Narcotics Treatment Agency. The five have now been transformed into seven administrations which bring together previously separate but related functions and which give emphasis and visibility to seven areas of priority interest. Those seven areas are Narcotics Treatment, Community Health Services, Hospitals and Medical Care, Mental Health, Veterans Affairs, Vocational Rehabilitation, and Social Services. On February 1, 1971 the former Coroner's Office, which the Court Reform and Criminal Procedures Act changed to the Office of the Chief Medical Examiner was transferred to this Department for administrative purposes. Dr. James L. Luke, Chief Medical Examiner for the State of Oklahoma, has been selected to head this office after a nation-wide search and reports next month.

Today, some fifteen months after the initial consolidation, our energies are still directed at melding these units together so that we may systematically converge on the problems which affect the people we serve. We are concerned with treating the whole person, and are redesigning our program and our operations to meet his needs in a manner that will enable the individual to function at maximum capacity.

Before pinpointing the areas in which we are asking an increase, I must say that those of us in the Department are well aware of the basic needs of this city, and we realize that many are not being met.

But our focus at present is on more effective management; greater utilization of the total resources of the community, private as well as public; and the development of tools which help the Department to measure the effectiveness and evaluate the impact of its programs in the community. Thus, we should be able to tailor our programs to areas of greatest need and highest pay-off.

I would like to cite a few of the organizational changes which we have made in order to improve service delivery since I last appeared before this committee. By merging the medicaid eligibility functions of the old Welfare Department with the medicaid service functions of the former Health Department and bringing them together with the public hospitals, the medical charities, and medicare programs, under a new agency-The Hospitals and Medical Care Administration our medical care system has been made more efficient. This should lead to better services to clients, increased revenues for services rendered, a speed-up of payments to hospitals and other private vendors, as well as an opportunity to design better systems of delivery.

Likewise, the mental health and mental retardation functions of the former Health and Welfare Departments have been combined into a new Mental Health Administration, and a more vigorous and effective service is expected to develop. We also look forward with keen anticipation, Mr. Chairman, to the possibility of integrating St. Elizabeth's Hospital more effectively into the District's mental health system under this arrangement.

A new Mental Health, Drug, and Alcoholism Section of the Vocational Rehabilitation Administration, will provide for greater coordination and effectiveness of our rehabilitation of drug addicts and people who are mentally ill. The net benefit to the community will be two-fold. First, an additional 400 addicts will be served; and second, and more important, vocational rehabilitation service will be provided as part of the total treatment effort for narcotic addicts, particularly those who are in the methadone maintenance program administered by our Narcotics Treatment Administration.

The Veterans' Affairs Administration has been instrumental in opening up new areas of funding for treatment of alcoholics serviced by the Department's Mental Health Administration. Through opportunities recognized as a result of our consolidation of functions, a Veterans home at the Rehabilitation Center for Alcoholics in Occoquan, Virginia has been established. This will provide additional reimbursement funds to the Department which can be used for improved services to alcoholics, particularly veterans.

These efforts demonstrate the multiplier effect being realized through joint planning within the Department. Instead of focusing on their individual interests, each Administration now emphasizes what it can do to advance the whole human resources system. We plan to tighten management controls even further through the consolidation and centralization of major planning, program development, and resource allocation functions within the Department. We will keep this Committee informed as our planning proceeds.

The total local operating funds requested for the Department of Human Resources for fiscal year 1972 is $206,961,700 which represents an increase of $42,380,000 over the 1972 base of $164,581,700. Of this amount $7,290,400 is for

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mandatory increases such as annualization, within-grade salary advancements classified pay act and wage board increases. In addition to the mandatories, the following major program increases are requested :

$15,350,200 to meet the cost of the higher public assistance caseload. The Department projects an increase in the caseload from 30,000 currently to an average of 36,000 monthly during fiscal 1972.

$5,256,800 to pay 84% of the 1970 cost of living standards instead of the 75% we now provide in public assistance grants. This would raise the public assistance payment for the average family of four from approximately $238 to approximately $270 per month.

$4,900,000 to help fund the Medicaid program, in which a projected 147,000 persons will require service next fiscal year.

$4,800,000 for the program of supplementing the wages of female heads of households. This public assistance program is mandatory to meet the require ments of the 1967 Social Securty Amendments. It should also assist in moving persons from a dependency status into available jobs.

$2,600,000 to allow reimbursement of payments for Medical Charity patients on a more reasonable basis. The $38 per day we pay in the face of actual costs in excess of $70 per day to cooperating hospitals severely limits our ability to involve the private sector in our medical care system.

$924,600 for narcotics treatment programs to replace Federal grant funds expiring this year.

$628,000 to add 267 positions to the public assistance staff, which is now funded on the basis of the 13,000 cases of two years ago.

$250,000 to continue our efforts to lower the population of Junior Village by developing more community resources and providing services to the children placed in these resources.

$250,000 to broaden the urine surveillance program in the Narcotics Treatment Administration.

$100,000 needed to expedite the collection of payments for health services rendered. This increase should provide substantial additional revenues to the District.

$30,000 to help provide District veterans with counseling services and other needed assistance.

In addition, we are requesting $12,843,300 for Capital Outlay. Of this amount, $9,930,000 is for construction of a new Receiving Home for Children; $135,000 is for Glen Dale Hospital; $170,000 for construction of a 40-bed residential treatment center for juveniles; $447,500 for additional warehouse and office space at Children's Center; and $2,160,800 for important permanent improvements at D.C. General Hospital, D.C. Village and the Department's institutions for children Mr. Chairman, I would like to elaborate briefly at this time on one capital outlay request of critical importance. That is our request for construction funds for a new Receiving Home for delinquent youths awaiting court action.

Planning for a new Receiving Home for the District has been underway since 1967, involving a variety of community groups, experts, and criminal justice officials. Twice such a request for funds has been submitted to the Congress— only to be withdrawn because of lack of unanimity on a site location. This issue has been resolved.

Overcrowded conditions and an inadequate physical plant have reached the point where Superior Court Chief Judge Harold Green has ruled that the present Receiving Home violates the requirements of the Court Reform and Criminal Procedures Act and that no youth can be sent to the present Receiving Home after October, 1972.

Because of the seriousness of the court order and because of the critical limitations of the present available space, we feel we must move forward in this budget with the request for funds for a new facility.

The budget as transmitted by the President contains a request for 13.5 million dollars to construct a facility with 192 beds, plus other supportive features. The final estimate of 13.5 million dollars came after several revisions in projecting the population requiring a secure facility, and changes in architectural design in an effort to meet requirements of the new D.C. Crime Bill.

Following extensive discussions with the City Council, the size of the detention facility has been revised downward to a 128 bed facility with an estimated cost of 10.2 million dollars, over three million dollars less than originally requested.

We plan later to request an amendment to our operating budget to permit the Department to develop capacity for an additional 72 beds in minimum security community-based facilities.

At the proper time, Miss Winifred Thompson, Director of the Social Services Administration, and I will be prepared to speak in more detail in support of this request.

Mr. Chairman, I have also attached for the convenience of the Committee a summary of budget requests with brief comments on areas we felt to be of interest to this Committee. If I can be of further assistance to the Committee at this time, I would be pleased to do so.

DISTRICT OF COLUMBIA DEPARTMENT OF HUMAN RESOURCES

OPERATING EXPENDITURES

The 1972 budget estimate as presented to the House is as follows:

The major program components of the total operating budget (District and Federal Funds) of $307.0 million for 1972 will be:

$3.5 million to provide overall policy development and direction, and administrative and executive staff services;

This is 1.2 percent of total payments.

$6.2 million to improve the employability of handicapped citizens and thus enable them to become independent and self-sufficient through a Vocational Rehabilitation Administration;

This is 2.0 percent of total payments.

$30.0 million to protect the health of the public by preventing and controlling disease and disability through the Community Health Services Administration; This is 9.8 percent of total payments.

$155.8 million to fully develop the potential of District residents to achieve economic independence, while maintaining a decent and dignified quality of life for needy persons and family through the Social Services Administration; This is 51.4 percent of total payments.

$0.02 million to provide veterans of the District of Columbia the range of benefits offered by the U.S. Veterans Administration;

This is 0.1 percent of total payments.

$5.6 million to operate a drug addiction prgoram with the goal of providing effective treatment to all addicts in the District of Columbia through a Narcotics Treatment Administration;

This is 1.9 percent of total payments.

$68.1 million to administer a hospital and medical care program for services which the people themselves cannot provide adequately through a Hospitals and Medical Care Administration;

This is 22.2 percent of total payments.

$37,1 million to provide a community health program for the prevention and cure of mental illness and mental retardation and for the prevention of alcoholism and rehabilitation of alcoholics through a Mental Health Administration; This is 11.2 percent of total payments.

$0.5 million for a Chief Medical Examiner to meet legal requirements pertaining to all deaths from other than natural causes;

This is 0.2 percent of total payments.

The highlights of the proposed Department of Human Resources increases for 1972 are:

Total budget increases-

$42.4 million

$4.9 million for increase in workload provided under the Medicaid Program; $2.6 million for reimbursement to Contract Hospitals at reasonable cost for services rendered;

$0.1 million to expedite collection payments for health services;

$0.9 million for the Narcotics Treatment Administration to replace Federal funding;

$0.3 ($250,000) million to broaden the urine surveillance program;

$4.8 million to supplement the incomes of mothers who are heads of AFDC (Aid to Families with Dependent Children) households and working full time; $15.4 million to meet the cost of the higher Public Assistance caseload;

$5.3 million to pay 85 percent of the 1970 cost of living standards instead of 75 percent;

$0.6 million to provide 267 staff positions for Public Assistance casework services;

$7.2 million for mandatory increases such as within-grade salary advancements; annualization of prior year increases, and other personnel increases; and $0.3 ($250,000) million to lower population of Junior Village by developing more community resources and providing services to children placed in these

resources.

The major program components of the total District appropriated operating budget of $207.0 million for 1972 will be:

$1.7 million to provide overall policy development and direction, and administrative and executive staff services;

This is 0.8 perecent of total payments.

$1.2 million to improve the employability of handicapped citizens and thus enable them to become independent and self-sufficient through a vocational rehabilitation administration;

This is 0.6 percent of total payments.

$20.6 million to protect the health of the public by preventing and controlling disease and disability through the Community Health Services Administration; This is 10.1 percent of total payments.

$98.1 million to fully develop the potential of District residents to achieve economic independence, while maintaining a decent and dignified quality of life for needy persons and family through the Social Services Administration; This is 47.4 percent of total payments.

$0.02 million to provide veterans of the District of Columbia the range of benefits offered by the U.S. Veterans Administration:

This is 0.1 percent of total payments.

$3.0 million to operate a drug addiction program with the goal of providing effective treatment to all addicts in the District of Columbia through a Narcotics Treatment Administration;

This is 1.4 percent of total payments.

$47.6 million to administer a hospital and medical care program for services which the people themselves cannot provide adequately through a Hospitals and Medical Care Administration;

This is 22.9 percent of total payments.

$34.1 million to provide a community health program for the prevention and cure of mental illness and mental retardation and for the prevention of alcoholism and rehabilitation of alcoholics through a Mental Health Administration; This is 16.5 percent of total payments.

$0.5 million for a Chief Medical Examiner to meet legal requirements pertaining to all deaths from other than natural causes;

This is 0.2 percent of total payments.

Mr. NATCHER. You proceed according to the way you desire, Mr. Rutledge.

GENERAL REVIEW

Mr. RUTLEDGE. Thank you. Mr. Chairman, when I last appeared before this committee a year ago, the Department of Human Resources was in its initial process of becoming organized. That process is not yet complete. The Department of Human Resources, as the chair will recall, was established in March 1970 in order to consolidate programs closely related in mission, function, and purpose in an effort to increase efficiency and improve the delivery of health, welfare, and rehabilitative services to the community.

The first year of the Department has been one of assessing needs and capability, of initiating a process of reorganization, and experimenting with new concepts of service delivery.

While at the same time-and I would wish to emphasize this-we were continuing to serve our clients without interruption because, in spite of our desire to make changes for efficiency, our clients still required assistance.

The functions and responsibilities of four departments and one emerging agency were consolidated to form the Department of Human Resources. They were the Department of Public Welfare, the Department of Public Health, the Department of Vocational Rehabilitation, the Department of Veterans' Affairs and the Narcotics Treatment Administration which had been formed approximately 3 weeks prior to the consolidation.

Those five agencies have now been transformed into seven administrations which bring together previously separate but related functions and different emphasis and give visibility to seven areas of priority interest.

Those seven areas of priority interest are narcotics treatment, hospitals and medical care, mental health, community health services, veterans affairs, vocational rehabilitation, and social services.

At some point in the future, Mr. Chairman, as our needs change and as our priorities change, these administrations may also change and be replaced by other functions and new structures which serve the needs recognized at that time.

TRANSFER OF CORONER'S OFFICE

On February 1 of this year, the former coroner's office was transferred to the Department of Human Resources. The former coroner's office under the Court Reform and Criminal Procedures Act was changed to the Office of the Chief Medical Examiner. We immediately undertook a nationwide search for a chief medical examiner to meet the requirements of that act. Dr. James Luke, who was the chief medical examiner for the State of Oklahoma, has been selected to head this office. He reports on the 19th of this month.

FOCUS ON EFFECTIVE MANAGEMENT

Some 15 months after the initial consolidation, Mr. Chairman, our efforts and our energies are still directed at melting these units to