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.

Evaluation, development and achievement of a realistic rehabilitation goal for a severely disabled person requires the skills of many professionals for extended periods.

A complex array of services must be available to the severely handicapped and their highly individual needs met through provision of compassionate, competent, and sustained service. Such services are available and their use with the severely handicapped should not be limited by funding.

Increased appropriations for contracts and grants for facility construction and improvement to $60 million for fiscal 1973, $70 million for 1974, and $80 million for 1975.

Such increases would reflect more accurately the rehabilitation facility needs.

Extension of the mortgage insurance program to all rehabilitation facilities rather than limiting such coverage to new facilities.

Elimination of the limit on the principal amount which could be insured under the mortgage insurance program and coverage of 100 percent of the project cost.

Provision for use of grant and loan program together without duplication.

We would like to call your attention to the plight of the severely disabled individual who is homebound.

Although the proposed legislation provides for a significant increase in services to the severely handicapped, we would ask specific mention and special provision for the services to the homebound disabled. A recent national survey of State and local rehabilitation agencies, completed by the programmatic research project, funded by Social Rehabilitation Services found that only 25 agencies actively offer systematic services to the homebound. Yet, that same project discovered that if the homebound are given a suitable rehabilitation program, at least 20 to 25 percent may be expected to resume their rightful place in the community.

For this reason, we recommend the specific identification of homebound programs in title III, section 304, as a means of providing comprehensive service to the severely disabled.

In addition, we support section 413, which calls for national centers for spinal-cord injuries to provide intensive services to the civilian paraplegics, train personnel, and fund research.

Resources for civilian paraplegics are woefully inadequate.

Last, we support the section providing services to people with kidney diseases.

Time does not permit me to comment further on these provisions. In conclusion, I want to say that I have experienced the reality of Geothe's statement which asks that we treat "people as if they were what they ought to be and help them become what they are capable of being."

Through the extension of the vocational rehabilitation legislation, you can make this statement a reality for the disabled.

I appreciate the opportunity to appear before you.

Senator CRANSTON. Thank you very much, Mr. Kemp, for a very, very fine and very useful statement.

In that statement, you referred to the current crisis being experienced by community rehabilitation centers.

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Do you think that crisis results from the lack of Federal funds available or lack of funding in general?

Mr. KEMP. It is my personal opinion that I think it would be a lack of Federal funding. The executive director might have a few comments on that.

Miss SHOVER. In some cases, Senator, it is both. But if we had more adequate Federal funding, we would be able to do much more for the disabled.

Senator CRANSTON. You also refer in the same context to the 5 million who could benefit from rehabilitation services.

Are you referring to all types of disabilities or a specific group? Mr. KEMP. These are people with all types of physical, mental, and emotional disabilities who actually need treatment and are not presently receiving the benefits rehabilitation programs offers.

Senator CRANSTON. What is the basis for the 5-million figure?
Miss SHOVER. The Rehabilitation Service Administration.

Senator CRANSTON. The partnership that you describe between governmental and voluntary agencies, would you describe it as effective at the present time?

Mr. KEMP. No; I think it is rather ineffective in the sense that both public and voluntary agencies could handle more, much more, than is being done right now.

Senator CRANSTON. Is it getting better?

Mr. KEMP. Hopefully, it will be getting better.

Senator CRANSTON. Do you think it is presently improving or not? Mr. KEMP. I would like to refer that question to the executive di

rector.

Miss SHOVER. If you are saying nationwide, it is improving very, very much. There are States in which we have the very finest cooperation. There are other States in which the cooperation leaves something to be desired and part of that lack of cooperation is due directly to inadequate funding.

Senator CRANSTON. Can you be more specific in how it is not working?

Miss SHOVER. We have pointed out in our testimony that a large percent of Easter Seal rehabilitation facilities are not operating anywhere near capacity. Many of these facilities were developed and expanded in response to the needs of handicapped persons as represented to us by State vocational rehabilitation agencies. Similarly, the expansion of staff was frequently based upon the growing number of clients referred by State agencies, and the expectation that the rate of referrals would continue at the same pace or even increase. This has not been the case in many States. When State programs are inadequately financed as a result of policy and administrative changes at National and State levels, they are unable to refer the many clients who require service. In addition, there appears to be a reluctance to refer the more severely handicapped person since the rehabilitation process may extend over a greater period of time, rehabilitation may be more costly and employment prospects less favorable than for the mild or moderately handicapped individual.

I do want to stress that we highly commend the Federal and State vocational rehabilitation agencies which have truly created a partnership with the voluntary rehabilitation sector. Our societies have main

tained a close and friendly relationship for over two decades. They have been assisted financially, not only through the payment of fees on an individual basis and through contracts, but, in addition, through grants for demonstration projects and expansion of our facilities and programs. Accomplishments of the program over the years warrant the extension and expansion of support from both Congress and State legislatures.

Senator CRANSTON. What do you feel could be done to render more effective services under this-what should be done so there would be more effective services rendered under this partnership arrangement? Miss SHOVER. I think there could be a greater consideration of the involvement of community rehabilitation centers on the part of a few of the State rehabilitation agencies, which also, of course, have Federal funds.

My reason for saying this is that when you have citizens directly involved in providing services and becoming concerned about services for handicapped people, they assume a greater responsibility for taking them into the corporations for business, for employment. They accept them on all types of activities within their community. They have a concern for them, and they get this through the involvement. Senator CRANSTON. Have the services available to the physically handicapped actually diminished, as you note on page 3 of your statement, or would it be more accurate to say that the resources have been diverted to other areas within the present scope of VR responsibility? Miss SHOVER. Probably.

Thank you for bringing that to our attention.

Senator CRANSTON. You refer to the services proposed under title III of the House-passed bill as an important first step in the rehabilitation. Do you feel that title III is the proper place to take the first steps, as opposed to having all steps of the rehabilitation process under the basic program, which would be in title I of H.R. 8395? Do you want to supply that for the record?

Miss SHOVER. Let me speak to that, Senator. We feel very strongly that the severely handicapped have not had the services that they should have and need if we are going to have them become even selfsufficient so that we do not take the care of a lot of other people in providing care for them.

We feel section III is essential to have if we are going to reach those severely handicapped people. Granted, they can provide care for the severely handicapped under title I and nothing has been

done.

Senator CRANSTON. Could you give some examples of where you feel there is a lack of coordination of information dissemination by the Federal and State agencies?

Miss SHOVER. We will be glad to send it to you.

Senator CRANSTON. Fine.

(Information subsequently supplied for the record follows:)

EXAMPLES OF LACK OF COORDINATION OF INFORMATION DISSEMINATED BY FEDERAL AND STATE AGENCIES

When one considers the multiple needs of handicapped persons and the number and complexity of government programs established to provide the required services, it is understandable that problems arise in the dissemination of infor

mation. Several government agencies have developed information-giving programs. Each, however, operates from a different data basis. Some are concerned with many problem areas but with different population segments of the handicapped. Some are restricted to one problem area but cover all disabilities in a wide age range. "Closer Look" of the Bureau of Education for the Handicapped gives information on educational services; "HURRAH" of the Social Rehabilitation Service is concerned with vocational rehabilitation; the Social Security Administration dispenses information on the various aspects of the Social Security Act including "Medicare," disability and Social Security benefits; the Administration on Aging fosters information programs on services to aged persons and the Department of Defense counseling and referral services to military rejectees.

By means of concerted compaigns via radio, TV, placards and brochures, efforts are made by each of these agencies to make Americans aware of the existence of available resources. The result, however, is confusion to the public who still find it difficult to know, for example, where to turn in the event of a catastrophic illness or accident. Hopefully, the National Information and Resource Center will coordinate these various information systems and link people in need with available services.

Senator CRANSTON. We are told that there are approximately 46 agencies of over 80 programs designed to provide information to individuals with physical and mental handicaps. It would appear that some coordination of efforts would be necessary given that number. Do you foresee that type of coordination as possible if the section providing for the "National Information and Resource Center" is adopted?

Mr. KEMP. I think it is a practical matter to have this National Resource Center as far as a central location for dissemination of information.

Miss SHOVER. We have 45 information referral operating programs at the present time, and it is the opinion of the people operating these centers out in the country that it would be helpful to have a central coordinated force in the Federal Government.

Senator CRANSTON. On page 4, you comment on the proposed National Commission on Transportation and Housing for the Handicapped. Would you see the scope of authority of that Commission as including specific recommendations as to how public transportation could be more accessible to the physically handicapped?

Mr. KEMP. Yes. I would definitely think that there would be in this scope of authority responsibility to suggest means of insuring that the handicapped person can get to and from work, so as to take his place in society as an economically self-sufficient individual.

Senator CRANSTON. Do you think the availability of public transportation rates first or does making an adaptation in private modes of transportation rank first in priority?

Mr. KEMP. I think it is the obligation of the Department of Transportation, for example, to be responsible for getting the handicapped person to and from work, rather than trying to force the private sector to adapt their facilities.

Miss SHOVER. One of the things we would like to see expanded in other communities is a new pattern developed in San Francisco and in Washington, D.C. Provisions should be made for physically handicapped to the extent that existing types of transportation can be modified. This is extremely desirable.

New plans and new construction should include provisions for the physically handicapped.