fact that there are two parts in the community comprehensive mental health program, but the two parts have striking differences. The first part deals with the mental retardation research centers, and the second part deals with the mental retardation facilities. In discussing these two parts I would like first to insert in the record that portion of the President's message that covers just this mental retardation aspect which will give you the background. Mr. ROBERTS. Without objection. EXCERPTS FROM THE PRESIDENT'S SPECIAL MESSAGE TO THE CONGRESS OF FEBRUARY 5, 1963, ON MENTAL ILLNESS AND MENTAL RETARDATION RELEVANT TO CONSTRUCTION OF MENTAL RETARDATION RESEARCH CENTERS AND MENTAL RETARDATION FACILITIES Our single greatest challenge in this area is still the discovery of the causes and treatment of mental retardation. To do this we must expand our resources for the pursuit and application of scientific knowledge related to this problem. This will require the training of medical, behavioral, and other professional specialists to staff a growing effort. The new National Institute of Child Health and Human Development which was authorized by the 87th Congress is already embarked on this task. To provide an additional focus for research into the complex mysteries of mental retardation, I recommend legislation to authorize the establishment of centers for research in human development, including the training of scientific personnel. Funds for 3 such centers are included in the 1964 budget; ultimately 10 centers for clinical, laboratory, behavioral, and social science research should be established. The importance of these problems justifies the talents of our best minds. No single discipline or science holds the answer. These centers must therefore, be established on an interdisciplinary basis. Because care of the mentally retarded has traditionally been isolated from centers of medical and nursing education, it is particularly important to develop facilities which will increase the role of highly qualified universities in the improvement and provision of services and the training of specialized personnel. Among the various types of facilities for which grants would be authorized, the legislation I am proposing will permit grants of Federal funds for the construction of facilities for (1) inpatient clinical units as an integral part of university-associated hospitals in which specialists on mental retardation would serve; (2) outpatient diagnostic, evaluation, and treatment clinics associated with such hospitals, including facilities for special trainng; and (3) satellite clinics in outlying cities and counties for provision of services to the retarded through existing State and local community programs, including those financed by the Children's Bureau, in which universities will participate. Grants of $5 million a year will be provided for these purposes within the total authorizations for facilities in 1965 and this will be increased to $10 million in subsequent years. Such clinical and teaching facilities will provide superior care for the retarded and will also augment teaching and training facilities for specialists in mental retardation, including physicians, nurses, psychologists, social workers, and speech and other therapists. Funds for operation of such facilities would come from State, local and private sources. Other existing or proposed programs of the Children's Bureau, of the Public Health Service, of the Office of Education, and of the Department of Labor can provide additional resources for demonstration purposes and for training personnel. Mr. COHEN. Secondly, I would like to insert in the record the letter of February 11, 1963, from the Secretary of Health, Education, and Welfare outlining the provisions of the bill. Mr. ROBERTS. Without objection. (The material referred to appears on p. 25.) Mr. COHEN. Third, I believe that it would be desirable to include in the record the document from which I testified this morning which presents it is entitled "The Mental Retardation Program of the U.S. Department of Health, Education, and Welfare, Fiscal Year 1964"-which presents the entire program of the Department in this field and contains in the back the figures for fiscal 1963 on existing programs, the proposed activities for 1964 under existing authority, and the proposed new legislation and the total which consists of not only the legislation that we are talking about before this committee, of course, but other legislation pending in a number of other committees so that you have the whole picture of what the Department is doing in this area. Mr. ROBERTS. Without objection. (The information referred to follows:) MENTAL RETARDATION PROGRAM OF THE U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, FISCAL YEAR 1964. (Prepared by the Secretary's Committee on Mental Retardation, U.S. Department of Health, Education, and Welfare) SECRETARY'S COMMITTEE ON MENTAL RETARDATION Office of the Secretary: MEMBERSHIP Mr. Luther W. Stringham, Chairman. Mr. Wallace K. Babington, Staff Assistant to the Committee. Dr. William H. Stewart. Public Health Service: Dr. Joseph Bobbitt. Dr. Clifford Cole. Dr. Jack C. Haldeman. Dr. Donald Harting. Dr. Richard L. Masland. Mr. Allen Pond. Office of Education: Dr. Romaine P. Mackie. Vocational Rehabilitation Administration: Dr. Morton A. Seidenfeld. Mr. Charles E. Hawkins. Mr. Rudolf Hormuth. Dr. Arthur J. Lesser. Mrs. Mary M. Steers. Food and Drug Administration: Dr. Irwin Siegel. SUMMARY The program to combat mental retardation, which the U.S. Department of Health, Education, and Welfare has proposed to the Congress, totals $204,723,000 for fiscal year 1964. The recommended program for fiscal year 1964 is an increase of $76,219,000 over the total of $128,504,000 for mental retardation activities estimated for fiscal year 1963. The program extensions and improvements proposed for fiscal year 1964 are in accord with the President's special messages to Congress on mental illness and mental retardation (Feb. 5, 1963) and on education (Jan. 29, 1963). They also are responsive to recommendations contained in the report of the President's Panel on Mental Retardation. Activities already underway and the additions proposed for fiscal year 1964 break down as follows: Programs under present authority: Research, training, services, and other activities relating to prevention and treatment.. Public assistance and social security payments to persons disabled because of mental retardation.. 96, 800, 000 Activities for which new legislation is proposed.. 111, 300, 000 42,375,000 Grand total. 128, 504,000 204, 723,000. CURRENT ACTIVITIES OF THE DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE During fiscal year 1963 funds for mental retardation activities of the Depart-ment of Health, Education, and Welfare will total an estimated $128,504,000. These activities may be grouped under five main categories: (1) research and studies; (2) professional preparation; (3) services; (4) construction of facil-ities; and (5) income maintenance. A listing of the programs approved by Con-gress in prior years and presently underway follows: Research and studies Intramural and extramural support programs of the National Institute of Mental Health and the National Institute of Neurological Diseases and Blindness of the Public Health Service. The Office of Education programs of studies, surveys, and cooperative research. Special project grants under the maternal and child health program of the Children's Bureau, Welfare Administration. Research and demonstration projects of the Vocational Rehabilitation Admin-istration. Professional preparation Vocational Rehabilitation Administration grants to educational institutions: for training of personnel for all phases of rehabilitation. Teaching and training programs of the Public Health Service, including the grant programs of the National Institutes of Health and the Bureau of State Services. Office of Education training grants to colleges and universities and State educational agencies for leadership positions in education of the mentally retarded. Services Consultation by the Office of Education to State and local school systems, educational personnel, and voluntary groups. Collection and dissemination by the Office of Education of comprehensive basic statistics and reports concerning the education of exceptional children, including the mentally retarded. Consultation and technical services of Children's Bureau staff to State and local communities under the maternal and child health and the child welfare services programs. Consultation and technical services to State rehabilitation agencies under the Vocational Rehabilitation Administration programs. Consultation and technical assistance to State and local agencies provided byprogram representatives of the regional offices of the Department of Health, Education, and Welfare. Activities relating to the application of knowledge to problems of mental retardation through the neurological and sensory disease service program of the Bureau of State Services, Public Health Service. Construction Facilities for the mentally retarded under the hospital and medical facilities construction program of the Bureau of State Services, Public Health Service. Income maintenance Payments to mentally retarded persons under the public assistance program of aid to the permanently and totally disabled of the Welfare Administration. Payments by the Social Security Administration from the old-age and sur- vivors insurance trust fund in behalf of persons whose disability commenced before age 18 and continued thereafter. EXPANDED AND NEW ACTIVITIES PROPOSED FOR FISCAL YEAR 1964 UNDER EXISTING AUTHORITY A number of extensions and improvements in programs relating to mental retardation authorized under existing legislation are included in the President's budget for fiscal year 1964. Increases from $31.7 million in fiscal year 1963 to $51 millon in fiscal year 1964 are proposed for research, training, services, and other activities relating to prevention and treatment. The additional funds for next year would permit an expansion of programs in fiscal year 1964 as follows: 1. The Public Health Service, through the National Institutes of Health, would support a wide range of research explorations; evaluate new methods of casesfinding, diagnosis,care, and rehabilitation; explore preventive measures; support, in institutional settings, projects for the care of the mentally retarded and aimed at testing and utilizing research findings; increase the numbers of postdoctoral fellowships and increase support of training for relevant scientific and clinical personnel; provide support for inservice training by State institutions; and furnish professional and technical assistance designed to assure acceleration of the dissemination and utilization of scientific and clinical findings. 2. The Public Health Service would provide funding for the new National Institute of Child Health and Human Development, which was authorized at the last session of Congress. The program of the new Institute would provide an additional resource for attacks on the causes and prevention of mental retardation in the context of the basic processes if human development. Program areas that would receive early attention in the new Institute would be research centers for the study of developmental abnormalities and perinatal biology; research projects related to premature infants, biological and behavioral development of the mentally retarded, the biological relationships between the mother and fetus with specific attention to the effects of drugs on the developing individual during pregnancy, childhood, and later life; training programs; national and international conferences; and dissemination of research information relevant to mental retardation. 3. Through the Bureau of State Services, the Public Health Service would support a wide range of professional training and community service activities for patients, families, and physicians directed toward the application of knowledge in prevention, early detection, diagnosis, treatment, and rehabilitation; the development of a demonstration training center for medical and allied medical personnel; and the development of a demonstration service center for a comprehensive community approach to mental retardation. 4. The Children's Bureau would promote research and demonstration projects. in child welfare, with special emphasis given to projects related to mentally retarded children and their families; and expand the collection and dissemination of statistical information and a variety of special studies relating to mentally retarded children such as laws and legal procedures. 5. The Office of Education would support and conduct research in the learning process; expedite, through the establishment of research and demonstration centers, the application of research findings to actual teaching programs for the mentally retarded; and conduct studies on the improvement of curriculums, professional preparation of teacher training, the characteristics of children in need of special education, and the development of teaching aids. 6. The Vocational Rehabilitation Administration would initiate 25 additional research and demonstration projects, mainly in the areas of occupational centers for the mentally retarded, and of special education-vocational rehabilitation cooperative programs; develop centers for intensive training of counselors, social workers, pathologists, audiologists, workshop personnel, placement specialists, and research workers in the vocational rehabilitation of the mentally retarded; and expand State rehabilitation services to the retarded. In addition to the extension and improvement of the research, training, services, and related activities listed above, increases also will occur in payments made under the public assistance and social security programs in behalf of mentally retarded persons. These payments are made by the welfare administration under the program of aid to the permanently and totally disabled and by the Social Security Administration from the old-age and survivors insurance trust fund in behalf of mentally retarded persons who are dependents of retired wage earners or survivors of deceased wage earners. Payments made under these programs will increase from $96.8 million in fiscal year 1963 to an estimated $111.3 million in fiscal year 1964. NEW LEGISLATION TO COMBAT MENTAL RETARDATION Funds are included in the President's 1964 budget for a number of legislative proposals which would increase the scope of the national programs to combat mental retardation. These proposals, some of which are directed specifically to the problem of mental retardation and some of broader application which have provisions relating to mental retardation, would authorize the appropriation of $42.3 million in 1964, as follows: New obligational authority, fiscal year 1964 Legislative proposal: Maternal and Child Health and Mental Retardation Planning Grants for planning comprehensive action to combat mental Increase in maternal and child health services_. Project grants for research relating to maternal and child Grants for construction of centers for research on mental Vocational Rehabilitation Act Amendments of 1963– $2,200, 000 500,000 500, 000 500,000 5, 100, 000 6, 050, 000 (1) 2,525,000 5, 000, 000 Special projects or programs directed toward improving edu- 20, 000, 000 Total_. 1 Would begin in fiscal year 1965. 42, 375, 000 Each of these proposals is described in the sections that follow. Grants for planning comprehensive action to combat mental retardation This proposal would authorize a one-time appropriation of $2.2 million for grants to assist the States (including the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa) to plan for and take other steps leading to comprehensive State and community action to combat mental retardation. Any such grants to a State would be used to determine what action is needed to combat mental retardation in the State and the resources available for this purpose, to develop public awareness of the mental retardation problem and of the need for combating it, to coordinate State and local activities relating to the various aspects of mental retardation and its prevention, treatment, or amelioration, and to plan other activities leading to comprehensive State and community action to combat mental retardation. In order to be eligible for grants a State would be required, among other provisions, to assure full consideration of all aspects of services essential to planning for comprehensive State and community action, including services in the fields of education, employment, rehabilitation, welfare, health, and the law, and services provided through community programs for and institutions for the mentally retarded. Grants will be awarded on a selective basis to State agencies presenting acceptable proposals for this broad interdisciplinary planning activity. |