will have been given training in mobility skills, essential training to avoid repeated bruising and consequent possibility of gangrene. It can mean that an elderly blind person can be taught mobility skills to avoid falls which can result in a fractured hip, long time invalidism, and shortened life. It can mean that an older blind person can be taught the wide variety of essential basic rehabilitation skills to enable him to walk by himself from his bedroom to his bathroom, go for a walk on the street by himself, fix himself a snack. In short, become an independent member of his family group instead of a burdensome dependent who has to be waited on hand and foot. Unfortunately, because of the age factor, persons who become blind past 40 are infrequently accepted for vocational rehabilitation services. The number accepted decreases as age increases, These essential basic services for acquiring skills are needed by every blind person to function effectively. They are available to persons accepted for vocational rehabilitation services. They are becoming increasingly available for blind children in educational programs. They are not readily available under any other Federal program to individuals who are past middle age. To those blind older persons who chose to live in a home for the aged or a nursing home provision of rehabilitation services can mean participation in the recreational and social programs of those institutions. We have heard of instances where older blind persons are kept virtual prisoners in their rooms, sometimes even kept in bed, because of unnecessary anxiety on their part or on the part of personnel at these institutions. In fact, Mr. Chairman, some 15 or 20 years ago in Veterans' Administration domiciliaries, there were instances of elderly blinded veterans being kept bed fast because people didn't know what to do with them; whereas with the type of training that would be provided under the provisions of S. 1030, they could have become largely independent in terms of getting around in the institutional setting and participating in program activities. With regard to strengthening the services for the severely handicapped in the basic program, we are recommending establishment of priorities in service for the severely handicapped. Över the years the numbers of severely handicapped individuals who have been denied service have increased, and this is reflected in the statistics of the number of individuals on aid to the permanently and totally disabled public assistance under title XIV of the Social Security Act. That caseload has more than tripled in the past 13 years from 311,000 to 1,068,000, and we have no doubt that the fact that too many of these individuals have been arbitrarily denied service because of the complexity of their disabilities is a factor here. With adequate counseling, evaluation, and other procedures that are readily available under the basic Federal-State vocational rehabilitation program, these individuals in many instances could have been given training and restored to substantial gainful activity. We are therefore recommending that priority be given to the severely handicapped in the initiation and expansion grants under section 104 of H.R. 8395, and similarly that priority be given to severely handicapped individuals in State plan provisions. We would also strongly recommend prohibition of any kind of financial need consideration as a criterion of eligibility for goods and services in vocational rehabilitation programs. Similarly, we are recommending amendments which would change the structure of title III in H.R. 8395 to make it part B of title I and change its title to "Supplementary Rehabilitation Services for the Severely Handicapped." In our concept of the way the program should work, every severely handicapped individual should be given the maximum services possible under the basic program in what would then be part A of title I. When after extensive diagnostic and evaluation services over a substantial period of time it is determined that the individual in fact has no genuine vocational potential, he should then be served under the provisions of part B to assist him to achieve maximum independence in his home and community environment in order to make it possible for other family members to be freed for work and other activities. Some of the other amendments we are advocating would provide for a formal hearing mechanism for handicapped individuals who are denied service or who have some question about the types of service they are provided. This would be extended to include an arbitration mechanism and ultimately judicial review. We would also strongly recommend that there be authorization for the handicapped individual to use the assistance of individuals or organizations of the handicapped as claims representatives in the same way as is now done under Veterans' Administration programs. As you can well imagine, the complexity of regulations and other factors for an individual dealing with an agency of the Government makes it essential for him to have the assistance of knowledgeable people in this process. In the testimony given by previous witnesses there was expressed the idea that alcoholics, drug addicts, and public offenders were to be the individuals for whom the initiation and expansion grants are intended. Although there is no question that these are individuals who have serious problems, we believe the laws now on the books to serve them should be strengthened rather than diluting services for the traditionally physically and mentally handicapped in this program. In summary, Mr. Chairman, we would strongly advocate that the subcommittee act favorably on the amendments we have proposed which are designed to strengthen services for severely handicapped individuals under the basic vocational rehabilitation program and under the new program for those who clearly have no vocational potential so that they can achieve independent living. We would also strongly recommend inclusion of the provisions of S. 1030 in H.R. 8395, either integrated in title IV of the bill as we have done in the amendments appended to our testimony, or through establishment of a separate title. We feel that the only way this vital service is going to be provided to these individuals is through a target program. With further regard to older blind persons, I would like to call your attention to the editorial appended to the statement which appeared in the Washington Post of March 30, 1971, endorsing the enactment of S. 1030, and I would also like to point out that it was one of the major recommendations of the Special Concern Session on the Aging Blind during the White House Conference on Aging last December. That will conclude my oral presentation so that we can have some time for my colleagues and for questions. (The prepared statement of Mr. Schloss follows:) AMERICAN FOUNDATION FOR THE BLIND, INC. 50 YEARS OF HELPING BLIND PEOPLE BECOME JUST PEOPLE STATEMENT OF IRVIN P. SCHLOSS, LEGISLATIVE ANALYST, SUMMARY The American Foundation for the Blind, American Association of Workers for the Blind, and Blinded Veterans Association endorse enactment of H.R.8395 with suggested amendments to strenghten vocational rehabilitation services to the severely handicapped. We recommend amendments to assure categorical services of proven effectiveness to meet the special needs of different groups. These same organizations endorse enactment of the provisions of S.1030 as an amendment to H.R.8395 to assure basic nonmedical rehabilitation services to older blind persons through the federal-state vocational rehabilitation program without regard to feasibility for vocational services. This group constitutes 75% of the blind population of the United States and is not now receiving these essential services on an adequate basis through any other federally assisted program. Some who are now denied services will be vocationally restored as well. We recommend substantially increased funding for training of rehabilitation personnel to assure effective vocational rehabilitation services to the 1,000,000 severely handicapped welfare recipients called for in H.R.1. We question the desirability and effectiveness of the vocational rehabilitation program for the disabled serving the nondisabled disadvantaged as provided for in H.R.8395. We endorse establishment of an Office for the Handicapped in the Office of the Secretary of Health, Education, and Welfare to coordinate activities in the Department for handicapped individuals. 15 WEST 16TH STREET, NEW YORK, NY 10011/TEL: (212) 924-0420/CABLE ADDRESS FOUNDATION, NEW YORK FIELD OFFICES 1660 L Street, NW, Washington, DC 20038 AMERICAN FOUNDATION FOR THE BLIND, INC. 50 YEARS OF HELPING BLIND PEOPLE BECOME JUST PEOPLE STATEMENT OF IRVIN P. SCHLOSS, LEGISLATIVE ANALYST, May 23, 1972 Mr. Chairman and members of the Subcommittee, I appreciate this opportunity to appear before you in support of legislation to extend Today, I am representing the American Foundation for the Blind, the national voluntary research and consultant organization in 15 WEST 16TH STREET, NEW YORK, NY 10011/TEL: (212) 924-0420 CABLE ADDRESS FOUNDATION, NEW YORK - 2 persons. For handicapped Americans, the Vocational Rehabilitation Act ranks with the Education of the Handicapped Act and the Social Security Act as one of the three major pieces of legislation which can make a profound difference in their lives. As important as all other programs to benefit the handicapped may be, they are still ancillary to the three vital laws to assure basic income maintenance, basic education, and training for independent living and competitive employment as well as placement in a job. This Subcommittee, the full Committee, the Congress have a golden opportunity this year to make the programs authorized by the Vocational Rehabilitation Act truly effective in reaching and restoring the nation's severely handicapped to independent living and genuinely gainful employment. We respectfully urge you to take this responsibility. The three organizations I am representing joined with the American Council of the Blind, the National Council of State Agencies for the Blind, and the National Federation of the Blind in developing proposals for improvements in the Act which have been embodied in one of the bills you are considering. It is S. 1030, introduced by the distinguished Chairman of the Subcommittee, Senator Jennings Randolph of West Virginia for himself and 52 co-sponsors, to assure rehabilitation services for older blind persons. |