Table 5.--Major disabling condition of persons rehabilitated by State

vocational

rehabilitation agencies, Fiscal Years 1966-1970

/ Beginning with 1967 excludes diabetes as the cause of another major disabling condition such as blindness or amputation. g/ Figures for 1967-1970 not comparable to figures for 1966.

23. Please explain how the H.R. 1 funding procedure would fit into the present VR system and your proposed changes in it, as well as the system as it would exist under the House-passed bill.

Neither the Administration's proposed amendments, nor H.R. 8395, would change the planned H.R. 1 VR funding system. Since welfare reform is an employment oriented program, however, services to the severely disabled under the proposed Title III of H.R. 8395 (provided without regard to employment potential) would probably not be reimburseable under 100% H.R. 1 funding. H.R. 1 provides two major roles for the VR program, incapacity determination and services to incapacitated and disabled individuals. These roles are compatible to the VR system as it now exists or as it would be changed by any currently offered 1972 Amendments.

Incapacity Determination

The funding for incapacity determination under Title XXI of H.R. 1 will be a separate account. Under present plans, appropriations would be made to the Department of Labor to pay for the rehabilitation services of participants in the Opportunities for Families Program, administered by DOL for welfare recip ients determined to be employable. A separate appropriation would be made to HEW to pay for the rehabilitation services provided to welfare recipients not immediately available for employment. (These two programs are Parts A and B of Title XXI).

Both appropriations would be transferred to SRS (RSA), which would make allocations to the State VR agencies. SRS (RSA) would assist in budget preparations.

Vocational Rehabilitation Services

The 100% reimbursement for VR services will come from three sources. Under Title XX, the VR services for disabled adults will be funded by appropriations made to the Social Security Administration. Under Title XXI, Part B, appropriations would be made to HEW to cover the costs of VR services to incapacitated Family Assistance Plan recipients. Under Part A of Title XXI, appropriations would be made to DOL to cover the cost of VR services to members of the Opportunities for Families Plan registered families who are found to be incapacitated. The appropriated funds from all there of these agencies would be transferred to RSA for allocation to the States. In this way, existing mechanisms would be utilized and the States would report to a single Federal agency with regard to services to the handicapped. Of course, the people being served will be identified by category of H.R. (Title XX, Title XXI, Part A, Title XXI, Part B) in order to allow for separate reports and accountability.

Except for the above, the funding and operation of the VR program will be the same for H.R. 1 recipients as it is under the existing system. H.R. 1 funding, in other words, will operate somewhat similar to that now in place for Social Security Disability Insurance rehabilitation program where Trust Funds are used to finance rehabilitation services.

Present planning calls for two other new responsibilities for State VR agencies with regard to their overall responsibilities for the handicapped. The first is a referral-advocacy-monitoring-service function with regard to disabled children under Title XX. Separate funds would be appropriated to the Social Security Administration and transferred to RSA for this purpose. RSA would allocate the funds to the State VR agencies which would make arrangements with Crippled Childrens and other appropriate agencies to directly provide services to disabled children. The VR agencies would, where necessary, also provide services directly to fill any gaps that may exist. The second new responsibility would be referral of alcoholics and drug addicts for available treatment as required in H.R. 1 as a condition of continued eligibility for payments. Some of the alcoholics and drug addicts will be served as VR clients, but this new function applies to referring all of them for treatment.

Other differences from the present system will be the funding of child care and and monthly training incentives. Present planning indicates that day care for children of VR clients (as well as children of all OFP enrollees) will be paid through separate funds, rather than from services funds. This is also true of monthly training incenitve payments. The training incentive will probably be added to the monthly assistance check and will not require any VR agency handling of funds.

24. Are there protective measures which can be taken to prevent economic exploitation of the handicapped? The mentally retarded are most susceptible to economic exploitation. What measures are taken to protect the mentally retarded?

Protection afforded by labor laws

Protection of the mentally retarded from economic exploitation is provided by Section 14(D) of the Fair Labor Standards Act and Regulations No. 525 C.F.R. 29. This law is also applicable to other hadicapped individuals.

Under this legislation sub-minimum wages to be paid the mentally retarded (handicapped individuals) may not be less than 50 percent of the amount provided by the minimum wage law (currently $1.60 per hour). There are certainly exceptions to this "50 percent" provision:

1. Persons employed incidental to evaluation and training.

2. Persons with multi-handicaps or otherwise severely handicapped. The minimum for this group is 25 percent of the minimum wage.

3. Persons employed in work activity centers. No wage floor is applicable. It is estimated that approximately two-thirds of all handicapped (including the retarded) persons employed in sheltered workshops and activity centers are protected by this legislation. Compliance is determined by monitoring and surveillance of workshops and activity centers by the Department of Labor.

The Fair Labor Standards Act requires generally that handicapped individuals be paid wages commensurate with those paid the non-handicapped in the community for the same type, quality and quantity of work.

Protection afforded by courts

In Wyatt vs. Stickney the U.S. District Court (Middle District of Alabama) the Memorandum of Agreement filed by all parties addresses itself to the subject of "Training Tasks and Labor" in public institutions for the mentally retarded, pertinent excerpts as follows:

1. "Residents may be required to perform vocational training tasks which do not involve the operation and maintenance of the institution, subject to a presumption that an assignment of longer than three months to any task is not a training task..."

2. "No resident shall be required to perform labor which involves the operation and maintenance of the institution or for which the institution is under contract with an outside organization. Privileges or release from the institution shall not be conditioned upon the performance of labor covered by this provision. Residents may voluntarily engage in such labor if the labor is compensated in accordance with the minimum wage laws of the Fair Labor Standards Act, 29 U.S.C. Sec. 206, as amended, 1966.

The present trend in filing of court cases may be quite effective to reduce exploitation.

Senator CRANSTON. We are recessing now until this Thursday at 1:30; and I thank all of you for your presence and your interest.

(Whereupon, at 1:20 p.m., the subcommittee was recessed, to reconvene on Thursday, May 18, 1972, at 1:30 p.m.)

REHABILITATION ACT OF 1972

THURSDAY, MAY 18, 1972

U.S. SENATE,

SUBCOMMITTEE ON THE HANDICAPPED

OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE,

Washington, D.C. The subcommittee met, pursuant to recess, at 1:35 p.m., in room 6226, New Senate Office Building, Senator Alan Cranston, presiding pro tempore.

Present: Senators Cranston and Stafford.

Committee staff members present: George Lawless, professional staff member; Robert R. Humphreys, special counsel; Jonathan R. Steinberg, counsel; and Roy H. Millinson, minority professional staff

member.

Senator CRANSTON. The hearing will please come to order.

We reconvene the Subcommittee on the Handicapped this afternoon to continue our study of the bills now before us which would amend the Vocational Rehabilitation Act.

On May 15, we received testimony from the Department of Health, Education, and Welfare. Today, we begin to hear testimony from some of the experts in the field of vocational rehabilitation and its various aspects, as well as from consumer groups.

We will hold further hearings on May 23 and June 2 and June 6. Senator Harrison A. Williams, the chairman of the full Committee on Labor and Public Welfare, asked me to read for him a statement welcoming our first witness, Senator Tower, and the National Kidney Foundation to this hearing.

His statement reads as follows:

"I am pleased to welcome Senator Tower and the National Kidney Foundation to testify on S. 2813, a bill to provide assistance to individuals suffering from end-stage renal disease.

"On November 5, 1971, Senator Tower, Senator Boggs, and I joined in introducing this bill in order to aid individuals to pay the high and continuing costs of treatment for renal disease.

"Since that time, we have been joined by many of our colleagues in cosponsoring this bill. In discussion with many of the sponsors, I have found that we have all been called upon to assist in locating sources of funds for this life-sustaining therapy, and yet the sources of this support are very limited.

"I believe that S. 2813, and the companion provisions which were included in H.R. 8395, will take an important step toward making this much-needed assistance available to the thousands of kidney patients who presently must make use of artificial kidney therapy.