State and The Elderly

Special Articles / T.K. Nair / Old Age in an Indifferent Society

Social services are organized societal approaches to the amelioration or eradication of those conditions which are viewed at any historical point of time as unacceptable and for which knowledge and skills can be applied to make them more acceptable (Beattie, Jr., 1976). The emergence of social security systems throughout the world gave impetus to social responsibility for the provision of different social services for the elderly depending on the resources available to the countries and the level of awareness as well as acceptance of the needs of older persons. The term “Social Security” was first used in the title of the United States legislation, the Social Security Act of 1935. It was used in 1941 in the wartime document known as the Atlantic Charter. The ILO adopted the term. It adopted a Convention of Minimum Standards of Social Security in 1952 which has influenced many social security measures all over the world. 

Social Security is included in List III of the seventh schedule of the Indian Constitution. Social Security is the concurrent responsibility of the central and state governments. Item 9 of the state list, and items 20, 23 and 24 of the concurrent list relate to  “social security and social insurance”; and “welfare of labour including conditions of work, provident funds, employers’ liability for workmen’s compensation, invalidity and old age pensions, and maternity benefits”. The Directive Principles of State Policy concerning social security in the Constitution are Articles 38, 39, 41, 42 and 47. Article 41 states as follows: “The state shall, within the limits of its economic capacity and development, make effective provision for securing the right to work, to education and to public assistance in cases of unemployment, old age, sickness and disablement, and in other cases of undeserved want”.  The Employees’ State Insurance Act (1948), the Employees’ Provident Funds and Miscellaneous Provisions Act (1952), and the Payment of Gratuity Act (1972) are the major social security legislations since Independence for the benefit of the organized labour. The Provident Funds Act was supplemented in 1971 with a family pension scheme and in 1976 with a deposit-linked insurance scheme. 

Social Insurance
Social insurance is one of the principal measures of social security designed to provide income security for the elderly in many countries. In India, government and quasi-government employees are eligible for pension, provident fund and gratuity. The system of government pension flows from the Pension Act of 1871. Pension is based on the principle of ”pay-as-you-earn”which, in effect, means that the present working population pays for the old age security of the elderly generation. A separate Department of Pension and Pensioners’ Welfare was set up by the government of India in 1985. The lot of the government pensioners has been improving through pensioners’ associations, collective bargaining, political lobbying, litigation and government-appointed pay commissions. The employees in the organized sector of industries and business establishments are entitled to provident fund and gratuity. However, some organizations in the private sector too give pension to their managerial, supervisory and secretarial personnel. 

In 1999, a significant report of the project OASIS (Old Age Social and Income Security) was presented to the government of India by an expert committee chaired by Surendra Dave. The government of India launched a New Pension Scheme (NPS) in April 2008 on the recommendation of the OASIS project report and extended it to all citizens from May 2009. This is the first government-designed pension product for citizens other than government and quasi-government employees, who are covered by various old age benefit schemes. According to a survey by the Invest India Economic Foundation, which was reported in “The Week” of March 22, 2009, the protected Indian work force comprises 22 million people who are government employees and another 15 million people who are covered by various retirement saving schemes. NPS aims to cover 80 million people who are capable of saving and investing at least Rs. 6,000 per annum. The New Pension Scheme is claimed to be a government initiative to help the “common man” tide through the twilight years. But large sections of the population cannot afford to avail of the NPS due to poverty or low income.

The provident fund system follows the principle of “save-as-you-earn”.  Coverage under the Employees’ Provident Funds and Miscellaneous Provisions Act is presently restricted to establishments employing 20 or more persons. The minimum rate of contribution under the act is either 8.33 or 10 per cent of the employee’s salary depending on the industries to be notified by the government of India. Employers are required to make a matching contribution. The savings are accumulated over the working life of the workers in a trust fund, and the sum collected will be released in total together with interest at a predetermined age or at retirement.

In contrast to the provident fund which is a contributory scheme made up of contributions by the employer and the employee, gratuity is a lump sum paid by the employer alone as a benefit on retirement, resignation, death or disablement. The Payment of Gratuity Act is applicable to factories, mines, oilfields, plantations, ports, railway companies, shops and other establishments employing 10 or more persons. The payment of gratuity is subject to the completion of a minimum continuous service of five years. It is payable at the rate of 15 days’ wages based on the wages last drawn by the employee for every completed year of service subject to a maximum permissible amount of gratuity of Rs 3,50,000,which has been enhanced to Rs.one million recently.

Social Assistance
Social assistance in the form of means-tested old age pension (OAP) has been introduced in all the states and union territories for the destitute elderly persons  in the below poverty line (BPL) households, that is, those who have no source of income or have only nominal income which is inadequate for survival, and who have no adult carers. Uttar Pradesh was the first state to initiate the scheme in 1957. The minimum age of eligibility for old age pension is 60 , while many states have prescribed lower age limits for women, widows and the disabled. The amount paid as pension ranges from state to state.    
  
On August 15, 1995 the government of India launched the National Social Assistance Programme.  For the BPL (below poverty line) elderly aged 65 years and above , Indira Gandhi National Old Age Pension Scheme (IGNAOPS) with a central assistance of Rs 75 per month was introduced. In the 2011 budget, the age was reduced to 60. In the 2006-2007 budget, the government of India increased the central assistance to Rs.200. The state governments can match this amount with additional grant. In Tamilnadu, the amount of old age pension was enhanced to Rs.1,000 per month in May 2011 by the newly elected government. In Tamilnadu, the recipients of old age pension are also given 4 kg of rice every month and clothes  (dhotis for men and sarees for women) twice a year. OAP is also a populist measure for electoral gain. In Haryana, increase in the old age pension amount was an electoral slogan in 1987. Implemented in 1987 with great enthusiasm by the government after election, the political commitment has become a “fiscal burden” to the state government and payments were discontinued in February 1990.The implementation of the old age pension scheme is unsatisfactory because of stringent eligibility provisions, procedural formalities, bureaucratic delays, corruption, and unhelpful attitude of the officials. Payment of the OAP amount was normally delayed by the postmen. In Chennai city many received OAP during the third or last week of the month. The long wait was often compounded by the corrupt practices of the postmen who almost always deducted 10 per cent of the OAP amount as their “service charge” before handing over the amount to the beneficiaries. In many instances the OAP recipients were made to stand in long queues while the OAP was required to be delivered at the residence. In September 2010, the Central Bureau of Investigation (CBI) raided three post offices in Chennai and arrested eleven postmen for misappropriation of OAP amount.

In Tamilnadu, the Revenue Department is the implementing office of OAP and the Special Tahsildars (Distress Relief Schemes) are the sanctioning authorities who are overloaded with many responsibilities. OAP beneficiaries have to be prepared for a major hurdle by way of abrupt stopping of OAP. Getting the OAP benefit back is not easy. Added to this strain is the denial of OAP amount for the period of suspension. 

Sidhammal, a destitute widow of Swaminathapuram village in Tamilnadu, was denied old age pension by the  concerned officials on the ground that she was making a living by begging and hence she had a source of income. It was in September 1979. Left with no other option, she filed a writ petition before the Madras High Court in 1984. Following admission of the writ petition by the High Court, the Revenue Divisional Officer of Salem district sanctioned the pension with effect from November 1984. While passing the final orders in 1988, the High Court observed that the woman was 69 years old and blind, and therefore could not earn for her living. As she has been unjustly deprived of pension, the High Court directed the Revenue Divisional Officer to pay the arrears of pension to her from September 1979 to October 1984 within three months.Though justice was meted out to her, it was a long wait after laborious efforts for the inane interpretation of the rules by the officials. 

A strange example of the cumbersome and unfriendly social assistance delivery system is the arbitrary action of the lower level personnel in some Tamilnadu villages resulting in the deprivation of family ration cards to many widows as reported in the New Indian Express of 19 October, 2009.
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When Lakshmi had gone to the public distribution system (PDS) outlet at her village, she was told that   she was not entitled to a ration card as she was   receiving the government’s widow pension. The   card was taken away from her, rendering her unable to avail of its benefits.Lakshmi is one of the many women in Mullipallam and other  neighbouring villages of Vadipatti taluk who say that their ration cards have, for unknown reasons, been confiscated by the PDS staff. Under the pension scheme, Lakshmi receives Rs.400 a month and four kg of rice. Twice a year, she is also given a saree.While the money helps her pay the house rent, not being able to buy sugar, wheat and dhal at the PDS shop adds to the burden of daily expenses, she said. But the Vadipatti taluk tahsildar said that women getting the widow’s pension could also use their ration cards for PDS benefits and there was no rule against this.

The government of India initiated the Annapurna Scheme in 1999, which was implemented in 2001 by the Ministry of Rural Development. Under this scheme, free food grains (wheat or rice) up to 10 kg per month are provided to older persons who are otherwise eligible for old age pension under the Indira Gandhi  National Old Age Pension Scheme. Target for each state is fixed by the central government. The Commissioner of Civil Supplies and Consumer Protection is the Nodal Officer for implementation of the Annapurna Scheme. Funds are allocated to the nodal office which, in turn, allocates the needed funds to the District Collector whose office selects NAOP recipients. Separate ration cards in different colour from the other ration cards with the identification mark “Annapurna” printed on the cards are given to the recipients. At present, only a small proportion of the OAP beneficiaries could receive the Annapurna benefit and the criteria for selection are unclear to the elderly. 

The OAP scam unearthed by the CBI prompted the Tamilnadu government to explore alternate methods to ensure disbursement of several social security pensions. That led to the door delivery of pension amounts through banks  by retaining “business correspondents”. Bank accounts are opened for the pension recipients, who are given biometric smart cards. Despite use of hand-held device, biometric authentication equipment and issuance of a printed receipt, newspapers brought to light the demanding of “service charge” by business correspondents for door delivery. The government has been acting on the media reports as promptly as possible.
A landmark legislation of the government of India is “The Unorganised Workers’ Social Security Act”,2008.The statement of objects states that the Act aims to provide for social security and welfare of the unorganized sector workers, who constitute more than 94 per cent of the total workforce in the country. The Act provides for a National Social Security Board and State Social Security Boards for unorganized workers as well as workers’ facilitation centres under the auspices of the state governments. In the 2010-2011 budget, the Finance Minister announced the creation of a National Social Security Fund for unorganized sector workers with an initial allocation of Rs.1,000 crore. But this is only an enabling Act without specifying any specific social security measure. In 2010, the government of India amended the Employees’ State Insurance Act, 1948 to provide medical facilities to unorganized workers in ESI Corporation hospitals and recognized private hospitals under the Rashtriya Swasthya Bima Yojna (RSBY), a cashless health insurance scheme for the BPL households , the size of which is arbitrarily fixed by the Planning Commission. There are serious instances of corruption in the implementation of the RSBY scheme by the doctors and hospitals with the support of the officials.

In India, social security arrangements have evolved over the years in a piecemeal fashion. Among all sections of the elderly, government and quasi-government employees are served best, or rather have ensured that they are best served. Other sections in the organized sector are also well protected in retirement. JairamRamesh , a prominent economic commentator, observes that India’s organized sector has become a parasite, an oasis of relative prosperity in a desert of destitution (India Today, March 8, 1999). 

National Policy on Older Persons 
The long-felt need for a national policy for the welfare of the elderly was realized in 1999 with the formal announcement of a detailed National Policy on Older Persons (NPOP) by the government of India. The Ministry of Social Justice and Empowerment (MSJE), earlier the Ministry of Welfare, is the nodal agency for the implementation of the national policy. The main objectives of the NPOP are to encourage families to take care of the older members, to support NGOs to supplement family caregiving, to provide healthcare to the elderly, to ensure income security in old age, and to enable the older persons to function independently. 

The NPOP has the following thirteen functional areas:
i. Financial security which includes income security through hassle-free old age pension for the destitute elderly; and pension schemes in the public, private and other sectors.
ii. Health care and nutrition with focus on strengthening primary health care system and orienting its services to older persons also; expanding geriatric care at secondary and tertiary facilities; health education; health insurance for low income groups; and mental health services for older persons.
iii. Shelter : Earmarking 10 per cent of government housing schemes for allotment to older persons 
iv. Education :Programmes to meet the educational and training needs of the elderly.
v. Welfare :Prioritising the needs of older persons; encouraging non-institutional services by voluntary organizations; and providing assistance to voluntary agencies for a variety of services. 
vi. Protection of life and property: Protecting older persons from physical, emotional and financial abuse; and protecting the life and property of the elderly with the involvement of the police and neighbourhood associations. 
vii. Other areas of action which include concessions in all modes of transport, and priorities in various public services .
viii. Non-governmental organizations : Networking NGOs; and promoting   self-help groups and associations of the elderly. 
ix. Realising the potential of the elderly
x. Family : Strengthening family support and promotion of values. 
xi. Research
xii. Training of manpower
xiii. Media :   Involving media with issues related to aging.

Apart from the Ministry of Social Justice and Empowerment, 22 ministries are to be involved in the implementation of the NPOP. Each of the 23 ministries is expected to prepare five-year and annual action plans. The MSJE would review the implementation of the NPOP in a detailed manner every three years. In July 2005, the MSJE made a review of the NPOP and added some more areas of action such as involvement of the private sector in elder care by providing tax benefits, and creation of a national federation of organizations caring for the elderly.                                            
The NPOP mentions the intention to set-up a bureau of older persons under the MSJE. The national policy is committed to the formation of a national association of older persons (NAOP) with state level and district level associations. TheMSJEhas created a National Council for Older Persons (NCOP) with 36 official and non-official members to advise the MSJE. The National Council for Older Persons is the third national council to be set up by the government of India. The Ministry of Health created a National Council on Ageing and Older People in 1997 to advise the Minister on all aspects of aging to promote the health of the older people superseding an earlier National Council for the Elderly. The NCOP is a meeting body and the nomination of non-official members is not based on any objective criteria.

The 1999 national policy document included almost all possible areas of action for the well-being of the older persons. It appeared like a ‘dream policy’. But as dreams often do not materialize, the first decade of the implementation of NPOP was far from cheerful for the elderly. The NPOP recognizes the need for affirmative action for the welfare of the elderly with their productive involvement. The policy stresses on an age-integrated society. But the implications of these stated goals are not clearly internalised by those who are responsible for action. There is a clear conviction deficiency. Panchayati Raj institutions are crucial for the implementation of the NPOP along with the associations and forums of the older persons at the panchayat, block and district levels. But even after ten years since the launching of the NPOP, no worthwhile step was initiated by the central and state governments. A policy sans effective action is no policy at all. Though MSJE is the nodal ministry, the absence of a functioning secretariat made the NPOP ineffective. In January 2010, the MSJE constituted a committee to review the NPOP and to draft a new policy. A policy called the National Policy on Senior Citizens (NPOS) was drafted by the committee and submitted to the government in 2011 (vide Appendix). It is a summarized version of NPOP and the government has not yet notified it till recently. A policy of this nature needs to be drafted on the foundation of reliable database. A time-bound action plan needs to be drafted. The elderly, who constitute about 14 per cent of the voting population, should not be treated as mere objects of state benevolence. They have a right to state support and to participate in policy formulation and programme implementation. What is needed is a paradigm shift in policies concerning the older persons.                                                                                                 
Eldercare Legislation
Aware of the failure of children to perform their filial responsibility in caring for the elderly parents, the state has initiated legislative action to protect them against neglect. The Criminal Procedure Code, 1973 has made statutory provisions to mitigate the hardships of neglected elderly parents. Under section 125 of the Criminal Procedure Code, a magistrate of the first class can order any person having sufficient means to maintain his father or mother, who is unable to maintain himself or herself, by paying allowance at the rate not exceeding Rs. 500 per month to the parent. If the person fails to pay this amount without sufficient cause, the magistrate can issue a warrant for levying the amount, and if the amount still remains unpaid, he can sentence the person to imprisonment and fine. The magistrate may make such alteration in the amount of monthly maintenance (which means food, clothing and lodging) as he thinks fit on proof of a change in the circumstances of the person receiving or paying the allowance. The magistrate may also cancel or vary the order as he thinks fit in consequence of any decision in a competent civil court relating to the parties. The relief given by the Criminal Procedure Code is available to persons belonging to all religions.                                                                
Hindus and Muslims have, in addition to the protection of the general law, their own personal laws of maintenance. The personal laws of both the Hindus and Muslims enable an indigent member of either of these two communities to claim maintenance from a wider circle of relatives than the general law which limits claims of parents to children. Under section 20 of the Hindu Adoptions and Maintenance Act, 1956, a Hindu son and daughter are bound to maintain their aged or infirm parents who are unable to maintain themselves out of their own earning or other property. An adopted son or daughter is also bound to perform this duty to the same extent as a natural born child.

When section 125 was incorporated in the Criminal Procedure Code, there was skepticism as to its effectiveness and whether the parents would seek legal remedy to redress their grievances. But, with growing awareness of their legal rights, elderly parents in distress have started seeking legal remedy. 

A pertinent question that arose from the Criminal Procedure Code, 1973 was the legal obligation of daughters. A Supreme Court judgement in 1987 in the case involving a married daughter and her indigent father made it mandatory for the offspring, irrespective of sex, to give financial support to the parents, who have no other source of income. The daughter, a medical practitioner in Maharashtra, tried to prove that section 125 of the Criminal Procedure   Code said “his” father or mother and therefore was applicable only to sons. “We do not see why the daughter is to be excluded from such obligations” to the parents, declared the Supreme Court. The court also observed that in case the contention of the daughter is accepted, then the parents having daughters only and who are unable to maintain themselves would go destitute unless the daughters, provided they have independent and sufficient means of their own, help them.

Himachal Pradesh Maintenance of Parents and Dependants Act of 2001 is a significant state legislation. But it was not applicable to the Muslims. The Maharashtra government enacted a similar law. In 2007, the government of India passed ”The Maintenance and Welfare of Parents and Senior Citizens Act”, which was notified on 31 December, 2007. It extends to the whole of India except the state of Jammu and Kashmir, and also covers Indian citizens living outside India. 

Salient Provisions of the Act 
i.    The Act provides for entitlement for maintenance by a 
            senior    citizen,     including a parent, who is unable to 
            maintain himself / herself from his / her own earning 
            or out of the property owned by him / her against one 
            more of his / her children not being a minor and in the 
            case of a childless senior citizen against his / her 
            relatives who would inherit his / her  property.                                                                     
ii.    The state governments would constitute one or more 
            Tribunals for each sub-division and the Tribunal shall be 
            presided over by an officer not below the rank of a Sub-
            division Officer. The Tribunal will have the powers of a 
            first class judicial Magistrate for securing the 
            application, refer the same to Conciliation officer for 
            amicable settlement.                                                       
iii.    The application for maintenance may be made by a 
            senior citizen or a parent and if he / she is incapable, 
            by any other person or organization authorised by him 
            / her. The Tribunal may also take cognizance suo motu. 
            An application for monthly allowance shall as far as 
            possible be disposed of within ninety days and definitely 
            within 120 days from the date of the service of notice 
            of the application. The Tribunal is empowered to 
            sanction monthly allowance during the pendency of the 
            proceedings.    
iv.    If children or relatives neglect or refuse to maintain a 
            senior citizen, the Tribunal may order such children or 
            relatives to make a monthly allowance for the 
            maintenance of such senior citizen which shall not 
            exceed rupees ten thousand.
v.    A senior citizen or a parent aggrieved by the decision 
            of the Tribunal has a right to prefer an appeal to the 
            Appellate Tribunal within sixty days from the date of 
            the order of the Tribunal. The Appellate Tribunal shall 
            be presided over by an officer not below the rank of a 
        district magistrate, and it shall try to decide the appeal 
            within one month from the date of filing of appeal.
vi.    Legal practitioners are prohibited from participating 
            in the proceedings before the Tribunals and Appellate 
            Tribunals. The state governments shall designate the 
            District Social Welfare Officer or an officer not below 
            the rank of a District Social Welfare Officer as 
            Maintenance Officer who shall represent a parent if he 
            / she so desires before a Tribunal or Appellate Tribunal.                                           
vii.    An important provision in the Act is that if a senior 
            citizen, after the commencement of this Act, transfers 
            his / her property by way of gift or otherwise, the said 
            transfer of property can be declared void by the Tribunal 
            at the option of the senior citizen. It also provides that 
            where any senior citizen has a right to receive 
            maintenance and if he / she is incapable of enforcing 
            the rights, action may be taken on his / her behalf by 
            any voluntary association. 
viii.    A person who intentionally abandons a senior citizen 
            under his /her care shall be liable for punishment of 
            imprisonment up to three months or with fine which may 
            extend to five thousand rupees.
ix.    The Act also stipulates that the state governments should 
            ensure that beds be provided for all senior citizens in 
            government hospitals or hospitals funded by the 
            government, and geriatric facilities in all district 
            hospitals should be arranged.
x.    For the indigent elderly, the Act contemplates 
            establishment of old age homes by the state 
            governments in a phased manner with at least one in 
            each district to accommodate a minimum of one 
            hundred and fifty poor senior citizens.                                                                                                                                     

Comments  
The older adult protection legislation of 2007 is a welcome measure. But there are hurdles in its implementation. Though the Act stipulates wide dissemination of information by the officials of the state governments, this is seldom reflected in action so far.                                                                                                                       
The Act appears to exclude the poor elderly as they do not own property. However, provision for setting up old age homes by the state governments has been made. This does not appear to be a sound proposition. Old age homes, however well-maintained, cannot be emotionally satisfying to most of the elderly. Instead of considering different community-based options for the well- being of the poor elderly, setting up old age homes in all the districts of thecountry for the indigent elderly may cause large scale segregation of older persons. The way residential institutions for destitute children and students from socially disadvantaged communities are run by the governments would not enthuse even a liberal optimist to welcome government-run old age homes. Further, identification of the indigent elderly to be eligible for admission to old age homes is to be made by the government official which gives scope for corruption.                                                                
Fixed time limits for disposal of petitions and prohibition of legal practitioners are two positive features of the Act. But the ceiling of Rs 10,000 as maintenance allowance is questionable and lacks rationale. There is a widespread ignorance among the elderly, particularly women, of their rights. Even among those who have knowledge of the legal provisions, there will be reluctance to seek legal recourse from their children unless compelling situations drive them to that remedy for what is considered as essentially a family matter and a moral obligation. Another weakness of the Act is that a neighbour or a well-wisher cannot file a complaint of elder abuse or neglect.                                                                    
The Act makes provisions for geriatric services and research by the state governments. So also are there directives for life and safety of the elderly who are often soft targets. But these clauses appear to be mere tokenism. A law by itself cannot mitigate the hardships of the elderly unless there is a political will, and elderly-friendly bureaucratic and judicial procedures. 

Reference
1.    Beattie,W.M.Jr.(1976). “Aging and the Social Services”. In, 
            R.H. Binstock& Ethel Shanas (eds.). Handbook of Aging 
            and the Social Sciences.  New York: Van NostrandReinhold : 
            619-642.

Appendix
National Policy on Senior Citizens 2011

Policy Objectives 
The focus of the new policy: 
1. Mainstream senior citizens, especially older women, and bring their concerns into the national development debate with priority to implement mechanisms already set by governments and supported by civil society and senior citizens  associations. Support promotion and establishment of senior citizens  associations, especially amongst women. 
2. Promote the concept of "Ageing in Place"  or ageing in own home, housing, income security and homecare services, old age pension and access to healthcare insurance schemes and other programmes and services to facilitate and sustain dignity in old age. The thrust of the policy would be preventive rather than cure. 
3. The policy will consider institutional care as the last resort. It recognises that care of senior citizens has to remain vested in the family which would partner the community, government and the private sector. 
4. Being a signatory to the Madrid Plan of Action and Barrier Free Framework it will work towards an inclusive, barrier-free and age-friendly society. 
5. Recognise that senior citizens are a valuable resource for the country and create an environment that provides them with equal opportunities, protects their rights and enables their full participation in society. Towards achievement of this directive, the policy visualises that the states will extend their support for senior citizens living below the poverty line in urban and rural areas and ensure their social security, healthcare, shelter and welfare. It will protect them from abuse and exploitation so that the quality of their lives improves. 
6. Long term savings instruments and credit activities will be promoted to reach both rural and urban areas. It will be necessary for the contributors to feel assured that the payments at the end of the stipulated period are attractive enough to take care of the likely erosion in purchasing power. 
7. Employment in income generating activities after superannuation will be encouraged. 
8. Support and assist organisations that provide counselling, career guidance and training services. 
9. States will be advised to implement the Maintenance and Welfare of Parents and Senior Citizens Act, 2007 and set up Tribunals so that elderly parents unable to maintain themselves are not abandoned and neglected. 
10. States will set up homes with assisted living facilities for abandoned senior citizens in every district of the country and there will be adequate budgetary support. 

Areas of intervention 
The concerned ministries at central and state level as mentioned in the Implementation Section  would implement the policy and take necessary steps for senior citizens as under: 

I. Income security in old age 
A major intervention required in old age relates to financial insecurity as more than two third of the elderly live below the poverty line. It would increase with age uniformly across the country.

1. Indira Gandhi National Old Age Pension Scheme
1. Old age pension scheme would cover all senior citizens living below the poverty line. 
2. Rate of monthly pension would be raised to Rs.1000 per month per person and revised at intervals to prevent its deflation due to higher cost of purchasing. 
3. The  “oldest old” would be covered under Indira Gandhi National Old Age Pension Scheme (IGNOAPS). They would be provided additional pension in case of disability, loss of adult children and concomitant responsibility for grand children and women. This would be reviewed every five years. 

2. Public Distribution System 
4. The public distribution system would reach out to cover all senior citizens living below the poverty line. 

3. Income Tax 
5. Taxation policies would reflect sensitivity to the financial problems of senior citizens which accelerate due to very high costs of medical and nursing care, transportation and support services needed at homes. 
4. Microfinance 
6. Loans at reasonable rates of Interest would be offered to senior citizens to start small businesses. Microfinance for senior citizens would be supported through suitable guidelines issued by the Reserve Bank of India. 

II. Healthcare 
With advancing age, senior citizens have to cope with health and associated problems some of which may be chronic, of a multiple nature, require constant attention and carry the risk of disability and consequent loss of autonomy. Some health problems, especially when accompanied by impaired functional capacity require long term management of illness and nursing care. 
7. Healthcare needs of senior citizens will be given high priority. The goal would be good, affordable health service, heavily subsidized for the poor and a graded system of user charges for others. It would have a judicious mix of public health services, health insurance, health services provided by not-for-profit organizations including trusts and charities, and private medical care. While the first of these will need to be promoted by the State, the third category given some assistance, concessions and relief and the fourth encouraged and subjected to some degree of regulation, preferably by an association of providers of private care. 
8. The basic structure of public healthcare would be through primary healthcare. It would be strengthened and oriented to meet the health needs of senior citizens. Preventive, curative, restorative and rehabilitative services will be expanded and strengthened and geriatric care facilities provided at secondary and tertiary levels. This will imply much larger public sector outlays, proper distribution of services in rural and urban areas, and much better health administration and delivery systems. Geriatric services for all age groups above 60— preventive, curative, rehabilitative healthcare will be provided. The policy will strive to create a tiered national level geriatric healthcare with focus on outpatient day care, palliative care, rehabilitation care and respite care. 
9. Twice in a year the PHC nurse or the ASHA will conduct a special screening of the 80+ population of villages and urban areas and public/private partnerships will be worked out for geriatric and palliative healthcare in rural areas recognizing the increase of non-communicable diseases (NCD) in the country. 
10. Efforts would be made to strengthen the family system so that it continues to play the role of primary caregiver in old age. This would be done by sensitizing younger generations and by providing tax incentives for those taking care of the older members. 
11. Development of health insurance will be given priority to cater to the needs of different income segments of the population with provision for varying contributions and benefits. Packages catering to the lower income groups will be entitled to state subsidy. Concessions and relief will be given to health insurance to enlarge the coverage base and make it affordable. Universal application of health insurance – RSBY (Rashtriya Swasthya Bima Yojana) will be promoted in all districts and senior citizens will be compulsorily included in the coverage. Specific policies will be worked out for healthcare insurance of senior citizens. 
12. From an early age citizens will be encouraged to contribute to a government created healthcare fund that will help in meeting the increased expenses on healthcare after retirement. It will also pay for the health insurance premium in higher socio economic segments. 
13. Special programmes will be developed to increase awareness on mental health and for early detection and care of those with Dementia and Alzheimer's disease. 
14. Restoration of vision and eyesight of senior citizens will be an integral part of the National Programme for Control of Blindness (NPCB). 
15. Use of science and technology such as web based services and devices for the well being and safety of senior citizens will be encouraged and expanded to under-serviced areas. 
16. National and regional institutes of ageing will be set up to promote geriatric healthcare. Adequate budgetary support will be provided to these institutes and a cadre of geriatric healthcare specialists created including professionally trained caregivers to provide care to the elderly at affordable prices. 
17. The current National Programme for Health Care of the Elderly (NPHCE) being implemented in would be expanded immediately and, in partnership with civil society organizations, scaled up to all districts of the country. 
18. Public private partnership models will be developed wherever possible to implement healthcare of the elderly. 
19. Services of mobile health clinics would be made available through PHCs or a subsidy would be granted to NGOs who offer such services.
20. Health Insurance cover would be provided to all senior citizens through public funded schemes, especially those over 80 years who do not pay income tax.
21. Hospices and palliative care of the terminally ill would be provided in all district hospitals and the Indian protocol on palliative care will be disseminated to all doctors and medical professionals. 
22. Recognize gender based attitudes towards health and develop programmes for regular health checkups especially for older women who tend to neglect their problems. 

III. Safety and Security 
23. Provision would be made for stringent punishment for abuse of the elderly. 
24. Abuse of the elderly and crimes against senior citizens especially widows and those living alone and disabled would be tackled by community awareness and policing. 
25. Police would be directed to keep a friendly vigil and monitor programmes which will include a comprehensive plan for security of senior citizens whether living alone or as couples. They would also promote mechanisms for interaction of the elderly with neighbourhood associations and enrolment in special programmes in urban and rural areas. 
26. Protective services would be established and linked to help lines, legal aid and other measures. 

IV. Housing 
Shelter is a basic human need. The stock of housing for different income segments will be increased. Ten percent of housing schemes for urban and rural lower income segments will be earmarked for senior citizens. This will include the Indira Awas Yojana and other schemes of the government. 

27. Age friendly, barrier-free access will be created in buses and bus stations, railways and railway stations, airports and bus transportation within the airports, banks, hospitals, parks, places of worship, cinema halls, shopping malls and other public places that senior citizens and the disabled frequent. 
28. Develop housing complexes for single older men and women, and for those with need for specialized care in cities, towns and rural areas.
29. Promote age friendly facilities and standards of universal design by Bureau of Indian Standards.
30. Since a multi-purpose centre is a necessity for social interaction of senior citizens, housing colonies would reserve sites for establishing such centres. Segregation of senior citizens in housing colonies would be discouraged and their integration into the community supported. 
31. Senior citizens will be given loans for purchase of houses as well as for major repairs, with easy repayment schedules. 

V. Productive Ageing 
32. The policy will promote measures to create avenues for continuity in employment and/or post retirement opportunities. 
33. Directorate of Employment would be created to enable seniors find re- employment. 
34. The age of retirement would be reviewed by the Ministry due to increasing longevity. 

VI. Welfare 
35. A welfare fund for senior citizens will be set up by the government and revenue generated through a social security cess. The revenue generated from this would be allocated to the states in proportion to their share of senior citizens. States may also create similar funds. 
36. Non-institutional services by voluntary organizations will be promoted and assisted to strengthen the capacity of senior citizens and their families to deal with problems of the ageing. 
37. All senior citizens, especially widows, single women and the oldest old  would be eligible for all schemes of government. They would be provided universal identity under the Aadhar scheme on priority.
38. Larger budgetary allocations would be earmarked to pay attention to the special needs of rural and urban senior citizens living below the poverty line. 

VII. Multigenerational bonding 
39. The policy would focus on promoting bonding of generations and multigenerational support by incorporating relevant educational material in school curriculum and promoting value education. School Value Education modules and text books promoting family values of caring for parents would be promoted by NCERT and State Educational Bodies. 

VIII. Media 
40. Media has an important role to play in highlighting the changing situation of senior citizens and in identifying emerging issues and areas of action.
41. Involve mass media as well as informal and traditional communication channels on ageing issues 
Natural disasters/ emergencies 
42. Provide equal access to food, shelter, medical care and other services to senior citizens during and after natural disasters and emergencies.
43. Enhance financial grants and other relief measures to assist senior citizens to re-establish and reconstruct their communities and rebuild their social fabric following emergencies. 

Implementation Mechanism 
There will be efforts to provide an identity for senior citizens across the country and the ADHAAR Unique identity number will be offered to them so that implementation of assistance schemes of Government of India and concessions can be offered to them. As part of the policy implementation the Government will strive for: 

I. Establishment of Department of Senior Citizens under the Ministry of Social Justice and Empowerment 
The Ministry of Social Justice and Empowerment will establish a “Department of Senior Citizens” which will be the nodal agency for implementing programmes and services for senior citizens and the NPSC 2011. An inter-ministerial committee will pursue matters relating to implementation of the national policy and monitor its progress. Coordination will be by the nodal ministry. Each ministry will prepare action plans to implement aspects that concern them and submit regular reviews. 

II. Establishment of Directorates of Senior Citizens in states and union territories 
States and union territories will set up separate Directorates of Senior Citizens for implementing programmes and services for senior citizens and the NPSC 2011.
III. National/State Commission for Senior Citizens 
A National Commission for Senior Citizens at the centre and similar commissions at the state level will be constituted. The Commissions would be set up under an Act of the Parliament with powers of Civil Courts to deal with cases pertaining to violations of rights of senior citizens. 

IV. Establishment of National Council for Senior Citizens 
A National Council for Senior Citizens, headed by the Minister for Social Justice and Empowerment will be constituted by the Ministry. With tenure of five years, the Council will monitor the implementation of the policy and advise the government on concerns of senior citizens. A similar body would be established in every state with the concerned minister heading the State Council for Senior Citizens. 
•    The Council would include representatives of relevant 
            central ministries, the Planning Commission and ten 
            states by rotation. 
•    Representatives of senior citizens associations from 
            every state and Union Territory. 
•    Representatives of NGOs, academia, media and 
            experts on ageing. 
•    The council would meet once in six months. 

V. Responsibility for Implementation 
The Ministries of Home Affairs, Health & Family Welfare, Rural Development, Urban Development, Youth Affairs & Sports, Railways, Science & Technology, Statistics &Programme Implementation, Labour, Panchayati Raj and Departments of Elementary Education & Literacy, Secondary & Higher Education, Road Transport & Highways, Public Enterprises, Revenue, Women & Child Development, Information Technology and Personnel & Training will setup necessary mechanism for implementation of the policy. A five-year perspective Plan and annual plans setting targets and financial allocations will be prepared by each Ministry/ Department. The annual report of these Ministries/ Departments will indicate progress achieved during the year. This will enable monitoring by the designated authority.

VI. Role of Block Development Offices, Panchayat Raj Institutions and Tribal Councils/Gram Sabhas
Block Development offices would appoint nodal officers to serve as a one point contact for senior citizens to ease access to pensions and handle documentation and physical presence requirements, especially by the elderly women. 
Panchayat Raj Institutions would be directed to implement the NPSC 2011 and address local issues and needs of the ageing population. 
In rural/ tribal areas, the tribal council or gram sabha or the relevant Panchayat Raj institution would be responsible for implementation of the policy. 
The provisions of the 13th Finance Commission for special funding to them would be made applicable.

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