As a result, scarcely more than half the public institutions for the retarded in the country are benefiting from each, in this, the sixth year of the program. The President's Committee recommends that funds be made available to all public institutions on the basis of a State plan for bringing present institutions up to standard and developing new types of localized residential facilities which will not have the dehumanizing characteristics often associated with large, remote hospitals. It is time to move from an underfunded project approach to a realistic formula grant approach which includes a direct attack on the problem of inadequate residential care. The magnitude of the need was already enormous in 1963. The extent of it was better brought home to State officials and responsible citizens by the comprehensive mental retardation planning effort undertaken in every State during 1965-68, with Federal support and encouragement. Each State now has a clearer view of its problems and a clearer idea of its own priorities, and of the steps it must take to meet them. In many States, new agencies have been created within a State government to spearhead the new efforts, to assume increasing commitments and display more effective and diversified capabilities in directing their own State programs. At the same time, it is being increasingly recognized that mental retardation is frequently associated with other kinds of developmental disability-such as cerebral palsy, epilepsy, congenital malformation, sensory disorders, and the like-and, further, that even the normally intelligent among children and adults with these disorders often have similar problems of special care, training, treatment and living arrangements. They are part of a continuum of disability. Like the retarded, they frequently have certain urgent needs which are not encompassed in any of the Federal programs of which we boast, because they are too young or too old or too handicapped. For all of these reasons, the time has come to propose new and more comprehensive approaches to the problems of those afflicted with developmental disabilities. I believe that the Developmental Disabilities Services and Facilities Construction Act of 1969, introduced by Senator Kennedy, and which I cosponsored, deserves the support of all of us. I congratulate Senator Kennedy for his initiative in this area and pledge my full support in behalf of S. 2846, the Developmental Disabilities Services and Facilities Construction Act of 1969. Senator KENNEDY. Our first witness today will be a group of three distinguished representatives of the Department of Health, Education, and Welfare, who will testify on the status of current Federal programs for the retarded, and present the administration's recommendations with respect to the pending legislation. The second witness will be Dr. William Gibson, of Ohio State University, who will testify with special reference to the Federal program for university-affiliated facilities for the retarded. The third witness will be Mr. Sherwood Messner, of the United Cerebral Palsy Associations, who will be accompanied by Mr. Ernest Weinrich. Mr. Weinrich, who is moderately disabled by cerebral palsy, understands the problems of the severely retarded, and will speak for them at these hearings, since they cannot speak for themselves. The fourth witness will be the Reverend Damien O'Shea, of Westville Grove, N.J., who will testify with respect to the role of private nonprofit institutions in the Federal program. The magnitude of the problem of mental retradation and developmental disabilities is enormous. Today, there are 6 million retarded persons in the Nation. More than 125,000 babies are born each year who are, or will become, mentally retarded. Together with their families, the retarded make up nearly 10 percent of our national population; and the cost of their care is several billions of dollars each year. The challenge we face is immense, and we must make our resources equal to the task. Mr. Black, you are the first witness, would you please proceed. STATEMENT OF CREED C. BLACK, ASSISTANT SECRETARY FOR LEGISLATION, HEW; ACCOMPANIED BY JESSE STEINFELD, DEPUTY ASSISTANT SECRETARY FOR HEALTH AND SCIENTIFIC AFFAIRS, HEW; ROBERT JASLOW, M.D., CHIEF, DIVISION OF MENTAL RETARDATION, REHABILITATION SERVICES ADMINISTRATION, SRS; AND EDWARD NEWMAN, PH. D., COMMISSIONER, REHABILITATION SERVICES ADMINISTRATION, SRS Mr. BLACK. Thank you, Mr. Chairman. We appreciate your welcome. In addition to Mr. Newman and Dr. Jaslow, I have with me on my right, Dr. Steinfeld, Deputy Assistant Secretary for Health and Scientific Affairs. It is a privilege to appear today to testify on the progress that has been made under the Mental Retardation Facilities Construction Act and proposals for its extension and amendment. This legislation, as you know, was initiated in 1963 with the objectives of stimulating the development of needed manpower, research, and a network of facilities for the delivery of services to the mentally retarded. In the years since 1963, progress toward those goals has been significant. Under the community mental retardation facilities program (part C), for example, 297 projects have been approved. When completed, they will make available modern and efficient facilities to provide services to 30,000 persons who were not being served at all and improved services to another 45,000 persons. When the present authorization expires on June 30, 1970, about 67 other facilities will have been funded, which when completed will provide services to 15,000 more persons. Comparable progress has been recorded under the program of initial staffing grants for community mental retardation facilities, which was added to the act by the Mental Retardation Amendments of 1967. These grants are available to assist in the initial staffing of both new facilities and new services in existing facilities. To date, 237 projects have been funded, providing support for staff to serve over 60,000 retarded. It is expected that by June, 1970, when the present authorization expires, 468 projects will have been funded, providing staff to serve more than 120,000 retarded in their home communities. The third major effort financed under this act is the universityaffiliated facilities program (part B), which provides grants to assist in the construction of facilities affiliated with universities or colleges which offer interdisciplinary training based on exemplary models of comprehensive services to the mentally retarded. The university-affiliated centers are a major resource for training professional and technical personnel needed to work with the mentally retarded, such as physicians, social workers, nurses, psychologists, special educators, therapists, and rehabilitation specialists. Through 1969, 18 project have been approved and funded; six have been completed and eight more should be completed within the next 12 to 18 months. The facilities are coordinating their activities with other community programs, and with State residential programs for the retarded. As a broad resource for specialized training, continuing education, and the provision of exemplary service in complex cases, they fill a role in the system of mental retardation services similar to that of the teaching hospitals in the health field or the research and training centers in the field of vocational rehabilitation. Before turning from this brief summary of results thus far to the question of where we go from here, Mr. Chairman, I think it is important that we put this particular legislation into the broader context of our department's total activities in the mental retardation area. As the members of this committee are no doubt aware, the Mental Retardation Facilities Construction Act is but one part of a much larger effort which spans the entire Deparment of Health, Education, and Welfare. The impressive scope of these departmentwide activities was described in a report prepared earlier this year for the House Appropriations Subcommittee by the Secretary's Committee on Mental Retardation. With your permission, I should like to submit a copy of the complete report for the record of these hearings and summarize it briefly for the purposes of our discussion today. (The report referred to follows:) MENTAL RETARDATION ACTIVITIES OF THE U.S. DEPARTMENT OF HEALTH, Prepared by Secretary's Committee on Mental Retardation Prepared for House January 10, 1969 SUMMARY OF MENTAL RETARDATION ACTIVITIES The 1964 Appropriations Act of the Department of Health, Education, and Welfare makes available over 3507,963 million for mental retardation program activities in the current fiscal year. Of this amount $193,700 is to be used for Lacome pacatenance of persons who are mentally retarded. 1/ The mental retariatum activities of the Department have been arranged according to the following categories preventive services, basic and supportive services, training of personnel, research, construction, and income maintenance. Preventive Services Preventive services are defined as those services rendered as a part of programs designed to reduce the incidence of mental retardation. The major programs in this area are administered by the Children's Bureau, Social and Rehabilitation Service. Maternity and Infant Care Projects support programs which provide necessary health care to prospective mothers in high risk populations. By December 1968, fifty-three such projects were in operation. Grants which support screening programs for phenylketonuria (AU) and other metabolic diseases also are awarded by the Children's Bureau. As of December 1968, forty-three States had enacted laws related to PKC, most of them making screening for this disorder mandatory. The Public Health Service carries on preventive services in relation to the health services provided beneficiaries of the Service. Basic and Supportive Services Basic and supportive services are defined as those services rendered to or for persons who are mentally retarded. State health departments, crippled children's agencies and State welfare agencies use funds administered by the Children's Bureau for programs designed to: increase the health and welfare services available to the retarded, enlarge existing mental retardation clinics by adding clinic staff, increase the numer of clinics, begin evaluations of children in institutions, extend screening programs, provide treatment services for physically handicapped retarded youngsters, increase inservice training opportunities, and provide homemaker and other care services for the mentally retarded. The mentally retarded receive a variety of services through the vocational rehabilitation program supported by the Rehabilitation Services Administration: medical diagnosis, physical restoration, counseling and testing during the rehabilitation process, assistance in job placement and follow-up to insure successful rehabilitation. Public Law 90-391, "Vocational Rehabilitation Act amendments of 1968," will assist in the rehabilitation of additional mentally retarded persons to productive life. The Health Services and Mental Health Administration, in conjunction with the Division of Mental Retardation, Rehabilitation Services Administration, support projects for the retarded which have service components of well integrated 1/ A Table of Obligations for Fiscal Years 1966-1968 is included on page 65. |