support of a pilot project will involve a substantial grant. One cost estimate used in justification of the legislation amounted to an annual cost of over $4 million for a regional medical program. A less comprehensive beginning phase would still involve considerable sums. The increase requested for grants, therefore, is essential if orderly development of this new program is to include sufficient experience from a limited number of pilot projects. This experience will be necessary as the basis for evaluation of the program and the development of future program recommendations as required in the authorizing statute. The requested expansion is essential if the early years of this program are to serve the exploratory purpose which was the clear intent of the Congress in this initial authorization period.

These funds will be used for an expansion of the program development and technical assistance activities which will provide help to the regional groups who are involved in planning and implementing regional medical programs. This function will require extensive activities in the field in order to provide the necessary close contact with these regional groups and will provide a wide variety of consultative expertise which will help to assure the development of sound plans and programs at the regional level. The staff involved in this function will also be able to provide information to a regional group concern.. ing similar efforts by other regional groups being undertaken in the initial phases of the program. This interchange of information will enable each regional group to benefit from the experiences and innovative solutions to problems being developed in many areas of the country,

The workload of this activity will undergo a considerable increase because of the increase in grants for operational pilot projects. To cope with this increased workload, an increase of 15 positions and $298,000 is requested, of which $170,000 is for annualization of positions new in 1966 and $11,000 is for the annualization of the general schedule pay increase.

The requested increase of $358,000 consists of $206,000 for annualization of positions new in 1966, $12,000 for annualization of the general schedule pay increase, and 18 positions and $140,000 to support increased activities in the Program Review and the Grants Management Branches. An increased activity level in the program review functions will be required to evaluate and process the larger number of grant applications and to prepare these grant applications for advisory council review. It is expected that in 1967 a higher proportion of the grant applications will be concerned with the establishment of pilot projects. The program review functions will then become considerably more complex and will require increased staff to deal with the larger workload. The grants

management function will also need to be expanded to deal with the many difficult financial, legal, and management aspects of the regional medical programs.

The overall program leadership and administrative capability provided by the office of the Chief will have to be expanded in 1967 to cope with the overall program expansion and the increased challenges to effective program direction and administration arising from the increased operational activities under regional medical programs. Many policy and administrative complexities requiring the attention of the top program leadership will be developed out of the plans being formulated throughout the Nation under planning grants awarded in 1966. Solution of these policy issues will place heavy demands on program leadership and will require expansion of supporting staff. Overall program expansion will also require increases in the administrative and coordinating functions located in the office of the Chief.

The activities of the Planning and Evaluation Branch will have to be augmented to deal with the provision of the act that requires the submission of a report to the President and the Congress evaluating progress under the program and making recommendations for modifications and extension of the program. It is expected that some of the studies relating to the evaluation of the program and development of future plans will be conducted through contracts to competent professional organizations and academic institutions.

To provide the necessary expansion in the office of the Chief and the Planning and Evaluation Branch, an increase of 17 positions and $368,000 is requested. Included in the net increase requested are $200,000 for annualization of positions new in 1966, $12,000 for annualization of the general schedule pay increase and $25,000 for centrally furnished services from the NIH management fund.

Division of Regional Medical Programs, new positions requested in 1967

FRIDAY, MARCH 4, 1966.

NATIONAL INSTITUTE OF DENTAL RESEARCH

WITNESSES

DR. SEYMOUR J. KRESHOVER, ACTING DIRECTOR, NATIONAL INSTITUTE OF DENTAL RESEARCH

DR. JAMES A. SHANNON, DIRECTOR, NATIONAL INSTITUTES OF HEALTH

HERBERT C. CHRISTOFERSON, EXECUTIVE OFFICER, NATIONAL INSTITUTE OF DENTAL RESEARCH

FRANCES H. PETTINATO, BUDGET OFFICER

CHARLES MILLER, FINANCIAL MANAGEMENT OFFICER, NATIONAL INSTITUTES OF HEALTH

DR. WILLIAM H. STEWART, SURGEON GENERAL

HARRY L. DORAN, CHIEF FINANCE OFFICER

JAMES B. CARDWELL, DEPARTMENT DEPUTY COMPTROLLER

1 Includes capital outlay as follows: 1965, $162,000; 1966, $210,000; 1967, $187,000. * Selected resources as of June 30 are as follows: Unpaid undelivered orders, 1964, $601,000 (1965 adjustments —$7,000); 1965, $680,000; 1966, $680,000; 1967, $680,000.

Mr. FOGARTY. Dr. Kreshover, you have been here before when Dr.' Arnold was ill or out of the country once or twice. I have just been told you have been appointed Director and Assistant Surgeon General. I want to congratulate you. You have done a good job in the past, and I am sure you will in the future.

Dr. KRESHOVER. You are very kind, Mr. Fogarty. Thank you. Mr. FOGARTY. Go right ahead.

GENERAL STATEMENT

Dr. KRESHOVER. Mr. Chairman and members of the committee, recently, one of our research scientists remarked that "the mouth is an even tougher environment than outer space." Because of the enormous complexity of the oral disorders, progress does indeed at times seem discouragingly slow. Nonetheless, the past 5 years in particular have seen remarkable gains. With intensification of research effort, we are confident that many of the still elusive oral health problems

61-548-66-pt. 4 -36