Additional material submitted for the record by American Nurses' Association, Inc., Eileen M. Jacobi, Ed. D., R.N., Committee to Preserve Community Mental Health and Retardation Page 178 177 140 Community Coalition, Inc., Brooklyn, N.Y., addendum to the state- 147 Additions to community mental health centers by family income, 9 Construction grants without staffing grants---. 15 Correlation between State mental hospitals and community 8 Decline in resident population of the State hospitals number and 7 29 Statistics bearing on CMHC program objective: decrease the in- 9 Interstate and Foreign Commerce Committee: Resolution of the Senate of the Indiana General Assembly, sub- Kentucky Department of Mental Health: Attachments to Dr. Farabee's prepared statement: Exhibit I-Results of integrated program between the com- 101 Exhibit II-Kentucky's experience with administrative 106 Exhibit III-Revenue chart____ 107 Letter dated May 18, 1973, from Dr. Farabee to Chairman Rogers 109 National Council of Community Mental Health Centers: Attachment 1-Approved unfunded Federal grants for 44 Attachment 2-CMHC staffing grant applications pending 45 General revenue sharing funds use by CMHC's, report of the 47 Letter dated May 18, 1973, from Jonas V. Morris, executive direc- New York State Department of Mental Hygiene, letter dated July 10, 1973, from Anthony Spellman, M.D., deputy commissioner, to Congressman James F. Hastings re recommendations for possible changes in the community mental health centers legislation______ 123 ORGANIZATIONS REPRESENTED AT HEARINGS American Psychiatric Association, Dr. Robert J. Campbell, secretary Citizens United for the Handicapped, Max Schneier, vice president. Committee to Preserve Community Mental Health and Retardation Centers, Boro Park and Sunset Park, Brooklyn, N.Y., Edwin J. Cooper, chairman. Community Coalition, Inc., Brooklyn, N.Y., Madalene Sabino, chairman. Federation of Parents Organizations, New York State, Max Schneier, chairman. ORGANIZATIONS REPRESENTED AT HEARINGS-Continued Health, Education, and Welfare Department: Brown, Dr. Bertram S., Director, National Institute of Mental Health, Health Services and Mental Health Administration. Feldman, Dr. Saul, Associate Director for Community Mental Health Services, Health Services and Mental Health Administration. Zapp, Dr. John S., Deputy Assistant Secretary for Legislation (Health). Jamaica-South Flushing Mental Health Council, Queens, N.Y., Betty Still, chairman. Kentucky Association for Mental Health, Ashar S. Tullis, executive director. Kentucky Department of Mental Health, Dr. Dale H. Farabee, commissioner. Mental Health and Mental Retardation Authority of Harris County, Houston, Tex., John Carver, Ph. D., executive director. National Association for Mental Health, Orion N. Hutchinson, Jr., chairman, Community Mental Health Centers Committee. National Council of Community Mental Health Centers: Carver, John, Ph. D., executive director. Mental Health-Mental Retardation Authority of Harris County, Houston, Tex. Diamond, Dr. Herbert, medical director, West Philadelphia, Pa. Community Mental Health Consortium. Ediger, Elmer, administrator, Prairie View Mental Health Center, Newton, Kans. Hart, Dr. William, director, Rochester Mental Health Center, Rochester, N.Y. Morris, Jonas V., executive director, National Council of Community Mental Health Centers. New York Citizens Against Mental Illness, Irving Blumberg, executive director. New York City Department of Mental Health and Mental Retardation Services, Dr. June J. Christmas, commissioner. New York State Association of Community Mental Health Boards, Carman Santor, president. New York State Department of Mental Hygiene, Dr. Alan D. Miller, commissioner. Prairie View Mental Health Center, Newton, Kans., Elmer Ediger, administrator. Rochester Mental Health Center, Rochester, N.Y., Dr. William Hart, director. Washington Heights-West Harelm-Inwood Mental Health Center: Hatcher, William H., chairman of the board. Paster, Dr. Vera, executive director. West Philadelphia, Pa. Community Mental Health Consortium, Dr. Herbert Diamond, medical director. COMMUNITY MENTAL HEALTH CENTERS OVERSIGHT WEDNESDAY, MAY 9, 1973 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT, The subcommittee met at 10 a.m., pursuant to notice, in room 2218, Rayburn House Office Building, Hon. Paul G. Rogers, chairman, presiding. Mr. ROGERS. The subcommittee will come to order, please. This morning the Subcommittee on Public Health and Environment is conducting oversight hearings on community mental health centers, a program initiated by the Congress in 1963. The original goal of the program was the establishment of 2,000 federally supported community mental health centers in virtually every geographical area of the United States in order to cover the population of this Nation. Although the goal of the number of centers needed has been changed from 2,000 to 1,500, the original goal of the legislation-that every citizen of the United States have access to the services of a community mental health center, initiated, if necessary, with Federal assistancehas not changed. This goal is now one-third complete, as there are approximately 500 centers in existence. As you know, the budget recommendations of the present administration call for termination of Federal seed money for the construction and initial staffing of new centers. The rationale for this recommendation appears to be based on the assumption that the community mental health centers program was a demonstration program. As one of the principal authors of the original legislation, I want it to be clear at the outset of this hearing that the community mental health centers program was never intended to be a demonstration program, and any arguments to that effect have been effectively refuted during previous hearings conducted by this subcommittee and the Senate Health Subcommittee. Most importantly, the legislative history of the Community Mental Health Centers Act refutes this claim. Although the funding of individual programs was to be limited to a certain number of years, the number of newly initiated centers to be federally supported has always been fixed at the number necessary to cover the population of the United States. This morning we will hear from representatives of the Department of Health, Education, and Welfare and a panel of directors of community mental health centers. (1) Our first witness is Dr. John S. Zapp, Deputy Assistant Secretary for Legislation (Health), Department of Health, Education, and Weifare, accompanied by Dr. Bertram Brown, Director of the National Institute of Mental Health, and Dr. Saul Feldman, Associate Director, Division of Mental Health Service Programs at NIMH. We welcome you gentlemen to the committee and will be pleased to receive your statement. STATEMENT OF DR. JOHN S. ZAPP, DEPUTY ASSISTANT SECRETARY FOR LEGISLATION (HEALTH), DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY DR. BERTRAM S. BROWN, DIRECTOR, NATIONAL INSTITUTE OF MENTAL HEALTH, HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION; AND DR. SAUL FELDMAN, ASSOCIATE DIRECTOR FOR COMMUNITY MENTAL HEALTH SERVICES, HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION Dr. ZAPP. Thank you, Mr. Chairman and members of the committee. My testimony today will be brief, as this subcommittee has had a continuing interest and involvement in the community mental health program. There thus is no need for me to restress the acknowledged value of community-based care as opposed to isolated institutionalized treatment. ADMINISTRATION'S HEALTH STRATEGY We have not felt, in developing our present health strategy, that our only choice is to cling to the patterns of the past. Instead, we have tried to define carefully a proper Federal role in health and then to measure various individual proposals for Federal intervention in terms of this definition. Briefly, as we have discussed previously with this subcommittee, we feel that first priority should be placed on reducing financial barriers that limit access to needed health services. This is primarily accomplished now through the medicare and medicaid programs; it will be furthered by enactment of a sound national health insurance program on which we will soon be making our recommendations to Congress. While we are not in a position to discuss the details of our still-developing proposal, we can state at this time that it will have a mental health component. In our view, Federal support should also be provided for health and medical research and many preventive health and consumer protection activities are appropriate Federal concerns in the collective national interest. A more limited Federal role and increased reliance on the capabilities of local public and private sectors are, however, indicated in certain other situations, such as the demonstration of new facilities or services or startup funding for their establishment. Any such programs should be time-limited and should incorporate from the outset feasible plans for permanent takeover financing from alternate sources. This strategy reflects our conviction, as expressed by Secretary Weinberger before this subcommittee on March 1 and again on March 29 of this year, that not every worthwhile health program can automatically become or remain the financial responsibility of the Federal Government if we accept our obligation to maintain a fiscally sound Federal budget. |
