HEALTH SERVICES AND HEALTH REVENUE SHARING THURSDAY, FEBRUARY 14, 1974 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT, Washington, D.C. The subcommittee met at 10 a.m., pursuant to notice, in room 2322, Rayburn House Office Building, Hon. Paul G. Rogers, chairman, presiding. Mr. ROGERS. The subcommittee will come to order, please. This morning the subcommittee begins 6 days of hearings on H.R. 11511 and H.R. 11845, introduced by most of the members of the subcommittee, H.R. 11518, introduced by Mr. Heinz, as well as several related bills dealing with targeted services programs which affect millions of Americans, most of whom are disadvantaged physically, culturally, or economically. They involve the provision of health care in special areas of national significance. They include block grants to States, a program which was developed in the early 1960's to help States defray the costs of public health services. They include assistance to community mental health centers, a program initiated in 1963 with the goal of providing all citizens access to mental health services with emphasis on community treatment. They involve assistance for family planning programs which serve not only as a means of fertility control but also as the only entry point into health services for many people. They include the developmental disabilities program, a program designed to expand the role of the States in the development of a wide variety of comprehensive resources to bear on the problems of the developmentally disabled. They include assistance to migrants, most of whom are culturally and economically deprived and ineligible for medicaid. Finally, they include assistance to neighborhood health centers, which have brought primary care to millions of economically deprived Americans. The concern of the Congress with these programs is reflected in the fact that the number of Members of Congress that sponsored the bills that affect these programs run into the hundreds. A year ago this subcommittee conducted hearings on a bill which extended these and other expiring health programs for 1 year. In debate on that legislation on the floor of the House, members of this subcommittee promised thorough review of each expiring program and legislative changes if necessary. It is a proposal, not a decision. This subcommittee welcomes constructive suggestions on ways to improve these services programs. Without objection the text of the bills covered by this hearing shall be placed in the record at this point. [The testimony resumes on p. 457.] [The text of bills and agency reports thereon follow:] [H.R. 11511, introduced by Mr. Rogers on November 15, 1973; and H.R. 11845, introduced by Mr. Rogers (for himself, Mr. Kyros, Mr. Preyer, Mr. Symington, Mr. Roy, Mr. Carter, Mr. Heinz, and Mr. Hudnut) on December 7, 1973, are identical as follows:] A BILL To amend the Public Health Service Act and related laws to revise and extend programs of health revenue sharing and health delivery, and for other purposes. 1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 3 That this Act may be cited as the "Health Revenue Sharing 4 and Health Services Act of 1973". 5 6 TITLE I-HEALTH REVENUE SHARING SEC. 101. This title may be cited as the "Special Health 7 Revenue Sharing Act of 1973". 8 SEC. 102. Section 314 (d) (1) of the Public Health 9 Service Act (relating to grants to States for comprehensive 10 public health services) is amended by striking out “and” 2 1 after "1973," and inserting immediately after "1974" the 2 following: ", $100,000,000 for the fiscal year ending June 3 30, 1975, and $100,000,000 for the fiscal year ending June 4 30, 1976". 5 6 7 TITLE II-COMMUNITY MENTAL HEALTH CENTERS SEC. 201. This title may be cited as the "Community 8 Mental Health Centers Amendments of 1973". SEC. 202. The Congress finds that (1) community mental health care is the most effective and humane form of care for a majority of mentally ill individuals; (2) the federally funded community mental health centers have had a major impact on the improvement of mental health care by (A) fostering coordination and cooperation between various agencies responsible for mental health care which in turn has resulted in a decrease in overlapping services and more efficient utilization of available resources, (B) bringing comprehensive community mental health care to all in need within a specific geo graphic area regardless of ability to pay, and (C) developing a system of care which insures continuity of care for all patients, and 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 thus are a national resource to which all Americans should enjoy access; (3) there is currently a shortage and maldistribution of quality community mental health care resources in the United States; and (4) until such time as legislation is enacted and becomes effective which insures all Americans financial access to the mental health services which are presently available through community mental health centers, Federal funds should continue to be made available for the purposes of initiating new community mental health centers responsive to community needs and national goals relating to community mental health care. SEC. 203. The Community Mental Health Centers Act is amended to read as follows: "TITLE II-COMMUNITY MENTAL HEALTH CENTERS "PART A-OPERATIONS ASSISTANCE 19 "REQUIREMENTS FOR COMMUNITY MENTAL HEALTH 20 225 21 CENTERS "SEC. 201. (a) For purposes of this title, the term 22 'community mental health center' means a legal entity (1) 23 through which comprehensive mental health services are 24 provided in the area served by the center (referred to in 25 this title as a 'catchment area') in the manner prescribed by |