of a vision care center and to assist in integrating the optometric profession and its institutions into the overall health program of the State. Members of this committee have already done much to bring optometry into the mainstream of federally directed or sponsored health programs and are probably more conscious than most leaders of the importance of vision to functional capabilities. There is a tendency at the State agency level, however, to ignore or remain uninformed about the importance of good vision in such vital areas as accident prevention, achievement in school, vocational productivity, and care of the aging, and so forth. I believe it will be necessary for Congress through its legislative reports, if not in the legislation directly, to stress the need for involvement of optometry in health programs, lest vision programs be lost in the battle for priority attention to other areas of health. You are familiar with the Neighborhood Health Center programs now being developed through the Office of Economic Opportunity. A number of these centers are already in operation. Several more are in the process of being funded. Under this program, there is a family medical team composed of three persons, for every 1,500 family units. The captain of the team is to be a "basic adult health physician." His speciality will be either general practice or internal medicine. There will also be a pediatrician and a specialist in obstetrics and gynecology. If the population is large enough-say 30,000 to 50,000 persons-there will be several such family health management teams. They will refer cases requiring the services of dermatologists, orthopedists, and so forth, to such specialists in the community. Or, if the need for such speciality service is great enough, appropriate specialists will be retained on the Center's staff. In most instances, however, it is believed unlikely that such medical speciality needs will be large enough to warrant speciality staff positions. It is known, however, that the optometric and dental needs of the population are so great that the health specialities of optometry and dentistry will have to be employed in these centers. At least 60 percent of the neighborhood population will require the regular periodic attention of optometrists employed as staff professionals. In order to project the necessary total health services required by a community, please contrast the professional needs of neighborhood health centers with your knowledge of the involvement of optometry in planning for health facilities, resources, services and training required by a State and you will understand our association's concern that Congress call to the attention of the several States the need for participation by optometrists and optometric institutions in the planning process. There is one area of Federal Public Health Service planning activity which our association wishes to compliment particularly and bring to your attention. I refer now to the Division of Health Mobilization. I quote from the "Introduction" to the U.S. Government Printing Office brochure "The Role of the Optometrist in National Disaster": In 1963 the American Optometric Association established a Subcommittee on Civil Defense to study the potential visual needs of the population surviving a nuclear attack on this country and to develop plans to meet these within the framework of national survival programs. The Subcommittee, among other things, concerned itself with the provision of emergency priority optometric services for individuals who are visually handicapped because of the destruction or loss of their corrective spectacles. Two years of research followed and a disaster plan was developed, coordinated with the Federal agencies most concerned with emergency health services; the Division of Health Mobilization, Public Health Service, and the Office of Emergency Planning. Optical manufacturers were consulted regarding the assembly of an emergency visitation care kit equipped to provide corrective lenses for 500 people in a disaster situation. Because of the involvement of the optometric profession in the planning by Federal agencies working to cope with health problems resulting from disasters, we are alert to the need and commend to this committee's attention provision for cooperation with States in emergencies as contained in H.R. 6418 on page 8, beginning with line 19. It also appears to us reasonable and a proposition of commonsense that the Secretary of the Department of Health, Education, and Welfare should be empowered to accept volunteer and uncompensated services for use in the operation of a health care facility as well as in provision of health care as requested in the section of H.R. 6418, found on page 16, beginning with line 2. It is as yet impossible for us to provide sufficient tax and philanthropic dollars to pay for all the health facilities and care required by the disadvantaged of our Nation. The spirit of voluntary effort among health professionals is a dominant drive to be protected and stimulated. In a number of instances, however, there is a need to wed the tax expenditure with voluntary effort so as to provide a viable instrument for service. As an example, consider the East Bay Children's Vision Center of Oakland, Calif. The East Bay Children's Vision Center developed from a demand by the local board of education for vision care of children who were unable to secure such care from any community, State, or Federal program known at the time. A local landlord provided space for a center gratuitiously. The center was made a legal entity through the gratuitous service sof a local attorney. East Bay unions donated necessary partitioning, flooring, painting, and carpentry services. Optical equipment and ophthalmic supplies were furnished at no charge by local optical laboratories. Professional services were volunteered by members of the local optometric society. The need was known; the community was responsive; yet-the project could have floundered for lack of funds to pay for such items as utilities, maintenance of building space, clerical help, and administrative supervision. Thanks to a grant from the Office of Economic Opportunity, funds were made available for these items and the Easy Bay Vision Center is today an important and necessary health resource for Oakland and neighboring communities and it is growing. The Center represents a good balance of voluntary effort, philanthropic endeavor, and wise investment of tax dollars. It is with a sense of partnership and a desire for cooperation that members and units of the optometric organizational structure approach the proposals now pending before this committee in H.R. 6418. We note especially that section on page 16 of the bill providing for a sharing between the Public Health Service and health schools, agencies, or institutions of facilities and services on a reciprocal or reim bursement basis. We protest the title "Medical Care Facilities and Resources." We believe the term limits the "sharing" to those areas which are clearly medical-meaning solely within the field of medicine-as compared with "health" areas-meaning within the province of all recognized professions and persons concerned with total human health and well-being. We respectfully suggest that lines 12 and 13 on page 16 should be changed to read "Cooperation as to Health Care Facilities and Resources" and line 17 be changed to read "Sharing of Health Care Facilities and Resources." And, in the same vein-a desire to cooperate and be of service-we are concerned that the section found on page 19, beginning with line 11 titled, "Medical Care for Federal Employees at Remote Stations of the Service" is misnamed and should be corrected to read "Health Care for Federal Employees at Remote Stations of Service." We also respectfully suggest that line 22 of page 19 be amended as follows: Insert a comma and the words "and optometric care" following the word "hospitalization." Federal employees need and should be entitled to optometric care on the same basis as medical, surgical, dental, and hospital care. In summary, we wish to state that the optometric profession is in agreement with the need for comprehensive health planning at each level of our social and political structure in order to provide more efficient, higher quality health care at reasonable cost and in a spirit of partnership among all elements of health resources and facilities. From our prior experience we know that vision care and the optometric providers of service will be discounted or ignored unless Congress clearly indicates its intent that they be appropriately included. Most of our actions each day are triggered or stimulated by God's priceless gift to us-the gift of vision. Our emotional and physical well-being are dependent upon the degree to which our visual capabilities are protected and enhanced. Your consideration of the recommendations and amendments proposed in this statement will be appreciated and implementation of them will be a major step in assuring total health care, which we believe to be the intent of the Congress in passing this legislation. Thank you for the kind attention you have given to my statement. If you have any questions, I will be happy to answer them. Mr. OTTINGER (presiding). Thank you very much for your fine statement, Dr. Haffner. I am particularly pleased to welcome you to the committee as a representative from the State of New York. It is very interesting to hear about your center for vision and your desire to see to it that the contributions in the profession of optometry are adequately included in this legislation. I think some of your suggestions certainly can be met without any problem. I have no questions. Mr. Nelsen? Mr. NELSEN. Thank you, Mr. Chairman. I have no questions but I certainly want to add my commendation to the gentleman for his fine statement and his efforts in this very important field. Obviously as we consider the legislation that is needed it is necessary that certain things be clarified. This always happens and I am sure there will be a more clear indication as to what the legislative intent and administrative intent are along the lines that you have suggested. Dr. HAFFNER. Thank you, Congressman. Mr. OTTINGER. Mr. Blanton? Mr. BLANTON. I have no questions. Mr. OTTINGER. Mr. Brotzman ? Dr. HAFFNER. Thank you. Mr. OTTINGER. We appreciate your taking the time and trouble to come before us. We will give your suggestions very serious consid eration. This concludes the hearings scheduled for today on this legislation. The Chair regrets to announce that the hearings on this bill scheduled for next week will have to be postponed. The full committee will start hearings next Tuesday on House Joint Resolution 559 introduced today by Chairman Staggers which was requested by the President, dealing with the current threatened railroad strike. The committee stands adjourned. (Whereupon, at 3:10 p.m. the committee adjourned, to reconvene at the call of the Chair.) PARTNERSHIP FOR HEALTH AMENDMENTS OF 1967 TUESDAY, JUNE 20, 1967 HOUSE OF REPRESENTATIVES, COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D.C. The committee met at 10 a.m., pursuant to notice, in room 2123, Rayburn House Office Building, Hon. Harley O. Staggers (chairman) presiding. The CHAIRMAN. The committee will come to order. Today we are resuming hearings on H.R. 6418, which is the Partnership for Health Amendments of 1967. Unfortunately, it became necessary for the committee to suspend these hearings on this legislation in order to consider proposals by the President to deal with the threatened nationwide railroad strike. I am sorry we had to inconvenience some of the witnesses who had planned to be able to testify before the committee over a month ago when we had to suspend these hearings so abruptly. I hope this has not given hardship to any of the witnesses. Our first witnesses this morning will be Mr. Donald Elliott, chairman of the New York City Planning Commission, and Dr. Howard Brown, health services administrator of New York City. Would you gentlemen come forward to the table. I want to welcome both of you and say we appreciate the fact that you are here to give us the benefit of your views on this very important legislation. You may proceed as you see fit. STATEMENTS OF DONALD ELLIOTT, CHAIRMAN, NEW YORK CITY PLANNING COMMISSION; AND DR. HOWARD BROWN, ADMINISTRATOR, HEALTH SERVICES ADMINISTRATION OF NEW YORK CITY Mr. ELLIOTT. Mr. Chairman, we thank you very much. If it is acceptable, Dr. Brown will lead off and I will follow. Dr. BROWN. I am Dr. Howard J. Brown. I am health services administrator for the city of New York. In this capacity I am responsible for coordinating the programs of all the official health agencies of the city of New York including the health department, department of hospitals, the mental health board, and the office of the chief medical examiner. We are here to support H.R. 6418, which would amend Public Law 89-749, probably the most significant health legislation in our view recently enacted by Congress. The city of New York wholeheartedly is in favor of this legislation, filed by you, Congressman Staggers. 80-641-67—13 187 |