dialysis. At the end of 24 months there will be 44 patients on institutional dialysis, 21 patients will be on home dialysis; 15.5 living transplants and 10 cadaver transplants. At 36 months there will be 56 institutional dialyzed patients, 24 living transplants, 18 cadaver transplants, 31 patients on home dialysis. In 48 months, 68 patients in-hospital dialysis, 31 living transplants, 24 cadaver transplants, 40 patients on home dialysis. At the end of 60 months there will be 80 patients in-hospital, 37 living transplants, 30 cadaver transplants and 47 people in home dialysis; roughly 50 patients would have died during that time. It should be noted that based on our past year's experience most of these numbers are quite accurate with the exception of the transplantation numbers which are lower than projected. Unless the transplantation numbers keep up with the projections in the program, the number of patients requiring institutional dialysis would go up at a more rapid rate. As I indicated to you, I would be most happy to discuss these numbers in any detail you wish at your convenience. I hope I can be of assistance to you. Sincerely yours, JOSEPH A. CHAZAN, M.D., Director, Division of Renal Diseases. Senator CRANSTON. Our next witness is Harold Russell, Chairman of the President's Committee for the Employment of the Handicapped. STATEMENT OF HAROLD RUSSELL, CHAIRMAN OF THE PRESIDENT'S COMMITTEE FOR THE EMPLOYMENT OF THE HANDICAPPED, ACCOMPANIED BY BERNARD POSNER, DEPUTY ADMINISTRATIVE ASSISTANT Mr. RUSSELL. Thank you, Mr. Chairman. I have with me Mr. Bernard Posner, who is Deputy Administrative Assistant of the President's Committee. I am glad to have the opportunity and privilege of being here today. I would like to make four comments. First, I refer you and members of the committee to section 404, promotion of employment opportunities. I call your attention to the fact that this section calls for the cooperation of the Secretary of Labor and Secretary of Health, Education and Welfare to recommend policies and procedures to the States which would facilitate job placement of handicapped people who have been rehabilitated. It calls upon them to work with the Chairman of the President's Committee to assure maximum utilization of services of the committee and of State and local committees, in promoting job opportunities for the handicapped. These are laudable objectives. During the 17 years this provision has been in effect, however, it has not always worked as effectively as it might have. The reason has been very simple: money. Only 18 States of the Union-less than half-have full-time staff people administering the affairs of Governors' committees on employment of the handicapped. In a majority of the States, Governors' committee activities usually are extra duties, to be attended to when other work permits. In some instances, small amounts of money have been allocated for printing, promotion, travel and administration. In other instances, there isn't even money for these items. To solve the problem of money, we propose that section 404 be changed, to provide for authorization for funding of State committees. The key addition lies in the words: "and shall authorize their respective State agencies to fund staff positions and related expendi tures of State committees on employment of the handicapped. This change is essential to really build opportunities for the handicapped of America. Second, we should like to see an item incorporated into the Vocational Rehabilitation Act which would enable the President's committee to keep pace with the rising load of handicapped persons receiving vocational rehabilitation. This item would eliminate the ceiling authorization of $1 million which now limits the President's committee appropriations. I assure you, removal of the ceiling would not result in a sudden "gold rush" for funds. The President's committee has no intentions of such a rush. The point is, however, that after a quarter of a century of responsible operations, we feel the President's committee has earned the right to be free standing, like virtually all other agencies of Government; it has earned the right to be considered as a mature and responsible Agency; it has earned the right to be trusted to spend its money wisely; it has earned the right not to be treated as though it needs special watching. It has earned the right, in brief, to operate without a ceiling. In the past, every time a pay increase occurred, every time we were called upon to expand our activities to be responsive to national needs, we found that we had to go through a time-consuming legislative process of coming to Congress to ask for an increase in a ceiling which had proved inadequate. We never were denied. Congress always has been most courteous, most responsive to our needs. But this seems to have been an exercise in a waste of valuable time-the time of the Congress even more than the time of the committee. If the ceiling were removed, I assure you that we would exercise the same fiscal prudence, the same careful management of funds, the same squeezing the full value out of every dollar, as we have shown time and time again during the first 25 years of our history. Third, we should like to see a provision in the act for a National Center for the Homebound. Over the years, as I have seen the gains made in building opportunities for the handicapped, I have thought: "yes, but these do not pertain to the homebound." And I have seen gains in rehabilitation, and thought: "yes, but these do not pertain to the homebound." I think it's time the homebound stopped being the "shadow people" of our society. For too many generations, they really have been "out of sight, out of mind." There are more than 2 million of them. They are in dire financial need, most of them. Yet there is every indication that they can become self-sufficient; they can leave the welfare rolls; they can become contributors to, rather than consumers of, American tax revenues. This already has been demonstrated by the federally funded demonstration projects that have attempted to bring them into the Nation's mainstream-yes, even though confined at home. A National Center for the Homebound could demonstrate on a large scale, to every State and every city, that improved techniques of rehabilitation can bring true independence to the homebound. The President's Committee strongly endorses the proposed National Center for the Homebound. It is long overdue. Fourth and finally, we should like to see a provision in the act for a system of Federal payments supplementing the incomes that certain handicapped people in sheltered workshops are able to earn by their own efforts. These, of course, are people whose productivity is so low, because of their disabilities, that they cannot hope to earn anything near the minimum wage. Yet we know we cannot stop there and claim we have done all we can for them. Their expenses of living go on, the same as ours. Their needs for the minimums of life go on, the same as ours. It is time that America recognized their needs, and supplemented their incomes to bring their wages up to existing minimums. These levels, I might point out, are not far from the poverty levels for our country. It is time that America recognized their needs, and supplemented their incomes to bring their wages up to existing minimums. These levels, I might point out, are not far from the poverty levels for our country. Of course, there would have to be safeguards. These handicapped people would have to be in an "employee" status in the workshop, rather than a "trainee" status. They would have to be employed fulltime. Certification would have to be made that they are producing at their highest level of skill and earning power. They would have to be reviewed periodically regarding their potential for outside employment. These, then, are my four suggestions for the Vocational Rehabilitation Amendments-funding of Governors' Committees on Employment of the Handicapped; removal of the ceiling on expenditures of the President's Committee; a National Center for the Homebound: a system of wage supplements for severely handicapped persons in workshops. Thank you for your attention. Senator CRANSTON. Thank you very much. Would you please describe the special funding of your committee? Mr. RUSSELL. Actually our committee is funded by the Congress through appropriations each year. We have a ceiling of $1 million and we are coming close to that ceiling as wage increases go on, as the need for programs expand, as the demands upon our time and money and staff grow greater and greater. The point is that within a short period of time, once again we may have to come to the Congress and ask for a removal of the ceiling or increase in our ceiling so that we can carry on these programs. Senator CRANSTON. What is the relationship of your functions to RSA, and how do your functions relate to those of RSA? Mr. RUSSELL. We operate actually as a separate organization. The President's committee report directly to the President. We cooperate closely with all the agencies that are involved, both public and private, in the field of rehabilitation and employment of the handicapped. We are housed in the Department of Labor for housekeeping purposes, but actually we are a separate organization. Mr. POSNER. We are independent from RSA. RSA rehabilitates the handicapped. Our main mission is to open the doors of business and industry so when they are rehabilitated they find more acceptance in their search for work. Senator CRANSTON. Who has the statutory responsibility for promoting jobs for handicapped people within the Government? Mr. RUSSELL. We have the statutory responsibility. Senator CRANSTON. Do you have the responsibility for placement in jobs! Mr. RUSSELL. Not for placement, for promoting employment. Senator CRANSTON. Who has the statutory placement responsibility? Mr. POSNER. It is spread around. The employment service throughout the United States has a responsibility for placement for the handicapped, for the disadvantaged, for all other groups. Rehabilitation Services Administration has a responsibility to see that those who are rehabilitated end up in productive jobs. The Veterans' Administration has a responsibility to see that disabled veterans are rehabilitated and enter the job market. The Civil Service Commission has a responsbility to see that handicapped people seeking Federal employment get a fair shake in their search for jobs. Senator CRANSTON. Do you think this diffusion of responsibility is sufficient or insufficient? Mr. RUSSELL. Well, I think it probably would be more efficient if it were placed with one organization. Senator CRANSTON. Which organization were you referring to? Mr. RUSSELL. I think the Department of Labor. But these agencies deal with different categories of people. Vocational rehabilitation deals with disabled people. The Veterans Administration deals with disabled veterans. Labor deals with handicapped and nonhandicapped. So it does become somewhat of a problem. I suppose if the major responsibility had to be placed upon anybody, it would be with the employment service. Senator CRANSTON. Is there any inter-agency coordinating committee on this? Mr. POSNER. There is, sir. Under the aegis of the President's committee, we have an advisory council, made up of the Secretary of Labor, the Secretary of Health, Education, and Welfare, the Administrator of Veterans Affairs, Chairman of Civil Service Commission, Secretary of Agriculture, Secretary of Commerce, Secretary of Transportation, Secretary of Housing and Urban Development. Senator CRANSTON. Has that committee ever met? Mr. POSNER. We try to meet once a year. Senator CRANSTON. With those officials present? Mr. POSNER. Some attend and some do not. We have a fairly good batting average of getting those people or their top subordinates. Senator CRANSTON. How much coordinating authority does it have? Mr. POSNER. It does not have any real authority, it is advisory. It operates mainly by giving counsel and by the formation of an ad hoc task force to get things done. For example, there was an ad hoc task force some years ago that helped get the entire national program of architectural barriers, the elimination of architectural barriers off the ground. There have been other ad hoc task forces to look into better coordination and the placement activities of Labor and HEW. The advisory council gets its work done by spotlighting the problems and by turning them over to staff for implementation. Senator CRANSTON. Could you submit for the subcommittee's information minutes of the last the 3 years' meetings of that advisory committee, and for the record, a summary of information on it? Mr. POSNER. Gladly. (The information referred to follows:) ADVISORY COUNCIL MINUTES You wanted Minutes of the past three meetings of the Advisory Council. They are enclosed. (1) We said that we have aimed for annual meetings. As you can see, we have fallen short of our aim. Yet, meetings which have taken place have been highly productive. Examples: The Advisory Council Meeting of 1968 proposed that the President's Committee become involved in transportation barriers against the handicapped. An Ad Hoc Committee was appointed. Because of this Committee's efforts, we have made sizable strides in overcoming some of the transportation barriers. The enclosed report will be of interest. (1-A). The Advisory Council Meeting of 1970 suggested that the President issue a "National Commitment to the Handicapped," describing America's goals in meeting the needs of handicapped citizens. Such a commitment has been prepared and is at the White House today, awaiting issuance. A copy is attached. (1-B) Senator CRANSTON. What would you think of the idea of having a statutory coordinating committee with perhaps the Secretary of Labor as its chairman, with more authority to really coordinate? Mr. RUSSELL. I think it would be most commendable. I think it would be a more efficient way. I think with this statutory provision it would give it more punch. Senator CRANSTON. Would you submit for the record who you think should serve on such a committee if it was formed? Mr. RUSSELL. We would be delighted to. (The information referred to follows:) STATUTORY COMMITTEE ON PLACEMENT You suggested the possibility of a "Statutory Committee on Placement of the Handicapped," chairman of which would be the Secretary of Labor. You wanted our suggestions for members of such a committee. I am not sure what this committee could accomplish. Its work would seem to duplicate much of the work of the President's Committee-particularly of its Executive Committee and its Advisory Council-but if such a committee were to be formed it should include representatives from the following: Business and industry Organized labor Veterans organizations Women's organizations GOVERNMENT, PRIVATE SECTOR Organizations of the handicapped Voluntary health organizations Medical organizations Educational organizations Youth groups Mass Media Rehabilitation organizations Sheltered workshops Service groups Church groups The above representation would provide a cross section of America. Such a cross section would be needed to develop employment opportunities to the fullest extent. Again my thanks for your consideration. |