ment loans insured under title II of the National Housing Act, in unsecured loans insured or guaranteed under the provisions of the Servicemen's Readjustment Act of 1944, as amended, or chapter 37 of title 38 of the United States Code, and in other loans for the alteration, repair, or improvement of existing structures on real property or the construction of new structures thereon, or for home furnishings and equipment: Provided, That no such loan, unless so insured or guaranteed, shall be made in excess of $5,000: And provided further, That the amount of loans for home furnishings and equipment outstanding at any time shall not exceed 5 per centum of the assets of such association; and "(2) in the purchase, development and improvement of real property for primarily residential purposes, and may hold, sell, lease or otherwise exercise the rights of an owner of any such property: Provided, That the investInents of any such association in such real property outstanding at any time, exclusive of any property acquired under any other authority exercised pursuant to this section, shall not exceed 5 per centum of its assets." Add at the end of subsection 5(d) the following new paragraph: "Without regard to any other provision of this subsection, any such association may invest in loans, obligations, and advances of credit (all of which are hereinafter referred to as loans) for the acquisition of mobile dwellings, but no association shall make any investment under this sentence if the principal amount of its investment in such loans, exclusive of any investment which is or which at the time of its making was otherwise authorized, would thereupon exceed 5 per centum of its assets." * SIMPLIFICATION OF TITLES Add at the end of subsection 5(a) of the Home Owners' Loan Act (12 U.S.C 1464(a)), a new sentence reading: "Any Federal savings and loan association may at its option omit the words 'and loan' from its prescribed title." SECTION-BY-SECTION ANALYSIS Section 1 would add to existing authority the authority to finance as a property improvement loan a new structure on real property and authorize unsecured loans for the purchase of home furnishings and equipment. These loans could not exceed $5,000 and the amount in loans for home furnishings could not exceed percent of the association's assets. Section 2 would authorize Federal associations to invest 5 percent of assets in the purchase, development, and improvement of land and exercise the rights of an owner of such property. Section 3 would authorize an association to invest up to 5 percent of assets in loans on mobile dwellings. Section — would authorize a "Federal savings and loans association” to adopt at its option the legal title "Federal savings association." NATIONAL RECREATION & PARK ASSOCIATION, Washington, D.C., April 5, 1966. Hon. WILLIAM A. BARRETT, Chairman, Housing Subcommittee, Room 2129, Rayburn Building, MY DEAR CONGRESSMAN: Enclosed is testimony by Joseph Prendergast, executive vice president of the National Recreation and Park Association, relating to H.R. 13790 and H.R. 13792. We would appreciate it very much if his statement could be included in the official record. Thank you. Sincerely, KENNETH J. SMITHEE, Washington Representative. STATEMENT OF JOSEPH PRENDERGAST, EXECUTIVE VICE PRESIDENT, NATESE RECREATION AND PARK ASSOCIATION Honorable chairman and members of the subcommittee, my name is Jop Prendergast, and I am executive vice president of the National Recreatio and Park Association. This organization came into being on January 1, # after six national recreation and park organizations merged into a single orgas zation to serve the people of the United States in their pursuit of better pen and recreation facilities and programs and to help provide more wholeso and meaningful leisure time activities for the American people. The organiz tions that now comprise the National Recreation and Park Association former) were the National Recreation Association, American Institute of Park Exe tives, American Recreation Society, National Conference on State Parks, X tional Association of State Park Directors, and the American Association fr Zoological Parks and Aquariums. Laurance S. Rockefeller is president of this organization and its board of trustees is made up of distinguished lay and professional leaders from all parts of the Nation. Over 600 outstanding parks and recreation leaders serve on its various national and district advisory committees. Some 2,500 national, State. and local parks and recreation agencies, both public and private, are service affiliates of the association and over 7,000 professional recreation leaders are members of its professional division. We would like to testify today on behalf of H.R. 13790 (on financial and other aid to encourage and assist in the preservation and maintenance of historic structures) and H.R. 13792 (on the promotion and coordination of historic preservation activities of the Federal, State, and local governments, other public bodies, and private organizations and individuals). The National Recreation and Park Association is pleased that the Federal Government is showing concern and is seeking legislation to preserve one of our Nation's richest heritages-the perpetuation of our historic structures and landmarks. It is our moral obligation to insure that future generations can be inspired and stimulated by being able to identify with the lives of our famous personages and the great moments in history. Our historical structures are being destroyed at an alarming rate. They are either being razed or abandoned through sheer neglect. We must not allow this trend to continue. It is imperative that we act now before it is too late. H.R. 13790, by providing financial assistance for acquisition and rehabilitation of historic structures, will provide the impetus to get this worthwhile movement into high gear. This bill also provides for the establishment of a National Advisory Council on Historic Preservation to carry out the policies of the act. We are pleased to see that representation on the council will include elected officials at the local and State levels by the appointment of two mayors, one county official, and a representative of each State's Governor. This action will generate interest at the grass roots level where programs to be successful must receive their support. H.R. 13792 provides for assistance and cooperation with State and local gov ernments for historic preservation of activities. The compilation of a national register of historical sites with pertinent inventories prepared for State and local governments will be of infinite value in accounting for and instituting the action necessary to safeguard our historical legacies. The National Recreation and Park Association enthusiastically supports both of these bills, and urges their prompt enactment. STATEMENT BY JOHN W. EDELMAN, PRESIDENT, NATIONAL COUNCIL OF SENIOR CITIZENS, IN SUPPORT OF H.R. 9256 Mr. Chairman and members of the committee, the National Council of Senior Citizens is a nonprofit, nonpartisan organization of independent senior citizen clubs and individuals located in all States. In the few years since it was first set up in August 1961 to spearhead widespread public support for medicare, it has become the largest-and perhaps one of the most effective-national organizations for older people ever seen in America. Our more than 2,000 affiliated clubs include a combined membership of over 2 million elderly people linked through statewide and area or community councils. In supporting vital legislation such as the nuclear test ban treaty, civil rights and voting rights, tax and excise bills, the Housing and Urban Development Act of 1965, the antipoverty programs, etc., the National Council of Senior Citizens nas not merely sought special favors for older people. It has promoted the interest of senior citizens in harmony with the national interest. And we have asked to make this statement today to support H.R. 9256 and the identical bill introduced by Mr. Gonzalez, because we believe this legislation is another much-needed step along the road to achieving a better life for all Americans-of all ages. We believe that it is the duty of government to assist its citizens to secure and enjoy those rights to which they are entitled in a free society but which they cannot procure and possess unaided. We also believe that health is a right and that a state of health is in the public interest. A healthy population is a vigorous, dynamic and creative population and therefore, for its own sake, a government should take appropriate steps to assure the healthiest possible citizenry. It was a natural development that legislation for hospital development came into being. Because the construction of health facilities was financed with public money, the quality of services in them was a concern to all interested citizens, and there was increasing demand that these services be of high quality. The enactment of the social security amendments of 1965 which have become popularly known as medicare is, of course, a giant step in the direction of providing many of our citizens with an opportunity to achieve the right of health. The National Council of Senior Citizens is convinced it may take many years to develop the best kind of comprehensive programs to meet the health rights of all our people, but the programs which begin on July 1, 1966, represent perhaps lifegiving benefits to millions of older people who are unable to carry the burden of serious illness unassisted. But we cannot totally ignore the health rights of those Americans who are neither aged nor indigent. Government must continually seek to close the gaps in availability and accessibility of quality health services for all citizens. A program to assist voluntary associations in the construction and equipping of facilities for comprehensive group practice of medicine, such as provided for in H.R. 9256, can importantly help in bringing good medical care to all our people. No one today denies the efficiency and effectiveness of group practice in delivering high quality health care. More than 2,000 group practice organizations exist in all States-plus nearly 60 dental group practices. Some offer comprehensive prepayment plans, others are on a fee-for-service basis. But ones of the chief obstacles to the development of these plans has been the difficulty of securing financing on reasonable terms to meet the high cost of constructing facilities and providing needed equipment for essential health services. When such financing is granted under the terms of this bill, more prepayment plans will find it possible to open up in communities which desperately need more readily accessible high quality health care. The expansion of group practice facilities will importantly help to direct emphasis on prevention in the health programs of the future-and eventually help us turn back the tide of rising health care costs. The ready availability of group practice facilitates the education of citizens to the advantages of preventive measures, early diagnosis and treatment. More and more will come under treatment in the early course of their illness. ON SENIOR CITIZEN HOUSING While addressing itself to this Housing Subcommittee the National Council of Senior Citizens would also like to express its views on what it considers serious limitations in the Housing Act of 1965. We would also like to make further suggestions concerning housing for the elderly. First, we support wholeheartedly, the President's request for appropriation of the full $30 million authorized for this fiscal year to implement the rent supplement program. We earnestly request this subcommittee to support the President with all the strength it can muster in this crucial program. We urge removal of the limit imposed by the experimental portion of the rent supplement program in the Housing Act providing that only up to 5 percent of the funds appropriated for rent supplements can be used for section 202 and section 231 housing. The limited funds available if appropriated under current authorizations would meet only a small part of the need among elderly residents of "202" projects who would be eligible in projects financed even before the 1965 Housing Act passed. Nor would these funds meet the need in new projects under this direct loan pre gram which will continue to increase rapidly as the new 3 percent interest ra enables more and more potential sponsors to participate in this program whil serves the needs of the lower middle income older people so well. We urge your committee to support S. 2520 which would enable the Depart ment of Housing and Urban Development to make direct loans covering 100 per cent of development cost for new or rehabilitated nursing homes to nonprež groups, limited dividend corporations and public bodies. Provisions of S. 2520 which has been introduced by Senator Harrison J. W÷ liams of New Jersey would permit loans to be made at a maximum interest rate of 3 percent and for 50-year terms. It has been estimated that this bill work permit nursing home charges to be reduced by as much as $30 a month in coparison with nursing homes financed with FHA 232 mortgage insurance. It is the experience of the leaders of our clubs across America that older Americans require built-in access to health facilities and social services. Good planning of housing developments should include common space for senior activities— including craft shops, meeting rooms, and lounges. Space should also be available for a health center, dining room and other facilities to reduce isolation, provide meaningful activity and stimulate good health, in the retirement years. But the members of the Housing Subcommittee know that the installation of these vital common spaces tremendously increases the cost of construction and requires the elderly residents of the project to bear higher rental charges to meet these costs. It is therefore our hope that the committee will provide these much-need-l facilities under the existing nonprofit, consumer cooperative and public programs in the Department of Housing and Urban Development by instituting a program of grants for the capital cost of necessary related facilities such as these. These facilities might be used by elderly persons in the entire community-DU limited only to residents of the project. Frankly, the rapid growth of the elderly population calls for a serious research and evaluation program into all aspects of senior citizens housing. We must learn more about the types of housing needed and must provide adequate funds to research such a program. We must also seek to provide a program of grants to States-preferably administered by the Department of Housing and Urban De velopment-to provide communities with the necessary technical assistance to evaluate and review needs and plans for housing needs for the elderly. We also urge the Federal Government to make grants to States, communities and national nonprofit organizations for initial working capital and "seed money” for the necessary working capital required for elderly housing-despite the availability of 100 percent development loans or mortgage insurance loans. We urge that low interest direct loans and grants for rehabilitation in urban renewal areas be made available to low-income elderly homeowners who live in substandard housing anywhere. It will benefit the health, safety, and comfort of the elderly and help to upgrade neighborhoods. The Federal Government should also make grants to low-income elderly home owners forced to relocate because of government action, such as urban renewal. etc., to assist them to purchase another home if they wish. Many elderly forced to relocate in this way now own their homes mortgage free and wish to cou tinue homeownership. However, the cost of a modest and suitable replacement home is generally greater than the proceeds received in the sale of their existing home. It should not be difficult to work out a grant to cover the difference with proper safeguards with respect to resale, maximum cost and maximum income limits, etc. Hon. WRIGHT PATMAN, PALO ALTO MEDICAL CLINIC, Palo Alto, Calif., March 22, 1966. Chairman, Banking and Currency Committee, Washington, D.C. DEAR MR. PATMAN: I am writing you with some suggestions as to the pending legislation in regard to group practice. I have been associated with group practice for 40 years and have been the head of one of the largest community oriented groups in the country, the Palo Alto Medical Clinic. I am certain that the only way in which medical services can be delivered efficiently to those who need them, in these days of marked shortages of medical and paramedical personnel, is by the utilization of the device of group practice, and I believe it is important to help it in every way. There are two things which I think would aid this. The first is to have funds available on some sort of FHA basis to be loaned at regular interest but for long periods so that clinics could build their own establishments. These loans should be made without demanding any equity from the group because when a group of young doctors wants to start a clinic, they ordinarily have no savings to draw upon. All this money would be returned in time and there would be a minimum of risk of losing any of the mortgages. The second is to qualify groups in the same way as corporations so they, too, could withhold retirement and disability funds. If the group could be sure it could have a tax-exempt retirement plan, this would encourage group practice greatly. The limitations imposed by the Keogh amendments are so close that it does not permit a group of doctors to set up a really adequate retirement plan. Legislation should permit the group to put as much money as it thinks desirable into the retirement plan they set up. It is only fair to give the professional man the same opportunity as the businessman and would, in itself, be a considerable boost to group practice. In the long run, the encouragement of group practice will solve many of the problems of the supply and demand of medical practice. Sincerely. RUSSEL V. LEE, M.D., Consultant. Hon. WRIGHT PATMAN, MONTEFIORE HOSPITAL & MEDICAL CENTER, Banking and Currency Committee, Washington, D.C. DEAR REPRESENTATIVE PATMAN: I understand that your committee has under consideration at this time the matter of the development of group practices in the United States and the need for further encouraging such activities by the provision of Federal funds. Experience elsewhere in the United States as well as our own experience at Montefiore Hospital over the past 15 to 20 years with medical practices both on the solo fee-for-service basis as well as group practice leads us to the conclusion that in the interest of the public's health and in the interest of the economy of our health system, it is urgent that every conceivable method of encouraging the development of group practice should be undertaken. I shall address myself to the professional and health aspects of group practice as well as to the economic considerations. In the past 35 years, the growth of new knowledge in the health field has inevitably produced specialization, and this trend, if anything, is being accelerated as a torrent of new knowledge and new techniques become available to the medical profession. Eighty-five percent of the graduates of American medical schools are now going into specialty practice. This, of course, is a most wholesome and welcomed development, for it is this extraordinary infusion of science into medicine which extends such hope to the American people for longer and healthier life. Despite its promise of far superior medical care, specialty practice has the serious disadvantage that it tends to fragment the patient so that instead of receiving all of his care at the hands of one physician, today his proper care may involve two, three, or even more specialists. To overcome this fragmentation and make easily available to the patient all of the specialty services and to bring all the specialists in contact with one another, the best organizational device has been group practice, where in one place the patient can receive all the varieties of medical care which he requires, where the specialists, working with one another and sharing a single record, can provide for the patient all the benefits of specialty care without its disadvantage. While we don't usually think in these terms, all the great hospitals are in fact group practice activities, and certainly famous clinics such as the Mayo and Lahey clinics are demonstrations of the effectiveness of bringing various special |