a day. So that is about 10 percent of the senior population in my State that doesn't have the food security that I believe that they should have. In that same survey, it was found that there were 50,000 Coloradoans who had lost 10 or more pounds in the past 6 months without meaning to lose those pounds, and it had to do with the fact that they were not getting the amount of food that they should have had. So it is an issue which is very much an issue of concern in my State of Colorado, and also those statistics, I think, can be well extrapolated around the country. I would make two comments on things that I believe that we should do, and Ms. Houston and Mr. Walker, I think these are comments related to what I consider to be the Administration's lack of urgency with respect to acting upon these issues in a clear, effective and immediate way. The first has had to do with our own efforts here in the U.S. Senate to try to include funding for food stamps programs, as we have moved forward with the economic stimulus package for the country. We attempted to do that in the U.S. Senate, the Administration pushed back very hard. We knew that from an economic stimulus point of view, it made sense for us to invest more in food stamps. Certainly from a moral point of view in terms of the people that it helps, it would have also helped the senior populations of America, and that would something that I hope would have been endorsed by the Administration. Second, the 2007 Farm Bill, which Senator Dole spoke glowingly about in terms of the nutrition programs that are included in there, from my point of view--and I have a sign on my desk that says ``no farms, no food.'' I think it is a travesty and a shame that frankly we have not been able to get the Farm Bill across the finish line, in large part because of the opposition of the Administration. When you look at the 67 percent of the money that is included in that Farm Bill over the next 5 years that goes to nutrition, the very essence of what we are talking about here with respect to food security and elder Americans, it is tied up in the language and the programs that would move many of the nutritional programs forward. So I would hope, and I do this with the sense of great respect for the President and for the Department of Agriculture, that today can be part of a calling card to them that we need to get the 2007 Farm Bill finished and that we need to get that done in the next week or two before March 15 so that we can move forward with the food security programs that are in the nutrition title of the Farm Bill. Thank you, Mr. Chairman. Senator Smith. Thank you, Senator Salazar. First witness will be deputy assistant secretary Edwin Walker. Mr. Walker will provide an overview of the programs and the Administration on Aging that provide congregate meals for seniors as well as home delivered meals for those who are homebound. He will be followed by deputy under secretary Kate Houston, and I understand Kate, that the pronunciation is correct? Ms. Houston. That is correct. Senator Smith. Okay. Ms. Houston is the deputy under secretary for Food, Nutrition and Consumer Services at USDA. She will update us on the programs that work to combat senior hunger such as food stamps and ways that we can ensure seniors are utilizing the programs available to them. Edwin, take it away. STATEMENT OF EDWIN WALKER, DEPUTY ASSISTANT SECRETARY, ADMINISTRATION ON AGING, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, WASHINGTON, DC Mr. Walker. Senator Smith, thank you and distinguished members of the Committee, thank you for inviting the Administration on Aging and my distinguished colleague, Kate Houston, from the U.S. Department of Agriculture to address you today. Adequate nutrition plays an integral role in keeping adults healthy and independent as they age. It can prevent hunger and reduces the risk and presence of chronic diseases and disabilities. Malnutrition, including being underweight or obese, is closely associated with decreased functionality and impedes independent living. Several million older adults in the U.S. lack access to the food needed to sustain health and reduce the risk of disability. Nutrition services such as congregate and home delivered meals have always been one of the core elements of our national strategy for reducing food insecurity among the elderly. However, this is not the only thing we are doing to address this problem. Key to enabling and empowering older adults to remain in their homes as well as to reduce hunger is access to comprehensive service and support systems. The Nutrition Program for the Elderly, or NPE, is a targeted program to reduce hunger and food insecurity and promote the health, well being and independence of older adults. The NPE helps prevent deterioration of health status, reduces the need for more costly medical interventions, and participants like the meals they receive. Socioeconomic factors impact the vulnerability of older adults. Being poor, near poor, having less education, living alone, being isolated and having an inadequate diet are indicators of an increased risk for poor nutrition and health. Diseases like diabetes and other chronic conditions that change eating habits also contribute to making older adults vulnerable. The federal NPE appropriation of $758 million is leveraged to a total of $1.3 billion with other funding from State and local governments, as well as private sources such as individual contributions and local program fundraising. As a result, $238 million meals to 2.7 million older adults were provided in fiscal year 2006. Efficiency has consistently trended upward, and program participants indicate high satisfaction with the quality of the meals and the service delivery. For this, we applaud the Aging Services Network. The Older Americans Act does not require that all people be served, but does require that services be targeted. The NPE is effectively targeted to those with greatest levels of food insecurity, those who are poor or near poor, socially isolated, functionally impaired and in poor health. Despite the high level of need, the NPE, coupled with the home and community based services that compliment it, make a significant difference to a vulnerable population. For the majority of program participants, the program provides one-half or more of their total food intake and enables them to continue living in their own homes. The Older Americans Act has brought consistency and quality to the nutrition program. The most recent reauthorization of the act strengthened not only nutrition services, but provided authority to give people more flexible options in addressing their health, nutritional and long-term care needs. To help older adults and caregivers learn about and access needed services and supports, we have developed aging and disability resource centers, or ADRCs, single-entry points or coordinated systems of information and access. Initiated in Wisconsin, ADRCs are a perfect example of how a more comprehensive and coordinated approach to services and programs aids those at risk of losing their independence. Since it is often difficult for homebound older adults to apply for Medicaid and food stamp benefits, the ADRC in Florida assists high risk individuals in accessing social, health and nutritional assistance. In Oregon, evidence-based physical activity programs are offered through congregate nutrition sites that help older adults manage their chronic disease symptoms, change eating habits, take their medications properly and improve their ability to function physically and socially. To assist in meeting the needs, AOA and the Aging Services Network collaborate with USDA programs. For instance, in Oregon, to improve access to food stamp benefits for hard to reach populations, we complete applications without a second trip to the office for a face to face interview, which is often difficult for individuals who are older, adults with disabilities and the home-bound. Our programs also coordinate with other USDA programs to ensure that meals are provided in adult day care settings and to supplement meal programs with cash and commodities. All of these collaborations enhance our ability to help older adults and their caregivers meet basic food and nutrition needs, maintain health and functionality, and remain at home in the community. Thank you, Mr. Smith, for this opportunity. We look forward to entertaining your questions. [The prepared statement of Mr. Walker follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Thank you, Mr. Walker. Ms. Houston. STATEMENT OF KATE HOUSTON, DEPUTY UNDER SECRETARY, FOOD NUTRITION AND CONSUMER SERVICES, U.S. DEPARTMENT OF AGRICULTURE, WASHINGTON, DC Ms. Houston. Thank you, Mr. Chairman, and I appreciate the opportunity to come before you and members of the Committee today. I am Kate Houston, deputy under secretary for Food, Nutrition and Consumer Services at the United States Department of Agriculture. No one in America should go hungry. FNS provides children and low-income people access to food, a healthful diet and nutrition education. The elderly are a particularly vulnerable population, and we take the food security status of seniors very seriously. Improving access to nutrition assistance for the elderly is in fact one of the corporate priorities of the Food Nutrition Service this year. I am pleased to be sitting at the table with the Administration on Aging, and I appreciate the testimony of Edwin Walker. I would also like to take the opportunity to thank the Meals on Wheels Association for supporting the important research that we are discussing today. I think it reaffirms a concern of USDA that far too many seniors experience some level of food insecurity. I think there is broad agreement on the need to address food security among seniors. So today we should start talking about solutions. USDA tracks the prevalence of food security among seniors and other subgroups on an annual basis. While the measures used by USDA are slightly different from those used in the Meals on Wheels report, we generally believe that the results are comparable. In addition to the nutrition assistance programs funded through the Administration on Aging, the Food Stamp Program is the largest of USDA's nutrition assistance programs and is an important nutrition support for low-income seniors. We also administer other programs that reach seniors, including the Child and Adult Care Food Program, which has an adult day care component; The Emergency Food Assistance Program, which supports food banks and food pantries across the Nation; and the Senior Farmers Market Nutrition Program. In 2006, approximately 2.2 million elderly received food stamp benefits comprising about 9 percent of total participants. Elderly recipients living alone received an average benefit of $74 per month. The average benefit for households with elderly persons was $91. Individuals aged 60 and older participate in the Food Stamp Program at a rate that is substantially lower than other eligible groups. This is a significant problem and something that we are working to fix. In 2005, the participation rate for eligible elderly individuals was 31 percent, compared to 60 percent for non- elderly adults and 65 percent for the population in total. From 2001 to 2005, the participation rate for the elderly only rose by about three percentage points, while the rate for non-elderly adults increased by 11 percentage points. This is something we need to fix. We have found that the elderly are less likely to know whether they are eligible for the Food Stamp Program, the amount of benefits for which they qualify, and where to apply for benefits. One-third of eligible elderly say they would not apply for food stamp benefits even if they were eligible because of their desire for personal independence, the perceived cost of applying and participating, the low expected benefits, and of course, stigma. The Food Stamp Program has unique eligibility policies that take into account the special circumstances faced by seniors. These policies make it easier for seniors to receive assistance. FNS has undertaken a number of initiatives designed to encourage food stamp participation by eligible elderly. These initiatives provide information and raise awareness, simplify the program, and make the application process easier while maintaining the integrity of the program. I would like to briefly mention a few of these activities. Between 2002 and 2004, we conducted pilot projects to test three alternative approaches. These approaches addressed simplified eligibility determination rules, one-on-one application assistance for the elderly, and a commodity alternative. The impact and cost of each model varied significantly. USDA has also awarded grants to community-based organizations to increase participation among under-represented subgroups, including the elderly. These projects indicate the importance of partnerships with familiar community groups and teach us that the desire for privacy and independence among the elderly is sometimes more important than the benefits. Some seniors need intensive assistance to understand and complete the application process. Another effort on the part of USDA to simplify the application process for seniors is the Combined Application Project. This project combines standardized benefits, minimal need for independent verification, and normally no need to go to the local office. This has produced a significant increase in participation among seniors. Currently, 13 State agencies are operating CAP programs. Three additional States are approved but not yet implemented, and seven are pending. Overall, food stamp participation among SSI participants in CAP states is higher than in States that do not have the access to CAPs. We also have additional activities such as standardized medical deduction demonstrations, and elderly disabled simplified application and simplified reporting demonstration projects. Within the Food Stamp Program, FNS conducts outreach targeted to seniors at the national level and we support related efforts at the regional, State and local levels. The Food Stamp Outreach Coalition was formed to build and strengthen those very partnerships. Last year, the Coalition held a meeting specifically focused on the issue of outreach to seniors. Mr. Chairman, I thank you for the work of the Committee and what you are doing to focus the Nation's attention on critical issues facing the senior population. USDA affirms our commitment to the pursuit of new ways to work with Congress, the States and our communities, and our advocacy partners to reach our elderly population with critical nutrition assistance. I am happy to answer any questions you have. [The prepared statement of Ms. Houston follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Kate, I suppose from the beginning of the Food Stamp Program there has been a certain stigma attached to it that makes folks reluctant to take advantage of it. I don't know how to break that down, but I guess we got to look for new ways to try and do that if we are going to make sure we address this issue of food insecurity. I think the food insecurity issue is going to go up because obviously the numbers of seniors is going to go up. If anyone has checked the grocery store lately, the cost of near everything has gone up because so much food is being diverted into fuel. Are you seeing more people apply now? Is the use going up? Ms. Houston. We have seen increases in participation among those who are eligible. As you can probably appreciate, our data do lag somewhat behind, so we don't have information that may reflect some of the economic downturns that we are seeing right now. But we will have access to those data in the near future. Senator Smith. When does that report come out? I am just curious. Ms. Houston. Around June of each year. Senator Smith. June of each year. It reflects the whole year? The whole preceding year? Ms. Houston. It is a 2-year lag. In June 2008, the Food and Nutrition Service will release participation rates for 2006. Senator Smith. Two-year lag. Okay. Ms. Houston. As soon as we have the new report out, we would be pleased to provide a copy to the Committee. Senator Smith. I would appreciate that. Edwin, under Title III of the Older Americans Act that provides the funding for nutrition programs like Meals on Wheels, we have learned that despite the increasing numbers of seniors and the increasing levels of seniors who are facing hunger, many nutrition programs are able to serve fewer seniors than in recent years. Is that because of the flat funding that has occurred for so long? Mr. Walker. Yes, Senator, it is because of the flat funding. But we are, as I indicated in the testimony, and certainly in the written version, which goes into more detail, we could not applaud our Aging Network more for the degree to which they leverage additional funding. Senator Smith. From private sources. Mr. Walker. From private sources and from State and local sources. Senator Smith. What are the net dollars? Are they going down? Because of the leveraged dollars from the private sector, when you combine public and private dollars available, are they going down or are they going up? Mr. Walker. Well, thanks to the generosity of the Congress, the dollars have gone up. Senator Smith. This last year, we got a small increase. Mr. Walker. There was an increase in the last year. Senator Smith. That was the first time in a long time. Mr. Walker. We can provide you the details over the past 10 or so years which can show you the track record in terms of how the dollars have progressed and increased. Senator Smith. Whatever those dollars are from the public sector, say there is one dollar of public money, how many dollars of private money does that leverage? Mr. Walker. Well, as a general rule in the Older Americans Act, we leverage about two dollars for every dollar in federal investments. For homebound services, that goes up to three dollars. Specifically in home-delivered meals, it is about $2.50 for every dollar of federal money invested. For congregate, it is about, I think $1.40 for every federal dollar invested. Senator Smith. So has the amount of private contributions, have those been going up as federal funding has been flat funded? Mr. Walker. I would actually have to check the figures on that, because-- Senator Smith. I would be very interested to know that. The American people are very generous and what I am really getting at, though, is what is happening to the net dollars available from any source arrived, public or private, is it all flat or is it going up, or going down? Mr. Walker. Those are figures that I would have to pull for you and I would be happy to provide them to you. [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. I would be very interested to know that. I think that would tell a story, but my questions are really focused on my fundamental concern that our population is aging, cost of fuel, cost of food are all going up. We have got to give thus focus or we are going to have a growing food insecurity problem among older Americans. That is just unacceptable in the United States of America, for crying out loud. So I would sure hope that this Congress, I am just curious--do you know what the President's request was in his budget, offhand? Was it an increase for this year? Mr. Walker. The President's budget for fiscal year 2009 is the same level as fiscal year 2008. Senator Smith. Well, I hope we can better that in the Congress. Senator Wyden, I am sure you will help me in that. You always do, you are a real champion of seniors. Kate, I understand the program participation for seniors in food stamps has increased by about a third from 2002 to 2006. I understand there are various reasons for this increase that include the outreach efforts from the USDA, and I applaud you for that. But with the increased rates of population, there has not necessarily been an increase in the totality as a percentage of older Americans, despite their eligibility. Are there any other reasons why more people aren't signing up? Ms. Houston. Well, you are correct that while the needle is moving in the right direction, it is not moving fast enough. It tends to get a little stuck, particularly for seniors. We know that there are specific barriers that relate to the unique circumstances of older Americans, and we are trying to target those specific barriers so that we can make better strides in increasing participation among those who are eligible. For example, there is myth that there is a $10 maximum benefit for seniors for food stamps. That certainly is not true. We know that there are transportation limitations that might occur for seniors. A lot of the modernization projects that are ongoing in many States enable seniors to apply for benefits through gateway organizations, such as senior centers or other places where they may be able to receive assistance in applying for benefits, we are also seeing a lot more online transactions. Senator Smith. How about just--what is the focus in terms of customer service, quality control and dealing with people? Is there a focus on that? Can there be any improvement in. Ms. Houston. There certainly is, and some of the grant programs that we have been funding through the Food and Nutrition Service provide specialized assistance to the elderly to help them sign up and obtain food stamps. We know that added assistance often can make a difference that enables them to get assistance through the program. I might also add that the Administration's Farm Bill proposal does include some specific provisions that we believe would be helpful to improve program access for seniors. I know some comments were made in opening statements regarding the Farm Bill. We continue to work with Congress and have made a priority to get the Farm Bill passed and signed into law this year. We have proposed a name change for the Food Stamp Program, given that we have moved to an electronic benefits system. We think that the name ``food stamps'' has a stigma, particularly among the elderly, that we can now eliminate given that we are no longer using paper coupons in the program. We also propose to exclude retirement savings accounts when determining the income eligibility of adults, and we think particularly for seniors, this is an important proposal. We would continue program participation grants that are focused specifically on how we can increase participation among elderly and other population groups. Senator Smith. Well, we talk about stigma and I am hoping that at least those who do come to USDA for food stamps, they are greeted with some dignity. I am not saying you have to have a Wal-Mart greeter out front, but I do think quality control and human relations is something to keep a focus on so that these folks who are in need are not discouraged from enjoying their eligibility for these programs that are designed to address the very problem this hearing is focusing on. Senator Wyden. Ms. Houston. We try to, if I might add, not make there be any kind of thinking about the Food Stamp Program as a welfare assistance program. This is really a nutrition assistance program. I think that distinction is important, particularly among the elderly, who tend to be less interested in wanting any help from the government. But if they see it as nutrition assistance, they may be more willing to participate. Senator Wyden. Senator Smith, thank you, and I thought your questions were very helpful. Let me just kind of pick up on some of them. Mr. Walker, every time I go to a Meals on Wheels program, they always tell me they have a very long waiting list. Can you give me a sense, looking at our country as a whole, how many older people are on these waiting lists? Mr. Walker. Thank you for the question, Senator. There is no national system of maintaining waiting lists. We have heard anecdotally that, many programs do use waiting lists as one method of prioritizing their services to those who are most in need. However, there are no standards for maintaining waiting lists. They vary around the country, even within States by providers, and so there is no way for us to determine on a national basis the number of people on waiting lists or that waiting lists would represent the universe of people who are not receiving services. Senator Wyden. Wouldn't it be useful to have something that would even give us a ballpark idea of how many people are on these waiting lists? I think your point is valid that there are different kind of systems, but it would seem to me that you all, with your connections into all of these programs, could accumulate this information and come to the Congress. It would be very useful to have this information as we try to make this bipartisan case to get additional funding. Do you disagree with that? Mr. Walker. No, I don't disagree. But I would say that the Older Americans Act and, as you all have pointed out, has always enjoyed strong bipartisan support. There is a real sense of ownership at every level, the federal, State and local level, into the program. There's ownership related to the program. People feel that it is not a welfare program, it never has been, and therefore there is a real affinity which accounts for the degree of participation by seniors themselves, in terms of volunteering their time, donating their resources, and in terms of identifying the degree of need that exists. We have looked at a variety of things, and we believe today's study that you will hear about is one additional tool available to us to identify and highlight the degree of need today, the degree of need that we can project in the future, and it can assist us and our programs in determining how best to target the resources that we have available to us. Senator Wyden. That all sounds plenty useful to me. I certainly think that you are right about the affinity that the Congress feels for this program. But I still don't understand why it wouldn't be useful to have a ballpark number of how many people are on these waiting lists, because I think that would send a message to the Congress that there is a lot of heavy lifting to do. Is this something that you think you could take on now and try to pull together for us? Because I know I would like to have it. I would like to be able to use that with other senators, to be able to say, look, there is this huge, huge waiting list out there across the country, and I think it would help us make the case. Mr. Walker. Certainly. We operate this program in partnership with the 56 State units on aging, the 655 area agencies on aging, the more than 29,000 local service providers, in excess of 5,000 who are nutrition service providers, and the 243 tribal organizations representing more than 300 tribes. We would be very interested in attempting to find out more about the unmet need. However, we would have to use the caveat that waiting lists are not kept by every program. We don't even have a sense of how many programs keep them. But it would be one indicator. Senator Wyden. How long do you think it would take to be able to give to this Committee, the Chairman and Senator Smith, our ranking minority member, even a ballpark idea of how many people are on these lists? Mr. Walker. I think that by working with our partners throughout the entire network, we could work on methods, including waiting lists. But I would not want to limit it to waiting lists because I think that your question really speaks to the need as opposed to a mere number on a waiting list. Senator Wyden. That is fine. I just know that every time I go to a program, this is the first thing they tell me. They say, Ron, we have this enormous waiting list. So could you have this for us in, say, 90 days? Mr. Walker. Senator, we would be more than pleased to provide you all of the data we have from other studies that have taken place. I don't believe we have the ability to go to every provider in order to find out whether or not they have a waiting list and how many people are on their waiting list as an average number per year within a 90-day period. Senator Wyden. I want to ask some other questions, but I find this a little odd. There is a network of federally-funded programs, Meals on Wheels, we have names, addresses and phone numbers, and it would seem to me fairly straightforward to send them an e-mail saying that the Senate Special Committee on Aging would like to have an idea in a general way of how many people are on your waiting list. I hope you will do it. I want to move on to some other areas. Mr. Walker. Certainly. Senator Wyden. Ms. Houston, give me your sense, if you would, of how your efforts are increasing the percentage of older people who are using the Food Stamp Program. It seems to me you all have undertaken a number of efforts in the last few years, and just take the last 5 years. In the last 5 years, as a result of your efforts, what has been the increase in the percentage of older people who are using the food stamp program? Ms. Houston. From 2001 to 2005, we have seen an increase of three percentage points in the use of the program among elderly. This is significantly slower growth than we have seen for the food stamp population as a whole. Between the same period of time, the total increase has been about 11 percentage points. So we know that we have specific work to do with this population, which is why we have placed, as a corporate priority at the Food and Nutrition Service, emphasis on how we can increase participation among the elderly. We have a number of initiatives that are underway specifically designed to address this issue, and I would be happy to provide you detailed information about a wide range of activities that are ongoing in this regard. [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Wyden. My light is on, and extra points for candor. I appreciate your really giving us concrete numbers about the gap. I would just wrap up by saying, what do you think in terms of the most recent initiatives that you have taken on? What do you think are the most promising efforts for closing the gap? In other words, as Senator Smith has indicated, we are going to have to make some choices and certainly we want to do as much as we can as quickly as possible, what do you think would be the recent initiatives that would be most likely to close the gap? Ms. Houston. Well, for several years we have been funding program participation grants. Those grants are helpful because they give us information about unique pilots and demonstration activities around the country and what they have done to make improvements in participation. One of the model programs that we think has been particularly interesting and that we would like to see replicated is called MiCafe. Through this program, trained application assistants locate seniors at places like senior centers and then they do a facilitated enrollment. So instead of having the seniors go to the food stamp office, they can actually fill out the application at places where they already go, where they feel comfortable, where they know the people, where they feel a sense of privacy. This eliminates transportation needs. It breaks down barriers with regards to the use of technology. If we can identify ways in which we can support what we know about seniors and their culture, and then get them the benefits that way, we will see improvement in participation. Senator Wyden. Thank you. Thank you, Mr. Chairman. Senator Smith. Thank you, Senator Wyden. I think your questions were very helpful, too, and I think they point up a need that we have to have more information so we can better guide, frankly, what kind of budgets we ought to be producing, what kind of budgets the Administration ought to be asking for. What I would suggest is that the minority and majority staffs of the Aging Committee work with the Administration Meals on Wheels program to perform a survey so that we can get at least a ballpark number, because I think we have pointed up a real need in order for us to be better able to meet our responsibility in these programs that will, by a matter of demographics, they will be growing. So with Senator Kohl's permission, I will visit with him as well, and I know my staff is anxious and ready to go on this. Thank you, Edwin Walker, Kate Houston, we appreciate you very much, your service and what you have done to help us to understand these vital programs. Ms. Houston. Thank you very much. Thank you. Senator Smith. Our second panel, we are pleased to welcome Marcus Lampros, who is the present of Lampros Steel, Portland, OR. Mr. Lampros is also a volunteer with the Loaves and Fishes centers, a program, and Senator Wyden, in my home State that serves congregate and home-delivered meals. He will discuss his work as a volunteer and the needs of local programs like Loaves and Fishes. Loaves and Fishes, in fact, has 35 meal sites in Multnomah, Washington, and Clark Counties, and serves 5,000 meals daily, and more than 1.3 million meals each year. Our second witness will be Dr. James Ziliak. He is director of the Center for Poverty Research at the University of Kentucky. He will present the work that he, along with Professor Craig Gunderson of Iowa State University performed to author the Meals on Wheels Association of America Foundation funded study. It is entitled ``The Causes, Consequences and Future of Senior Hunger in America.'' Then we will hear from James Weill. He is president of Food Research and Action Center. He will discuss the work and advocacy that FRAC on behalf of those who go hungry across the Nation. Then Robert Blancato, he is executive director of the National Association of Nutrition and Aging Services Programs. He has discussed the needs and struggles that many meal programs face and provide recommendations for improvement and a range of programs that aid seniors. Finally, last but not least, Jan Jones. She is senior vice president of communications and government relations of Harrah's Entertainment, Inc. She will discuss the corporate response to hunger and the need to have not only government intervention in the problem but also the necessity of mobilizing private contributions to combat senior hunger. Marcus, good to see you. Take it away. STATEMENT OF MARCUS LAMPROS, PRESIDENT, LAMPROS STEEL, INC., PORTLAND, OR Mr. Lampros. Good to see you, Senator Wyden, Senator Smith. Thank you very much for everything you do for our great State. You are champions, both of you. Thank you for the opportunity to testify before the Committee today. My name is Marcus Lampros, and I volunteer for Loaves and Fishes, the Meals on Wheels people in Portland, OR, and I am here on behalf of the Meals on Wheels Association of America. Our senior meal program in Portland serves 5,000 meals per day, or 1.2 million meals each year to elders in northwest Oregon and southwest Washington. We provide this vital service with a $9 million operating budget. Almost half of that is supported from government sources. We are one of the few programs in the country that does not have a waiting list. For the past 15 years, our staff and board of directors has been planning for the aging of the baby boomers. In 2003, we constructed a State of the air central kitchen, and we have been adding and upgrading our 35 meal sites each year. As our community population ages, we are experiencing significant increases in demand for food and project by 2019, we will double the amount of meals that we deliver. Our kitchen, which is one of the largest non-profit facilities in the Nation, is equipped to prepare over 12,000 meals a day, or more than 3 million meals a year. Let me tell you about our typical client. She lives alone in her own home, she doesn't have the money to buy all the food she needs to maintain an adequate diet. Our community based Meals on Wheels program gives homebound seniors like her the option to remain healthy and independent in their own home. Without this valuable, basic service of hot meals, these people would be placed in costly care facilities. It should be noted that if half of our 5,000 daily clients, just half of them, had to turn to nursing homes, just in the Portland area, the additional cost would be $100 million. Much of the financial burden would fall upon the Federal Government. If you extrapolate that figure nationally and replicate programs like Meals on Wheels in Portland, you could the American people billions of dollars a year. Remember, the Portland senior program feeds 5,000 people a day, 1.3 million people each year on only a $9 million budget. How the heck do we do it? In a word, volunteers. Meals on Wheels in Portland depends upon 7,500 volunteers every year to serve and deliver meals. Each day, we have enough volunteers to fill a Boeing 747. That is right, every single day, 500 volunteers show up to work at our local meal sites and deliver hot meals in our area. We estimate that we receive over $25 million a year in free volunteer labor. This in itself tells all of you and prospective donors that we are a good investment for the community. Last, we provide more than just a hot meal. We also provide fellowship and dignity to our clients. Throughout my 20 years of service with Loaves and Fishes Meals on Wheels, over 100 of my clients were able to pass their final days in the comfort and security of their own home. I delivered meals to Joe and Helen for 10 years. Joe was disabled and confined to a wheelchair. One day, he wife, Helen, the healthier of the two, died suddenly. When Joe answered the day and told me the sad news, he was certain that he would have to move to a nursing home. But with help from a friend and our commitment to continue to deliver meals, Joe was able to continue living at his home for 5 more years. By sharing stories like these with colleagues, friends and relatives, each week someone new steps up to volunteer and make a difference in the lives of seniors. The Meals on Wheels people make a difference in hundreds of thousands of lives across the country. I am particularly proud of our Portland, OR program, which is the model for the entire country. In Oregon, our investments, our staff, our supporters are laying the foundation and creating a template which will serve the millions of elderly Americans coming our way. With your help and the continued support of our donors and volunteers, seniors in our community will have the opportunity to spend more time in their own home as they grow older. Thank you again for the opportunity. [The prepared statement of Mr. Lampros follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Thank you, Marcus, that is a very inspiring story. Good news for Oregon because of your work and the work of Loaves and Fishes. Senator Wyden. Might have to put you in charge of the Federal Government. No waiting list. [Laughter.] Mr. Lampros. No waiting list. I was interested to hear you say that, but we are one of the few. Joan wanted me to make sure everyone knew that. Senator Smith. James, I understand Craig Gunderson is here. I failed to mention him. I think he is here to backstop you. Okay, we will see if you need him. STATEMENT OF JAMES ZILIAK, DIRECTOR, CENTER FOR POVERTY RESEARCH, DEPARTMENT OF ECONOMICS, UNIVERSITY OF KENTUCKY, LEXINGTON, KY Mr. Ziliak. Mr. Chairman, Senator Wyden, I thank you for the opportunity to appear before you today. My name is James Ziliak, and I am a professor of economics at the University of Kentucky and director of the Center for Poverty Research. The center is a non-partisan, non-profit research organization and is one of four poverty research centers funded by the Assistant Secretary for Planning and Evaluation in HHS. My co-principal investigator, Professor Craig Gunderson of Iowa State University, and I are here to discuss the results of our study on senior hunger in America. Funding for this study was generously provided by the Meals on Wheels Association of America Foundation and underwritten by Harrah's Foundation. The views expressed are our own and do not necessarily reflect the views of any sponsoring organization or agency. Hunger is serious threat facing five million, or 11 percent of all seniors age 60 and over in the U.S. Despite this important public health threat, we know very little about the extent, causes, consequences and future of senior hunger in our Nation. The purpose of our report was to fill in some of the gaps in our knowledge. Our study paints a portrait of senior hunger in America that is at once familiar and surprising. The familiar being that seniors are more likely to be at risk of hunger if they are living at or below the poverty line, if they are a high school dropout, an African-American or Hispanic, divorced or separated, socially isolated. The surprising being that seniors are more likely to be at risk of hunger if they are relatively young seniors between the ages of 60 and 64, or if they are living with a grandchild. Also surprising are the staggering differences in hunger risk across age, education, race, family structure and social support networks. Controlling for other factors, we find that seniors in their mid-80s are over one-third less likely to be at risk of hunger than seniors in their mid-60s. A high school graduate is 20 percent less likely to be at risk of hunger compared to a high school dropout. A college graduate is 40 percent less likely. On the other hand, African-American seniors are 75 percent more likely to be at risk of hunger than white seniors. Never married seniors are 20 percent more likely to be at risk at hunger compared to married seniors. Seniors living with a grandchild or who are socially isolated are each about 50 percent more likely to be at risk of hunger. Our results highlight a sizeable population facing an unmet food need that is likely to grow significantly with the baby boom generation entering their 60s. The next part of our report examines the health related consequences of hunger risk among senior Americans. After controlling for other factors, we find that seniors facing the risk of hunger are significantly more likely to have lower intakes of energy and major vitamins, more likely to be in poor or fair health, more likely to have limitations in activities of daily living. For example, a senior at risk of hunger has the same chance of an ADL limitation as a senior at no hunger risk that is 14 years older. We conclude by offering predictions on the possible scope of senior hunger in America in the year 2025, when the demographic bulge of retirees will be at its peak. In 2025, an estimated 9.5 million seniors will experience some form of food insecurity, or about 75 percent more than in 2005; 3.9 million seniors will be at risk of hunger, a 50 percent increase; 1 million seniors will suffer from hunger, a 33 percent increase. Although these are about the same percentages of the senior population as today, the substantial growth in numbers at risk of hunger is alarming and highlights an additional challenge with the looming retirement of baby boomers. Making projections 20 years into the future should always be accompanied with some caveats. For example, our projections of hunger may be too low if there is something unique about current retirees born before the Great Depression. Alternatively, if the combination of strong economic growth and enhanced public policies reduced poverty substantially in the future, or if there are significant improvements in education attainment, it is possible that our estimates of hunger will be too high. Moreover, we recognize the influence of elderly nutrition programs such as Meals on Wheels and the Food Stamp Program have on alleviating senior hunger. Expansions of these and related nutrition programs could lead to future reductions in hunger. This report is but a first step in improving our understanding of senior hunger in America, and much work remains to be done. We again thank the Committee for the opportunity to share the results of our research. We hope our findings will serve as a springboard for additional research on the causes of hunger identified here and for further policy discussions on the provision of food assistance to ensure that no senior will be at risk of going without safe, adequate and nutritious food. Thank you. [The prepared statement of Mr. Ziliak follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Thank you. Craig, did you have anything to add to that? Did he do okay? [Laughter.] Mr. Gunderson. He did a great job. Senator Smith. Okay, alright. James Weill. STATEMENT OF JAMES WEILL, PRESIDENT, FOOD RESEARCH AND ACTION CENTER, WASHINGTON, DC Mr. Weill. Senator Smith, I am Jim Weill from the Food Research and Action Center, and we appreciate the opportunity to testify here this morning. We are pleased that the Committee is having this hearing on this important problem. More than one in five elderly persons in this country had income below 150 percent of the federal poverty line in 2006, the last year for which there are data. When people have inadequate incomes, very often they are food insecure. That is the U.S. Department of Agriculture phrase for households struggling with hunger, where resource constraints mean that people are skipping meals or otherwise can't afford a basic, balanced diet. For seniors, food insecurity, of course, has significant adverse health and quality of life outcomes. The most recent government report showed that 6 percent of households with elderly members in them are food insecure. That is simply not acceptable. These numbers may well get worse in the years ahead, as the Committee has mentioned this morning, and as Professor Ziliak did as well, as the elderly population grows, as some of the more disadvantaged groups among the elderly population grow the fastest, and as seniors face rapidly rising out-of-pocket health care costs, energy costs and food costs. The first thing we need to do is to make sure that the Nation protects and shores up economic supports like Social Security, SSI and other supports. Second, we have to make sure that the federal nutrition programs are strong enough to supplement the income programs. Programs like Senior Farmers Markets, the Emergency Food Assistance Program, the Commodity Supplemental Food Program and Meals on Wheels have been weakened as their funding has lost ground to inflation and population growth. Thankfully, Congress has repeatedly rejected the president's proposal to eliminate the Commodities Supplemental Food Program, but it's funding has been eroded so that it has 17 percent fewer slots than in 2003. The number of slots is declining while the senior population grows. The same thing is true of Meals on Wheels and the congregate meals programs. But I want to focus the last couple of minutes I have on the food stamp program, which is the Nation's most important bulwark against hunger. As has been said this morning, only about 65 percent of eligible people receive food stamps. Shockingly, less than a third of eligible seniors receive food stamps. The program is still incredibly important and has broad sweep. Well over two million seniors receive food stamps every month. But it can do much, much more, and it needs to do more both to meet the current problem and the growth in food insecurity that Professor Ziliak has projected. As described in detail in our written testimony, elderly persons are being deterred from applying by stigma, by unnecessary paperwork, by a belief, not always correct, that they are likely only to get the $10 minimum monthly benefit, and by a lack of respect from the program bureaucracy in some places, even including fingerprinting. Senator Smith. Fingerprinting? Mr. Weill. Yes, yes, Mr. Chairman. Senator Smith. Why would that be--why would there be fingerprinting? Mr. Weill. I believe it is an ill-conceived attempt to deter fraud and detect fraud. It is only happening at this point in a couple of States, but it shouldn't be happening anywhere in the program. Senator Smith. Sorry to interrupt you-- Mr. Weill. No, that is fine. We applaud the Food and Nutrition Service's recent media efforts and other outreach to seniors. We need more such outreach from FNS and State and local agencies. Senator Wyden asked, what works best? I believe the answer to that may be the SSI CAP program that Kate Houston referred to, which involves the Social Security Administration in contacting seniors, helping to get food stamps to seniors so they have less interaction with State food stamp bureaucracies. The CAP program also offer many seniors somewhat more benefits than they think they are going to get under the program. But the CAP program only operates in a few States, and we need it to operate in many more States. We also need States and localities to use the many options they have under federal law to lower the barriers I described earlier. Congress needs to strengthen the program. The Farm Bill that is pending right now in a Conference Committee potentially makes some important first strides. Indeed, there are important changes in the Farm Bill for seniors in the food stamp program. Both the House and Senate bills raise the minimum benefit from $10 to $16 and adjust it for inflation. That benefit hasn't been raised since 1977, and the amount of it deters people from applying. The Senate Bill also raises the asset limits applicable to households with elderly or disabled members from $3,000, where it was set three decades ago, to $4,500 and indexes it for inflation. One or both of the bills make other helpful changes: improving the standard deduction, simplifying reporting, and, as Kate Houston said, renaming the program, which will help de- stigmatize it since it no longer actually has coupons or scrip. These are great first steps. We need the Farm Bill to be finished, and we hope the members of this Committee will push to get the bill with its good nutrition provisions for elderly persons past the last hurdles. Then we hope to work with you to do more in these key respects. One last thing. I want to refer back to something that Senator Salazar said about the stimulus bill and mention how important it would be to get a food stamp boost into a second stimulus bill if that happens in the Congress. Thank you very much. [The prepared statement of Mr. Weill follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Thank you. Robert Blancato. STATEMENT OF ROBERT BLANCATO, EXECUTIVE DIRECTOR, NATIONAL ASSOCIATION OF NUTRITION AND AGING SERVICES PROGRAM, WASHINGTON, DC Mr. Blancato. Thank you, Senator Smith, Senator McCaskill, good morning. It is an honor to be back testifying before this Committee. My name is Bob Blancato, and I am executive director of the National Association of Nutrition and Aging Services Programs. I commend the focus of this hearing, the causes, consequences and future of senior hunger in America. I salute our colleagues from the Meals on Wheels Association for the study they are releasing today. Studies and constant advocacy can help us develop a call to action on senior hunger. Senior hunger is neither a myth nor a mirage. Real national data dispels the falsehood. There are older people going hungry every day in our country. Terms that have been used to discuss this issue include food insecurity, food insufficiency, malnutrition, and of course, hunger. There is one common bond--more older Americans than ever before are at risk of being victims. Some major findings from a 2003 study done at Brandeis University remain true today. There is a close connection between inadequate income and hunger. National estimates of food insecurity among older Americans then ranged between 5.5 to 16 percent. A 2007 study of hunger among New York City's elderly, cited in my testimony, reveal a 35 percent rate of food insecurity among older people. Food insecurity rates are higher where the elderly live alone, and most recently, the 2007 profile of older Americans report that 48 percent of women 75 and over now live alone. Hispanic and African-American seniors are more likely to live in food insecurity. Other causes include functional physical impairments, social isolation and reduced ability to regulate energy intake. Also among causes, as mentioned, is access to benefits. Programs such as food stamps continue to be underutilized by needy seniors. There is ever-growing higher demand on emergency food assistance programs across the county. There are a growing number of persons, including older persons, living in food desert areas, where supermarkets with healthy and affordable food are miles away. The consequences of senior hunger are all health related. Seven of the top 10 diseases in this Nation have a connection to nutrition. Work that was done at the 2005 White House Conference on Aging pointed to the fact that only 9 percent of the diets of poor, older people are categorized as good. Forty percent of community residing persons 65 and over have inadequate nutrient intake. Food insecurity leads to malnutrition, which itself can lead to increased utilization of health care services, premature institutionalization and increased mortality. To help prepare for the hearing, we did an informal canvas of some nutrition providers in different parts of the United States to ask them about the State of their programs and the seniors they serve and what they might see ahead. From the Aging Resource Center in Douglas County, Wisconsin, their director said, ``The need for services continues due to high gas prices, along with the growing aging population in northern Wisconsin. Providing this service helps people stay in their homes. But the cost for these seniors to maintain their home and the increase in the cost of food is a hardship. Sometimes the meals we deliver are the only source of nutrition,'' In San Diego, 90 percent of seniors coming to one nutrition provider live at or below poverty. In Washington State, a State provider points to a survey of Meals on Wheels participants. Forty-three percent of them had food insecurity before the program, and if they didn't have home-delivered meals, 17 percent of them said they would go hungry. In Michigan, we learned that 25 percent of the 60-plus population in one area of the State live in isolation, but there is also a decrease in participation in nutrition programs, which is a concern. In Kansas, we are told of a very rural community with no grocery store or restaurant, but one vending machine, with the nearest food being 12 miles away. There are more of these in my testimony. Let me go to some policy recommendations that we support, and I have a longer list in my written statement. NANASP, along with the Leadership Council of Aging Organizations, support a 9 percent across the board increase for Older Americans Act programs in fiscal year 2009, including nutrition programs. Yes, we do commend the Congress for the roughly 6 percent increase that has been afforded to the nutrition programs in the last 2 fiscal years under the Older Americans Act. We want to see restoration of funding for the Commodities Supplemental Food Program, restoration of funding for the Community Services Block Grant, and a restoration of a proposed $500 million cut in Social Services Block Grant, all of which are programs that serve nutrition programs for the elderly. Like others have said, we want to see action finished on the Farm Bill that will strengthen the food stamp program by getting more seniors enrolled and providing a higher minimum benefit, and also extending the Senior Farmers Market Nutrition Program. NANASP appreciates the invitation to participate today. We must reduce hunger and food insecurity among the elderly. There can be no quality of life for an older person who goes hungry. Thank you, Mr. Chairman. [The prepared statement of Mr. Blancato follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Jan Jones. STATEMENT OF JAN JONES, SENIOR VICE PRESIDENT, COMMUNICATIONS AND GOVERNMENT RELATIONS, HARRAH'S ENTERTAINMENT, INC., LAS VEGAS, NV Ms. Jones. Good morning, Mr. Chairman, Senator McCaskill. I am Jan Jones, a senior vice president for Harrah's Entertainment, and I appreciate the opportunity to testify in front of the Committee this morning. As you are well aware, the Meals on Wheels Association of America is the largest and oldest national organization representing senior meal programs. Since 2002, the Harrah's Foundation has been proud to be the primary sponsor of the Meals on Wheels Foundation, donating $4.5 million to their initiatives, which has included the purchase of 30 additional vehicles that have driven 900,000 miles to deliver 2.5 million additional meals to hungry seniors in America. We enthusiastically funded the senior hunger study for several reasons. First, it was a way to put into action our Code of Commitment. Established in 2000, the Code of Commitment was our industry's first articulation of corporate social responsibility standards. The Code governs our relationship with our guests, employees and the communities in which we do business. It defines who we are and what we stand for. The Code commits us to making our home communities more vibrant places to live in and work and sets standards for employee volunteerism and corporate philanthropy. Before we underwrote the research, we had some sense of the magnitude of senior hunger in the United States because hundreds of our employees regularly deliver meals to needy seniors in all of our States where we do business. These employees know firsthand that America's greatest generation sometimes is going hungry. Multiplying those employees' experiences across the country gives a scope to a problem that has been hidden from most Americans. We also knew from working with MOWAA that at least 40 percent of home delivered meal programs have waiting lists, evidence of an enormous unmet need for those services. We are pleased that the research discussed today provides up to date estimates on the scope of senior hunger in the United States and increases our knowledge of risk factors and consequences. Better understanding of the problem will lead to better understanding of public and private resources that must be dedicated to the solution. Second, applying the research findings will lead to targeted fact-based interventions that render more effective both private sector and public sector efforts to reduce senior hunger. The research will help MOWAA realize its vision, a vision that we share, of no senior going hungry. Third, our fervent hope is that the research and today's hearing can energize corporate America to recognize ending senior hunger as a moral and philanthropic imperative, one that depends on effective leadership in corporations, governments and communities across the country. MOWAA has recognized the crucial role of the private sector through the development of its Corporate Response to Senior Hunger. A key part of the National Center for Nutrition Leadership, the Corporate Response to Senior Hunger is designed to harness the resources of America's corporate community in a joint effort to identify its role and to expand its commitment in the battle to eliminate hunger and malnutrition among our Nation's elderly. An important component of the Corporate Response to Senior Hunger is to challenge the corporate community to become engaged in this issue. Here in the richest country in the world, many corporations want to make a difference. However, for a variety of reasons, they often do not known how they can help. The Corporate Response to Senior Hunger seeks to bridge this knowledge gap. We are working to identify key business leaders who share the commitment to ending senior hunger and engaging their corporations in this effort. Some of these individuals are already assembled through their service on the MOWAA Foundation board of directors, but many more leaders are needed. I challenge my colleagues in corporate America to join Harrah's and take a leadership role in the Meals on Wheels Association of America Corporate Response to Senior Hunger. Writing a check is one solution, but the Corporate Response to Senior Hunger believes that it is as important for America's business leaders to consider other initiatives where they can help. Effectively transferring surplus food produced by American manufacturers to senior meal programs. Encouraging meal providers to participate in an existing purchasing program that enable them to buy their food more efficiently. Offering mentoring services to identify ways to educate meal providers about running businesses and efficiencies in operations and distribution. Working effectively in partnership with meal providers to identify solutions and create systems that work best for them in the collective mission to end senior hunger. Very importantly, increasing awareness about the nutrition needs of America's seniors and the issue of hunger among the elderly. All of our company efforts on behalf of America's seniors have been fulfilling, and particularly our association with MOWAA. But the hard work to address senior hunger has only begun. The research discussed today is a call to action for all Americans. It is no small measure a call to action for corporate America. The need is clear, the need is documented, the need is critical. I thank the Chairman, members of the Committee for helping to bring senior hunger to the attention of the public. I also thank you for allowing me to explain the Corporate Response to Senior Hunger and to challenge corporate America to embrace its very important role in ensuring that no senior continues to go hungry. [The prepared statement of Ms. Jones follows:] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] Senator Smith. Thank you, Jan. We commend you and your company for their sense of responsibility in the involvement of this program. We are joined by Senator McCaskill. If you have an opening statement or a statement you want to make, questions you want to ask. OPENING STATEMENT OF SENATOR CLAIRE MCCASKILL Senator McCaskill. That is terrific. Thank you, Senator, I appreciate it. I just want to, first of all, thank all of you because I don't think any of you are here because what you know about and what you are testifying about today has brought you fame or fortune. I think you are all here because you believe in caring for our fellow man and helping other people. I think so often we don't include that in the umbrella of patriotism, but you are patriots for what you are doing, and your work and your willingness to come and try to shed some light on what is a heartbreaking problem in our very wealthy Nation. A lot of the problem, I think, is a combination of the squeaky wheel getting the grease and the elderly, by their very nature, are not anxious to step up and say ``I am hungry.'' I have some experience, I have a mother who is high intellect but also high pride. Her pride keeps her from speaking out and asking for help sometimes. I think that is so common in our elderly population, that the greatest generation feels like they should be doing for others and no one should have to be doing for them. So they do not lobby as aggressively as they could. They do not complain, they do not ask for help. As a result, some of our systems aren't as efficient and fine-tuned as they should be. Mr. Lampros, I missed your testimony, but I must say hello to you from my family that knows you in Portland, and I got-- the family member who notified me about your being here today, I know you know her. You know that it isn't a matter of one e- mail. It was a matter of seven e-mails, four phone calls and saying, ``You have got to be there to listen to Marcus.'' So would you please tell her I got here, even though I had three other hearings this morning so I don't get 17 text messages this afternoon? Mr. Lampros. Don't tell her I deleted her phone message after about 5 minutes. Senator McCaskill. Okay, good. We are in on this together, and hopefully she will never know we talked this way. But you talked, I know, in your testimony about the efficiency of the way that you are helping people in your organization. I know that government has a hard time with efficiency, and I know you are also a businessman. Could you briefly give us some ideas of if you could do a weekend retreat with the government part of this operation in terms of Meals on Wheels, what would you recommend in terms of how we could be more efficient with the programs we have out there, as opposed to the private sector programs like yours that is obviously relying heavily on a massive volunteer base, which I am not sure that we always work at doing in the government sector? Mr. Lampros. That was one of my questions. I don't even know if the government has an area that concentrates on getting volunteers, because Portland is very blessed. We have many people who step to the plate. I think we are very out of the ordinary in Portland. I think if we have a retreat, I think, yes, feeding people, that is great, but getting people, first of all, to volunteer, gathering volunteers is harvesting money. When you think about it, your arms and legs are very important when you help people. Getting the food to them, beyond that, is easy. So getting those volunteers is very important. Senator McCaskill. Can any of you speak to the ability of the Meals on Wheels program to attract volunteers? No one? Ms. Jones. Within Harrah's, hundreds of employees have given thousands of hours, and it has been because the Meals on Wheels organization creates a passion. Our employees see where they can really help make a difference. So some of it is very much communication. I think across corporate America you would find volunteers that are ready and willing to give their time if they know how and if they know where, and if they are given a strategy that they can be a part of. Mr. Blancato. I would also add that both in the home delivered meals and in the congregate meal programs, volunteers are critical to the success of both of those programs. There has been a steady stream of volunteers for the many years that these programs have been in existence. The trends continue to grow for volunteerism. It is word of mouth, and it is also outreach and it is people's capacity to want to help. Senator McCaskill. Seems to me that we have witnessed, regardless of who you are for in this presidential race, we have witnessed an awakening of the American public in terms of their ability to participate by virtue of a mouse click. Just a little bit, but millions and millions of people doing just a little bit. We have never seen that before. Not to this extent. I know that it is sometimes hard to reach the elderly population with an Internet based effort to gather people because many of them are not don't have access or they are not as computer literate. But it seems to me the volunteer base is extremely computer literate and extremely available by Internet. Are any of you aware of any effort being done through Internet communication, whether it is Facebook or--we have got an awful lot of young people who are doing most of their communication through Facebook. Bizarre, trust me, I have got three of them that do it. It drives me crazy, but I know there is a lot of volunteerism out there in this generation, and frankly it would do them good to spend time around some of the people that they were helping with these meals. They would learn a lot. It would give them great perspective on their lives and what is important. Are you aware of any effort that has been made in some creative ways to reach out to the younger generation to volunteer in this regard? Mr. Weill. Well, Senator, one that is slightly different and not necessarily directed specifically to seniors, but there is a network called Campus Kitchens, which is college students who are taking prepared and perishable food and delivering it to food pantries and congregate meal sites and other places that need emergency food in communities. So that is one important place where college students are working. Senator McCaskill. If possible, if you would get to--we will follow up with you get the information about that program, because I think that would be something that we would want to try to emulate in various campuses around the country. We need to capture these kids and get them thinking about beyond where they are going for spring break as quickly as possible, and make sure that we turn them into the contributing citizens that we know they all want to be if they have the nudge. I would love to help participate in trying to get that program around. I thank all of you for being here today and thank you, Mr. Chairman, for this Committee. Senator Smith. Thank you, Senator McCaskill. Marcus, I think it goes without saying it, but I will say it anyway. I think Senator Wyden and I feel a great deal of pride in the program you have described to us of Loaves and Fishes. Senator McCaskill asked an important question about the federal government's role. I wonder if--and my own view of it is the federal government's role is to utilize the army of volunteers, not to displace it. For example, Loaves and Fishes, just the name is inspiring to me. Probably wouldn't have as good a volunteer turnout if we said, come and volunteer for the United States Department of Agriculture program. [Laughter.] Mr. Lampros. You are right. Senator Smith. Would you agree with that? Mr. Lampros. I would agree with that. Senator Smith. Okay, but clearly, you figured out for the great blessing of a lot of people in our largest metropolitan area how to get people to show up so that there are no waiting lists. That is astonishing. What is the key? Mr. Lampros. Well, we have involved a lot of corporations. We have over 70 companies in the Portland area that have volunteered to do a route, and a lot of them do one route per week. When you have a company that has 50 employees and you ask them to sign up, why, if you are an employee, you work 2 hours on a Wednesday, then you might not deliver again for 2 months. So it is easy, it is simple. Then we pass that on and it snowballs from there. Senator Smith. The employees of these companies, I assume, take a great deal of pride in doing it. Mr. Lampros. Absolutely. Senator Smith. As you look at other programs around the country--I assume you have some familiarity with them--do you share that key with them? Mr. Lampros. Well, I haven't been in contact with too many. My grandparents were recipients of Meals on Wheels in San Francisco, and they had to wait 6 months to get a meal delivered. They were on a waiting list. But no, I am not too familiar with any other ones but ours. Senator Smith. Now, you mentioned in your testimony, 45 percent of your funding is from government sources. Obviously, you have got 55 percent coming form elsewhere. I assume that these companies that you recruit give money and their employees donate time. Mr. Lampros. Yes, they do. Actually, we have to include all of the recipient's money as government money. So the federal and local governments, only about 38 percent of what we get. Senator Smith. So it is primarily corporate money. Mr. Lampros. It is corporate money, individuals. Senator Smith. As you think about the growing population, do you all make plans for increasing the ranks of volunteers, or do you got nothing to spare? Mr. Lampros. We have never spent a cent on marketing, and I am on the marketing Committee, and this next year we are going to start actually advertising for the first time, spending money to get more volunteers. Because we realize if we get volunteers, we get money. We get free labor and we get donations. Senator Smith. I am curious, does any training go into a volunteer? Things, not just how to deliver a meal, but things to look for? Mental health issues, suicidology that they might detect, that kind of thing? Mr. Lampros. Yes, we just observe and write down what we see and then the case worker at the headquarters deals with it after that. But we are there. We are there for them every single day. So if someone is obviously disoriented or distraught about something, we report it. So it is a very good link to the community. Senator Smith. What are the kind of things they often bring back? What information does a volunteer get that they would pass on to a case worker? Mr. Lampros. Well, if someone is falling down all the time, that is a typical client of ours. After 20 years I have seen a lot of people age, and as they get closer to the nursing home part of their life, they do exhibit certain signs of not being able to stay at home. So we just observe and we report. Senator Smith. Is there good follow up on the reports, as far as you know? Mr. Lampros. Oh yes, very good. Senator Smith. Well, that is just incredibly commendable. James, you talk about how many of the grandparents in these programs are actually younger and they have their grandchildren living with them. They are raising them and they are likely to be a little bit more inclined to suffer from hunger, insecurities. What can the government do to better target that group? Or are we doing enough, or what would you suggest? Mr. Ziliak. At this point in time, no, I don't think enough is being done to address this population. It has been a growing population over the last two decades, kind of a demographic shift toward grandparents raising grandchildren. So there is some activity that the government can certainly be involved, but in particular, reaching out to these families to find out whether or not they are eligible for government programs, including the Food Stamp Program. Many of these children are from lower income families. Not all of them, though, by any stretch. So it is not simply an income constraint. There are other issues that are going on within the household that we still don't know the answers to. This is one of those results that stuck out pretty prominent in our study and raises a whole host of questions that we think need to be addressed going forward, because this is and has been a growing population of seniors in the United States. Senator Smith. So if you got grandparents who are food insecure, it obviously follows that the grandchildren would be in the same circumstance. Mr. Ziliak. That is correct. Senator Smith. Well, it really points out a focus that the Federal Government needs to have. I am not sure we have all the information that we ought to be getting. I think that is one of the things this hearing has pointed out to me. We need know a lot more, and then we can marshal the ways to help. You also indicated in your testimony that, at least as I heard it, the World War II generation, the greatest generation, those who were young during the Great Depression, there may be lots of resistance to getting help. Is there generational change, of the baby boom generation and that generation that we are losing far too quickly, but will our generation be more inclined to get the help that they need and to ask for involvement in the programs that are out there? Mr. Ziliak. I think there is some evidence to support that conjecture. The reasons vary, of course. Part of the current-- the greatest generation grew up in a very difficult time in United States history, the Great Depression. So many of these families developed coping strategies to deal with hunger. These were lifelong lessons that as children they learned and they carried on into their older ages. So these individuals are most likely to be much less likely to report that they need food, because they learned how to just kind of save every penny and save every scrap of bread and make ends meet. The looming retirement generation of baby boomers did not confront such a social dislocation like the Great Depression. They have also grown up in the presence of the Food Stamp Program. It is important to remember this program wasn't started until the mid-1960s, and then came in its modern form about 30 years ago. So there is much more knowledge amongst the generation of baby boomers of assistance programs than there was with the oldest old today. Senator Smith. James Weill, you mentioned that the problem that seniors who are caring for their grandchildren, you talked about how they face issues related to hunger. My investigative team is working on a report related to grandparents caring for grandchildren, and the problems they face ought to concern us all. They certainly do me. How do you think we could better target this group to address the problems that have been raised here? Mr. Weill. As you know, Senator, there are a growing number of support programs for grandparents raising grandchildren and efforts from groups like Generations United to do more. Children's groups and seniors groups like AARP have joined together around those. AARP has a grandparent support center. So there is a lot that is going on. In the support programs, the cash and food stamp programs, a lot of the outreach that we have been talking about has to be redoubled for those types of families. But also we need to focus on a range of the supports for the children within those families as well as the grandparents as caregivers. Food stamps go to the whole household, but if the children have no income for their other needs, no cash assistance, no support from refundable federal tax credits because the credits aren't structured the right way, it hurts the whole family. One of the things we know from the research is that parents and grandparents skip meals so the kids get enough to eat. So the heaviest burden of food insecurity, the most serious burden falls on the adults, because they protect the kids, although it doesn't work because the studies also show that the stress on the adults translates down to the children and hurts them in other ways. So we have to just get all of these supports to families. Senator Smith. I want to note for the record, or highlight for the record your comments and your testimony regarding the applications for food stamps and some of the difficulties that it poses and probably the discouragement that follows from that. I did not know about fingerprinting. Obviously, we don't want fraudulent activities in food stamps, but perhaps there is a less intrusive way to get the information that is needed to discourage fraud without making people feel criminal. Mr. Weill. We think there is. The Senate Farm Bill requires States, under standards that would be set by the Secretary, to ensure that finger imaging is a cost effective way before they use it, compared to other measures they could use. Senator Smith. Robert, coming from a rural part of my State, I obviously am very struck by what you talked about food deserts and it comes to my mind that if you live in a very small community, you may not have much access. But I suppose you are also referring to the likelihood that some urban areas where the store is a convenience store, and they are selling stuff that it is nutritional value is probably not what they need. Mr. Blancato. Right. In fact, the limited amount of work that has been done focused on both urban and rural areas. It is about what is available, with the emphasis on choice, cost and healthiness of the food. The growing problem in certain areas is exacerbated by isolation on the part of older people to go to places to begin with, and the cost of transportation. So this is something which I think this Committee could look at more and study some more. I want to make one other point, too, about grandparents because I am on the board of Generations United, and I know that there is a lot of work in this area. But there is a small effort under way through the Older Americans Act. The National Family Caregiver Support Program does set aside some funds for grandparents raising grandchildren. At least in terms of giving them information about access to community supports and programs, and I think that that is a program that was trend setting when it was established in 2000 and needs to grow in reflection of the rising number of grandparents who are primarily raising their grandchildren. Senator Smith. Jan, I assume that your employees at Harrah's take the same kind of satisfaction as Marcus Lampros' employees do and those of other corporations. Does it add to the esprit de corps at Harrah's? Ms. Jones. It creates the culture. If employees believe that the company they work for is committed to doing something in their communities and they can be a part of that, it changes the way they feel about going to work. I think it is key to attitude and then customer service and just a positive esprit de corps. Senator Smith. Well, I suspect that the lesson there is it is good business to be--I doubt it costs Harrah's more of what puts it up in terms of dollars and involvement, I bet it gets that much and more back in terms of employee esprit de corps and customer service in your core business. Ms. Jones. I don't think there is any question about it. Senator Smith. Yes. Well, I commend you for that, and on behalf of the Senate Special Committee on Aging, we thank you all for your time. You have been generous with it, and more generous to those that you are concerned about and care for. Each of you adds measurably to, I believe, the greatness of our country and the real American spirit. You certainly added measurably to the Senate record and our understanding of this growing problem and awakened, I think, many to the responsibility we all have individually and as a country. So with that, our heartfelt gratitude, and we are adjourned. [Whereupon, at 12:17 p.m., the Committee was adjourned.] A P P E N D I X ---------- [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]