sionals. Also under new legislation, we proposed to convert the existing student loan programs to guaranteed loan programs utilizing private capital, retaining all the special features of the present programs. PUBLIC HEALTH SERVICE HOSPITALS Turning to our own medical services programs, our long-term goal is to convert the Public Health Service Hospitals into centers of excellence. Our 1967 budget request will enable us to move in this direction by providing additional funds to plan for modernizing the facilities, to improve staff patient ratios, to expand the training capability of the hospitals, and to develop their operational and clinical research capability. Mr. Chairman, I would now like to touch briefly upon some of our health programs aimed at specific problem areas. HEALTH OF MIGRATORY WORKERS Migratory workers represent a group with inadequate access to health care services. For this reason, the Congress established the migratory workers health service program in 1962. This program was extended last year and expanded to include for the first time necessary short-term hospital care. Our 1967 budget includes a substantial increase for this program. MENTAL RETARDATION I have already mentioned our program in education of the handicapped including the mentally retarded. We have also included in the 1967 budget funds to continue the program of grants to States to assist in the development of comprehensive community programs to combat the problems of mental retardation. We have already made the initial awards for construction of mental retardation service facilities, and this program is expected to enter the full-scale construction phase within the next few months. We have also received a large number of requests for assistance in the construction of university-affiliated mental retardation facilities; with the 1967 budget request, a total of 16 such centers would be supported by the end of 1967. The complementary professional training program administered by the Children's Bureau will be initiated in 1967. MENTAL HEALTH In the field of mental health, we have awarded the first community mental health center construction grant; we are requesting in 1967 a continuation at the same level of support as in 1966. By the end of 1967, construction assistance will have been provided for 230 community centers. The 1967 budget also includes a sizable increase in support for staffing these centers, as well as for staffing new services in existing mental health centers. REGIONAL MEDICAL PROGRAMS The Heart Disease, Cancer, and Stroke Amendments of 1965 authorized a new program of project grants to assist universities, medical schools, and research institutions to develop and disseminate new tech niques for the diagnosis and treatment of heart disease, cancer, stroke, ard related diseases. This program will emphasize regional planning and coordination of medical resources, continuing education for doctors and other medical personnel, and the rapid distribution of new knowledge and techniques. We are beginning to implement this program with a 1966 supplemental appropriation: in 1967 we are requesting almost a doubling of funds. HEALTH RESEARCH I would like now to discuss the other programs of the National Institutes of Health. Thanks to the interest and support of this committee, the appropriations for the National Institutes of Health have grown from about $70 million in 1954, the first year after the Department was created, to about $114 billion in 1966. And with these funds an organization of excellence has been created. Our health research expenditures have been credited as being among the most worthwhile of all Federal expenditures. We have made every effort to continue the forward progress of recent years by applying the 1967 increases selectively. Our budget of over $1.3 billion for NIH will permit a considerable degree of progress in our health research effort. The largest single increase for NIH in the 1967 budget is for research grants. This includes an increase in the regular research grant program to finance continuation projects, and increments of new and supplemental projects. The 1967 budget request for special research grants includes increases for the general research support program, the animal resources and primate center programs, and for multidisciplinary research and training centers to study the possible toxic effects of drugs on man. The NIH training grant and fellowship programs will be increased in the 1967 budget, particularly in the area of mental health. Direct operations also receive a higher level of support in the 1967 budget, with the largest single increase for the intramural research program. ENVIRONMENTAL HEALTH AND CONSUMER PROTECTION Mr. Chairman, I would now like to turn to the area of environmental health. It is a grim fact that in this country today we are polluting our environment more quickly than we can devise ways of dealing with that pollution. The 89th Congress has already given this Department broad new authority to combat the problems of pollution including the establishment of a new Federal Water Pollution Control Administration but we will have an uphill struggle for some years to come. WATER POLLUTION Since the Federal Water Pollution Control Act became law, over 5,000 waste treatment facilities have been constructed and an additional 900 now under construction will be completed by the end of 1967. Last year, the Congress amended the act to raise the authorization for construction support. With the new maximum authorization, which we are requesting in 1967, construction of an additional 1,070 waste treatment facilities can be supported. The 1965 amendments also authorized a new program of research and demonstration projects dealing with sewer overflow and storm water control, and our 1967 budget seeks the full authorization. In direct Federal operations, the largest increases in the 1967 budget are for developing comprehensive river basin pollution control programs to provide a regulated supply of clean water for all legitimate uses. The 1967 budget provides for initiating four new development phase projects and expanding six existing projects. In addition, by the end of 1967 it is anticipated that five water laboratories will be completed and in operation. Under new legislation we propose to strengthen enforcement procedures, including registration of all wastes discharged into navigable rivers. Expansion of research, training, and control programs is also proposed, with greater support for demonstration of new techniques for advanced waste treatment. AIR POLLUTION AND ENVIRONMENTAL SANITATION The Clean Air Act Amendments and Solid Waste Disposal Act of 1965 are aimed at strengthening our ability to combat the contamination of our environment by giving us the authority to control air pollution from new motor vehicles and to support projects for the planning, development, and conduct of solid waste disposal programs. We have already published standards to control air pollution from new motor vehicles. The 1967 budget requests substantial increases for all parts of the air pollution program, and for the solid waste disposal program. CONSUMER PROTECTION The authority of the Food and Drug Administration to control the illicit distribution of dangerous psychotoxic drugs was expanded in legislation approved last year. In 1967, we are requesting a very substantial staffing expansion for the Food and Drug Administration, principally for drug abuse control activities, medical and scientific evaluation of drugs and other industry proposals, and education and voluntary compliance activities. PUBLIC WELFARE Our programs of vocational rehabilitation, social insurance, income maintenance, and the new programs for the aging all reflect the basic concern of this Department for human well-being and personal development. VOCATIONAL REHABILITATION Development of the full potential of disabled persons is the purpose of the Department's vocational rehabilitation program. The Vocational Rehabilitation Act Amendments of 1965 will enable us to expand rapidly our potential for achieving rehabilitation. A change in the matching formula under the basic Federal-State support program will result in a very substantial increase in Federal support. The amendments also establish new programs to help States plan for expanding rehabilitation services, construct rehabilitation facilities and workshops, and improve workshop programs to bring about a capacity for rehabilitating larger numbers of persons. We estimate that with this new authority, the number of persons rehabilitated will increase from 135,000 in 1965 to 207,500 in 1967. To provide the skilled manpower needed to achieve our goals, our 1967 budget includes a higher level of support for the training program, particularly for long-term traineeships. In a related development, the 1965 social security amendments for the first time provided for the payment from trust funds for vocational rehabilitation services to disability insurance beneficiaries. This program is also being administered by the Vocational Rehabilitation Administration. SOCIAL SECURITY I have already mentioned the new health insurance and rehabilitation programs established in the 1965 social security amendments. The amendments also affected other parts of the social insurance programs. The new law provided the first general increase in social security cash benefits since 1958. The amendments also liberalized the definition of disability, and provided for the continuation of benefits to disabled workers' children who attend school after reaching age 18. With the changes in the law, we estimate that in 1967 about 22.7 million persons will receive over $20.8 billion in old-age, survivors, and disability insurance benefits. PUBLIC ASSISTANCE The 1965 Social Security Act Amendments also made significant improvements in Federal programs to provide money payments to needy individuals and families and expanded authorizations for social welfare services needed by these persons as well as others in our society. These new and improved efforts enable us to build on the basic and important programs of public assistance and child welfare, recognizing them as central to the overall campaign to ameliorate and overcome the effects of poverty and to prevent dependency whenever possible. Under the public assistance programs, part of the increased Federal requirements in fiscal year 1967 are related to newly authorized program changes designed to stimulate States and localities to make more adequate payments to needy recipients, to provide greater incentives to recipients who have the potential to seek employment and rehabilitation opportunities, and to include new groups of needy persons not previously eligible under the federally assisted programs. In addition to their medical assistance aspects, the public assistance programs as they have been modified and strengthened by Congress in recent years provide the chief means of aiding those who live below the poverty level. The Federal, State, and local funds that support these programs assist approximately 2.8 million needy aged, blind, and disabled persons each month, and they also assist about 3.5 million children and over 1 million adults in families caring for these dependent children. Social services without money payments reach several hundred thousand additional persons. ADMINISTRATION ON AGING The Older Americans Act of 1965 established a new agency within our Department--the Administration on Aging. It also authorized a program of support for community planning, services, and training in the field of againg, and for contracts for research, demonstration, and training projects. The dimensions of the needs in these areas are reflected dramatically in the number of older Americans and the paucity of the resources now available to serve them. Prior to the Older Americans Act, only about 800 of some 18.000 communities in the United States had established groups planning coordinated programs for the elderly. By 1970, we estimate a need for 7.500 persons trained in the area of aging. Our 1967 budget requests increases in all programs under the act to begin to meet the identified need. DEPARTMENTAL LEADERSHIP Mr. Chairman, as I have already indicated, first among the things that we must do in 1967 is the task of insuring that these many new programs and responsibilities get off to a good start and operate smoothly and effectively. During the half dozen months that have passed since I became Secretary, I have devoted particular attention to the selection of key personnel to insure leadership and direction both at the departmental level and at the operating agency level. During this time, we have, with the support of the Congress, established additional Assistant Secretaries—all of which have been filled-and we have also established and filled a number of other key positions in my own office, including a Special Assistant for Civil Rights—an area to which I plan to give a great deal of attention during the coming year. At the operating agency level, we have appointed a new Surgeon General, and new Commissioners of Education, Food and Drugs, and Aging. We still have before us the task of selecting a commissioner to head the newly organized Federal Water Pollution Control Administration and certain other key positions at the operating agency level. Our objective here is to bring the Department's activities closer together and to improve leadership at every level. Although I am gratified by our accomplishments thus far, I nevertheless see a need to strengthen and improve our organizational structure and our ability to provide leadership and staff support throughout the Department. A number of proposals to this end are contained in the budgets of the operating agencies and the budget request for the Office of the Secretary. I submit these proposals to you and urge their adoption. If I may insert one comment here, Mr. Chairman, I want to emphasize as strongly as I can the great need for effective management of these programs. It seems to me that nothing can thwart the intent of Congress more effectively than bad management. If someone is trying to thwart you deliberately, you have a chance to get at him, but if he is thwarting you because he is managing a program badly, there is little you can do. It seems to me anything I can do to get these programs off to an effective start to meet the intent of Congress will be to the benefit of all of us. CONCLUSION That concludes my statement, Mr. Chairman. I strongly urge your approval of our 1967 budget, which will enable us to achieve sub |