I am sure that the Chairman has met the Deputy Assistant Secretary of State, Mr. Alan Reich, a quadraplegic, who supports himself fully and is an asset to this society.

But I would also like to mention the many I have met who are in that middle ground, the director of Sperry-Rand Corp., who, because he had contributed to our society and because he has amassed some wealth, and at the age of-my age, exactly-at 42, he became a quadraplegic. Now his finances are finished and yet he happens to own a house. And so long as he owns that house and as long as he stays with his family, there is no care that is available for him. I think that the waste of a man's talents, the man who has been a director of a large corporation, who could earn, who could pay, could contribute, is a financial loss we should consider."

But the moral loss of the ability of this man to get back into our society is almost incomprehensible to me.

I think I would like to read two short paragraphs into the record from David Barrie, who is the chief medical examiner of Liberty Mutual.

In discussing spinal-cord injury:

Not too great a reduction can be anticipated in medical, hospital, drugs, and equipment costs, with one glaring exception: properly treated, trained in self care and familiar with the causes of expensive post-hospital treatment, the difference between a well-treated and trained paraplegic and the poorly treated and untrained one can run into thousands of dollars.

This, of course, requires spinal-cord injury treatment facilities that do not exist today. One ulcer or bed sore can cost $5,000 in a regular hospital in medical costs. And if independence is lost, custodial or attendant care can cost many more thousands. Loss of income, taxes, wage substitution, et cetera, can only be avoided if the patient is first properly treated and trained. Only then is vocational retraining a practical undertaking.

Consider two actual case histories of quadraplegics. One ten-year post history is regularly employed full time. He is 100 percent self supporting and his medical expenses run to $1,000 a day.

The second case, with identical injury, same age, is in a nursing home rotting away physically and emotionally at a cost of $11,000 per year for care and $3,000 per year in insurance payments, plus he pays no taxes and contributes little, if anything, to society.

Although I fought for section 414 in the House, I hope that it is enacted with the intent of its supporters-that is, that there be established national regional spinal cord centers and that this not be interpreted as just another research and demonstration grant. The concept. of regional spinal cord centers has been proven in other countries and in selected areas of this Nation. These existing centers should be expanded and made the prototypes for the network of regional centers. In connection with this effort, I think it would be advantageous for this committee to be more specific in its authorizations for this section. I would recommend that $10 million be spent in the first year in coordination with the existing centers in the first year in coordination with the existing centers with an increment of $10 million each subsequent year. The figures I quote here are quite modest and the minimum amounts necessary to get this project off the ground. They would be a great deal more if we did not have such centers as the Good Samaritan, Woodrow Wilson, and others, to which we could contribute and help make their care more comprehensive in a larger area.

I would also like to bring to the attention of this committee a situation which I feel is detrimental to all the handicapped of our Nation.

Moneys which are being appropriated to the States for vocational rehabilitation are not being used totally for the handicapped. At least in my own State we have a situation where the State and HEW are entering into a contract where the State can cut off some 26 percent of the appropriated funds for vocational rehabilitation and use this money for administrative purposes.

The State hopes to raise this percentage in this coming year to 33 percent.

I would like to see that moneys appropriated for the handicapped are used for the handicapped. I think it is high time that this Congress took better advantage of those private areas of handicapped rehabilitation where people are willing to work for less and where there is less administrative overhead.

In my State, the handicapped have been left without funds and must in some cases go on welfare, giving up both their family and home; this at a time when the State is waging a war trying to get people off of welfare.

Again, I would like to extend my appreciation to you, Mr. Chairman, and the committee on behalf of the thousands of people to whom you have given help.

I think in most cases, however, they still wait for us to meet our expectations of bringing a comprehensive system to those Americans who suffer the greatest of injury, the inability to participate as viable members of their community and Nation.

I know that this committee shares my concern in this effort; and I only hope that we can bring this message to the entire Congress. Senator CRANSTON. I thank you very much, Congressman, for that very constructive and carefully thought out testimony. It is obvious. that you feel very deeply about the subject that you addressed yourself to. I have developed the same concern about spinal cord injury, in particular, as well as other aspects of the problems of the handicapped. I assure you I will do all I can to see to it that we have some strong mprovements in the legislation that this committee reports out in the area of meeting the needs of those with spinal injuries.

How many centers do you believe would be adequate to meet populat on of spinal-cord injury in our country?

Mr. MCKINNEY. I really have no pragmatic answer for you, Mr. (sirman. I think this committee would have to authorize research to find out just how many we have. It is incredible to me that nowhere in the Nation can you really get a concrete figure on how many spinalcord injured we have. That is why I suggest in my testimony that we start by giving the extra needed help to those centers that we already have, and while we are helping them, we then find out what the need would be within the wisdom of this committee or HEW for regional

For instance, just very briefly, and I will not take any time, I had quadraplegic working for me in my campaign, answering the telephone, and I was appalled when the campaign was over that I literally had to send him back to a nursing home.

When I started to look just in one small town in Connecticut, I found we had over 12 paraplegics and quadraplegics basically hidden away. Most people just do not know that they are there except for their close family and friends.

Senator CRANSTON. Thank you very, very much, Congressman. We are grateful for your presence.

Our next witnesses are John Kemp, member, board of directors, National Easter Seal Association, and Jane Shover, executive director of the National Easter Seal Association.

Good morning.

STATEMENT OF JOHN KEMP, MEMBER, BOARD OF DIRECTORS, NATIONAL EASTER SEAL ASSOCIATION, ACCOMPANIED BY JANE SHOVER, EXECUTIVE DIRECTOR, NATIONAL EASTER SEAL ASSOCIATION

Mr. KEMP. Mr. Chairman and members of this distinguished committee, I am pleased to be afforded the privilege of appearing before you because, as a congenital quadruple amputee, I am convinced of the importance of rehabilitation. I feel it a personal duty to be here in support of this important vocational rehabilitation legislation.

I will be entering my second year of law school this fall and serve as a member of the Youth Committee of the President's Committee on Employment of the Handicapped-and a member of the board of directors of the National Easter Seal Society for Crippled Children and Adults. This summer, I will be working in Washington for the Small Business Administration, doing legal research.

As one who is sensitive to the great needs of disabled persons and who has experienced the great value of rehabilitation, I want to assure a similar opportunity to the millions of other handicapped young people and adults--an opportunity that can for many become a reality through continuing and strengthening of the Vocational Rehabilitation Act.

In my particular case, rehabilitation, which began as a very young child, was under the auspices of private and voluntary agencies in which the National Easter Seal Society played a vital role. Today, I speak as a board member of the largest voluntary health organization serving the physically handicapped-the National Easter Seal Society for Crippled Children and Adults.

My comments reflect two perspectives: that of a consumer of rehabilitation and that of an agency delivering services to the physically handicapped at the community level.

THE EASTER SEAL SOCIETY

The Rehabilitation Act of 1972 under consideration by this subcommittee is of direct concern to Easter Seal societies. For more than half a century, rehabilitation of the physically handicapped has been the primary goal of the National Easter Seal Society.

Through our 2,000 affiliated societies, services were extended to 378,390 disabled children and adults in the past year.

Easter seal services include physical restoration, special education, vocational evaluation, training, and adjustment, sheltered employment, camping and recreation, information, referral, followup, transportation, and equipment loan.

These services are provided to any handicapped child or adult whose potential for self-realization and independence can be enhanced. Cause, diagnostic label, age and economic status are not considerations.

PARTNERSHIP-PUBLIC AND VOLUNTARY EFFORT

A creative partnership between governmental and voluntary rehabilitation agencies has achieved substantial progress in the Nation's rehabilitation program. Major resources for the governmental agencies are the community rehabilitation centers.

Planned, developed, directed by local volunteers and staffed by ski.led professionals, these rehabilitation centers supply needed servIs to clients of the State vocational rehabilitation agencies as well as other public agencies and the community at large.

Fees for clients' services, grants for construction and initial staffing, for expanding services and upgrading professional staff, and for technical assistance to enhance management skills have been provided through the Vocational Rehabilitation Act. This productive coalescence of public and voluntary programs deserves continued support.

CURRENT PROBLEM

Today, many community rehabilitation centers are experiencing a crisis a crisis of underutilization created by inadequate funding. A revent survey indicates that one-third of our Easter Seal rehabilitation facilities are operating at 60-percent capacity and that threequarters of these facilities receive less than 50 percent of their operating expenditures from fees for services. Easter Seals' experience 28 not unique.

With the community rehabilitation centers operating at their highest level of competence, a reservoir of professional skill lies untapped for lack of funding for rehabilitation services.

More importantly, there are an estimated 5 million Americans who can benefit from rehabilitation services.

Americans who with appropriate services can regain some measure of self-worth if not total self-sufficiency. Public and voluntary agencies. can respond only if the existing rehabilitation program is strengthened and expanded. The proposed legislation will not solve the problems, immediately, but can provide the vehicle which can set the direction for the future.

PROPOSED LEGISLATION

The President, in his State of the Union message, said:

I am presenting only vital problems which are within the capacity of this Congress to enact, within the capacity of the budget to finance, and which I believe should be above partisanship-programs which deal with urgent prioriLes for the Nation

The proposed Rehabilitation Act of 1972, in our view, is a priority. The National Easter Seal Society strongly supports the purposes and intent of the Rehabilitation Act of 1972-H.R. 8395.

We are in accord with the following provisions of H.R. 8395: The increased emphasis upon rehabilitation services for the severely handicapped in the basic program, title I. The more severely handi

capped due to the pressures to serve others have been neglected by the vocational rehabilitation program, and more recently the extension of service for the socially disadvantaged has reduced the services available to the physically handicapped.

The addition of followup, follow-along, and other part-employment services necessary to assist the handicapped to maintain employment and to secure services from other agencies.

Such services are essential to the successful placement of the physically handicapped and will increase the potential for sustained employment.

Establishment of a program of grants to States and to initiate or expand services, incorporating and broadening the expansion grant concept in section 4 (a) (2) of the present act.

Authorization of appropriations under title II of the act for vocational evaluation and work adjustment, a program in the current law but one which has never been funded.

The establishment of a new title III-Comprehensive Services to the Severely Handicapped. Improved ability to live independently is an appropriate goal for the severely handicapped and an important first step in economic self-sufficiency. The ability of the State rehabilitation agency to serve these severely handicapped persons with their highly individualized needs is significantly increased through title III.

The authorization of the Secretary to conduct research studies, investigations, demonstrations and evaluation programs and the specific mention of architectural, transportation, and other environmental and attitudinal barriers in the listing of problems appropriate for the Secretary to support.

The establishment of a National Information and Resource Center, which would centralize and facilitate the collection and dissemination. of information on needs, problems, and resources for handicapped persons.

Lack of centralized information remains a basic deterrent to effective utilization. Knowledge of resources is essential to planning use of existing services and to identify gaps in services.

The National Easter Seal Society has operated an informational and educational materials center on rehabilitation since 1923. Although the services provided are below the scope demanded by the act, the demands placed on these limited services would indicate that there is a real need.

The establishment of a National Commission on Transportation and Housing for the Handicapped, which would consider, among other matters, how travel expenses in connection with transportation to and from work for handicapped individuals can be met or subsidized when such individuals are unable to use mass transportation. Two major deterrents to the use of public transportation by the handicapped are the inaccessibility of the vehicle itself and the inability to get to and from transit stops.

PROPOSED AMENDMENTS

The National Easter Seal Society endorses the following amendments and strongly support their inclusion in the Rehabilitation Act. These amendments would provide:

Increased appropriation authority for title III to $50 million for fiscal year 1973, $80 million in 1974, and $100 million in 1975.