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attained small amounts, relatively small amounts of funds in order to find the personnel, provided the personnel that we needed to enable us to be involved effectively in this program, but I don't think, Mr. Kyros, that these criticisms are at the moment very serious.

Mr. KYROS. In the State of Maine, I have been told by doctors that one of the valuable benefits of this program is that in a State where you don't have a medical school, as in Maine and I imagine there are other States in the United States that don't have a medical schoolyou serve an educational function by disseminating vital and current information to doctors who normally would not have that kind of information.

Dr. CHAPMAN. Yes, sir; and many of us who are deans regard many of the most important aspects of this activity to be the continuation education feature for physicians, and in our own northern tier of States, Mr. Kyros—of course, we represent three regions there, Maine and Vermont are separate regions, and Maine is tied in with New Hampshire.

We are meeting regularly with the Maine and the Vermont regional medical program officials, and one of the main things is this: the continuation of medical education.

Mr. Kyros. On page 4, you talk about the desire, perhaps, in the act to obtain a more definitive organizational guideline and to reconsider critically the geographic structure of the various regions. What specifically are you suggesting ?

Dr. CHAPMAN. New England is a good case in point. As you well know, sir, New England for a long time was been working itself as a region with the northern tier of States focusing for many purposes on Boston, and to some extent on Montreal and Albany as well.

Our present regional structure will undoubtedly have to undergo modification. In fact, I would say it already is in a functional sense. The northern tier of States is a similar region in terms of population, climate, geography, and medical health problems.

Mr. KYROS. On page 4 again, you say cooperation between lay and professional groups in designing such methods—that is, of getting the latest advances in diagnosis and treatment translated into action for the patient have been most impressive, but the balance has not been invariably ideal. What does that mean?

Dr. CHAPMAN. I think it is a matter of groups that have never really worked together before are now having to do so, and as I said earlier, I think, in the State, some such difficulty was inevitable and indeed predictable.

In our own area, the balance is coming around very nicely, as I see the operating in the advisory group, which has brought together people who had certainly never approached any serious proposals together jointly.

Mr. Kyros. Do I understand your testimony this morning to be entirely in favor of the program that is set forth in the act before us today?

Dr. CHAPMAN. Yes, sir. We would consider it very distressing indeed if it were not continued. It is at the point now where we will begin to obtain the critical information we need in order to bring forth a program that will really do the job, and will really carry out the intent of the original act.

Mr. KYROS. Are you satisfied with the $65 million provided for fiscal 1969?

Dr. CHAPMAN. I am really in no position to speak to that. I believe under the circumstances it will take us the next step.

Mr. Kyros. Dr. Elam, I understand your multiphasic screening turned up uterine cancer in patients that would not otherwise hare been found. Will that be continued ?

Dr. Elam. Yes, sir; and the results of the screening will be sent to a doctor in the anticipation of turning up such things.

Mr. KYROS. Thank you.
Mr. ROGERS. Dr. Carter ?
Dr. CARTER. No questions.

Mr. ROGERS. It has been helpful to have your testimony, and we appreciate your sharing your knowledge with the committee. I hope that you will let us have your suggestion for any improvement that you think the program should undertake. Particularly I am concerned about bringing in more hospital people. I think maybe this balance that you are talking about the people in the program, along with the medical people—I think it has got to involve more people, and I would like to get more details if you could submit that to us, on your examination program. I think this could be most helpful to the committee.

Dr. CHAPMAN. Thank you, Mr. Chairman.
Mr. ROGERS. Thank you.
The committee stands adjourned.

(Whereupon, at 12:30 p.m., the committee adjourned, to reconvene at 10 a.m., Wednesday, March 27, 1968.)





Washington, D.C.
The subcommittee met at 10 a.m., pursuant to notice, in room 2322,
Rayburn House Office Building, Hon. Paul G. Rogers presiding (Hon.
John Jarman, chairman).

Mr. ROGERS. The committee will be in order, please.

We will continue hearings on H.R. 15758, introduced by the chairman, Congressman Staggers of West Virginia, and our first witness today is the Honorable Richard Daley, mayor of Chicago, who cannot be with us, but whose statement will be read by Miss Phyllis Snyder, who is the executive director of Chicago's Alcoholic Treatment Center.

We are delighted to have you with us Miss Snyder, and we will be pleased to have you read the mayor's statement.

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Miss SNYDER. “Mr. Chairman, members of the committee, I welcome this opportunity to add my support, on behalf of the city of Chicago, for passage of title III, part A, of H.R. 15758, known as the Alcoholic Rehabilitation Act of 1968.

“We in Chicago have long recognized the need for an adequate program of alcoholism care and control. We are very proud of the fine work being done at Chicago's Alcoholic Treatment Center, a municipally supported facility providing inpatent care for 72 males and outpatient services to men and women. This facility has been operating since 1957.

“My commission on rehabilitation, comprised of 22 very able, dedicated, and knowledgeable citizens, has been studying the city's alcoholic problems and the needs to combat these problems since 1955. Our treatment center is a direct result of their recommendations.

“The studies of this commission have confirmed that it is not within our fiscal power to implement the kind of comprehensive program which is so necessary. Inasmuch as Chicago and Cook County have an estimated 250,000 alcoholics, more than one-half of the total alcoholics


in the State of Illinois, passage of title III, part A, of H.R. 15758 will be of significant help to us in Chicago.

“Enactment of legislation in this area is long overdue. The disease of alcoholism ranks among the foremost health problems of our society. Under present conditions, the primary burden of dealing with the more severe stages of alcoholism on the community level lies with law enforcement, rather than public health authorities.

: “This situation is as unrealistic as it is ineffective. Law-enforcement authorities, already burdened with increased responsibility in the area of crime control, are no better equipped to handle incidents of alcoholism than medical doctors to handle crime problems in the community. Several Federal, State, and local courts have already transferred responsibility for handling chronic alcoholic repeaters from law enforcement to public health agencies.

"The President's National and District of Columbia Crime Commission both recommended such a transfer in communities throughout the Nation, not only for sound humanitarian reasons, but to relieve lawenforcement authorities of an onerous, unproductive responsibility, a responsibility, I might add, which drains law-enforcement resources away from the real fight against crime and criminals taking place in the country today.

"The legislation being considered by the committee would therefore be extremely helpful to U.S. communities, especially major urban centers, which need assistance in the development and improvement of alcoholism care and treatment facilities and services.

“This is particularly true in light of the possible court decisions which would prohibit the criminal detention of chronic alcoholics on charges of public drunkenness. Action must be taken, and soon, to prepare communities for the task of effecting an orderly transfer of community responsibility for chronic alcoholism from law enforcement to public health hands.

The Alcoholic Rehabilitation Act of 1968 is therefore a vitally needed step toward alleviating one of the most serious urban health problems of our time. It will help the communities to help themselves in developing local programs to curb the incidence and prevalence of alcoholism in our society. And let us not forget that in addition to the humanitarian and administrative aspects of this legislation, it will also be a step toward reducing the economic impact of a disease costing American industry an estimated $2 billion annually in lost man-hours and work efficiency.

"In conclusion, then, our country urgently needs a comprehensive national program to deal with the health problem of chronic alcoholism. The Alcoholic Rehabilitation Act of 1968 represents the beginning of such a program. The administration is to be commended for proposing it, and Chairman Staggers for sponsoring it.

“On behalf of the city of Chicago, I sincerely hope that your committee will approve, the 90th Congress will pass, and the President will sign to law, this bill that will aid our States and communities in providing services for the care and control of a disease afflicting millions of American citizens.

"I thank you."

Mr. Rogers. Thank you very much, Miss Snyder, for this statement from Mayor Daley. We appreciate his testimony, and I think it might



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