OFFICE OF ECONOMIC OPPORTUNITY-COMPREHENSIVE NEIGHBORHOOD HEALTH SERVICES PROJECTS Alabama Lowndes County Board of Health's Community Health Project, P.O. Box 236, Health Services, Inc., 1000 Adams Street, Montgomery, Alabama 36104 Neighborhood Health Center, Alviso, California 95002 East Palo Alto Health Center, 2148 University Avenue, East Palo Alto, California 94303 Southern Monterey County Health Project, 210 Canal Street, King City, California 93903 South Central Multipurpose Health Service Center, 2051 East 103rd Street, Los Angeles, California 90002 Mission Neighborhood Health Center, 2318 Mission Street, San Francisco, California 94110 Colorado Eastside Neighborhood Health Center, 2900 Welton Street, Denver, Colorado 80205 Westside Neighborhood Health Center, 990 Federal Boulevard, Denver, Colorado 80204 The Sangre de Christo Comprehensive Neighborhood Health Center, San Luis, Colorado 81152 District of Columbia Community Group Health Foundation, Inc., 3308 14th Street N.W., Washington, D.C. 20010 Florida Economic Opportunity Family Health Center, Inc., P.O. Box 875, Biscayne Annex, Miami, Florida 33152 Georgia Price Area Health Center, 1070 Washington Street N.W., Atlanta, Georgia 30315 Illinois North Lawndale Neighborhood Health Center, 3312 West Grenshaw Street, Chicago, Illinois 60624 Mile Square Neighborhood Health Center, 2049 West Washington Street, Chicago, Illinois 60612 Kentucky Leslie County Health Project, Court House, Hyden, Kentucky 41749 Floyd County Comprehensive Health Services Program, Floyd County Health Department, Prestonsburg, Kentucky 41653 Louisville Neighborhood Health Center, 1817 South 34th Street, Louisville, Kentucky 40211 Maryland Provident Comprehensive Neighborhood Health Center, 1106 Mondawmin Concourse, Baltimore, Maryland 21215 Massachusetts Columbia Point Health Center, 300 Mount Vernon Street, Dorchester, Massachusetts 02122 Roxbury Neighborhood Health Center, 700 Harrison Avenue, Boston, Massachusetts 02118 Michigan Western Michigan Comprehensive Health Service Project, 5718 Highway M-37, Baldwin, Michigan 49304 Comprehensive Neighborhood Health Center, Pavilion 6, Herman Kiefer Hospital, 1151 Taylor, Detroit, Michigan 48202 Minnesota Community Comprehensive Health Services, Red Lake, Minnesota 56671 Mississippi Mound Bayou Community Hospital, Mound Bayou, Mississippi 38762 Missouri Wayne Miner Health Center, 911 Michigan Avenue, Kansas City, Missouri 64127 Comprehensive Neighborhood Health Center of Human Development Corp. of St. Louis, 1321 Clark Avenue, St. Louis, Missouri 63103 Montana *Eastern Montana Community Health Assn., Box 502, Glendive, Montana 59330 New York Gouverneur Health Services Program, Beth Israel Medical Center, 9 Gouverneur Slip, New York, New York 10002 Long Island College Hospital, 340 Henry Street, Brooklyn, New York 11201 Sunset Park Health Center, 514 49th Street, Brooklyn, New York 11220 Neighborhood Medical Health Center, 3674 Third Avenue, Bronx, New York 10456 Neighborhood Health Center, 476 Nostrand Avenue, Brooklyn, New York 11216 Neighborhood Health Service, 160 West 100 Street-2nd Floor, New York, New York 10025 Catholic Medical Center of Brooklyn, and Queens, 152-11 89th Avenue, Jamaica, New York 11432 University of Rochester School of Medicine and Dentistry, 260 Crittenden Boulevard, Rochester, New York 14620 Syracuse Neighborhood Health Center, Onondaga County Dept. of Health, 300 South Geddes Street, Syracuse, New York 13204 Ohio Community Health Center, 4882 Jefferson Street, Bellaire, Ohio 43906 Newton D. Baker Health Center, 1465 East 55th Street, Cleveland, Ohio 44103 Oklahoma North Tulsa Comprehensive Community Health Center, 603 East Pine Street, Tulsa, Okalahoma 74112 Oregon Portland Kaiser Health Center, 4707 S. E. Hawthorne Boulevard, Portland, Oregon 97215 Pennsylvania Hartranft Health Center, 2539-43 Germantown Avenue, Philadelphia, Pennsylvania 19133 Nicetown-Tioga Neighborhood Health Center, Broad and Ontario Streets, Philadelphia, Pennsylvania 19140 Pennsylvania Hospital, Eighth and Spruce, Philadelphia, Pennsylvania 19107 Homewood-Brushton Neighborhood Health Center, P.O. Box 5721, Pittsburgh, Pennsylvania 15208 South Carolina Charleston Comprehensive Care Project, 80 Barre Street, Charleston, South Carolina 29401 Tennessee *Chattanooga-Hamilton Co. Community Action Program, 846 McCallie Avenue, Chattanooga, Tennessee 37403 Meharry Neighborhood Health Center Proj., 1820 Albion Street, Nashville, Tennessee 37208 West Virginia Family Health Center, Beckley-Appalachian Regional Hospital, Beckley, West Virginia 25801 *West Virginia Dept. of Mental Health, 1721 Quarrier Street, Charleston, West Virginia 25305 Wisconsin *Wisconsin State University, Stevens Point Foundation, Inc., 2100 Main Street, Stevens Point, Wisconsin, 54481 *Planning projects. Mr. ROGERS. The next on the witness list is the Association of State and Territorial Health Officers. I am going to call on Congressman Nelsen for introduction here. Mr. NELSEN. Mr. Chairman, the next witness is a friend of mine, Dr. Barr, secretary and executive officer of our State department of health. Having served in the Minnesota Legislature for many years and having known Dr. Barr, likewise, for many years, I must say that it is a pleasure to welcome you, Dr. Barr, to Washington, to present your views on this very much needed legislation. I hope you excuse me if I go on to another committee. I have a bill before another committee and I should necessarily appear there in support of my own proposal. I am sure you will take care of things in fine shape and will offer some opinions that will be very valuable to the committee. Thank you very much. Mr. CARTER. Mr. Chairman, would the distinguished gentleman yield on this? Mr. NELSEN. I will yield. Mr. CARTER. I regret very much that the commissioner of health of the State of Kentucky, Dr. Russell Teague, past president of the State and Territorial Health Officers, is incapacitated and unable to be here with you today. Certainly we welcome you to testify before the committee. Mr. ROGERS. Also, we have Mr. William F. Henderson, the executive secretary of the North Carolina Medical Care Commission. We are delighted to have you. The North Carolinian might want to say something there. Mr. PREYER. It is a personal pleasure to welcome Mr. Henderson here. I have known him and the work that he and his commission have done in North Carolina from personal experience. I can tell you that it has meant a great deal to the hospitals of North Carolina and Mr. Henderson is most highly regarded by all of the hospitals. I extend you a cordial welcome to Washington, Mr. Henderson. STATEMENTS OF DR. ROBERT N. BARR, SECRETARY AND EXECUTIVE OFFICER, MINNESOTA STATE DEPARTMENT OF HEALTH, AND WILLIAM F. HENDERSON, EXECUTIVE SECRETARY, NORTH CAROLINA MEDICAL CARE COMMISSION, IN BEHALF OF THE ASSOCIATION OF STATE AND TERRITORIAL HEALTH OFFICERS Dr. BARR. Mr. Rogers, due to the fact that Dr. Teague is ill, I will present a statement covering the policies of the Association of State and Territorial Health Officers. Mr. Henderson and I were going to discuss each of the problems as it relates to Hill-Burton in our own State as an example of this. So in his absence, I will present his statement. Mr. ROGERS. That will be fine. Dr. BARR. I have submitted a statement that I prepared partially for Minnesota on this which will be made a part of the record if it is agreeable to you folks. Mr. ROGERS. Your statement will be made a part of the record and you may comment as you wish. (See p. 265.) Dr. BARR. The Association of State and Territorial Health Officers fully supports the sound principles upon which the Hill-Burton Act is based. It is an outstanding example of effective legislation designed to enhance close and effective cooperation between Federal and State Government. A vital aspect of this legislation, and one that should be preserved in its extension, is the decentralization of the decisionmaking function to the State level where the most complete information regarding plans, needs, resources, and priorities is available. Indeed, we could improve our utilization of limited health resources if more Federal health programs were patterned after the Hill-Burton Act. Our Federal investment to date under the Hill-Burton Act in the construction and modernization of health care facilities amounts to $3 billion. This investment has attracted another $7 billion of State and local funds on a matching basis. The 9,600 projects that have been approved provide more than 413,000 additional inpatient beds in hospitals and nursing homes and 2,700 other health facilities, such public health centers, diagnostic or treatment centers, and rehabilitation centers. Despite this progress, we must expand our investment in the construction and modernization of health care facilities if we are to meet the needs of today and satisfy the demand of our citizens for health services. The State Hill-Burton authorities report an urgent need for the construction of new health care facilities at an estimated cost of $5 billion and an equally compelling need to modernize or replace obsolete health care facilities at an estimated cost of $11 billion. These needs will continue to grow unless we take action now. APPROPRIATION AUTHORIZATIONS OF THE GRANT PROGRAM Since the backlog for new construction and modernization of health care facilities amounts to in excess of $16 billion, ASTHO recommends that the authorization for grants under the Hill-Burton Act be substantially increased. The total authorization for appropriations for grants for 1970 is $295 million for the construction and modernization of hospitals, public health centers, long-term care facilities, diagnostic or treatment centers, and rehabilitation facilities. ASTHO recommends that the total authorization for appropriations for grants for the construction and modernization of health care facilities be increased to $365 million for 1971, $385 million for 1972, and $395 million for 1973. These amounts are provided for in H.R. 6797. EXTENDED CARE SERVICES Both H.R. 6797 and H.R. 7059 would encourage general hospitals seeking Hill-Burton construction or modernization assistance to make provision for utilizing the services of extended care facilities. Such facilities cost less to operate than general hospitals and therefore offer a great potential for contributing to a reduction in the soaring costs of medical care. ASTHO favors the approach of H. R. 6797 that would give a priority to projects where there is a reasonable assurance that extended care services will be available through a facility operated by or affiliated with the hospital applicant. ASTHO recommends against the provision of H. R. 7059 that would deny construction or modernization assistance to a general hospital unless there was reasonable assurance that extended-care services |