and Oklahoma have a combined program, Georgia has a combined program. But, of course, they administer their public assistance to the blind under the Welfare and Vocational Rehabilitation, under the regular vocational rehabilitation program. If you ask me which is better, I could not answer you. I do not think there is any one way to do it. I think good work is done both ways and bad work also. Mr. NICHOLSON. Do you think that a commission could correlate all these things that we do for the blind in every State? Miss SWITZER. Sometimes it does. It depends on who is on the commission and how much they want to. I think that there has been some good work done in places where they have a commission and there has also been good work done in places where it is combined with something else. Mr. NICHOLSON. Could the Commission hire agents or whatever you may call them to contact different States? Miss SWITZER. They should, I think. Mr. NICHOLSON. And bring all that material? Miss SWITZER. They should. Mr. NICHOLSON. Is that in the bill? Miss SWITZER. Yes; it is in the bill and authorizes the Commission to have its own staff. I think both bills do that or should. I am sure it is Mr. Matthews' intention. It is spelled out in Mr. Wainwright's bill. Mr. WAINWRIGHT. It is in Mr. Matthews' bill, too. Miss SWITZER. I do not know whether Mr. Matthews' bill stipulates the staff director, but it is his intention that the Commission have a staff adequate to carry out its function. Mr. NICHOLSON. I am interested and I suppose everybody must be because we feel so helpless when we see a blind person and we wish we could do something. I suppose everybody has that feeling. I do not think a commission made up of Members of Congress can do the right kind of a job on it. We are here in August now and Lord knows how long we will be here. When we get through here, we are called on by constituents to do a hundred and one things. I should think if we are to have a commission, there ought to be no Members of Congress on it. Miss SWITZER. That would be entirely up to you people to decide, I would say. Mr. ELLIOTT. While we have you here, Miss Switzer, summarize for the record what we are doing in HEW now in connection with the blind. Miss SWITZER. First of all, we have the public-assistance aid to the blind, which is the largest program in terms of money. In 1956 about $73 million in Federal money was being expended for the support of 105,000 blind men and women, including money payments and medical care. That is the public assistance in the Social Security Administration. In the Public Health Service the National Institute for Neurological Diseases and Blindness has a number of research projects going on, and among the most significant is a continuing investigation into the retinoblastoma problem, cooperating with 75 outside investigators in 18 different hospitals. Most of the research that this institute is doing is directed toward diseases of the eye and their principal fields of current investigation include: Uveitis. This is a blinding disease caused by tuberculosis, syphilis, and brucellosis. Of course, glaucoma is one of our most serious causes of blindness. Then we have electronic investigations and allied techniques directed to early diag nosis and also to the compensation for the loss of sight. As to the amount of money that is represented in that spread, I do not know what it is, but I will supply it for the record because I think it should be in here. (The information referred to appears at close of witness' statement.) Miss SWITZER. As to the Children's Bureau, this is interesting and was rather surprising to me. It has no special activity at this time. It has, of course, some joint work going on with the States through its maternal and child health program. But the crippled children's program of the Children's Bureau does not include blind children. That is in itself an interesting fact. It has a few programs cooperat ing with the States for preschool blind children with the main emphasis on parent education. The Office of Education, which is primarily concerned at this stage in providing technical consultation to States, in compiling statistics on blind school population and in giving some expert advice on special education problems, but a minimum of work is going on in the field of blindness in the Office of Education. The American Printing House for the Blind, which is an agency under the Department, has an important program in connection with the blind. In the first place, it serves two groups of blind schoolchildren, students who attend special schools and classes and blind students who attend regular public schools and classes. It has about $328,000 to provide three Braille textbooks and other educational materials needed for the education of the Nation's blind children. In addition to doing this specific educational job, which is done on a pupil population ratio basis, it also does a large-scale Braille printing job. It prints the Reader's Digest, for example, in Braille and prints a great many books in Braille for which it gets paid. It makes talking books. Have you any idea of their total appropristion? Mr. AYCOCK. The total operating budget runs many times this amount. I do not have the exact figure. Miss SWITZER. We will put that figure in the record for you and perhaps additionally we would list exactly how the books are financed. Some are paid for, some are bought, some are subscribed to by schools, et cetera. You will get the fiscal picture. We will insert that in the record with your permission. (The information referred to appears at end of witness' statement.) Miss SWITZER. The Library of Congress has an important library function in the distribution of talking books. It arranges for the recording of the books, selection of the books, it circulates the machines and the records through regional libraries, usually public libraries located in different places throughout the country, and on an individual loan basis it makes available talking books to blind people. Of course, the Veterans' Administration has a program for blind veterans and a center for blind veterans at Hines Hospital in Chicago The President's Committee under the chairmanship of General Maas takes some responsibility for the encouragement of the employment of rehabilitated and properly trained blind people. The armed services would have a limited acute medical program for victims of accident or disease that would cause blindness while in the armed services. I think I have covered the ground pretty fully. Mr. Aycock. In addition, another Federal activity is the WagnerO'Day program of the purchase of blind-made products by Federal agencies, which gives certain preferential consideration for items made and certified as blind-made products. Mr. WAINWRIGHT. Like brooms? Mr. Aycock. Brooms, mops, a large number of items. Miss SWITZER. I think that is everything I can think of. Mr. ELLIOTT. Did you include the Randolph-Sheppard matter? Miss SWITZER. We included that as part of the program of the Office of Vocational Rehabilitation. If I have any other thoughts when I look over the testimony, I will insert them. Mr. ELLIOTT. Thank you very much, Miss Switzer. As usual, your testimony has been very edifying. Miss SWITZER. We do well when we are in a friendly and constructive atmosphere, Mr. Chairman. You have been so wonderful to us, you and your committee. We like to come down and tell you our story. (Information referred to earlier in witness' statement follows:) Hon. CARL ELLIOTT, Chairman, Subcommittee on Special Education, House Committee on Education and Labor, House of Representatives, Washington, D. C. DEAR MR. CHAIRMAN: This letter is in response to your oral request at the hearings on H. R. 1955 and H. R. 8427 held on July 31, 1957, for additional information with respect to the American Printing House for the Blind, and the National institute of Neurological Diseases and Blindness. The American Printing House for the Blind is a nonprofit educational institution located in Louisville, Ky. Each year the printing house receives Federal appropriations to be used to provide free braille textbooks and other educational materials needed for the education of the Nation's blind children. The printing house serves two groups of blind schoolchildren. Educational materials are provided (1) to students who attend special schools and classes for the blind and (2) to blind students who attend regular public schools and classes. The latter group of students was brought within the program of the printing house by the enactment of Public Law 922 in the 84th Congress. The enrollment of blind pupils in the residential and public-school classes for the blind served by the printing house was 7,520 in fiscal year 1956 and 7,959 in fiscal year 1957. It is estimated that an enrollment of 9,650 will form the basis for distribution of materials under the 1958 appropriation. This enrollment includes 8,350 pupils attending specialized public schools and classes for the blind and 1,300 students enrolled in regular public schools and classes. In addition to a $10,000 permanent appropriation, the appropriations for the American Printing House for the Blind for the past 3 years have been as follows: Fiscal year: 1956 1957 1958. Appropriation $224, 000 230, 000 328, 000 We are informed by the Division of Business Operations of the National Institutes of Health that the following moneys appropriated to the National Institute of Neurological Diseases and Blindness have been obligated for eye research. us. If there is any additional information you desire, please do not hesitate to call Sincerely yours, E. E. FEREBEE, Acting Director. (Miss Switzer's prepared statement follows:) STATEMENT OF MARY E. SWITZER, DIRECTOR, OFFICE OF VOCATIONAL REHABILITATION, UNITED STATES DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Mr. Chairman and members of the committee, I appreciate the opportunity to meet with you and to present the views of our Department on the two legislative proposals, H. R. 8427 and H. R. 1955. In this instance, we find ourselves in rather favorable circumstances, in that both legislative proposals have a common objec tive to examine, on a national basis, the problems relating to blindness and the needs of blind persons in an enlightened 20th century society. The two measures differ primarily in the breadth or scope of the proposed studies and the organizational mechanism by which the investigations would be undertaken. We are in full accord with the overall objective of both proposals. LEGISLATIVE INTEREST A national study of the needs of the blind and the services necessary to meet these needs has often been suggested. The American Foundation for the Blind. the American Association of Workers for the Blind, the National Federation of the Blind, and the American Association of Instructors of the Blind have jointly sponsored legislation in the last several sessions of Congress to provide for a national study of the problems, as a basis on which to plan to meet their needs. The investigation of the Subcommittee To Investigate Aid to the Physically Handicapped, House Committee on Labor (78th Cong.) in 1944-45, covering the whole field of disability, was one of the first congressional efforts to approach the study of blindness on a national scale. RANGE OF THE PROBLEMS As that study indicated, the problems of the blind are as broad and as varied as the problems of human affairs, for the blind represent all classes, conditions. and interests of our society. Any approach to their needs must be on a broad and comprehensive basis, permitting participation and advice from local, State, and national groups and individuals, with full attention to both voluntary and public programs which presently serve the blind directly or indirectly. In the structure of the Federal Government alone, we have a long list of agencies which presently are concerned with one or more phases of the needs of our blind citizens. A national study should be in a position to fully assess the present laws and programs for such agencies as the Veterans' Administration, the Library of Congress, the National Research Council-National Academy of Sciences and the several agencies which administer related provisions for taxes, transportation and other special services and benefits. In our Department of Health, Education, and Welfare alone, the breadth of interest and responsibility for serving blind is so extensive that it cuts across organizational lines and programs more or less constantly. Directly involved by law are the Office of Vocational Rehabilitation; the Public Health Service and its research arm, the National Institutes of Health, including especially the National Institute of Neurological Diseases and Blindness; the Office of Education; the Social Security Administration and its Bureaus of Old-Age and Survivors Insurance, Public Assistance, and Children's Bureau; and the federally aided American Printing House for the Blind. To provide this broad type of approach which would rejuvenate and modernize programs for the blind, which would stimulate greater interest and action among the resources of our medical, behavioral and social science research talent in the prevention and reduction of the handicapping effects of blindness and which would foster and stimulate a national atmosphere or social climate for developing a positive and realistic attitude, among the blind and the sighted, would in my opinion, require the basic administrative arrangement and organization authorized in H. R. 8427. NUMBER OF BLIND PERSONS The absolute number and distribution of blind persons throughout the United States presently is not known. Experts estimate that there are upward of 320,000 blind persons of all ages in the United States today. About 55 percent are males and 45 percent are females. In terms of age, there are several striking things which should be recognized. Available estimates indicate that about 79 percent of blind persons are over 40 years of age and 52 percent are over age 65. With the average age of our adult population expected to climb steadily for the next several years, and with blindness more prevalent among older persons, due primarily to such conditions as cataracts and glaucoma, we can expect, other things being equal, the number of blind persons to increase in proportion to the increase in the number of older persons in our population. On the other hand, conditions have occurred-and there is always the chance they might occur in the future which have a profound impact on the number of blind persons at any age level. Blindness identified as retrolental fibroplasia is a case in point. As a result of advances in medical science, the mortality rate among premature births has been greatly reduced in recent years. Unfortunately, there occurred during the same period, a startling increase in the incidence of blindness among babies born prematurely. Fortunately, researchers have discovered the cause the excessive oxygen intake and now the number of blind premature babies has been greatly reduced but not yet entirely eliminated. It is estimated that there are about 8,000 blind persons whose blindness is identified as retrolental fibroplasia. Therefore, whereas enrollment in schools for the blind and day classes for the blind had begun to decline, enrollment in the lower grades has increased. This also means that agencies should prepare in advance to meet the needs of this group as they approach adulthood. ATTITUDES The problem of blind persons in the United States cannot be measured in terms of numbers alone. It has been said that blindness has received more public and legislative attention, and that more money has been spent for services per capita, than for any other disability group. It should not be implied, however, that the amount of money spent on the problems of blindness has always been adequate, or that the services were always substantial and constructive. Most persons would agree that all handicapped persons should have available to them the services they need. Historically, the problem of blindness has been dealt with largely on an emotional basis, and until comparatively recent times, almost to the exclusion of any national consideration. As we know from history, it was considered ethical in our early culture to destroy the defective child. Only in recent years has the concept of reintegration into full participation in our society been given serious consideration. The interdependence of men upon each other and the highly mechanized industrialization which characterizes our society have removed in large measure the physical obstacles to complete participation. The barriers that now remain lie largely in the minds of both blind and seeing men. Much progress has been made. But more must be done if blind persons are to fully share and participate in this 20th century society. Many blind persons, without fanfare, take responsible places in society in such a successful manner that they are known by those about them for their personalities and their abilities rather than for their single point of difference. For the majority, however, many doors remain closed. The accumulation of centuries of historical attitudes is still with us in varying degrees and in various persons. The attitudes of parents of blind children, persons with blind neighbors, teachers, employers, and the public at large range from complete and intelligent understanding, to traumatic and overtly expressed sympathy, to rejection which is as primitive as any recorded in history. Rejection is usually subtle and disguised, which serves only to complicate the situation. |