small amount will make barely a start in increasing the number of trained personnel. In view of the fact that Secretary Hobby has actually testified several times that the more people we can rehabilitate, make them useful and gainfully occupied people in this country, the more this country will profit, financially, in addition, of course, to the humanitarian aspect-under those circumstances, do you not feel that the program should be expanded much more rapidly than is now contemplated and with far greater recognition of the needs of the States in carrying their share of this work and in recognition of the abilities of the States to carry on this work? I would like some comment from you on that. Mr. POWER. I certainly do agree that it should be expanded as rapidly as possible. The thing that I fear in S. 2759 is that, even though it proposes to expand rehabilitation at a rate indicated, that will not take place. I point out in my statement which I filed that 20 States lose 10 percent the first year, many of them 10 percent the next year, and I indicated the situation, in my own State, where we lose $84,000, with nothing to replace it on the basis of present appropriation. I also pointed out that there are 8 States in relation to this bill that have gone too far so far as having any recognition in the allotment of funds, 7 in addition to West Virginia. So, I don't think there is a chance, as I see the thing from my position, as a State director of rehabilitation, that this thing can work out on the basis of this arrangement for financing in S. 2759. The need for trained rehabilitation workers is certainly apparent, and I agree that whatever can be done should be done to solve that problem; but I would like to recommend again that the most important thing, and the first step, should be to repeal the allotment provisions in the 1954 appropriation act and return to the provisions that were in effect for 10 years that gave this program encouragement, a matching formula basis that provided Federal funds in relation to State funds. Now, beyond that we should go as far as we can. We should have funds, if we can get them, for rehabilitation facilities, for sheltered workshop, for special services for the blind, for all purposes, all auxiliary services that would carry on, for training of rehabilitation workers, therapists, and anything else that con be done; but I do not believe, after studying this bill, that the financial provisions will carry out the objectives set forth in the bill at all. Senator LEHMAN. Thank you. Senator GOLDWATER. Have you anything further, Senator? Senator GOLDWATER. Mr. Power, did I understand you to say that facilities could be built under the Hill-Burton Act? Mr. POWER. Rehabilitation facilities? Senator GOLDWATER. Yes. Mr. POWER. Well, Mr. Chairman, I don't think they have been built. There has been talk that there might be a possibility in the administration of the bill, with a more liberal interpretation. You mean the Hill-Burton Act as it now stands? VIRRARIES Mr. POWER. I haven't known of any being built or any grants being made to a rehabilitation facility and, on the basis of that act I think it would not be possible. Senator GOLDWATER. To your knowledge, during the administration of this bill, up to the present time, there have been no rehabilitation facilities built under the Hill-Burton Act? Mr. POWER. That is correct, sir. Senator GOLDWATER. I think you mentioned in your testimony that you thought that they could be built. Mr. POWER. I think you are referring to the type 2 provision of S. 2759, where there is a provision for special grants and special approval for projects for the expansion and extension of rehabilitation services, which I understand to be an integral part of the rehabilitation program. That doesn't refer to the grants for the rehabilitation facilities. Senator GOLDWATER. Were any attempts made, to your knowledge, since the inception of the Hill-Burton Act to build rehabilitation facilities under that act? Were any applications made? Mr. POWER. I don't know of any, but that could have been because I am not in touch with that sort of thing on a national basis. I operate, of course, within my State and try to keep up with what goes on nationally. Senator GOLDWATER. I just wanted to get your testimony on that, because it seems to be a confused point. Some witnesses feel that it can't be done and others feel it can be done. Mr. POWER. Well, I think, Mr. Chairman, from the standpoint of Vocational rehabilitation, I would recommend or urge special legislation for rehabilitation facilities in behalf of vocational rehabilitation because I think they would be more likely to serve the needs of vocational rehabilitation and more likely to contribute to the preparation of disabled persons for jobs and employment. I think there would be a greater likelihood they would develop into superspecialized hospitals, as I said in my statement, where the rate would be very high and the output would be very low and the emphasis would not be primarily on preparing people for jobs, but the general rehabilitation approach. Senator GOLDWATER. If there are no other questions and if you have no further remarks Mr. POWER. Yes, sir. Senator GOLDWATER. I want to thank you very much for coming here STATEMENT OF MISS JAYNE SHOVER, ASSOCIATE DIRECTOR, Miss SHOVER. Yes; I do, sir. It was sent in last week to you, 75 copies. Senator GOLDWATER. It will become a part of the testimony and you can either read it or work from notes, either way you desire. 46293-54-pt. 2-11 the States appropriated their own funds. This enabled State rehabilitation officials to go to their legislatures and request State appropriations with the understanding that a proportionate amount of Federal aid would be granted as a result of the State appropriation. This helped in getting State money to rehabilitate the disabled into jobs. Repeal 1953 rehabilitation law amendment Because of a desire to reduce Federal financial participation in the program, and a lack of understanding of how the vocational rehabilitation program operates and the need for a fixed Federal matching of State funds on a continuous basis in order to permit effective planning of rehabilitation services, a campaign was pushed to repeal the matching provisions for Federal aid in Public Law 113, and the substitution of an allotment system. It may be pointed out here that a practical way to have reduced the percentage of Federal financial participation in the program and at the same time preserved the matching feature which would have permitted satisfactory planning, would have been to change the law relating to matching. For example, a change in Federal reimbursement from 100 percent to 75 percent of the cost of administration and vocational guidance would have reduced Federal participation in the program but would not have destroyed the matching system formula. The amendment repealing the matching provisions of Public Law 113 and substituting an allotment system for the distribution of rehabilitation aid was recommended as a part of the appropriation language of the 1954 appropriation bill, and was approved by the 83d Congress, Public Law 170, the provision under the subheading "Office of Vocational Rehabilitation," and reads as follows: "Provided further, That after payment of amounts certified to be due for prior fiscal years, the funds herein appropriated shall be apportioned among the States in accordance with regulations promulgated by the Secretary to insure equitable maintenance and improvement of State programs; and the obligation of the United States to any State under such act for fiscal year 1954 shall not exceed the amounts so apportioned to such State: Provided further, That the amount apportioned to a State for fiscal year 1955 shall not exceed $1 for each 75 cents contributed by the State for the same purposes." The above amendment has all the undesirable features of an allotment system of distributing Federal funds to vocational rehabilitation. It relieves the Federal Government of any obligation to match State rehabilitation funds on a fixed basis. Under this provision, States have no assurance of the amount of Federal participation that will be in their programs from 1 year to the next since the amended law does not require Congress to support the program on a fixed matching basis in relation to State expenditures. This feature, as has been previously pointed out, prevents planning which will permit an orderly operation and development of the program from 1 year to the next. This uncertainty has done and will continue to do harm to the Federal-State program of vocational rehabilitation. It is a vital matter and is resulting in great loss because of its hindrance to future planning. Because of the harmful effect of the allotment procedure outlined in the amendment referred to above, it should be repealed. If Congress believes that the original matching provisions of Public Law 113 provide for too large a part of the cost of the Federal State programs of vocational rehabilitation, it can reduce Federal participation by amending the matching provision and provide for a smaller share of Federal expenditures in relation to State expenditures, By taking some such action, the Federal aid could be reduced and at the same time continuous Federal participation in accordance with a fixed proportion of State expenditures could be assured. I. therefore, recommend as a first step in strengthening and expanding rehabilitation services, repeal of the 1953 amendment to Public Law 113 which amendment was approved as a part of the appropriation language for the 1954 vocational rehabilitation appropriation. Oppose reduction of grants Considering the fact that the vocational rehabilitation of the disabled into suitable jobs is so great a problem and that so much needs to be done, a reduction of Federal financial participation in the provision of vocational rehabilitation service in any State would be unfortunate at this time. It is not only desirable that the Federal Government give as much financial assistance as possible, but that it promote a situation which encourages States to put forth their best possible efforts in securing appropriations of State funds and the development of services. It is really not a question of whether we can afford to spend public funds for vocational rehabilitation. It is rather a question of whether we can afford not to spend money for this purpose. A program that is doing less than one-fourth of the job which is recognized to be done should certainly be given sound encouragement. With 250,000 disabled men and women coming to need vocational rehabilitation each year and only 00,000 being rehabilitated the need for expansion of vocational rehabilitation services is apparent. While some States are providing more rehabilitation services than others, none are doing enough. A plan should be pursued which would encourage and help all to do more. A legislative proposal to reduce Federal aid for rehabilitation services to a larger number of States is unfortunate when the need for rehabilitation is increasing. In West Virginia, the need for vocational rehabilitation is greater than at any time in 20 years. More and more physically handicapped men and women are losing their jobs under present employment conditions. It is more difficult to prepare disabled men and women for and place them in suitable jobs today than a year ago. With relief costs mounting, it does not seem to be sound policy to reduce vocational rehabilitation services when the opportunity and the need is so great to help men and women into jobs at which they can earn a living. Major problem in rehabilitation The major problem faced by the Federal-State program of vocational rehabilitation is to provide additional appropriate rehabilitation services for the thousands of eligible disabled men and women awaiting service on the rolls of the rehabilitation agencies in the States. Additional skilled professional employees are needed to counsel, to provide vocational guidance, to arrange for purchase of case services, and to place the disabled in suitable jobs. Additional funds are needed to employ the professional workers and to buy the case services such as surgery, artificial limbs, hearing aids, wheelchairs, training, and job-placement equipment. Unless we can provide for these services and aids in increasing amounts, the program will not go forward in its mission to transform tax users into taxpayers. Any proposed legislation should be examined first to see how it contributes toward the solution of this problem. If it does not soundly contribute, it should be rejected. First things should come first. All agree that we have a long way to go before we can meet the minimum rehabilitation needs of the run-of-mine eligible disabled men and women who are applying for rehabilitation. This important fact should not be lost sight of in considering rehabilitation legislation. It emphasizes the need for an overall plan which will promote the expenditure of more Federal, State, and private funds in the provision of appropriate rehabilitation services. Even with the marshaling of all available help, in the most effective manner, many years will be required to extend rehabilitation to a major part of those who need it. In addition to the expansion of the usual program of vocational rehabilitation services, rehabilitation centers, sheltered workshops, additional specialized services for the blind, and many more things are needed. All who are aware of the problem of disablement and rehabilitation are pleased that the President and the Congress are giving consideration to the problem at this time. It is my sincere hope that legislation will be enacted at this session of Congress which will result in the improvement and the expansion of vocational rehabilitation service. My organization will be glad to contribute what it can to the solution of this problem. I appreciate this opportunity to present my views to the committee, and I hope they may be of some help. Mr. POWER. I greatly appreciate the privilege of testifying before your committee. I express a point of view of a State worker in vocational rehabilitation. For over 21 years I have been working in the Federal-State rehabilitation program, rehabilitating disabled people into jobs. It has been my business to try to stretch the tax dollar and rehabilitate as many disabled people as I could and to hope for more funds to rehabilitate more disabled people. * President's messize en January 18, pse rrant an emerson and an imvement of the Certainly, I think we all are is program rund and newta to go f rani tae been pronesed to carry cat the Pres: lent's its ežera to enlarge and expand the Mills do not arrear to me to carry out the ***, as I understand them, an i I want to direct my ere that I regard as important in these several q* me con d have a fair prepect of in proving rehabil.taor that is he ig curs tered. If it doesn't dy, it sees to me that it should be quesI don't see any justification for changing the Just for the sake of charge, an amer drent to the Federal rehabilitation teen referred to as the restrictive appropriation amend1 a great deal of harm to the program, as I see it. It 2 provisions as they had been in the basic rees and epetituted an allotment procedure. that we can, best consider the proposed rehabilitation legisJeton ba nes barag it with our present rehabilitation law, Public 7 ( Je wil give me an idea of what we have, what provisions we have in the law, and what is being proposed to be done toward improve I sm got g to give attention first to the amendments to the Hospital Survey and Con truction Act, H. R. 8149 and S. 2758. These bills propose to authorize and allot funds for rehabilitation facilities. They al o define what is meant by a vocational rehabilitation facility, Our pre-ent law doesn't provide for any authorization of Federal fund or allotment of Federal funds to the State for rehabilitation centers. Such centers are needed in the rehabilitation of the disabled for certain serion-ly disabled cases, and such a grant of funds should help to meren-e this type of facility. The definition given in the bills, which varies a little between the two bills but is substantially the same, appears to me to put special emphasis on the medical aspects of vocational rehabilitation and minor emphasis on the vocational aspects. There is no reference to Vocational training in this definition. |