Chart S-Vocational rehabilitation; Federal appropriation-fiscal 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 1955 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 S. 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 $8.8 million would be requested to achieve this objective. This chart shows how the proposed supplemental appropriation would be used: $3.8 million would be used to maintain the current basic program at its present level, $23 million 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. OVR EXPANDED REHABILITATION PROGRAM PRESENT PROGRAM PROPOSED EXPANSION % 10 25 30 50 STATE STATE SHARE SHARE 60 55 50 50 50 % 1955 1956 1957 1958 1959 1955 1956 1957 1958 1959 OVR FED APPROPRIATION, FISCAL 1955 PAS C FROMAM REQUIRES $ FEDERAL EX-AN ON S While the new three-part grant structure is the most significant aspect of the bill before you, the bill also contains many other desirable changes which would facilitate 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 disseminate knowledge concerning such techniques. Expansion of special facilities by the States, such as community workshops, speech 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 level. 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 the medical evaluation functions for the Bureau of Old-Age and Survivors Insurance, would result in the referral of thousands of disabled workers annually to the State rehabilitation agencies. These two related proposals would complement the bill before you today so as to provide a well-rounded national plan for the improvement of rehabilitation opportunities. To summarize: S. 2759 would establish the legal and financial framework within which to achieve the administration's goal of rehabilitating 200,000 disabled persons annually by 1959. It would initiate a constructive program for restoring thousands more of our fellow citizens to positions of independence and self-respect. It is a bill which combines a recognition of human needs with the promotion of the economic interests of the Federal, State and local governments. We urge that you give the bill your favorable consideration. Senator PURTELL. I would like to ask you, Mrs. Secretary, while we have the opportunity here, or perhaps you would prefer to have Mr. Rockefeller or another one of your associates tell us a little bit more about the projects that are contemplated under the extension and improvement section of the bill. We have had several questions asked about that and I feel we would like to have a little information about that. Secretary HOBBY. Mr. Chairman, may Mr. Dabelstein from the Office of Vocational Rehabilitation tell you? Senator PURTELL. We will be very happy to have Mr. Dabelstein explain that. Mr. DABELSTEIN. Mrs. Secretary and Mr. Chairman. Some of the examples of extension and improvement projects contemplated, are along the following lines: In a number of instances the States have wanted to do more for public-assistance recipients. One type of extension and improvement grant might be made to help the States set up a special procedure for analyzing the public-assistance rolls, to try to identify those who could be rehabilitated. Another illustration of an extension and improvement project would be setting up a special procedure for the rehabilitation of persons with epilepsy. As you know, treatment in this field is of relatively recent origin. Through drug therapy it is now possible to control seizures for about 80 percent among this group. It may be a particular facility to provide a good diagnostic and neurological workup, determining the type of drug therapy that was needed to control that individual's seizures, and then providing a program of training in the regular system. Perhaps one other project might illustrate the point. In the State of Wyoming at the present time they have three local offices. In the southern part of the State, one is at Cheyenne and one at the other side of the State at Rock Springs. But, as you recall, the mountain range goes up the center of Wyoming. They have only one office in the northern area, so that that person has to cut across the mountains to serve people on the other side. It may be the establishment of another local office on the other side of the mountains so that the State agency could bring services to more of the people who might need it. I think that gives you an idea. Mr. Chairman. Senator PURTELL. We thank you very much. Have you any questions, Senator Lehman? Senator LEHMAN. No, I have not. May the record show that Senator Hill, whose interest in vocational rehabilitation is well known, is of necessity in attendance at another |