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1 (b) Section 137 of such Act is amended by striking

2 out "four", and by striking out "1968" and inserting in lieu

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7 Act is further amended (1) by amending the heading thereof 8 to read "TITLE I-FACILITIES FOR THE MEN9 TALLY RETARDED", and (2) by adding at the end 10 thereof the following new part:

11 "PART D-GRANTS FOR THE COST OF PROFESSIONAL AND

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TECHNICAL PERSONNEL OF COMMUNITY MENTAL

RETARDATION FACILITIES

"AUTHORIZATION OF GRANTS

"SEC. 141. (a) For the purpose of assisting in the es16 tablishment and initial operation of facilities for the mentally 17 retarded providing all or part of a program of comprehensive 18 services for the mentally retarded principally designed to 19 serve the needs of the particular community or communities 20 in or near which the facility is situated, the Secretary may, 21 in accordance with the provisions of this part, make grants 22 to meet, for the temporary periods specified in this section, a 23 portion of the costs (determined pursuant to regulations 24 under section 144) of compensation of professional and tech25 nical personnel for the initial operation of new facilities for

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1 $15,000,000 for the fiscal year ending June 30, 1970, 2 $15,000,000 for the fiscal year ending June 30, 1971, and 3 for the next four fiscal years, such sums as may be necessary 4 to enable the Secretary to make grants under the provisions 5 of this part."

6 SEC. 2. Subsections (e) and (f) of section 401 of the 7 Mental Retardation Facilities and Community Mental Health 8 Centers Construction Act of 1963, as amended, are amended 9 to read as follows:

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"(e) The term 'construction' includes construction of new buildings, acquisition of existing buildings, and expan12 sion, remodeling, alteration, and renovation of existing 13 buildings, and initial equipment of such new, newly acquired. 14 expanded, remodeled, altered, or renovated buildings.

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"(f) The term 'cost of construction' includes the cost

16 of architects' fees and acquisition of land in connection with 17 construction, but does not include the cost of off-site im18 provements."

19 SEC. 3. This Act may be cited as the "Mental Retarda20 tion Facilities and Community Mental Health Centers Con21 struction Act Amendments of 1967".

Senator HILL. Dr. Lee, you will be our first witness.

STATEMENT OF PHILIP R. LEE, M.D., ASSISTANT SECRETARY OF HEALTH AND SCIENTIFIC AFFAIRS; ACCOMPANIED BY MISS MARY E. SWITZER, ADMINISTRATOR, SOCIAL AND REHABILITATION SERVICE; DR. RALPH K. HUITT, ASSISTANT SECRETARY FOR LEGISLATION; DR. JAMES J. GALLAGHER, ASSOCIATE COMMISSIONER, BUREAU OF EDUCATION FOR THE HANDICAPPED, OFFICE OF EDUCATION; DR. ROBERT I. JASLOW, DIRECTOR, DIVISION OF MENTAL RETARDATION; DR. JAMES W. MOSS, OFFICE OF EDUCATION; AND DR. EDWIN MARTIN, OFFICE OF EDUCATION

Dr. LEE. Mr. Chairman, I am grateful for this opportunity to appear before you in support of S. 1099, the Mental Retardation Amendments of 1967, introduced by the distinguished chairman, Senator Hill. I have with me today Miss Mary E. Switzer, Administrator, Social and Rehabilitation Service, Dr. Ralph K. Huitt, Assistant Secretary for Legislation, and Dr. James J. Gallagher, Associate Commissioner, Bureau of Education for the Handicapped, Office of Education. This team indicates the importance the Secretary attaches to this particular program. As you know, he has a committee with representatives of all of the agencies working closely to coordinate the various activities of the Department on behalf of the mentally retarded. This particular Secretary's committee is under the chairmanship of Wallace Babington, and, as you know the President has a Committee on the Mentally Retarded, and this is chaired by the Secretary, which indicates the importance that we all, I think, attach to this effort.

S. 1099 would continue Federal support of community and university-based programs in the area of mental retardation. In spite of the gains made over the past few years, I am confident these hearings will demonstrate that a critical need still exists for continued support of these programs.

Although mental retardation is recognized as the major handicapping condition of childhood, services for the retarded have long been neglected in public programs. The mental retardation legislation enacted in 1963 marked the beginning of our attempt to correct this neglect. It provided a start from which the Department of Health, Education, and Welfare could launch a broad attack on the problems of mental retardation through mechanisms such as research, training, and the provision of services in a community setting.

S. 1099 provides the basis for the extension and expansion of the programs authorized in Public Law 88-164, Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963. It would continue through fiscal year 1972 the construction programs for the university-affiliated and community facilities, as well as the professional training programs in the education of handicapped children, and research and demonstration activities in this area.

In addition to extending the university-affiliated facilities construction program, S. 1099 expands this authority in two ways:

First, it authorizes construction of facilities which may include services to persons with "other neurological handicapping conditions

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found by the Secretary to be sufficiently related to mental retardation to warrant inclusion" under the university-affiliated program.

Second, it allows a portion of the university-affiliated project to be planned and utilized for research activities incidental or related to the purposes spelled out in the existing law. Such a provision will help. to assure continuing and well-directed research in mental retardation. As to community mental retardation facilities, the bill also authorizes a new program of initial staffing grants to help meet a portion of the cost of professional and technical personnel for initial operation. This grant program, patterned after the staffing support for community mental health centers, provides for declining Federal participation over a period of 4 years and 3 months: 75 percent Federal share for the first 15 months, 60 percent for the next year, 45 percent for the next year, and 30 percent for the last year. Only services in new federally financed facilities or services not previously furnished would be eligible for Federal assistance. Federal funds would be used to supplement and increase, to the extent practicable, the level of State, local, and other non-Federal funds for mental retardation services.

I would like to include for the record additional information regarding the need for extension and expansion of the mental retardation programs included in S. 1099.

In conclusion of my direct oral presentation, Mr. Chairman, the effort to mount an effective attack on mental retardation has had the interest and dedication of two Presidents, as well as a record of bipartisan congressional support. Nothing has happened to cause us to doubt the wisdom of these efforts. We, therefore, ask for a reaffirmation of this effort.

I appreciate the opportunity you have accorded me in permitting testimony on S. 1099. Miss Switzer has a brief statement to make regarding this bill. After her statement, if there are any questions, we would be happy to answer them.

Senator JAVITs. Mr. Chairman, before Miss Switzer speaks, may I just put a short statement in the record?

The CHAIRMAN. Surely. But for the sake of continuity, we will now receive for the record the supplemental statement by Dr. Lee.

(The supplemental statement of Dr. Lee follows:)

SUPPLEMENTAL STATEMENT OF PHILIP R. LEE, M.D., ASSISTANT SECRETARY OF HEALTH AND SCIENTIFIC AFFAIRS, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

S. 1099 would continue Federal support of community and university based services to the retarded. In spite of the gains made over the past few years, I am confident these hearings will demonstrate that a critical need still exists for continued support of these programs.

There are an estimated 6,000,000 mentally retarded in this country, representing 3 percent of our Nation's population. They are persons whose normal intellec tual growth has been arrested at some time before birth, during the birth process, or in the early years. Because of their impaired ability to learn. the mentally retarded usually have difficulty meeting the needs of everyday living. Their problems are medical, social, educational and economic, and require broad and unified resources of health, education, and welfare service programs.

Despite the fact that mental retardation is the major handicapping condition of childhood, services for the retarded have long been neglected in public programs. The mental retardation legislation enacted in 1963 marked the beginning of our attempt to correct that neglect. It provided a start from which the Department of Health, Education, and Welfare could launch a broad attack on the

problems of mental retardation through mechanisms such as research, training, and the provision of services in a community setting.

S. 1099 provides the basis for the extension and expansion of this intensified national effort to combat mental retardation. It would provide for the first time, Federal support for the initial staffing of community mental retardation facilities. It would continue the construction programs for the university-affiliated and community facilities authorized in the legislation recommended by the Committee in 1963. It would also extend through fiscal year 1972, authority for the professional training programs in the education of handicapped children, and research and demonstration activities in this area.

The Department is presently sponsoring a variety of professional and technical services to assist the mentally retarded. In the current fiscal year, an estimated $403 million will be used for the support of mental retardation programs to be carried out by the operating agencies of the Department. These funds will be used to support research, demonstrations, professional preparation, services and construction. Part of these funds will be used as income maintenance for the mentally retarded. Departmental programs include:

Research projects relating to maternal and child health and handicapped children's services;

Support for extension of diagnostic and health services to mentally retarded children and development of new services for such children;

Support for special projects to help reduce the incidence of mental retardation caused by complications associated with childbearing;

Preparation of professional personnel for service and research in the field of mental retardation;

Demonstration of improved methods of care, treatment, and rehabilitation of the mentally retarded in State institutions, and improved and extended in-service training to direct-care personnel in such facilities;

Construction programs which provide support for communities and universities in their efforts to expand and improve the training, research, and service activities in the field of mental retardation;

Income maintenance programs, administered through the social security program and public assistance, which provide needed support for designated mental retardation beneficiaries.

To coordinate the wide variety of programs relating to mental retardation the Department has established a Secretary's Committee on Mental Retardation composed of representatives from all agencies of the Department with responsibility to the retarded. Departmental activities are thus administered as a unified, total program utilizing every resource at our disposal. A portion of the programs authorized by S. 1099 will be administered by the newly organized Social and Rehabilitation Service directed by Miss Mary Switzer. This agency brings together various services of HEW that deal with special groups-one of these groups being the mentally retarded.

It is the Secretary's intent that "the aged, the handicapped and children should continue to be given special emphasis, and assigning each of these groups special status within the new Service, while preserving their administrative integrity, insures that each will receive the priority attention it needs and deserved." The newly-formed Social and Rehabilitation Service will be building on a firm base of program achievements which have been made under the legislation passed in 1963; namely the "Maternal and Child Health and Mental Retardation Planning Amendments of 1963" (P.L. 88-156) and the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963" (P.L. 88–164). I am pleased to report the following highlights of these achievements:

Every State has completed planning for comprehensive mental retardation services under P.L. S8-156.

Over 160 community facility projects have been funded to date. With the completion of construction of these facilities, about 45,000 persons will receive day care, diagnostic and evaluation services, and residential care in a community setting.

Fourteen university-affiliated facilities have been funded, and when completed will offer services to approximately 8,000 mental retardates. These facilities will offer training to nearly 10,000 professionals.

Twelve mental retardation research centers have been approved and funded. Over 32,000 individual grants have been awarded for training in education of the handicapped.

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