Chart S-Vocational rehabilitation; Federal appropriation—facal year 1955 This chart shows the budget request for the fiscal year 1955 in relation to the President's proposal for an expanded program of vocational rehabilitation. The $19.2 million of Federal funds currently requested is based on the appropriation act proviso limiting Federal reimbursement in the fiscal year 1975 to $1 for each 75 cents contributed by the States. It means a reduction from the $23 million appropriated by the Congress for the fiscal year 1954. The appropriations act language would have to be revised or 8. 2759 (or another bill) enacted to remedy this situation.

In his budget message to the Congress, the President recommended major expansion of the program and stated that a supplemental sum of $8 million would be requested to achieve this objective. This chart shows how the proposed supplemental appropriation would be used: $3.8 million won'd be used to maintain the current basic program at its present level, $23 milion of Federal support; $3.5 million would be used as "special project” grants to initiate a nationwide expansion of the program to rehabilitate 10,000 more disabled persons; $1 million would be used to increase the supply of trained personnel and rehabilitation teams and stimulate research; $500,000 would be used for departmental administration and permit increases in staff for carrying on the Office of Vocational Rehabilitation functions, particularly as they relate to new services and operations under the expanded program.

While the new three-part grant structure is the most significant aspect of the b before you, the bill also contains many other desirable changes which would flitate an expanded and modernized program.

II. PROPOSED BROADENING OF THE SCOPE OF THE PROGRAM

The bill would authorize Federal funds to be expended for certain important purposes which have heretofore not been authorized by the law, but which are essential to a well-rounded rehabilitation program. These include:

Personnel training, to help relieve the present extremely acute shortages of doctors specializing in rehabilitation, physical therapists, occupational therapists, and rehabilitation counselors, as well as psychologists and social workers skilled in rehabilitation.

Research and demonstration, to improve rehabilitation techniques and to diserinate knowledge concerning such techniques.

Expansion of special facilities by the States, such as community workshops, Reech and hearing clinics, and the like, including the initial staffing of such facilities.

III. PROVISIONS FOR INCREASED STATE AND LOCAL RESPONSIBILITY

Another set of provisions in the bill would have the general effect of increasing State and local responsibility and flexibility in the administration of the program, with a corresponding reduction in Federal controls. These provisions are as follows:

1 Opportunity for community or county administration of the program under State supervision, rather than requiring all administration to be at the State ievel. 2. Opportunity for the States to create independent rehabilitation agencies, not under the State boards of vocational education.

3. Opportunity for separate State plans for the State agencies for the blind. 4. Assignment to the States of responsibility for establishing certain standards relating to facilities and personnel; priorities among applicants for services; and cooperative arrangements with other related agencies, such as public assistance agencies and employment offices.

5. Elimination of the present requirement of Federal approval of fee schedules for medical services, hospitalization, training, and prosthetic appliances, as well as of rates of compensation for State agency personnel.

IV. SUGGESTED AMENDMENTS

We wish to recommend for the committee's consideration three amendments to S.2759:

First, a judicial review provision similar to the one recommended yesterday for the public health grant-in-aid bill, S. 2778.

Second, a provision to define the District of Columbia as a State and to transfer the District's rehabilitation program from the Department of Health, Education, and Welfare to the government of the District of Columbia.

Third, a provision to amend the Randolph-Sheppard Act so as to increase employment opportunities for the blind under the vending stand program. The proposed amendments would

Make the act applicable to all Federal property, instead of buildings only; Provide that licensed blind persons be given preference in the operation of vending stands on Federal property; and

Provide that Federal cusodial agencies establish regulations to assure that the preference is actually put into effect.

SUMMARY AND CONCLUSIONS

Before concluding this statement, Mr. Chairman, I should like to call to the attention of the committee two other administration proposals which bear directly on the rehabilitation program. The first is the proposed amendment to the Hospital Survey and Construction Act to authorize financial aid for the construction of comprehensive rehabilitation facilities. The second is the proposal which would preserve the benefit rights, under the old-age and survivors insurance system, of persons who become totally disabled. This second proposal, which provides for the use of State rehabilitation agencies to perform

From this brief background, I think you can understand the tremendous importance of the rehabilitation program, both to disabled individuals and to the Nation as a whole.

The charts have also illustrated the static condition of the program today in terms of numbers of persons rehabilitated annually. Our total effort is exceedingly inadequate. A vast backlog of physically handicapped persons exists, and yet every day newly disabled individuals are becoming dependent upon their families and the public. As a nation, Mr. Chairman, we have shown great shortsightedness is not devoting more attention to the potentialities of the rehabilita tion process. As the President stated in his special health message of January 18: "There are no statistics to portray the full depth and meaning in human terms of the rehabilitation program, but clearly it is a program that builds a better

America"

It was for these reasons that the President, in his health message, recommended a progressive expansion of our rehabilitation program over a 5-year period. He suggested that we establish goals to increase the number of rehabilitants far above the present 60,000 per year. As a 1955 goal he recommended 70,000 rehabilitants, for 1956, 100.000; and progressively upward until we reach by 1959 the goal of 200,000 rehabilitated persons in the course of the year. This schedule progression takes into consideration the time required to expand facilities and to increase the sup, ly of trained personnel. It also gives the States an oppor tunity to plan for their part of the additional financial support needed.

If the program were to be merely continued at its present level during the next 5 years, we could anticipate rehabilitating in that period about 300,000 persons. The expanded program would rehabilitate an additional 360,000 persons at an estimated additional cost of $209 million. As you will see, however, this additional cost to the States and the Federal Government would be offset several times by the resulting savings in public assistance costs and the revenues from income taxes of the persons restored to jobs.

The bill before you is des gned to provide the legislative framework for the dynamic expansion of the program which the administration has recommended. Before we proceed with the actual legislative changes in the bill, however, I would like to ask Mr Rockefeller to illustrate, with the charts, the goals and the costs of the proposed expansion.