x . j o da qose ee [COMMITTEE PRINT] NOTICE.—-This report is given out subject to release when con- sideration of the bill which it accompanies has been completed by the whole committee. Please check on such action before release in order to be advised of any changes. 8irm Conaress HOUSE OF REPRESENTATIVES Report Ist Session No. DEPARTMENTS OF LABOR, AND HEALTH, EDUCATION, AND WELFARE, AND RELATED AGENCIES APPROPRI- ATION BILL, 1962 May 15, 1961.—Committed to the Committee of the Whole House on the State of the Union and ordered to be printed Mr. Foearry, from the Committee on Appropriations, submitted the following REPORT [To accompany H.R. ——]j The Committee on Appropriations submits the following report in explanation of the accompanying bill making appropriations for the Departments of Labor, and Health, Education, and Welfare (except Indian health activities), the National Labor Relations Board, the National Mediation Board, including the National Railroad Adjust- ment Board, the Railroad Retirement Board, the Federal Mediation and Conciliation Service, the Interstate Commission on the Potomac River Basin, and the United States Soldiers’ Home. The budget estimates forming the primary bases of consideration by the Committee will be found in the budget for 1962 on the following pages: Pages Department of Labor. _...-.-_--------2 eile 813 to 838, inclusive Department of Health, Education, and Welfare.____.____ 619 to 698, inclusive National Labor Relations Board...-...222222 184 and 185 National Mediation Board_.____..22.-22..--_-_-u Lo. 185 and 186 Railroad Retirement Board___-...---..-_--- eee 189 Federal Mediation and Conciliation Service__....__....__. 163 and 164 Interstate Commission on the Potomac River Basin... .__ 175 United States Soldiers’ Home. ___-__..-_-.2 602 and 603 68893—61——__1 2 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Additional budget estimates for the Department of Labor will be: found in budget amendments contained in House document 108, and - for the Department of Health, Education, and Welfare will be found. in Budget amendments contained in House document 104 and in. House document 133. The detailed tabulation at the end of this report reflects each. amount included in the bill for 1962, the corresponding budget: estimate, and the amount available for the fiscal year 1961 with. appropriate comparisons. SUMMARY OF ESTIMATES AND APPROPRIATIONS The following table compares, on a summary basis, the appropria- tions for 1961, the requests for 1962, and the amounts carried in the bill: Bill compared with— Approptia- Budget esti- Department or agency tions, 1961 mates, 1962 | Bill for 1962 Appropria- | Budget esti- tions, 1961 mates, 1962 Department of Labor.....-.-| $1, 074, 560,860 $285, 292, 000 | $283, 113, 000 | —$791, 447, 800 |—$2, 179, 000 Department of Health, Edu- eation, and Welfare..-.----- 8, 869, 867, 181 [3, 971, 979, 081 |4, 020, 184, 000 +150, 266, 869 |+-48, 154, 919 National Labor Relations Board. _-.-------------- 18, 218, 000 18, 880, 000 18, 218, 000 |_.-.-.---------- —667, 000 National Mediation Board __- 1, 604, 000 1, 604, 000 1, 604,000 |..-.-.----------|------------- Railroad Retirement Board: . Salaries and expenses__.__ {9, 785, 000] [9, 740, 000] [9, 746, 000] (—48, 000] |{-------..-. j Payment to Railroad un- employment insurance account __-._---------... 20, 000, 000 |_..-----.--..~|------~.------ —20, 000,000 |___- ~~ eee _ Federal Mediation and Con- ciliation Service__-_-.------- 4, 166, 400 4, 388, 000 4, 388, 000 +221, 600 |.---------- Interstate Commission on the Potomac River Basin... ...- United States Soldiers’ Home_ [4-388, 600} | [- —660, 959, 381 |4-45, 308, 919 5, 000 (6, 052, 000] 4, 827, 457, 000 5, 000 [6, 062, 000] 4, 282, 148, 081, 5, 000 [6, 664, 000] 4, 988, 416, 331 TRAINING For the last several years the Committee has encouraged, especially the Department of Labor, to institute a really effective program for the training of men and women for skilled industrial jobs. This is especially important in areas where automation, migration of industry, and other economic factors have raised unemployment to high levels. While such a program is needed to relieve unemployment, the relief of unemployment is far from being the only factor involved. We have the situation today where large numbers are unemployed and at the same time there is a large unfilled demand for people skilled in certain industrial activities. Anyone who doubts that situation. exists has only to look at the many columns of help-wanted ads in the Sunday edition of any metropolitan newspaper. Thus we have: a, perhaps equally important, problem of meeting an existing demand for much needed, skilled people. This year the Committee has decided to quit just talking about. this problem and has included funds in the bill to start really doing something about it. Funds are included in the Secretary of Labor’s Office to supervise and coordinate the program in the Department. of Labor. Funds are included in the Bureau of Labor Statistics to make a study of the problems resulting from automation. The Com- mittee has approved the small increase requested for the promotion. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 3 of industrial training programs in the Bureau of Apprenticeship and Training and, in addition, has recommended an increase of $500,000 over the budget to enable this Bureau to staff up to the level necessary to do a really effective job. The Committee has increased by $1,000,000 the appropriation request for area vocational educational programs under the Defense Education Act and will expect that these programs be encouraged to follow the lines that will result in maximum contribution toward the solution of this problem. Finally the Com- mittee has recommended an increase, over the budget request, for the cooperative research program in the Office of Education, and will expect that a part of this increase be used to establish at least one demonstration project in the field of training, and of retraining per- sons displaced from their jobs in industry. . LEGISLATIVE PROVISIONS OF THE BILL Over a period of many years, going back far beyond the establish- ment of the Department of Health, Education, and Welfare, a few legislative provisions have been added to this bill practically every year. With very few exceptions these have been of relatively minor uaportance. They were usually for convenience or to correct small inequities that would otherwise exist and were not considered to be of sufficient importance to go to the legislative committee for additional legislation. Last September the Chairman of the Subcommittee in charge of this bill wrote to both Secretaries calling their attention to this situation and strongly urging that they review their respective portions of the Bill and request, through the proper legislative com- mittees, the enactment of substantive legislation to cover those pro- visions which they believe it is necessary to preserve. Both Secre- taries replied with indication of full cooperation in this matter. The. subject was brought up with each of the new Secretaries in connection with hearings on this bill and both agreed to follow through in the. matter. Since several of these provisions are important for efficient program. operations, it would not only prove embarrassing but would definitely effect programs in an adverse manner if they were suddenly deleted. Since time has not been sufficient for substantive legislation to be. enacted, the Committee has not deleted the old provisions this year. The Committee has however, disallowed additional legislative provi- sions requested in the budget for 1962, such as the authority to hire aliens for the National Library of Medicine, and the authority ‘to: reapportion funds among the states in a different manner than pre- scribed under the National Defense Education Act. TITLE I—DEPARTMENT OF LABOR OFFICE OF THE SECRETARY Salaries and expenses —The Bil includes $1,711,000, a reduction of $184,000 from the request, and a reduction of $158,800 frem the amount appropriated for fiscal year 1961. It should be noted how- ever, that the 1961 appropriation included $378,360 for the Inter- national Labor Affairs activities of the Department which are provided for in a separate appropriation: for 1962: On a comparable basis, after taking this and other adjustments into consideration, the 1962 appropriation recommended for Salaries and expenses, Office of the 4 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Secretary is $128,160 more than was appropriated for fiscal year 1961. The major item of increase is $70,000 for a staff to assist the Secretary to plan and coordinate programs of the Department dealing with problems brought about by increased automation. The major item of decrease from the request is $150,000 requested as the Department of Labor’s share of the cost of the President’s Advisory Committee on Labor-Management Policy established by Executive Order Number 10918, February 16, 1961. The proposal was that the Department of Labor and the Department of Commerce - jointly finance this Committee. This item was disallowed with the thought that the more orderly procedure would be to fully finance this Committee from one appropriation. Since this Committee is not the responsibility of any one agency of the Federal Government, the logical place for this appropriation would be in the Executive Office of the President. The Committee did not allow $27,450 re- quested for expenses heretofore borne by the Office of Civil and De- fense Mobilization. The Committee saw no good reason for changing the method of financing. The other reduction was $7,170 for an additional employee counselor in the Office of Personnel Adminis- tration. BUREAU OF LABOR-MANAGEMENT REPORTS Salaries and expenses.—The Bill includes $5,775,000, a reduction of $500,000 from the request, and an increase of $225,000 over the amount appropriated for fiscal year 1961. While there are backlogs in connec- tion with some activities carried on by this Bureau, the total workload has not reached the level originally anticipated. The Committee is convinced that the increase provided in the Bill will be sufficient to allow this Bureau to efficiently discharge its responsibilities. comeL BUREAU OF INTERNATIONAL LABOR AFFAIRS Salaries and expenses.—The bill includes $444,000, a reduction of $66,000 from the request, and an increase of $66,000 over the amount which was available for 1961. This Bureau integrates all international labor affairs activities with other agencies and provides departmental euidance for U.S. participation in the International Labor Organiza- tion. The Committee recognizes this as a very important respon- sibility but believes that the Bureau will be able to do a good job with the amount allowed. OFFICE OF THE SOLICITOR Salaries and expenses.—The Bill includes $3,616,000, the amount of the request, and an increase of $737,700 over the amount appro- priated for fiscal year 1961. However, activities currently being financed from another appropriation are being transferred to the Solicitor in 1962. These activities amount to $447,400. So, on a comparable basis, the increase for 1962 is $290,300. This increase was allowed in full in recognition of the fact that new legislation, in- cluding the recent amendments to the Fair Labor Standards Act, add considerably to the workload of this office. BUREAU OF LABOR STANDARDS Salaries and expenses —The Bill includes $3,208,000, the amount of the request, and $686,000 over the amount appropriated for fiscal LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 5 year 1961. The major increase is $537,200 for maritime safety work under the provisions of the Longshoremen’s and Harbor Workers’ Compensation Act, particularly under the 1958 amendments and the regulations which became effective September 17, 1960. Activities required of this Bureau by the Welfare and Pension Plans Disclosure Act cost approximately $500,000 per year. Secretary Mitchell stated that this act provides only “a shameful illusion” and “* * * no persuasive deterrent to those who wish to ignore its provi- sions, or to manipulate or embezzle funds.”” When asked his opinion of this statement Secretary Goldberg said “TI join in that statement 100 percent.” ‘The Committee does not like to see funds wasted and hopes that legislative action will be taken to correct this matter. BUREAU OF VETERANS’ REEMPLOYMENT RIGHTS Salaries and expenses —The Bill includes $633,000, the amount of the request, and $700 over the amount appropriated for fiscal year 1961. BUREAU OF APPRENTICESHIP AND TRAINING Salaries and expenses —The Bill includes $4,976,000, an increase of $500,000 over the request, and an increase of $647,000 over the amount appropriated for fiscal year 1961. The recommended increase includes approval of the requested increase of $147,000 aimed pri- marily at strengthening the Bureau’s support of the Department’s manpower program by providing staff and promotional materials to expand and improve training in industry. The Committee has added another $500,000 to initiate a really effective program of training. The Committee will expect that special emphasis be given to those areas of high unemployment due to increased automation, migration of industry, and other factors; and to those areas where serious shortages of properly trained personnel exist. BUREAU OF EMPLOYMENT SECURITY Appropriations recommended for this Bureau total approximately $800,000,000 less than the appropriations for 1961. The large reduc- tion is accounted for primarily by two facts. (1) A $500,000,000 supplemental appropriation for 1961 for payment to the Federal Extended Compensation Account. No consideration was given to an appropriation for 1962 since much better estimates of the need can be made after a few months of experience with the new program. (2) The 1960 amendments to the Social Security Act change the method of financing of both the State and Federal administrative expenses in connection with unemployment compensation and employ- ment service activities. Whereas in previous years a direct appropria- tion was made for these activities they will henceforward be fmanced from the Administration account in the Unemployment trust fund. This shift necessitated a supplemental appropriation of $268,000,000 to the Administration account in 1961. Due to the fact that tax receipts will be credited to this account during the year, the compara- ble appropriation necessary for 1962 is only $20,000,000. Limitation on salaries and expenses —The Bill provides for a limi- tation of $9,600,000, a reduction of $158,000 from the request, and an increase of $600,000 over the amount allowed for fiscal year 1961. 6 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS The increase is primarily to enable the Bureau to assist the States to expand and improve the employment service. Limitation on grants to States for unemployment compensation and employment service administration.—The Bill provides a limitation of $391,700,000, the amount of the request, and $31,700,000 over the amount provided for 1961. The net amount of the increase is almost entirely to enable the States to expand their employment services to meet the needs of unemployed workers and the needs of employers looking for qualified workers. The Committee has received complaints that in some areas these funds are being used to pay for help wanted advertising. While there may be a few instances where special circumstances would warrant such an expenditure of these funds, the Committee is con- vinced that, as a general rule, such use of these funds is not in keeping with the purpeses of the program. Help wanted advertising will not help the unemployed for they must report each week to the State Employment Service, and if there is a job open for which they quality they are referred. This is a requirement to continue receiving unemployment benefits. It would seem that the only purpose in advertising would be to attract already employed people. During the past few years consideration has been given to the erection of a new building to house the employment service and unemployment compensation activities for the District of Columbia. Plans have now progressed to the point where construction might begin in the near future. Testimony before the Committee shows that the present cost to the Government is $2.21 per square foot. The annual cost for the building planned to be erected at 6th and Pennsylvania Avenues is estimated to be $4.45 per square foot. With the increased cost to the taxpayer, the Committee recommends a delay in the construction of the building. Considerable construc- tion is presently being done in the District of Columbia, and the saving to the taxpayer in this instance certainly warrants further study. It was also stated that authorization might be required in order that a deed could be properly prepared. Advances to Employment security administration account, Unemploy- ment trust fund.—The Bill includes $20,000,000, the amount of the request, and $248,000,000 less than the amount appropriated for 1961. As explained above the decrease is accounted for by the fact that tax receipts credited to this account will be sufficient to cover most of the expenses which will be charged to the account in 1962. Unemployment compensation for Federal employees and €L-SETVICE men.—The Bill includes $147,000,000, the amount of the request, and $30,000,000 less than the amount appropriated for 1961. The reduc- tion represents the net effect of anticipated improvement in economic conditions, and a slight increase in some States in the benefit payments per individual. Compliance activities, Mexican Farm Labor Program.—The Bill includes $720,000, a reduction of $429,000 from the request, and $448,700 less than the amount appropriated for 1961. Since legisla- tion to extend the program has not yet been enacted, the Bill includes sufficient funds to continue this activity at its current level and pro- vides funds for liquidation of the program after December 31, Of course, if legislation is enacted to extend the program, it will be LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 7 necessary to consider the need for additional funds in connection with a subsequent supplemental appropriation. | Salaries and expenses, Mexican Farm Labor Program.—The Bill includes a limitation of $925,000 on the amount which can be used from the revolving fund, a reduction of $594,000 from the request, and $571,100 less than the amount provided for 1961. As in the ‘preceding item the amount in the Bill will provide for a continuation of activities at the current level and for funds to liquidate the program after December 31. The Committee has not allowed the request for two additional positions. BUREAU OF EMPLOYEES’ COMPENSATION Salaries and expenses.—The Bill includes $3,834,000, the amount of the request, and $402,200 over the amount appropriated for 1961. The major part of the increase is to provide additional staff and other related costs necessary to effectively carry out the plan for complete decentralization of activities under the Federal Employees’ Compen- sation Act. Experience with partial decentralization has convinced both the Department and the Committee that much more satisfactory service can be given on this basis. Employees’ compensation fund.—The Bill includes $64,000,000, a reduction of $1,500,000 from the request and an increase of $1,000,000 over the amount appropriated for 1961. The requested increase of $2,500,000 was based on the additional costs estimated to result from the 1960 amendments to the Federal Employees’ Compensation Act. Tt was testified that more refined estimates, available at the time of the hearings, indicated that the previous estimates were high by approximately $1,500,000. BUREAU OF LABOR STATISTICS Salaries and expenses..—The Bill includes $12,167,000, the amount of the request, and $1,049,000 over the amount appropriated for 1961. The amount recommended includes. an increase of $325,000, included in a budget amendment which is primarily for the purpose of enabling the Bureau of Labor Siatisties to undertake intensive studies on the impact of automation. The remaining increases were in the Presi- dent’s budget submitted in January. They are to insure better statistics in such areas as characteristics of the unemployed; labor turnover and employment, and industrial relations, all of which are in high demand by both management and labor. Also included in the regular budget was an increase of $100,000 to study the impact of foreign trade on employment in the United States. Revision of the Consumer Price Index.—The Bill includes $2,100,000, the amount of the request, and $778,000 over the amount appropriated for 1961. This will provide funds for the third year of a five year program to revise and bring up to date the very important Consumer Price Index. WOMEN’S BUREAU Salaries and expenses —The Bill includes $668,000, the amount of the request, and $114,100 over the amount appropriated for fiscal year 1961. $25,000 of the increase is for non-recurring work in 8 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS connection with the analysis and publication of 1960 census data relating to women workers. The balance of the increase was re- quested to provide for work in the fields of equal pay, child day care services, and automation. WAGE AND HOUR DIVISION Salaries and expenses-—The Bill includes $12,261,000, the amount of the request, and the same amount as was appropriated for 1961. In the course of the hearings, it was found that the Wage and Hour Division currently is not using any automobiles from General Services Administration pools. Many other agencies are doing this with consequent savings in travel costs. The Committee found that the Food and Drug Administration was using GSA pool cars at a cost of approximately two cents per mile less than the Wage and Hour Division is paying its employees for driving their personally owned automobiles. While it is realized that one must take into considera- tion many variations in travel requirements between. agencies, it is the desire of the Committee that a thorough study be made and that a shift to the use of GSA pool cars be instituted if it is found that a savings will result with no serious handicapping of necessary activities. TITLE TI—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE FOOD AND DRUG ADMINISTRATION Salaries and expenses.—The Bill includes $23,580,000, the amount of the request, and $4,732,000 over the amount appropriated for 1961. The budget was prepared in line with the recommendations of the Citizens Advisory Committee report which was made to the Sec- retary of Health, Education, and Welfare in 1955. This was an excellent Committee and they made an excellent report; however, as was pointed out in the report on the Labor-HEW Billi for 1961, this advisory committee’s report is now sadly out of date. There seems to be complete agreement on this by the Secretary’s Office, the Food and Drug Administration, and the experts in this field outside of the Federal Government. The Committee is therefore hopeful that a new study will be made without further delay. Pharmacology-animal laboratory building-—The Bill includes $1,750,- 000, the amount of the request, for construction of an animal and laboratory building necessary for the research program of the Food and Drug Administration. Plans and specifications are now being prepared for this building with the $100,000 appropriation made last year. FREEDMEN’S HOSPITAL Salaries and expenses.—The Bill includes $3,736,000, the amount of the request, and $238,400 over the amount appropriated for 1961. The major part of the increase is to cover the cost of opening the third floor of the annex building for short-term medical and surgical cases. This floor is not being used at the present time, and will pro- vide much needed relief from the frequently overcrowded conditions in the main hospital. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 9 OFFICE OF EDUCATION Promotion and further development of vocational education.—The Bill includes $33,672,000, a reduction of $81 from the request, and $30,081 less than the amount appropriated for 1961. $81 of the reduction represents simply a rounding of the figures, and $30,000 is a reduction provided for by the Hawaii Omnibus Act which terminated the special grant Hawau had previously received as a territory. Further endowment of colleges of agriculture and the mechanic aris.— The Bill includes $8,194,000, the amount of the request, and an in- crease of $5,692,500 over the amount appropriated for 1961. The 86th Congress amended the Bankhead-Jones Act of 1935 to increase the authorization to $11,950,000 in recognition of the increase in population and the increase in costs since the Act wes passed. While the amount recommended in the Bill is'a substantial increase it is $3,756,000 less than the new authorization. Grants for library services —The Bill includes $7,500,600, the amount of the request, and the same amount as was appropriated for 1961. For the smail amount of Federal funds involved this has been not only one of the most popular, but one of the most worthwhile pro- grams of the Federal Government. Since this program was insti- tuted, over 160 rural counties and an equal number of New England towns formerly without any public libraries are now receiving library service. More than 6,000,006 books and other informational materials have been added to the resources of rural communities. This has not been done just with the Federal funds. This program is a fine dem- onstration of Federal leadership, and the local interest and contribu- tions that can result from such leadership. Since this program started state funds for the development of rural public library service have in- soon 75% and local appropriations for rural libraries have increased 50%. While significant gains have been achieved there is still a big job which remains to be done in the whole field of library services. The Committee was rather disappointed to find that the Office of Educa- tion is not giving more attention to the study and assessment of the deficiencies that still exist. Payments to school districts —-The Bill includes $85,700,000, the amount of the request, and $131,600,000 below the amount appro- priated for 1961. The amount carried in the bill is estimated to be sufficient to cover 100% of the entitlements under the permanent provisions of Public Law 874. The temporary provisions expire at the end of fiscal year 1961. It will, therefore, be necessary to con- sider the need for additional funds, in connection with a supplemental appropriation bill, if legislation is enacted to extend some or all of the temporary provisions. Assistance for school construction.—The Bill includes $24,850,000 the amount of the request, and $38,542,000 less than the amount appro- priated for 1961. As in the previous item the amount carried in the Bill is estimated to be sufficient to cover all entitlements under the permanent provisions of the act. Defense educational activities.—The Bill includes $210,857,000, a reduction of $350,000 from the request, and $23,377,000 over the amount appropriated for 1961. The net decrease of $350,000 is composed of three items: (1) a decrease of $1,000,000 from the 68893—61—~-2 10 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS $22,762,000 requested for national defense fellowships, (2) a reduction of $350,000 from the $7,250,000 requested for institutes for counseling personnel, and (3) an imerease of $1,000,000 for area vocational education programs. The request for the latter program was $11,800,000 compared to the authorized ceiling of $15,000,000. It was testified that there is considerable doubt that the States would match more than the amount that was contained in the budget. The Committee is disappointed that the Office of Education has not taken a more active part in encouraging the expansion of this very important activity. The Committee feels certain that there is a sufficiently wide-spread recognition of the importance and need for training programs and for the retraining of workers displaced by automation, migration of industry and other economic developments, that there will be no difficulty in putting these additional funds to very effective use. Expansion of teaching in education of the mentally retarded.—The Bill includes $1,000,000, the amount of the request, and the same amount as was appropriated for fiscal year 1961. The Committee received impressive testimony on the possibilities for enlarging the program of assistance for teachers of. mentally retarded children to include teachers of children with speech and hearing defects. ‘The Committee believes that the broadening of the authorizing legislation to cover this area, together with the removal of the present limitation of $1 million on the annual expenditures for this program, should be considered by the legislative committee. Salaries and expenses—The Bill mcludes $11,364,000, a reduction of $5,641,060 from the request, and $2,511,000 less than the amount appropriated for 1961. It should be noted, however, that the budget submission included funds for the Cooperative Research Program whereas the latter is broken out as a separate appropriation in the Bill. On a comparable basis, the recommendation of the Committee represents a reduction of $500,000 from the budget request and an increase of $846,000 over the amount available for the same purposes in fiscal year 1961. It is the intention of the Committee that the reduction be applied primarily to the additional positions and related expense requested in the budget. This will mean a reduction of over 50% in the funds so budgeted. A large part of the increase requested. for other expenses and which is allowed by the Committee, will be for nonrecurring expenses such as the cost of special studies of the vocational education program by contract, and a considerable portion of the costs directly attributable to moving into the new building. The Office of Education has made real advances in activities im the field of mental retardation during the past few years. This has. been especially true under the cooperative research program. How- ever, the Committee is disappointed that this very important activity has not been given a more prominent place in the organizational structure of the office. The only place where this activity is identified is so far down that it does not even show in the justification material submitted to the Committee. The Committee feels that this activity is of enough importance, and is of enough interest throughout the Nation, that consideration should be given to designating an Assistant to the Commissioner to be in charge of the Office’s activities in_con- nection with retarded and other exceptional children, and children with speech and hearing defects. The Committee also thinks that LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Ii more attention should be given to the mentally retarded blind. . At the present time there are not even good estimates on how many children are in this category. Cooperative research—The Bill includes $5,500,000 for this activity which was previously carried as a part of the appropriation “Salaries and expenses.” The amount recommended represents an increase of $359,000 over the amount requested and an increase of $2,143,000 over the amount available for 1961. The Committee received excel- lent testimony from deans and professors of schools of education from all over the Nation demenstrating the worthwhile results which have already been secured through this program, and the expectations for much more significant benefits to be derived in the future if this relatively new program is permitted to develop properly. This program can play a very important part in the over all train- ing program that the Committee is developing this year. While the program is primarily a research activity, the authorizing legislation also provides for demonstration projects. The Committee will expect that at least one demonstration preject be established in the field of training. with special emphasis on retraining of workers displaced by automation, migration of industry, and other economic developments. The Committee is inclined to agree with the new Commissioner that increased emphasis should be placed on improvement of English cur- riculums and on the identification and encouragement of pupils whose abilities are not being effectively utilized. A request for additional funds for research in these areas was submitted te the House in a special amendment to the Budget. This portion of the increase was described as “directed research”. The Committee has approved the funds requested, but wishes to express its strong belief that no coop- erative research project applications should be funded unless evaluated and approved by the Research Advisory Committee. Salaries and expenses (special foreign currency program)—The Com- mittee has not allowed the budget request for $9,000 for this program, which compares with $30,750 appropriated for fiscal year 1961. The Committee doubts that sufficient information of value would be secured to warrant this appropriation, especially in consideration of the unusual administrative difficulties that go with any appropriation for programs using foreign currencies. OFFICE OF VOCATIONAL REHABILITATION Grants to States-—The bill includes $64,450,000, a reduction of $27,050,000 from the request, and $8,250,000 above the amount appropriated for 1961. The Budget included a recommendation to drop the provision for an allotment base separate from the amount appropriated and recommended an appropriation of the full $90,000,000 for section 2. Since there are many states that cannot match their allotment on the basis of $90,000,000 being available, the budget submission provided $27,050,000 more than would actually be obli- gated. This amount would have lapsed and been returned to the. ‘Treasury at the end of the fiscal year. The Bill includes an allotment base of $90,000,000 for section 2 grants. Thus the Committee action and the budget request would have the same end result; the only difference bemg that under the budget request we would appropriate approximately $27,000,000 that would not be used and under the Com- mittee action only the amount estimated to be used is appropriated. 12 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS This program, very deservingly, has received the full support of recent administrations without regard to personalities or any political implications. It has received equally strong support by the Congress. The result has been that during the past ten years we were able to help in the rehabilitation of more people than during the entire preceding thirty years—636,000 from 1950 through 1960 as against 589,000 from 1920 through 1950. Last year, through this program, 88,275 disabled men and women were returned to a useful working life, marking a new record for the fifth year in a row. This record will again be broken in 1961 with an estimated 96,000 rehabilitated. With the funds recommended in the Bill this number will again increase to an estimated 107,000 in 1962. While the Committee is not satisfied that this progress is as rapid or as great as it should be, real progress has been made. Research and training.—The bill includes $19,250,000, an increase of $2,000,000 over the amount requested, and $3,820,000 over the amount appropriated for fiscal year 1961. The $2,000,600 increase jis composed of $1,000,000 to expand the training program and thus help reduce the great shortage which exists of properly trained per- sonnel; and $1,000,000 to establish two regional institutes of re- habilitation. The Committee heard considerable testimony from outstanding leaders in the field of vocational rehabilitation which convinced the Committee of the need to inaugurate a program of regional institutes of rehabilitation to promote graduate medical education and medical research in the rehabilitation of physically handicapped persons. These institutes should be established in connection with medical schools which have developed a comprehensive program of undergraduate and graduate curricula in physical medicine and re- habilitation and provide comprehensive medical, psychological, social and vocational counseling and affiliated pre-vocational evaluation services for rehabilitation of physically handicapped patients. Such a program should establish formal arrangements for cooperation with a voluntary comprehensive rehabilitation center providing re- habilitation services on a regional basis in order to test and demon- strate how university, state, and voluntary agencies can cooperate to provide rehabilitation services. It is the aim of the Committee that this pilot program for regional institutes for rehabilitation be established to study the means of developing adequate facilities for graduate medical education and research which will be as comprehensive in support of the develop- ment of rehabilitation as the National Institutes of Health are in support of the categorical medical research programs. Research and training (special foreign currency program).—The bill includes $1,372,000, the amount of the request, and $442,000 more than the amount appropriated for fiscal year 1961. Salaries and expenses —The Dill includes $2,325,000, the amount of the request, and $366,000 more than the amount appropriated for fiscal year 1961. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 13 PUBLIC HEALTH SERVICH INFANT MORTALITY During the hearings it was brought to the attention of the Com- mittee that nine nations in the world have a lower infant mortality rate than the United States, and that the infant mortality rate in the United States has actually gone up during the last few years. In the opinion of. the Committee, the Public Health Service has not shown the concern that should be warranted by these facts. This isa probiem that needs to be dealt with not only by the medical research arm of the Public Heaith Service, but also by the Bureau of State Services. This is amply demonstrated by the variation in infant mortality between the States. The Children’s Bureau presented statistics showing that the rate varies from 20 per one thousand live births in the State with the lowest mortality rate to 43 in the State with the highest. Thus it is obvious that in many areas the medical knowledge that we already have is not being put mto practice. The Committee will expect that the Public Health Service make a thorough analysis of this problem and institute measures to correct it. While the Children’s Bureau has already indicated considerable concern, the Committee will expect that they, too, intensiZy their . efforts in attacking this problem. APPROPRIATION STRUCTURE The budget proposed many transfers of activities between appro- priations in the Public Health Service in an attempt to consolidate similar activities under the same appropriation. The Committee feels that a good job was done in this regard and has approved al! such transfers. The budget then went further and lumped together into six large appropriations ali of the activities of the Public Health Service which precede the National Institutes of Health in the order of the bill. During the past few years there has been considerable: dissatisfaction, both within the Congress and on the part of interested individuals and organizations, with the past appropriation structure because even it lumped too many activities under one appropriation. The Committee certainly could not approve an even further consolida- tion and has therefore broken up the six proposed appropriations. into eighteen appropriations thus setting forth, individually, such items as “‘Control of tuberculosis,” “Water supply and water pollution. control,’ “Nursing services and resources,” ‘Air pollution control,’” etc. Since the budget estimates for 1962 for this group of appropriations: were set up on a different appropriation structure than were the appropriations for 1961; and since the bill follows a structure different, from either, a comparison of the 1961 appropriations, 1962 estimates, and amounts carried in the bill is dificult. The following table shows, for each of the appropriation items included in that portion of the bill, the comparable amount included in 1961 appropriation, the compara- ble amount included in the 1962 President’s Budget, and the amount carried in the bill, with appropriate comparisons. 14 LABOR-HEALTH, HDUCATION, WELFARE APPROPRIATIONS 1961 com- Recom- Bill compared with— parable 1962 com- mended Appropriation item appropri- parable in bill for ations estimates 1962 1961 appro- 1962 esti- priations mates Buildings and facilities_____...-. $3, 470,000 | $16,630,000 | $16, 630,000 [4+-$13, 160,000 |.-.--...-.---- Accident prevention__.____...--- 2, 905, 300 8, 368, 000 3, 368, 000 +462, 700 |_.-2.--------- Chronic diseases and health of the aged____.----------~--.---. 1, 385, 800 3, 958, 000 8, 958, 000 ~+-2, 572, 400 Communicable disease activities _ 9, 930, 800 9, 778, 100 9, 778, 000 152, 900 Control of venereal diseases.____- 5, 814, 500 5, 814, 500 5, 815, 000 +500 Control of tuberculosis. _....---- 6, 493, 000 6, 498, 400 6, 493, 000 j..-----------. Community health practice and research..__...------------------ 28, 382, 000 24, 781, 000 23, 961, 000 +579 000 Dental services and resources Hospital construction activit Nursing services and resources __-_ Air pollution control__ Milk, food, interstate munity sanitation ._ 2, 092, 700 2, 182, 000 2, 182, 000 +89, 300 187, 936,000 | 187,972,000 | 187, 972, 000 +36, 000 |__-------.---- 7, 291, 800 7,375, 000 7, 875, 000 -£883, 200 +300, 000 7, 057, 100 8, 100, 000 8,600,000 | -F1, 542, 900 +500, 000 4, 547, 100 5, 604, 000 7,424,000 | -+2, 876, 900 +1, 820, 000 Occupational health_. - 3, 332, 600 3, 981, 000 3, 981, 000 +648, 400 |----.----.---. Radiological health..-------.---- 7, 680, 000 9, 147, 000 9,147,000 | +1, 487,000 }-...---.------ Water supply and water pollu- . tion control__-_...------------- 12, 058, 000 15, 028, 000 15, 028,000 | -+-2,970,000 |.------------- Grants for waste treatment works construction..__....-.-- 45, 000, 000 50, 000, 000 50, 000, 000 +5, 000,000 |-...---------- ‘Hospitals and medical care-_-_--- 48, 835, 000 49, 332, 000 49, 835, 000 +1, 000, 000 +503, 000 ‘Foreign quarantine activities_.__ 4, 948, 800 5, 150, 000 5, 850, 000 +401, 200 +200, 000 Buildings and facilities —The bill inciudes $16,630,000, the amount of the request, and $13,160,000 above the amount appropriated for fiscal year 1961. This appropriation covers several construction projects, by far the largest being $12,000,000 for the Communicable “Disease Center in Atianta. The Communicable Disease Center in Atlanta has a new building which was dedicated only a few months ago. The original plans for this building were drawn up over ten years ago. There is considerable question that they were adequate for the organization that then existed. On several occasions during the past several years the Com- mittee was critical of the Public Health Service for not revising the plans to bring them in line with current realities. However, in spite of the opposition of this Committee, the building was constructed in line with these sadly out-of-date plans under the ill-fated lease-purchase scheme. During the last several years the basic activities of the Communicable Disease Center have increased considerably. In addition to this, other activities previously carried_out elsewhere, have been consolidated with the Communicable Disease Center. The construction of the additional proposed facilities will enable the service to consolidate all of these activities, whieh are now located in four separate cities and many separate buildings, in one place and should result in considerably increasing the efficiency of operations. This Committee has long been concerned over the undue procrasti- nation and delay in the completion of projects for the construction of new facilities of the Public Health Service. Tt has been repeatedly necessary for the Committee to prod for the completion of these projects ‘in its reports on the appropriation bills. Among the many examples of this sorry situation are the Communicable Disease Center which took more than eight years to complete following ex- press criticism on the delay in moving forward in the Committee Report on the 1952 Bill; the Sanitary Engineering Center which took five years to complete; the Shiprock Indian Hospital project which the Committee noted in the report on the 1959 Bill had not moved LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 15 forward two and a half years after Congress appropriated funds for its construction; and the construction of the Dental Research Building for which submission of the budget proposal following completion of plans was so long delayed that the Congress had to act on its own to get the project underway. It now appears that the same pattern of delay and procrastination is being followed in connection with the proposed Environmental Health Center. The Congress appropriated $785,000 for the planning of an Environmental Health Center in the 1961 Act on the basis of testimony as to the importance of environmental health research needs and overcrowding at the Sanitary Engineering Center. However, the Committee was greatly surprised to find that witnesses had no progress to report and no funds have been obligated to date. Instead, witnesses reported using substitute measures such as temporary buildings and renting space and altering it to laboratory needs. The Committee regards this expedient as being necessary to enable long overdue work to go forward in the environmental health field but points out that such temporary measures are inefficient and costly aud urges that the planning and implementation for the permanent facilities go forward without delay. From. ail the information the Committee has been able to get, the Bureau of the Budget has been the main stumbling block. Accident prevention —The bill includes $3,368,000, the same amount as was included in the budget for this activity under the proposed appropriation item “Community health activities,” and $462,700 over the amount that is available in 1961. This activity has received far too little attention in the past in view of the gravity of the prob- lem. Accidents rank fourth in the leading causes of death in the United States and, for the age group 1 through 34, they are the leading cause of death. More productive manyears are lost by accidental death than by any other cause of death in the United States. Chronic diseases and health of the aged:-—The bill includes $3,958,000, the amount carried in the budget for these activities under the -pro- posed appropriation “Community health activities’, and $2,572,400 over the amount available in 1961 for similar activities. One of the really big problems of our Nation is the terrifically large bill for hospitalization and the bill gets bigger every year. The increase provided in the Bill is an attempt to do something about this problem. This increase is to finance an effort to aid and stimulate communities in the establishment of additional cooperative projects in community health services for the care of the aged sick at home. It is planned to give attention to such things as promoting development of more home nursing services, expansion and improvement of home ‘maker’s services, promotion and development of community infor- mation and referral service centers, and improvement of care given to residents of nursing homes. The Committee received a considerable amount of testimony both from governmental witnesses and from public witnesses that this type of activity will go far in reducing the terrific burden of hospital bills in the area of chronic diseases, which of course are most prevalent in our older pepulation group. Communicable disease activities —The bill includes $9,778,000, the amount requested for these activities in connection with the proposed appropriation “Community health activities,” and $152,900 under the amount available for fiscal year 1961. While the amount recom- 16 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS mended is a reduction from the amount available for these activities in 1961, there was a non-recurring item in 1961 of $1,000,000 for the purchase of live polio vaccine. Taking this ito consideration, there is actually an increase for basic activities which will be applied to such things as more work in the field of institutionally acquired infec- tions, especially those resistant to standard antibiotic treatment; epidemic services, including studies in connection with the use of live virus polio vaccine; activities aimed at developing faster and more accurate diagnosis for various diseases; etc. Community health practice and research.—The bill includes $23,961,- 000, a reduction of $820,000 from the amount requested fer these activities under the proposed appropriation item “Community health activities,” and $579,000 over the amount appropriated for these activities for 1961. The reduction is to be applied to grants to States for general health activities, which the budget proposed to increase from $17,000,000 in 1961 to $17,820,000 in 1962. Control of tuberculosis.—The bill includes $6,493,900, a reduction of $400 from the amount requested for this activity under the proposed appropriation item “Community health activities,” and the same amount as was appropriated for 1961. Control of venereal diseases—The Bill includes $5,815,000, an increase of $500 over the amount requested for these activities under the proposed appropriation item “Community health activities’, and $500 over the amount appropriated for 1961 for the same activities. The Committee is greatly disturbed as a result of the factual infor- mation received concerning the increase in venereal disease. While the full amount of the budget request is allowed, this will not do the work that needs to be done in this field. Work in this field is badly in need of reorganization. Syphilis is easily detected and in the early stages treatment is successiul and not difhcult. This is a disease that ought to be eliminated in the United States. However, this will not be accomplished until the Public Health Service and State Health Depart- ments attack it jointly and with a firm attitude. The money appro- priated by the Congress will be frittered away with little result if we continue in the same manner as we have during the last few years. Tt is ironic that more attention is paid to the control of foot and mouth disease in cattle and vesicular exanthema in hogs than we do to venereal disease which is affecting so many of our young people. The Committee has in the past urged more realistic control measures and continues to do so. Public Health people have a knowledge based upon facts. This knowledge must be converted into action. The Committee will expect the Public Health Service to have recom- mendations for an effective program when hearings are held next year. Dental services and resources.—The Bill includes $2,182,000, the same as the amount requested for these activities in the proposed appropria- tion item “Community health activities’, and $89,300 over the amount appropriated for these activities in fiscal year 1961. Nursing services and resources—-The Bill includes $7,675,000, $300,000 more than the budget request for these activities included in the proposed appropriation item. “Community health activities’, and $383,200 over the amount. appropriated for these activities for fiscal year 1961. While there is still a very serious shortage of trained nurses in many parts of the Nation, the budget provided for no increase in training grants. It is the desire of the Committee that the increase of $300,000 be applied to this purpose. This will increase LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 17 the amount of funds for training grants from $6,525,000 te $6,825,000. It is hoped by the Committee that additional emphasis will be placed on training in physical therapy. This training 1s important for the type of home care programs, discussed in connection with “Chronic diseases and health of the aged’, that could do much to reduce the great burden of hospital bills. Hospital construction activities —The Bill includes $187,972,000, the amount of the budget request, and $36,000 over the amount appro- priated for these activities for 1961. The amount carried in the Bill for construction purposes is $185,000,000, the same as the amount which is available in 1961. The remainder of the amount recom- mended in the Bill is $1,200,000 for hospital and medical facilities research and $1,772,000 for administrative expenses. Air pollution controlThe Bill includes $8,600,006, an increase of $500,000 over the ammount requested for these activities in connection with the proposed appropriation “Environmental health activities”, and $1,542,900 over the amount available in 1961 for the same activities. The increase is primarily fer research in connection with auto exhaust, which is generally recognized as the largest single problem in the area of air pollution. The problem of air pollution has been of major magnitude for many years and is growing every year. It is amazing that so little attention has been paid toit. According to a recent report, the annual economic losses from air pollution total $7 billion in the United States, or about $65 for every person. The health hazards are not definitely known. We do know that the 1952 London smog was blamed for the deaths of 4,000 people. We also know that in the 1948 Donora, Pennsylvania incident, air pollution caused the deaths of 20 and illness of 5,910 according to a study made at that time. While these are some of the currently measurable results, it is probable that the now immeasurable results are of far greater magnitude. We need to find out much more about what forms of pollution are the most significant factors in health and how pollution can be controlled. Milk, food, interstate and community sanitation.—The Bill includes $7,424,000, an increase of $1,820,000 over the amount requested. for these activities in connection with the proposed appropriation item “Environmental health activities’, and $2,876,900 above the amount available for these activities in fiscal year 1961. The increase of $1,820,000 over the amount requested is to establish and operate two shellfish laboratories, one on the East coast, and one on the Gulf coast. About $1,000,000 of this allocation will be for nonrecurring expenses. Our population is continuing to grow at a rapid rate along our tide- waters adjacent to shellfish growing areas. Many industries find salt water localities desirable for location of their plants. The re- sulting effluents, while they may not kill shellfish, may well be ac- cumulated by them so that they are toxic and dangerous for human consumption. Radioactive wastes present a comparable problem. Practically nothing is known about the transmission and survival of certain viruses in salt water or their concentration in shellfish. One thing we do know is that within recent months there have been two outbreaks of hepatitis, which have been definitely traced to contaminated shellfish, one to oysters originating on the Gulf coast, and one to clams originating on the Atlantic coast. 68893—61——38 18 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS At the present time, the Public Health Service has only one shell- fish sanitation research unit which is located in the state of Washing- ton. The establishment of laboratories on the East coast and Guif coast is critically important, not only for public health reasons but also for the economic protection of the shellfish industry. Problems continue to arise from time to time in connection with milk moving in interstate commerce, especially with regard to the presence of certain bacteria and antibiotics. The Committee desires that close attention be paid to this phase of activities under this appropriation. Occupational heaith.—The Bill includes $3,981,000, the amount requested for this activity in the budget request under the proposed appropriation ‘“HEinvironmental health activities”, and $648,400 over the amount available in fiscal year 1961. Radiological health.—The Bill includes $9,147,000, the amount re- quested for this activity in the budget request under the proposed appropriation “Environmental health activities’, and $1,487,000 over the amount available for the same purposes in fiscal year 1961. The problems incident to exposure to ionizing radiation are no longer limited to a few people. ‘They reach into the lives of all of the people of our nation. Fallout radiation caused by weapons testing is familiar to practically everyone. This, however, is far from the whole problem. There is and will continue to be a steady increase in the use of atomic energy in the production of electrical power and the use of radioactive isotopes in industry. Among the growing number of radiation. hazards to which particular attention must be paid is the exposure related to aero-space vehicles powered by nuclear energy, especially rockets and ramjet propulsion devices. There is urgent need, for the protection of the public health, to have more information on the nature and levels of radiation of devices in fixed positions as well as in flight. Another problem is that radioactive wastes cannot be made innocuous by any known methed of treatment. They can only be removed to an isolated spot where their power will, it is hoped, be spent harmlessly. With ionizing radiation we cannot afford to make mistakes. The effects on the human body are cumula- tive and irreversible. The sum carried in the bill is certainly modest compared to the magnitude of the problem to be dealt with. Water supply and water pollution control.—The Bill includes $15,028,000, the amount of the budget request for this activity in- cluded under the proposed appropriation “Environmental health activities’, and $2,970,000 over the amount available for these activities in fiscal year 1961. The major increases are $826,600 for research and $831,900 for the comprehensive program of water pollution control which is carried out on a drainage basin basis. Of the total merease for research, $606,000 is for research grants. The unexplored problems and needs for new and refined knowledge related to water supply and pollution control require action through many scientific disciplines. Research interest in these problems has lagged far behind interest and activity in the more widely publicized research fields. The purpose of the grant program is to bring new talent and interest in the research that is related to water quality problems. The funds allowed will provide for approximately 47 more grants than are being financed in 1961. One of the most important responsibilities contained in the Federal Water Pollution Control Act is the requirement that the Surgeon LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 19 General ‘prepare or develop comprehensive programs for eliminating or reducing pollution of mterstate waters and tributaries there- of * * *’. The comprehensive program, developed in coopera- tion with other Federal agencies, states, cities, and industries, is the preventive medicine of water pollution control. It is not only de- signed to eliminate current problem areas, but to provide a plan for the prevention of new pollution as the development of a river basin progresses. Having begun implementation of this responsibility in 1960, the Public Health Service plans the development of comprehen- sive programs for all of the 26 major continental United States drainage basins by 1975. The increase of $831,900 allowed for this very im- portant activity is in keeping with this schedule. Grants for waste treatments works construction.—The Bill includes $50,000,060, the amount cf the request, and $5,000,000 more than was appropriated for fiscal year 1961. Hospitals and medical care—The bill includes $49,835,000, an increase of $503,000 over the budget request for these activities under the proposed appropriation ‘‘ Medical care and foreign quarantine’, and $1,000,000 over the amount available for these activities in fiscal year 1961. Four years ago the Surgeon General had special surveys made of the Public Health Service hospitals to determine their staffing needs. Even in view of the considerable needs that were demonstrated by these surveys, only modest increases were provided in fiscal years 1959, 1960 and 1961 as the first three steps in a four-year program to get the hospitals to an adequate staffing level. The 1962 budget provided for an increase of only 27 additional man-years of employ- ment. In recognition of the madequacy of the budget request the justifications stated * * * the estimate provides for additional staff in the hospitals to the level approaching that previously identified as needed * * * (italic supplied). Everyone who has made any seri- ous study of the Public Health Service hospitals has concluded that there are two definite needs that are not yet filled. One is for addi- tional operating staff and the other is for a good research program which will help in attracting and retaining good personnel as well as contributing to our conquest of disease. The Committee will expect that the increase of $1,000,000 be allocated to these two purpeses, giving first priority to operating personnel, thus assuring better care for patients. Foreign quarantine activities —The bill includes $5,350,000, an increase of $200,000 over the amount requested for these activities under the proposed appropriation “‘ Medical care and foreign quaran- tine’, and $401,200 more than the amount available in fiscal year 1961. These activities are tied directly to the level of international travel. In view of the vast increase in international travel by Ameri- can citizens, it is difficult to understand why the budget provided for an increase of only 8 positions. The Public Health Service had originally requested 77 in its 1962 budget request to the Department. The Committee will expect that the modest increase above the budget will be applied primarily to the staff at international airports. NATIONAL INSTITUTES OF HEALTH During the last year there has probably been more review, analysis and reanalysis of the annual budget for the National Institutes of 20 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Health than during any other similar period since the first Institute was established. The culmination of this effort to arrive at a proper level of financing was the final review in connection with the budget amendment submitted by the current Administration. This review by the National Institutes of Health resulted in a recommendation of $641,000,000. This recommendation was submitted by the Public Health Service to the Department. After budgetary review by the Office of the Secretary this recommendation was submitted without change as the Depariment’s recommendation to the Bureau of the Budget. The Committee has tried to determine from the Secretary, from the Surgeon General, and from the Director of the National Institutes of Health, why the Bureau of the Budget reduced this reauest by $58,000,000. Since no other specific reasons have been given the Committee, it can only conclude that this was purely an arbitary reduction. The Committee has included in the bill the $641,000,000 budget. NEED TO IMPROVE THE COMMUNICATION OF THE RESULTS OF RESEARCH The Committee feels strongly that the lapse of time between the development of clinically useful research results and their application to diagnosis and treatment by physicians throughout the country is often much too long. .The ultimate purpose of medical research, which has induced the Congress to make very substantial funds avail- able for its support, is to enable physicians and other health prac- titioners to give the people of this country more skilled, more certain and more effective preventive and therapeutic care. The Committee is well aware of the difficulties of communicating new knowledge to busy practitioners, many of them in remote areas, who have neither the time, the energy or, in some unfortunate cases, the inclination to keep abreast of new developments. At the same time, it seems to the Committee that quick access to new knowledge is more difficult than it needs to be and that communication between the medical investigator and the practitioner is left too much to chance. The medical community has been slow to take advantage of the great progress made in the field of communication during the past decade. ‘During the course of the hearmgs, the Committee explored with representatives of NIH the extent of NIH’s activity in the field of adapting present-day development in the field of information stor- age and retrieval to the problems of providing physicians in private practice with the current findings arising from the Nation’s research, effort. The Committee has been impressed with the potentialities of such approaches as described by General Sarnoff of RCA and others, but was disappointed in what appears to be a very restricted point of view on the part of NIH. in respect to this very important field. The Committee will expect that this whole field be thoroughly explored and that the NIH will be prepared to present a full report on the potentials and a plan for development of a program to reach these potentials at the hearings next year. INSTRUMENTATION It is becoming more and more widely recognized that medical research can very significantly benefit from cooperative research with scientists in the fields of the physical sciences and engineering. For LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 21 anyone interested in the potentials of such cooperative research, the Committee would call attention to the testimony of Dr. Howard A, Rusk and David Rose beginning on page 605 of the Committee’s Hearings with Members of Congress, interested organizations, and individuals. One of the examples given in this testimony was a stapling device used to sew the ends of blood vessels together with micrescopically small threads of metal. This device does in a matter of seconds what is impossible for a surgeon to do by hand. This now makes possible operations that could not previously be performed atail. The Committee has received other examples that, while not so striking to a layman, may well be of even greater importance. The Committee encourages the National Institutes of Health to more vigorously pursue this type of activity. PERSONNEL PROBLEMS The Committee is deeply disturbed by the fact that the NIH has still to find a reasonable solution for their continuing problem of recruiting and retaining scientists of the highest caliber. As a result of the steady improvement of research facilities and the expansion of research programs in the universities and medical schools, the excellent opportunities offered to investigators by the NTH are no longer unique. Normal competition for scientific personnel is healthy, but the Insti- tutes now find themselves in a critical position in the competition for outstanding talent with institutions that can offer far better remunera- tion often including unrestricted opportunities for private practice and consultation. Offers received by senior scientists at NIH have ranged as high as $50,000 and offers in the $20,000-$30,000 range are common. The top salary which the Institutes can offer, in limited numbers, under Section 208(g) of the Public Health Service Act, is $19,000. The position of leadership in the scientific community which the Institutes have attained, is in large measure the result of the outstand- ing competence of the professional staff at Bethesda. This compe- tence must be maintained if the effectiveness of NIH programs and the past and present level of achievement is to continue. The Secretary and the Surgeon General have stated that they are well aware of the NI¥’s difficult personnel problem. The Committee hopes that they will give serious consideration to, and will vigorously pursue, pro- posals to alleviate this dangerous situation and that suitable recom- mendations will shortly be made to the appropriate Congressional Committees. TRAINING GRANTS The Committee is pleased to note that the progressive adjustment of the starting dates of NIH training grants, which was made possible by Congressional increases in the NIH training appropriations in 1960 and 1961, has been completed a year earlier than was originally proposed. Under the new cycle on which these training grants are now being awarded, a school will know well before the academic year begins what training funds will be available to it and will thus be in a position to plan its training programs much more effectively. The adjustment to forward-financing of training grants involved the expenditure of $16,158,000 in 1961 over and above the one-year cost of these programs. The reduction in the appropriation requested for training to $96,242,000, compared to $110,000,000 appropriated 22 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS for 1961, therefore does not represent any cut-back in the level of support for programs so essential to the production of highly qualified manpower in biomedical sciences. Actually, the appropriation request, which was approved, included an increase of $2 million for the expansion of the graduate research training program and $400,000 for the dental chairside assistants program. The Committee was assured that the maintenance of the other training grant and fellowship programs at the 1961 level did not reflect any lack of enthusiasm on the part of the Administration for the further development of these programs and would not result in any loss of momentum by these important training efforts. Ut is the judgment of the Institutes and their advisors that the substantial expansion of the training programs in 1960 and 1961 has greatly helped the grantee institutions but has also created difficult adminis- trative and curricular problems for them. It is therefore felt that the maintenance of the existing level of these grants for another year will give these institutions time to adjust their programs to their expanded research training role. The Committee is satisfied that this is a sound professional assessment. No convincing evidence was submitted which would indicate that the present levels of the research training programs are sufficient to assure the country of a steady and adequate supply of highly qualified research manpower in each of the important—and especially in the rapidly growing—scientific and inter-disciplinary areas relevant to medical research. The Committee therefore requests that the NIH prepare, before next year’s appropriation hearings, a balance-sheet of estimated research manpower requirements five and ten years hence and a projection of expected output. INSTITUTIONAL GRANTS An Institutional Grants Program was authorized last year after the appropriation bill had been enacted. Under the terms of this legis- lation, a portion, not to exceed 15 percent, of the research project funds appropriated to the NIH may be used to make grants to public or non-profit universities, hospitals, laboratories, and other institu- tions for the general support of their research and research training programs. Initiation of this program has been deferred to fiscal year 1962. The Committee believes that it is desirable that this program be gradually phased into the NIH grant program and that it is therefore intended to limit the total value of these grants, during fiscal year 1962, to approximately 5 percent of the appropriation for research project grant funds. In this first stage of the program these grants will be confined to medical, dental and osteopathic schools, schools of public health, and independent institutions where current research activity is at a level in excess of $100,000. The Committee has been informed that with the beginning of the Institutional Grant Program, the so-called smail-grants program, parttime fellowships for medical students, and post-sophomore fellow- ships will be discontinued because, in the judgment of the Institutes and their advisors, the objectives of these programs can be better attained by enabling the institutions themselves to offer this type of LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 23 support. The Committee concurs in this proposal. Tt is the desire of the Committee that these funds be used only for the support of research and research training activities. They are not to be avail- able for general teaching and operating expenses, fer the support of service functions, for non-research construction, or any indirect costs except as permitted under regular research project grants. CAREER RESEARCH PROFESSORSHIPS The new program for the support of Career Research Professor- ships, for which the Congress provided funds last year, was designed to meet the need for mere secure positions for those who wish to devote their careers to research. ‘The primary purpose of the program is to retain in medical research a substantial number of highly competent and productive investigators who, for lack of a suitable and secure research position, now feel corapelled to forsake research. The availability of a greater number of career positions in medical research, and the demonstration of public interest in such careers through Federal support for them, will also make a medical research career more attractive to gifted young men and women who, during the past decade or so, have been increasingly enticed into other scientific fields. Past neglect of medical research and the very dramatic advances in some of the physical sciences during and since World War IT, have put medicine at a decided dis- advantage in the competition for scientific brainpower. This com- petitive disadvantage must be promptly removed if the opportunities that beckon all along the medical research frontier are to be vigorously pursued. The Committee was disappointed to learn that the NIH staff had encountered difficulties in working out the administrative guidelines for this program and that it has therefore not yet been brought into effect. Problems arose from the fact that many institutions tended to interpret the award of one of these professorships as national recog- nition of professional distinction and therefore nominated senior faculty members who already hold tenure positions, thus defeating the basic purpose of the program. Another difficulty is inherent in the inclusion of the word “professorship” in the name of the program. The universities and other schools feel quite strongly that it is their prerogative to determine the title and institutional status of faculty members. To limit nominations for the program to full professers would not accomplish its objectives; to insist that other recipients of career awards must be called professors is thought to infringe on the rights of the institution. I+ is therefore proposed to call the program the Career Research Award Program. The Committee is assured that none of the difficulties is insuperable and that strenuous efforts are being made to develop a set of adminis- trative guidelines which will fully serve the objectives of the program and at the same time be readily acceptable to the institutions con- cerned. General research and services——The bill includes $119,275,000, an increase of $23,934,000 above the request, and $35,375,000 above the amount appropriated for 1961. This appropriation supports the activities of the Division of General Medical Sciences and the Division of Biclogics Standards. 24. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS The Division of General Medical Sciences administers the NIH grant programs supporting research and training in the preclinical, biological and other health-related sciences and in certain clinical areas. Although it does not yet enjoy the status of an Institute and conducts no research program of its own at Bethesda, this Division ranks with the larger categorical Instijutes in the value—whether measured in dollars or in scientific significance—of its extramural pro- grams. ‘Research in the basic sciences is not only complementary to the categorical missions of the Institutes but must necessarily precede an understanding of many major health problems and is essential to continued progress in clinical research. In our natural preoccupation with the battle against disease and disability we must not overlook the fact that a broader and more precise knowledge of basic biological processes is likely to lead to significant breakthroughs in areas of research which have thus far yielded only little to frontal clinical attacks. The Committee feels that it is of the utmost importance to continue to strengthen the nation’s research and training efforts in such fields as genetics, the systematic study of reproduction, growth, and aging, tissue and organ transplantation, the biophysical sciences, biomathematics, and biomedical engineering, as well as the more tra- ditional preclinical and biological sciences. At present the Division supports approximately 2,000 research projects in the basic sciences including considerable work in such new and critical fields of inquiry as the manner in which the genes control metabolic processes, and the body’s mechanism for making and storing antibodies which form during immunologic reactions. Current research in genetics gives increasing hope that man may some day be able to forestall many disabilities and diseases and will be able to reinforce beneficial genetic characteristics. Other basic research projects supported by the Division are throwing light on. the precise effect of drugs and poisons on liver cells; the roles played by certain organic chemicals in emotional, digestive and cardiovascular functions; on the value of substituting salt solutions for whole blood in certain types of transfusions; on electrocardiographic tools; on the importance of essential fatty acids as food; and on the role of dietary deficiencies in causing congenital defects. The Division also administers fellowship programs under which approximately 1,800 students and_ scientists are being assisted to enhance their research training. This varies depending on the pro- gram from part-time medical school fellowships, aimed at the recruit- ment for science of the more promising student early in his career, to the more senior fellowships aimed at the development of a broad base for the professional scientist. A further 3,000 medical students and graduates are receiving some measure of research training in the basic medical and biological sciences in 450 grant-supported training programs in medical schools and other institutions across the Nation. These programs are designed to meet our future manpower needs in such fields as the anatomical sciences, biochemistry, biomedical engineering, biometry, biophysics, embryology and development, epidemiology, genetics, microbiology, pathology, pharmacology, and physiology. The General Clinical Research Center Program, begun in the fall of 1959, is designed to meet national needs for imtensified clinical research. The program provides more adequate facilities for precise LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS .25 observation of research patients and for subjecting the results of laboratory research on animals to final clinical tests. Unlike the clinical research centers being supported by other components of. the National Institutes of Health, the General Centers are concerned with a wide spectrum of diseases and with the application. of various scientific and. clinical skills to a variety of fundamental scientific problems. - Since the inception of the program, 19 General Centers have been established in medical institutions across the country and a number of additional applications are now under review. Funds for the Division of Biologics Standards are also mcluded in the appropriation for general research and services. This Division is responsible for ensuring the safety, purity, and potency of all biological products that come within the regulatory function of the Public Health Service. The extraordinarily rapid rate at which new vaccines, antitoxins, therapeutic sera, and blood products are intro- duced requires the constant development of new standards against which these products may be tested before they are made commercially available. The development of these standards and improvement of testing techniques and procedures are dependent on the effective- ness of a vigorous research program. The current research activities of the Division include the extensive investigation of live poliovirus strains with a view to establishing suitable regulations governing the production of a live oral vaccine; continued research on killed polio vaccines; preparation of a standard reference reagent and the standardization of techniques for evaluating a measles vaccine; improvement of testing procedures for the control of blood products, including all phases of blood collections, processing, shipment and storage; the isolation of an agent which may be related to serum hepatitis (the form of liver infection which sometimes results from an injection); re-evaluation of the standards for cholera vaccine; and the development of testing procedures and modification of standards for the control of multiple antigens. The Committee was pleased to note that the Division of Biologics Standards was last year brought together, for the first time in its ‘history, in its own building for which funds were appropriated in 1959. These new modern facilities will enable the Division to dis- charge still more effectively its vital role in the protection of the health of our people. Guardianship over the biological products on “which the life of an individual so often depends is a task for which every needed resource must unstintingly be made available. National Cancer Institute—The bill includes: $125,672,000, an increase of $8,505,000 above the request, and $14,672,000 above the amount appropriated for 1961. - The Committee was much impressed by the evidence of significant progress that has been made in specific areas.of cancer research and by the important leads that have been developed in broad areas of program planning. The Institute’s 25th anniversary will occur in 1962. The Committee can think of no more fitting way to com- memorate this anniversary than to provide the funds necessary to follow these leads toward the ultimate conquest of this disease. As the result of several years of intensive study, Institute scientists for the first time achieved the five-year survival of cancer patients treated wholly with drugs. These are cases of choriocarcinoma, a 68893—61——_4 26 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS rare but severe form of cancer in women, treated at the Clinical Center in Bethesda. One of the most significant accomplishments under the national chemotherapy program was evidence of an improvement in survival for women with breast cancer. This was accomplished by treatment with the drug-thio-TEPA. Inthe chemotherapy program as a whole, the number of agents in clinical trial increased from 109 to 160 during the past year, and the number of patients currently participating in clinical studies increased from 8,000 to 16,500. Preliminary screen- ing of compounds continues at the rate of 50,000 a year. The Committee was impressed by new methods of aiding leukemia patients made possible by a solution of the problem of securing blood products to prevent spontaneous bleeding which is a common cause of death of these patients. This is now done by the donation of blood platelets by a process in which the red cells are returned, to the donor, thus permitting frequent donations. One of the most intriguing areas of cancer research is that of the relation of viruses to human cancer. Studies in recent years have demonstrated that viruses cause many kinds of cancer in animals under laboratory conditions, and many scientists regard the possibility of viral causation of human cancer as demanding the fullest investiga- tion. The Committee was pleased to learn that the Institute has enlarged and intensified both its intramural and extramural activities in this area. Early this year a special laboratory was established as the focal point of the Institute’s intramural virus-cancer research. Steps were taken toward the establishment of a national virus-cancer service program, similar to that developed in chemotherapy, in re- sponse to a heavy demand for vital research materials resulting from grant-supported work started in 1960. The Committee will expect that a considerable part of the increase provided in the bill will be used to strengthen and expand these activities. It is encouraging that there are a number of new promising oppor- tunities and mechanisms for advancing cancer research in well de- lineated areas. The first of these large areas, that of chemotherapy, was recognized five years ago. Opportunities also exist in the develop- ment of integrated, multidisciplinary approaches to clinical research in institutions which can be properly staffed and equipped to carry on comprehensive investigations, such as in radiation therapy. I[t is appropriate that these activities be carried on both as direct operations of the Institute and through the support of research centers and broad research programs. The latter approach seems to be particularly suitable for the new program in radiation therapy. This program designed to fill a need for more trained radiotherapists to carry out patient care and research, will undoubtedly greatly enhance the thera- peutic effectiveness of radiation in treating many types of cancer. Research on diagnosis has already produced one reliable test, the cytologic examination for uterine cancer, which is now being put to use as a public health measure by the Bureau of State Services of the Public Health Service in cooperation with State and local health departments:. The Committee is dismayed that far too few women are as yet taking advantage of this simple test which permits early detection. and could save many thousands of lives. It urges the Institute and the other appropriate components of the Public Health Service to take vigorous steps to publicize the test and to persuade the women of this country to have an annual! cytological examination. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 27 The Institute’s direct operations are faced with serious space prob- lems. In the 1961 appropriation planning funds were included for a new National Cancer Institute building to relieve the space problem. The Committee hopes that plans for this building will be completed during the coming year. It is important that a medical research institution have the ability to change its orientation and move in new directions as developments in its area indicate. The Committee noted with satisfaction that the Institute has recently reorganized to enable it to carry out more effec- tively the new programs described above. Mental health activities—The bill includes $92,182,000, an increase of $3,858,000 above the request, and $8,718,000 less than the amount appropriated in 1961. The reduction from the 1961 appropriation level is accounted for by the fact that $11,114,000 was required in 1961 to adjust the starting dates. for training grants, and the 1961 appropriation included $5,139,000 for construction. Since both are non-recurring costs, the 1962 appropriation recommended in the bill is, on a comparable basis, an increase of about. $734 million. The Committee is pleased to note that for the fifth consecutive year there has been a decrease in the number of patients in mental hospitals. The reversal in trend shows the wisdom of Congress in providing im- petus and support for the mental health program, since this advance would not have been possible without the application of results ob- tained through research financed by these appropriations. The Committee has been impressed by testimony regarding the many new developments in the care and treatment of patients, both in and out of hospitals, meriting wide application, but it is disturbed -to note that this information has not. been fully utilized. While one reason for this is lack of personnel, another. may well be insufficient dissemination of information. The Committee therefore hopes that there will be an. expansion in the dissemination of such information _by all appropriate means and to all appropriate people, including not only the professionals in the field but others such as the various com- munity agencies, including schools; and also the public at large. There is urgent need for additional demonstrations in various parts of the country, as well as intensified field trials, making use of infor- ‘mation that is now available but has not yet been applied to the solution of mental health problems. In short, there is further need to bridge the gap between research findings and utilization of infor- mation; and the Committee feels that solving the problem of applying research results is as much the responsibility and duty of the NIMH and other segments of the Public Health Service as is the support and conduct of research. It hopes that greater efforts will be expended on this aspect of the mental health program. - , The Committee is pleased that the Institute has made progress in studying the role, function and case load of the community outpatient clinic, and plans further steps in developing comprehensive reporting of the patterns of existing and needed psychiatric care in each State. In 1959 this Committee initiated a program for psychiatric training of general practitioners. According to both the Institute Director and non-government experts this has proven to be one of the most popular and worth-while training programs in the whole mental health field. The Committee hopes that this program will be strength- ened still further in 1962. 28 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS The Committee continues to be interested in a number of critical problem areas in the mental health field, including juvenile delin- quency and mental retardation. While the Institute has made reasonable progress and has utilized the funds made available last year for new pilot demonstration projects, planning, research and training, the Committee feels that greater efforts should be made in these areas. Alcoholism continues to be one of the nation’s great social, medical, and economic problems. Estimates vary but it seems likely that there are approximately 5 million people in the United States who could be classified as alcoholics. The problem of course affects far more people. Just considering the immediate families would increase ‘the number of people directly affected to approximately 20 million. Until a very few years’ ago when this committee increased the budget for: this institute for the specific purpose of beginning a research program in this field, practically no research was being done. The Committee is encouraged by activities to date but hopes that more effort will be placed on this research in 1962. The Committee notes that the Institute’s Psychopharmacology Service Center is successfully stimulating both basic and clinical résearch dealing with the clinical efficacy and basic mechanisms of the psychiatric drugs. The success of such drugs has substantially contributed to the decrease in the number of patients in hospitals, and has helped maintain social adjustment: of chronic psychiatric patients returned to the community. The Committee hopes that the National Institute of Mental Health will continue to actively support this activity. , National. Heart Institute-—The bill includes $105,723,000, an an increase of $8,650,000 above the request, and $18,823,000 above the amount appropriated for 1961. It is encouraging to the Committee that progress during the past year against diseases of the heart and blood vessels was substantial. Much promising work is being done against atherosclerosis, the great- est killer of adults. This is the type of hardening of the arteries that often leads to heart attacks. An important advance is the discovery by Institute scientists, in studies on animals, that the rates at which cholesterol, a fatty substance found in many of the foods we eat, enters and leaves the wall of major arteries is a significant factor in the development of atherosclerosis. Strenuous efforts are being made to reach a precise understanding of the processes and mechanisms by which fats are transported, synthesized, stored, and broken down by the body. | The search is also continuing for drugs which will prevent or remove cholesterol deposits. An important step in this direction was the demonstration during the past year that the mechanism by which the drug MER-29 lowers blood cholesterol levels is by blocking the last step in the chemical sequence by which the body manufactures cholesterol. The usefulness of gas chromatography, an important research tool in the study of fatty substances, has also been greatly expanded by two technical advances extending its scope into areas hitherto inaccessible. The solution of many of the problems encountered in the study of atherosclerosis are dependent on a better knowledge of basic biological and chemical processes and involve the adaptation of research tech-~ niques borrowed and extended from the physical sciences. This is a common situation in medical research and underlines the need, to LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 29 which the Committee has already referred, for. vigorous support for basic research in a wide spectrum of science fields. Because of their categorical disease missions, the National Institutes of Health are primarily responsible for the conduct and support of clinical research but progress will be slowed—and. will, in some instances, be impos- sible—if research in non-clinical areas of the health-related sciences does not keep ahead of the needs of the clinical investigator for basic knowledge and data. Findings from epidemiological studies, carried on to explore factors and influences which contribute to the development of coronary heart disease, are producing data that are making it possible to identify the “coronary prone” individual with increasing accuracy. In the field of hypertension, it has become evident that many drugs which alter the metabolism of amines also effectively lower blood pressure. Hence, much important research is directed at obtaining more complete knowledge of the processes of amine metabolism. The Institute is now conducting clinical trials of a family of compounds ° which inhibit the synthesis of several amines. The compounds ap- pear promising both as research tools in hypertension and as thera- peutic drugs for treating the condition. Another.family of enzyme inhibitors under continuing study are compounds that block the ac- tion of monoamine oxidase, an enzyme which plays an important role not only in hypertension but in mental disorders. Several of these compounds were found to be powerful blood pressure lowering agents but were too toxic for therapeutic use. A new compound with’ a different chemical structure, now being tested, appears effective in lowering blood pressure and, so far, to be free of toxic effects. The Committee was impressed by the remarkable progress which - continues to be made in surgery. A dramatic achievement was the design and successful use, in treatment of patients with complete heart block, of a transistorized, portable, pacemaker. It is strapped to the patient’s chest and maintains the heartbeat until his heart can resume normal rhythm. Another important development was the design of new and improved artificial heart valves and of procedures for installing them to replace severely damaged natural valves. There were significant achievements during the year in the refine- ment of techniques and procedures for the precise diagnosis of both congenital and acquired heart defects. The origination of a method of closed-chest cardiac massage to restore blood flow in persons with cardiac arrest without requiring exposure of the heart is an advance of obvious importance to emergency treatment. There are other developments, some too new to yet show substantial results, which give hopes for additional advances in the future. In the field of heart drug development, cooperative efforts with industry resulted in the clarification of problems encountered with clot- dissolving agents and a determination of the needs for standardizing methods of drug preparations. The gerontological research program of the Institute, a unique research enterprise conducted at Baltimore, continued to develop as an outstanding resource in the field of aging research. The primate research resources program also made good progress; construction of the first regional center is nearly completed and negotiations for establishing several more of these unique research resources are underway. The Committee will expect that clinical drug trials be continued and expanded. 30. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS _ Dental research activities —The bill includes $14,681,000 an increase of $748,000 above the request, and $819,000 less than the amount appropriated for 1961. The apparent reduction from the 1961 level is accounted for by the fact that activities amounting to $2,149,700 in 1961 will be financed elsewhere in 1962 and that the 1961 appropria- tion included funds for nonrecurring expenses totaling $1,427,000. Thus the appropriation for 1962 is an increase of approximately $2.7 million on a comparable basis. The past year has seen much in the way of research progress, in- cluding what may well prove to be a major breakthrough in the long search for the cause of dental caries. Insititute investigators have shown that dental caries can be induced in germfree rats by infecting them with a single strain of streptococcus bacteria and that caries could also be developed in the normally caries-free albino hamster . with another type of streptococcus. If these preliminary observations are confirmed by more extensive investigations, the presently-held view that dental caries in humans can be caused by a variety of microorgan- isms will need reappraisal. If human caries is also found to be caused by a single, or only a few specific microorganisms, the problem of its eventual control will be greatly simplified. It might then, in fact, be possible to develop an anticaries vaccine or a specific chemothera- peutic agent. With information now available on the mode of caries infection, and the identification of specific bacterial pathogens, Institute in- vestigators were able in the past year to begin a systematic search for chemical agents that inhibit the normal growth pattern of par- ticular oral bacteria. The testing program on animals, which is a necessary preliminary to clinical trials in humans, has thus far yielded three organic compounds that have produced a significant reduction in animal caries by interrupting the bacterial metabolism. Scientists at the Institute have also shown that dental decay in animals is markedly reduced by adding certain mineral phosphates to the diet. The application of these experimental findings to humans is now being undertaken in large scale clinical studies in the Midwest to assess the effects of dicalcium phosphate on caries in children. Laboratory studies are also underway to determine how these com- pounds alter the decay process. It must, for example, be determined whether the effectiveness of a compound in inhibiting caries is due to a local reaction at the exposed surfaces of the teeth or whether it is systemic in origin and due to the absorption of the compound during digestion. Experiments with animals have thus far pointed to dif- ferent answers for different types of phosphates. This important and promising project seems to the Committee to provide another illustra- tion of the potential value of research on fundamental biological processes. If scientists had a better knowledge of basic body chem- istry, it might have been possible to explain the apparent differences in the effects of mineral phosphates and organic phosphates without the necessity for a protracted series of experiments which the dental investigators are now forced to undertake. LABOR-HBALTH, EDUCATION, WELFARE APPROPRIATIONS 31 The Committee was impressed with the vigor of the Institute’s pro- gram and by the wide opportunities for significant progress in the rela- tively neglected field of dental research. It hopes that the Institute’s success will inspire the dental schools and ‘other institutions to con- tinue to expand their research interests and capabilities so that the people may benefit from a many pronged attack on the problems of tooth decay and oral diséases. Arthritis and metabolic disease activities —The bill includes $73,661,- 000, an increase of $4,921,000 above the request, and $12,461,000 above the amount appropriated for 1961. The past year—the Institute’s tenth—has witnessed several highly important research accomplishments and a number of very promising trends. Tremendous efforts are being devoted to achieve a fulk understanding of the immunologic aspects of rheumatoid arthritis, the most crippling form of the disease. Nearly one-third of alk research in arthritis is being devoted to this effort. Recent scientifie | findings strongly suggest that rheumatoid arthritis may have its basis in the phenomenon known as hypersensitivity and that the disease results when individuals become overly. sensitive (i.c., allergic) to substances in their bodies, possibly even to some component of their own tissues. In addition to basic work on the origin of rheumatoid arthritis, clinical research continues‘on the effects of the newer anti- inflammatory drugs which have largely replaced cortisone. More effective methods of physical therapy are also being developed to restore already crippled arthritics to useful, active lives. The Committee was glad to hear that the Institute has embarked on a long-term cooperative program for testing new drugs to treat arthritics, to provide physicians with reliable therapeutic data and to speed up the clinical application of laboratory findings. In diabetes, a large scale, carefully controlled study involving seven research centers has been launched to define more precisely the natural history of this disease, and to determine which forms of therapy (diet, insulin, oral drugs, etc.) are most effective in preventing the late complications of the disease. Special attention is being given to assessing the long-term-value of oral drugs as compared with insulin injections. The Committee was encouraged by reports that investigators may be on the verge of solving the hitherto perplexing problem of why some persons become diabetic even though their pancreases appear to produce insulin. Recent research has uncovered a new type of insulin resistance whose existence may well throw further light on the nature and cause of this disease. In fundamental biochemical studies, two extremely important accomplishments were reported to the Committee. Institute scien- tists in Bethesda have demonstrated for the first time a specific mechanism by which hormones exert their powerful controlling effects on the body. Grantee scientists at the University of Pittsburgh have succeeded in putting together 23 amino acids to synthesize ACTH, an important hormone of the pituitary gland which controls the production of cortisone and other essential hormones. These two achievements. give important clues to the understanding of many aspects of endocrinology and metabolism. Moreover, the techniques developed in the synthesis of ACTH open the way to the synthesis of a number of other hormones and even hold out the hope that it 32 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS may be possible to produce specially modified hormones for specific therapeutic purposes. There were equally significant advances toward the understanding of nature’s genetic communication system which transmits not only inherited physical characteristics.but proneness to certain diseases and disabilities of later life. The whole field of molecular biology, dealing with the interrelationships of biological structure and function, is becoming increasingly active and the Committee heartily shares the view of competent witnesses who appeared before it that this type of research, needs strong support because the final solution of many out- standing medical problems depends upon future findings in this basic research area. Continuing progress was reported in the study of diseases which affect the digestive system, a useful achievement being the clarification of the cause of ulcer pain. Research has also resulted in a simple test for liver disease. _ Progress is also being made in the study of cystic fibrosis, one of the major causes of death in children, however, the Committee is not satisfied that as much progress is being made as could be made. The Institute will be expected to increase its efforts in this disease area. The Committee was also disappointed that the complex field of skin diseases, which at one time or another affect so many people and are frequently disabling and disfiguring, is still relatively neglected. International studies in epidemiology and research in nutrition: problems throughout the world, with the primary object of throwing light on possible environment and nutritional origins of certain diseases in this country, are also promising activities in which the Institute is engaged. Allergy and infectious disease activities—The bill includes $52,182,000 an increase of $3,860,000 above the request, and $8,182,000 above the amount appropriated for 1961. The Committee feels that one of the most encouraging recent achievements of this Institute was the development of the first ex- perimental vaccine effective against measles which, in recent years, has been responsible for more deaths in children than poliomyelitis. Although usually a mild and extremely common disease, measles can also lead to very serious complications. including pneumonia, the permanent impairment of hearing and sight, and even to brain damage. Trials to date have shown that the new vaccine can prevent this widespread viral disease. A particularly promising tool in the fight against staphylococcal infections, which are a very serious problem in hospitals, is a new synthetic penicillin, named Staphcillin. A number of medical centers, including the National Institutes of Health, have participated in the clinical testing and evaluation of this drug. Highly encouraging results have been reported in the management of severe and chronic staphylococcal infections which had proved resistant to treatment with other antibiotics. The drug is now available to hospitals and physicians. Other studies on these often fatal infections have recently thrown light on the way in which staphylococcal epidemics develop in hospital nurseries, and will aid in preventing such epidemics in the future. In the field of chronic disease, allergy ranks high both in terms of prevalence and of cost. Research in this area and in the closely related field of immunology has been rapidly accelerated in recent LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 33 years and has a usefulness which extends to many other fields. Knowledge acquired through fluorescent antibody studies for example, is now being applied to the diagnosis of a host of bacterial, viral and parasitic diseases, and making possible much faster and more accurate diagnosis. Such examples not only underline the importance of immunologic research for all of medical science, but illustrate the inter-relation of research results and the broad applicability of techniques evolved in a particular research area. Although progress in these fields has again been substantial, the ‘Committee remains as much concerned by the wide range of problems still to be resolved as it is impressed by the notable achievements of the past. Respiratory diseases and a host of unidentified virus infestions continue to be common occurrences and constitute not only a major health hazard, especially serious among young children, but the cause of considerable economic loss. Virus research in relation to acute respiratory disease has rapidly forged ahead during the past year. Intensive analysis of two new groups of viruses among nursery-age children has substantially in- creased the number of agents which can be identified as causing certain acute illnesses in the very young. The study of virus infec- tions among adults is also being actively pursued by means of a group of human volunteers who are being inoculated with a variety of respiratory viruses known to cause disease. One of thé most en- couraging practical results of the past year was the demonstration of a successful treatment for one type of penumonia. Neurology and blindness: activities —The bill includes $57,624,000, an increase of $3,524,000 above the request, and $1,024,000 above the amount appropriated for 1961; however, the 1961 appropriation contained $7,000,000 for construction which is a nonrecurring ex- pense. Thus, on a comparative basis the increase over 1961 is in excess of $8,000,000. Disorders of the brain and central nervous system are seriously handicapping millions of Americans. It is estimated that one out of every eight persons in the United States suffers from some form of neurological disability. More unanswered questions exist about the brain than about any other organ of the human body. It is so incredibly intricate that medical knowledge of its functioning has advanced only slowly. Significant strides, however, have now been made in the effort to prevent and cure many of the complex and mysterious ailments that affect the brain and nervous system. The Committee considers it important to note some of these forward steps which have taken place in recent years. In the area of strokes, a disorder which afflicts a million and a half Americans, research has made possible a new understanding of the processes underlying the formation of blood clots in the brain, the use of anticoagulants to discourage strokes, and effective surgical treatment for some stroke patients. The role of disturbances of body chemistry in relation to certain diseases is beginning to be more fully appreciated. Additional forms of inborn errors of metabolism have been shown to be responsible for mental retardation and promising dietary therapy is being developed. New clues concerning the chemical basis of some forms of Parkinsonism (‘shaking palsy’’) have been uncovered as a result of the discovery that certain tranquilizing drugs may produce trans- itory Parkinson-like symptoms. 34 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS _° Multiple sclerosis is another neurological disorder in which chem~ istry plays an all-important role. Some progress has been made but there are many unknown aspects of this disease. An important break- through may result from intensive pursuit of the theory that the dis- ease is connected with an over-sensitivity or “allergy” on the part of the body to its own necessary substances. . If this theory can be sub- stantiated, scientists may be able to find a way to. alter the body’s immunity through some drug agent and thereby cure or at least arrest the disease. Another interesting theory is that a virus agent may be the cause of this family of disorders.. The Committee heard expert testimony that a successful program geared to the search for viruses would require special experimental facilities previouly unavailable. The unusual geographic distribution of multiple sclerosis is also chal- lenging, and existing studies in the epidemiology of the disease should be broadened. / The Committee believes that the present approaches now offer enough promise to warrant a considerable increase in the research effort related to this disease which is causing untold suffering in the 20 to 40 age group. There have. also been notable advances in research on several serious diseases leading to blindness. In glaucoma, broader under- ‘standing of the disturbances of fluid production in the eye has been achieved, and increased recognition. has been given to the advantages of early detection of pressure by means of the tonographic test. Drug therapy has been found to be effective in treating uveitis caused by toxoplasmosis. Insight into the chemistry of cataract formation 1s growing, and research shows that retinal degenerations are due:to a basic. chemical. defect. Yet, despite the progress achieved so far, every year some 30,000 Americans become blind. And more than half the incidence of blindness is due to diseases whose causes are not yet known. The first line of attack against these disorders must. be through an expanded program of medical research. In the area of speech and hearing, an outstanding recent achieve- ment is the development of highly specialized methods to differentiate between hearing impairment caused by specific ear diseases and im- pairment resulting from defects of the sensory mechanisms which conduct and analyze sound in the brain. Another advance is the surgical technique for relieving otosclerosis, a disease which immobi- lizes. the small bones of the middle ear and is frequently a cause of deainess in older people. Neurological and sensory disorders of infancy and childhood con- stitute a major public health problem in the United States. It is estimated that one in every 16 babies born each year is thus afflicted. The Institute’s Collaborative Project, specifically concerned with such diseases as cerebral palsy, mental retardation, congenital malforma- tions of the nervous system, blindness, and speech and hearing defects, will study some 50,000 expectant mothers and their babies. At the end of 1960 (the second year of the main phase of the study), a total of 13,545 expectant mothers had been enrolled in the project, and 8,346 newborns examined. At the present rate of enrollment, some 9,000 new expectant mothers a year can be added to the study. Through this project new knowledge is being gained about the relationship between events ‘and circumstances of pregnancy, labor, delivery, and the first month of life on the one hand, and the later oc- LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 35 currence of neurological or sensory disorders on the other. It is the hope and expectation that this new knowledge will make it possible to prevent many of these disorders. The laboratory of perinatal physiology in Puerto Rico and the free- ranging colony of rhesus monkeys, the only one of its kind in this hemisphere, offers an unusual research opportunity. The initial objective is to ascertain the role of asphyxiation in producing neuro- logical disorders. Infant monkeys asphyxiated and resuscitated at birth have been found to develop all degrees of neuromotor and psychological: handicaps, including syndromes resembling cerebral palsy, epilepsy, deafness, and mental retardation. Recent investigations have included the study of the pattern of pathological changes demonstrable in the brains of asphyxiated monkeys. Behavioral tests have revealed abnormalities in normal- appearing monkeys deprived of oxygen at birth, and considerable information on normal physiological values in these monkeys has been collected and analyzed in preparation for further investigations. New objectives of the project. are first to standardize the physiological conditions during asphyxia and to measure damage under agreed criteria, and then to seek means of preventing nervous system damage by introducing certain therapeutic measures. Some very real accomplishments have been made but much remains to be done. It is impossible to estimate the tremendous drain on our economy because of the long-term disability of millions of Americans with neurological disorders for which answers have not yet been found. It is estimated that the cost of care for one group alone, the 5,400,000 mentally retarded, is more than a billion dollars a year. Fortunately, because of the training programs sponsored by the Institute, we now have a corps of trained scientists who can spearhead a broader attack on this staggering national problem. Grants for construction of cancer research facilities —The bill includes $5,000,000, the same amount as was included for this purpose in the appropriation for the National Cancer Institute for 1961. There was no budget request for this item for fiscal year 1962. It was obvious from. the hearings that the reason no request was included in the Budget was a misunderstanding concerning the Congressional intention in appropriating the funds for 1961. The greatest unfilled need of the medical research program in the United States today is for adequate facilities. The Health Research Facilities Act of 1956 obviously helps. This Act. provides for a fine program and is based on sound principles. However, it places a limitation of $30,000,000 on appropriations. and, much more im- portantly for some institutions, it requires 50% matching funds. Some of the most crying needs for research facilities exist in institu- tions that are not able to meet the matching requirements. This is especially true in connection with cancer research facilities. In the absence of a supplementary, special purpose program such as this, some institutions are completely eliminated from the Federal program for assistance in the construction of research facilities and valuable research potential is lost... Applications, for the $5,000,000 already ‘appropriated, which have been approved by the Advisory Council, total over $13 million. In view of this the Committee feels that the amount recommended in the Bill is very modest, : 36 | LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Grants for construction of hospital research facilities —The bill in- cludes $10,000,000 for this purpose. As for the immediately preceding item this program is to be undertaken under the authority of sec- tion 433(a) of the Public Health Service Act which requires no match- ing. However, in this case the Committee feels that. there will be sufficient benefit to any community where such research facilities are constructed that there should be a minimum of one third non-Federal matching funds. Outstanding doctors from the Mayo Clinic and Rochester Methodist ‘Hospital of Rochester, Minnesota, appeared before the Committee and presented the results of research which they have done on a smail scale with an experimental unit connected with the Methodist Hos- pital. This unit is of radical design, being circular in form with the nurses unit in the center. The hearings and exhibits showing this design appear beginning at page 674 of the Committee’s hearings with public witnesses. These doctors testified that with this unit they were able to reduce nursing care, that would amount to $54.00 per day for the type of intensive-care patients that were being treated, down to $13.88 per day. Even if. only half of such an amazing reduc- tion in cost could be obtained in a full scale facility the total savings on a nationwide basis would be in the hundreds of millions of dollars per year. The potential savings are staggering when one considers the fact that approximately 20% of all hospital patients require the type of intensive care that was given in connection with this study, and that nursing care of this type costs approximately $50 per day. According to the Bureau of Labor Statistics, hospital rates have gone up over 300% during the last two decades. This increase will contintte unless, through research of the type proposed here, hospital design and operations can be improved. The Committee does not wish to leave any implication that it desires that any individuals or any community be given special con- sideration in the application of these funds. The project or projects approved for financing should be approved only after having been screened and approved by the appropriate advisory council of the National Institutes of Health, and after it has been determined that the research and demonstration potential of the applicant or appli- cants meets acceptable standards. Grants for construction of health research facilities —The bill includes $30,000,000, the amount of the request. and the same amount as was appropriated for fiscal year 1961. Scientific activities overseas (special foreign currency program).—The bill includes $8,000,000, a reduction of $2,084,000 from the request, and $4,293,000 over the amount. appropriated for. 1961. National health statistics.—The bill includes $4,642,000, the amount of the request, and $595,700 over the amount available for comparable activities in fiscal year 1961. This is a new appropriation item which consolidates the activities of the National Health Survey previously financed under the appropriation ‘Salaries and expenses’ and the activities of the National Office of Vital Statistics previously funded under the appropriation “Assistance to States, general’’. Operations, National Library of Medicine-——The bill includes $2,066,000, the amount of the request, and $328,000 over the amount appropriated for 1961. The major part of the increase, $311,000, is LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 37 accounted for by the move to the new building in Bethesda. The General Services Administration is currently bearing the costs of such items as janitorial services, guard services, etc., at their temporary quarters. These costs will be borne by this appropriation starting in 1962 when the Library will be occupying its new building. Salaries and expenses, Office of the Surgeon General.—The bill includes $5,275,600, the budget request, and $1,951,000 below the appropria- tion for fiscal year 1961. It should be noted, however, that pro- posed transfers of activities affecting this appropriation result in a net decrease of expenses, borne in 1961 and not being required in 1962, totaling approximately $2,000,000. Thus the appropriation recom- mended in the bill represents a slight increase in the activities remain- ing under this appropriation. SAINT ELIZABETHS HOSPITAL Salaries and expenses.—The bill includes $5,105,000, an increase of $166,000 over the request and $533,000 over the appropriation for fiscal year 1961. In 1957 a committee of consultants was formed to survey the needs of St. Elizabeths Hospital. Their report showed many serious de- ficiencies. This survey was evaluated and further studies were made which did httle but confirm the facts originally revealed that the Hospital urgently needed additional staff if it were to give satisfactory care and treatment to its patients. The 1961 budget approved by the Congress provided for an increase of 299 additional positions as the first major step in a proposed staffing program of several years’ duration. The Committee was surprised and disappointed that the budget submitted for fiscal year 1962 provided for only 150 additional positions, thus falling short by 50%-of the program initiated last year. ‘The increase proposed by the Committee will provide for approximately the same advance which was made last year. Buildings and facilities —The bill includes $575,000, the amount of the request, and $4,764,000 less than the amount appropriated for the same purposes for fiscal year 1961. This appropriation consolidates into one account all of the major repair and construction items for the Hospital. The major item provided for in the bill is $270,000 to con- tinue plans and specifications for a 400 bed ‘continued ‘treatment’ building to replace 3 smaller obsolete treatment facilities constructed during the period 1853-1872, SOCIAL SECURITY ADMINISTRATION Limitation on. salaries and expenses, Bureau of Old-Age and Survi- vors Insurance.—The bill includes $241,070,000, an increase of $320,000 over ‘the request, and $8,870,000 over the amount appropriated for fiscal year 1961. While the figures show that the amount recommended in the bill is an increase over the amount requested, this is only technically true. A supplemental request for $320, 000 was submitted earlier during this session of Congress and was considered in connection with the Third Supplemental Appropriation Bill, 1961. It was denied at that time solely on the basis that 1t was not a deficiency item. Since 38 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS the Committee took credit for a reduction in connection with that bill it is shown as an increase in connection with this one. The increase over the 1961 allowance is also more apparent than real. The bill includes a contingency fund of $10,000,000 to be used only if claims workloads exceed the estimates on which this appropriation is based. Since it is anticipated that there will be less than $4,000,000 left in the contingency reserve at the end of fiscal year 1961, the base appropriation for 1962 is almost the same as the amount estimated to be spent in 1961. Grants to States for public assistance.—The bill includes $2,285,800,000, the amount of the request, and $108,800,000 above the appropriation for fiscal year 1961. The major part of the increase reflects the additional effect in 1962 of the 1960 amendments, pri- marily in old age assistance and medical assistance for the aged. A small part of the increase is due to an estimated increase in the number of recipients in the aid to dependent children and aid to the permanently and totally disabled categories. Under the Social Security Act there is practically no administrative control over the amount of funds granted to the States so long as the States’ programs meet the requirements of the Act. The Committee saw no reason to question the calculations of the Department as to the Federal matching funds that will be required, and has approved this item without change. Hospitalization and services for repatriated mentally il Americans.— The bill includes $364,000, the amount of the request. This is a new program, authorized by the last session of Congress, which combines two previous authorizations under which St. Elizabeths Hospital provides care and treatment for, (1) persons belonging to the Foreign Service of the United States, and (2) Americans who have become mentally ill in Canada and cannot be considered residents of any state. These two authorizations are repealed as of the end of the current fiscal year and the new program 1s effective July 1, 1961. Salaries and expenses, Bureau of Public Assistance.—The bill includes $3,221,000, a reduction of $79,000 from the request, and $494,100 over the amount appropriated for 1961. The major part of the increase will be required to annualize new positions provided in supplemental appropriations for 1961. The few additional positions are mostly for the field offices and are felt to be necessary due to the expansion of the program under the 1960 amendments. Salaries and expenses, Children’s Bureau.—The bili includes $2,668,000, the amount of the request, and $174,500 above the amount appropriated for fiscal year 1961. it has been suggested to every Secretary of the Department of Health, Education, and Welfare and every Administrator of the Federal Security Agency that it is wrong to relegate the Children’s Bureau to a third level position. The Committee strongly feels that the responsibilities and the activities of the Children’s Bureau are of sufficient importance to warrant placing it on a level directly below the Secretary rather than being just another office in the Social Security Administration. The Secretary has always had the authority to make such an organizational change and give the Children’s Bureau the recognition that it deserves. The Committee also feels that the Children’s Bureau should be given more responsibilities for research than it has in the past. The LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 39 research programs of the National Institutes of Health have been primarily in the disease areas and the Committee is of the opmion that this is as it should be. There has been some tendency however during the past few years to de more work in the behavioral research area especially in connection with children. This, it seems to the Committee, should more properly be the role of the Children’s Bureau. When this was discussed during the hearmgs, considerable doubt was expressed as to the authority of the Children’s Bureau to make re- search grants in this area. While much important research could be done directly, a well rounded research program should include extra- mural activities. The Committee is especially anxious that the Chil- dren’s Bureau be given a more important role in connection with the problem of juvenile delinquency. It may well be that the Committee itself is as much at fault as anyone for the current situation, for the Committee encouraged the Mental Health Institute in this field rather than attempting to lay a foundation, and encouraging the Department to take the steps necessary, for such a program in the Children’s Bureau. However, it will be expected that the Department give serious consideration to this matter during the next year and if nec- essary seek legislation to make a well-rounded program possible; and be prepared to present such a well-rounded program to the Committee next year. Grants to States for maternal and child welfare-—The bill includes $67,100,000, an increase of $2,350,000 over the budget request, and $15,267,000 over the amount appropriated for fiscal year 1961. The net increase over the amount requested represents an increase of $1,000,000 each for the three origmal categories and a reduction of $650,000 in the amount requested for the new activity ‘Research or demonstration projects in child welfare.” There was $1,000,000 re- quested for the latter program of which $350,000 was estimated to be necessary for expenses in fiscal year 1962, and $650,000 was for obligations to be incurred in 1963 and succeeding years. The Com- mittee does not feel that it is wise to deviate from the standard pro- cedure of providing funds for such activities on an annual basis, thus assuring a review at least once each year. The authorization for each of the three original categories is $25 000,000. For ‘Maternal and child health services” the bill provides. $23,000,060 compared with $18,167,000 available for 1961. The bill includes $25,000,000 for “Crippled children’s services” compared with $20,000,000 available for fiscal year 1961. The bill includes $18,759,- 006 for “Child welfare services’? compared with $13,666,000 available for 1961. Over the last several years these appropriations have not even kept up with the increase in child population and the increase in: costs, let alone provide for any improvement in these services. In one category the figures show that in the decade from 1950 to 1960 these appropriations actually decreased $6 per year per 1,000 children. In view of these facts the Committee feels that this increase is rather modest. In the past far too little attention has been paid to the plight of unwed mothers in the teenage group and their children. Despite the efforts of welfare agencies and law enforcement officials, there con- tinues to be a thriving black market in babies. This is made possible to a large extent by the lack of decent programs for young unwed. mothers and their children. The Committee will expect that the Children’s Bureau use a portion of the increased funds in fiscal year 40 LABOR-HEALTH, EVUCATION, WELFARE APPROPRIATIONS 1962 to get effective programs started to better deal with the prob- lem, and to rehabilitate these mothers so that they may become a part of decent society rather than going on to further degradation as now so often happens. Cooperative research in social security —The bill includes $700,000, a reduction of $800,000 from the request, and $350,000 over the amount appropriated for fiscal year 1961. The reduction made by the Com- mittee represents funds that were requested for obligation beyond fiscal year 1962. As explained above, the Committee does not feel that it is wise to deviate from the standard procedure of appropriat- ing funds for such programs on an annual basis. Research and training (special foreign currency program).—The bill includes $1,000,000, a reduction of $1,213,000 from the request. Salaries and expenses, Office of the Commissioner.—The bill includes $590,000 and authorization to use $322,000 from the OASI trust fund, the amount of the request in both instances and an increase over the amounts for 1961 of $217,200 and $26,000, respectively. While this is a rather substantial increase for this office, the Social Security programs have expanded greatly during the last several years with very little increase in the staff of the Commissioner. This budget represents a combination of a belated increase to enable the Com- missioner’s Office to keep abreast of the already expanded program, and a recognition of further changes and expansion that are almost certain to come this year and in the very near future. AMERICAN PRINTING HOUSE FOR THE BLIND Education of the blind—The bill includes $400,000, the amount of the request, and the same amount as was appropriated for fiscal year 1961. GALLAUDET COLLEGE Salaries and expenses.—The bill includes $1,200,000, the amount of the request, and $136,000 over the amount appropriated for fiscal year 1961. Construction.—The bill includes $127,000, the amount of the request and $2,395,000 less than the amount appropriated for fiscal year 1961. HOWARD UNIVERSITY Salaries and expenses —The bill includes $7,007,000, the amount of the request, and $1,517,000 above the amount appropriated for fiscal year 1961. An increase of $767,000 was included in the January budget presented by the last Administration, in addition, a $750,000 increase is contained in a budget amendment submitted by the current Administration. This represents an attempt to build up the instruc- tional staff to a level comparable with other universities of the size and scope of Howard University. The Committee feels that this is an admirable goal. Plans and specifications —The bill includes $211,000, the amount of the request, and $14,000 less than the amount appropriated for fiscal year 1961. The major part of the appropriation is to prepare plans LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Al and specifications for an additional men’s dormitory to take care of the greatly creased enrollment of out of town students. Construction of buildings.—The bill includes $4,447,000, the amount. of the request, and $3,014,000 more than the amount appropriated for fiscal year 1961. A major part of the appropriation for 1962, $3,947,000, will be used for construction of a much needed physical education building for which plans and specifications are being com- pleted with funds previously appropriated. Construction of auditorium-fine arts building (liquidation of contract auihority).—The bill includes $95,000, the amount of the request, as the final amount necessary to liquidate contract authority previously granted for the construction of the auditorium-fine arts building. OFFICE OF THE SECRETARY Salaries and expenses.—The bill includes $2,382,000 and authority to transfer $352,000 from the OASI trust fund, the amount of the request in both instances; and $173,000 and $26,000, respectively, above the amounts allowed for 1961. During the hearings the Chairman of the Subcommittee expressed deep concern, disappointment and dissatisfaction with the Depart- ment’s activities in aging. There is no clearly defined program and little evidence of leadership directed toward positive action following the White House Conference on Aging. . The report of the Conference, ‘““The Nation and Its Older People,” transmitted to the President, April 10, 1961, is not “the blueprint for action” the country was promised during the years preceding the Conference and in the hundreds of meetings that were held through- out the nation in preparation for it. The report at best is little more than a directory of participants, a collection of general policy statements and a wide assortment of recommendations that have little significance without some indication of the plans that will convert them into action. Unless a more useful document is prepared for the American public with a determination on the part of H.E.W. to. follow through, the White House Conference on Aging will have been not only one of the most expensive, but the least productive of the national conferences, and could become one of the cruelest hoaxes ever perpetrated against the nation’s senior citizens. Immediate action must be taken to develop a program that will achieve the aims and purposes set forth in the bill which established the conference. Salaries and expenses, Office of Field Administration—The bill includes $3,225,000 and authorization to transfer funds totaling $1,285,G00 from other accounts, a reduction of $138,000 from the appropriation requested and the same amount as requested for authorization to transfer from other accounts. The amounts allowed are $283,000 and $85,000, respectively, over the amounts allowed for fiscal year 1961. ; The reduction recommended by the Committee represents the dis- allowance of funds for an analyst and secretary for each regional office (18 positions) and for an increase of two positions for the State merit system staff. The major part of the increase over 1961 is for A2 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS a regional representative on aging activities in each regional office and an increase of 11 positions in the grant-in-aid audit staff whose work- load has been considerably increased as a result of the expanded Social Security program. Surplus property utilization —The bill includes $862,000, the amount of the request, and $76,000 above the amount appropriated for fiscal year 1961. Salaries and expenses, Office of the General Counsel—The bill includes $713,000 and authorization to transfer $696,000 from other accounts, the budget request in both instances, and $63,000 and $50,000, respectively, above the amounts allowed for fiscal year 1961. A large part of the increase is simply to annualize the increase al- lowed under a supplemental appropriation fer 1961. An increase of approximately 14 positions is allowed to enable this office to keep abreast of the expanding programs of the Department. TITLE TI—NATIONAL LABOR RELATIONS BOARD Salaries and expenses.—The bill includes $18,213,000, a reduction of $667,000 from the request, and the same amount as was appro- priated for fiscal year 1961. ~ In fiscal year 1960 this agency had funds to support 1,820 posi- tions. The budget submitted to Congress for fiscal year 1961 re- quested funds to continue the 1,820 positions. That budget was al- lowed by Congress without a change of one dollar. However, through the use of savings during the first nine months of the year, the agency planned to add 31 additional positions for the last three months of the fiscal year, thus building their staff up to a point where Congress would have to appropriate additional funds if the higher number of personnel were to be kept on the payroll. Stated in simple terms, the anerease requested for 1962 was to annualize 1961 staff increases that were never granted by Congress. The Committee is surprised at such shoddy budgeting, and is em- phatically not disposed to sanction it by approving the requested in- crease. Congress has been rather liberal with appropriations for this agency during the recent past. In fact during the last three years Congress has appropriated more funds than were requested. The Committee feels confident that if the workload warrants an increase, and if a request is submitted in a straight-forward manner demon- strating the requirements, Congress will provide the necessary funds. The budget presented to the Committee was based on decisions made, and was actually prepared, before the current chairman was appointed. Its deficiencies should in no way be attributed to him. TITLE IV—NATIONAL MEDIATION BOARD Salaries and expenses.—The Bill includes $1,604,000, the amount of the request, and the same amount as was appropriated for fiscal year 1961. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 43 TITLE V—RAILROAD RETIREMENT BOARD Salaries and expenses (trust fund limitation) —The Bill includes authorization to use $9,740,000, from the trust fund, the amount of the request, and $45,000 less than the amount authorized for fiscal year 1961. For each of the last few years, the Committee has urged the Bureau of the Budget, the Department of Health, Education, and Welfare, and the Railroad Retirement Board to get together and determine the adjustments that, under existing law, should be made between the general funds of the Treasury, the Railroad retirement trust fund, and the Old-age and survivors msurance trust fund. The Committee has been especially interested in seeing that the law was carried out in regard to appropriations to the Railroad retirement trust fund for military service credits. This year in connection with the hearings, the Committee was told that the three agencies did hold a meeting on November 16, 1960, which was attended by the board members of the Railroad Retire- ment Board, the Deputy Director of the Bureau of the Budget, and staff members, and the Secretary of Health, Education, and Welfare and a staff member. Out of this meeting came, what the Railroad Retirement Board thought, was a general agreement that the trust fund was entitled to an appropriation and, secondly, that a method would be set up whereby these payments would be budgeted in five or six installments beginning with fiscal year 1962. A “‘memoran- dum of understanding” setting forth the general agreements reached was prepared. A copy of this document is reproduced on page 494 of the hearings with the Railroad Retirement Board. After everyone involved had apparently agreed, the whole matter was vetoed by the Director of the Bureau of the Budget, Mr. Stans. From what the Committee could learn this was simply an arbitrary de- cision. The Committee has since learned that discussions have been. re- instituted and that this whole question is under consideration by the new Budget Director. Before taking any further action in this matter the Committee wishes to give the new Director of the Bureau of the Budget an opportunity to consider this matter and make his own decision. Believing him to be a fair minded person, the Committee has little doubt that he will come to the decision that has been obvious to the Committee for some time, that is, that the law passed by Congress some years ago should be implemented without further undue delay. TITLE VI—FEDERAL MEDIATION AND CONCILIATION SERVICE Salaries and expenses.—The Bill includes $4,388,000, the amount of the request, and $221,600 over the amount appropriated for fiscal year 1961. TITLE VII—INTERSTATE COMMISSION ON THE POTOMAC RIVER BASIN Federal contribution.—The Bill includes $5,000, the amount of the request, and the same amount as was appropriated for fiscal year 1961. PERMANENT APPROPRIATIONS, GENERAL AND SPECIAL FUNDS Agency and item Appropriated, 1961 Estimates, 1962 Increase(+-), decrease (—) Office of Education: Payments to States and Territories for colleges of agriculture and mechanic arts (act of Mar. 4, 1907)_.00.2------ a 8 $2, 550, 000 Payments to States for promotion of vocational education (act of Feb. 23, 1917) __.-__----------------------- 22-8 7, 170, 800 $2, 550, 000 7, 170, 000 5 9, 720, 000 9, 720, 000 TRUST FUNDS {Not a charge against general revenue] Agency and item Estimates, 1961 Estimates, 1962 Increase (++), decrease (—) DEPARTMENT OF LABOR Bureau of Employees Compensation: Relief and rehabilitation, Longshoremen’s and Harbor Workers’ Compensation Act, as amended____.-----.___._.- $26, 000 $25, 000 ~— $1, 000 Relief and rehabilitation, Workmen’s Compensation Act, with- in the District of Columbia___.-.-.---------------------- 8, 000 8, 000 j_------- eee Administration of the District of Columbia Workmen’s Com- pensation Act... ---.-------------------------------- 271, 000 280, 000 +9, 000 Bureau of Labor Statistics: Special statistical work__....-.--.----- 35, 000 |... -- — 35, 000 Total, Department of Labor... ----. ope eee eee eee eee 340, 600 313, 600 — 27, 060 a SNOLLVINdOUddY TUVATEM ‘NOLLVOOCE ‘SLVIVEH-YOdV I DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Office of the Secretary: Federal Council on Aging.__.0-2 2222-88 Public Health Service benefit and gift funds_....-..-_._-_ 222 _ St. Elizabeths Hospital patients’ benefit fund_........._..-.____. St, Elizabeths Hospital conditional gift fund....-...2.--22 Total, Department of Health, Education, and Welfare______ RAILROAD RETIREMENT BOARD Railroad retirement account__......-.----.---- eee Limitation on Railroad Unemployment Insurance Administration Fund___------2 22 e eee TREASURY DEPARTMENT TRUST FUNDS FOR LABOR-H.E.W. PROGRAMS Office of the Secretary: Federal Disability Insurance Trust Fund_._ Office of the Secretary: Federal Old Age and Survivors Insurance Trust Fund__..----.-------.- eee Office of the Secretary: Unemployment Trust Fund_....2-.._____ Total, Treasury Department__.._.......22--22 Total trust funds, all agencies__._.--.002000- 2. 6, 000 6, 000 |..--- eee eee 181, 000 91, 000 —90, 000 1, 000 1,000 |.00.22- 22 9, 000 9,000 |..---2--- eee 197, 000 107, 000 —90, 000 1, 132, 000, 000 1, 176, 000, 000 +44, 000, 000 8, 960, 000 9, 280, 000 +320, 000 1, 140, 960, 000 1, 185, 280, 000 +44, 320, 000 1, 081, 448, 000 1, 136, 047, 000 54, 599, 000 11, 821, 203, 000 3, 580, 800, 000 12, 322, 868, 000 1 3, 634, 100, 000 +501, 665, 000 +53, 300, 000 16, 483, 451, 000 17, 093, 015, 000 +609, 564, 000 17, 624, 948, 000 18, 278, 715, 000 + 653, 767, 000 4 Includes receipts due to a budget amendment of $20,000,000, SNOLLVIUdOUddV GUVATEM ‘NOILVOOdGH “SELIVEE-NOaVT oP COMPARATIVE STATEMENT OF APPROPRIATIONS FOR 1961, ESTIMATES RECOMMENDED IN THE BILL FOR 1962 TITLE I—DEPARTMENT OF LABOR FOR 1962, AND AMOUNTS Agency and item Appropriations, 1961 1 Estimates, 1962 Recommended in Bill compared with— OFFICE OF THE SECRETARY Salaries and expenses_..__.__..-.-------- BUREAU OF LABOR-MANAGEMENT REPORTS Salaries and expenses___________-_--..--- BUREAU OF INTERNATIONAL LABOR AFFAIRS Salaries and expenses____-_-.-.---------- OFFICE OF THE SOLICITOR Salaries and expenses_.......--.--.------ BUREAU OF LABOR STANDARDS Salaries and expenses...-..___.-_.------- BUREAU OF VETERANS’ REEMPLOYMENT RIGHTS Salaries and expenses......._.----------- BUREAU OF APPRENTICESHIP AND TRAINING Salaries and expenses._.....-.----------- SECURITY BUREAU OF EMPLOYMENT Limitation on salaries and expenses.....-.-~- PUM or 1982 1961 appropriations 1962 estimates $1, 869, 860 2 $1, 895, 000 $1, 711, 000 — $158, 800 —~ $184, 000 5, 550, 000 6, 275, 000 5, 775, 000 +225, 000 — 500, 000 (@) 510, 000 444, 000 +444, 000 — 66, 000 2, 878, 300 3, 616, 009 8, 616, 000 +737, 700 |__.------------- 2, 522, 000 43, 208, 000 3, 208, 000 +686, 000 |..--.--.-------- 632, 300 633, 060 633, 000 +700 |..---------~----- 4, 329, 000 4, 476, 000 4, 976, 000 +647, 000 +500, 000 [ 9, 000, 000] 5 [9, 758, 000] [9, 600, 000] { +600, 000] [ - 158, 000] Si SNOLLVIUdOUdaY TUVITIEM ‘NOILVONdE SHLIVEH-WOaVv. Grants to States for unemployment com- pensation and employment service ad- ministration..__..2022222220 22 uo ee Limitation on grants to States. ....2 22222. Payment to the Federal extended compen- sation account.______ wee Advances to Employment Security Admin- istration account, Unemployment Trust Fund Unemployment compensation fer Federal employees and ex-servicemen___.____.__ Compliance activities, Mexican farm labor program =~ 2. ee Salaries and expenses, Mexican farm laber program (transfer from revolving fund) ___- Total, Bureau of Employment Se- curity 2-2-2 ee BUREAU OF EMPLOYEES’ COMPENSATION Salaries and expenses: Direct appropriation. _.________- pee Transfer from Longshoreman’s Trust FPund__. 2-22 ee Employees’ compensation fund. ._.-._.__- Total, Bureau of Employees’ Com- pensation. -__--. 222-22 See footnotes at end of table, p. 58. 18, 924, 000 |._-.-222 22 ee Je eee —18, 924, 000 |_----.._--__._e- [ 360, 000, 000]| * [391,700,000] [ 891, 700, 000]| [+81, 700, 000]|[......-..--_-- ] 500, 000, 000 |. 8-8 |e eee —500, 000, 000 |....-2-2- ee 268, 000, 000 6 20, 000, 000 20, 000, 000 | —248, 000, 000 |---.-2. 2222-8 e-- 177, 000, 000 147, 000, 000 147, 000, 000 —30,.000, 000 |....-.- 2-2-2. 1, 168, 700 1, 149, 000 720, 000 — 448, 700 — 429, 000 [1, 496, 100] [ 1, 519, 000] (925, 000] [ —871, 100] [ —594, 000] 965, 092, 700 168, 149, 000 167, 720,000 | —797, 372, 700 — 429, 000 3, 431, 800 3, 834, 000 3, 834, 000 +402, 200 |... 2.2 [61, 700] [51, 700] [51, 700]|[....-.-------- ]I[-------------- ] 63, 000, 000 65, 560, 000 64, 000, 000 +1, 000, 000 —1, 500, 000 66, 431, 800 69, 334, 000 67, 834, 000 +1, 402, 200 —1, 509, 000 SNOILLVIUdOUddY TUVATAM ‘NOLLVONaG ‘ALIVaH-yOaVT LY Comparative statement of appropriations for 1961, estimates for 1962, and amounts recommended in the bill for 1962—Con. TITLE I-—DEPARTMENT OF LABOR—Continued Agency and item Appropriations, 1961 1 Estimates, 1962 Recommended in bill for 1962 Bill compared with—- 1961 appropriations 1962 estimates BUREAU OF LABOR STATISTICS Salaries and expenses.....--.---------.-- Revision of the Consumer Price Index. ___-_ Total, Bureau of Labor Statisties___ WOMEN’S BUREAU Salaries and expenses_____.-----.------.- WAGE AND HOUR DIVISION Salaries and expenses..-.--.------------- Total, Department of Labor____._-- $11, 118,000 | 7 $12, 167, 000 $12,167,000 | +$1, 049, 000 |.--..----._.__-- 1, 322, 000 2, 100, 000 2, 100, 000 +778, 000 |.--.-------.---- 12, 440, 000 14, 267, 000 14, 267, 000 +1, 827, 000 [-.-.---. ee 553, 900 8 668, 000 668, 000 +114, 100 |...-------- ee 12, 261, 000 12, 261, 000 12, 261, 000 |_-..----- eee 1, 074, 560, 800 285, 292, 000 288, 113,000 | —791, 447, 800 —$2, 179, 000 TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE FOOD AND DRUG ADMINISTRATION Salaries and expenses_._.------------------- Salaries and expenses, certification, inspec- tion and cther services (indefinite appro- priation)__.--...---------------------- $18, 848, 000 [ 1, 692, 000] $23, 580, 000 [ 1, 882, 000] $23, 580, 000 [1, 882, 000] + $4, 732, 000 [+ 190, 009] 87 SNOLLVINdOUddY TUVITIGM ‘NOLLVONGS ‘HAVIVaH-MOaVI Pharmacology-animal laboratory building. Total, Food and Drug Administra- tion_._------------------------ FREEDMEN’S HOSPITAL Salaries and expenses...____-___--.------ OFFICH OF EDUCATION Promotion and further development of vocational education..__...2 222k Further endowment of colleges of agri- culture and the mechanic arts.._...__._- Land-grant college aid (non-recurring grant to Hawaii)...-.--------------------- Grants for library services__......-.-....- Payments to school districts_....-.......-- Assistance for school consiruction___._...._ Defense educational activities__..._______ Expansion of teaching in education of the mentally retarded__._.......--------~-- Salaries and expenses___...-....--.-.0.-2 Cooperative research...-...02.22--2-.-- + Salaries and expenses (special foreign cur- rency program)________--.---------.--- Total, Office of Education_..._.___- See footnotes at end of table, p. 53. 100, 600 i, 750, 000 i, 750, 000 +i, 650, 000 [..-.. 22 aalee 18, 948, 600 25, 330, 000 25, 330, 000 +6, 382, 000 |_.---.- 2 eee 3, 497, 600 3, 736, 000 8, 736, 000 +238, 400 |_--2 eee 33, 702, O81 33, 672, 081 33, 672, 000 —30, 081 —81 2, 501, 500 8, 194, 000 8, 194, 000 +5, 692, 600 |-.---.--- on 2, 225, 000 |______------__}ee-e eee —2, 225, 000 |... ne 7, 500, 000 7, 500, 000 7, 500, 000 |__....-.--------|--------- eee. 217, 300, 000 9 85, 700, 000 85, 700,000 | 131, 600,000 |_.-_- eee 63, 392, 000 24, 850, 000 24, 850, 000 — 38, 542, 000 |-_..- Ln. 187, 480, 000 | 19 911, 207, 000 210, 857, G00 4-23, 377, 000 ~-350, 000 1, 000, 600 1, 000, G00 1, 000, 000 |..-.-..-------- [22-2 13, 875, 000 1 17, 005, 000 11, 364, 000 —-2, 511, 000 —5, 641, 000 (8) (2) 5, 500, 000 -+ 5, 560, 000 +5, 500, 000 30, 750 9,000 |. eee. —80, 750 —9, 000 529, 006, 331 389, 137, 081 —140, 369, 331 —500, 081 388, 637, 000 SNOILVIUGOUddY GUVATIAM ‘NOLLVOOad ‘HLIVEH-NOaVT 6P Comparative statement of appropriations for 1961, estimates for 1962, and amounts recommended in the bill for 1962—-Con. TITLE TI—_DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1961 1 Estimates, 1962 Recommended in Bill compared with— bill for 1962 1961 appropriations 1962 estimates OFFICE OF VOCATIONAL REHABILITATION Grants to States......-.--- 2+ --L-eee Research and training.-_-.-_-..---------_. Research and training (special foreign cur- rency program).-_---.-------------_- Salaries and expenses._..-.-.-.-------.-- Total, Office of Vocational. Rehabil- itation_...---_--_-.------ eee ee PUBLIC HEALTH SERVICE Buildings and facilities_...----.-.02.00-.-- Community health activities_.....-.-...-. Accident prevention_...-.-.------------- Chronic diseases and health of the aged___. Communicable disease activities__.-..-__-- Community health practice and research.__ Control of tuberculosis.......-..-.------- $56, 200, 000 | #8 $91, 500, 000 $64, 450,000 | -£ $8, 250,000 | | —$27, 050, 000 15, 430, 000 17, 250, 000 19, 250, 000 +3, 820, 000 +2, 000, 000 930, 000 1, 372, 000 1, 372, 000 +442, 000 |__-...---.--_--- 1, 959, 000 2, 325, 000 2, 325, 000 +366, 000 |....--0---- oe 74, 519, 000 112, 447, 000 87,397,000 | +12, 878, 000 —25, 050, 000 3, 470, 000 16, 630, 000 16, 630,000 | +13, 160,000 |.....---___.-_-- vee ee eee eee ee ee 4 63, 750, 000 |.-..._---..-.--_|.--------------- —63, 750, 000 wee ee eee eee 3, 368, 000 +3, 368, 060 +3, 368, 000 oo eee e lene eee eee eee 3, 958, 000 +3, 958, 000 +3, 958, 000 15, 398, 000 |_..---.---2 Lo _ 9, 778, 000 —5, 615, 000 +9, 778, 000 woe eee eee eee ee [eee eee eee eee 23,961,000 | +23, 961, 000 4-23, 961, 000 6, 493, 000 |L__---- ee 6, 493, 000 |. e eee +6, 493, 000 0¢ SNOILLVINdOUddV TUVTIEM ‘NOLLVORGE ‘HLIVaH-woayt Nursing services and resoureces__...0.-___- Hospital construction activities.......2___ Grants for hospital construction___......_- Salaries and expenses, hospital construction services___..---.---------------- eee Environmental health activities........__2 Air pollution control._.....--.----- Milk, food, interstate and community sanitation..____.-------.----------4-. Occupational health_-___-_...2-- 2-2. Radiological health...0002220-2- 22 LL Water supply and water pollution control__ Grants for waste treatment works. con- struction._._.-_-_--.2.22 2 eens Medical care and foreign quarantine... _ _. Foreign quarantine activities___._._...___ Hospitals and medical care._.-___..2._ 2 See footnotes at end of table, p. 58, 186, 200,000 1, 736, 000 27, 768, 000 5, 110, 000 55, 823, 000 50, 000, 000 54, 482, 000 5, 815, 000 2, 182, 000 7, 675, 000 187, 972, 000 8, 600, 000 7, 424, 000 3, 981, 000 9, 147, 000 15, 028, 000 50, 000, 000 5, 350, 000 49, 835, 000 +5, 815, 000 +2, 182, 000 +7, 675, 000 +187, 972, 000 — 186, 200, 000 —1, 736, 000 —27, 768, 000 +8, 600, 000 +7, 424, 000 +3, 981, 600 +9, 147, 000 +15, 028, 000 +5, 000, 000 +240, 000 5, 988, 000 +5, 815, 000 +2, 182, 000 +7, 675, 000 — 41, 860, 000 +8, 600, 000 +7, 424, 000 +3, 981, 000 +9, 147, 000 +15, 028, 000 — 54, 482, 000 +5, 350, 000 -+-49, 835, 000 SNOILVIUdOUddY TUVHTEM ‘NOILVOOGE ALVIVAH-YOaVT Tg Comparative statement of appropriations for 1961, estimates for 1962, and amounts recommended in the bill for 1962—Con. TITLE TI—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1961 1 Estimates, 1962 Recommended in bill for 1962 Bill compared with— 1961 appropriations 1962. estimates PUBLIC HEALTH SERVicE—continued National Institutes of Health: General research and services._.....__ National Cancer Institute........_._- Mental health activities..__._..-___- Allergy and infectious disease activities. Neurology and blindness activities ____ Subtotal, National Institutes of Health_..-.-.-.-2000----------- Grants for construction of cancer research facilities... -20 2 nee Grants for construction of hospital research facilities... ee $83, 900, 000 16 $95, 341, 000 $119, 275, 000 +$35, 375, 000 +$23, 934, 000 111, 000,000 | 47 117, 167, 000 125, 672,000 | +14, 672, 000 +8, 505, 000 100, 900, 000 | 8 88, 324, 000 92, 182, 000 —8, 718, 000 +3, 858, 000 86, 900, 000 | 1 97, 073, 000 105, 723,000 | +18, 823, 000 +8, 650, 000 15, 500, 000 | 29 13, 933, 000 14, 681, 000 —819, 000 +748, 000 61, 200,000 | 2" 68, 740, 000 73, 661, 000 | ++ 12, 461, 000 +4, 921, 000 44,060,000 | 22 48, 322, 000 52, 182, 000 +8, 182, 000 +3, 860, 000 56, 600,000 | 8 54, 100, 000 57, 624, 000 +1, 024, 000 +3, 524, 000 560, 060, 000 583, 000, 000 641, 000,000 | -+ 81, 000,000 | +58, 000, 000 4 ee 5, 000, 000 +5, 000, 600 -+5, 000, 000 pee eee e eee ee |ee eee een eee e eee 10, 000,000 | +10, 000,000 | +10, 000, 000 oS SNOLLVINdOUddY DUVATIGM ‘NOLEVONa ‘ALIVaH-HOaVI Grants for construction of health research facilities. .........--.------ 2 ee. Scientific activities overseas (special foreign currency program) National health statisties.....-----..---2- Operations, National Library of Medicine... Retired pay of commissioned officers (indefi- nite appropriation) Salaries and expenses, Office of the Surgeon General__....---------+--- +e ee Assistance to States, general....__.....___ Total, Public Health Service________ SAINT ELIZABETHS HOSPITAL Salaries and expenses...-_.-.--_..2_-__-- Building and facilities......-....-.---..-- Major repairs and preservation of buildings and grounds._.....---.------.-----_-e Construction and equipment, treatment and cafeteria building..-........-_.. 2 - Extension and modernization of adminis- tration buiiding....---2222--- ee Total, Saint Elizabeths Hospital. ___ See footnotes at end of table, p. 58, 30, 000, 000 30, 000, 000 30, 000, 000 |... eee 3, 707, 000 10, 084, 000 8, 000, 600 4-4, 293, 000 — 2, 084, 000 woe eee eee eee 4, 642, 000 4, 642, 000 +4, 642,000 |..----- ee. 1, 738, 000 2, 066, 000 2, 066, 000 +328, 000 |----.-----2 noe. [1, 920, 000} [2, 180, 000] [2, 180, 000] [ +260, 000]|[-..-----..---- ] 7, 226, 000 5, 275, 000 5, 275, 000 —1, 951,000 |-.2.--- eee 27, 277, 000 |.-.-------------|-- ee -ee eee —27, 277, 000 |...----------.-- 976, 941,000 | 1,049, 761,000 | 1, 123, 180,000 | +146, 239,000} +73, 419, 000 4, 572, 000 4, 939, 000 5, 105, 000 +533, 000 +166, 000 ween eee eee ee 575, 000 575, 000 +575, 000 |....------.----. 345, 000 |_._....-.-------|-----------e eee —345, 000 |_.-.---2---- =e 4, 493, 000 |.-...-----------|-----e eon —4, 493, 000 |_---------- ooo 501, 000 |.._...-..-------|-.----e--- eee —501, 000 |__.---------oee 9, 911, 000 5, 514, 000 5, 680, 000 —4, 231, 000 +166, 000 HUVITEM ‘NOLLVONGE “ELIVaH-YOsVI SNOLLVIUdOUddVy &¢ Comparative statement of appropriations for 1961, estimates for 1962, and amounts recommended in the bill for 1962-—Con. TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1961 4 Estimates, 1962 Recommended in Bill compared with— bill for 1962 1961 appropriations 1962 estimates SOCIAL SECURITY ADMINISTRATION Limitation on salaries and expenses, Bureau of Old-Age and Survivors Insurance (trust fund)... -2...----------------------- Grants to States for public assistance_.____ Hospitalization and services for repatriated mentally ill Americans._._....----.---- Salaries and expenses, Bureau of Public Assistance__.___--..------------------ Salaries and expenses, Children’s Bureau____ Salaries and expenses, White House Con- ference on Children and Youth__...-_-- Grants to States for maternal and child welfare._.........---.---------.------ Cooperative research in social security .- -- . Research and training (special foreign cur- rency program)____....-.------------- Salaries and expenses, Office of the Com- missioner: Appropriation. ..-.......-------.--- [ £282, 200, 000] 2, 177, 000, 000 2, 726, 900 2, 493, 500 150, 000 51, 833, 000 350, 000 372, 300 [ 8240, 750, 000) 2, 285, 800, 000 364, 000 3, 300, 000 2, 668, 000 23 64, 750, 000 1, 500, 000 2, 213, 000 590, 000 [ $241, 070, 000] 2, 285, 800, 000 364, 000 3, 221, 000 2, 668, 000 67, 100, 000 - 700, 000 1, 000, 000 590, 000 [ +88, 870, 000] +108, 800, 000 +364, 000 +494, 100 +174, 500 — 150, 000 +15, 267, 000 +350, 000 +1, 000, 000 +217, 200 [ +8320, 000] +2, 350, 000 —800, 000 —1, 213, 000 VG SNOLLVIUdOUddY GUVATAM ‘NOLLVOOGS. “HLIVaH-YOav1 Transfer from OAST trust fund_.__-_-- Total, Social Security Administra- tion AMERICAN PRINTING HOUSE FOR THE BLIND Education of the blind... 2-22-2222 GALLAUDET COLLEGE Salaries and expenses_____.....-__-__--_- Construction. _.....-._..2 22-2 eee HOWARD UNIVERSITY Salaries and expenses..______.....-_-___-- Plans and specifications Construction of buildings Construction of auditorium-fine arts build- ing (liquidation of contract authority) .__ Total, Howard University_......__. OFFICE OF THE SECRETARY Salaries and expenses: Appropriation __...- ce eee eee eee Transfer from OAST trust fund_...__.- See footnotes at end of table, p. "8. . 1296, 000] {322, 000] [ 322, 000]! [ +24, 000}|[ _-___ wane eee ee j 2, 234, 926, 200 | 2, 361, 185,000 | 2, 361, 443,000 | +126, 516, 800 +258, 000 400, 000 400, 000 400, 000 |_-...22 222-222 |eo eee 1, 074, 000 1, 200, 000 1, 200, 000 +186, 000 |... 222s ee 2, 512, 000 127, 000 127, 000 2, 395, 000 |... 3, 586, 000 4, 327, 000 1, 327, 000 —2, 259, 000 |---.------ 5, 490, 000 2 7, 007, 000 7, 007, 000 +1, 517,000 |_---2-2.- ee 225, 000 211, 000 211, 000 —14, 000 |..-_--- 22 8. 1, 433, 000 4, 447, 000 4, 447, 000 +8, 014,000 |.-.2-22 22. wee lee eee e eee 95, 000 95, 000 +95, 000 |.-.--2 2s 7, 148, 000 11, 760, 000 11, 760, 000 +4, 612, 000 |-.----- ee 2, 209, 000 2, 382, 000 2, 382, 000 +178, 000 |....22--- 28. [ 826, 000] [ 852, 000] [ 352, 000] [+26, OOO]I[..-22 2-2 j dV¥V QaVATOM ‘NOLLVONGH TEIVaH-FOgvt SNOILVINdOUd gg Comparative statement of appropriations for 1961, estimates for 1962, and amounts recommended in the bill for 1962--Con. TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Bill compared with— Agency and item Appropriations, 1961 4 Estimates, 1962 Recommended in bill for 1962 1961 appropriations 1962 estimate OFFICE OF THE SECRETARY-—continued Salaries and expenses, Office of Field Ad- ministration: Appropriation......---.---------~-- $2, 942, 000 $3, 363, 000 $3, 225, 000 + $288, 000 — $188, 000 Transfers. ...---.------------------ {2, 200, 000] [1, 285, 000] [1, 285, 000] [ +85, 000]|[-----.-------- ] Surplus property utilization....._.--..--- 786, 000 862, 000 862, 000 +76, 000 | _.---.-------- Salaries and expenses, Office of the Gen- eral Counsel: Appropriation..-.------------------ 650, 000 713, 000 713, 000 +63, 000 | -------------- Transfers..-_---------------------- [646, 000] [696, 000} [696, 000] [4+40, 000]|[-----.-------- ] White House Conference on Aging__--.---- 785, 000 |_.._.------- a _|----- eee — 785, 000 |.-.------------- Total, Office of the Secretary_-_--_- 7, 372, 000 7, 320, 000 7, 182, 000 — 190, 000 — 1388, 000 Total, direct appropriations, De- partment of Health, Education, and Weilfare..____-.------------ 3, 866, 255, 131 3, 967, 917, 081 4, 016, 072, 000 +149, 816, 869 +48, 154, 919 Indefinite appropriations..._.------------ 3, 612, 000 4, 062, 000 4, 062, 000 + 450, 000 |___------------- Total, direct and indefinite appro- priations, Department of Health, Education, and Welfare.....----- 3, 869, 867, 131 3, 971, 979, 081 4, 020, 134, 000 +150, 266, 869 +48, 154, 919 9g SNOILVIUdONddVY TUVATEM ‘NOTLVOOGS “SHINVaEH-woavI TITLE ILI—NATIONAL LABOR RELATIONS BOARD Salaries and expenses________--_.--.+---- $18, 213, 000 $18, 880, 000 $18, 213, 000 |__--------------- — $667, 000 TITLE IV—NATIONAL MEDIATION BOARD Salaries and expenses_-__-.--.------------ $1, 604, 000 $1, 604, 000 $1, 604, 000 |_....----------.]------------.--- TITLE V-—-RAILROAD RETIREMENT BOARD Salaries and expenses (trust fund limita- tion) .---_-.------~------------ eee [$9, 785, 000] [89, 740, 000] [89, 740, 000] [—846, OOO] |[.---.------.-.- ] Payment to Railroad unemployment in- surance account..____....-.---------- 20, 000, O00 |___.------------|---------------- ~— 20, 000, 000 |_-_-..--.-.----- Total, Railroad Retirement Board - - 20, 000, O000_|.....---.------_|---------------- — 20, 000, 000 |_.....---..----- TITLE VI—FEDERAL MEDIATION AND CONCILIATION SERVICE Salaries and expenses._...-....---------- $4, 166, 400 $4, 388, 000 $4, 388, 000 + $221, 600 ERSTATE COMMISSION ON THE POTOMAC RIVER BASIN Federal contribution_____...-....-------- $5, 000 $5, 000 $5, 000 See footnotes at end of table, p. 58. SNOLLVINdOUddVY BUVATAEM ‘NOLLVONaT ‘HLIVIH-HOdVI Lg TITLE VIIL—UNITED STATES SOLDIERS’ HOME Comparative statement of appropriations for 1961, estimates fer 1962, and amounts recommended in the bill for 1962—Con. _Agency and item Appropriations, 1961 1 Estimates, .1962 Recommended in Bill compared with— bill for 1962 .| 1961 appropriations 1962 estimates Limitation on operation and maintenance and capital outlay__-..-- 22. [ 85, 664, 000] [ 86, 052, 000] [ 86, 052, 000) [ +388, 000]IT . Total direct appropriations, all titles of the bill...-----_2--------___- 4, 984, 304, 331 Total, indefinite appropriations, all titles of the bill---_-____-____2_. Grand total_.__.----_ =e 4, 988, 416, 331 4, 278, 086, 081 | 4, 323, 395,000 | —661, 409, 331 | +845, 308, 919 4, 062, 000 4, 062, 000 +450, 000 |.---2-- 22 4, 282, 148, 081 | 4, 327, 457,000 | —660, 959,331! +45, 308, 919 iTneludes amounts carried in third and prior supplemental appropriation bills for 1961. 2 Includes $220,000 contained in H. Doc. 108. 3 Included in Office of the Secretary. for 1961. 4 Includes $300,000 contained in H. Doc. 108. 5 Includes $1,420,000 contained in H. Doc. 108. 5a Includes $23,700,000 contained in H. Doc. 108. § Contained in H. Doc. 108. 7 Includes $325,000 contained in H. Doe. 108. 8 Includes $80,000 contained in H. Doc. 108. ® Includes $8,700,000 contained in H. Doc. 104. 10 Includes $16,715,000 contained in H. Doe. 104. 1 Includes $1,905,000 contained in H. Doe. 1388. 12 Included in ‘Salaries and expenses’’. ®8 Includes $15,000,000 contained in H. Doc. 104. 4 Tncludes $2,000,000 contained in H. Doc. 104. 1 Includes $35,000,000 contained in H. Doe. i104. 16 Includes $7,937,000 contained in H. Doc. 104. 1 Includes $7 ,875,000 contained in H. Doc. 104. 18 Includes $5,402,000 contained in H. Doc. 104. 1! Includes $5, 716, 000 contained in H. Doc. 104. 20 Includes $898,000 contained in H. Doc. 104. *t Includes $6,501,000 contained in H. Doc. 104. 2 Includes $4,037,000 contained in H. Doc. 104. 3 Includes $4,634,000 contained in H. Doc. 104. 4 $5,000,000 included for this purpose undér National Cancer Institute for 1961. 25 Includes $9,917,000 contained in H. Doc. 104. 26 Includes $750,000 contained in H. Doc. 104. SNOLLVINdOUdAY TUVATGM ‘NOTLVOOaR “HLIVaEH-WOaVI 8g