Mr. ROGERS. Mr. Secretary, we have had what, two Federal facilities over the years for addicts and clinical research?

Secretary RICHARDSON. Yes.

Mr. ROGERS. And they are what?

Secretary RICHARDSON. Lexington and Fort Worth.
Mr. ROGERS. Fort Worth?

Secretary RICHARDSON. Yes.

Mr. ROGERS. It is my understanding that you plan to transfer Fort Worth from its present functions and turn it over to the prisons? Secretary RICHARDSON. Yes.

Mr. ROGERS. Are you aware that the Senate has passed a resolution saying that the public health hospitals and clinics should be kept open and that the House committee has already passed such a resolution saying that it is the intent of Congress that also Fort Worth and Lexington be kept open. We hope to have this before the floor on Monday and in concurrence with the Senate, if this is passed along with the $14 million additional that the House has put into keep open public health facilities including Fort Worth, to be run by the Public Health Service as a drug treatment center, will this intent of the Congress be carried out?

Secretary RICHARDSON. Well, I can assure you that it will. I do think, though, it might be useful at this point to restate for the record the administration's case for the proposed action.

The Fort Worth institution was originally designed and constructed as a medical facility suitable for prisoners. Over the life of the hospital it has been used extensively for treatment and confinement of Federal prisoners. So it seemed both to us in HEW and to the Department of Justice that it would be a suitable facility for conversion to a medium security institution under the Bureau of Prisons. There is a medical facility there essentially.

Now, the principal objection that has been raised to this is not that the Bureau of Prisons cannot make effective use of it, including effective use of it for prisoners who are addicts and thus draw effectively upon personnel who have been treating addicts there right along, but it would reduce the capacity to treat addicts on an in-patient basis in the Southwest generally.

Now, we have two answers to that. One is that treatment on an inpatient basis in a facility closer to the community from which the patient comes is substantially more effective in achieving success than treatment at an institution too far away for families and others close to the patient to be able to get there.

Second, the community based facility is more effective because it does not withdraw the individual so far from the environment in which he originally became addicted. Part of the reason we believe the recidivism rates for Fort Worth and Lexington have been so relatively high is that we think that you detoxify the patient and then give him treatment in a very artificial situation. Then when you turn him loose, he goes back into the circumstances out of which he became addicted in the first place and he is unprepared for this. You could have a halfway house, perhaps, but a community based in-patient facility can already serve the functions of a halfway house at the point where the individual can come back at night and so on. So the success rate is better.

The second answer is the net capacity of the in-patient communitybased facilities that we do plan to bring into being in Texas will total substantially a larger number than the number served in the Fort Worth hospital.

The number of Texas addicts specifically who were committed for treatment at Fort Worth in fiscal year 1971 was about 400. Under contract with NIMH operational in-patient facilities in Texas now are 175 addicts, and these facilities have a potential for an additional 185. Early in fiscal 1972, as many as 70 additional in-patient contracts may be negotiated, depending upon the need to do so, and this will create the capability to treat another 260 in-patient addicts. This would bring, therefore, the total in-patient capacity, in Texas alone, in 1972, up to an estimated 618.

Mr. ROGERS. Well, may I say this, Mr. Secretary, you just told us how the VA hospitals are going to bring them in, detoxify them and send them back to their community with followup service we hope to be able to establish. They do this right now in New York. They take them out of their environment just like the VA is going to do and then send them back to communities but they have to have followups and the reason for the rate of recidivism from Fort Worth and Lexington is because we have not given them followup service in the home community.

This is changing we hope and also as far as the facilities you are going to provide in Texas these are not going to take care of enough. For instance, we were in St. Louis and they used a hospital also at Fort Worth and they have an estimated 6,000 addicts. Do you know how many in-patient beds they have in St. Louis?

About 11, and we went to New Orleans and they used Fort Worth and do you know how many detoxification beds they have there? About 10.

So until we get these facilities, I don't know how we can close and not use them, yet I understand a request has already gone out not to accept any more patients and not use them.

Don't you agree with me it would be better to keep these open until we get all of these facilities to take care of them and with 6.000 addicts in New Orleans and 6,000 in St. Louis, just as two examples right off and with 20 beds to take care of them.

So the old argument that I have heard used about "OK, we are taking them out of the community and detoxifying them" simply does not stand up, but if you send them back to a community with after-care service, which I understand is the thrust of the program you want to establish, I think you could.

Secretary RICHARDSON. Clearly, we would have the responsibility to assure the availability of in-patient beds for any individuals who were transferred from Fort Worth or for those who would have come to Fort Worth if it continued to be operated by HEW.

But, in fact, we have made plans to do this effective August 1, 1971. Let me ask Dr. Brown to pick up at this point and tell you how this stands.

Mr. ROGERS. Yes: but it is my understanding that with the intent of the Congress, which I am sure will be expressed by a concurrent resolution which has already passed the Senate and passed the House committee, and with the additional funds, and clear intent in the debate on the floor providing additional funds, I presume you would

not make any change there, but begin to use the facilities? However, I think your letter told me that the transfer was planned for October 1.

Secretary RICHARDSON. I had better reserve an answer to the question. In my response earlier as to carrying out the intent of Congress, that was predicated upon the assumption that the intent of Congress was expressed in a way other than with respect to the appropriation of $14 million for that purpose.

Mr. ROGERS. We express it in a direct resolution, which we will do. This will be done Monday in the House.

Secretary RICHARDSON. Well, this could, of course, override plans that we had already began to carry out. I do think, however, that we owe it to ourselves as well as to the Congress to try to convince you that we proposed to do makes sense.

Let me ask Dr. Brown to pick up on the alternative arrangements that would be made.

Dr. BROWN. Mr. Rogers, the plan to transfer Fort Worth to the Bureau of Prisons I think, taking into consideration all of your points arbout the lack of beds in St. Louis and other places, is a thoughtful and wise one, that would enhance the narcotic treatments capacity of this country.

On the budgetary side, funds were allowed in the NIMH budget to develop the alternative community in-patient, out-patient, and followup services and we were developing capabilities that would be equal to those we had in the way of in-patient capacity at Fort Worth.

Second, the facility and its expertise, an issue not quite addressed, but I know is important to you, would have been maintained. I have heard the Director of the Bureau of Prisons state right here, through his deputy, that over 50 percent of the patients that will be treated in Fort Worth in the Bureau of Prisons would be narcotics addicts, so the bulk of the personnel would have continued to do that for which they have been trained and we would not have lost that and I think the Federal prisoners who have narcotics problems are part of a citizenry which we at public health have responsibility for. On the issue of carrying out the intent of Congress I defer to Secretary Richardson, we have been proceeding with an orderly sequence of transfer. For example, there were neuropsychiatric patients at Fort Worth that have been already transferred to Lexington hospital, and we asked the courts to stop sending us new in-patients and are proceeding as effectively as we can with developing the in-patient and "after-care" service in communities from whence the patients came to Fort Worth in the past.

I think it was a wise and thoughtful plan. Of course, if Congress advises us otherwise, I think the executive branch will take that into account, to say the least.

Mr. ROGERS. I would hope so. As I say, the Senate has acted and the House will act Monday and I am sure the Senate will concur in that feeling and the funds have already been provided. So I would hope that you would suspend any further action in disassembling that hospital.

Now, let me ask you this. What about education, Mr. Secretary? I saw one group denounce about three-fourths of the educational matter in the files on drug abuse because they said they were unfounded and had no basis in fact. Have these materials been reviewed and what is your comment on that, sir?

Secretary RICHARDSON. It is, I think, highly important to try to assess the effectiveness and impact of educational materials. As a matter of fact, when I was in Massachusetts several years ago, we developed a grant application to NIMH for money to try to assess the effectiveness of materials believed by adults to be effective, but which often have tended to be regarded as ridiculous, naive, even amusing to the more sophisticated children to whom they were supposedly addressed.

In fact, in the meanwhile NIMH has sponsored substantial research to assess the impact of various educational materials. The results of this research are only beginning to be analyzed, but should be of great importance in the design of educational materials in the future.

Dr. BROWN. Just a brief point, this is one of those places where I think the critical flaws and faults that were found are a bit of an asset, that we finally have organizations such as the National Coordinating Council looking at these films and materials and giving us a scientific assessment as to their accuracy and impact. And the fact that we found a significant number that were less than effective, often inaccurate, is the indicator we were getting down to the task.

One other point, if I can piggyback, is an example of agency integration. We have worked closely with the Office of Education so that in developing materials for teachers, schools, curricular materials, you have the benefits of the agency of the Office of Education which has the contacts with the school system and also the benefits of the scientific establishment. And, thirdly, to evaluate for both whether it is effective or not.

Mr. ROGERS. You had that coordination?

Dr. BROWN. Yes; we have it going now under the lead agency concept that the Secretary has supported very effectively.

Mr. ROGERS. Would you let us have, for the record, a listing of the basic educational materials you have prepared and the evaluations of them?

Dr. BROWN. Yes; we would be glad to for the record.
(The following information was received for the record:)

EDUCATIONAL MATERIALS-NATIONAL INSTITUTE OF MENTAL HEALTH-
OFFICE OF EDUCATION

The National Institute of Mental Health, in cooperation with the U.S. Office of Education, has developed a set of drug education materials (The Social Seminar), filmed and printed, to be used in training teachers and in educating adults. It is possible to use either the entire series of separate components to provide information and modify attitudes toward the drug abuser. The two basic components are a 12-part film series of half-hour and full-hour segments and a multi-media package containing a programmed text, three six-minute films and a role-playing simulation game. A series of field trials have been conducted by the contractors who developed the materials, the U.S. Office of Education at a meeting for state coordinators of drug education, and NIMH at selected settings. A summary of findings from the evaluation is attached.

The series is available from state educational film libraries and from the NIMH Drug Abuse Film Collection, National Audiovisual Center, GSA.

12-PART FILM SERIES

Changing-An examination of contemporary culture; in particular the quality of life as its impact is felt by a young family trying to re-orient themselves in a society of conflicting standards and values. (1⁄2 hour, color)