involvement by disabled artists and other professionals with disabilities to participate in the planning and implementation of quality, ongoing arts programs that will be conducted together with their able-bodied peers. It is also our goal to have in place 50 statewide and ongoing Very Special Arts Festival Programs by 1985. Our vision for this program includes having all segments of the population disabled and able-bodied children, youth, adults, older persons, artists, etc. participating in cultural

and learning experiences that enhance their living and learning. We look forward to an arts program in each school which includes the major art forms of dance/movement, drama, music and visual arts that will be offered to disabled and able-bodied children in an integrated setting. We look forward to museums and other cultural facilities examining and setting in place structures that provide access to their programs and facilities for disabled persons. will continue to explore through the arts alternative methods of learning that focus on the abilities, not the disabilities, of learners.

We

Another major program of the National Committee is its National Awareness program. The National Awareness program is designed to stimulate public interest and promote the concept of utilizing the arts to enhance the lives of disabled people. Efforts include affiliation with museums and cultural institutions such as the Boston Children's Museum, where disabled and able-bodied children learn together and enjoy the arts; and the Kennedy Center's IMAGINATION CELEBRATIONS, where mainstreamed children are exposed to professional theatre to enhance their aesthetic learning. Affiliations with both cultural and educational institutions constitutes NCAH's efforts to make both learning and leisure time experiences integrative and joyful experiences for disabled and nondisabled persons.

The National Committee, Arts for the Handicapped hopes that through awareness, programming and advocacy efforts, the arts will be used to bring all segments of our society together in a positive atmosphere of mutual creative expression.

MR. DAVID SAKS, DIRECTOR, ORGANIZATION FOR USE OF THE TELEPHONE, INC.

The Organization for Use of the Telephone (OUT) is an all-volunteer non-profit advocacy organization working on behalf of hearing-impaired people. Our primary concern is the effective use of hearing aids with telephones. Our immediate goal is to assure that all telephones in the United States are capable of transmitting sound through hearing aid telephone pickups (telecoils).

In order to bring about this universal access to telephones for hearing aid users, it is vital pre-condition that the people and government be fully aware of the critical role played by telecommunications in the lives of all of us, including those of us who have suffered hearing impairment.

The Decade of Disabled Persons affords a unique opportunity to raise the level of national awareness in this regard. Accordingly, we call for the inclusion of full access to communication facilities as an added goal to be listed among the present nine goals of our national effort.

Approximately 45,000,000 (25 percent) of the telephones in the United States are not usable by more than 2,000,000 of our people. These people use hearing aids with built-in telephone pickups in order to hear telephone conversation. If the telephone is not compatible with the hearing aid, the hearing aid user is rendered "phone deaf"—that is, he is unable to use the phone despite his ability to communicate effectively in personal conversation. This adversely affects the hearing aid user as well as the many non-impaired people who wish to communicate with him. This is reflected in limited employment potential, restricted travel, exposure to safety and health hazards as well as educational difficulties and limitations in all aspects of modern life.

In order to alleviate to some degree this intolerable situation, the 97th Congress enacted Public Law 97-410, which provides that the Federal Communications Commission (FCC) issue regulations and technical standards to require "reasonable access" to telephone service for persons using hearing aids, and hearing aid compatibility for "essential telephones" only. These provisions promise to bring sorely needed relief in specific usage categories for some hearing aid users. They fall far short of the stated purpose of the Communications Act of 1934 "to make available, so far as possible, to all the people of the United States. . . communication service with adequate facilities . . . (emphasis added).

In order to expand the benefits that may be derived from Public Law 97-410 and to build upon the first step it provides toward recognition of the telephone/hearing aid incompatibility problem, Congressman Clarence D. Long of Maryland has introduced H.R. 210. This bill has been referred to the Subcommittee on Telecommunications, Consumer Protection and Finance of the Energy and Commerce Committee. Except for one added provision, H.R. 210 is identical to H.R. 5022 in the 96th Congress, of which Chairman Yatron was a co-sponsor. H.R. 210 would require that all new telephones be made hearing aid-compatible at the time they are manufactured. The one difference between the current H.R. 210 and the earlier H.R. 5022 allows greater flexibility to the telephone industry in the choice of technologies employed in making their instruments hearing aid-compatible.

The enactment of Public Law 97-410; the introduction of H.R. 210; the modification of 6,000 telephones in Maryland hospitals to make them hearing aid compatible; the decision of the General Services Administration (GSA) to begin specifying hearing aid-compatibility in all telephone procurements after October 1, 1983; the total modification of its coin telephone by GTE Corporation to make them usable with hearing aid telephone pickups-all point to the growing national awareness of "phone deafness" as a serious problem capable of solution through utilization of readily available, widely known, inexpensive technology.

However, these example of progress should not be allowed to mask the enormity of the remaining problem. All over the United States people are unnecessarily phone deaf. They are needlessly handicapped by limited awareness of their problem and widespread failure to deal with it beneficially. Painful, partial solutions prolong the years of wasteful and agonizing deprivation.

Disabilities that are not capable of solution must be tolerated. Disabilities that are capable of solution must not be tolerated-must not be allowed to become lifelimiting handicaps.

Mr. Chairman and members of the Subcommittee on Human Rights and International Organizations; we call on you to help.

1. Please consider, as individual members of Congress, co-sponsoring H.R. 210 and helping Congressman Long move it forward through the legislative process.

2. Support our contention that the nine goals of the National Organization on Disability be expanded to ten by the addition of this goal: Full Access To Communications Facilities.

We feel certain that your expressed support will do much to elevate communications disabilities to greater importance among the disabilities receiving national attention during the Decade of Disabled Persons.

ASSOCIATIONS

HERBERT B. DOLINSKY, D.D.S., CHAIRMAN, COUNCIL ON DENTAL HEALTH AND HEALTH PLANNING, AMERICAN DENTAL ASSOCIATION

The American Dental Association supports H. Con. Res. 39 which calls for attaining the objectives, in the United States, of the United Nations Decade of the Disabled.

The American Dental Association has had a long-standing concern for and commitment to meeting the oral health needs of all our citizens, especially those who encounter barriers to receiving care.

For many years, the Association has emphasized the critical need to improve the access to dental care for special populations. Approximately 30 years ago, the ADA, to emphasize the importance of identifying the oral health needs of special populations, urged its constituent dental societies to conduct needs assessments and to develop demonstration projects to meet those needs. In 1966, the ADA's Council on Dental Health called on dental societies to work in conjunction with the dental divisions of state health departments to develop programs to provide needed care to the homebound aged, chronically ill and disabled individuals. In 1976 and 1977, the Association further called upon dental societies to identify barriers to full access to dental care in their communities and to seek appropriate remedies.

The Association's concern was synthesized in the 1979 planning document, titled, "Prevention and Control of Dental Disease Through Improved Access to Comprehensive Care." This report identifies the most common barriers to dental care and establishes a framework for future Association activities directed to special populations. Five groups were identified as deserving the dental profession's primary attention: the elderly; the disabled, homebound and institutionalized; the poor and working poor; remote area residents and uninsured workers. The report stresses that the responsibility for improving the availability of oral health services is one to be shared cooperatively by the dental profession, the government and other segments of society. Recognizing the magnitude of this effort, the ADA identified the disabled as a priority group.

The oral health status of disabled individuals is unnecessarily poor. One study of mentally retarded and cerebral palsied children confirmed that 55 percent had unfilled cavities and nearly 50 percent had never received dental care. Another study demonstrated that developmentally disabled people, particularly those with Downs Syndrome, suffer from a much greater incidence of periodontal disease than the non-disabled population.

The reasons for these significant oral health problems are many and varied. One of the principal factors restricting the disabled person's ability to obtain optimal care is a lack of personal finances to pay for that care. About 57 percent of the disabled population come from families where the annual income is less than $10,000. These families simply do not have the resources to obtain adequate care. This need is compounded by the absence of basic dental benefits in Medicare and in many state Medicaid programs. Even in states that provide Medicaid coverage for basic dental services for adults, fee schedules are often inadequate, especially for treatment of the disabled, whose disabilities often necessitate higher costs. The Association is especially concerned that the federal government is reducing its financial support for public health care, ignoring its obligation to assist in financing care for those unable to pay for needed dental services.

Disabled individuals often face additional problems which impede the attainment of optimal oral health. Complex medical difficulties, combined with specific disabling conditions, restrict mobility, increase transportation difficulties and inhibit the performance of recommended daily oral hygiene techniques.

The Association seeks to ensure that all individuals, regardless of their condition in life, have the opportunity to enter the dental delivery system. This is, however, an obligation that all segments of society must be willing to share. It is not realistic to expect the dental profession to assume this responsibility alone.

Since the mid 1970's, the Association has helped fund a nationwide initiative of the National Foundation of Dentistry for the Handicapped. The NFDH is conducting preventive dentistry outreach programs for over 30,000 disabled individuals nationwide and provides treatment services through the use of specially designed portable equipment to those individuals who are unable to reach a dentist's office. The Association believes that the Foundation's model programs represent an effective way of addressing the serious oral health needs of the disabled population. The Foundation has demonstrated that, through the cooperative efforts of community groups, governmental agencies and the private sector, the oral health status of these underserved groups can be significantly improved.

It is recognized that one of the obstacles encountered by the disabled population in getting dental care is that of identifying those dentists in the community who are prepared to treat them. Through its state and local dental societies, the Association maintains current listings of dentists experienced in treatment of the disabled. Such listings are now available in most states.

In addition, the availability of funding sources to pay for treatment is a critical determinant of whether these individuals will be able to enjoy the comfort and dignity of optimal oral health. As part of the Association's access initiatives, the Auxiliary to the American Dental Association, in May 1981, inaugurated a special project designed to identify funding sources for dental treatment of disabled individuals. Some limited success in identifying local funding sources has been reported.

Another acknowledged access barrier to dental care for certain individuals is their physical inability to reach the dentist's office or any other location with fixed dental equipment. For years, the dental profession has attempted to address this problem through the use of specially designed mobile and portable dental units. The Association acknowledges the value of utilizing these methods as one important way of delivering dental services to special population groups unable to reach fixed dental facilities. In this regard, the Association's Council on Dental Health and Health Planning has prepared a special access resource packet, "Portable Dentistry Information," designed to provide dental societies and others with guidelines and program ideas for developing a portable dentistry program.

Additionally, the Association has developed various print and audiovisual materials for use by parents, teachers and allied health personnel, and publishes a journal, Special Care in Dentistry, which focuses on the needs of special patients and provides a forum for the exchange of ideas, innovations and opinions.

These are just a few examples of the efforts by the dental profession to address the oral health needs of our disabled population. The dental profession, however, cannot do the job alone. We must have the understanding, the support and the cooperation of concerned individuals, organizations and government. The responsibility, as well as the benefits, belong to us all. In addressing the National Organization on Disability, Association President, Dr. Burton H. Press commented, "Establishment of the Decade of Disabled Persons is an important step in our recognition of the many talents and abilities of the disabled, and of the many doors too frequently closed to them through ignorance and misinformation. Working together, we can open those doors and expand the access of the disabled to all of society, for their benefit and ours." We urge you to affirm the commitment of the United States to bettering the health of the disabled.

JAMES H. SAMMONS, M.D., EXECUTIVE VICE PRESIDENT, AMERICAN MEDICAL

ASSOCIATION

The American Medical Association supports H. Con. Res. 39. The United Nations General Assembly has proclaimed 1983-1992 as the United Nations Decade of Disabled Persons to encourage the continuation of improvements begun during the International Year of Disabled Persons (IYDP) and the National Year of Disabled Persons (NYDP). H. Con. Res. 39 would express the sense of the Congress that the President should implement the objectives of the United Nations Decade of Disabled Persons in the United States.

AMA ACTIVITIES

The AMA was involved in both IYDP and NYDP. Our primary efforts have been in two areas-increasing public awareness and prevention of disability.

Public professional information.—AMA publications played an important role by featuring articles about IYDP and NYDP, the disabled and prevention of disability. For example, the Journal of the American Medical Association (JAMA) published a detailed review of IYDP's accomplishments. We also published an editorial on eye

injuries and their prevention as well as articles on adjustment to visual loss, leprosy (the major cause of disability in India), DPT vaccines and many other related subjects. Other publications of the AMA such as Allied Health Education Newsletter, AMA Employee News, and American Medical News (circulation: 300,000) also published articles on disabilities and the disabled.

AMA also encouraged state and local medical societies, as well as medical specialty groups to participate in IYDP and NYDP activities and offered guidelines for possible emphasis and activities.

Finally, the AMA developed and used an AMA/IYDP logo. AMA used the logo as a postage meter imprint that appeared on an estimated 5 million pieces of mail sent from the AMA. This logo also appeared on posters displayed at major AMA meetings and was printed in JAMA. The logo was redesigned for NYDP and was utilized in similar ways.

Prevention of disability.—The AMA has a valuable role to play in reducing disabling injuries. The AMA is sponsoring a conference on the Prevention of Disabling Injuries May 20 and 21, 1983, to focus on the extent of the problem of injuries and to search for solutions. Topics include Prevention of Injuries: On the Highway, at Home and During Recreation; Injuries Related to Agriculture and Industry; the Physician's Role in Preventing Disability due to Alcohol Related Problems; and Traumatic, Disabling Injuries: Why They Occur and Extent of the Problem. A brochure describing the conference is attached.

During IYDP and NYDP, the AMA's Council on Scientific Affairs prepared a number of reports regarding the prevention of disability including: "Genetic Counseling and Prevention of Birth Defects," "Fetal Effects of Maternal Alcohol Use," "Brain Injury in Boxing," "Revision of AMA Guides to Impairment,' " "AutomobileRelated Injuries: Components, Trends, Prevention," and "AMA Involvement in Prevention and Treatment of Child Abuse." (Copies of these reports are attached.) These reports are official AMA policy and provide guidance to physicians, medical societies, governmental agencies and the public. Some of these reports have been prepared in booklet form for distribution to the public, such as "Fetal Effects of Maternal Alcohol Use" and "Alcoholism as a Disability." In addition the AMA has prepared booklets aimed at helping individuals recognize risks and how to avoid them, such as "Drinking and Driving," "Home Accidents Aren't Accidental," and "Immunization."

The Association has also supported federal and state legislative efforts to reduce the incidence of disability. For example, AMA supported the recently enacted federal drunk driving legislation and H. Con. Res. 23, which encourages the states to increase their drinking age to 21. AMA has also encouraged state medical societies to support strengthening of state drunk driving laws.

Other activities.-During the NYDP, AMA Board of Trustees Chairman Joseph F. Boyle, M.D., and AMA President-Elect Frank J. Jirka, Jr., M.D., became members of the Board of the National Organization on Disability. The AMA also contributed financially to the National Organization on Disability. Such activities strengthen the link between organized medicine and the disabled community.

During 1982, the AMA published a book entitled "Travelers' Health Abroad" which contains a chapter providing information for the handicapped traveler. This chapter includes discussion of special arrangements the handicapped traveler should make and the special facilities available from transportation companies.

Recognizing the importance of accessibility, the AMA's Chicago_headquarters building was made accessible to persons in wheelchairs during 1979. The effort was furthered during IYDP by placing Braille floor markings at and in the building's elevators. During NYDP, a new AMA office was opened in Washington, D.C. that is also fully accessible to individuals in wheelchairs.

DECADE OF THE DISABLED

Although the AMA has been active in this area for some time, the designation of 1981 as IYDP and 1982 as NYDP provided the impetus for us to increase our efforts. Although many improvements were made in the United States during IYDP and NYDP we believe much remains to be done. Both the public and private sector should be encouraged to support activities to improve the quality of life for the nation's disabled. Participation by the United States in the Decade of Disabled Persons would focus attention in the public and private sectors on efforts to provide opportunities to the handicapped. AMA supports H. Con. Res. 39 as a means of increasing public awareness of the special needs and capabilities of the disabled.

During the Decade of Disabled Persons, AMA plans to conduct activities similar to those we were involved in during IYDP and NYDP. Medical organizations can be