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Statement of—Continued

Kuykendall, Hon. Dan, a Representative in Congress from the State Page
of Tennessee

147
Larsen, Bernard, former member, board of directors, North American
Association of Alcoholism Programs..

185

Lee, Dr. Philip R., Assistant Secretary for Health and Scientific

Affairs, Department of Health, Education, and Welfare.

9

Likoff, Dr. William, immediate past president, American College of

Cardiology

161

Lookout, F. Morris, industrial representative, Tulsa (Okla.) Council

on Alcoholism.

258

Marston, Dr. Ralph Q., Director, Division of Regional Medical Pro-

grams, Department of Health, Education, and Welfare..

9

Millikan, Dr. Clark, chairman, Council on Cerebrovascular Disease,

American Heart Association..

163

Moore, William, executive director, National Council on Alcoholism,

Inc.

211

Nelligan, William D., executive director, American College of Cardi-
ology -

161
Pittman, David J., director, Social Science Institute, and professor
of sociology, Washington University, St. Louis, Mo.

238

Price, Rev. Thomas E., director, Department of Alcohol Problems

and Drug Abuse, General Board of Social Concerns of the Methodist

Church.

174, 181

Ruhe, Dr. William, director, Division of Medical Education, American

Medical Association...

147

Schnibbee, Harry C., executive director, National Association of State
Mental Health Program Directors -

271

Shoemaker, Richard, assistant director, Social Security Department,

American Federation of Labor and Congress of Industrial Organiza-

tions (AFL-CIO)---

231

Sibery, D. Eugene, executive director, Greater Detroit Area Hospital

Council.

218

Smith, Hon. Hulett C., Governor of the State of West Virginia, pre-

sented by Louis S. Southworth, assistant supervisor, Division of

Alcoholism, West Virginia Department of Mental Health..

205

Snyder, Phyllis K., executive director, Chicago Alcoholic Treatment

Center

131

Southworth, Louis S., assistant supervisor, Division of Alcoholism,
West Virginia Department of Mental Health --

205

Stark, Nathan J., chairman, Missouri regional medical program. 193

Tuerk, Dr. Isador, commissioner, Maryland State Department of

Mental Hygiene, representing the National Association of State

Mental Health Program Directors ..

271

Works, Rev. David A., executive vice president, North Conway

Institute, Boston, Mass.

174

Yolles, Dr. Stanley F., Director, National Institute of Mental Health,

Department of Health, Education, and Welfare.

9

Additional information submitted for the record by-

Alcoholic Recovery Homes Association, San Francisco, Calif., tele-

gram from Allen Skinner, chairman..

298

Alcoholism Council of Palm Beach County (Fla.), letter from Richard

A. Conlin, chairman..

304

American Dental Association, letter from John B. Wilson, chairman,

council on legislation --

303

American Hospital Association, letter from Kenneth Williamson,

associate director

299

American Medical Association, letter dated April 3, 1968, re need for

halfway houses, under title III of H.R. 15758

158

American Nurses' Association, Inc., statement of Judith G. Whitaker,

executive director..

296

American Psychiatric Association, statement of Dr. Walter Barton,

medical director...

289

California Committee on Regional Medical Programs, statement of
Dr. Lester Breslow.

171

Gateway Council on Alcoholism, letter from Steve Clark, chairman. 304

Geis, Dr. Gilbert, professor of sociology, California State College,

statement..

290

Additional information submitted for the record by-Continued

Greater Detroit (Mich.) Area Hospital Council, article from the

Journal of the American Hospital Association, December 1967,

entitled “Hospitals and Regional Medical Programs: A Plea for Page

Coordinated Action”,

222

Hampton, Dr. H. Phillip, Tampa, Fla., letter-

304
Hawaii, University of, School of Medicine, letter from Dr. Windsor C.
Cutting, dean.

303

Health, Education, and Welfare, Department of:

Criteria for the evaluation of regional medical programs, state-

ment on

86

Effectiveness of regional medical programs, statement on.

84
Estimated new obligation authority required under H.R. 15758
for fiscal years 1969–77 (table) -

119

Extent of "homeless alcoholic” problem, statement on.

121

Hospital administrators participating in regional medical pro-

grams, statement on..

62

Involvement of the Kansas City General Hospital in the Missouri

regional medical program, statement on

85

Migrant health program status, March 1968, statement on.

Migrant health projects assisted by Public Health Service grants,

a directory of

88

Migrant hospitalization, statement on -

115

Operational projects affecting rural areas, statement on.

76

Patient care costs supported with regional medical program grant

funds.

65

Professional involvement in regional medical programs, statement

64

Public Health Service report on 12 operating regional medical

programs.

46

Television, radio, and telephone networks for continuing

education.

61

Regional medical programs, progress report, for heart disease,
cancer, stroke, and related diseases.

13
Regional medical program efforts directed against the health

problems of the inner city, statement on..

Status of regional medical programs, statement on.-

66-72

Table 1.- Participation in regional medical programs by in-

dividuals and organizations.

33

Table II.—Regional medical programs, total obligation of funds,

fiscal years 1966–69.-

31

Howard University Community Mental Health Center:

Career development and related training and education for per-

sonnel in the mental health program.

279

Participation of subprofessional aides in rehabilitation treatment

programs

281

Illinois Department of Mental Health, letter dated April 1, 1968,

with attachments, replying to Congressman Rogers' request for

additional information re Illinois general hospital detoxification

program..

264

Matsunaga, Hon. Spark M., a Representative in Congress from the
State of Hawaii, letter-

298

Missouri regional medical program, organization and goals.

195

National Consumers League, statement.

297

National Council on Alcoholism, Inc., supplemental statement reply-

ing to questions posed by Congressman Rogers ---

213

Appendix A-Estimates of alcoholics with and without compli-

cations, 1960, by States, and rates per 100,000 adult population

(table)

216

Appendix B-"Model” halfway house.

216

National Council on Alcoholism, Monterey Peninsula area, Monterey

County, Calif., telegram from George E. Ridgway, president... 298

National Tuberculosis and Respiratory Disease Association, letter

from James E. Perkins, managing director..

301

Seattle (Wash.) Mental Health Institute, statement of Myron Kowals,

assistant director.

297

Smithers Foundation, The Christopher D., letter from R. Brinkley

Smithers, president..

303

73

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Additional information submitted for the record by-Continued
Washington University (St. Louis, Mo.) Social Science Institute:
St. Louis detoxification diagnostic and evaluation center-

Budget and personnel, Dec. 1, 1967-Nov. 30, 1968..

Preliminary evaluation report--
West Virginia Department of Mental Health:
Statement of-

Dr. M. Mitchell-Bateman, director.
Donald R. Dancy, supervisor, division of alcoholism.

Page 243 250

206 206

REGIONAL MEDICAL PROGRAMS; ALCOHOLICS AND

NARCOTICS ADDICTS FACILITIES; HEALTH SERVICES FOR DOMESTIC AGRICULTURAL MIGRATORY WORKERS

TUESDAY, MARCH 26, 1968

HOUSE OF REPRESENTATIVES,
SUBCOMMITTEE ON PUBLIC HEALTH AND WELFARE,
COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

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. KYROS (presiding). The subcommittee will please be in order.

The hearings today are on H.R. 15758, introduced by Chairman Staggers at the request of the administration.

This bill would extend and expand the existing authorizations for regional medical programs, would extend the program of health services for domestic agricultural migratory workers, and would provide matching grants for construction and staffing of facilities for prevention of alcoholism addiction and for treatment of alcoholics and narcotic addicts.

REGIONAL MEDICAL PROGRAMS

In 1965, the Congress considered legislation proposing the establishment of regional medical programs designed to improve the health care of the American people in the fields of heart disease, cancer, stroke and related diseases. The Congress made substantial revisions in the proposed program, providing in general for a maximum of decentralization of the decisionmaking process and encouraging the maximum feasible cooperation between public and private groups interested in the health of the American people.

It is impossible to give a simple description of a regional medical program since every program established is different, with each program tailored specifically to the needs of the region served.

Over 90 percent of the population of the United States is or will be covered by regional medical programs established on the local level either on an operational basis today or through programs currently in the planning stage. Eventually, 100 percent of our population will be covered by these programs.

Many fears and reservations were expressed at the time the Congress was considering the initial legislation. It is my understanding, however, that many of the groups which had reservations about the initial proposals have since modified their positions, in large measure

(1)

because of the modifications that were made in the program by the Congress and the manner in which the program has been administered to date.

As I understand the bill presented to us, no major changes are proposed. The principal purpose of the legislation is to extend the program beyond its scheduled expiration date of June 30 this year, with minor improvements that experience has shown to be necessary or desirable.

In regard to the section on domestic agricultural migratory workers, the bill also proposes to extend for two additional years the existing program of Federal grants for health services to domestic agricultural migratory workers. The existing program is also scheduled to expire June 30 this

year, so extension is essential at this time if these workers, who are among the neediest today, are to continue to receive the services they need.

ALCOHOLIC AND NARCOTICS ADDICTS

Title II of this bill would establish a program designed to provide assistance in the treatment and rehabilitation of alcoholic and narcotic addicts. The program proposed is an extension of the principles already embodied in the community mental health centers and mental retardation facilities acts approved by this committee in 1963. The bill provides matching grants for construction and operation of facilities which are part of a complex providing essential elements of comprehensive mental health services in order to provide services for the prevention and treatment of alcoholism.

Grants are also authorized for construction and operation of special residential and other facilities for treatment of homeless alcoholics; grants for construction and operation of facilities for prevention and treatment of narcotic addiction; and grants for training and evaluation relating to the prevention and treatment of narcotic addiction.

There are a substantial number of witnesses who have requested the opportunity to be heard on this legislation, which is indicative of the broad public response to the needs which will be served by the enactment of this bill.

We hope to be able to expedite these hearings in order that the legislation may reach the President's desk at the earliest possible date in view of the relatively brief time remaining before two of the programs contained in the bill are scheduled to expire.

The bill under consideration, and agency reports on the bill, will be included in the record at this point.

(The bill, H.R. 15758, and departmental reports thereon, follow :)

[H.R. 15758, 90th Cong., second sess.) A BILL To amend the Public Health Service Act so as to extend and improve the provisions

relating to regional medical programs, to extend the authorization of grants for health of migratory agricultural workers, to provide for specialized facilities for alcoholics and narcotic addicts, and for other purposes

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

TITLE I-REGIONAL MEDICAL PROGRAMS

EXTENSION OF REGIONAL MEDICAL PROGRAMS

SEC. 101. Section 901(a) of the Public Health Service Act (42 U.S.C. 299a) is amended by striking out "and" before “$200,000,000” and by inserting after

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