There are other specific alterations and improvements that we believe should be considered for this legislation in order that it will most effectively achieve its purpose. We take this opportunity to suggest these changes as follows: 1. Page 2, line 14.-Strengthening of leadership and capacities should apply to voluntary health organizations as well as to State health agencies. 2. Page 3, line 2.-We believe that the Surgeon General should act with the advice and approval of a suitable advisory council. In this respect we recommend the establishment of a National Health Planning Advisory Council similar to that provided for in Public Law 89-239, the Regional Health Planning Act. 3. Page 3, line 17.-It appears reasonable that the composition of State health planning councils be more specifically outlined than in the present bill. We would favor an arrangement providing that no less than one-half of the membership of such councils be drawn from nongovernmental sources and that representatives from each regional medical program operating within the State be included. We further believe that the State health planning councils should have the authority to approve as well as to advise upon plans of the State health agency. 4. Page 3, line 22.-There should be comprehensive planning for facilities and personnel, as well as for health services, both public and private. The language of the bill should make this entirely clear, because it is our understanding that is not the purpose of the bill to provide for extensive construction projects. 5. Page 4, line 11.-The intent of this bill, as we understand it, is not to supplant but to supplement with Federal appropriations funds made available by State government and private sources. 6. Page 5, line 5.-We believe that the function of the State health planning council to advise and approve should be extended to all reviews and changes of plan made by the State health agency. This applies to page 5, line 5; page 7, line 18; page 8, line 8; and page 11, line 3. 7. Page 7, line 22.-It is to be hoped that nothing in this bill will operate at cross-purposes with medical practices and services existing within the States. Just as was accomplished in the case of the regional health programs law, 89-239, so here it is of utmost importance that all major forces contributing to the people's health have a strong voice in determining the nature and form of the health services to be delivered to the people. 8. Page 8, line 22 and page 26, line 8.—In establishing and maintaining adequate public health services, training should be authorized for personnel from nonprofit private agencies, as well as from State and local government. This also would apply to the language on page 26, line 8. 9. Page 9, line 5.—It is presumed that "State health authority" as used in this line is synonymous with "State health agency" as previously used in this bill. 10. Page 25, line 20 and page 26, line 2.-There being so few independent schools of public health in the country, we suggest that grants also be made available to departments of public health within medical schools. The CHAIRMAN. Dr. Taussig, I believe you were a member of the DeBakey Committee on Heart Disease, Cancer, and Stroke. Dr. TAUSSIG. Yes, sir. The CHAIRMAN. That was a historic report. On Tuesday evening I had the honor of being at a dinner we had at the Statler Hotel when the James F. Mitchell Foundation honored Dr. DeBakey for his great work. You must have put in many hours on that report, did you not? Dr. TAUSSIG. Yes, sir. The CHAIRMAN. Well, again I want to say how honored we feel in having you here today. We thank you gentlemen, too. We want to thank you and express our deep appreciation to you. Now, our next witness is Mr. William T. MacCracken, Jr., Washington counsel, American Optometric Association. Mr. MacCracken, we are very happy to have you back with us again, sir. We would be glad to have you proceed now in your own way. 60-955-669 STATEMENT OF WILLIAM P. MACCRACKEN, JR., WASHINGTON COUNSEL, AMERICAN OPTOMETRIC ASSOCIATION Mr. MACCRACKEN. Thank you, Mr. Chairman, for this opportunity. My statement is very brief. My name is William P. MacCracken, Jr. My office address is 1000 Connecticut Avenue, 20036, Washington, D.Č., where I am engaged in the general practice of law. I am a member of the bar of the Supreme Court of the United States and of the courts of the District of Columbia. I was originally admitted to practice law before the Supreme Court of Illinois in 1911. It has been my privilege for more than 20 years to represent the American Optometric Association in the National Capital. The association is composed of optometrists duly licensed to practice their profession in 1 or more of the 50 States and the District of Columbia. There are approximately 17,000 licensed optometrists practicing in the United States, and two-thirds or more are members of the association. The purpose of the bill is to assist in the extension and the improvement of comprehensive health planning and public health services, as well as to provide for a more effective use of available Federal funds. It will authorize the Surgeon General of the United States to make grants to States which have submitted State plans for comprehensive State health planning approved by the Surgeon General. Section 314(a) (2) (B) requires a State plan to be approved to provide for the establishment of a State health planning council "which shall include representatives of State and local agencies and nongovernmental organizations and groups concerned with health and of consumers of health services to advise such State agencies." There is no question but that the language of the bill would permit the appointment of duly licensed health personnel to a State planning council, but in order to make certain that Congress intended that representatives of the various health professions be included on these State councils, we recommend that on page 3, line 15, after the word "health" there be inserted "duly licensed personnel in sciences related to health." The term "sciences related to health" has been used in several recent congressional enactments, one passed by the first session of this Congress known as the Medical Library Assistance Act of 1965, Public Law 89-291. The House committee report in referring to the term "sciences related to health” said: This means that the disciplines which may receive construction assistance under the health research facilities program are the same disciplines as will be included under the reported bill, such as medicine, dentistry, optometry, pharmacy, osteopathy, and other related sciences. Mr. Chairman, you will recall that when Dr. Henry Hofstetter testified before this committee in support of the amendment to include optometrists in the forgiveness provisions of the student loan fund legislation, the committee acted favorably upon his request and this amendment is now in the law. On behalf of the optometric profession, I want to express our appreciation for the recognition the committee has accorded them in the past as well as to express my own appreciation of the courtesies extended to me. If there are any questions which you or other members of the committee would like to ask, I will be pleased to endeavor to answer them. The CHAIRMAN. Well, we want to thank you for your appearance. You may be assured, sir, we will certainly consider carefully the suggested amendment which you have given us. Mr. MACCRACKEN. Thank you, sir. The CHAIRMAN. We are always glad to have you here and happy to have you here this morning. Mr. MACCRACKEN. It is always a pleasure to be here. The CHAIRMAN. We thank you very much. At this point we will insert in the record various communications we expect to receive after the close of the hearing. (The material referred to follows:) Senator LISTER HILL, Washington, D.C.: MONTGOMERY, ALA., April 1, 1966. We understand that S. 3008 is now before your committee. Nurses of Alabama will appreciate your support of this bill. We have discussed provisions of the bill with representatives of our State health department who also believe that passage w greatly assist in planning health services for Alabama. Mrs. WALTER BRAGG SMITH, Executive Director, Alabama State Nurses' Association. STATE OF ALASKA, Hon. LISTER HILL, Chairman, Senate Committee on Labor and Public Welfare, New Senate Office Building, Washington, D.C. DEAR SENATOR HILL: I understand that S. 3008 is now under consideration, and I would like to tell you that the State of Alaska would urge its passage. I believe this bill will promote and assist in the extension and improvement of public health services, particularly in those States with unique problems. Of primary importance in the bill is the provision of developing firm and practical health plans-plans which consider the needs, resources, and concurrent plans of the separate States and their components--as well as for furnishing comprehensible health services in accordance with these plans. All too often in the past health services could not be brought to bear on a problem of local significance where ample funds were available for a problem receiving national emphasis. It is our assumption that this bill will not decrease the Federal allotment to Alaska. I would like to point out to you that present formula for allotments on the basis of population and per capita income results in Alaska's receiving proportionately less health service than those States having lower per capita income and more buying power per dollar. Alaska is in the peculiar position of having a quite high per capita income, yet it has some of the most abject poverty under the American flag, aggravated by a rather high cost of living. It is hoped that consideration might be given to developing a formula for allotments which does not discriminate against States such as Alaska. I much appreciate your interest, and I sincerely hope that S. 3008 will be favorably considered. Kindest regards. Sincerely, WILLIAM A. EGAN, Governor. DEPARTMENT OF HEALTH AND WELFARE, Hon. E. L. BARTLETT, U.S. Senate, Washington, D.C. DEAR SENATOR BARTLETT: Currently under consideration in the Senate is S. 3008, a bill to amend the Public Health Service Act. I believe that this bill will, as its full title implies, promote and assist in the extension and improvement of public health services, and I therefore urge that you make all appropriate attempts to secure its passage. Of primary importance in the bill is the provision for developing firm and practical health plans-plans which consider the needs, resources, and concurrent plans of the separate States and their components, as well as for furnishing comprehensive health services in accordance with these plans. All too often in the past, health services were not possible to combat a problem of local significance, while ample funds were available for a problem receiving national emphasis. It is our assumption that this bill will not decrease the Federal allotment to Alaska. The bill provides for continuation of allotments to the States on the basis of population and per capita income. While this may be the best and simplest formula to use on a national basis, it results in Alaska's receiving proportionately less health service than those States having lower per capita income and more buying power per dollar. It is hoped that studies will continue with the view to developing a formula for allotments which does not discriminate against States such as Alaska. I much appreciate your interest and shall welcome your assistance in securing passage of S. 3008. Very sincerely yours, DEPARTMENT OF HEALTH AND WELFARE, Hon. ERNEST GRUENING, U.S. Senate, Washington, D.C. DEAR SENATOr Gruening: Currently under consideration in the Senate is S. 3008, a bill to amend the Public Health Service Act. I believe that this bill will, as its full title implies, promote and assist in the extension and improvement of public health services, and I therefore urge that you make all appropriate attempts to secure its passage. Of primary importance in the bill is the provision for developing firm and practical health plans-plans which consider the needs, resources and concurrent plans of the separate States and their components, as well as for furnishing comprehensive health services in accordance with these plans. All too often in the past, health services were not possible to combat a problem of local significance, while ample funds were available for a problem receiving national emphasis. It is our assumption that this bill will not decrease the Federal allotment to Alaska. The bill provides for continuation of allotments to the States on the basis of population and per capita income. While this may be the best and simplest formula to use on a national basis, it results in Alaska's receiving proportionately less health service than those States having lower per capita income and more buying power per dollar. It is hoped that studies will continue with the view to developing a formula for allotments which does not discriminate against states such as Alaska. I much appreciate your interest and shall welcome your assistance in securing passage of S. 3008. Very sincerely yours, Hon. J. W. FULBRIGHT, U.S. Senator, Washington, D.C. LEVI M. BROWNING, M.D., ARKANSAS STATE BOARD OF HEALTH, DEAR SENATOR FULBRIGHT: You are aware of the fact that hearings are now being conducted on S. 3008 which was introduced by Senator Hill. The principles of this bill deal with the public health briefly to the extent of: (a) establishing planning grants, (b) support grants with categories, (c) provide project grants for special health problems, and (d) to authorize an interchange of health personnel between Federal, State and local agencies. The association of State and territorial health officers, of which I am a member, strongly recommends the favorable consideration of S. 3008. I personally and officially have strong feelings regarding the following points in the bill: 1. The statutory language should require that the State health officer in each State be a member of the planning agency in his State. (As a matter of fact, it would probably be well to require that the State health agency be the planning agency.) 2. Basic health services are feasible and should be made available in all jurisdictions because health and disease are no respecters of political boundaries. 3. The authorization for an interchange of personnel through all governmental levels and agencies will be of considerable value to all concerned, since this provision would upgrade professional qualifications, experiences and services. 4. All types and levels of health programs and services should be required to perform according to previously prepared and approved plans. We would reject the philosophy of devoting our time, resources and professional services toward correcting detrimental situations and conditions that were not prevented. We should direct our efforts, plans and resources toward prevention, earlier diagnosis, and the application of modern treatment. The contents and provisions of S. 3008 will enable us to go far in this direction. Your support and favorable consideration is needed. Sincerely yours, J. T. HERRON, M.D., Hon. JOHN L. MCCLELLAN, U.S. Senator, Washington, D.C. ARKANSAS STATE BOARD OF HEALTH, DEAR SENATOR MCCLELLAN: You are aware of the fact that hearings are now being conducted on S. 3008 which was introduced by Senator Hill. The principles of this bill deal with the public health briefly to the extent of: (a) establishing planning grants, (b) support grants with categories, (c) provide project grants for special health problems, and (d) to authorize an interchange of health personnel between Federal, State, and local agencies. The association of State and territorial health officers, of which I am a member, strongly recommends the favorable consideration of S. 3008. I personally and officially have strong feelings regarding the following points in the bill: 1. The statutory language should require that the State health officer in each State be a member of the planning agency in his State. (As a matter of fact, it would probably be well to require that the State health agency be the planning agency.) 2. Basic health services are feasible and should be made available in all jurisdictions because health and disease are no respectors of political boundaries. 3. The authorization for an interchange of personnel through all governmental levels and agencies will be of considerable value to all concerned, since this provision would upgrade professional qualifications, experiences, and services. 4. All types and levels of health programs and services should be required to perform according to previously prepared and approved plans. We would reject the philosophy of devoting our time, resources, and professional services towards correcting detrimental situations and conditions that were not prevented. We should direct our efforts, plans, and resources towards prevention, earlier diagnosis, and the application of modern treatment. The contents and provisions of S. 3008 will enable us to go far in this direction. Your support and favorable consideration is needed. Sincerely yours, J. T. HERRON, M.D., Hon. LISTER HILL, PHOENIX, ARIZ., March, 24, 1966. U.S. Senator, Washington, D.C.: The provisions of S. 3008 will enable the Arizona State Department of Health and the county health departments in cooperation with public, private, professional and institutional health interests to develop and put in effect a State health plan for more effective and efficient use of manpower, facilities, and financial resources for comprehensive community health services. The department |