self-supporting, the greater is the financial, fiscal advantage to the country.

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 question as to what a public agency can do when I am associated with a private agency.

If you are asking 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 Office 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 spend on cancer research, and when we appro priated $16 million we found that wasn't enough for all the approved and all the obviously desirable and obviously worthwhile applications 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

IDDADICS

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 field-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 LEHMAN. 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

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 LEHMAN. No.

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!
Senator GOLDWATER. Yes; as it now stands.

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 S2759, 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 this morning and giving of your experience in testimony on this bill. The next witness this morning is Miss Jayne Shover, associate director of the National Society for Crippled Children and Adults. Miss Shover, we welcome you here this morning. Do you have a prepared statement?

STATEMENT OF MISS JAYNE SHOVER, ASSOCIATE DIRECTOR, NATIONAL SOCIETY FOR CRIPPLED CHILDREN AND ADULTS

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

Miss SHOVER. Well, I would rather talk from notes and talk with you about it, if I may.

Senator GOLDWATER. That is all right; but the statement will be made a part of the record.

(The prepared statement of Miss Shover is as follows:)

STATEMENT OF Miss Jayne SHOVER. ASSOCIATE Director, NATIONAL SOCIETY FOR CRIPPLED CHILDREN AND ADULTS, CHICAGO, IL.

My name is Jayne Shover. I am associate director of the National Society for Crippled Children and Adults. Our national office is located in Chicago, IL, and I reside in Wayne, Ill., a suburb of Chicago. I appreciate the opportunity of appearing before this committee today and testifying in support of the vocational rehabilitation amendment bill of 1954, S. 2759.

The National Society for Crippled Children and Adults is a voluntary health and welfare agency which has been serving the crippled for 33 years. Affiliated with the national society are 52 State and Territorial societies for crippled children and adults, having a total membership of hundreds of thousands of persons interested in crippled children and adults, most of them volunteers. The board of directors of each affiliated unit is made up of citizens who serve voluntarily and without pay. The national society is truly a community resource. With a program based on the work of hundreds of thousands of volunteers, it commands the significant participation of persons from every walk of life Included among these volunteers are more than 300,000 members of Pan Hellenic sororities, as well as Rotary, Kiwanis, American business clubs, and other civic and fraternal groups, Junior League, American Legion, and others too numerous to hame. Thus, real recognition is given to the national society as a channel through which these volunteers in community service may devote their efforts. These societies, together with 1,300 local affiliates throughout the country, carry out a 3-point program of care and treatment, education and research. Care and treatment services are based upon study of community needs, existing facilities, available and potential resources with regard to financing and personnel, and the program of other private as well as public agencies They are directed by voluntary boards of trustees and are staffed by professional personnel. More than 500 services and facilities are owned and operated or conducted by Easter Seal societies througout the country, including clinics, treatment centers, rehabilitation centers, mobile clinics, crippled children's hose pitals, purchase of medical care, sheltered employment, soc al service, psychological services, recreation, operation of craft shops, equipment pools, and provision of aids, appliances and prostheses.

This statement is submitted to the Health Subcommittee of the Senate Committee on Labor and Public Welfare, with the hope that the long term nationw.de experience of the national society in serving the crippled may be he'pfui in the committee's exploration of needs in the field of rehabilitation

The National Society for Crippled Children and Adults speaks from the viewpoint of wide experience in the fild, having developed a nationwide network of rehabilitation services,

In the development of these services, the national society has gained first han! knowledge of the problems in meeting construction costs, determining and meeting architectural specifications, community education, staffing, securing medical supervision, and the myriad of associated problems of operating a reh: bilitation center. The society recognizes the great need for making a d tional funds available to voluntary agencies for improved services and for expanding these services to areas not now covered.

CRIPPLED PERSONS SERVED

During the year ending August 31, 1953, affiliated State and local units of the National Society for Crippled Children and Adults cared for 101,000 persons, including $2,000 children and 19,000 adults. Specific diagnostic conditions included in the broad category of orthopedie handicaps included within the soone of the society's work are residual crippling from poliomyelitis, cerebral palsy, multiple sclerosis, muscular dystrophy, arthritis, hemiplegia, paraplegia, amtutations, congenital malformations, speech disorders, and others. Total expendi tures on services to these groups were in excess of $10 million during the year ending August 31, 1953.