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was assigned to the Soil and Water Conservation Research Branch of the Agriculture Research Service to make a more comprehensive study of the problem and to prepare a detailed research project statement outlining the necessary studies and the budget requirements. This budget is now being presented to Congress for its approval. The budget for work on this project by the United States Public Health Service is likewise being submitted for congressional approval. Their studies are closely correlated with those prepared by the Agriculture Research Service, in fact the studies proposed by each of the above agencies are completely interdependent and crucial in the solution of the overall problem. A detailed statement of the studies to be undertaken, their interrelationship, the need for them and their value will be found in the attached research project outline. In addition to the studies mentioned in this outline the United States Public Health Service proposes to study the incidence and natural history of the encephalitis viruses and the biology and control of their mosquito vector. The latter studies will be made in relation to irrigation water usage.

The Montana Agricultural Experiment Station will study the field ecology of the principal mosquito species in the Milk River area. Emphasis will be placed on determining the factors and conditions which are responsible for the choice of egg laying sites and a determination will be made of the minimum conditions necessary for egg hatch and larval survival. These studies will be made in relation to irrigation water usage within the area. The Montana station, in addition, will continue their studies on the effect of mosquitoes on milk production and weight gains on livestock.

The Montana State Board of Health plans to aid the United States Public Health Service in their encephalitis studies by gathering information on the nature, symptoms, etc., of the disease and in the preparation of case histories.

The State board of entomology will provide seasonal help to make mosquito collections throughout the State. These collections will be processed by the United States Public Health Laboratory at Hamilton, Mont., for the presence of encephalitis viruses.

The North Montana Experiment Station will act in an advisory capacity on such things as experimental site selections, land usage, soil treatments, and agronomic practices.

The United States Bureau of Reclamation will make available the knowledge which they have accumulated through the years they have operated in this area, as well as to loan or transfer specialized equipment.

The United States Soil Conservation Service will make available part-time help for the project by regular Soil Conservation Service staff members.

The Blaine County Mosquito Committee is contributing office space for field personnel and will aid in securing experimental sites.

The Montana Extension Service will aid in the dissemination of research data and in securing acceptance of the findings which results from this study.

The State entomologist will act as coordinator of the project and will assist in maintaining close liaison between the residents of the area and the operating agencies.

This Milk River mosquito project in all its ramifications is one of the few studies ever attempted in the comprehensive manner outlined above. Complete agreement between agencies has been reached as to the phases of study to be undertaken by each agency, and the manner in which these studies are to be carried out. It should be obvious that without the contributive studies from each agency being undertaken simultaneously, limited value would be forthcoming from any one study. The solution of a problem of this nature does not lend itself to a piecemeal approach. Budget summary for fiscal year 1955-56

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Budgets to be expended by contributing agencies other than Agricultural Research Service and United States Public Health Service. These budgets will be obtained and the funds utilized by the agencies listed below. They are not in

volved in the request being made by the Agricultural Research Service and the United States Public Health Service. Each individual budget is necessary to carry out the agency's particular segment of the problem. These do not involve requests for new additional funds.

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Senator HILL. I have received a statement from Senator Humphrey, of Minnesota, covering sundry items in the budget of the Department of Health, Education, and Welfare. His prepared statement will be included in the record at this point. (The statement referred to follows:)

HEALTH, EDUCATION, AND WELFARE APPROPRIATIONS

Mr. Chairman, the services of Health, Education, and Welfare provided to our citizens under the appropriation_bill before your subcommittee are among the most important activities of our Government. Not only do they relieve suffering from crippling illness and provide educational benefits to individual citizens, but these services work to the good of the entire Nation. The improvements in medical treatment through research and the raising of the educational levels of our citizens promote the general welfare in a way that far transcends their immediate effects. It does not overstate the case to say that the investment of the comparatively small sums spent through these programs gives us a return nearly immeasurable in terms of the general well-being of our society.

I know that the committee approaches its consideration of these appropriations with the overall public good in mind and would not practice economy for economy's sake where it might curtail worthy services. It is for this reason that I wish to support some of those appropriations now under study by your committee, for a number of them have already been reduced either by the Bureau of the Budget or by the House. Nearly all of them are not only important to the citizens of my own State of Minnesota, but are beneficial to all of the people of the United States.

VOCATIONAL REHABILITATION

The Vocational Rehabilitation Act which we passed last year provided that $45 million should be appropriated for fiscal year 1956 for the program under the act. This would allow for the progressive expansion of vocational rehabilitation services so that over a 5-year period the number of disabled persons rehabilitated could be increased from 60,000 to 200,000. The Office of Vocational Rehabilitation estimates that there are probably between 250,000 and 300,000 disabled persons who could be rehabilitated each year and that the backlog is about 2 million.

The full amount authorized for fiscal 1956 was not requested by the budget, but the estimate that was made would have provided rehabilitation for more than 95,000 disabled men and women so that they could play a more useful and satisfying part in the community. But this budget request was cut by the House Committee on Appropriations from $42,573,000 to $35,300,000, a decrease of $7,273,000. Of this, $39 million had been requested for grants to the States and other agencies, and this appropriation was cut back to $32,500,000. This cut would mean that only about 80,000 disabled persons could be rehabilitated during the coming year. If this cut is allowed to stand, the national goals set by the President and Congress of rehabilitating 200,000 people a year by 1959 will not

be met.

I cannot agree with the caution of the House Appropriations Committee in its concern that the program not be expanded too rapidly. When we consider the large numbers of disabled men and women whom we are not yet able to reach with this program, everything should be done to attempt to meet the intentions of the Congress in framing the Vocational Rehabilitation Act last year so as to extend its benefits as soon as possible. This is not only desirable in terms of the relief from a sense of helplessness and uselessness in which disabled persons now find themselves but also in terms of the contribution they can make to the community once they have been helped through vocational rehabilitation.

For this reason, I strongly urge that the Senate Committee on Appropriations restore the $6,500,000 cut from the grants to States and other agencies. As the success of the vocational rehabilitation program is dependent in large part on the personnel administering it, the cuts for training and salaries and expenses should likewise be restored. This would include $550,000 more for the special training of physicians and rehabilitation counselors and the restoration of $223,000 cut from the item for salaries and expenses. This would bring the total appropriation back to $42,573,000 so that vocational rehabilitation could then be extended to 95,000 disabled men and women and more nearly approach the number intended by the Congres. in its plan for the progressive expansion of the program.

PUBLIC HEALTH SERVICE

It is gratifying to note that the House recommended appropriations that would enable the Public Health Service to continue some of its most vital activities unimpaired and that in a number of cases the House even increased the budget request so that some activities can be expanded. I would especially like to express my support for the appropriations presently recommended for tuberculosis, Indian health activities, and the following activities under the National Institutes of Health: The National Cancer Institute, mental-health activities, the National Heart Institute, dental-health activities; arthritis and metabolic disease activities, microbiology activities, and neurology and blindness activities. There is one area of Public Health Service that has been cut quite drastically, however, and that is in grants for hospital construction. I wish to urge strongly that this cut be restored. The reduction in assistance to States should also be reinstated.

There is reason to hope that we are approaching a time when tuberculosis may be conquered. But it is still with us, and we are told that the annual expenditure for treatment of this disease still runs to more than half a billion dollars. When contronted with a sum like this, the $6,000,000 we are asked to appropriate here seems small indeed as it gives promise of helping to put an end to tuberculosis. The request for fiscal 1956 would make $4,500,000 available to the States to continue their needed and effective programs of tuberculosis case-finding and prevention. The other $1,500,000 would be for the continued operation of the research and consultative programs of the Public Health Service central and regional offices. I am sure that the committee will maintain the appropriation without reduction so that this vital work may go forward toward the elimination of tuberculosis.

Appropriations for Indian health activities were increased by the House committee by $250,000 to a total of $33,840,000. Also the amount of appropriations for construction of Indian health facilities has been raised by $200,000 to $4,750,000. It is hoped that these increases will be sustained. As the House pointed out in its report: "*** the American Indian is still the victim of an appalling amount of illness. The health facilities are either nonexistent in some areas, or, for the most part, obsolescent and in need of repair; personnel housing is lacking or inadequate; and workloads have been such as to test the patience and endurance of professional staff. This all points to a gross lack of resources equal to the present load of sickness and accumulated neglect." Certainly we should do everything possible to relieve these conditions, and the appropriations recommended by the House committee are a further step in this direction.

As I have indicated, the increase in appropriations for the activities of the National Institutes of Health is indeed gratifying. The additional funds will allow these services to carry forward their activities with renewed vigor during the coming year and give us increased hope that some of these diseases will soon be wiped out or at least alleviated. We have all experienced recently the immense sense of relief that comes to us when the hope of conquest of illness appears as it has in the case of poliomyelitis. It is with that recent lesson in mind that I support the increases presently in the bill for the activities of the National Cancer

Institute, mental-health activities, the National Heart Institute, dental-health activities, arthritis and metabolic disease activities, microbiology activities, and neurology and blindness activities.

HOSPITAL CONSTRUCTION GRANTS AND ASSISTANCE TO STATES

The two reductions in appropriations under the Public Health Service that I would like to see reinstated are those in grants for hospitals and hospital construction and those for general assistance to States.

We have a need for 800,000 additional hospital beds in the Nation today. When we consider the continuing rapid increase in our population-especially our older population-the shortage is seen to be acute. For this reason, it is important that appropriations for the Hill-Burton features of the act be maintained at the $75 million to which they were restored by House committee. If anything, we should be appropriating more, not less, than in prior years to stimulate construction of hospital facilities by the States and local communities. Considering that the amount that could be appropriated under the Hospital Construction Act is $150 million, it becomes clear that we are not doing all that we could and should to ameliorate this acute shortage of needed hospital facilities.

But while the House committee restored appropriations for the Hill-Burton features to the same level as last year, it cut the appropriation for the new features added in 1954 from the request of $60 million to $21 million. The new features include diagnostic and treatment centers, hospitals for the chronically ill and impaired, rehabilitation facilities, and nursing homes. As these provisions were aimed at meeting the urgent medical needs of our aged population, it would be regretable if the reduction is allowed to stand. For the tremendous increase in our population of 65 or over has brought about and will bring about a rising demand for chronic disease and nursing-home facilities. Consequently, I cannot urge too strongly that the Senate committee restore the appropriation for these needed facilities to the $60 million requested.

Likewise, the $300,000 cut from the appropriation for salaries and expenses of hospital-construction services and the $352,000 reduction in funds for hospitals and medical care should be restored.

The other reduction in appropriations under the Public Health Service that should be reinstated is, as I have said, that for general assistance to States. The reduction of $1,660,000 brings the total appropriation available for such assistance down far below that of last year. To indicate what this reduction would mean to my own State of Minnesota, I include at this point a letter and table sent to me by the Minnesota Department of Public Health. Dr. Albert J. Chesley, secretary of the department, states what effect the reductions in both assistance to States and also in grants for hospital construction will have on Minnesota's health program during the coming year.

Hon. HUBERT H. HUMPHREY,

MINNESOTA DEPARTMENT OF HEALTH,
Minneapolis 14, Minn., April 7, 1955.

United States Senate, Washington 25, D. C.

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DEAR SIR: The Department of Health, Education, and Welfare 1956 appropriation bill, H. R. 5046, passed March 21, provides $12 million under the heading, "Assistance to States, general.' This is $1 million less than the 1955 appropriation and $1,660,000 less than the Department's request for 1956. The House committee indicated that the reduction was to be applied against the $9,725,000 "Grants to States" item for general health purposes. This reduction in appropriations will mean a decrease of $31,937 to Minnesota for general health. (See exhibit I, attached.) Such a reduction would be extremely critical for Minnesota since replacement with State money is unlikely.

The House has voted $75 million for the original Hill-Burton program, a $10 million increase over HEW's request, and $21 million for the 4 new categories under the Hill-Burton Amendment, a $39 million decrease from the amount requested. We urge your assistance in obtaining the full authorized appropriations ($150 million and $60 million).

Recently, we sent you a brochure of information on our hospital services section. Part I, exhibit 8 indicates that projects in the various planning stages could utilize more than $20 million in Hill-Burton and amendment funds. Construction costs have increased substantially as noted in two recent bid openings. This will curtail the number of projects which can be assisted with the limited funds available. Minnesota still has more than 1,600 general hospital beds in non-fire-resistive buildings needing replacement. There is tremendous interest in

the construction of good nursing home facilities, but with only $65,434 available to Minnesota from the 1955 allotment and $68,070 as proposed for 1956 (House appropriation bill passed March 21, 1955), this total of $133,504 would assist in constructing and equipping only one 45- to 50-bed nursing home. More than 4,000 additional beds for the care of the chronically ill and the aged are critically needed in Minnesota.

With regard to the availability of survey and planning funds for medical facilities under the amendment, we note that the House bill terminates the use of these funds on December 31, 1956, whereas the present law makes them available until expended. Operations under such a limitation would be difficult since the process of planning is a continuous one in that changes are being made constantly throughout the State.

Respectfully,

ALBERT J. CHESLEY, M. D.,
Secretary and Executive Officer.

EXHIBIT I.-Minnesota Department of Health: Grants to States for health services as included in the House appropriation bill, fiscal year 1955–56 (compared with 1954-55 actual)

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1 Grant made to department of social welfare. to the Minnesota Department of Health.

Of this sum department of social welfare allotted $18,550

2 Recommended in President's budget. House figures not presently available.

CRIPPLED CHILDREN'S SERVICES

Grants to the States through the Children's Bureau to provide medical, surgical, and other corrective care and services for crippled children are not as large as they could be under the authorization by law. I would like to support Commissioner Morris Hursh of the Minnesota Department of Public Welfare in his request that consideration be given to raising the appropriation of funds available

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