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in great need of physicians and may even be forced to close their doors if they are unable to recruit physicians.
Field - $65.0 million
This amount requested would allow for a field strength of approximately 867 federal hires, in addition to increase the recruitment activities of the NHSC.
NHSC Scholarship/Loan Repayment - $101.0 million
This amount would provide for approximately 714 agreements in FY 1992, as well as $10 million for nurse practitioners, physician assistants and other non-physician health providers, and $10 million for state loan repayment grants.
Health Care for the Homeless - $80 million
This amount would provide funding for this program at its fully authorized level for both primary care and substance abuse services, and would provide services to another 240,000 homeless individuals as well as providing for expansion of the program.
Black Lung Clinics - $5.0 million
This amount would allow services to 50,000 persons in FY 1992.
AIDS Treatment - $75 million
This amount would support outreach and treatment services to approximately 19,500 persons with AIDS and up to 63,000 HIV-infected persons out of the estimated 247,000 health center patients who are currently infected with the HIV virus.
Public Housing Health Services - $35.0 million
This amount would provide for the full authorized level for this program. The amount requested would provide health and social services to approximately 200,000 residents of public housing.
VIII. Native Hawaiian Health Care - $6.4 million
This amount would allow for continuation and expansion of the program in FY 1992, including development of at least two new primary health centers.
Minority Health/Translation Services - $25.0 million
This amount would ensure the availability of $3 million to assist providers of primary health care and preventive health services for translation services to thousands of nonEnglish speaking patients.
Mr. Chairman, and members of the Committee, I deeply appreciate the opportunity to present this information to you today. I will be happy to answer any questions.
Senator HARKIN. Thank you, Dr. Wallace.
You say Federal funding for centers has actually decreased by up to 30 percent over the last 10 years, right?
Dr. WALLACE. Yes, sir.
Senator HARKIN. Yet they have increased the number of patients served by nearly 1 million over the same period?
Dr. WALLACE. That is correct.
Senator HARKIN. And you really are prevention-oriented, are you not?
Dr. WALLACE. That is correct.
Senator HARKIN. Keeping people well.
Dr. WALLACE. We provide very good service. That is why I am here. Because if we were not there, minor things would become major and catastrophic. There is just no close center around except for the major cities, in Memphis and in Little Rock.
Senator HARKIN. How long have you been with the community health center?
Dr. WALLACE. I have been working in the community health center for several years now. In Memphis, I was working in the Salvation Army clinic, which was a pilot program which worked very well. I have been working in Arkansas now for this past year.
Senator HARKIN. National Health Service Corps provided a lot of physicians for the community health centers, right?
Dr. WALLACE. Yes; but the
Senator HARKIN. Do you have any left in yours?
Dr. WALLACE. That is why I am here. I, actually, the services were so needed that I was covering for my colleague and because there was such a need there I decided to stay on and do some of this work.
Senator HARKIN. Do you have any National Health Service Corps doctors in your center?
Dr. WALLACE. Yes; we do.
Senator HARKIN. How many?
Dr. WALLACE. Two now. One is Dr. Payne and the other one is Dr. Bulky.
Senator HARKIN. I assume that some time in the past there were quite a few more than that?
Dr. WALLACE. I am not really sure. I just know that there is much difficulty getting physicians because of the area, the location, it is not very attractive. It is isolated. It is the last out for most people's choice.
Senator HARKIN. For the last 10 years our funding for National Health Service Corps has gone down drastically. When I took over this subcommittee we started increasing the funding for it in 1989, 1990, 1991, and we will start increasing it again next year, too. If we can get that pipeline built back up for National Health Service Corps doctors because they do provide services for the community health centers.
I can tell you that this subcommittee has a great deal of support here for community health centers. I personally see these as perhaps one of the most cost-effective ways of reaching out to those people who are uninsured, underinsured, rural areas, especially where I come from and also in inner cities. Plus, it brings together a lot of different services, as I said, in a preventive manner, immu
nizations, preventive health care, all the nutrition services, things like that.
Dr. WALLACE. That is correct.
Senator HARKIN. I congratulate you on working with the community health center.
Ďr. WALLACE. Thank you very much. I am very happy to be here
Senator HARKIN. Thank you very much, Dr. Wallace.
STATEMENT OF RALPH J. MOORE, JR., ASSOCIATION FOR RETARDED CITIZENS OF THE UNITED STATES [ARC]
Senator HARKIN. Next, we have Ralph Moore, chairman, Government Affairs Committee, Association for Retarded Citizens [ARC] of the United States.
Welcome to the subcommittee. Your statement will be made part of the record. Please proceed.
Mr. MOORE. Thank you, Mr. Chairman. It is a pleasure and an honor to appear before you today on behalf of the Association for Retarded Citizens of the United States, the ARC.
I bring you greetings from Art Headburg and Marietta Lane two of our folks in Iowa who are particularly active in our governmental affairs activities.
Senator HARKIN. Good friends of mine.
Mr. MOORE. As you know, we have 130,000 members throughout the country, most of them are parents of children and adults with mental retardation, but we have many professionals and many selfadvocates as well.
All of us in the ARC deeply appreciate your outstanding efforts as chairman both of the Subcommittee on Disability Policy and of this subcommittee to secure the rights to which Americans with disabilities are entitled and the services they need. We look forward to honoring you next week at our annual conference with an award. I must say it will not begin to express the deep appreciation we feel for the role you have played.
Seven million people in the United States have mental retardation. There are both young and old. Their disabilities range from mild to profound. Their needs and the needs of their families vary greatly. They need help and their parents need help to maximize their ability to learn, to work, and to live as independently as possible in their communities.
Government plays an essential role in providing education, training, housing, and other vital services. There are dozens of federally supported programs which assist persons with mental retardation. At the end of our prepared statement, we have a list of our recommendations. And the staff has been supplied with the detailed budget books of the Consortium for Citizens With Disabilities, as prepared on these programs.
In my limited time, I would like to focus on a few very important education programs.
We urge the subcommittee to give priority to increasing the appropriations to the early intervention preschool and transition programs of the Individuals With Disabilities Education Act. With respect to the preschool program, Congress has promised school systems $1,000 per child reimbursement in the next school year. We
expect all children with disabilities from ages 3 years through 5 years will be receiving special education services next year. This is an outstanding achievement. We urge Congress to keep its fiscal promise and fully reimburse school systems to assure the success of these programs.
Equally important is the part H early intervention program that serves infants and toddlers with handicaps. Most States will decide this year whether or not to opt into this program. Many of those decisions will be based primarily on the level of the Federal commitment to fund the program. We recommend the funding level of $250 million to successfully launch the service phase of this program.
It is essential that parents participate meaningfully into the development of their child's special education program. An important component of the Individuals With Disabilities Education Act provides funds to operate parent training and information centers. These centers assist parents to understand their rights and responsibilities under that law. We urge Congress to make the funds available to establish a center in each State.
Several programs need to be expanded to prepare students leaving school for jobs. One is the transition program under the Individuals With Disabilities Education Act. We spent almost $2 billion federally in special education, but only $15 million to assist the more than 200,000 special education students who leave schools for work every year. This program needs to expand quickly. We recommend appropriating at least $40 million next year to implement the newly authorized joint transition projects for State vocational rehabilitation and special education agencies.
Two very important Rehabilitation Act programs also play vital roles in preparing young adults with mental retardation for work. These are the vocational rehabilitation State grant program and the support of employment State grant program. Both of these programs need substantial increases. This would allow several thousand additional individuals with mental retardation to be trained to enter the work force where they will be taxpayers instead of tax
Mr. Chairman, we thank you and the members of this subcommittee for your strong support in the past. We hope you will, again, allow our programs to expand.
[The statement follows:]
STATEMENT OF Ralph J. MOORE, JR.
Mr. Chairman, it is a pleasure and an honor to appear before you today on behalf of the Association for Retarded Citizens of the United States (ARC), an organization of 130,000 members throughout the country, most of them parents of children and adults with mental retardation. The ARC is greatly appreciative of your outstanding efforts as Chairman of both the Subcommittee on Disability Policy and this Subcommittee to secure rights protections and program expansions for Americans with disabilities. We look forward to honoring you next week at our conference.
There are an estimated seven million individuals with mental retardation in the United States. Mental retardation thus constitutes over 15 percent of all persons with disabilities. There are persons with mental retardation of all ages, from infants to senior citizens. Levels of retardation vary widely, from mild retardation to severe
and profound retardation. Given the diversity of the severity of the disability and that mental retardation affects persons of all ages, the needs of persons with mental retardation and their families vary greatly.
Parents of persons with mental retardation need help to maximize their child's ability to learn, to work and to live as independently as possible in their communities. Government must and does play an important role in providing education, training, housing and other vital services. There are dozens of federally supported programs which assist persons with mental retardation. Since my time is limited, I would like to spend a couple of minutes concentrating on several very important education programs. We urge this Subcommittee to give priority to increasing the appropriations to the Early Intervention, Preschool, Transition and Personnel Development programs, as well as the Part B State Grant program of the Individuals with Disabilities Education Act.
For the Preschool program, the Congress has promised school systems a $1,000 per child reimbursement in the next school year. We expect all children with disabilities from ages three through five will be receiving special education services next year. This is an outstanding achievement. The Congress should live up to its fiscal promise and fully reimburse school systems as authorized by Public Law 99-457.
Equally important is the Early Intervention program to serve infants and toddlers with handicaps. Most states will decide this year whether or not to opt into this program. Many of those decisions will be based primarily on the level of commitment given by the Federal Government to fund this program. We recommend a funding level of $250 million for the Part H program to successfully launch its service phase.
It is essential that parents meaningfully participate in the development of their child's special education program. An important component of the Individuals with Disabilities Education Act provides funds to operate parent training and information centers. These centers assist parents to understand their rights and responsibilities under Public Law 94-142. Unfortunately, nine states do not presently have a parent training center, primarily due to funding limitations. The Congress must appropriate sufficient funds in the Special Education Personnel Development program to allow for a parent training center in each state.
Several programs need to be expanded to better prepare students exiting school for jobs. One is the Transition program under the Individuals With Disabilities Education Act. We spend almost $2 billion Federal dollars in special education but only $15 million to assist the more than 200,000 special education students who exit schools every year to transition into the adult world. This program needs to expand quickly and we recommend at least $40 million be appropriated next year to implement the newly authorized joint transition projects for State Vocational Rehabilitation and Special Education agencies.
Two very important programs within the Rehabilitation Act also play vital roles in preparing young adults with mental retardation for work. They are the Vocational Rehabilitation State Grant program and the Supported Employment State Grant program. Both of these programs merit substantial increases. This would allow for several thousand additional individuals with mental retardation to be trained to enter the work force, thus making them taxpayers instead of tax users. Mr. Chairman, since the needs of persons with mental retardation are lifelong, many other Federal programs that I do not have the time to review today also need your attention and support. Very important are funding increases for the Jobs Training Partnership Act, the Maternal and Child Health Block Grant, the Title XX Social Services Block Grant and the programs within the Developmental Disabilities Act. We sincerely hope the Congress sees fit to fund these programs at the recommended amounts. Again, Mr. Chairman, we thank you and members of this Subcommittee for your strong support in the past and we hope you will again allow our programs to expand.
The following list of key disability programs compares the current (fiscal year 1991) year's funding with the ARC's fiscal year 1992 recommendations.
(in millions of dollars)