Now, I wanted to call your attention to the fact that another part of the President's proposals in connection with mental retardation and mental illness is found in the Vocational Rehabilitation Act amendments, already introduced in the Senate. This measure was not introduced in the House unless it was introduced yesterday. It is ready for introduction. A bill comparable to it as relates to facilities is H.R. 3740, which is a bill the National Rehabilitation Association is sponsoring. I think the provisions as related to facilities are identical, if not they are virtually identical.

Under the Vocational Rehabilitation Act, it is now possible to build certain types of rehabilitation facilities. And such facilities are being constructed. There have been some difficulties, though, in the program. One is the fact that there is no earmarked money for facilities. Another is that new construction is not permitted. And there are some others I might mention if I had some time. The administration is proposing to liberalize the law to make earmarked money available, and to establish a program principally for the construction and staffing of what we might call the vocationally oriented rehabilitation facilities. I think your committee should be familiar with this bill as you draft your own legislation.

Now, in this connection I am suggesting one amendment to the mental retardation facilities bill. On line 16, page 20-this is the definition of the mental retardation facility-we are suggesting an amendment.

Mr. ROBERTS. What is the page number again?
Mr. WHITTEN. It is page 20, line 16.

The suggestion we are making is that this be amended in such a way as to make it clear that workshops-and I think you know what we mean when we speak of a workshop-will not be constructed under this legislation you have before you unless the workshop is a part of a comprehensive mental retardation facility. The reason we are suggesting this is that the workshop itself is an entirely different type of facility from other types of facilities that might be envisioned in this legislation.

It uses work as the principle element in the services it provides; work for evaluation, work for therapy, work for production. The staffing pattern is quite different, the medical component being either very small, generally on a consultative or part-time basis.

The other professional workers do not work under medical supervision. Vocational teachers, production managers, and so forth, constitute an important part of the staffing of such an organization. And it is the administration's position, we understand-and we certainly concur in it-that where a workshop is built as a workshop, that this be built under the Vocational Rehabilitation Act rather than under this act.

Incidentally, the administration is not opposed to this amendment which we are suggesting. We have discussed it with the administration people.

We had not proposed an identical amendment to the mental illness bill, that is H.R. 3688, although we think now we may do so. If so, this would come on page 19 of H.R. 3688 where you find the definition of a mental health center.

We think that we may do so now in the light of Mr. Jones' testimony yesterday, during which he mentioned the workshops specifically as

one of the facilities that might be built independently under that proposal. You may remember that testimony. We had not assumed that that would be true, but if there is any confusion about this we probably will suggest an amendment that will make it clear that the workshop as such will be built under the Vocational Rehabilitation Act, although we have no objection whatever to a workshop being constructed as a part of a comprehensive rehabilitation facility under this bill.

We think that in keeping some of our lines straight on things like this we can avoid confusion, and that the result will be conducive to the purposes we all have in mind.

Now, Mr. Chairman, I am here in town, and easily accessible to the committee and its staff, and I am not going to make any other statement now, but I will defer, unless you have questions that you want to raise.

Mr. ROBERTS. I have no questions, except to thank you for your appearance, and also for the suggested amendments. I think I am in agreement with you and your viewpoint on the two amendments. I haven't had time to study them, but I think in my opinion I would go along.

Mr. WHITTEN. There is something else, Mr. Roberts.

You remember you were interested yesterday in how a facility such as you described in your own district might profit from this legislation?

Mr. ROBERTS. Yes.

Mr. WHITTEN. Actually, in my judgment, the type of facility you are talking about-and you have several such in Alabama- will come nearer getting benefits through the rehabilitation vocational amendments, which does include staffing, than under H.R. 3388, which does not.

In other words, workshops could be staffed under the Rehabilitation Vocational Act amendments. And knowing your facilities there as I do and the vocational emphasis that is put upon them, I think these facilities might get their benefits through the Vocational Rehabilitation Act, although some of them no doubt would be appropriate for assistance under the mental retardation and mental illness acts.

Mr. ROBERTS. I might say that I certainly would desire that this effort, which I think has been very beneficial in our statement, it would be my desire that that effort be continued and expanded. And I would certainly hope that we could do a better job of staffing. A lot of that has been volunteers with limited resources.

We have done a good job, but I think more needs to be done. I know in my own particular area of one workshop that has not been able to operate more than about 2 or 3 days a week. And they have a backlog of applicants that could benefit from 5-day operation.

Mr. WHITTEN. Your State constitutes one of the best illustrations in the United States of how voluntary agencies and public agencies have combined their efforts to create a chain of workshops in which the mentally ill and the mentally retarded among others are being served. And, incidentally, you have in Minnesota at Minneapolis the Minneapolis Retardation Center, which is one of the facilities of the kind for which we think there is the greatest need in the vocational field. Mr. NELSEN. At the University of Minnesota Medical School we have a similar operation.

Mr. WHITTEN. In fact, the center I am referring to, the Minneapolis Retardation Center, is used as a place where handicapped adults of all classes come, and they are evaluated and then referred to whatever community facility is best able to serve them. You have a very fine cooperative spirit in Minneapolis and St. Paul, and in fact the whole State in developing rehabilitation facilities.

Mr. ROBERTS. Thank you very much.

I am going to pass from Mr. Ray for the time being, as he is from Arkansas, and the chairman, Mr. Harris, expressed the desire to be here when Mr. Ray testified. And we are running pretty close to the noon hour. And at this time the committee will be in recess until 1:45 in the same hearing room.

(Whereupon, at 11:55 a.m., the committee recessed to reconvene at 1:45 p.m., of the same day.)

AFTERNOON SESSION

Mr. HARRIS (presiding). The committee will come to order. Our first witness this afternoon will be to the Honorable Arnold Olsen, our friend and colleague from the State of Montana. Mr. Olsen we are honored to have you here today.

STATEMENT OF HON. ARNOLD OLSEN, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MONTANA

Mr. OLSEN. Thank you, Mr. Chairman, I am happy to be here. There are some 5 million Americans who are mentally retarded. This is one of the greatest problems facing our country today. Care facilities for these individuals must be integrated into the mental health program of every community.

The extent to which this situation will grow in future years depends upon our ability to research the problem. Some breakthroughs have been effected and it has become possible to prevent some mental retardation. However, much more has to be done to alleviate the growing number of persons who become afflicted each year. Therefore, more research, trained personnel, and financing must be made available. We also need better standards of care for the institutionalized retarded, special educational programs, day-care centers within the community, counseling services for the parents of retarded children and efforts to create job opportunities for retarded adults. To make such programs possible the Nation also needs additional facilities. Emphasis should be placed on research facilities, for I believe the ultimate answer to this problem is one of prevention. We must recognize that mentally retarded individuals must be cared for and they must also be educated and trained to the very maximum of their capacities.

Psychiatric knowledge, techniques and tools have now progressed to the point where it is feasible, as well as desirable, to treat a mentally ill patient in the confines of his home environment. Community care will enable all practicing physicians to participate in the treatment of their mentally ill patients.

Title I of H.R. 3688 pertains to the construction of community health centers. Few communities have the resources necessary for adequately developing and expanding their mental health services.

The use of matching grants for the construction of community health centers will place within reach of the community the opportunity to provide the needed services to its residents.

The President, in his admirable message to Congress on February 5, relative to mental illness and mental retardation, stated: "We need a new type of mental health facility, one which will return mental health care to the main stream of American medicine." He added, "Ideally, the center could be located in an appropriate community general hospital, many of which already have psychiatric units. Later in his message the President commented, "For the first time, a large proportion of our private practitioners will have the opportunity to treat their patients in a mental health facility served by an auxiliary professional staff that is directly and quickly available for outpatient and inpatient care." I am in complete agreement with these statements and hope they will be carried out in the administration of the law should this bill be enacted. In this regard, then, the already established general hospital should be given priority in planning for the establishment of the community mental health center. In most instances the general hospital provides the best opportunity for continuity of treatment and integration of service in caring for the mentally ill. This does not establish the general hospital as the sole facility to sponsor such centers. As outlined in the President's message, other already existing outpatient facilities could also be used. Mr. Chairman, I want to urge this committee to pass favorably on this legislation. The community mental health center should be integrated into the existing medical complex of the community.

Mr. HARRIS. Thank you for your fine statement.

We will continue by hearing our colleague from our 50th State, the Honorable Spark Matsunaga.

STATEMENT OF HON. SPARK M. MATSUNAGA, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF HAWAII

Mr. MATSUNAGA. Thank you, Mr. Chairman, I appreciate the opportunity to make this statement in support of H.R. 3688, the Community Mental Health Centers Act of 1963.

I believe that passage of this bill will mark the beginning of the greatest advancement in the treatment of mental illness in the United States we have yet witnessed. It will make possible a more efficient treatment of our mentally ill and in the long run, effectuate tremendous savings to us at the State, local, and National levels, not only monetarywise but in human resources.

Mental illness is one of the greatest problems of our age. The concern of the people of Hawaii was well expressed by its Governor, the Honorable John A. Burns, a former Member of the House when in a speech before the State comprehensive mental health program committee in Honolulu on March 20, 1963, he stated:

Mental illness is a critical problem in our community, as it is across the Nation; and we, in Hawaii, have an opportunity to join in the recently accelerated national attack on this problem. At any one time, an estimated 12 to 15 percent of the Hawaiian population is mentally ill.

Incapacity of this magnitude presents a terrible waste of human resources, untold suffering, and major drains on the financial resources of individuals and the public. We must make a concerted effort to lessen its burden.

The State of Hawaii is making needed plans to take advantage of the program offered by this proposed legislation. The people of Hawaii and the other 49 great States of our Union will reap untold benefits under the provisions of this bill. I urge your favorable report.

Mr. Chairman, I also wish to express my views on H.R. 3689, the Mental Retardation Facilities Construction Act of 1963.

I wish to register my support of the bill with just one qualification. I am apprehensive that the restrictive use of $5 million of the sums appropriated for the fiscal year 1965 and $10 million of the sums appropriated for each of the succeeding 4 fiscal years to facilities associated with college or university hospitals or other appropriate parts of a college or university would prohibit the construction of needed facilities at State institutions for the mentally retarded. The Honorable John A. Burns, an esteemed former Member of the House and now Governor of the State of Hawaii also shares this view.

It is respectfully requested, therefore, that the restrictive provision be deleted and the proposed program thereby be made more widely applicable.

I believe that the bill has much merit, and I intend to vote for its passage on the floor of the House provided the suggested change is made.

Mr. HARRIS. Thank you, Congressman, for your fine statement. The next witness will be Mr. David B. Ray, Jr. Mr. Ray is superintendent of Arkansas Children's Colony, Conway, Ark.

Mr. Ray, I have heard a lot about the children's colony at Conway. I have never had the privilege of visiting there, but my colleague and your Congressman, Mr. Mills, has been telling me about this program, of the fine things that you are doing there and the outstanding record that you have had there. I think that with the experience that you have had in our State on this problem it is highly appropriate for you to give the committee the benefit of that experience. And on behalf of the committee, and Mr. Mills, your own Congressman, of the Ways and Means Committee, I want to tell you how happy we are to have you with us.

I believe you have a statement that you would like to present. STATEMENT OF DAVID B. RAY, JR., SUPERINTENDENT, ARKANSAS CHILDREN'S COLONY, CONWAY, ARK.

Mr. RAY. Yes, sir.

Honorable members of the committee since my report is written, and so much has been said in the past, and you gentlemen know it, I would just like to make a few quotes from my statement, because after making the trip if I went home and told the board I didn't say anything I would feel guilty.

Mr. HARRIS. You may have your statement included in the record, and you may proceed in the way you choose.

Mr. RAY. Thank you, sir.

First of all, I would like to say that since there are so many distinguished people that will comment on H.R. 3688 that pertains to mental health centers I will not make any comment on it, I favor it, but my field is mental retardation, and I will comment on that.