(The information requested follows:) Average per bed project cost (adjusted to March 1954 cost index)' under the hospital survey and construction program Location Building and fixed Project cost Representative building construction costs-Hospital facilities approved for construction GENERAL HOSPITALS-NEW BUILDINGS Ground and 4 stories. Brick walls, November 1952 $604, 202 $18.76 $1.52 $708, 400 $22.00 $14, 168 100 52, 200 522 665,000 do. 982, 000 18.62 1.45 1, 177, 000 22.55 11, 770 Sigourney, Iowa.. 17 11,800 562 138, 500 1 336 Basement and 3 stories. Concrete December 1952 1, 320, 121 355, 000 Part basement, 1 story. Fireproof, 2 stories. Bar joists, brick-faced terra 2 stories. Reinforced concrete block 477, 467 4 stories. Reinforced concrete frame; Mar. 1953. Brevard, N. C. 25 10, 700 428 Goshen, Ind. 33 25,018 758 110,000 Mexico, Mo. 65 35 75 41,312 551 455,000 2 and 6 stories. Fireproof construction, reinforced concrete and steel. 36,000 554 403,000 .do. 1,411, 868 34. 17 3.10 1,600,000 38.72 21,333 24. 07 2. 20 1, 164, 748 28. 16 16, 370 Basement and 3 stories. Fireproof, January 1953.1, 023, 064 2 stories. Fire-resistive construction. 2 stories. Brick walls, stone-faced, re- 1 New work includes services for 121 beds. Senator LEHMAN. In these diagnostic and treatment centers, is it proposed to provide psychiatric treatment in the event that somebody comes to them suffering from mental illness? Dr. SCHEELE. That would, of course, be optional with the community that built the diagnostic or treatment clinic. We would hope that these clinics would be staffed by groups of physicians who would represent a variety of specialties Modern care of patients requires psychiatric treatment in many cases, and in the ideal diagnostic and treatment clinic or center such service would probably be available. Senator PURTELL. Are there any other questions, Senator Hill? Senator HILL. Not at this point. I have some questions later, but not at this point. Senator PURTELL. Thank you very much, Doctor. Mrs. HOBBY. Mr. Chairman, from what you have just seen, I believe it is clear that the proposals described thus far in our presentation would provide better medical and hospital services to more peoplewith lower unit costs for construction, and with lower daily costs for patient care I would like to pause for a few minutes while the charts are changed before I proceed to the rehabilitation facilities. Senator PURTELL. We will be very glad to have this rest period. We would like to compliment you on the excellence of your presentation here. With your graphic charts, it helps us understand a very very difficult problem. Mrs. HOBBY. Thank you very much. 5. REHABILITATION FACILITIES Having discussed the first four major proposals of S. 2578, let us turn now to the fifth proposal-the construction of rehabilitation. facilities. Rehabilitation is the process of restoring a physically handicapped person to the point where he can either take care of himself in the same, or even better, assume a position in productive employment. The latter is called vocational rehabilitation. As the President stated in his message of January 18 on the health needs of the Nation, considerations of both humanity and self-interest demand immediate measures for the expansion of our rehabilitation programs. While, as the President states, "there are no statistics to portray the full depth and meaning in human terms of the rehabilitation program," nevertheless it also has a very practical dollars-andcents meaning. Rehabilitation for self-care is an important step in relieving the economic burden on families and the patient load in hospitals and nursing homes. Rehabilitation for employment has a direct effect in reducing governmental relief expenditures in those instances where disabled persons are receiving public assistance. Furthermore, as a group, disabled persons who have returned to work will, during their remaining work lives, more than repay the cost of their rehabilitation through Federal income taxes. In the area of vocational rehabilitation, the President's health message calls for a vastly expanded program-a goal of 200,000 rehabilitants annually by 1959 as compared with the present 60,000. If these goals are to be met, two major steps must be taken. First, our total rehabilitation facility capacity must be greatly enlarged, and, second, we must have more trained personnel and increased financial support for providing rehabilitation services. The bill we are now considering seeks to meet the first of these objectives. S. 2759, scheduled for consideration by your committee at a later date, is designed to achieve the second objective. The bill defines a "rehabilitation facility" as one which is operated for the primary purpose of assisting in the rehabilitation of disable persons through an integrated program of medical, psychological, social, and Vocational evaluation and services under competent professional supervision Under the present act, rehabilitation facilities are eligible for Federal construction aid only if they are part of a hospital. This bill would extend eligibility to include separate facilities. It should be noted that the rehabilitation facilities contemplated in the bill would be available to all disabled persons of the community-children, aged, and others-irrespective of whether they are being rehabilitated for employment. Thus, these facilities would not be limited to persons coming within the scope of the FederalState vocational rehabilitation program. The legislative proposal before you includes rehabilitation facilities for the blind. Although the medical services required by the blind are often less extensive than those required by other disabled persons, the adjustment training conducted in these centers for the blind is a crucial part of their rehabilitation. The construction and planning of rehabilitation facilities is in the developmental stage. It is too early, therefore, to be precise in presenting the actual needs or the extent to which the $10 million authorized in S. 2758 would meet these needs. The survey provided for in the bill will give us these facts. I will now ask Mr. Kimball to present charts showing the present status of our rehabilitation facilities and illustrating our proposal. Senator PURTELL. We will be very happy to hear from Mr. Kimball. Mr. KIMBALL. Thank you. Mrs. Secretary, Mr. Chairman, members of the committee, this next series of charts is concerned with the fifth category of grants under this proposed legislation. That is, they would provide for the authorization of $10 million per year for 3 years for the construction of comprehensive rehabilitation facilities. As the Secretary has pointed out, in this particular field there is particular need for this survey and planning authorization because, today, there is not too much known about the need for such facilities, that is, where they should be placed and the exact type of facility in each locality. The important fact to keep in mind in connection with the comprehensive rehabilitation facilities is that they lessen the load on hospitals and other of the types of facilities which have been discussed earlier this morning. As the Secretary has pointed out, they are closely related to hospital and nursing facilities. It will be noted in this next chart that the comprehensive rehabilitation facility draws from the general hospitals, the chronic |