« PreviousContinue »
elsewhere (section 12 of the Vocational Rehabilitation Act) for grants for con1 'struction of rehabilitation facilities and workshops for the physically and menpoden tally handicapped without the requirement that they be part of facilities pro
viding comprehensive services.
However, after further discussion with the Office of General Counsel, we are of the view that an applicant which operates facilities providing comprehensive services for the mentally retarded would not be precluded from receiving Federal assistance for construction of a sheltered workshop by reason of the fact that the workshop is not on the same site as that used to provide general services for the mentally retarded by the same organization. I hope this clarifies our position in this matter. Sincerely yours,
MARY E. SWITZER, Administrator.
Miss SWITZER. It is wonderful to have your statement in the committee.
STATEMENT OF MARY E. SWITZER, ADMINISTRATOR, SOCIAL AND
REHABILITATION SERVICE, U.S. DEPARTMENT OF HEALTH,
Miss SWITZER. Mr. Chairman and members of the committee, I welcome this opportunity to once again appear before this committee in my new role of Administrator of the Social and Rehabilitation Service of the Department of Health, Education, and Welfare. The Social and Rehabilitation Service was established to bring needed services to our citizens in a more coordinated and comprehensive manner. By com
bining the functions of the Welfare Administration, the Vocational I Rehabilitation Administration, the Administration on Aging, and the
Mental Retardation Division of the Public Health Service into a single agency, we believe that greater progress can be made to solve the special problems faced by this Nation.
The area of mental retardation is one example of that type of problem into which we must put our wholehearted combined efforts in order to meet the tremendous challenge facing us.
During the last few years much has been done to help the mentally retarded. However, much remains to be done. Our increased concern with mental retardation in recent years has enabled us to see something of the depth of the problem. As the President's Committee on Mental Retardation has said, "we have learned that problems ignored or neglected do not go away. On the contrary, they grow, both in urgency and cost, until at last we are forced to contend with them, often at enormous expense for measures that can only hold the line.” This applies not only to mental retardation, but as we found in the whole field of physical disability, this applies across the board in the field of public welfare also.
The CHAIRMAN. We have waited all too long in attacking these problems, have we not?
Miss SWITZER. That is right.
A few weeks ago the report of the President's Committee on Mental Retardation was released to the public. That report pointed to the fact that three-fourths of the institutionalized mentally retarded live in buildings 50 years old or more--many of the "hand me down" mental or tuberculosis hospitals or abandoned military installations.
In addition, the committee estimated that the full-time staff now in public facilities for the mentally retarded must be almost doubled to reach minimum adequacy.
These are indeed sobering facts. The Committee further indicated that the mentally retarded in disadvantaged neighborhoods often receive significantly less service from public and private agencies than do the retarded living in other neighborhoods and that an estimated 2 million retarded persons capable of learning to support themselves need job training and placement services. Even at minimum wage, these individuals have a potential annual earning capacity of $6 billion.
I was in Hartford, Conn., last Saturday at the annual meeting of the Connecticut Association of Retarded Children, and this very question came up in a very dramatic way. The voluntary organization in Connecticut has determined to try to reach out to the inner city of Hartford which has many problems, because it was clear from the discussion at that meeting that many of these people were not being reached by the conventional means. And this is a problem all over the country, and we want to get at it as fast as we can.
We intend to work hard to meet these needs through the combined programs of the Social and Rehabilitation Service and especially through the Rehabilitation Services Administration. I know that greater progress can be made to solve these problems. We have learned through the years that a pinpointed attack on specific problems is a very important and almost indispensable way to spread the results of good knowledge.
The reorganization has brought about a regrouping of several existing programs in the Department into the Rehabilitation Services Administration of the Social and Rehabilitation Service. States and communities that want help in mental retardation programing will now be able to get more help through a single agency.
In the brief weeks that I have been Administrator, the stepped-up momentum that comes from being associated with the Bureau of Mental Retardation which came to us from the Public Health Service it is also very significant and something we should repeat over and over again—that one of our strongest elements in spreading the improvement of service and the expansion and understanding of services for the mentally retarded is the strong voluntary effort that exists all over the country. The National Association for Retarded Children, particularly the State and local units, are absolutely indispensable. They are responsible for highlighting the problem; they are responsible for bird dogging it, if you will, and their support and their understanding is, to me, one of the most encouraging optimistic aspects of this whole problem.
The CHAIRMAN.They are seeking to meet the challenge.
Miss Switzer. Seeking to meet the challenge, and they have met it in their own way, and now they must take satisfaction, as we do with them, at the combined effort of Government and voluntary organizations from the very smallest units in the smallest community in the country up to the mobilization of national public opinion that is really one of our greatest assets. So, I would like to make this very, very clear for the record.
A major problem in mental retardation has always been the coordination of services, for many agencies and programs have been
involved in meeting the needs of the retarded and their families. I would like to emphasize “their families" for which Senator Javits made such a plea. In the Department the Secretary's Committee on Mental Retardation has served well in coordinating the variety of mental retardation programs which we administer. Now, the resources of our specialized mental retardation programs can form an even stronger striking force to attack the problems of mental retardation. Through a central focus on the retarded and their families, more effective approaches can be developed to meet their needs. Professional staff whose work has been well coordinated, even though they were formerly separated by agency lines will have the opportunity to work even more closely together in a unified approach. The CHAIRMAN. You will have a better team, will you not?
? Miss SWITZER. A better team and better day-by-day relationships, and this makes all the difference.
In addition, many activities for the retarded in those programs serving the general population or broader groups of handicapped persons can be coordinated for more efficient and effective operations. Furthermore, many retarded persons who are also multiply handicapped can now benefit from the services of the various agencies joined together in the Social and Rehabilitation Service. Our basic guideline will be the rehabilitation philosophy that each handicapped person should be helped to realize his maximum potential.
The President's Committee listed 10 areas as most urgently in need of attention. The program to be extended or initiated by S. 1099 were developed to meet the first two of these areas of need: (1) availability of mental retardation services to more of the Nation's people, and (2) more effective and extensive manpower recruitment and training programs for work with the mentally retarded. The community facilities construction program is probably doing more to stimulate expansion of mental retardation services than any other Federal program.
The CHAIRMAN. That bring it home to the community.
Miss SWITZER. That brings it home to the community and is visible evidence for the community.
The CHAIRMAN. They can see the challenge and see what is being done and what needs to be done.
Miss Switzer. This is what happened in the hospital construction program under the Hill-Burton, and this is what happened in the rehabilitation facilities development program under vocational rehabilitation, and I think we need to have some visible evidence in a good many more of our public programs.
The CHAIRMAN. Under the Switzer program.
Continuing with reference to the community facilities construction program. This is and will continue to be a formula grant program to States with approval of individual construction projects by the Social and Rehabilitation Service staff in the Department of Health, Education, and Welfare regional offices.
The Mental Retardation Amendments of 1967 authorize initial staffing grants for these facilities, along with other improvements in the legislation. This will assist States and communities to begin service programs not heretofore developed. In this program, funds will be reserved for each State, and individual projects will be approved after review by a panel of experts in the field. Advice on individual applications will be sought from State agencies concerned with the respective program areas.
The university affiliated facilities construction program will begin to have a marked impact on the manpower situation in mental retardation as the new facilities are completed and go into operation. This is a project grant program which is administered in light of recommendations made by a committee of outstanding experts who assure programs of the highest quality and encourage innovation. There is doubt that the great bulk of professionals trained in the future to provide services to the retarded will come from training programs in the newly constructed facilities.
I would like to mention here and remind the committee that the Vocational rehabilitation program has over the past several years established research and training centers directed particularly to mental retardation in nonmedical settings, and we now have over three or four of these. We have one in Wisconsin, one in Texas, one in Oregon, and one or two others.
The CHAIRMAN. Any in the eastern half of the United States?
This is another evidence of the importance of bringing together these programs.
These three programs are basic to our attack on mental retardation: Training facilities, service facilities, and adequate staff. Around this core will be grouped those other programs which round out the complement needed for effective action-research, demonstrations, improvement projects, and training. Together, they will force retardation out of the grip of despair in which it has held too many, too long.
The CHAIRMAN. We very much need all of these, do we not?
Miss SWITZER. All of them, yes, and we strongly urge the committee to do the very best it can.
The CHAIRMAN. How many research centers have been funded under this legislation?
Dr. LEE. The university research facilities, I believe 14, Senator Hill
The CHAIRMAN. How about the others?
Dr. LEE. There are 12 research centers and 14 university affiliated training centers.
The CHAIRMAN. All in operation now?
Dr. LEE. No, sir. The construction, of course, requires planning, and the construction requires time, and they are not yet in operation, but some of them soon will be.
Dr. Jasnow. Out of the 12 research centers, 11 are funded out of Public Law 88–164. The one that is in operation at the University of Chicago is considered one of the research centers but it is funded out of a different source. However, it is considered in the same grouping. the 12th one. That is in operation at the present time.
The CHAIRMAN. What source is it funded out of?
Dr. LEE. They had a $66,000 grant, Senator Hill, and went into operation in March of this year, I believe.
Dr. Jaslow. They primarily required only movable equipment, so they did not require the construction lag period which others had. The University Affiliated Centers, there is one in operation in Boston opened for approximately 4 weeks.
The CHAIRMAN. I see.
Senator YARBOROUGH. Did you say "of the universities"; is this a university research center?
Dr. LEE. Yes, sir.
Dr. Jaslow. One of each in operation; one of the research training centers and one of the university affiliated training centers.
Senator YARBOROUGH. One each in operation?
Dr. LEE. Twelve research centers and 14 of the university affiliated training centers.
Senator YARBOROUGH. What is the difference between the 12 and 14, and one of each in operation?
Dr. LEE. The research centers are health research facilities in which basic research is conducted. The university affiliated facilities are for training, and these are primarily for the referral of severely handicapped patients and for the training of needed personnel. As Miss Switzer indicated, this makes a considerable difference in meeting the service needs in communities. One of the great shortages is in the skilled manpower needed to provide the services.
Miss SWITZER. We might give an ex:umple Senator YARBOROUGH. The reason for my interruption is to learn whether we have 14 of these centers, or whether we have one.
Dr. LEE. There are 14 that have been funded.
Senator Y ARBOROUGH. You mean the money has been set apart. It is there. It has not been cut back to the budget. Are we going to end up with 14 centers or one center? That is what I am driving at.
Dr. LEE. We will end up with 14.
Dr. LEE. The dates on completion we have, and we can submit this for the record. I do not have those figures.
Senator YIRBOROUGUI. I would like to have those before we vote on this bill.
I do not want to delay the bill, and I apologize for this interruption, but I think this information is important and should be available for our consideration.
Dr. LEE. The construction dates and the university affiliated training centers, the fundings, total cost, Federal share, and estimated completion dates--we have those figures available, and we will be glad to submit them.
(The material referred to follows:)
PROGRESS REPORT ON MENTAL RETARDATION RESEARCH CENTERS AND L'NIVERSITY
MENTAL RETARDATION RESEARCH CENTERS
One of the programs authorized in P.L. 88–164, "Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963,” is the con