All I can say is, if it doesn't turn out to be successful on a cost-benefit basis, then I think we just have to look at it in terms of subsidizing people who work. I have thought a great deal about that. You will remember last year you asked for that study on the manpower development. Such a report was made to your committee. At some point when the Finance Committee and the Ways and Means Committee. is again reexamining the legislative base, I think you should consider proposals for some type of subsidized work program for marginal people who don't have the ability to really earn a minimum wage.

Mr. MICHEL. But still with enough incentive to do something? Mr. COHEN. Right. I think if a person is willing to work-and the evidence seems that more of them are willing to work than have opportunities-you are going to have to put more money in the program. That is really what Mr. Mills on the Ways and Means Committee decided when he wrote the WIN program into law. He said he was willing to spend more money on providing day care centers, to put the children into the day care centers so the mother could get training, if even for several years it didn't result in a single penny reduction in welfare, and I agree with him. I think that is one way of overcoming the cultural disadvantage of the young child and giving the mother an opportunity to work and perform and have a sense of achievement and motivation.

I also regret the cut of $64.3 million in vocational rehabilitation. I do not know the reduction in the number of persons who would be rehabilitated by this cut. I urge you to evaluate the cost-benefit effects before making a decision on this item. You might wish to restore some of the cut.

I do this because, as you have always said, every person you rehabilitate turns much more back in the taxes. This can seriously reduce the number of people who have to be rehabilitated. I think it has the highest cost-benefit of almost any program.

I support the $5 million added for innovative approaches on income maintenance.

In the next 5 years I think we are going to make definite changes in our income maintenance programs and you really need more information on which way to go.

I support the requests made by President Nixon for civil rights assistance to school districts, $6 million; nutrition, $4 million; and aid to medical schools, $5 million. I do not favor his eliminaton of Federal payments for mentally ill patients in State and local institutions after 120 days under medicaid without further discussion with the States as to how to handle this problem without adverse impact on the mentally ill. Nor do I favor the reduction of about $9 to $10 million in mental health activities.

That item is estimated at $126 million in the budget and I could not believe it when I read that in the budget, that that was a correct estimate of that proposal. If it is, I am appalled and it even underscores my point that that would really mean pouring $126 million more on the States. I still don't know whether that estimate is correct. The first thing I think I'd ask you to do is to reexamine that estimate. There are requirements in the law for the States to reexamine people who are mentally ill, but with the State budgets already fixed if you were to deduct this $126 million immediately, I just, in my own heart,

don't know what the effect would be on these mentally ill people. I don't know where the States would get the money. I don't know whether they would kick them out. I just don't know whether they would make the families take them. There is just nothing in the material that I have that gives me enough idea of what is going to happen to them and I ask you to reexamine it.

Mr. MICHEL. Our State mental health people from Illinois were out to see me yesterday on that very subject. While we didn't have the time to go into it sufficiently to find out what the alternatives might be, in our home State

Mr. COHEN. There are a lot of provisions that were written in the 1967 amendments on how you handle the mentally ill. I think they are very excellent provisions. If the States are not abiding by them, they should, because I think there are a lot of people in mental hospitals who don't need to be in mental hospitals. The community mental health centers which you supported are an attempt to get them out of institutions and back in the diagnostic and outpatient care. I think a lot more of that can be done. But I don't think you can do it that fast. You have to bring the States into the planning of it. I think this will play havoc with the States in their treatment of the mentally ill. There may be a plan that I haven't seen, but I know the States are quite upset about it.

I don't favor the reduction of $10,712,000 in certain of the mental health activities-I guess it comes mostly in NIMH-even though there is a $1,379,000 increase in direct operations for mental health. I don't know what the $1,370,000 is intended to do in the budget, but I think it is very unfortunate to cut that $10 million including some cutback in the community mental health centers when this is one of the highest cost-benefit programs that you have got in the whole department.

I would really like you to put in the record what I think is one of the-here is the whole plan that I developed with our people on what would happen on mental health. You can see that line-indicatingup until 1956 it was the growth of people in mental hospitals, and what would have happened if, by population growth, it would continue.

Here is what is happening now. If you continue to fund the community mental health program, the plan is by 1976 to get down to 76.000 instead of the 859,000 that would have been in State mental hospitals. If you are interested in shared revenue with the States, the best thing you can do is to improve the mental health program and take this mental health cost off the States, which is what you are doing. I consider this one of the most significant programs to help not only the financing of the States and localities which now bear this almost exclusively, but to do more for, you know, mentally ill people and their families.

That, to me, is a very, very important part.

Mr. FLOOD. We have been discussing this at some length. It would be interesting to have this in the record.

(The charts follow:)

DECLINE IN MENTAL HOSPITAL PATIENTS BY 1976

Goal No. 7 under "Health" calls for the "elimination of large State mental hospitals and the expansion of community mental health centers accessible to all." The patient population of State mental hospitals has been declining since 1955, due largely to the advent of new drugs and new treatment procedures. This trend has been accelerated since 1963 when the Community Mental Health Centers Construction Act was adopted. This act provided funds and encouragement for the construction of community mental health centers and for the development of comprehensive community mental health services. Services include diagnosis of mental illness, preventive measures, care and treatment of mentally ill persons, and rehabilitation of persons recovering from mental illness.

The location of mental health centers at the community level helps to make preventive and treatment services more accessible. It also enables many persons receiving mental health services to remain with their families and to live as normal lives as possible.

New knowledge is providing a better understanding of the causes and methods of preventing mental illness. The expansion in the number of mental health centers in the years ahead, until the entire population is served, should help bring the latest professional services to all people needing them.

Present program projections suggest that the number of resident patients in State mental hospitals will continue to decline, reaching a level of about 76,000 by 1976. A somewhat larger effort offers the possibility of reducing the number to 50,000 or less by that year.

Mr. FLOOD. We have discussed this with several witnesses, but I haven't seen any chart quite as graphic as this is.

Mr. COHEN. You can't get the results unless you fund these community mental health centers.

I think that is a very important point.

I hope you could find a way to restore some of the grants for purchase of public library books and materials.

I urge you to appropriate the full amount requested for departmental management-$35.1 million exclusive of payments to the Corporation for Public Broadcasting.

In order for the Secretary to have the effective ability to supervise programs, evaluate proposals, review budget and legislative proposals, he must have more help directly responsive to his immediate needs and not oriented to a particular program. I originally submitted to the Bureau of the Budget a request for $38 million, which I believe is eminently justified. I would be pleased, if you found it possible, to give Secretary Finch this amount. He will need it to carry out the responsibilities which the Congress and the President have placed upon him.

I also urge you to include the amounts requested for evaluation of programs. My experience convinced me of the value of this activity in determining priorities, making budget changes, and making legislative proposals. It is worth every dollar appropriated.

The personnel ceilings in existing law are, in my opinion, seriously impairing the performance of HEW programs. I strongly recommend repeal of the existing limitations.

As a matter of fact, I really think that with the existing personnel limitations of social security, you are wasting money, because since you have personnel ceilings you are forced to go to overtime, you pay more for overtime, you are working the people to death. There are 25 million checks that have to be paid every month, and if you don't remove those personnel ceilings on social security pretty soon, you may hear from your constituents about delays in payments and errors from the payment centers and I urge you strongly, on both social security and NIH, to eliminate those personnel ceilings.

I wholeheartedly endorse Secretary Finch's policy that it would be unwise and tragic for the Federal Government to interfere in the internal administration of educational institutions.

I believe existing Federal, State, and local laws are adequate to take care of the situation. I favor repeal of the existing amendments to the appropriation and education laws which are discriminatory, ineffective, and inappropriate. I urge you to include in the Office of Education funds to staff a small mediation center to assist educational institutions in dealing with student unrest which, in my opinion, is not likely to terminate under present circumstances.

Mr. MICHEL. That vast majority of students who don't kick up a fuss in the universities, but find themselves deprived and denied the opportunity to pursue their education, aren't they being denied their civil rights?

Mr. COHEN. Yes, sir; and I would apply the Civil Rights Act of 1968, which already is on the statute books, and gives the Department of Justice authority to protect the rights of the student whose civil rights are interfered with. I would prefer to use that as a legal basis than to create any more legislation in either the education or Appropriation Act.

Mr. MICHEL. This is a point I personally have been making, and I think we ought to be stressing it more.

Mr. COHEN. I do, too.

Mr. MICHEL. If I were a student on campus so denied, I would surely file a suit myself.

Mr. COHEN. I haven't looked up the statute myself. I think it is a criminal statute; isn't it?

Mr. MICHEL. Yes.

Mr. COHEN. I think if the Department of Justice used that a couple of times it would have a very salutary effect. I think it is likely to be much more appropriate and effective than either what you have in 411 or 412 of the 1969 Appropriation Act, or section 504 of the Higher Education Act.

I just want to say this to you as my own intuition. I think that next year the situation in the colleges and universities will be as bad or worse than this year.

Mr. MICHEL. Why do you say that?

Mr. COHEN. I say that because there are still a lot of institutions that have not changed any of their present policies. What you have in this present situation as a result of television and newspapers is a kind of situation in which the students at the next institution are going to follow what was done at another one. I am convinced it is a very small minority and they feel very strongly and I think that we may be in for a tough time next year. College officials are apprehensive. I think they have learned a lot this year. I think all of them have learned a lot.

Mr. MICHEL. What do you do about the situation among the professors themselves, who can't get their own way with the "establishment" so-called, and join in with the students as a means of expressing their own dissension? Obviously a president is handicapped if he doesn't have the full support of his faculty. What has happened in many cases is that the faculty members themselves have been the promoters of the unrest.