COMMUNITY MENTAL HEALTH CENTERS

The community mental health center program will continue to move ahead. As you know, this program has played a very significant role in the continuing decline of the patient populations in the State mental hospitals. We estimate that all approved projects currently on hand will be funded in 1972. The 1973 appropriation of $135 million will continue these projects and provide $9 million for 22 new projects. The total number of centers receiving staffing grants will accordingly rise from 379 in 1972 to 401 in 1973.

PATIENTS IN STATE MENTAL HOSPITALS

Mr. FLOOD. Will you have the record show the patient population in State mental hospitals 10 years ago and as of today?

Secretary RICHARDSON. Yes, we will be glad to do that, Mr. Chairman. It is in dramatic decline nationally as you know. (The information follows:)

DECREASE IN RESIDENT PATIENT POPULATION

For several years now there has been a steady reduction in the number of patients residing in mental hospitals. This reduction is a measure of the effectiveness of the national mental health program. The resident patient population has decreased from 527,000 in 1961 to 308,000 in 1971-a decrease of almost 42 percent.

SPECIAL PROGRAMS FOR THE AGING

Secretary RICHARDSON. As the President promised at the White House Conference on Aging, the 1973 budget requests an appropriation of $100 million for the Administration on Aging, more than double the 1972 appropriation and nearly six times what was appropriated in 1971. The primary objective of this increase is the prevention of unnecessary institutionalization for the elderly. A concerted effort will be made through the State and local agencies for the aging to permit older Americans to continue to live self-sufficient, independent, and dignified lives in their own homes.

FAMILY PLANNING SERVICES

We are requesting an appropriation of $139 million for the center for Family Planning Services, an increase of $49 million over the 1972 appropriation. This level of funding will keep the Department on schedule in carrying out the President's commitment to provide, by 1975, family planning services to all women who want these services, but cannot afford them. The number of women served through the programs of the National Center and other programs which the Center coordinates will reach 3.4 million in 1973.

Mr. FLOOD. At this point will you show for the record the amount of funds involved for family planning service 10 years ago, 5 years ago, and as of today?

Secretary RICHARDSON. We will be glad to do that.

(The information follows:)

The Department has no information on family planning services obligations by its programs prior to Fiscal Year 1965. The above table presents obligations for Fiscal Years 1965, 1969, 1972, and the President's budget request for Fiscal Year 1973. The remarkable growth in the Department's programs has been made possible by two legislative acts--The Social Security Act Amendments of 1967, which provided that not less than 6 percent of the appropriation for Title V (Maternal and Child Health Services) be earmarked for family planning services, and PL 91-572, the Family Planning Services and Population Research Act of 1970. The chief Federal support for subsidized services is the project grant mechanism. However, there has been some concomitant growth in support through Medicaid, a third-party reimbursement mechanism.

LEAD-BASED PAINT

Secretary RICHARDSON. We are requesting $9.5 million to continue our efforts to protect children against lead-based paint poisoning. By the end of 1973 we will have screened 1.5 million children in neighborhoods where there is a particularly high risk of lead-based paint poisoning because of deteriorated housing. This is 60 percent of the estimated 2.5 million children who run the highest risk of lead-based paint poisoning. In addition, we are encouraging the States to look for lead poisoning under the new medicaid regulation which allows for screening of young children. We also will look to medicaid for providing the treatment for those poor children whose screening indicates that they do have a dangerous level of lead in their blood."

Mr. FLOOD. In your Department are you concerned, do you have any clout as to whether or not lead should continue to be used in the manufacturing of paint?

Secretary RICHARDSON. Yes; we do, Mr. Chairman. Lead has been radically reduced in paint since the buildings, where the paint is flaking now and causing lead-based paint poisoning in children, were built. The Food and Drug Administration within recent months has taken a further step to eliminate even this small residue of lead that has continued to be used.

Mr. FLOOD. Will you show more about that and develop that at this point?

Secretary RICHARDSON. Yes.

(The information follows:)

RECENT FOOD AND DRUG ADMINISTRATION ACTION RELATIVE TO LEAD-BASED PAINT On November 2, 1971, the Food and Drug Administration published a proposed regulation in the Federal Register which identified the special toxicity problem of chronic exposure to lead-based paints and proposed that lead-based paints containing more than 0.5 percent lead, 0.05 percent heavy metals (antimony, arsenic, cadmium, mercury and selenium) and 1.0 percent soluble barium be considered hazardous substances. Paints containing more than these amounts would require cautionary labeling except that paints to be used on children's articles or on articles with which children may come in contact would be banned if they contained more than the above listed amounts of heavy metals. At present, the paint industry is voluntarily restricting the amount of lead in paints to 1 percent. Concurrently, the Food and Drug Administration published as a proposal a petition submitted by Representative Ryan and other individuals to ban all paints containing more than "minute" traces of lead.

Interested parties were given 60 days to file written comments on both proposals. As of February 14, 1972, comments are being evaluated and the subject of lead-based paints is being further studied. No final regulations have been issued.

VENEREAL DISEASES

Secretary RICHARDSON. In 1973 we are requesting $24.8 million to combat venereal diseases, an increase of $2.5 million over 1972 and nearly four times the 1971 level. These funds will be used to work closely with State and local public health agencies in a concerted effort to control the spread of these diseases. Our activities will place primary emphasis on the interruption of the transmission of venereal diseases through case finding, tracing contacts, and an intensive effort at public education.

Mr. FLOOD. At this point will you show in some way, by chart or statistics or graphs, with particular reference to syphilis and gonorrhea, the statistics 10 years ago, 5 years ago, and today for each disease? Secretary RICHARDSON. Yes. We have this right here.

(The information follows:)

Mr. MICHEL. Is there any relationship between the increase in venereal disease and the increased amounts going into planned parenthood? It is a silly question but I heard a city councilman the other day making a big wild claim on television to that effect, in opposition to the city requesting funds for planned parenthood. I personally thought it was one of the most ridiculous things I have heard. Mr. FLOOD. What was that?

Mr. MICHEL. His view was that the miserable, horrible rise in venereal disease around the country has a direct relationship to the increased amounts of money we are putting into programs such as planned parenthood to sponsor promiscuity, et cetera. What can you tell me for the record to shoot that down?

Secretary RICHARDSON. Dr. Hellman would be a more authoritative witness but I would say, Mr. Michel, that family planning services and sex education through whatever form would tend to make it more likely that young people would be aware of the problem of venereal disease and would be more likely to be capable of taking preventive action or seeking treatment than otherwise.

There are always people who would argue that creation of knowledge leads to promiscuity. I don't believe that is the way it works. I think the social forces that have tended to lead to looser kinds of sexual relationships can be found somewhere else.

(Discussion off the record.)

Mr. MICHEL. Mr. Secretary, I just want to say personally for the record I am glad to see this amount of increase in here to combat venereal disease. I can recall a number of years ago when we were fighting in this subcommittee to get a little $500,000 increase to go after the problem, and it has kept going from bad to worse. There is no use putting it under the rug or covering it up. It is going to be talked about more. We must have means in my opinion, as you say. of educating people to the problem and eradicating it. I am glad to see your budget reflects that need and that you are addressing yourself to that problem.

Secretary RICHARDSON. Thank you, Mr. Michel. We appreciate the committee's support of this effort.

The 1973 budget for regional medical programs includes $15 million for demonstrations in the delivery of emergency health services. This effort is being begun in fiscal year 1972 by targeting $8 million of the current RMP appropriation for this purpose. For the most part, the Nation's emergency medical services are barely out of the horse and buggy era. Although more than 10 million patients enter the health care system through emergency rooms and ambulances, many of the personnel initially seeing the patient are not adequately trained and insufficient use has been made of existing technology to improve the effectiveness of the delivery of services. This situation cannot be allowed to continue. Accidents are the third leading cause of death in the United States. Very often the difference between life and death depends on what happens in the first few minutes after the accident or health crisis occurs. Our intention is to fund at least five comprehensive emergency health care systems which would integrate hospital emergency rooms, transportation facilities, and communications systems into one coordinated unit in each community participating in these demonstrations.

RIGHT TO READ

The 1973 budget includes $12 million to be put under direct control of the right-to-read program to finance special demonstrations in overcoming illiteracy. The basic purpose of these demonstrations is to show school districts and other public and private institutions how to make significant improvements in reading. The major impact would be that they could more efficiently use the funds currently available to them for this purpose. The overall goal of the program-functional literacy, by 1980, for 99 percent of the 16 year old and 90 percent of those over the age of 16-can only be achieved if current sources of funding are coordinated and used much more efficiently than they are at present. Indeed, the major role of the right-to-read staff is to coordinate and provide technical assistance for the many programs which support reading. The special demonstration funds would enable the right-toread staff to exert greater leverage so that these very large expenditures from other programs will have maximum impact on the literacy problem.

Mr. FLOOD. How long has that program been in operation?

Secretary RICHARDSON. It was announced in about July 1970 and it has been gathering headway in the interval. The internal activity of the Office of Education have been accompanied by work outside the Department under the auspices of the National Reading Council. This is chaired by Mr. Walter Straley. It has the National Reading Center as one of its activities and it seeks to develop a base of volunteer support for tutoring in reading.

Mr. FLOOD. As a matter of fact we have a program in the District. I know Mrs. Flood is very active in it and a number of other people. You are aware of that I suppose.

Secretary RICHARDSON. Yes. John Erlichman is the one.

Mr. FLOOD. Yes; Mr. Erlichman on the President's staff at the White House heads this up. I attended two or three of their meetings and they are very impressive. That was within the last several months. As