Senator CRANSTON. One last question for you, Dr. Lowman. In your testimony, you support title III-comprehensive services for the severely handicapped; and section 412 comprehensive rehabilitation centers for deaf youths and adults. There is concern that there may be some overlap here. From your point of view, are both of these sections needed?

Dr. LOWMAN. I think so, yes. I think you need a separate center. I think the severely handicapped-severely disabled, talking in terms of patients that right from the start you have serious doubt that you will ever get them back into productive employment. I think specifically of a lady, a patient that I had, that got up to go to the bathroom, she opened the wrong door and fell down the stairs and she developed quadraparesis. This woman deserved services and she ended up on medicaid getting services. But I am not sure that this woman should not be demeaned to such a level. Why shouldn't she have Federal help so she can become at least partially self-sufficient and then go live with her daughter? But she had to resort to medicare means. She had no potential to get back.

Senator CRANSTON. Do you have any questions, Senator Stafford? Senator STAFFORD. No, Mr. Chairman.

Senator TAFT. No questions, Mr. Chairman.

Senator CRANSTON. Thank you both, Dr. Rusk and Dr. Lowman. Your testimony has been very helpful.

STATEMENT OF ERNEST WEINRICH, ASSISTANT DIRECTOR AND SOCIAL WORK CONSULTANT, UNITED CEREBRAL PALSY ASSOCIATION, ACCOMPANIED BY PAULA BURTON AND ARNOLD FISHLER Senator CRANSTON. We will now call Mr. Ernest Weinrich, assistant director, Professional Services Program Department, United Cerebral Palsy Association, Inc.; accompanied by Paula Burton, consultant, Washington office; and Arnold Fishler, UCP project coordinator, RSA grant.

I will defer to Senator Stafford who has some questions at this time.

USE OF EXTENDED EVALUATION FOR SEVERELY HANDICAPPED

Senator STAFFORD. Thank you, Mr. Chairman.

In connection with extended evaluation currently authorized for up to 18 months: Is extended evaluation being utilized for the severely handicapped?

Mr. WEINRICH. Almost never. Our experience has been-and we travel around the country a good deal-that this just doesn't exist. It has been used very, very rarely.

CONSUMER PARTICIPATION

Senator STAFFORD. Insofar as consumer participation is concerned, how do you feel about the handicapped themselves participating in planning services?

Mr. WEINRICH. I think it is essential. As a matter of fact, I think it is one of the most obvious ways of getting services to the handicapped and to the people who need it. I think consumers ought to be on every level-National, State, and local-not only in planning overall services, but also in being more directly involved in planning their own services. This includes the parents as well as the handicapped individuals.

USE OF ENGINEERING DEVICES

Senator STAFFORD. What kind of engineering devices are being used by your engineering, rehabilitation staff today? Are they simple, or are they highly sophisticated?

Mr. FISHLER. My name is Arnold Fishler. I am a mechanical engineer. I have been in aerospace programs for about 20 years. I was recently associated with the Apollo program. I worked for 7 years on the Apollo guidance and navigation system.

I joined United Cerebral Palsy under the auspices of an RSA grant last year to assist our affiliate workshops in developing the techniques and devices that will enable the more seriously involved handicapped that haven't qualified for their workshops to become more productive. These devices are quite simple. Generally, they are made at the site with spare parts or surplus Government materials, rather simple jigs, and fixtures.

Attached to our prepared testimony, we have some illustrations. The first is simply a wooden platform that enables a quadraplegic to sort buttons by shifting them over to a hole and having them drop into a box. This particular quadraplegic had not been able to qualify for the work program at that workshop center. The job was normally done by lifting the buttons and dropping them in boxes. His incapacity prevented him from doing this.

There are many, many other examples that I have encountered in this area.

Senator STAFFORD. Would you care to comment on the administration's reference to a national system on rehabilitation engineering?

Mr. FISHLER. I am really not familiar with the full import of that. Miss BURTON. Perhaps we could address the question in terms of administration references to working with other Government agencies outside of RSA in development of a systematic approach toward rehabilitation and engineering.

Mr. FISHLER. I have been exposed to exploration in this area. There had been a joint program to pursue these aspects with NASA and Veterans' Administration and a university and United Cerebral Palsy. This was held at the NASA facility in California, and we found that there were many, many things being done, but rather disjointed. A lot of interesting investigations. Dr. Rusk talked about some of them. We heard about this. But there was no concerted effort to bring them together to really help the man in the workshop or in his daily independent living. These are usually pie-in-the-sky ideas that would need tremendous budgets to become accomplished.

REHABILITATION QUOTA

SYSTEMS AND CASE BALANCING

Senator STAFFORD. The House in its action on this bill, H.R. 8395 took particular cognizance of rehabilitation quota systems and case balancing practices. They noted that these policies often do not recognize the wide variations in the expenditure of time and effort needed to satisfy particular client needs.

What impact do these practices have on excluding those with more severe disabilities from obtaining services?

Mr. WEINRICH. Senator, I think the previous presentors, made that very clear.

To reinforce what they said this is still generally true. Mostly it is a matter of funds. It is also a matter of attitude, a matter of philosophy and it is a matter of what people can demand and deserve. And the more dependent you are, the less you can demand. This is part of the problem. This is one of the reasons consumer representation is so essential.

It is very difficult to make demands on people who are going to help you when you are in need of help.

SOCIAL REHABILITATION

Senator STAFFORD. There has been much criticism of rehabilitation programs in recent years over the increasing tendency of the agency to become involved in a variety of social rehabilitation needs with resulting failure to serve the severely handicapped individual because such services are costly and time consuming. The House has asked that a redirecting of priorities be accomplished through rather subtle legislative and report language. I am considering strengthening that charge by requiring that under the basic rehabilitation program, that priority be given to those whose handicaps are most severe. What reaction would you have to that?

Mr. WEINRICH. We would support it 100 percent. We think that the people who are most handicapped and most outside the pale of our society, should receive the opportunity to develop whatever potentials they have, not as a matter of a gift, but as a matter of a right.

Senator STAFFORD. Thank you very much.

Thank you, Mr. Chairman.

Senator CRANSTON. Thank you.

I would like to request now, Mr. Weinrich, if I may, that you summarize very briefly the principal points you want to make. We have reviewed the prepared testimony. We have time problems and I do have quite a few questions I do want to pose to the three of you.

Mr. WEINRICH. That was our intent and we will do it as quickly as possible. The thing that I would ask is that in an attempt to speed it up, my speech may be less clear. If you do not understand, please let me know.

Just to clarify our introduction-my name is Ernest Weinrich and I am assistant director and social work consultant, professional services program, Department of United Cerebral Palsy Associations, and this is Paula Burton of our Washington office and Arnold Fishler. who is the special project coordinator for United Cerebral Palsy.

You have the text and I would like to emphasize just the following points, if I may.

First we would like to commend the House bill and the report and we would also like to commend the Senate for its new subcommittee on the handicapped. We think this is essential. We like especially the new definition of the handicapped person in H.R. 8395. It removes the vocational potential requirement on services. A person need only show that he can benefit from rehabilitation services and he is eligible for such services.

We like the statement on priority for severely handicapped of the House report and I would like to give you two quotes from that report of the House Education and Labor Committee.

"The committee has reevaluated and assessed the goals and directtions of the Rehabilitation Services Administration and finds it necessary to express its desire that priority in services be assigned to those individuals who are severely physically handicapped or mentally handicapped as distinguished from either the socially handicapped or the nonseverely physically or mentally handicapped."

"Given the fact that Federal and State resources for rehabilitation for the forseeable future will be so limited as to compel choices to be made in terms of whom to serve, the committee expects the Rehabilitation Services Administration to explore in depth and to develop appropriate measures to reach those who have the most severe physical or mental handicaps."

I am forced to add a personal note. I think it is a shame that we have to make priorities as to who we give assistance to. I think some day somewhere we have to get over that. At least for now we reinforce the need for priorities of serving the severely handicapped and especially we emphasize title III of H.R. 8395 with supplemental services to the handicapped.

There are a couple of things that are not in this statement which I think are important. We are concerned about vocational rehabilitation services.

There is some question about the RSA indication that almost a quarter of the RSA caseload are severely disabled. I have other quotes here, for example, in 1968-70, fewer than 2 percent of the eligible CP adults needing RSA's service requirements have sought counsel. Of that group more people were rejected for severe disability or terminated as not being rehabilitated due to severe disability than the number successfully rehabilitated.

We have a publication, a report of a conference on life enrichment needs of persons with multiple handicaps who are socially and culturally deprived and I would like to send you a copy.

Senator CRANSTON. Please do.

Mr. WEINRICH. Just one quote if I may: "It was agreed that work for pay is not the only life style, although our American mores project this thought forcibly, through every media for the multihandicapped. Desirable alternatives exist in meaningful, satisfying activities, many of which were proposed by the workshops referred to."

In other words, we are cognizant of what the needs are and what work can contribute to everybody concerned. One aspect of the severely handicapped is the project Mr. Fishler is working on. We would appreciate a few minutes for him to discuss this a little more fully, the kind of thing he began a while ago in answer to Senator Stafford's questions.

Mr. FISHLER. I will try to be brief also, and just perhaps talk about some recent experiences on this program.

One of our functions at UCPA National is to survey regions to determine the availability of facilities for referral of cerebral palsied clients where they are not being served by local facilities.

We recently surveyed two counties in California, Santa Clara and San Mateo. We visited all the workshops, rehabilitation workshops, in the area and could not find one severely involved CP. The basic problem was that they were not being sponsored by the local rehabilitation agency. That is VR does not find them eligible for service support. The other reasons they gave was that the work wasn't suitable for them. They didn't have the architectural facilities to accommodate them, and they didn't have the additional staff support that the more severely involved require. We struck out in that area. Last month we conducted our United Cerebral Palsy Annual Conference in Chicago. It was our desire to set up a demonstration of a work activity for severely involved cerebral palsied patients. We wanted to take a group from Chicago and show what they were doing. We visited about 12 workshops in Chicago and could not find a genuine severely handicapped cerebral palsy client working. What we had to do is select a job from one of the workshops not presently serving severely handicapped. We then recruited some severely handicapped CP's from a social club for CP clients at our local affiliate. We worked up some simple devices, some tooling and got them started on this little demonstration. It worked out tremendously. We took about 2 hours of practice and there they were severely disabled people producing at our conference. We have had many other experiences like this.

We think that our pilot program has demonstrated that this job can be adapted for the severely disabled. We are very hopeful that the new vocational rehabilitation legislation can provide an ongoing tax supported system to provide a means of reaching all of our severely handicapped population and bring them into the mainstream of society by involvement with work-related activities.

On my own I think this has been a very exciting year for me. I have had a lot of great personal satisfaction from what I have been doing. I know a great many aerospace engineers who are available to accept assignments like this. I hope they are given the opportunity.

Senator CRANSTON. I wish we could give them the opportunity. It is great to be doing what you are doing.

Mr. Weinrich, you mentioned that you have serious reservations about the approximately 23 percent caseload of the severely disabled which HEW stated in their testimony to be an accurate estimate for those served by both agencies.

Could you elaborate briefly on this and supply what information you have to contradict that for the record?

Mr. WEINRICH. In the statement we also indicate that we will be glad to give you a complete analysis of this.

Miss Burton?

Miss BURTON. First, we need to look at both the statement and the figures given by the administration to see the statement the administration made, and what that means.