you might say, a practice by the Government personnel that you would actually be more dependent than you had been before on private practitioners. I think that is very important in consideration of this legislation. I don't know if that point has been made before, but it certainly appeals to me.

I would appreciate it very much-I think you organization is probably the best qualified to do this-if you would submit for the record a breakdown on each State of the amounts budgeted for its mental health facilities and services, and also those for the mentally retarded. I would like to have those figures for the last 10 years, if you can get them for the record. If you could without much inconvenience give us that in a per capita figure, I think it would be most helpful, rather than just a lump sum of the various States.

(The information requested follows:)

NATIONAL ASSOCIATION OF STATE MENTAL HEALTH PROGRAM DIRECTORS, Washington, D.C., April 16, 1963.

Hon. KENNETH A. ROBERTS,

Chairman, Subcommittee on Interstate and Foreign Commerce,
House of Representatives, Washington, D.C.

DEAR CONGRESSMAN ROBERTS: During the hearings on the mental illness and retardation bills (H.R. 3688 and 3689) you asked our organization to furnish for the committee record certain data on expenditures by the various States over the past 10 years on mental illness and retardation programs.

I now have data from several States. It will give you an idea of how much effort the States have put into these programs.

Perhaps at the time we receive the data from the 50 States, I could furnish it to you, and if you deem it helpful in considering the proposed legislation, you might insert it in the Congressional Record.

I regret not being able to move faster on your request, but compiling this data in the States is a fairly exacting job and with some of the State legislatures still in session, our State mental health directors have had a heavy workload. Sincerely,

DANIEL BLAIN, M.D., President.

Per capita expenditures in last decade by the States for treatment of all mental

Source: Compiled by National Association of State Mental Health Program Directors, Apr. 30, 1963.

State expenditures in the past decade to combat mental illness and retardation

State expenditures in the past decade to combat mental illness and retardation-Continued

2 "Last 10 years" illness and retardation not separated.

3 Expenses at Arkansas Children's Colony, 1959-63 (3 years-plus).

4 No breakdown available. 5 1953-54 estimate.

Mental illness:

A. Capital expenditures.

B. Operating expenditures.

C. Data from States where no separation was made between capital and operating expenditures.

B. Operating expenditures

C. Data from States where no separation was made between capital and operating expenditures...

Total

Data from States where no separation was made between mental illness and retardation expenditures..

Source Compiled by National Association of State Mental Health Program Directors, Apr. 30, 1963.

Mr. ROBERTS. Mr. Nelsen.

Mr. NELSEN. One question. On page 4 you referred to a formula grant program of the National Institute of Mental Health for community mental health services, and you point out that it has been a beacon in encouraging further exploration in these areas. Would you give me a little information about this particular point that you make there? I am not familiar with it.

Dr. DAVIS. What I was thinking primarily there was the Federal community mental health services grant program in which an appropriation by Congress is divided among the States on the basis of a formula having to do with the population and the per capita income of the State.

In New Jersey at the moment we get some $186,000 a year. And we have been getting this since about 1949, I believe. And this has been for the purpose of developing community mental health serv-ices in other words, we cannot use any of this money to pay for inpatient services in State hospitals.

Mr. NELSEN. Or facilities?

Dr. DAVIS. Or facilities. But we can use it for paying staff and the necessary operational expenses of community clinics, that is what it has been for the most part used for.

Mr. NELSEN. My point in asking the question is, so many times we find a vast duplication of efforts in different areas all pointing toward some central objective. And of course it is important, if this program is to be an efficient one, that you don't have an overlapping duplication in any area. And if there are any areas where we do that we would like to know it so that we can do a better job.

I thank you, gentlemen.

Mr. ROBERTS. The gentleman from New York, Mr. O'Brien.

Mr. O'BRIEN. May I say first to Dr. McPheeters, I am glad you read that telegram from New York, because that is obviously one issue we won't have to worry about in 1964.

But I am quite pleased that the chairman requested a summary of the cost in the several States of mental hospitals. That is the point I was trying to get at before. And I notice, Doctor, you said, I believe, that if this program comes into being that within a certain period of time you might reduce by one-third, was it, the population of your mental institution.

Dr. MCPHEETERS. I would hope so.

Mr. O'BRIEN. That would be translated to a national basis. And that could possibly mean as much as a billion dollars of State budget costs which could be transferred through the Federal aid end—and you will forgive me for the expression-from mental institutions into the very human cure at the community level. So the additional cost of this program to the States and communities could be minimal, and it could be actually a saving. Isn't that correct?

Dr. MCPHEETERS. That is right. We are still going to have the problem of the indigent patient. And of course a good many of our patients in the State hospitals are now indigent, at least they become so after they have been away from their jobs for several months. And I am sure the State is going to have to find some way of covering the cost of indigent patients. This is going to amount to a much higher per diem than now, but presumably for a much shorter time, to get.