DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Hon. EDWARD M. KENNEDY, DEAR SENATOR KENNEDY: I am very pleased to send the attached material in response to the questions you raised in your letter of March 31, 1965, about the significance of the proposals made in S. 1525, the Vocational Rehabilitation Act Amendments of 1965, particularly in relation to advancing services for the mentally retarded. These proposals in S. 1525 have great potential for opening the gates of services for the retarded. We appreciate the wonderful interest you and the other members of the Subcommittee on Health showed during the hearings on S. 1525. I particularly appreciate your sustained interest in improving the rehabilitation of mentally retarded people. Sincerely yours, Enclosure. MARY E. SWITZER, Commissioner. S. 1525 AND SIGNIFICANCE FOR THE MENTALLY RETARDED QUESTIONS AND ANSWERS 1. The record shows truly impressive progress in rehabilitating the mentally retarded to employment, to the point where last year over 7,000 retarded were rehabilitated. On the basis of this experience, what have proved to be the benefits of rehabilitating this group of the disabled? What have you found to be the main problems? What are the reasons for our reaching so few of the vast number of retarded persons who could well benefit from vocational rehabilitation services? The significant progress vocational rehabilitation has made in delivering services to increasing numbers of the mentally retarded is the result of a combination of investments. From research and demonstration have come new techniques for serving the retarded, and demonstrations such as the nationwide series of projects to demonstrate the effectiveness of occupational training centers and the values of introducing work-training content and counseling services in school settings to facilitate the transition from school to work. Special research and training centers for mental retardation at the University of Wisconsin and the University of Texas were started this year. From the training grant program have come special efforts to train rehabilitation professionals in working with the mentally retarded, particularly for persons preparing for rehabilitation counseling and for counselors already employed by State rehabilitation agencies. From the State rehabilitation agencies have come the development of special programs conducted with local public education agencies; the assignment of special counselors to work with the mentally retarded, often in the larger metropolitan areas; the establishment of rehabilitation facilities in State institutions for the mentally retarded; and generally heightened activity to reach more of this comparatively neglected disability group. Among those rehabilitated in 1963, whose major handicap was retardation, the following point up some of the benefits to the Nation, the families, and the individuals themselves: Before rehabilitation services, three-quarters were primarily dependent on family and friends for support. Almost a fifth were being supported by public funds. Approximately 90 percent were not earning wages. After rehabilitation, approximately 40 percent entered service-type occupations; 20 percent entered unskilled occupations; and 17 percent became semiskilled employees. As many as 8 percent became clerical and sales employees; another 8 percent became skilled employees. Additional benefits are the taxes paid to Federal, State, and local governments by the retarded person following successful rehabilitation. Of inestimable value of course is the release of the family from the anxiety and the drain that a dependent mentally retarded member ordinarily means. The major problems remaining are these: 1. We need to extend services to more of the retarded, applying techniques we have already proved. 2. We need to find out how to reach the more severely retarded effectively. 3. We need to build more resources for delivering services; i.e., primarily (1) more trained people in the professions engaged in rehabilitation and (2) more facilities; such as, rehabilitation centers, workshops, and occupational training centers. 4. We need (1) large-scale effort to identify and open up new lines of job opportunities for the retarded, in cooperation with other public and voluntary agencies; such as, the President's Committee on Employment of the Handicapped, the Employment Service, and the National Association for Retarded Children, and (2) an aggressive public education program on the employability of the retarded. 2. Section 2 of the bill takes a new and progressive approach in investigating the potential of the retarded and the ways in which to determine such potential under the vocational rehabilitation system. How many mentally retarded will be involved under the program in section 2 during the first year? What estimate can you make of the number of retarded who would finally need this service? Even with the services proposed under this bill, how else are we to meet the real need? With this new authority, which includes more generous Federal financing than the regular formula program provides (75 percent matching), State agencies will be willing and able to take on many more of the difficult cases where the outcome of rehabilitation is so hard to predict. In the first year of this new authorization, fiscal year 1967, we have estimated that from 11,000 to 13,000 mentally retarded persons would be evaluated under this section. Our first objective is to reach the point where the number of mentally retarded being rehabilitated each year equals the number of new cases coming into the picture each year. This means reaching a point where about 36,000 mentally retarded are being rehabilitated annually. Then we can move into the backlog which is estimated at about 1 million. 3. What is the relation between the proposals made in S. 1525 and the President's program on mental retardation? The proposals for legislation made by the President's Panel on Mental Retardation have been accomplished except for those involving vocational rehabilitation. S. 1525 would complete this last step. 4. Plainly the improvements this bill would bring into the total rehabilitation program would advance the rehabilitation of the mentally retarded. Does this bill make any proposals which specifically mention the retarded? Yes. One proposal would authorize vocational evaluation services up to 18 months for the retarded (instead of the 6 months authorized for persons with other handicaps). S. 1525 also contains a special provision in the construction of rehabilitation facilities, to permit pilot projects involving residential accommodations in the case of worskops for mentally retarded individuals. This is a special provision, for, under present authority in sections 2 and 3 of the Vocational Rehabilitation Act, dormitory space in connection with workshops has been precluded. We expect this to be of particular importance in the rehabilitation of the mentally retarded who are without families. 5. S. 1525 makes various proposals for workshop construction and improvement. In what ways will these provisions benefit the mentally retarded? The set of workshop proposals in S. 1525 will be especially important in accelerating the delivery of better services to more of the retarded. First, there is the new authority for grants for construction of workshops and rehabilitation facilities. These grants for construction, alteration, initial equipment, and initial staffing would go to public and nonprofit organizations. We expect a sizable proportion of these grants to go to organizations serving the mentally retarded. Second, the workshop improvement grants and particularly the grants for training services in workshops for the handicapped, including training allowances, will also bring substantial strengthening to the workshop as an effective resource for the rehabilitation of the mentally retarded. Third, there is the provision for residential accommodations at workshops for the retarded which has been mentioned above. The net effect of this set of proposals will be a significant increase in the number of slots or stations in workshops for (1) training mentally retarded individuals and (2) maintaining them in sheltered employment for a period before they go on into competitive employment. 6. What does the Administration have in mind in the proposed projects for expansion of services? These project grants would be a flexible authority, quickly responsive to special program emphases. In the State vocational rehabilitation programs, for example, there has been a strong growth in joint projects with special education. efter to give the retarded counseling and work training and experience as preparation for the transition from school to work. With ecsetment of S. 1525, we expect to approach this through an organized series of projects of this nature, to bring more services to the retarded 7. Does the provision in S. 1525 for statewide planning for vocational rehabili tation services have a bearing on planning for mental retardation activities? Yes. This provision is designed to provide for the statewide planning involved in the orderly development of rehabilitation servioss, patile and private, with the objective in each State of making vocational rehabilitation services available to au payssly and mentaly ban tapped individuals in the State needing servises, by July 1, 1975. It is intended that this planning will complement and be fully consistent with the planning done in the mental retardation area. State vocational rehabilitation agencies have participated in the States' retardation planning 3. The various new authorities and new programs will mean n-▼ dentands for trained persons in the many professions involved in providing rehabilitation services. Have you taken this into account in making these proposals in S. 1525? We have assumed the continued growth of appropriations for the rehabilitation training grant program. By helping training programs expand and by financial Besistance to students, the VRA training program increases the supply of profes#ional personnel in fields involved in the rehabilitation of disabled persons and attacks the problem of manpower shortages in these felis. In addition. VRA hopes to utilize professional manpower effectively through the training and preparation of subprofessional personnel. To meet this need. VRA is already supporting the preparation of occupational therapy assistants and the associate in arts program for prosthetic-orthotie technicians. We are also giving increasing emphasis to recruitment programs for rehabilitation personnel to provide the rehabilitation services and man the facilities recommended in S. 1525, including summer and vacation work experiences for young people with a potential interest in the field of rehabilitation. In connection with the proposals in S. 1525, we are making plans to develop a concerted drive on training staf particularly for the workshops where there will be a sharp rise in needs. STATEMENT OF HON. JOSEPH M. MONTOYA, A U.S. SENATOR FROM THE STATE OF NEW MEXICO, ON PROPOSED AMENDMENTS TO THE VOCATIONAL REHABILITATION ACT. S. 1525 Senator MONTOYA. The proposed amendments to the Vocational Rehabilitation Act give us today the chance to make sure that the Great Society is not a great farce for the hundreds of thousands of men and women in this country who, through no fault of their own, are forced to spend their lives in a half-world of pain and hopelessness. I feel it is incumbent upon the U.S. Congress to enact these amendments so that we may provide the medical assistance, training, and other services necessary to help the chronically ill and crippled to become useful and productive citizens. This expanded vocational rehabilitation program will reach new thousands and give to them-often for the first time in their lives-a sense of hope and a feeling of independence and pride. For many of them, this will be their first real chance to become part of the world in which they live, and to contribute to it. The proposals of S. 1525 build upon a foundation of proven programs. This measure would expand services which are already aiding 120,000 handicapped Americans every year. In New Mexico during the fiscal year 1964, 1.143 men and women were given vocational rehabilitation, and of these, 360 cases were marked "completed." That means these people went to work in productive employment, leaving the welfare rolls and becoming full partners in their society. This is a continuing program, and more of that 1,143 are achieving the same goal every day. The new goal, as outlined in S. 1525, is to aid 200,000 annually throughout the Nation. In view of the know-how and skilled manpower which already exists at both the Federal and State levels, I feel this should not be difficult to attain. Nor should the long-range objective of reaching all the handicapped who need help by the year 1975. There are several new departures in S. 1525 which I think are worthy of special mention. One would permit the Federal Government to match, dollar for dollar, local and county programs, instead of requiring all funds to be State-appropriated as the present law does. This amendment will thus permit more rapid program development, particularly in areas where local agencies are ahead of the States in planning for the handicapped. To me, one of the more important goals of this new legislation is the effort to adapt public buildings to the needs of handicapped citizens. We who are fortunate enough to be whole do not realize the barriers which conventional building design erects against the handicapped. A heavy door can be an insurmountable obstacle for a person on crutches or suffering from a heart condition. Few public buildings have ramps for wheelchair ingress, and I have never seen a building with a drinking fountain low enough to accommodate a person in a wheelchair. This bill proposes a National Commission on Architectural Barriers with the specific mission of creating awareness of these problems by architects and the construction industry. If the Commission does its work well, this "segregation by structure" can be eliminated. Architects I have talked to are always willing to do what they can for the handicapped, once the problem is brought to their attention. In summary, S. 1525 is the administration's program to bring the Great Society to the handicapped of this Nation. Let us not let this opportunity escape. Let us act now to help those less fortunate to enjoy the many benefits America offers. NEW YORK, N.Y., March 30, 1965. Hon. LISTER HILL, The National Association for Mental Health strongly supports S. 1525, the Vocational Rehabilitation Act Amendments of 1965, aimed at providing expanded and improved vocational rehabilitation services for the severely handicapped, including the mentally ill. The value of rehabilitation services, not only to the mentally ill themselves, but to the community, has been fully demonstrated. The proposed measure, in providing for sorely needed expanded and improved vocational rehabilitation services, represents a sound investment in the public good. We urge favorable action by your committee on this bill. PHILIP RYAN, Executive Director, National Association for Mental Health. Senator LISTer Hill, CHICAGO, ILL., March 29, 1965. We understand your bill S. 1525 is before the Senate and hearings are being conducted by your subcommittee. We urge enactment of this proposed legislation. It will be most beneficial in the vocational rehabilitation of the handicapped and disabled. GOODWILL INDUSTRIES OF CHICAGO & COOK COUNTY B. STUART WEYFORTH, Jr. President. Senator LISTER HILL, Senate Office Building, Washington, D.C.: KANSAS CITY, Mo., March 29, 1965. Understand hearings being held S. 1525. Hope this bill can be passed. Is desperately needed. KANSAS CITY GOODWILL INDUSTRIES, Executive Director, HARTFORD, CONN., March 29, 1965. Hon. LISTER HILL, Chairman, Labor and Public Welfare Committee, U.S. Senate, Washington, D.C.: Deeply appreciate your fine support Senate bill 1525, amendment to Vocational Rehabilitation Act. Senator LISTER HILL, Senate Office Building, Washington, D.C.: CONNECTICUT ASSOCIATION FOR RETARDED CHILDREN, HENRY P. DART, President. Ann Switzer, Executive Director. HARTFORD, CONN., March 29, 1965. American Psychiatric Association strongly supports Vocational Rehabilitation Act amendments, Senate bill 1525. Believe it an excellent and essential measure to give sufficient time to rehabilitate distressed patients. Our work with sick and injured is not finished until we have returned them to home and loved ones and made as many as possible self-supporting. This bill will help attain that end. FRANCIS J. BRACELAND, Chairman, Committee on Principles and Practices. NEW YORK, N. Y., March 29, 1965. Senator LISTER HILL, United Cerebral Palsy respectfully registers its request for favorable action on the vocational rehabilitation amendments for 1965 Senate bill 1525. The passage of this bill will have a profound effect on rehabilitation services for adults with cerebral palsy. For years to come the extended period of evaluation will be of immeasurable benefit to them if there is a reasonable chance they may become employable. The present law has worked untold hardships for adults with cerebral palsy. WHITNEY R. KERCHNER, President, United Cerebral Palsy Associations, Inc. |