Senator CRANSTON. I want to ask the same question I asked others about the fees, the variations, and the charges of income eligibility criteria.

Dr. RADER. As far as charges are concerned, if the fee scale is arranged to where no one is deprived of services because of charges, I think that of course is a very important factor, then I personally have very little difficulty in the concept of charging something for these services.

Again, this has to do with self-esteem. In the mental health centers oursliding scales run from zero, and that is important, and they rise very slowly, and then of course they go up to rather high figures.

Senator CRANSTON. What is your appraisal of present information dissemination practices of the Department of HEW?

Dr. RADER. Not good. I find that the information services of the Department of HEW are marginal at best. The information is primarily headcount. There is very little relevance to the performance of the programs and certainly cannot be used in judging effectiveness. Senator CRANSTON. How involved now are consumers in setting RSA and State program policy?

Dr. RADER. As far as vocational rehabilitation agencies itself are concerned, I cannot speak for them.

As far as mental health is concerned, they are quite involved, and participation is encouraged.

I would speak to one of the aspects of the bill which would allow research.

This is again from experience. We have discovered that in encouraging consumer participation, that some of the expectations that are written into the legislation do not seem to be very real, that citizens have to participate on their own terms, and frequently we are not real sure of what those terms are. You certainly cannot take off time during the day to sit in a committee.

To offer them committee structure to participate does not work. Senator CRANSTON. Would you describe the role of consumers in your program?

Dr. RADER. Yes, sir; I would be very glad to.

In every one of our mental health area sections, we have a group referred to as either core group or area management team. It is principally a planning and evaluation team. Citizens participate in this group specifically in the area of identifying problems that are unique to that one area, ranking these problems in terms of several priorities that may exist, and goal setting.

All of our programs in North Carolina have qualified goals before they can be funded.

Once the citizens have done this, then of course it bceomes a more professionally trained job to translate these goals and programs where technical expertise comes in.

Senator CRANSTON. I thank you very much for your testimony. I thank you for coming up from your State and waiting so long.

That concludes our hearing. The next hearing will be next Tuesday, the 23d, at 9:30 a.m.

(Whereupon, at 6 p.m., the committee was adjourned, to reconvene on Tuesday, May 23, 1971, at 9:30 a.m.)

REHABILITATION ACT OF 1972

TUESDAY, MAY 23, 1972

U.S. SENATE,

SUBCOMMITTEE ON THE HANDICAPPED

OF THE COMMITTEE OF LABOR AND PUBLIC WELFARE,

Washington, D.C. The subcommittee met, pursuant to notice, at 10:05 o'clock, in room 4200, New Senate Office Building, Senator Alan Cranston presiding, pro tempore.

Present: Senators Cranston, Randolph, Stafford, and Taft.

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

Senator CRANSTON. The hearing will please come to order.

We will proceed with the hearings on H.R. 8395 and related bills amending the Vocational Rehabilitation Act.

There are a number of witnesses of which our first is Senator Howard W. Cannon of the State of Nevada.

Senator, we are delighted to have you with us.

STATEMENT OF HON. HOWARD W. CANNON, SENATOR FROM THE STATE OF NEVADA

Senator CANNON. Mr. Chairman and members of the subcommittee, it is a pleasure to testify in behalf of H.R. 8395 now being considered by your subcommittee.

Of

primary importance to States with relatively small populations and high per capita incomes is the language in title I granting a $2 million minimum allotment for a basic support program of vocational rehabilitation for handicapped individuals. Presently my State is receiving a $1 million basic support fund, and the new basic allotment formula in title I of H.R. 8395 will be much more favorable for States with small populations. Mr. Chairman, the old formula works adversely for States such as Nevada with a low population. Nevada's population was estimated at 507,000 as of July 1971, and high per capita income at $4,562 per year.

The provision providing for a $2 million minimum basic allotment in title I is helpful in alleviating the inequity that the small States have suffered for some time. I believe this minimum figure of $2 million is a practical and timely step toward helping small States with their rehabilitation programs for the handicapped. Nevada's efforts to expand rehabilitation service to its handicapped has been seriously restricted under the present Rehabilitation Act; the figure of $1 million has imposed these severe restrictions on our program.

The State of Nevada has been subject to providing a 32.2 percent State proportion of basic support funds while most States have enjoyed a 20 percent State-80 percent Federal matching formula. Under the present provisions of the title I creating the $2 million minimum, Nevada's proportion will come closer to the 20-80 formula. Without additional Federal funds, Nevada will be subject to 60 percent of the cost of vocational rehabilitation over the next few years in order to maintain the same level of service, excluding any gains or expansion in service to Nevada's disabled citizens. Nevada has the resources available to match $2 million of Federal funds at the 80 percent Federal-20 percent State formula, and this formula will allow Nevada's division to implement an intensive and continuously expanding program, both quantitatively and qualitatively, to handicapped Nevadans.

I am aware that an alternate proposal, S. 3368, also under consideration by your committee provides an allotment formula for basic funds granting approximately $1,300,000 to Nevada. But, Mr. Chairman, you know this amount falls short of the minimum $2 million figure of H.R. 8395, and it would continue the hardship Nevada's division must work under in trying to provide proper services to their handicapped.

Section 4 of the present Vocational Rehabilitation Act has been important since the Rehabilitation Services Administration was able to grant an addtiional amount of $328,000 to the Nevada division. This special expansion grant fund relieved the inflationary impact on the State's basic $1 million allotment, and I wish to urge that title I section 104 of H.R. 8395 providing this same feature be left unchanged when this subcommittee is marking up this legislation. H.R. 8395, specifically title III is another important and timely step toward supporting the fine efforts of the Blind Division of Nevada and its counterparts throughout the country.

The Blind Division of Nevada being a comparatively small agency has expanded greatly since its inception in July 1965. Services rendered and the number of recipients have increased insomuch as there is a present lack of resources in the face of rising costs. Within a 5-year period the number of persons served by the Blind Division has increased by approximately 600 percent while their budget has little more than doubled. This division's present total budget is $376,941 inclusive of $169,633 State appropriation, and you must note, Mr. Chairman, that Federal participation falls considerably short of the 80 percent Federal participation authorized in H.R. 8395. To maintain the current expenditures this division must justify and retain State dollars which it can do only if the Federal share is increased.

Whereas title II asserts that the Rehabilitation Agency for the Blind, now excluded, can be an eligible recipient of grants, I urge the full support of this subcommittee in retaining the language of H.R. 8395 to benefit and support the outstanding work of the Blind Division of Nevada.

Senator, I want to thank you for your very constructive and helpful testimony. I know of your work in aiding handicapped individuals, including veterans who have particular handicaps. Your work has been tremendous in that regard.

We will give most serious weight to your testimony. I am particularly interested in the problems of Nevada because I know our neighboring States share an interest.

I am very grateful to you.

Senator CANNON. Thank you very much, Mr. Chairman.

Senator CRANSTON. I do not think Dr. Howard Rusk is present. Is Dr. Lowman present? I believe they were coming.

If not, we will proceed to a panel composed of Mr. Irving Schloss, legislative analyst, American Foundation for the Blind and also representing the Blinded Veterans Association and American Association of Workers for the Blind; Mr. John Nagle, chief, Washington office, National Federation of the Blind; and Mr. Durward McDaniel, national representative, American Council of the Blind.

The committee welcomes each of you. We are delighted to have you present. I suggest that you proceed in whatever way you see fit to present your testimony.

STATEMENT OF IRVIN P. SCHLOSS, LEGISLATIVE ANALYST, AMERICAN FOUNDATION FOR THE BLIND; ALSO REPRESENTING THE BLINDED VETERANS ASSOCIATION AND AMERICAN ASSOCIATION OF WORKERS FOR THE BLIND

Mr. SCHLOSS. My name is Irving Schloss. I am legislative analyst for the American Foundation for the Blind.

John Nagle, the Washington representative of the National Federation of the Blind, is on my left and Durward McDaniel, national representative for the American Council of the Blind, is on my right. If I may, I will lead off and summarize my statement which I would appreciate having included in the record of the hearing.

Senator CRANSTON. A copy of your prepared statement will be entered in the record at the end of your testimony.

Mr. SCHLOSS. Today I am representing the American Foundation for the Blind, the American Association of Workers for the Blind, and Blinded Veterans Association. All three of these organizations endorse enactment of H.R. 8395 with a series of amendments which are appended to my statement and are designed to substantially strengthen services to severely handicapped individuals under the program and establish a target program under the Vocational Rehabilitation Act for rehabilitation services for older blind persons.

We would specifically recommend to the subcommittee inclusion of the provisions of S. 1030, a bill to authorize rehabilitation services for older blind persons, which was introduced by Senator Jennings Randolph, the chairman of the subcommittee, and which you, sir, joined as cosponsor with 52 other members of the Senate.

This bill would fill the most serious gap in services to the largest single group of blind persons in our country, those of middle age and the elderly who constitute approximately three quarters of the total blind population of the country. The bill would authorize a formula grant program to the States to provide basic nonmedical rehabilitation services to older blind persons, services which are not now readily available through any other federally supported program.

The enactment of the provisions of S. 1030 can mean that an elderly blind diabetic won't have to become a leg amputee as well because he