Statement of—Continued Kuykendall, Hon. Dan, a Representative in Congress from the State Page 147 185 Lee, Dr. Philip R., Assistant Secretary for Health and Scientific Affairs, Department of Health, Education, and Welfare. Likoff, Dr. William, immediate past president, American College of Lookout, F. Morris, industrial representative, Tulsa (Okla.) Council Marston, Dr. Ralph Q., Director, Division of Regional Medical Pro- grams, Department of Health, Education, and Welfare.. Millikan, Dr. Clark, chairman, Council on Cerebrovascular Disease, Moore, William, executive director, National Council on Alcoholism, Nelligan, William D., executive director, American College of Cardi- 161 238 Price, Rev. Thomas E., director, Department of Alcohol Problems and Drug Abuse, General Board of Social Concerns of the Methodist Ruhe, Dr. William, director, Division of Medical Education, American Schnibbee, Harry C., executive director, National Association of State 271 Shoemaker, Richard, assistant director, Social Security Department, American Federation of Labor and Congress of Industrial Organiza- Sibery, D. Eugene, executive director, Greater Detroit Area Hospital 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.. Snyder, Phyllis K., executive director, Chicago Alcoholic Treatment Southworth, Louis S., assistant supervisor, Division of Alcoholism, 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 .. Works, Rev. David A., executive vice president, North Conway Yolles, Dr. Stanley F., Director, National Institute of Mental Health, Department of Health, Education, and Welfare. Additional information submitted for the record by- Alcoholic Recovery Homes Association, San Francisco, Calif., tele- gram from Allen Skinner, chairman.. Alcoholism Council of Palm Beach County (Fla.), letter from Richard American Dental Association, letter from John B. Wilson, chairman, American Hospital Association, letter from Kenneth Williamson, American Medical Association, letter dated April 3, 1968, re need for halfway houses, under title III of H.R. 15758 American Nurses' Association, Inc., statement of Judith G. Whitaker, American Psychiatric Association, statement of Dr. Walter Barton, California Committee on Regional Medical Programs, statement of 171 Gateway Council on Alcoholism, letter from Steve Clark, chairman. 304 Geis, Dr. Gilbert, professor of sociology, California State College, 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 Hampton, Dr. H. Phillip, Tampa, Fla., letter- 304 303 Health, Education, and Welfare, Department of: Criteria for the evaluation of regional medical programs, state- Effectiveness of regional medical programs, statement on. 84 119 Extent of "homeless alcoholic” problem, statement on. Hospital administrators participating in regional medical pro- Involvement of the Kansas City General Hospital in the Missouri regional medical program, statement on Migrant health program status, March 1968, statement on. Migrant health projects assisted by Public Health Service grants, Migrant hospitalization, statement on - Operational projects affecting rural areas, statement on. Patient care costs supported with regional medical program grant Professional involvement in regional medical programs, statement Public Health Service report on 12 operating regional medical Television, radio, and telephone networks for continuing Regional medical programs, progress report, for heart disease, 13 problems of the inner city, statement on.. Status of regional medical programs, statement on.- Table 1.- Participation in regional medical programs by in- Table II.—Regional medical programs, total obligation of funds, Howard University Community Mental Health Center: Career development and related training and education for per- sonnel in the mental health program. Participation of subprofessional aides in rehabilitation treatment 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 Matsunaga, Hon. Spark M., a Representative in Congress from the 298 Missouri regional medical program, organization and goals. National Consumers League, statement. National Council on Alcoholism, Inc., supplemental statement reply- ing to questions posed by Congressman Rogers --- Appendix A-Estimates of alcoholics with and without compli- cations, 1960, by States, and rates per 100,000 adult population Appendix B-"Model” halfway house. 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.. Seattle (Wash.) Mental Health Institute, statement of Myron Kowals, Smithers Foundation, The Christopher D., letter from R. Brinkley 73 Additional information submitted for the record by-Continued Budget and personnel, Dec. 1, 1967-Nov. 30, 1968.. Preliminary evaluation report-- Dr. M. Mitchell-Bateman, director. 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, 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 |