Committee on Labor and Public Welfare Subcommittee on the Handicapped U. S. Senate Statement of Rehabilitation Institute of Chicago Thursday, June 1, 1972 Mr. Chairman: We appreciate this invitation to testify on H. R. 8395 and other bills proposing to extend and amend the Vocational Rehabilitation Act. I am Dr. Henry B. Betts, Vice President and Medical Director of the Rehabilitation Institute of Chicago and Professor and Chairman of the Department of Rehabilitation Medicine, Northwestern UniversityMcGaw Medical Center. With me is Mr. Ray Brown, Executive Vice President of the Northwestern University McGaw Medical Center who is actively involved with us in the Center-wide planning of which we are a part. We are here today on behalf of the Northwestern UniversityMcGaw Medical Center and of its affiliated rehabilitation center, the Rehabilitation Institute of Chicago. Mr. Chairman, we want to discuss with you primarily certain features of this legislation: those proposing spinal cord injury centers; those dealing with research and training; and .... the coordinating mechanisms that are involved in university settings. - 2 We have attached to this statement our brief comments on several other provisions of the bill, in order that you may have our views. Spinal cord injury centers The proposal to begin establishing a national chain of spinal cord injury centers is one of the most important steps we can take toward mastering this difficult problem which now afflicts an estimated 100,000 people in this country. Mr. Chairman, I know you are well aware that this is a devastating injury, involving a multiplicity of problems including a variety of medical, psychological, social and vocational concerns. To cope with this problem requires the skills of an interdisciplinary team physicians, physical therapists, occupational therapists, rehabilitation nurses, orthotic specialists, psychologists, social workers, counselors and others. Working together in a specially equipped facility, such a rehabilitation team usually can restore the patient suffering from spinal cord injury to an active and useful life. We have had some 18 years of experience in working with these patients at the Rehabilitation Institute of Chicago. As one of least 25 national spinal cord injury centers, well-placed geographically. - 3 They should be basically a high type of service-giving facility, capable of providing the concentration of medical specialties and allied rehabilitation staffs necessary for this kind of care. They also should be organized in such a way that they function closely with the state rehabilitation agency, hospitals, community agencies, emergency health services and others who are involved in the total problem of spinal cord injury. Because of this urgent need for service-oriented centers, we urge the committee to revise the language in Sec. 413 of the bill, to provide for centers which provide high-calibre and complete service; which conduct studies seeking improved ways of organizing and delivering their services; to develop new working relationships with emergency rescue organizations, general hospitals and other groups involved in early care of the patients; and with the maintenance of records and the issuance of periodic reports on their experience which will provide us with a steady flow of information on which to base future planning. In addition, Mr. Chairman, we would like to see Sec. 413 provide for the Secretary of the Department of Health, Education and Welfare to conduct a one-year study of how the costs of spinal cord injury care itation from the moment of injury to the completion of rehabil are being met. Such a study could lay the foundation for seeing that cord injury costs are paid from the many health insurance and compensation programs which already exist. If this happens, it will not be necessary for us to come to the Congress every year for increasingly large sums of money to pay for this very expensive form of medical and rehabilitative care. - 4 If Sec. 413 is amended to provide this kind of chain of service facilities, it then will be possible to align plans for spinal cord injury research with other major research efforts in rehabilitation, which I would like to discuss with you now. Research and Training The total effect of H. R. 8395 is to build a base for the growth of public and private rehabilitation programs. If this is done, it will become possible to more nearly meet the needs of the immense number of seriously disabled people in this country. However, two factors will largely control both the amount and the effectiveness of our rehabilitation services. These are our research programs and our programs to train more rehabilitation personnel. If either lags, our service effort is certain to bog down. The present bill largely ignores both. The provisions for research and training do not even appear in the Table of Contents and they are completely inadequate for the set of programs set forth in the rest of the bill1. Mr. Chairman, we urgently request the committee to write a new title making provision for strenthened programs of research and training in rehabilitation. Such a separate title could set forth the research provisions as Part A and the training provisions as Part B. We feel the present law is very much out of date with respect to research and we hope the committee will write new language. The law should provide ...... general research grant authority, to aid and encourage individual investigators, and - 5 authority for certain major research support fields where the need is well known. Of these latter special fields, we propose that the research title make specific provision for (1) grants for research in spinal cord injury including support of Spinal Cord Injury Research Centers (2) Grants for rehabilitation engineering research including support of such research centers (3) grants for Rehabilitation Research and Training Centers, and (4) support of rehabilitation research abroad. We hope that new language will be prepared for the conduct of the rehabilitation training program. After many years of successful experience with this program, we now need a new basis which reflects this experience and which deals with the problems which we and so many others have encountered in the last few years. It is imperative that we start producing more trained physicians, therapists, counselors and others to staff these programs we are discussing here today. A new Federal law for the training program is an essential first step. At the Rehabilitation Institute of Chicago and elsewhere, this important training program has experienced serious probelms in the Federal financing during the past two years. We hope, to the extent this Committee can deal with the problem, that the new law will encourage growth and stability for all the professional fields which are essential to the rehabilitation process. We are especially anxious to have this expression of Congressional intent for a very practical reason. With the help of the Congress and the Department of HEW, we are now building a large new Rehabilitation Institute of Chicago, which will function as a part of the Northwestern University |