I would like to say here we have some units that are independent units. I mean they serve a whole community without any affiliation to any medical school or any hospital. They are a community resource. Then again we will have some rehabilitation centers in hospitals, but we certainly believe our rehabilitation centers that go into hospitals should have all of the services mentioned by the previous person who testified, including the important services of vocational counseling and testing and job placement.

I would like to speak to the point here again that the voluntary agencies and I will confine my remarks to the one which I am rep resenting, the national society and its affiliates-have mobilized "a fairly substantial amount of funds for scholarship training programs.

If you will take all that the voluntary agencies have done, it would be close to 4 or 5 million dollars. So, I think we are willing to carry what we can in the field of training, but we are desperately in need of assistance from the public agencies for the training programs across the board in the field of rehabilitation.

I would like to say that S. 2759 provides for studies. This is important. It is important to know how receptive employers are, for example, in the steel industry and throughout all the different types of industries to the employment of the handicapped worker; it is important to know what we must do in the labor groups to create a more favorable atmosphere for the person who is handicapped so he will have the opportunity to work. I think we do need very much, from our experience, these studies.

I would consider it would be very beneficial if we had funds to do studies in the centers we operate, many of which have clients and patients from vocational rehabilitation, private doctors, and agencies in the community.

We do not have those funds to do followup studies on what happens to the disabled person after the rehabilitation process is fairly well underway and they go out to work.

Leaving the subject of personnel and the great need for more trained personnel, I would like to go on to the consideration of facilities.

The national society's units and the society's board members are interested in and concerned about the possibilities of what might be available to us for the construction of rehabilitation facilities through the extension of the Hill-Burton Act.

I might mention such cities as Indianapolis, for example, where the community leaders believe they have now outgrown their present old storage building and find there are no more old buildings in the community suitable for use. A new building is required.

The extension of Hill-Burton funds would mean a great deal to s vast number of communities.

I could go into the State of Connecticut and mention extension possibilities there. The present facilities are outmoded. This means the building of a new rehabilitation center if we are going to take care of the number of persons who need rehabilitation and to permit us to work cooperatively and effectively with the public agencies and the doctors and the other private agencies in the community.

The national society believes that we need additional funds for rehabilitation.

The maintenance of a rehabilitation facility is an expensive process. One does not rehabilitate an individual at a low cost. However, we believe if there could be more funds made available through the vocational rehabilitation service for the purchase of care, for direct treatment and services as needed in the whole rehabilitation process, we could expand some of our programs to serve, for example, more children, for whom there are not always the funds available to serve.

I would like to say the societies for crippled children believe that the rehabilitation of handicapped, crippled persons is vital to the progress of our country, and we see our role as a very important role, working cooperatively with all of the agencies, all of the professions, from the beginning of the patient's life to the end, if need be, provided we have the resources with which to do it.

I think I would like to leave with you the thought that our 33 years of experience give us some knowledge and some scope of information from which to draw concerning the need for greater rehabilitation services. It is on that basis that we testify in support of both the Senate bills for vocational rehabilitation, S. 2759, and the Hospital Construction Act, S. 2758.

Senator GOLDWATER. Thank you very much, Miss Shover.

Senator Lehman, do you have any questions?

Senator LEHMAN. If I understood you correctly, you said you thought 1 million was all that could be well spent on training?

Miss SHOVER. I said the amount the vocational rehabilitation service was asking for was probably the amount that could be spent wisely at this time for the first year.

Now, we can spend $2 million if we can have the personnel to go

out to start the centers.

The problem of getting the personnel, Mr. Lehman, is great. There is a shortage of personnel. Someone must go out to set up the pro

grams.

We do not have enough programs in therapy, for example, but it will take several years to set them up.

One of our difficulties is that some of the students cannot go miles away to take the training. There are areas in the States where we do not have training units in physical therapy. An example of that is in New Orleans, where we hope to develop the physical therapy school there; but in the South there has not been a training program in close proximity to the potential students.

Now, whether or not $1 million is the amount the vocational rehabilitation people feel they can spend is up to them, I think, to speak to the point more precisely. I do know the need for personnel is one of the greatest needs we have.

Senator LEHMAN. You just said that it takes years and years to prepare, but you have got to make a start.

Miss SHOVER. Indeed.

Senator LEHMAN. After all, if you have available only $1 million, that is all you can appropriate, all that you can spend or obligate after the current appropriation has been made.

It seems to me, under those circumstances, your progress in training more personnel, the need for which your statement has greatly emphasized, would be very, very slow. It also seems to me to be a fact that the more people who are restored to gainful positions and are

self-pporting, the greater is the financial, fiscal advantage to the

I think you said for every dollar spent $10 would come back in increased tax revenues.

Under those circumstances, I can't see why anybody who is really deeply interested, as I am, in relieving this situation, which everybody has testified is a terrible situation, so far as numbers is concerned, should not be supporting a reasonable amount to be appropriated to make it possible to train more people in therapy, make experts of them, when we know from the testimony of everybody who has ap peared before us that the number of people who are available is Shockingly low.

Miss SHOVER. Your question to me is: Is a million dollars— Senator LEHMAN. I am trying to find out why you predicate your testimony on the theory that $1 million is sufficient or all that could be wisely spent or obligated for training purposes. I certainly think the number that could be trained if we had sufficient means could be far greater than that, and I am so deeply sympathetic to this whole program that I want to see it really pushed.

I don't want to have the people of this country think that we are doing something that is really going to be effective and then simply make a gesture, and that is what I believe is happening under this bill at the present time.

Miss SHOVER. Well, Mr. Lehman, I said it may be. I am not in a position to speak for the vocational rehabilitation people about how rapidly they can mobilize their forces. I said it may be a million dollars is all they can spend well this year. It is planned to put $1.5 million into training each year after the first or a total of $10 million in 5 years.

I feel it would not be proper for me to address myself to the ques tion as to what a public agency can do when I am associated with a private agency,

If you are a-king me whether I, personally, think in the Nation today a million dollars will meet the shortage of trained personnel, it will not; it cannot; but whether or not the Oice of Vocational Rehabilitation can mobilize its forces and expend adequately and intelligently more than a million dollars in the first year is something, I think, would have to be addressed to them.

Senator LEHMAN. I recall at one time it was said that $1 million was all we could effectively sperd on cancer research, and when we appropriated $16 million we found that wasn't enough for all the approved and all the obviously desirable and obviously worthwhile applica tions for research grants which came in.

MISS SHOVER. Well, I think if we take the figures of one of the medical associations that it costs $2,500 a year to train a doctor, and you know the number of years it takes to train a doctor, you know how far a million dollars would go in just beginning a medical care program. I mean to train doctors only. In rehabilitation you have the full team. You have the physical therapists, the occupational therapists and the speech therapists and the psychologists and the social workers and the nurses and the vocational counselors and the people who do the placement.

So, I think it is perfectly obvious, is it not, that a million dollars will not go very far in the training of this greatly needed rehabilita

tion personnel; but I do not think it would be appropriate for me to speak-I happen to be a speech therapist and psychologist in the feld-to what another public agency can do as far as mobilizing its resources when it supposedly has studied the program. However, I would like to say we definitely need millions of dollars for the training of personnel.

Senator LEHMAN. Why should we limit it, then, to $1 million?

It would appear to me it would be far better to appropriate too much than not enough, and there wouldn't be any waste because the money can only be spent on worthwhile and approved projects. They still have to be approved. I mean nobody would have the authority just to go out and throw the money away. The money still could be spent only on approved projects; but if we make an appropriation of only $1 million that is the limit. We can't go any further.

I want to ask you one more question. Mr. Power testified a little while ago that because of the financing provisions of this bill less money in the aggregate would probably be appropriated by States and Federal Government than would be the case if we went back to the formula in the original act. If that is the case, would you feel that we are making very much of a gain in this?

Isn't the test of the work that is to be done largely that of the money that may be made available for this very necessary activity? Miss SHOVER. Am I interpreting you correctly to say here that you interpreted Mr. Power to feel that under this new situation there would be less money available for the vocational rehabilitation agencies in the States; is that correct, and that the States would carry more of the burden and responsibility?

Senator LEIMAN. Mr. Power and others have testified that actually 20 States would get less, 10 percent less, under this bill than they have been getting, and I think another 8 or 10 would the following year get another 10 percent less-I think that was the testimony-and other witnesses have also testified to the effect that this would actually, in the aggregate, mean less money, not more money, and put an added burden on the States.

Miss SHOVER. Well, I would prefer to have one of our other people to speak to that, someone from the vocational rehabilitation side, who is more familiar with the distribution of funds and the amount available, keeping in mind that we are concerned with the amount that is available for every State in the Union, because we operate programs in each State in the Union, and that we work at the State level with the State people; but I believe your vocational rehabilitation people that are actively engaged in this program could speak more intelligently and be better informed in this regard. I would prefer they do so, Mr. Lehman.

Senator LEHMAN. That was the testimony of Mr. Power, was it not? Thank you very much.

I thought Mr. Power was still here and could verify the figures I had given; but I think they are correct.

Senator GOLDWATER. Miss Shover, this discussion about training is a very interesting one. It has come up several times during the testimony here. The training of a person to engage in this work is a very complex thing, is it not?

Miss SHOVER. Well, it is and, of course, the thing is you have so many professions involved in rehabilitation. For example, you start

with the physician, and the nurse, and then you have the social worker, rehabilitation counselor and the team of therapists.

We are now in the field of comprehensive rehabilitation for severely disabled people. For example, we accept very severely disabled people in many of our rehabilitation centers, some of them requiring, in addition to those I have mentioned, even the special education teacher for the child who is handicapped and must be trained. Now, that does not come within the realm of these two bills under discussion, but it is an important thing that the children who are handicapped have teachers who understand how to work with them.

In addition to that, you have the psychologist. It takes special training for a psychologist to test many of the severely handicapped people because of the special problems they present. They cannot communicate effectively. They may not hear too well. They may have a vision problem. They may have a coordination problem. They can't handle the test, and manipulate the coordinated activities required of some of these tests.

I am sure your vocational rehabilitation workers, such as Mr. Power, would speak to the desirability of having your counselors better trained. May I illustrate: We have one training course for vocational counselors of severely handicapped individuals which will be given by Dr. Rusk's staff this summer. We have only places for 25 people, yet we have 179 applications, and 140 of them meet the requirements. Now, I ask you: What are we going to do with the 115 we can't take but who are so desirous of having special training, perfectly willing to take it, take the time for it and have the need for it, you see?

The training goes all the way from 8 to 10 years, depending on the medical specialty, down to 1 year, where we have training courses for attendants, and practical nurses. The speech pathologist, takes several years. We have specialized courses in occupational therapy. The therapists must have specialized training to work with special disabilities. It is not the same to work with an amputee as it is to work with a cerebral palsied child with cerebral palsy. The child may try different things. The adult presents different things psychologically than the child, and the training programs vary depending on the field you are speaking about and the requirements of the profes sional groups.

Senator GOLDWATER. This class that Dr. Rusk is going to have this summer-is that limited only by Dr. Rusk's ability to handle a certain number? Is that why you can't get more of the 175 in?

Miss SHOVER. No; I wouldn't say so. I would say it is limited because we have a certain amount of money given to us by a philanthropic group of women, 30,000 of them in this country, every year, several thousand dollars that we put into a training course at this particular institution, and the maximum amount of money we have will take care of 25 persons. So, if we had additional scholarship money, sir, we would be able to take more people.

Senator GOLDWATER, How many schools are there in the country that have courses that would lead to trained rehabilitation people? Miss SHOVER. Are you speaking now of the total concept of rehabilitation?

Senator GOLDWATER. I will put it another way: Are there any schools that train for the field of rehabilitation alone?