P

Chart 8-Vocational rehabilitation; Federal appropriation—fiscal year 1955

This chart shows the budget request for the final year 1953 in relation to the
President's proposal for an erandei program of vocational rehabilitation.

The $19.2 million of Federa: fund currenty ren, nested is based on the appro. _OTMENT FORMULA
priation act proviso limiting Federal reimburselent in the fiscal year 1935 to $1
for earh 15 cents contributed by the states. It means a reduction from the ***GRAMS
$23 million appropriated by the Constess for the fi- al Fear 1934. The appro-
priations act lanzunge would have to be revid or S. 27:39 (or another bill)
ena, ted to remedy this situation.

In his budget message to the Consress the President recommended major expansion of the program and stated that apprental -um of million would be requested to achieve this oli jentile This chart shows how the proposed supplemental appropriation world le : $. milion would be used to maintain the current baie prozrain at its prevint level, 23 million of Federal support; $3.5 million would be used as "al projert" grants to initiate a nationwide exparision of the program to rebal'iiate 10.000 more disabled persons ; $1 million would be used to il Tease the supply of trained personnel and rehabilitation teams and stimulate research: *1.10) would be used for departmental administration a'i jeruit increases in staff for carrying on the Office of Vocational Rehabi.itation functions. puurt.cularis as they relate to new services and operations under the expanded program.

PRESENT PROGRAM

100

PROPOSED
EXPANSION

75

6

MILLION 50

42 MILLION

25

PRESENT
PROGRAM

While the new three-part grant structure is the most significant aspect of the till 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 fential 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

rehabilitation.
Research and demonstration, to improve rehabilitation techniques and to dis-
semnate 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

folows:

1. Opportunity for community or county administration of the program under State supervision, rather than requiring all administration to be at the State

lepel.

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 stand-
ants relating to facilities and personnel; priorities among applicants for serv-
ices; 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 sched-
ules 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 8.2759:

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 zaployment 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 propusal 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 disc abled 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 govern. ments. 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 PORTELL. 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