some workers would prefer to work in the private field, their skills would be available to the public welfare administrator through referral to private agencies, or through contractual arrangements between the voluntary agency and the public welfare administrator.

We believe that this type of broad training program constitutes one of two methods by which the Government can improve substantially the availability of professional service to people in need. By supporting the training program of candidates who might prefer to work in the voluntary field, the Government would be increasing the ability of private and voluntary services to fulfill more effectively their role as partner with public welfare services in meeting total community need. The second avenue by which the Federal Government can increase available social services, follows:

MAXIMUM USE OF EXISTING FACILITIES

We would urge the Senate to restore to this bill the language contained in the original proposal, H.R. 10032, wherein endorsement was given to the maximum use of existing voluntary private welfare services in providing necessary social services. This is a concept which has wide acceptance. It was part of the administration's bill at the beginning of this session of Congress. It has been recommended by the Advisory Council on Public Assistance, the Advisory Council on Child Welfare Services, and the Ad Hoc Committee on Public Welfare whose report was submitted to Secretary Ribicoff in September 1961. All of these proposals support a traditional American concept; namely, the opportunity and the obligation of individuals and of citizen organizations to do for themselves those things of which they are capable. The flourishing of private welfare organizations serves this concept. If, currently, the absence of sufficient financial support limited their ability to do this, it seems to be an indication to us that the Government would serve two desirable ends, by rendering this financial support for the direct and immediate meeting of the social welfare needs of its people and by promotion of the vitality and the effectiveness of citizen responsibility for meeting many of their own needs.

America seems to us to be built upon the idea of citizen capability and personal responsibility. We believe that the general, social, moral, and political health of our Nation is in direct proportion to the vital activity of voluntary citizen groups in the areas of health, welfare, and religion. The flourishing of voluntary services is indicative of an alert, self-reliant citizenry which is doing for itself the things of which it is capable. When the legislative bodies of our Federal Government promote the maximum use of existing community and private agencies, it seems to us that Government would be contributing mightily to the worth of individual citizens, and at the same time would be rendering an eloquent answer to those who envision in our Nation the development of a welfare state.

PRESENTATION OF THE NEW YORK STATE CATHOLIC WELFARE COMMITTEE ON H.R. 10606

The New York State Catholic Welfare Committee is privileged to present to you today its comments and criticisms on the bill before your committee designated as H.R. 10606. Our committee does so on behalf of the Archdiocese of New York and the seven Catholic dioceses in New York State, centered in Brooklyn, Buffalo, Rochester, Syracuse, Albany, Ogdensburg, and Rockville Center. Agencies and organizations of this archdiocese and these dioceses serve hundreds of thousands of persons in need every year.

Our agencies and organizations consider themselves as positive partners with public welfare agencies in meeting the total needs of the community for adequate services and benefits for persons in financial need. Our social service caseloads today have a significant number of persons who are receiving part or all of their income under the public assistance programs. In this partnership of public and voluntary welfare, the public agencies have assumed to meet the financial needs of welfare beneficiaries. The voluntary groups have continued to render increasingly broader services to welfare recipients and others who can benefit from professionally oriented services.

It is from this deep commitment to the importance of adequate public welfare services that we bring to you our comments and criticisms of H.R. 10606.

SERVICES TO THE NEEDY (SEC. 101)

We express deep disappointment and serious concern that the House deleted the provisions in the original bill (H.R. 10032) providing that services to needy persons through the use of nonprofit social agencies could be obtained by contract under certain conditions. This recommendation of the Secretary of Health, Education, and Welfare was consonant with the spirit of the partnership to which we have alluded.

We strongly oppose the present proposal of the bill requiring that a State provide services for every needy family with children (p. 6, lines 19-22) in order to receive reimbursement for grants and services provided for such families, so long as it does not contain language to give to the State a fair choice as to the use of nonprofit organizations in providing such services. So long as Federal funds may only be paid where the services are provided exclusively by the staff of public agencies, and only for such services, the use of voluntary nonprofit organizations in serving persons in financial need will cease and many of our strong and vital private agencies will be seriously, adversely affected.

The deletion of this essential part of the overall plan to increase services to people in need is regrettable as it runs directly counter to the charge to the States now contained in the directions for State plans (sec. 2(a) (10); 402(a) (12); 1002 (a) (13); 1402 (a) (12) as follows: "to assure, in the provision of these and any other services which the State agency makes available to individuals under the State plan, maximum utilization of other agencies providing similar or related services."

Furthermore, the bill is impractical and inductive of false hopes, as we all are well aware that existing staffing of public welfare agencies throughout the country is not equipped to provide adequate services to help all persons in financial need to become self-sufficient.

We believe that in some parts of the country a portion of this deficiency may be met by some fruitful use of voluntary social service organizations. The present proposal would not only exclude this important resource, but would have the effect of terminating the present instances where such organizations are used to provide much-needed services for persons in financial need.

It is our firm conviction that the enactment of this bill in its present form would harm seriously the programs and the development of voluntary organizations throughout the country. It would have the direct effect of narrowing the role and the responsibility of voluntary services in the country on behalf of an unwarranted extension of public welfare services.

This effect may be illustrated by reference to the provisions of H.R. 10606 which would require for the first time that public welfare agencies provide social services in direct competition with private, voluntary effort. The provisions of section 101 of the act would extend Federal financial assistance to programs of service for persons who are not applicants for or recipients of public assistance. By this device, the public welfare office, with unlimited Federal tax resources, would open its doors across from existing private agencies and beckon for clients and staff. It would do so on the same basis as the voluntary agencies-"where such services are requested" by the persons. How long will it be before the public office will be the only office providing social services? Not long, if this bill is enacted.

It would be a tragic development that a bill designed to provide additional services to persons in financial need would be so modified or changed in the process of congressional action as to harm seriously existing voluntary agency programs and would have the probable net effect of supplanting private effort with public effort.

We strenuously urge that the provisions of H.R. 10032 providing for the use of voluntary services under certain conditions be restored to the bill.

DAY CARE (PP. 19-22)

We are deeply concerned that the proposal for Federal support of day-care programs has been presented without an adequate showing that the provisions of such services will serve to strengthen family life of those who are receiving public assistance.

Our considered view is not predicated upon a lack of appreciation for the value of day-care programs under welfare ausices for specialized needs. In past years, our committee has said of day care:

"Day care has been a part of this broad program for children. It is a service which provides for the daytime group care, for all or part of the day, of preschool-age children and of school-age children after school hours. The basis of a day-care program is essentially welfare; that is, it aims to serve children having the greatest need economically and socially. Day-care facilities, therefore, should be under social welfare auspices. Day care is based upon a thorough and careful plan of casework. It requires an effective control at the source of admission which will insure help to children in the greatest need. There cannot be a haphazard admission policy unnecessarily removing children of tender years who might better remain in their own homes. The child's basic security lies in the home. The foundation of child welfare is normal home life. Where the security of that home is threatened by extraordinary circumstances, daycare services should be available. Good day-care services supplement and help preserve the home; they never substitute for it.

"The broad program of services to children in New York State has been accomplished by a full partnership of effort on the part of both public and private agencies; and in this partnership, the private agency has been a senior member. Only where the family and the nonprofit voluntary agencies, with proper aid and encouragement are unable to meet the needs of children, should government as such, directly undertake to substitute in place of the home and family a public agency to provide for the care and training of the child in his early years. The responsibility of the State is primarily to uphold and strengthen the family, using, in every practical way, the voluntary agencies and associations developed for that purpose. If it is necessary for government to supplement, financially, voluntary private efforts, then the program should be made available only to those children who need care from a welfare standpoint. Such funds should be allotted to all qualified agencies, private as well as public, on a per capita basis."

We are convinced that the present proposal for Federal subsidy for day-care centers has been pressed for passage without an adequate study of the value of this program to strengthen family life of public assistance recipients. Yet, it has been urged that it will accomplish this objective.

We are opposed to the proposed extension of Federal funds for day care and in place thereof we urge that studies be carried on to determine whether day care can be utilized to effectively help persons who are recipients of public assistance.

We urge upon you that the participation of the Federal Government in this program at this time should be limited to the subsidization of pilot projects for day-care centers in a few selected areas to be determined by the Secretary, under contract with local agencies, public or private. In these projects study might be conducted to ascertain how, if at all, day care can be of use to aid parents of children in financial need to strengthen their family life.

The present proposal provides a new role for Federal child welfare service funds. It proposes to allow subsidies for day-care centers without requiring that such centers be only available for use by persons in financial need. The present proposal might permit Federal subsidy for day-care centers where users are able to pay for the services rendered.

Some sociologists have argued that the breakdown of family life in some urban centers is a direct result of the absence of both parents from the home during a substantial part of the day. Two breadwinners in the family may increase the pay envelope but only at the expense of the children who are so neglected.

It is unfortunate those some well-intentioned persons with a crusading spirit have mistakenly urged that the solution to this neglect is to provide a government-supported substitute parent, while the parent works. This would, in our opinion, compound the wrong.

Instead, we urge a reexamination of the role of our established program of aid-to-dependent children, as it was originally conceived, to preserve the home and provide adequately for the homemaker to remain at home to maintain the home. This would require specialized casework and increased funds under public assistance for homes where the mother remains in the home to care for the children.

We urge that the present proposal for day care be stricken from the bill and a study-pilot project amendment be submitted for the expenditure of funds on a 1-year basis.

84071-62- -26

FOSTER CARE OF CHILDREN (SEC. 135)

The present bill provides a very important and desirable amendment to preserve for the States the right to choose the type of foster care in which a child may be placed when removed by a court from an unsuitable ADC home. The present law imposes a rigid restriction that the placement must be to a foster family boarding home only, even if the best interest of the child might require temporary or regular institutional care.

It

This unreasonable limitation was overlooked at the time of the passage of this emergency addition to the 1960 Social Security Act amendments. The necessary corrective amendment is contained in section 135 of the present act. would simply provide that like treatment under the act shall be accorded to children placed in institutions as in foster boarding homes, as determined by the State agency.

This amendment is essential to give to the State agency the right of choice of the type of care which the State agency deems to be in the best interest of the child. At present, the law, by financial inducement, would effectively deter the State agency from utilizing institutional care even though such was required in the best interest of the child.

We urge that this amendment be continued in the present bill.

The CHAIRMAN. The committee will recess until 2:30.

(Whereupon, at 12:20 p.m., the committee stood in recess to reconvene at 2:30 p.m., the same day.)

AFTERNOON SESSION

The CHAIRMAN. The committee will come to order.

The next witness is Cernoria Johnson, National Urban League. (No response.)

(Miss Johnson testified the following day.)

The CHAIRMAN. The next witness, then, is Dr. W. Judd Chapman, of the American Optometric Association.

Dr. Chapman, please take a seat, sir. Proceed, sir.

STATEMENT OF DR. W. JUDD CHAPMAN, VICE PRESIDENT,
AMERICAN OPTOMETRIC ASSOCIATION

Dr. CHAPMAN. Mr. Chairman, my name is W. Judd Chapman. I am an optometrist practicing my profession at 205 South Monroe Street, Tallahassee, Fla. My appearance here is as vice president of the American Optometric Association.

I graduated from Northern Illinois College of Optometry in 1948, having previously attended the University of Florida, and subsequently took post graduate work in the contact lens field at the School of Optometry, University of Houston.

I am past president of the Northwest Florida Optometric Association, member of the American Academy of Optometry, the American Optometric Foundation, former president of the Florida State Board of Optometry. I hold the rank of first lieutenant in the U.S. Air Force Reserve, Medical Service Corps (Optometry). I have been active in chamber of commerce work, Rotary club, and in religious and civic organizations.

Our association is an affiliation of State associations in the 50 States and the District of Columbia. Our membership also includes optometrists who are commissioned and on active duty in the armed services or are employed by the Federal Government in various governmental agencies.

There are somewhere between 18,000 and 19,000 optometrists licensed to practice in one or more of the United States, and substantially more than half that number are members of our association. There are less than 4,000 board-certified ophthalmologists, primarily located in the major metropolitan areas.

Our profession is the only one that is exclusively educated, trained, and licensed to care for the vision of the public. Over 65 percent of the public who have visual problems voluntarily seek the services of optometrists. There were sound and valid reasons why optometrists were included in the existing statute. Not the least of them is the lack of availability of ophthalmologists for, as I said before, there are less than 4,000 board-certified ophthalmologists and over 18,000 duly licensed optometrists.

Secondly, the optometrists have a sound and complete education in matters of vision, the details of which will be presented to your committee by Dr. Henry W. Hofstetter, former president of the Association of Schools and Colleges of Optometry.

An eye examination by an optometrist is very thorough and on the average consumes anywhere from half an hour to an hour, depending upon the particular case. Some people are inclined to criticize our profession for making such a thorough examination, but when one considers not only the importance of vision but the fact that the years which have been added to the lifespan of the average American are bound to create visual problems, not all of which can be speedily discovered and solved, one can readily understand the necessity for a complete examination.

For example, the State of New Jersey has prescribed certain minimum procedures which every optometrist must follow in making eye examination, namely:

1. Complete history.

2. Naked visual actuity.

3. Detailed report of the external findings.

4. Ophthalmoscopic examination (media, fundus, blood vessels, disc.)

5. Corneal curvature measurements (dioptral).

6. Static retinoscopy.

7. Amplitude of convergency and accommodation.

8. Phoria and duction findings; horizontal and vertical

distance and near.

9. Subjective findings.

10. Fusion.

11. Stereopsis.

12. Color vision.

13. Visual fields (confrontation).

14. Visual fields, central (after age 40).

15. Prescription given and visual acuity obtained.

Recently two optometrists questioned the constitutionality of these requirements when their licenses were suspended by the New Jersey board for failure to comply with them. The Supreme Court of New Jersey sustained the action of the board and the U.S. Supreme Court refused to review the action of the New Jersey court.