WORK EVALUATION INDUSTRIAL FITNESS VOCATIONAL COUNSELING TRANSITIONAL EMPLOYMENT PREVOCATIONAL EXPERIENCE TERMINAL EMPLOYMENT VOCATIONAL TRAINING

PLACEMENT

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COMPREHENSIVE REHABILITATION FACILITIES

PROPOSAL: INCREASE NUMBER & CAPACITY
OF COMPREHENSIVE REHABILITATION FACILITIES

This discussion of rehabilitation facilities completes our presentation of the five major proposals of S. 2758. In addition to these major proposals, the bill includes another provision designed to stimulate State and local action in constructing chronic hospitals, nursing homes, diagnostic or treatment facilities, and rehabilitation facilities. Under the present act the Federal share of in. dividual projects may vary from one-third to two-thirds of the total construction cost, in accordance wtih a matching formula keyed to the relative per capita

MENDATIONS

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incomes of the States. With respect to the four categories of facilities covered
by S. 2758, the bill provides that the Federal share may vary from one-half to
two-thirds. In other words, the minimum Federal share would be one-half
instead of one-third.

In brief, Mr. Chairman, the proposals contained in the bill represent both a
new emphasis and a broadening of the scope of the present act. They would
add to the present act one entirely new category-nursing and convalescent
homes. They would also broaden the provisions of the present law with regard
to rehabilitation facilities and diagnostic or treatment centers—which are now
eligible for Federal funds only if they are parts of hospitals. For each of these
types of facilities, as well as for chronic hospitals, the bill would provide addi-
tional emphasis and inducement: (1) by specifically earmarking funds which
can be used for no other purpose, and (2) by establishing a minimum Federal
matching ratio of 50 percent in all States.
With the one exception relating to Federal matching ratios, the administra-
tive and fiscal provisions of this bill correspond with those in the present
Hospital Survey and Construction Act—including the provisions relating to the
allotment formula; the role of the State agency; the procedures for submission
and approval of construction grant applications; appeals to the Surgeon General
and the Federal Hospital Council; and the applicability of minimum-wage rates
under the Davis-Bacon Act for construction workers.

Before concluding this statement it may be helpful to note, in summary form,
the differences between S. 2758 and the bill passed by the House, H. R. 8149.
As far as approach, scope, and major content are concerned, the two bills are
identical, but there are a few points of difference:

1. The House bill includes a declaration of purpose patterned after the declaration in the present Hospital Survey and Construction Act. We believe the addition of such a declaration is desirable.

2. The Senate bill would establish a statutory minimum Federal share of 50 percent of construction costs for all projects in the categories covered by the bill. The House bill would authorize such a minimum, at the option of the States, but would not make it mandatory. Thus, under the House bill, the States could elect 1 of 3 matching alternatives-either of the 2 options provided in the present law, or the new 50 percent provision. We would have no objection to this amendment.

3. With respect to eligible sponsors for the construction of diagnostic or treatment centers, the Senate bill would include any nonprofit sponsor, as well as public sponsor. The House bill would limit eligibility to a public body or, in the case of a nonprofit sponsor, to one owning a nonprofit hospital. We believe the broader eligibility provision of the Senate bill is preferable.

CAPACITY FACILITIES

3. FACILITIES