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1 in lieu thereof “Sec. 138.", and by inserting“ construction,” 2 after “planning,”.

(8) Section 142 (a) (2) (A) of such Act is amended

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4 by inserting "which was used by the State in which the

5 facility is located" before “to assist in financing the con

6 struction of the facility”.

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(b) (1) Section 401 (h) (1) of the Mental Retarda8 tion Facilities and Community Mental Health Centers Con9 struction Act of 1963 is amended by striking out "part C

10 of title I or”.

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(2) Section 401 (h) (2) of such Act is amended by

12 striking out “(A) for any project under part C of title I 13

may not exceed 66per centum of the costs of construction 14 of such project; and (B)”. 15 (3) Section 401 (h) (3) of such Act is amended by 16 striking out “under part C of title I or”. 17 (4) Section 403 (a) of such Act is amended by striking 18 out "section 134 in the case of a facility for the mentally

19 retarded or persons with other developmental disabilities,

20 or” and by striking out “section 136 or” and “as the case

21 may be," from clause (2) thereof.

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(5) Section 403 (b) of such Act is amended by striking

23 out "135 or”.

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(6) Section 404 of such Act is amended by striking out

2 "135 or" and "136 or" from the first sentence thereof.

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(7) Section 405 of such Act is amended by inserting

4 “or section 135" after "section 403”.

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(8) Section 405 (1) of such Act is amended by striking 6 out “135 or” from clause (A) thereof and by inserting

(in 7 the case of a community mental health center)" after “205"

8 in such clause.

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AMENDMENTS TO FEDERAL SHARE PROVISION

10 SEC. 5. The section of the Developmental Disabilities 11 Services and Facilities Construction Act redesignated as

12 section 135 (b) by section 4 (a) (1) of this Act, is amended

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“ (b) The 'Federal share' with respect to any State 15 for purposes of this section shall be 70 per centum for 16 the fiscal year ending June 30, 1974; 60 per centum for 17 the fiscal year ending June 30, 1975; and 50 per centum for 18 the fiscal year ending June 30, 1976."

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INCLUSION OF LAND ACQUISITION COSTS

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SEC. 6. Section 401 (e) of the Mental Retardation

21 Facilities and Community Mental Health Centers Construc

22 tion Act of 1963, is amended by inserting “, for purposes of

23 title II of this Act only,” before "the cost of the acquisition

24 of land.".

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INCLUSION OF AUTISM

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SEC. 7. Section 401 (1) of the Mental Retardation Fa

3 cilities and Community Mental Health Centers Construction 4 Act of 1963 is amended by inserting “(including autism)”

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7 SEC. 8. The amendments made by this Act shall be

come effective with respect to appropriations for fiscal year 9 beginning after June 30, 1973.

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COMPTROLLER GENERAL OF THE UNITED STATES,

Washington, D.C., April 29, 1974. Hon. HARLEY O. STAGGERS, Committee on Interstate and Foreign Commerce, House of Representatives.

DEAR MR. CHAIRMAN: You requested our report and comments on H.R. 11511, 33d Congress, a bill which, if enacted, would be cited as the “Health Revenue Sharing and Health Services Act of 1973."

Section 203 of the bill proposes to amend title II of the Community Mental Health Centers Act, and section 408 of the bill would add a new part to the Development Disabilities Services and Facilities Construction Act. Proposed section 238 of the first named act (page 40) and section 154 of the last named act (page 57) would provide for maintenance of records by recipients of assistance and audit thereof by the Secretary and the Comptroller General. We recommend that the language below, which is substantially similar but more inclusive, be substituted.

“Sec. —. (a) Each recipient of Federal assistance under this Act, pursuant to grants, subgrants, contracts, subcontracts, loans, or other arrangements, entered into other than by formal advertising, and which are otherwise authorized by this Act, shall keep such records as the Secretary shall prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such assistance, the total cost of the project or undertaking in connection with which such assistance is given or used, the amount of that portion of the cost of the project or undertaking supplied by other sources, and such other records as will facilitate an effective audit.

“(b) The Secretary and the Comptroller General of the United States, or any of their duly authorized representatives, shall, until the expiration of three years after completion of the project or undertaking referred to in subsection (a) of this section, have access for the purpose of audit and examination to any books, documents, papers, and records of such recipients which in the opinion of the Secretary or the Comptroller General may be related or pertinent to the grants, subgrants, contracts, subcontracts, loans, or other arrangements referred to in subsection (a)."

Proposed section 241 of the Community Mental Health Centers Act (page 42, line 4) would provide “that no individual shall be made the subject of any research which is carried out (in whole or in part) with funds under such grants (provided by this act] unless such individual explicitly agrees to become a subject of such research.” Since the subject of this portion of H.R. 11511 is construction and operation of mental health centers, it would appear that many persons might not be competent to give knowing consent. The Committee may wish to amend this section of the bill to require “knowing, competent, and explicit consent."

Proposed subsections 310(g) (4) and 330(d) (4) of the Public Health Service Act (pages 65 and 69, respectively) would require that every reasonable effort be made to collect appropriate reimbursement for its costs from third party reimbursement programs including private health insurance programs. They are silent, however, as to whether attempts should be made to collect from persons not covered by such programs who have the ability to pay for the cost of services. The Committee may wish to modify these sections to provide that persons with the ability to pay shall be charged appropriately for services rendered.

Proposed subsection 330 (C) (1) (page 67, line 10) would provide for grants to public and nonprofit private entities to assist in the establishment and initial operation of neighborhood health centers which will serve a medically underserved area or group. A medically underserved area or group is defined as urban or rural area or population group designated by the Secretary as an area or population group with a shortage of personal health services. No guidance is provided as to whether priority should be given to funding “low income" areas or groups with a shortage of personal health services. If it is intended that the income of the area or group be considered in funding projects, it is believed appropriate language should be added to this section,

Enclosed for your consideration are some technical or editorial changes which we believe should be considered by the Committee. Sincerely yours,

ROBERT F. KELLER, Deputy Comptroller General of the United States.

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31-151 O - 74 - Pt. 1 - 30

Technical or editorial changes to H.R. 11511, 93d Congress.

At the places listed, “1973” should be "1974." Page 1, lines 4 and 7; page 2, line 8; page 14, line 9; page 16, line 11; page 19, line 9; page 21, line 1; and page 46, line 4.

On page 8, line 23, "for" should be "to provide that.”
On page 11, line 17, "an" should be inserted after "as."
On page 16, line 11, “Centers'' should be inserted after "Health."
On page 25, lines 15, 16, "designate" should be “designates."
On page 27, line 16, "and" should be “any."
On page 49, line 14, the period should be outside the quotation mark.
On page 60, line 15, the word “organizations" is misspelled.
On page 65, line 12, “42” should be “41."
On page 67, line 20, "notification” should be “subsection."
On page 67, line 25, "conforms" should be “conform."
On page 68, line 4, eliminates" should be "eliminate."
On page 68, line 22, there should be a close parenthesis after “(2."

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,

Washington, D.C., April 4, 1974. Hon. HARLEY 0. STAGGERS, Chairman, Committee on Interstate and Foreign Commerce, House of Representa

tives, Washington, D.O. DEAR MR. CHAIRMAN : This is in response to your request of February 28, 1974, for a report on H.R. 12892, a bill "To amend the Public Health Service Act, the Developmental Disabilities Services and Facilities Construction Act, and the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, to revise and extend programs of health services, and for other purposes.” The bill is to be known under the short title as the "Health Services Amendments of 1974."

This bill embodies a legislative proposal that we submitted to the Congress, on behalf of the Administration, on February 13, 1974, and is designed to amend certain acts of concern to this Department.

For the reasons stated in the enclosed copy of our letter transmitting the draft bill to the Speaker of the House, we urge its prompt and favorable consideration.

The Office of Management and Budget advises us that there is no objection to the submission of this report and that enactment of this bill would be in accord with the program of the President. Sincerely,

CASPAR W. WEINBERGER,

Secretary.

Enclosure.

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,

Washington, D.C., February 13, 1974. Hon. CARL ALBERT, Speaker of the House of Representatives, Washington, D.C.

DEAR MR. SPEAKER: Enclosed for the consideration of the Congress is a draft bill. “To amend the Public Health Service Act, the Developmental Disabilities Services and Facilities Construction Act, and the Comprehensive Alcohol Abuse and Alcosolism Prevention, Treatment, and Rehabilitation Act of 1970, to revise and extend programs of health services, and for other purposes."

The Department now administers separate project grant structures, containing separate appropriations authorizations, (1) to assist in the prevention and treatment of alcoholism (parts C and E of the Community Mental Health Centers Act); (2) to provide health services for domestic agricultural migrants (section 310 of the Public Health Service Act); (3) to render services, disseminate information, and promote research in the field of family planning (title X of the Public Health Service Act); and (4) to provide services to meet health needs of limited geographic scope, and to develop and support new health services programs (section 314(e) of the Public Health Service Act).

Title I of the enclosed bill would consolidate these programs under the umbrella of the existing project grant portion of the Partnership for Health. It is hoped that the consolidation will enable us to simplify the administration

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