categorical coverage so I really cannot answer it. Our department is $25 million. We are the primary department that is involved. Senator MURPHY. Thank you.

The CHAIRMAN. Doctor, we certainly appreciate your fine statement and we are deeply grateful. Do not forget what we said to you about cooperation. If you do not get the money appropriated, you are not able to go forward with the program.

Dr. BARNETT. I will say this: Our national organization is much concerned. They are going to be of all possible assistance. They have been in touch with their Representatives and Senators, so we hope we will have some impact.

The CHAIRMAN. Thank you very much.

Now, Mrs. Fitzhugh Boggs, chairman of the Committee on Governmental Affairs of the National Association of Retarded Children, and Mr. Jonas Morris, of the National Association of State Mental Health Programs Directors.

We are happy to have you here.

Mrs. BOGGS. I am accompanied by Mr. Robert N. Gettings.
The CHAIRMAN. We are happy to have you.

You may proceed now.

STATEMENT OF ELIZABETH M. BOGGS, CHAIRMAN, GOVERNMENTAL AFFAIRS COMMITTEE, NATIONAL ASSOCIATION FOR RETARDED CHILDREN; ACCOMPANIED BY ROBERT M. GETTINGS, STAFF ASSISTANT

Mrs. BOGGS. The National Association for Retarded Children commends the continuing efforts of the Senate Committee on Labor and Public Welfare to enact sound legislation on behalf of the mentally retarded. Public Law 88-164, whose extension we are considering today, is one of a number of important pieces of legislation sponsored by the chairman during the past decade, and for which we wish to express our warm appreciation.

In the list of community facilities already funded, which you have received from the Department, you will find many that are sponsored by local units of NARC and many more which we have promoted and influenced. There are 167 projects in this list. We have more than 1,100 local associations. More than any other organization, we are conscious of what remains to be done, and of why, in many cases, it isn't being done.

We heartily endorse the extension of part C, title I, of Public Law 88-164 and urge that funding be authorized at the level proposed by the House, recognizing that this funding level is distinctly less than the need. Indeed, the need is estimated to exceed $2 billion.

We favor equally the extensions of part B and concur in the modified language proposed. The university affiliated facilities funded to date show great promise and more qualified applicants are eagerly awaiting passage of this bill.

We support the proposed extension of title III relative to education of the handicapped. In this connection, we also hope to see similar provisions relative to physical education and recreation of the handicapped as proposed last year and yesterday by Senator Edward Kennedy. We agree with Senator Javits and Dr. Barnett, too, that it

would be very helpful indeed if the acquisition of land in connection with new construction could also be incorporated among the items to be considered under the heading of cost of construction.

We ask that new provisions be added to Public Law 88-164 to authorize assistance on a project grant basis for the initiation, extension, and improvement of services to the retarded in community facilities. both those constructed with Federal funds and those made available with other initiative. Last year, the Senate adopted an amendment to this end introduced by the chairman of this committee in connection with the comprehensive health bill. It would have added a new part D to Public Law 88-164 similar in general intent, but less restrictive in language than section 4 of the House bill now before you. We believe that the language contained in S. 3008 of 1966, as passed by the Senate last October, is superior to that contained in the administration bills of 1967. We are happy that Senator Javits has placed the earlier language before the committee once again in his bill S. 389.

I am going to deviate from the prepared text in order to be brief. The CHAIRMAN. Your statement will be put into the record in full. (The prepared statement of Mrs. Boggs follows:)

PREPARED STATEMENT OF ELIZABETH M. BOGGS, CHAIRMAN, GOVERNMENTAL AFFAIRS COMMITTEE, NATIONAL ASSOCIATION FOR RETARDED CHILDREN

The National Association for Retarded Children commends the continuing efforts of the Senate Committee on Labor and Public Welfare to enact sound legislation on behalf of the mentally retarded. PL 88-164, whose extension we are considering today, is one of a number of important pieces of legislation sponsored by the Chairman during the past decade, and for which we wish to express our warm appreciation.

In the list of community facilities already funded, which you have received from the Department, you will find many that are sponsored by local units of NARC and many more which we have promoted and influenced. There are 167 projects in this list. We have more than 1100 local associations. More than any other organization, we are conscious of what remains to be done, and of why, in many cases, it isn't being done.

We heartily endorse the extension of Part C, Title I, of PL 88-164 and urge that funding be authorized at the level proposed by the House, recognizing that this funding level is distinctly less than the need! Indeed, the need is estimated to exceed $2 billion.

We favor equally the extension of Part B and concur in the modified language proposed. The university affiliated facilities funded to date show great promise and more qualified applicants are eagerly awaiting passage of this bill.

We support the proposed extension of Title III relative to education of the handicapped. In this connection, we also hope to see similar provisions relative to physical education and recreation of the handicapped as proposed last year by Senator Edward Kennedy.

We ask that new provisions be added to PL 88-164 to authorize assistance on a project grant basis for the initiation, extension, and improvement of services to the retarded in community facilities, both those constructed with federal funds and those made available with other initiative. Last year, the Senate adopted an amendment to this end introduced by the Chairman of this Committee in connection with the comprehensive health bill. It would have added a new Part D to PL 88-164 similar in general intent, but less restrictive in language than Section 4 of the House bill now before you. We believe that the language contained in S. 3008 of 1966, as passed by the Senate last October, is superior to that contained in the Administration bills of 1967. We are happy that Senator Javits has placed the earlier language before the Committee once again in his bill S. 389.

The language of Section 4 of S. 1099 is patterned directly on the Community Mental Health Staffing amendment of 1965. This legislation was designed to encourage à particular kind of development in the mental health field under conditions which, generally speaking, do not obtain in respect to mental retardation.

Our objective, especially in these critical times, must be to use every dollar where it will do the most good. Setting up a system which forces applicants to spend their own money in less than optimum ways is not consistent with that object. Three features of S. 389 commend themselves to us particularly:

1. Eligible Services. Under PL 89-333, the Vocational Rehabilitation Amendments, grants may be made for a variety of projects for the initiation, extension, and improvement of vocational rehabilitation services under Section 3 (a) (2) (B), Section 4(a) (2) (A), Section 12(f) and Section 13 (b), taken in combination. We believe the language of S. 389 if incorporated into S. 1099 would extend the spirit of this act to those direct services for the retarded which are not encompassed under the headings of vocational rehabilitation or of public education. We believe this more consistent approach to be very desirable.

2. Discretionary Decrement in Federal Share. The rapid mandatory decrement in the federal share specified in the "staffing" provisions of the Community Mental Health amendment, and of the Vocational Rehabilitation Act as amended in 1965 (Section 12(f)) presuppose a correspondingly rapid influx of funds from other sources. In the instance of mental health centers the withdrawal of federal aid can be compensated for, to a considerable extent, through third party payments, including federal medicare and medicaid funds whose flow will accele rate one a mental health center is "in business". In the second instance, initial staffing aid applicable to new sheltered workshops under the 1965 Vocational Rehabilitation Amendments, is but one element in a complex pattern of federal assistance which can be marshalled to provide continuing support, as well as opportunities for extension and improvement of programs in these and other facilities.

In both instances, there are existing mechanisms for federal formula grants to the states which permit continuing state-federal aid to flow to the program where the special staffing aid declines and expires.

Nothing comparable to these resources is available for augmenting community services to the mentally retarded. These services must, in the future, have greater assurance of ongoing support from local, state, and federal sources. While these new patterns of support are being worked out, it is highly desirable that we have a more flexible authority for non-recurring project grants, if we are to stimulate the most needed programs and use the federal seed-money to best advantage.

3. Types of Cost Which May Be Included. Salaries of technical and professional persons are an important part of every health, education, or welfare service. However, as the schools well know, there may be types of expenditures without which the personnel cannot function. In programs for retarded children and adults, such entries as consumable supplies, food, transportation, and building maintenance must also be paid for.

Actual experience in the field shows that where transportation is not provided for seriously retarded youngsters and adults, those clients whose parents cannot make the twice daily trip simply do not enroll. When transportation is provided it constitutes a major budget item. If Congress joins us in believing that services in community facilities must truly serve where the need is greatest it will not only permit but insist approved programs include realistic arrangements for getting the clients to and from the facility.

It is true that the salary of a bus driver directly employed by a facility may be paid under the heading of technical personnel; but this forces the facility to run its own service. There are thousands of school board members who can testify that a contract with a bus company may be more efficient.

We recommend that the most essential and significant of "other costs"--especially transportation-be includable for federal sharing at the discretion of the Secretary.

Recognizing the lateness of the season, and the sensitivities in the other body to any manipulations of figures, we nevertheless believe that, at least on the first and third points, some modifications of S. 1099 in the directions indicated could be introduced to good advantage even at this late date. We hope you will find this possible to achieve.

These are uncertain times. Much of the potential for good which this Committee on Labor and Public Welfare has built into recent statutes is lying unused, for reasons beyond your and our control. That funding to the limit of the authorizations is justified by need, few will deny, but none will expect it in this year of frustration on the domestic front. We do believe, however, that attention given now to the nurture of small but soundly structured programs is appropriate and necessary for the achievements of long-range goals as well as

short term relief. We commend this legislation and look forward to your affirmative action in the creative tradition of this Committee.

Thank you for the privilege of expressing our views.

Mrs. BOGGS. We believe that the objectives of H.R. 6430 in its entirety can and should be simply stated: to extend and improve community services to mentally retarded children and adults. Buildings are only a means to that end. The character of part D is therefore critical.

We believe that this new program should not be encumbered with restrictive language drafted some years ago for another purpose. Specifically, we believe, first, that the rapid mandatory decrement in the Federal share will inhibit applications from many of the most needy communities.

Secondly, we believe that the costs to which the Federal share may be applied should not be limited to staff salaries and should at least include transportation.

Thirdly, we believe that novelty is not in itself necessarily a virtue, and that section 142 (a) (2) (B) should be permitted to apply not merely to new types of service but to any significant extension or improvement.

The very fact that the appropriations will be pitifully small in the immediate future makes it all the more necessary that the funds be most efficiently used. We believe our suggested modifications would contribute to this goal.

We are most heartened, Mr. Chairman, that in the midst of overwhelming major domestic and international pressures here on the Hill you are taking time to consider the welfare of a relatively small and unvocal but seriously disadvantaged segment of our society. We commend this legislation and look forward to your affirmative action in the creative tradition of this committee.

Thank you for the privilege of presenting our views.

The CHAIRMAN. Thank you very much. You always bring us a mighty good statement.

Mr. Morris?

STATEMENT OF JONAS MORRIS, NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS

Mr. MORRIS. Thank you. I am representing the National Association of State Mental Health Program Directors.

Dr. Donald Bramwell, in whose name the statement was prepared, was unable to appear at the last moment.

The CHAIRMAN. Would you like to have the statement appear in full in the record?

Mr. MORRIS. I would like to submit it.

The CHAIRMAN. It will appear in full.

(The prepared statement of Dr. Bramwell, submitted by Mr. Morris, follows:)

PREPARED STATEMENT OF DONALD BRAMWELL, M.D., DIRECTOR OF MENTAL HEALTH, STATE OF NEW HAMPSHIRE, AND CHAIRMAN, COMMITTEE ON MENTAL RETARDATION, NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS Mr. Chairman, I am Donald Bramwell, M.D., Director of the New Hampshire Department of Mental Health. I am also Chairman of the Committee on Mental Retardation for the National Association of State Mental Health Program

Directors and I present this statement on behalf of the members of the Association.

In 32 states the members of our Association have total administrative responsibility for the treatment of the institutionalized mentally retarded. In these states the members of our Association operate 96 institutions and treat annually 140,512 patients.

In 21 other states and territories our members have partial responsibility for the treatment of the institutionalized mentally retarded that are essentially in public institutions.

Last year the states invested over one half billion dollars in the care and treatment of the mentally retarded and over 100,000 persons are employed to carry out this duty.

However, in spite of the tremendous effort by existing public agencies to care for the mentally retarded we are providing adequate treatment for only a portion of those in need.

We are critically short of both inpatient facilities, outpatient facilities and community facilities such as day care programs and sheltered workshops.

Last year our Association surveyed the states and territories to determine the number of applicants awaiting admission for treatment in public residential facilities.

In 49 states and territories responding there were 31,509 persons on our socalled "waiting lists". In most states the duration of wait before admission is about 2 years. In some states it is 5 or 6 years.

And it is a demonstrative fact, Mr. Chairman, that there are 2 or 3 times the number of mentally retarded who need help who are not now getting adequate care and are not now on the waiting lists.

If we wiped out all waiting lists today and started with a clean slate, by tomorrow we would have double the present number of applicants.

The waiting lists are 30,000 instead of 90,000 simply because 60,000 families know the futility of applying for help.

Mr. Chairman, I ask permission, at this time, to submit for the record, a copy of the 1966 survey conducted by the National Association of State Mental Health Directors of the number of applicants awaiting admission to state treatment facilities for the mentally retarded.