doctors' services, audiologists' metering centers, and it would be impossible for the strength of the program because it would not run any of them. Senator MAGNUSON. If you did not run any of them, you would be just a reference outfit, and if you are a reference outfit we ought to cut the budget about in half, if that would be all you are doing. Mr. EDWARD NEWMAN. I think, Mr. Chairman, that the strength of this program and why it has been able to develop and receive the support of this committee over the years is because it cut through some of the problems that other kinds of categorical programs seemed to have. What I mean by that is, if consolidation or coordination happened with this situation Senator MAGNUSON. Well, aren't you a guidance program? Mr. NEWMAN. Well, we give guidance to handicapped people, but the point I am trying to make is, we give a lot of services over a period of time in order to get that guy back to work, and what we feel our strength is, that our coordination begins with that individual and it ends with our attempt and our reasonably good success in getting him to become a productive member of society. COORDINATION OF RESOURCES We coordinate around that individual all of these resources, both public and private, that we have to bring in; and that is where that point of coordination comes in, at the local level between that counselor in the community and that handicapped individual. Senator MAGNUSON. I understand that, but you bring them together, you don't give them medical treatment. Mr. NEWMAN. We see that the gets it if he needs it. Senator MAGNUSON. That is what I am saying, you are a reference group. Mr. EDWARD NEWMAN. Yes. Senator MAGNUSON. You get a fellow and try to find out about him and find out what is good for him and how you can work this and bring in the other people who can do it, or refer him. Mr. NEWMAN. Right; and we pay for the thing if we have to, but we try first to see if we can get other community resources to be brought to bear upon the problem. Senator MAGNUSON. That is why I say maybe this might be a proper function of rehabilitation. It is a little different, I understand that. Now, what liaison do you have with the Veterans' Bureau, if any? I am talking about mental cases. Mr. NEWMAN. We do have a cooperative agreement with the Veterans' Administration and even though we do not provide services to veterans without service-connected disabilities, there are a lot of services that we do provide and help them with, because our people are stationed in all of, or most of the communities, or have access to the communities throughout the Nation. So we would be doing evaluations for them or they would be doing the evaluation for us, or we would, in those cases where their policies are more flexible, we would be asking them to use their resources for some people who have no such resources. Senator MAGNUSON. But you wouldn't necessarily be with a serviceconnected mental case? Mr. EDWARD NEWMAN. Not necessarily, except that where we are in some cases with them, where we help with the intake processes or in the evaluation, give our advice to the Veterans' Administration. Senator MAGNUSON. Because every other bed in the 183-bed veterans hospital is an NP case, every other bed, and the percentages have been just the same for the last 10 years, and we have not dropped it at all. And there are a lot of them; I suppose, in every drunk tank in the country today, there is some veteran there that should be an NP case in a hospital. These are the things, that sort, you have to be working on together. Of course, the law gives them a special responsibility that you folks don't have. You have a broad responsibility, but not for that. How much money do you have in there? You don't mention it. Mr. TWINAME. I am sorry it is not mentioned in the text, but $605 million for rehabilitation services. Senator MAGNUSON. This division? Mr. NEWMAN. For rehabilitation services. Senator MAGNUSON. How much is that over last year? Mr. NEWMAN. $570,390,000 last year, which is an increase of $34,610,000. Senator MAGNUSON. You also suggest that one of the reasons why we should continue this program at a reasonable level is that we are helping out States or other people that are burdened with institutions, and we are having it decreased? Mr. EDWARD NEWMAN. That is right, we are decreasing every year. Senator MAGNUSON. Applicants for the institution? Mr. NEWMAN. Every year for the last 5 or 6 years, so that 22 percent of the caseload, or 26,000 people have been taken out of public institutions, as a result of the help provided by our program. Senator MAGNUSON. All right. Off the record. (Discussion off the record.) SUBCOMMITTEE RECESS Senator MAGNUSON. We will recess now, and meet at 11 o'clock tomorrow morning. (Whereupon, at 4:45 p.m., Wednesday, June 23, the subcommittee was recessed, to reconvene at 11 a.m., Thursday, June 24.) DEPARTMENTS OF LABOR AND HEALTH, EDUCATION, AND WELFARE AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 1972 THURSDAY, JUNE 24, 1971 U.S. SENATE, SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, D.C. The subcommittee met at 11 a.m., in room 1114, New Senate Office Building, Hon. Warren G. Magnuson (chairman) presiding. Present: Senators Magnuson, Cotton, Fong, and Percy. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE SOCIAL AND REHABILITATION SERVICE STATEMENT OF JOHN D. TWINAME, ADMINISTRATOR ACCOMPANIED BY: PAUL J. FASSER, JR., DEPUTY ASSISTANT SECRETARY FOR RICHARD M. LONGMIRE, ASSOCIATE ADMINISTRATOR, PLAN- JOHN L. COSTA, COMMISSIONER, ASSISTANCE PAYMENTS AD- HOWARD NEWMAN, COMMISSIONER, MEDICAL SERVICES AD MINISTRATION JAMES A. BAX, COMMISSIONER, COMMUNITY SERVICES ADMIN- EDWARD NEWMAN, COMMISSIONER, REHABILITATION SERV- JOHN B. MARTIN, COMMISSIONER, ADMINISTRATION ON AGING WILLIS W. ATWELL, DEPUTY COMMISSIONER, ADMINISTRA- RANDOLPH W. LEE, DIRECTOR, BUDGET DIVISION, SOCIAL AND CHARLES MILLER, DEPUTY ASSISTANT SECRETARY, BUDGET, PROBLEMS OF AGED Senator MAGNUSON. The committee will come to order. We will continue on the fiscal 1972 budget estimates for the Social (1135) and Rehabilitation Service. When we recessed yesterday, we were about to hear the proposals for the special programs for the aging. Mr. Twiname is presenting the request and will you pick up where we left off, which I think, is page 12. Please proceed. Mr. TWINAME. The Administration on Aging and the programs it administers under the Older Americans Act represent one approach to meeting some of the problems of the elderly. These programs focus on the goals of fostering independent living, lessening isolation and withdrawal from life, and creating the environment necessary for a life of dignity for all older Americans. OLDER AMERICANS ACT: NEW PROGRAMS As originally proposed, the President's budget provided for increases in two new programs under the 1969 amendments to the Older Americans Act: Areawide model projects and the retired senior volunteer program, RSVP. Within the overall constraints of the development of the Federal budget, it was considered necessary to reduce support for other programs for the aging in order to accommodate these new initiatives. I am happy to say that the administration has found it possible to amend its budget to sustain the support of the community programs, the foster grandparent program, and related research and training programs under the Older Americans Act while pressing forward with the new efforts. Areawide projects initially will focus efforts of persons and agencies in the community, working together, on meeting a particular need of older persons. From the models developed, coordinated services can then be extended to larger numbers of older persons on a broader base. STATEWIDE PLANNING This new approach to meeting the needs of the elderly also ties into the development of statewide plans, which are now moving from the data collection phase to the plan development phase. WHITE HOUSE CONFERENCE ON AGING Statewide planning will also encompass the implementation of State and national recommendations developed by the White House Conference on Aging. State conferences will have been held in the States in advance of the national meeting. Senator MAGNUSON. Right there, when is the national meeting to be held? Mr. TWINAME. November of this year. Senator MAGNUSON. All right. Proceed. RETIRED SENIOR VOLUNTEER PROGRAM Mr. TWINAME. The retired senior volunteer program will open new opportunities for service as well as providing a place in society for older persons. The groundwork for this service has been developed by the Administration on Aging, and it will be transferred to the new Action agency in a workable form after initial launching. Along with RSVP will be transferred the foster grandparent program to provide a section in the new agency for volunteer services by older Americans. In 1971, much of the effort of State agencies on aging was devoted to the gathering of data for the development of State policy on aging and the holding of State conferences on aging. In 1972, participation in the National White House Conference on Aging this fall, and development of State goals, policy, and priorities based on the results from both conferences will be a major task. REGIONAL CONFERENCES Senator MAGNUSON. Now, you placed a lot of emphasis-I know you do down there on State programs. Why don't you, instead of having them all come back here, have regional conferences out in the States? What is the reason that all of them have to come back here? Mr. TWINAME. You mean at the November Conference? Senator MAGNUSON. Yes. Why doesn't your shop go out and have regional conferences? You are then closer to what they do, and you get more people there and more views, and when you come back here, it has to necessarily be limited as to who represents them, and, between you and me, they get into big arguments about who is going to come and who is not going to come. I thought these conferences were leaning a great deal on the State programs, and why shouldn't they be held in the field? Mr. TWINAME. I agree, because that is a good idea, and we did exactly that during this last year. We have held 6,000 community conferences sponsored and organized by the Administration on Aging. Mr. Atwell, Deputy Commissioner of the Administration on Aging, was responsible for managing the community and State and regional efforts to pick up on these ideas at the grassroots. That was really basically the forerunning collection phase and discussion phase for what would be capped off at the Washington end of it. We think what happened in the communities is important. Senator MAGNUSON. I think it is too late to change what we are going to do this fall. I understand that. It seems to me you would get more representation if you go out and do this in a regional way, because there are more people out there to contact and there is a smaller group of you people that want to be there to give advice and counseling, than to move out and try to get a real representative group back here. PERSONNEL INVOLVED PRIOR TO WHITE HOUSE CONFERENCE Mr. TWINAME. Right. In doing what you suggested, there is an innovation for the White House Conference. Senator MAGNUSON. How many people would you say are in volved? Mr. ATWELL. We expect there will be over 1 million people involved in the whole process of the White House Conference before the Conference is even held in November. Senator MAGNUSON. Well, I understand that. I want to keep contact with the 1 million people. You and I know they get into big disputes as to who is going to represent whom. You end up usually on this, the complaint is, in many of these conferences, as it was in a conference on youth that they held in Colorado, to make an effort to get out of this Washington atmosphere. |