retary level being somewhat removed from the day-to-day operational activities of the constituent agencies like PHS. However, if the Federal government were to rely solely upon this type of approach to administering Civil Rights compliance, the Federal Government would miss completely the real spirit and intent of the Civil Rights Act of 1964, because it is not through the "enforcement" approach but rather through the "voluntary compliance" approach that meaningful progress has been achieved in the nation in eliminating discrimination by institutions receiving Federal funds. It is this latter approach that can be effectively carried out only by operating agencies who with their specialized competancies and understanding of the intricate and complex functioning of, in this case, health institutions can through persuasion and negotiation elicit the changes that are so necessary, and yet sometimes so complex to obtain. It is through voluntary compliance that federally-supported health programs can continue and be made available to minority group members. It is not through arbitrary "enforcement" action that minority group members in this country are benefited since often federal funds would be required by law to be discontinued. In summary, centralization of Civil Rights functions in HEW will tend to overemphasize "enforcement" action and deemphasize and make ineffective "voluntary compliance" action overemphasis will be placed on the discontinuation of Federal programs. This will be repugnant to both health institutions across the land who are interested in providing quality health care services, and to members of minority groups who may not now receive adequate health services and who should continue not to receive these services, under an "enforcement" type of activity; but who would stand the chance to receive these services as recipients or participants, should "voluntary compliance" activity be preserved in HEW. A common argument often given to support the centralization of funding and functioning of a program is that it is more economical since through centralization one is able to eliminate duplication of functions and maximize the utilization of available resources, does not hold for the Civil Rights Program in HEW. During the past year there has been a clear definition of activities at the Office of the Secretary and constituent agency levels. The role of each has been entirely different so that there has been no duplication in functions to my knowledge, that could be eliminated through centralization. What one accomplishes then, through centralization, is the buying of a "new product" described above. While the very nature of constituent agency programming is conducive to the elicitation of "voluntary compilance", the existing and traditional role of HEW Office of the Secretary activities runs counter to successfully managing this type of program. The Office of the Secretary is basically geared to provide staff support and overall program guidance to constituent agencies. It is not equipped to become involved in day-to-day operational matters by virtues of its organizational structure and administrative support arrangements. It is more of a planning and evaluation role which is extremely slow moving and unresponsive to day-to-day operational needs which are inherently a part of any operational program. If one wished to place HEW in a position of inability to effectively administer the Civil Rights Act, then one would without question centralize Civil Rights activities of the Department, in the Office of the Secretary. The common belief seems to be that HEW is moving too rapidly in implementing the Civil Right Act which is now almost three years old. While this issue can be debated at length, I do not believe that the approach HEW has taken in implementing the Act can be seriously questioned. HEW has bent over backwards to work with and assist State and local governments and other recipients of Federal programs, to bring them into compliance prior to the initiation of enforcement action. The advocates of the "go slow" approach would bring about the very situation to which they are so opposed. Arbitrary enforcement action involving the cutoff of Federal assistance to non-complying institutions, which is required by law and which represents the only avenue of approach for the Executive Branch, when dollar and staff resources are so minimized as to prevent the kinds and amounts of technical assistance needed to elicit "voluntary compliance". Therefore, both the attempt to centralize Civil Rights functions in HEW and the attempt to minimize the amount of resources appropriated for this effort, tend to force HEW into the awkward position of arbitrarily cutting off Federal assistance if the Civil Rights Act of 1964 is to be administered in accordance with the alleged wishes of Congress. I therefore cannot recommend, too strongly the maintenance of a decentralized Civil Rights program in HEW. The progress that has been made in the past several years, which has been humane and reasonable, for all parties concerned has proven to be a successful approach to a very difficult and complex problem. I feel certain that the proposals to change these operational policies are being made in ignorance of the real situation within HEW and will result in inhibiting future progress towards civil rights compliance. I can think of no greater threat to the progress made to date than the recent action of your House subcommittee and I strongly urge that this entire matter be reconsidered without delay. JOHN L. S. HOLLOMAN, Jr., M.D., President, National Medical Association. QUENTIN YOUNG, M.D., National Chairman, Medical Committee for Human Rights. The preceding statement is after the fact, in the light of the published announcement of the centralization of Civil Rights Activities in HEW in the Office of the Secretary. I submit it for the record. The budgetary request made for Fiscal Year 1968 for departmental Civil Rights activities should be appropriated in full. In terms of the re-organization and the enormity of the job which will have to be done, I would earnestly hope that additional funds with some type of budgetary freedom built-in, would also be allocated. In Fiscal Year 1967, 278 positions and $3,434,000 were allocated for Title VI activities. In Fiscal Year 1968, 409 positions and $5,434,000 have been requested. I wish to reiterate: this request should be met. The necessity for more personnel to carry out compliance review seems obvious. The work which must be done cannot possibly be accomplished with a limited staff and resources. We cannot escape the interpretation that the move to centralize is a means and way to defeat Civil Rights. If there is no increase in positions or funds over last year's budget, this would seem prima facie evidence that the Subcommittee has rendered Title VI null and void. There is nothing else that we can deduce from this course of action. A decrease in funds and personnel will weaken policy in terms of substance and the ability to enforce policy. The public in general, and the minority groups in particular, are more sophisticated than they are given credit for. Health professionals and paraprofessionals know that an "arrangement" or "swap" is being contemplated, in fact, has been made. Equal opportunities in education and health are to be bartered for the passage of current primary and secondary education bills. I urgently request that the Subcommittee consider the implications which their action will convey to civil rights leadership and to the minority grassroots. The term "sell-out" is a strong one, but it is much in use these days. JOHN L. S. HOLLOMAN, President, National Medical Association. QUENTIN YOUNG, M.D., National Chairman, Medical Committee for Human Rights. PROGRAMS FOR HANDICAPPED CHILDREN STATEMENT OF CHARLES W. WURTH, EXECUTIVE DIRECTOR, INSTITUTE OF LOGOPEDICS Mr. WURTH. Mr. Chairman, I am Charles W. Wurth, Executive Director of the Institute of Logopedics in Wichita, Kansas. For many years the late Dr. Martin F. Palmer, founder of the Institute, appeared to testify before your Subcommittee. I have been a member of the Institute staff for 16 years and following Dr. Palmer's death on August 13, 1965, I was afforded the opportunity of becoming Executive Director. Today I submit this statement in behalf of the National Board of Trustees and Staff of the Institute of Logopedics. As you may know, the Institute of Logopedics has been keenly interested in the programs advanced by the Congress during the past several years in behalf of handicapped children. The Institute would again ask your indulgence in carefully reviewing the appropriations for the current fiscal year as well as the monies to be made available for fiscal year 1968. Funds supporting Title VI, as related to Handicapped Chil dren and Youth under Public Law 89-10, were certainly appreciated this year as they can be used for good planning for the remaining months available. However, we understand that the Administration has requested only $15 million for next year for Title VI programs although the Congress authorized $150,000,000 for this purpose. This is a scant ten percent of the authorized amount. We can hardly feel that this is sufficient when our best figures indicate that only 50 percent of handicapped children are receiving appropriate educational and related services such as speech and hearing. The announcement last year of $150 million was greeted with joy and anticipation by all professional people working in this area, as it provided a source for real progress in meeting the needs of these people. The current request of only $15 million is a bitter disappointment. It is obvious that we cannot accomplish what needs to be done with such a minimal appropriation. In regards to the traning of teachers, which is a most serious responsibility and is of national concern, over $50 million in training funds were requested by approved traning facilities. This current fiscal year some $24.5 million has been made available for this purpose. This is a commendable sum for fiscal year 1967. Again though, only $24.5 million has been requested for fiscal year 1968, after $34 million was authorized last year for fiscal year 1968. All of us realize that these are serious and trying times and that monies must be made available for our many commitments around the world. We cannot, though, it would seem to us, minimize our responsibilities in this area during these times. Mr. Chairman and members of the Subcommittee, the National Board of Trustees and Staff of the Institute join me in requesting your continued support in seeing that sufficient funds are provided for this purpose. Thank you very much. De Bakey, Dr. M. E_ Desmond, Miss Ruth_ Fuller, Edgar. Farber, Dr. Sidney. Flynt, Hon. J. J__ Geer, W. C.. Gibson, Dr. Robert_. Gorman, Mike.. Greene, H. S....... Hamer, Mrs. E. E Harrell, Dr. G. T. Harris, Dr. William_. Hubbard, Dr. W. N. |