Additional material submitted to the subcommittee-Continued Summary of Public Health Service mental health programs, cur- rent and proposed legislative authorities. Appendix A.-Legislative and related history-PHS mental Appendix B.-Appropriation history Appropriation history of PHS mental health programs by major functional area for selected fiscal years, table. Comparative analysis of mental health outlays, Federal, State, and local, private sector, including projected impact Table 1.-NIMH extramural program allocations, fiscal year 56 Table 2.-NIMH extramural program expenditures, by 57 Table 3.-NIMH extramural program expenditures, by prob- 59 Per capita expenditures in last decade by the States for treatment of all mental disorders, table submitted by Dr. Blain. "Philosophy of Developmental Vision," by Jerome Rosner, O.D. Policy statement of the Special Governor's Conference on Mental 228 155 President's Panel on Mental Retardation, submitted by Dr. Robert E. 324 Program of the Council on Mental Health, submitted by Dr. Charles L. 328 "Psychiatric Services in General Hospitals," American Hospital Asso- 194 Ray, David B., Jr., act No. 286 authorizing the Arkansas Children's 189 Report to the 1960 White House Conference on Children and Youth entitled "The Importance of Vision to a Creative Life in Freedom State expenditures in the past decade to combat mental illness and 229 Statement of the President's program on mental illness, made by a 434 "Vision Care of the Mentally Retarded Child: A Preliminary Report," 269 "Visual Perceptual Training and the Retarded School Achiever," by 254 Communications submitted to the committee— Beckman, Dr. W. P., State director, mental health, dated March 23, 457 Blain, Dr. Daniel, president, National Association of State Mental Bloomberg, Dr. Wilfred, commissioner of mental health, State of 228 Brown, Hon. Edmund G., Governor of California, dated March 20, 1963 162 Carvel, Hon. Elbert N., Governor of Delaware, dated March 25, 1963- 165 465 Conte, Dr. William R., supervisor, Mental Health Department of 459 Dalton, Hon. John M., Governor of Missouri, dated March 25, 1963-- Davis, Winborn E., director, State department of hospitals, dated Gordon, Lamar, Jr., president, Mental Health Association of Clarks- ville and Montgomery County, Inc., dated April 20, 1963. Guy, Hon. William L., Governor of North Dakota, dated April 1, 1963. Haines, Dr. R. A., State director of institutions, dated March 26, 1963 Hayes, John J., director of medical services, dated April 22, 1963. Heyns, Garrett, director of institutions, State of Washington, dated Hogshead, Thomas H., superintendent, New Mexico State Hospital, 453 Hughes, Hon. Harold E., Governor of Iowa.. 164 Hughes, Hon. Richard J., Governor of New Jersey, dated March 26, 165 Kaplan, Robert I., D.D.S., president, Academy of Dentistry for the 460 Karn, Dr. William N., superintendent, dated April 11, 1963. 459 Letter dated March 26, 1963. 163 Letter dated March 5, 1963_. 163 Knudsen, Dr. Helen L., director, Division of Hospital Services, 428 Meeter, Janie A., letter dated April 1, 1963- Olson, Clarence H., the American Legion, dated May 29, 1963. Orange County Association for Mental Health, dated March 25, 1963- Paiewonsky, Hon. Ralph M., Governor of the Virgin Islands, dated Robinson, Jerome, president, Maryland Association for Mental 456 Rosellini, Hon. Albert D., Governor of Washington, dated April 9, 167 Russell, Hon. Donald S., Governor of South Carolina, dated March 6, 167 Communications submitted to the committee Continued Page 454 456 Sanders, Hon. Carl E., Governor of Georgia, dated March 27, 1963__ Sanford, Hon. Terry, Governor of North Carolina, dated March 26, Schumacher, Dr. William E., director, Bureau of Mental Health, 455 Scranton, Hon. William W., Governor of Pennsylvania, dated March 164 MENTAL HEALTH MARCH 26, 1963 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON PUBLIC HEALTH AND SAFETY OF THE COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D.C. The subcommittee met at 10 a.m., pursuant to call, in room 1334, Longworth Building, Hon. Kenneth A. Roberts (chairman of the subcommittee) presiding. Mr. ROBERTS. The Subcommittee on Public Health and Safety will come to order. We are meeting today to consider H.R. 3688 and H.R. 3689, bills introduced by Mr. Harris on behalf of the administration to establish comprehensive community mental health centers and construction of research centers and facilities for the mentally retarded. We are considering these bills together since they deal with an interrelated health program which must be met within the framework of a national mental health program. Identical bills have been introduced by the gentlemen from New York, Mr. Farbstein, H.R. 3939 and H.R. 3940; and Mr. Halpern, H.R. 3947 and H.R. 3948; our colleagues, Mr. Boland of Massachusetts, HR. 4622 and H.R. 4623; Mr. Pepper of Florida, H.R. 4663 and 4664, and Mr Flood of Pennsylvania, H.R. 5023. In addition, the gentleman from Pennsylvania, Mr. Dent, has introduced H.R. 2567, dealing with the same subjects. Title I of H.R. 3688, the "Community Mental Health Centers Act of 1963" authorizes appropriations of such sums as Congress may determine for a 5-year matching grant program, beginning July 1, 1964, to assist in the construction of community mental health facilities. The purpose of these centers would be to provide coordinated services for the prevention or diagnosis of mental illness or the care, treatment, or rehabilitation of mentally ill patients and are intended to serve principally those persons residing in or near the area in which the facility is located. The Federal and State shares of the cost of construction are patterned after the matching requirements of other Federal health facilities construction programs. Under title II of the act, grant funds would be made available for each fiscal year beginning July 1, 1965, to defray the initial costs of staffing the centers constructed with the assistance provided under title I. H.R. 3689, known as the Mental Retardation Facilities Construction Act of 1963 authorizes project grants in the amount of $30 million over a 5-year period, beginning July 1, 1963, for the construction of special centers for research on mental retardation, and related aspects of human development, up to 75 percent of the total cost. Title II of the 1 act authorizes a 5-year grant program beginning July 1, 1964, for the construction of public and nonprofit facilities especially designed for the diagnosis, treatment, education, training, or custodial care of the mentally retarded. The bill earmarks $45 million of the sums appropriated during the program for facilities associated with a college or university hospital or other appropriate part of the educational institution. The problems of the mentally ill and the mentally retarded have been long neglected and generally misunderstood by the public. The record is very clear, however, that we are spending billions of dollars annually to care for hundreds of thousands of mentally ill and retarded patients in our public institutions. Many of these unfortunate people are confined to facilities which are unable to provide minimal care for lack of adequate staff and space. In addition, almost half the patients have been in these hospitals for a decade or more. The concept of comprehensive community mental health centers, in which the patient receives care close to home, would radically change the approach to the treatment of the mentally handicapped. New knowledge, techniques, and drugs have made this possible." To combat mental retardation requires improved community services and an accelerated research effort into its causes. Studies show that the incidence of mental retardation can be reduced by proper prenatal care. A comprehensive program can do much to improve conditions in this vital area of concern. The President in his message on mental illness and mental retardation has referred to the need for national programs requiring a new approach by using Federal resources to stimulate State, local and private action with emphasis on prevention, treatment and rehabilitation. However, the initial cost of implementing these programs is beyond the capacity of the States and local communities and requires short-term Federal assistance. The bills before us are directed toward those goals. We are very pleased at this time to call as our first witness the Honorable Claude Pepper who has introduced H.R. 4663 and H.R. 4664. Copies of the bills referred to in the opening statement along with agency reports will be placed in the record at this time. (The bills and reports referred to follow :) [H.R. 3688, 88th Cong., 1st sess.] A BILL To provide for assistance in the construction and initial operation of community mental health centers, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Community Mental Health Centers Act of 1963". TITLE I-CONSTRUCTION OF COMMUNITY MENTAL HEALTH CENTERS AUTHORIZATION OF APPROPRIATIONS SEC. 101. There are authorized to be appropriated, for grants for construction of public and other nonprofit community mental health centers, for the fiscal year ending June 30, 1965, and each of the next four fiscal years such sums as the Congress may determine. |