[COMMITTEE PRINT] HOTICE.— 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. 88rH CONGRESS HOUSE OF REPRESENTATIVES ¢{ REpoRT ist Session } No, —— DEPARTMENTS OF LABOR, AND HEALTH, EDUCATION, AND WELFARE, AND RELATED AGENCIES APPROPRIA- TION BILL, 1964 Aprit 25, 1963—Committed to the Committee of the Whole House on the State of the Union and order to be printed Mr. Fogarty, from the Committee on Appropriations, submitted the following REPORT (To accompany H.R. ——) 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, Construction of Indian health facilities, Emergency health activities, and Assistance to refugees in the United States), the National Labor Relations Board, the National Mediation Board, including the National Railroad Adjustment Board, the Rail- road 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 appendix for 1964 on the following pages: Pages Department of Labor____...._.._______---__--- eee eee 597-622 Department of Health, Education, and Weifare....--...------------- 397-486 National Labor Relations Board_____________...020 1-22 ---------- 862-863 National Mediation Board__.__..______._____________-___u.uu------- 863-864 Railroad Retirement Board.....-_____. 2. _- eee nee 868-869 Federal Mediation and Conciliation Service..__.....---------------- 848-849 Interstate Commission on the Potomac River Basin....-____--------- 867 United States Soldiers’ Home.._.._-...-0..--.--------------------- 382-383 97129—63. 1 2 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS The Committee also considered the amendment to the budget con- tained in House Document No. 83. The detailed tabulation at the end of this report reflects each amount included in the bill for 1964, the corresponding budget estimate, and the amount available for the fiscal year 1963 with appropriate com- parisons. The amounts shown for fiscal year 1963 include amounts contained in the Supplemental Appropriation Bill, 1963, as it passed the House of Representatives. SUMMARY OF ESTIMATES AND APPROPRIATIONS The following table compares, on a summary basis, the appropria- tions for 1963, the requests for 1964, and the amounts carried in the bill: Summary of estimates and appropriations Bill compared with— Appropria- tions, 1963 (includes Budget Recom- Appropriations, Department or agency funds in estimates, mended in | 1963 (includes supplemental 1964 the bill for funds in Budget appropriation 1964 supplemental estimates bill as passed. appropriation House) bill as passed House) Department of Labor__-____-_- $860, 453, 550 | $427,220, 000 | $384, 884, 000 -+$24, 480, 450 | —$42, 336, 000 Department of Health, Edu- cation, and Welfare _.-|5, 180, 176, 600 15, 301, 314, 000 |5, 035, 549, 000 ~144, 627, 600 | —265, 765, 000 National Labor Relations Board._-_-_------------ 21, 029, 000 28, 060, 000 22, 060, 000 -#1, 081, 000 —1, 000, 000 National Mediation Boar 1, 989, 150 1, 950, 000 1, 950, 600. --10, 850. |__---- eee Railroad Retirement Board_...| (9, 906, 000)| (10, 900, 000)| (10, 900, 000) (+994, 000) |-------------.. Federal Mediation and Con- ciliation Service-.-.--.----- 5, 195, 300 5, 940, 000 5, 540, 000 +344, 700 —400, 000 Interstate Commission on the Potomac River Basin....__-- 5, 000 5, 000 6,000 |----------------]--.----------- United States Soldiers’ Home..; (6, 272, 400) (6, 622, 000) (6, 622, 000) (+349, 600) }.---.-----2 28. Total.._-.----------- ee 5, 588, 798, 600 |5, 759, 489, 000 [5, 449, 988,000 | —118, 810, 600 ; —309, 501, 000 TITLE I—DEPARTMENT OF LABOR BUREAU OF LABOR STATISTICS Salaries and expenses.—The Bill includes $16,485,000, a reduction of $2,100,000 from the request, and an increase of $1,894,750 over the amount appropriated for 1963. The increase includes approximately $500,000 for mandatory cost increases; $75,000 for the extension of the Occupational Outlook program; $200,000 for expanded work in the area of labor-management relations; and $1,100,000 to be applied to other areas, primarily to carry out recommendations of the Presi- dent’s committee to appraise employment and unemployment sta- tistics (the Gordon Committee). Revision of consumer price index.—The Bill includes $1,320,000, the amount of the budget request, and $44,350 less than the amount ap- propriated for 1963. Fiscal year 1964 is the last of a 5-year program for revision of the consumer price index. The first publication of the revised index will be in January, 1964. The current index will be continued through June, 1964, to overlap with the revised index for a 6-month period. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 3 BUREAU OF INTERNATIONAL LABOR AFFAIRS Salaries and expenses.—The Bill includes $882,000, a reduction of $53,000 from the request, and an increase of $73,250 over the amount appropriated for 1963. OFFICE OF MANPOWER, AUTOMATION, AND TRAINING Manpower development and training activities.—The Bill includes $140,000,000, a reduction of $25,000,000 from the request, and an increase of $69,852,750 over the amount appropriated for 1963. For fiscal year 1963 the Department estimated their requirements at $100,000,000 which was reduced, in the appropriation authorized by Congress, to $70,000,000. It now appears that the $70,000,000 will not all be obligated by the end of the fiscal year. The evidence sub- mitted to the Committee did not indicate any reasonable possibility of expanding the program rapidly enough to utilize more than the amount allowed in the Bill. The budget was based on the supposition that the Department would reach a level of 140,000 trainees in 1964. The program started in late August of 1962 and by the end of March, 1963, approvals totaled only slightly over 32,000. At the time the budget was drawn up the program was new enough that 140,000 trainees by the end of 1964 may have seemed reasonable, but at this date it seems quite unrealistic. Area redevelopment activities—-The Bill includes $9,000,000, a reduction of $2,093,000 from the request, and $2,060,000 less than the amount appropriated for 1963. Section 16 of the authorizing legislation limits all costs of the program, with the exception of retraining subsistence payments, to $4,500,000 per year. Section 17 limits retraining subsistence payments to $10,000,000 per year. The Committee found that in actual practice these costs are running at a ratio of about one to one instead of the 234 to 1 contemplated by the legislative limitations. Thus no more than approximately $9 million of the $11,060,000 appropriated for 1963 will be used this year, and it is estimated that approximately the same situation will prevail for fiscal year 1964. BUREAU OF APPRENTICESHIP AND TRAINING Salaries and expenses.—The Bill includes $5,460,000, the amount of the request, and an increase of $247,800 over the amount appro- priated for 1963. Approximately $200,000 of the increase is for mandatory increases in costs, largely pay increases under public law 87-793. BUREAU OF EMPLOYMENT SECURITY Limitation on salaries and expenses.—The Bill includes authoriza- tion to use $12,640,000 from the employment security administration account in the Unemployment trust fund, $790,000 less than the request, and an increase of $704,140 above the amount authorized for 1963. The increase allowed will provide for mandatory increases in costs. Activities under this appropriation are closely related to activities under the appropriation “Limitation on grants to States for unemployment compensation and employment service adminis- tration.” In view of the action that it was necessary for the Com- 4 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS mittee to take in connection with the grants program, none of the requested increases under this appropriation, that involve an ex- pansion of the program, have been allowed. lamitation on grants to States for unemployment compensation and employment service administration —The Bill includes a limitation of $350,000,000, a reduction of $82,570,000 from the request, and $50,000,000 less than the amount appropriated for 1963. While the Committee feels that a somewhat larger amount could be used to advantage, the legislative limitation is $350,000,000. Unemployment compensation for Federal employees and ex-service- men.—The Bill includes $110,000,000, a reduction of $9,000,000 from the request, and $39,000,000 less than was appropriated for 1963. The release in August, 1962, of 154,000 reservists and guardsmen called up under the Berlin crisis resulted in a substantial demand on these funds that will not be recurring in 1964 so far as can now be de- termined. ‘This, coupied with the slght reduction in unemployment generally, which was predicted in the budget, should reduce fund requirements to the amount carried in the Bill. Compliance activities, Mexican Farm Labor Program—The Bill includes $870,000, the amount of the request, and $517,250 less than the amount appropriated for 1963. The amount carried in the Bill is sufficient to operate the program at its current level through December 31, 1963, and provide sufficient funds for liquidation of the program. The enabling legislation for the Mexican Farm Labor Program expires at the end of the current calendar year. If it is renewed the amount carried in the Bill for liquidation purpeses will of course be applied to the expenses of continuing the program after December 31. Salaries and expenses, Mexican Farm Labor Program —The Bill includes $1,135,000, the amount requested, and $913,500 less than the amount appropriated for 1963. These funds come from the Farm labor supply revolving fund, rather than from general funds of the Treasury. As for the preceeding item, the amount carried in the Bill is sufficient to continue the program through December 31, 1963, and provide sufficient funds for liquidation of the program if it is not extended, BUREAU OF VETERANS’ REEMPLOYMENT RIGHTS Salaries and expenses.—The Bill includes $790,000, the amount of the request, and $138,000 more than was appropriated for 1963. The release in August, 1962, of 154,000 reservists and guardsmen called up under the Berlin crisis, mentioned in connection with the appropria- tion Unemployment compensation for Federal employees and ex- servicemen, has resulted in an unprecedented increase in the number of problems that have come before the Bureau of Veterans’ Reemploy- ment Rights. This Bureau’s backlog of work has reached serious enough proportions that the Committee felt justified in allowing funds for 12 additional positions in 1964. BUREAU OF LABOR STANDARDS Salaries and expenses —The Bill includes $3,470,000, the amount of the request, and $1,215,550 less than the amount appropriated for 1968. The decrease below the 1963 level is accounted for by the fact LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 5 that the funds for the salaries and expenses of the Office of Welfare and Pension Plans have been transferred cut and established as a separate appropriation. The amount in the Bill will be sufficient to cover all mandatory cost increases in 1964 for the activities still carried under this appropriation but will allow for no new positions. OFFICE OF WELFARE AND PENSION PLANS Salaries and expenses.—The Bill includes $1,565,000 for this new appropriation item, $155,000 less than the request. During the hearings on the appropriation bill for 1963, in connec- tion with the budget for the Bureau of Labor Standards where these activities were then budgeted, the Secretary was asked about plans for an organizational change. The Committee was told by the Secretary that, while consideration had been given to a change, none was con- templated. The Committee placed in its report the following lan- guage: The Committee was pleased that the Secretary has decided against a proposal to shift the “registration and disclosure of welfare and pension plan data” activities from this Bureau to the Bureau of Labor-Management Reports. The Committee would look with disfavor on any major shift of this type being made without the justifications being pre- sented to the Committee in connection with the budgets involved. In the face of this, the Department made an even more drastic organizational change than the informal suggestion to transfer it to the Bureau of Labor-Management Reports, which suggestion had prompted the Committee’s looking into this in the first place. The Department proceeded to set these activities up as a new separate Office of Welfare and Pension Plans. Primarily as a result of this reorganization there was one grade GS-17 and five grade GS-15’s heading up this activity as of January 1, 1963, whereas there was one GS-15 and none in higher grades as of January 1, 1962. This revised organization was reflected in the budget between the time the House acted and the time the Senate acted on the appropria- tions for 1963. The total request which went to the Senate was $1,532,000 and 189 positions. The Senate allowed the full amount requested but in conference the amount was cut to $1,300,000. The agency proceeded to establish 189 positions, the exact number which were to be financed with the larger sum of $1,532,000, and in the budget for 1964 requested approximately $310,000 to annualize 45 additional positions allegedly authorized for 1963 on @ part-year basis. Since it is obvious that Congress did not intend to authorize all the additional positions requested in 1963 the Committee has allowed approximately one-half of the amount budgeted for 1964 to annualize these positions. The Committee feels that there is no good reason for having these activities set up as a separate Bureau in- the Department and is con- vinced that considerable savings could be effected by merging it with other parts of the Department engaged in similar activities. With respect to the establishment of unauthorized positions, the Committee has noticed other places in the Department where similar 6 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS questionable budgeting has occurred on a very much smaller scale, and in a way that, while somewhat misleading, has not actually affected the amount which would otherwise be budgeted for 1964. The Committee knows that the Secretary has personally taken steps to prevent this from occurring in the future and it has confidence in his sincerity in this matter. BUREAU OF LABOR-MANAGEMENT REPORTS Salaries and expenses.—The Bill includes $5,900,000, the amount of the request, and $23,900 less than was appropriated for 1963. The 1964 budget for this Bureau reflects a decrease in personnel for the second consecutive year, a reduction of over 8 per cent in permanent positions, with no discernible decrease in workload. Since the Com- mittee has received no complaints that the job is not being well done, it can only conclude that the administration and direction of this program is in quite capable hands. BUREAU OF EMPLOYEES’ COMPENSATION Salaries and expenses.—The Bill includes $4,285,000, the amount of the request, and an increase of $303,200 over the amount appropriated for 1963. The increase will allow for 11 additional positions for increased workload as a result of a recent Supreme Court decision which held that the provisions of the Longshoremen’s and Harbor- workers’ Compensation Act cover employees engaged in new ship construction work while a vessel is upon the navigable waters of the United States. As a result of this decision, many new employers and employees are brought within the purview of the act. Employees’ compensation claims and expenses.—The Bill includes $53,838,000, the amount of the request, and $11,233,000 less than the amount appropriated for 1963. The reduction in the amount which is required for 1964 results from the relatively new financing arrange- ments included in Public Law 86-767, which requires each Federal agency to reimburse this appropriation for payments made on account of the injury or death of its employees, based on occurrences after December 1, 1960. The Committee does not question the principle of this law, but a number of agencies’ reimbursements amount to less than $100. Obviously the administrative expenses involved are more than the amount of their reimbursement. It appears to the Com- mittee that the law should be amended to provide that no agency be billed if the reimbursement amounts to less than $1,000. WOMEN’S BUREAU Salaries and expenses.—The Bill includes $785,000, the amount of the request, and $145,050 less than the amount appropriated for 1963. The reduction is occasioned by a transfer of four positions to the Office of the Secretary, and a reduction in costs in connection with the President’s Commission on the Status of Women whose final report is scheduled to be submitted by October 1, 1963. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 7 WAGE AND HOUR DIVISION Salaries and expenses —The Bill includes $19,300,000, the amount of the request, and an increase of $1,026,400 over the amount appro- priated for 1963. The increase is for mandatory costs, largely pay increases under Public Law 87-793. There is no change in the number of positions authorized. It was testified that five or six industries will be surveyed during 1964 under the Walsh-Healey Wage Determination Program. It is perhaps a happenstance, but in the past it has often happened that the industries most adversely affected by foreign competition have been the industries first to be given attention under this program. The Committee hopes that such a priority system is not followed in the future. OFFICE OF THE SOLICITOR Salaries and expenses.—The Bill includes $4,570,000 and authoriza- tion to transfer $127,000 from the Unemployment trust fund; the amount of the request in both instances; and an increase of $208,300 and $2,150, respectively, over the amounts for 1963. The increase is for mandatory cost increases and to annualize new positions authorized for a portion of fiscal year 1963. No funds are included for additional permanent positions. OFFICE OF THE SECRETARY Salaries and expenses.—The Bill includes $2,364,000 and authoriza- tion to transfer $138,000 from the Unemployment trust fund; a re- duction of $300,000 from the appropriation requested, and the same amount as requested by transfer; and an increase of $270,550 and $2,200, respectively, over the amounts for 1963. The Committee has disallowed $228,000 requested “to finance properly those positions operating for the benefit of the Secretary which have been funded through other accounts’’; $25,000 requested to provide the Secretary with a special assistant for field operations to function as the liaison between the Department and the District of Columbia Commissioners; and $47,000 of the $72,000 requested to provide the Secretary with field representatives to coordinate the programs of the Department. In connection with the last item, the Committee has allowed $25,000 and two positions. TRADE ADJUSTMENT ACTIVITIES Salaries and expenses.—The Bill includes $4,000,000, a reduction of $3,635,000 from the request, and an increase of $3,900,000 over the amount appropriated for 1963. This is a new program for which it was impossible to determine the amount needed at the time the budget was prepared. While it is still impossible to predict the amount that will be required with any real assurance of accuracy, it is now obvious that the amount requested considerably exceeds require- ments. To date there have been few petitions that employment has been adversely affected by tariff action, and none that has been acted on by the Tariff Commission has been approved. The Committee is confident that the amount carried in the Bill will be sufficient to cover 8 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS all necessary expenses in 1964. The Committee has not attempted to make allocations for the different activities that may be carried out under this program, but it will expect the Department to fill no posi- tions until there is a clearly demonstrated need. In view of the un- certainty regarding future workload, the Committee will expect to review the staffing with an especially critical eye. TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE MENTAL RETARDATION In March 1955, in its report on the appropriation bill for 1956, the Committee stated: A great and a growing problem in this country is the problem of the mentally retarded children. It is estimated that there are from 3 to 5 million American children who fall in this category, yet the problem has gone almost unnoticed by the leaders in education and in medical re- search. So little attention has been paid to the problem that we have only the haziest notion of what percentage of the unfortunate children, of at least equally unfortunate parents, could be helped medically and through educational tech- niques fitting their needs, so that they could lead useful and satisfying lives. We have an equally hazy notion of the causes of the problem—how much is due to brain injury, how much is due to effect of environment, to heridity, ete. That year the Committee recommended and Congress appropriated funds over the budget to get a program started in this field. While the Committee is not satisfied with the progress that has been made since that time, encouraging progress has been made and is con- tinuing to be made. The Office of Education reported two particularly significant ad- vances in their field this year in connection with work done under the cooperative research program. One of the great problems has always been the early identification of mentally retarded children. Under a cooperative research project at the Stanford Laboratory School a test was devised to identify retarded children as young as twenty-two months of age. A second project which may have even more promise concerns the long standing controversy as to whether special classes are of benefit to mentally retarded children. A project at the Univer- sity of Iilinois has been following two groups of mentally retarded children, one group with special classes and the other group in a regular class, for three years. They have very good evidence that, not only do the children learn better in the special classes, but their social adjust- ment is considerably better. Both of these studies will be checked at other schools to be certain that similar results are obtained. Also in Vocational Rehabilitation the Committee was pleased to note considerable progress since 1955. It was testified that during the past year approximately 5,000 mentally retarded have been re- habilitated. This compares with 531 in 1955. Of course the ultimate goal is the prevention of mental retardation and the activities working toward this end are carried out by the LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 9 National Institutes of Health. The Committee was much encouraged by reports describing the progress made in sorting out and identifying the developmental defects and genetic faults that result in many cases of mental retardation. The Committee realizes that these findings just scratch the surface of this problem, and that the cases in which the cause of mental retardation can be identified represent only a small percentage of the children born with this handicap each year. Never- theless, the fact that identification of the causes of some forms of mental retardation has led to ways of preventing them offers the exciting possibility that further probing will reveal still more that can be done to reduce the incidence of mental retardation among the children of this Nation. The achievements resulting from research in mental retardation also demonstrate the real and practical benefits of studying defective development at the most fundamental levels possible with our present-day techniques. For example, research on chromosomes, the cellular apparatus concerned with transmission of genetic material in the division of the cell, has progressed to the point that one can actually see the differences between the chromosomes of children with mongolism and normal children. The defect that causes PKU (phenylketonuria), a metabolic disease that produces severe mental retardation if left untreated for any period of time, is due to the absence of a particular enzyme which can now be studied by the molecular chemist. The Committee strongly urges that all possible efforts be made in basic research and to increase exploitation of the findings which have resulted and will result from such research. It is confident that results of such an increased effort will have significant effects on our knowledge of ways in which to prevent and to ameliorate mental retardation. The Committee was pleased that the President gave this problem the recognition he did when he appointed the President’s Panel on Mental Retardation. While that Panel made an excellent report, there are certain aspects of the problem that could have been given attention if the Panel had had a little more time. For instance, the report makes reference to some of the early findings of the collabora- tive perinatal project of the Institute of Neurology and Blindness. It points to some of its results as ‘illustrative of research findings which have led to prevention of a significant number of cases of mental retardation”. However, the Panel makes no recommendation for continuation or extension of this important undertaking, the potential of which is largely unexplored. As another example, the Panel points out that a “number of viruses and other infectious agents have already been identified or are strongly suspected of producing damage to the fetal brain when the mother is infected during pregnancy.” However, no specific recommendation for an attack on this problem was made. The Committee hopes that the report will be used as a guide for all parts of the Department that have a role to play in mental retarda- tion, but also hopes that they will not consider it to be a limit on their activities when gaps, such as the two examples set forth above, are apparent. 97129—63-_—-2 10 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS FOOD AND DRUG ADMINISTRATION Salaries and expenses —The Bill includes $35,805,000, the amount of the request, and an increase of $6,740,300 over the amount appro- priated for 1963. Events of the last year have clearly shown the need for a considerable increase in the level of protection given the American consumer in the field of food and especially drugs. The budget and the Bill provide for an increase of 635 positions of which 315 will be allocated to the drug area in order to further strengthen the resources available to carry out the recently enacted legislation and new regulations. The remainder will be allocated to several activities: to provide greater inspectional coverage of foods and drugs imported from other countries, to engage in an expanded program of food research, to more effectively carry out responsibilities related to pesticide residues, for better enforcement of the provisions of the Act relating to illegal sale of prescription drugs, and to establish a much needed science information exchange program. Ever since the Food and Drug Act was passed, the law has provided for a level of protection of the American people that the Food and Drug Adminis- tration has not had the facilities to achieve. This budget provides for a big forward step in this direction. Certification, inspection, and other services—The Food and Drug Administration certifies batches of anti-biotics, insulin, and color additives for use in foods, drugs, and cosmetics; and establishes toler- ances for residues of pesticide chemicals in or on raw agricultural products, and establishes telerances for color additives in foods, drugs, and cosmetics. These services are financed entirely by fees paid by the affected industries. During the current and past years this has been handled as an indefinite appropriation, the appropriation provid- ing that such fees are available for the conduct of the services. The budget provides for this being changed to a revolving fund. This involves no basic change since the fees would be paid into the revolving fund and the expenses would be paid from it as is now done with the indefinite appropriation account. Since accounting would be some- what simplified the Committee has approved the change. Buildings and facilities.—The Bill includes $4,347,000 for this new appropriation account, a reduction of $8,953,000 from the request. This appropriation consolidates all activities related to planning, con- struction, and equipping of buildings and facilities for the Food and Drug Administration some of which have previously been carried under appropriations to the General Services Administration and some in the appropriation “Salaries and expenses, Food and Drug Administration.” The amount allowed includes $80,000 for an animal care building at Beltsville, $245,000 for planning additional head- quarters laboratory facilities at Beltsville, and for the most needed equipment and facilities improvements at the District laboratories. The request included $80,000 for the animal care building, $4,300,000 for planning and construction of additional headquarters laboratory facilities, and $9,638,000 for District facilities. Since the budget included a proposal to reappropriate $718,000 of unobligated balances which the Committee denied, the reduction from the budget is actually a total of $9,671,000. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 11 OFFICE OF EDUCATION Promotion and further development of vocational education.—The Bill includes $34,756,000, the amount of the request, and an increase of $40,000 over the amount appropriated for 1963. ‘The increase results from the inclusion of American Samoa in the program in 1964 under a recent amendment to the Act. Further endowment of colleges of agriculture and the mechanic arts.— The Bill includes $11,950,000, the amount of the request, and the same amount as was appropriated for 1963. Grants for library services —The Bill includes $7,500,000, the amount of the request, and the same amount as was appropriated for 1963. This has been a very popular and a very worthwhile program. Re- ports indicate that State appropriations for rural library development have increased 92 per cent above 1956 levels, and local appropriations are 74 per cent higher than in 1956. 38 million rural people now have new ot improved public library services available to them as a result of State plans under the Library Services Act. However, much remains to be done for there are still approximately 16 million persons without access to local library service. Payments to school districis—The Bill includes $104,466,000, the amount of the request, and $177,856,000 less than was appropriated for 1963. Since the temporary provisions of the authorizing legisla~ tion expire at the end of 1963, the 1964 budget is for only the per- manent provisions of the law. The budget and the Bill are calculated to pay 100 percent of entitlements under these permanent provisions. The budget contained an estimate of $216,204,000 to be requested later if the temporary provisions are extended. Assistance for school consiruction.—The Bill includes $23,740,000, a reduction of $60,000 from the request, and $39,946,000 less than the amount appropriated for 1963. As in the previous item the budget and the Bill are based on financing 100 percent of entitlements under the permanent provisions of the authorizing legislation. if the tem- porary provisions of the Act are extended, it is estimated that $37,984,000 will be requested in addition to the amount carried in the Bill. The $60,000 reduction from the budget was applied against the amount requested for technical services rendered by other agencies. This reduction leaves $800,000 for such services, the same amount as was appropriated for 1963. Defense educational activities —The Bill includes $229,620,000, the amount of the request, and an increase of $170,000 over the amount appropriated for 1963. In the short period of five years that the National Defense Education Act has been in operation, there is no doubt that it has greatly strengthened and improved the educational system of our country. The new Commissioner of Education, Francis Keppel, set forth many facts and figures _to illustrate this. These appear on page 457 of the hearings. The Bul includes the maximum amount authorized to be appropriated for most parts of the program including the. very important and popular student loan program. Expansion of teaching in education of the mentally retarded.—The Bill includes $1,000,000, the amount of the budget request, and the same amount as was appropriated for 1963. It is estimated by the Office of Education that there are at least 114 million mentally retarded school-age children and youth between the ages of five and seventeen. 12 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Not more than one-fourth of these children are now receiving the help they need from the schools. There is no doubt that much more needs to be done to improve the educational opportunities of these children, however, $1,000,000 is the maximum amount that can be appropriated under the authorizing legislation for this program. Cooperative research.—The Bill includes $11,500,000, a reduction of $0,500,000 from the request, and an increase of $4,515,060 over the amount appropriated for 1963. The Committee was impressed by the fine testimony of both Government witnesses and witnesses from several of the leading schools of education in the country. There is no doubt that the research conducted to date under this program has yielded results of great value to our educational system. However, the Committee feels that the amount included in the Bill, an increase of 65 percent, will adequately provide for the most pressing demands in the field of educational research. The reduction is composed of approximately $3,000,000 from the amount budgeted for so-called programmed research, approximately $1,000,000 for unprogrammed research, and deferral of three research and development centers budgeted for $1,500,000. The Committee reiterates its firm opinion that no cooperative research project applica- tions should be funded unless evaluated and approved by the Research Advisory Committee; and that the same degree of financing with regard to the priority ratings assigned by that Committee should prevail in all areas of research carried out under this appropriation. The Committee was surprised and disappointed to learn that small colleges of education are not participating in this program. In the opinion of the Committee the program would benefit from their participation, and these schools would benefit by participating. It is therefore the desire of the Committee that the Office of Education take active steps to encourage and assist the small colleges of education to assume a role in this program. Educational research (special foreign currency program).—The Bill includes $500,000, a reduction of $300,000 from the request and an increase of $100,000 over the amount appropriated for 1963. Foreign language training and area studies—The Bill includes $1,- 500,000 for this new program, a reduction of $1,600,000 from the re- quest. This program is authorized by the Mutual Educational and Cultural Exchange Act of 1961, and the activities to be carried out under this appropriation were delegated to the Department of Health, Education, and Welfare by Executive Order 11034. These activities, as stated in the Act are— * * * promoting modern foreign language training and area studies in United States schools, colleges, and universities by supporting visits and study in foreign countries by teachers and prospective teachers in such schools, colleges, and uni- versities for the purpose of improving their skill in language and their knowledge of the culture of the people of those countries, and by financing visits by teachers from those countries to the United States for the purpose of participat- ing in foreign language training and area studies in United States schools, colleges, and universities; While the objectives of the program appear quite worthwhile, the Committee thought it best to start the program on a somewhat lower LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 13 level than budgeted and will carefully review operations to determine if further expansion is desirable next year. Salaries and expenses—The Bill includes $14,761,000, a reduction of $1,500,000 from the request, and an increase of $2,116,000 over the amount appropriated for 1963. The increase allowed will cover the full amount of the so-called mandatory increases, will provide for financing the program of captioned films for the deaf at the maximum authorization, and will provide for a few additional posi- tions to strengthen the statistics program and administer the new foreign language program. The amount in the Bill includes no funds for expansion of studies of education in foreign countries or any other foreign program with the exception of the amount necessary to admin- ister the new program for foreign language training and area studies. In the Committee’s report on both the 1962 and 1963 appropriation bill the Committee indicated that it was disappointed that the very important activities in connection with the mentally retarded and other nandicapped children had not been given a more prominent place in the organizational structure of the office. At the time of this year’s hearing the new Commissioner, who had been in office for only a short period of time, testified that he was giving this matter very serious consideration. The Committee has heard this story before, but hopes that the consideration being given will soon result in more concrete action than has been the case as a result of considera- tion previously given this matter. OFFICE OF VOCATIONAL REHABILITATION Grants to States —The Bill includes $88,700,000, the amount of the request, and an increase of $15,760,000 over the amount appropriated for 1968. The budget and the Bill recommended by the Committee continue the policy followed in recent years of providing Federal funds to match the steadily increasing funds provided at the State and local level, in accordance with the formula in the basic legislation. During the current year it is expected that 110,400 disabled people will be rehabilitated under the program. It is estimated that a new record high of 126,500 rehabilitations will be reached during fiscal year 1964. This will be 25,000 greater than the 1962 total. This increase, in two years, compares with the historical fact that it took 42 years to reach the first 100,060 annual total. This, in the opinion of the Com- mittee, is an excellent example of what can be done by a Federal-State partnership strongly supported by each. Research and travning—The Bill includes $31,810,000, a reduction of $5,020,000 from the request, and an increase of $6,310,000 over the amount appropriated for 1963. The Bill includes no funds for the proposed new program of domestic support for international research which was budgeted for $300,000. Research and training (special foreign currency program).—The Bill includes $2,000,000, a reduction of $1,000,000 from the request, and the same amount as was appropriated for 1963. Salaries and expenses.—The bill includes $2,905,000, the amount of the request, and an increase of $419,000 over the amount appropriated for 1963. Of the increase allowed, approximately $150,000 is required for mandatory cost increases. Most of the remainder of the increase is for 21 additional positions for technical and administrative support of the expanded grant programs. 14 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS PUBLIC HBALTH SERVICE The 1964 budget contained many proposals for transfers in financ- ing of activities m order to show the money in the budget in the same place where the activities are actually carried out. The major part of these transfers was made as a result of the Committee’s comments in the report on the 1963 Bill which reads as follows: A rather significant amount of the funds included in the National Institutes of Health budget is actually transferred each year to the Bureau of State Services to finance programs administered by it. It appears to the Committee that it would be more orderly and business-like to have the funds budgeted in the appropriations for the organizational units administering programs. The Committee will expect that the budget for 1964 be prepared on this basis. The Committee is convinced that these transfers will result in a clearer budget in the future. However, in the transitional year, it leads to some confusion in making comparisons between the current appropriations and appropriations proposed in the budget and the Bill, as shown at the back of this report. The following table has been prepared to show on a strictly comparable basis what is available under each appropriation in 1963 for the activities that are included in the budget and the Bill for 1964. Comparative statement of the appropriations for fiscal year 1963, adjusted for com- parability, and the estimates and amounts recommended in the bill for fiscal year 1964 Bill compared with— Comparable appropria- tions, 1963 Comparable Gnecludes appropria- funds in Budget Recom- tions, 1963 Item supple- estimates, mended in (includes mental 1964 the bill for funds in Budget appropria- 1964 supple- estimates, tion bill mental 1964 as passed appropria- House) tion bill as passed House) “Buildings and facilities_.-------- $33, 200,000 | $19,072,000 | $13, 811, 000 —$19, 389,000 | —$5, 261, 000 Accident prevention------.-.---- 3, 668, 000 4, 857, 000 4, 163, 000 +495, 000 — 694, 000 Chronic diseases and health of the aged_.--------------------- 50, 978, 00 55, 907, 000 53, 377,000 | +2, 399, 000 —2, 530, 000 Communicable disease activities_ 17, 761, 000 30, 429, 000 25, 405, 000 -+7, 644, 000 —5, 024, 000 Community health practice and yesearch....---.---------------- 28, 932, 000 31, 648, 000 28, 608, 000 —324, 000 —8, 040, 000 Control of tuberculosis_- 6, 783, 000 6, 828, 000 6, 828, 000 +45, 000 Control of veneral diseases._- 7, 594, 000 9, 588, 000 9, 688,000 | +1, 994, 000 wees Dental services and resources---. 5, 442, 000 6, 227, 000 6, 218, 000 -+776, 000 —9, 000 Nursing services and resources_._ 10, 881, 000 11, 245, 000 11, 217, 000 +336, 000 —28, 000 Hospital construction activities. | 226, 220,000 | 179,514,000 | 177,914,000 | —48, 306, 000 —1, 600, 000 George Washington University Hospital___..--------------~---|----2--s5--77- 2, 500, 000 2, 500, 000 +2, 500,000 |..------------ Environmental health sciences_. 2, 236, 000 4, 246, 000 4,224,000 | +1, 988, 000 —22, 000 Air pollution_-_---.-------------- 11, 069, 660 12, 998, 000 12, 954, 000 +1, 885, 000 —44, 000 Milk, food, interstate, and com- munity sanitation 7, 779, 000 9, 079, 000 9, 009, 000 -++1, 280, 000 —70, 000 Occupational health 4, 122, 000 4, 621, 000 4, 590, 000 +468, 000 —31, 000 Radiological health_._----------- 15, 851, 000 18, 776, 000 18, 745, 000 +2, 894, 000 31, 000 Water supply and water pollu- tion control..---.-------------- 24, 707, 000 29, 980, 000 27,921,000 | -+3, 214, 000 —2, 059, 000 Grants for waste treatment works construction -.---.------ 90, 000, 000 7 100, 000, 600 90, 000, 000 j..------------ —10, 000, 000 Hospitals and medical care------ 48, 820, 000 50, 038, 000 49, 962,000 | +1, 142, 000 —76, 000 Foreign quarantine activities___- 5, 910, 050 7,116, 000 6, 456, 000 -+-545, 950 — 660, 000 I \ LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 15 Comparative statement of the appropriations for fiscal year 1968 adjusted for com- parability, and the estimates and amounts recommended in the bill for fiscal year 1964— Continued Bill compared with— Comparable appropria- tions, 1963 Comparable (includes appropria- funds in Budget Recom- tions, 1963 item supple- estimates, mended in (includes mental 1964 the bill for funds in Budget appropria- 1964 supple- estimates, tion bill . mental 1 as passed appropria- House) tion bill as passed. House) National Institutes of Health: General research and serv- . jees_----------- ------ 2 + $154, 981, 000 |- $164, 674, 000 | $163, 869,000 | +-$8, 888, 000 —$805, 000 Biologics standards_.--.---- 3, 947, 000 4, 787, 000 4, 787,000 +840, 000 |-.----.------- Child health and human development._-_-_.-----2-2)..---L--------|--------------|-----+~--+-~--|-+-- ene eee en] ee -----2------ National Cancer Institute.__| 145, 425, 000 145, 114, G00 144, 340, 000 ~-1, 085, 000 —774, 000 Mental health activities. ____ 148, 218,000 | 190,096,000 | 177, 288,000 | +34,070,000 | —12, 808,000 National Heart Institute__._| 129, 274,000 133, 624, 006 132, 404, 000 +3, 180, 000 1, 220, 600 National Institute of Dental Research_____..----------- 18, 763, 000 19, 809, 000 19, 689, 000 4-926, 000 —120, 000 Arthritis and metabolic dis- ease activities__-....------ 162, 898,000 | 114,717,000 | 113, 679,000 | +-10, 781,000 —1, 038, 000 Allergy and infectious dis- ease activities. _.------..-. 64, 595, 000 69, 226, 000 68, 723,000 | +4, 128, 000 —503, 000 Neurology and blindness ac- tivities.__-----.-.--------- 79, 207, 000 88, 407, 000 87, 675,000 | +8, 468, 000 —732, 000 Grants for coustruction of health research facilities._._| 50,000, 000 50, 000, 000 50,000, 000 |-------_--_---j|-------------- Total, National Insti- tutes of Health-__.---- 892, 308, 000 980, 454, 000 962, 454,000 | +70, 146, 000 —18, 000, 000 Scientific activities overseas (special foreign currency pro- _- 2, 800, 000 6, 647, 000 4,000,000 | +1, 200,000 —2, 647, 000 5, 150, 000 5, 949, 000 5, 949, 000 +799, 000 |- National Library of Medicine.-- 8, 335, 000 4, 074, 000 4, 074, 000 4-789, 090 Retired pay of commissioned of- ficers.-..---------------------- [5, 784, 000] [6, 436, 000] [6, 436, 000} {4-652, 000] }_--.---.------ Salaries and expenses, office of the Surgeon General________._. 5, 663, 000 6, 091, 000 6, 091, 000 +428, 000 }..------------ Total, Public Health Serv- iee__-------- ee +--+ 1, 511, 209, 050 |1, 597, 884, 000 |1, 546,058,000 | +34, 848,950 | —51, 826, 000 BUREAU OF STATE SERVICES EXTRAMURAL RESEARCH PROGRAMS Included in the transfers mentioned above, are certain of the NIH research grant and training support activities relating to community health program areas falling within the program interests of the Bureau of State Services. For 1964, these have been transferred to the appropriations supporting the activities of that Bureau of the Public Health Service. This action reflects the initiation of programs for the support of research through grants within the Bureau of State Services as was recommended by the Study Group on the Mission and Organiza- tion of the Public Health Service in its report some three years ago. The Committee feels that this is a logical step in the evolution of the programs of the Bureau of State Services. Similar action was taken in past years in respect to the transfer of the grant support of research activities in the field of environmental health to the Bureau of State Services. However, the Committee feels that there must be a very clear distinction made between the purposes and character of research activities supported through these community health programs and those of the National Institutes of Health. The Committee does 16 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS not expect that the approach to research in this Bureau will follow the identical pattern of the manner in which research support has developed and is carried out in the National Institutes of Health. The Committee feels that the research grant program of the Bureau of State Services in the field of Community Health should be carefully confined to the support of work considered essential to the solution of specific problems which are clearly identified as presenting obstacles to the discharge of the Bureau’s primary responsibilities in the area of Public health services and community health activities. In the view of the Committee this research program will be of a highly applied nature and will not extend to the broad undifferentiated support of scientific effort in the health sciences which the Committee considers to be the area of responsibility of the National Institutes of Health. Therefore, the Committee will expect to review quite carefully the particular research problems. toward which the Bureau of State Services will direct its research efforts in forthcoming years as a basis upon which funds will be made available for research grants and train- ing purposes. To facilitate this review the Committee directs the Public Health Service to submit a report to the Committee by December 1, 1963, setting forth the nature of the planned extramural research program of the Bureau of State Services, in the area of Community Health, in terms of its specific relationship to the primary objectives of the Bureau’s programs. The report should also convey clearly the rela- tionship of such research activities to the programs of the National Institutes of Health and the manner in which these relationships will be coordinated. COMMUNICATION OF MEDICAL INFORMATION In the report on the 1963 Bill the Committee expressed its concern over the lack of an overall plan and specific proposals to correct the generally recognized deficiencies in the field of communication of biomedical information. The Committee received a rather compre- hensive report on this subject that is included in Part IT of the Department of Health, Education, and Welfare hearings, pages 54 through 74, This is a good report, so far as it goes, but it seems to the Committee that too much of the Service’s planning in this area is aimed at doing what should be done now, and even at what should have been done years ago, and not enough at what we should be doing to keep up with future advances that are certain to be made in medical research and in the technology of communications itself. Some of General Sarnoff’s ideas in this field, which have been given recent publicity, may sound like dreams for the distant future but, in the past, such dreams have become reality sooner than we expected, and will again. Tt is hoped that the Public Health Service will not only catch up with present needs but will also place more effort in planning for the future in the area of communications. STROKES There are 300,000 new stroke patients per year. There are 1.8 million people in the United States today who have had a stroke. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 17 There are only 400 rehabilitation specialists to teach, do research, and treat patients. There are 10 States that have no medical rehabilita- tion experts at all. When a comparison is made of the extent of the problem with the effort to do something about it, it is obvious that this is one of the most neglected fields of medical science and rehabilitation. The medical schools appear to be even further behind than the Public Health Service in recognizing its importance. One third of the medi- cal schools have no teaching program in medical rehabilitation at all. Pages 330 through 334 of the hearings volume including the testi- mony of non-governmental experts should be must reading for both the officials of P.H.S. and the deans of the medical schools. Certainly more should be done in this field by both. Buildings and facilities.—The Bill includes $13,811,000, a reduction of $5,261,000 from the request, and a reduction of $19,389,000 from the amount appropriated for 1968. The reduction from the amount requested results from the Committee’s decision to defer appropria- tions for planning and-site acquisition for the Environmental Health Center which was budgeted for $2,761,000; and to defer construction of the regional water pollution control laboratory in Alaska which was budgeted for $2,500,000. The Committee still has serious doubts that it is wise to locate the proposed Environmental Health Center in the Washington, D.C. area. ‘Accident prevention.—The Bill includes $4,163,000, a reduction of $694,000-from the request, and an increase of $495,000 over the amount appropriated for 1963. The reduction results from the Committee’s disallowance of an increase requested for research activities primarily related to the development of an automobile driving simulator esti- mated to cost $4,500,000 in total; and the disallowance of a small amount budgeted for increasd costs of overhead allowances in con- nection with research grants, from the current maximum allowance of 20 percent to a maximum allowance of 25 percent. The Committee has disallowed similar increases wherever they occurred in the budget. . Chronic diseases and health of the aged—The Bill includes $53,- 377,000, a reduction of $2,530,000 from the request, and an increase of $30,435,000 over the amount appropriated to this account for 1963; however, on a comparable basis, the increase is $2,399,000. - The ‘budget transfers to this appropriation, amounting to approximately $28,000,000, are from the Nationa] Institutes of Health to cover activities in connection with disease control which are more akin to the activities carried on by this division than they are to the more basic research and training done by the National Institutes of Health. The administrative responsibility for these functions has in the past been with this division even though the money has actually been appropriated to the National Institutes of Health. Activities under this appropriation are aimed at preventing the occurrence and the increase of disability and dependency. This is done through programs of intramural and extramural research train- ing and technical services to provide preventative, restorative, and care aspects of those health problems of the aged and chronically ill which can be alleviated through community action. Programs such. as homemaker services, home care, information and referral services, nursing home care improvement and preventive and restorative serv- 97129-——68—-—3 18 LABOR-HEALTH, BDUCATION, WELFARE APPROPRIATIONS ices aré not generally available in the average community. In broad terms the objectives of this Division’s total programs are to assist States and communities in. meeting the health problems of their aged and chronically ill in (1) the development and improvement of out-of- hospital care services for those who are ill and disabled and (2) the pre- vention of disability through early disease detection, identification, and treatment. There is pe srhaps no other program in government that can directly do more to reduce the evermounting cost of hospital- ization than this program, if it is properly supported. Communicable disease activities —The Bill includes $25, 405 000, a reduction of $5,024,000 from the request, and an increase of $9, 913 ,000 over the amount appropriated to this account for 1963; however, on a coniparable basis, the increase -is $7,644,000. The Committee has disallowed the request for $5,000,000 and 600 additional positions to initiate a program to eradicate from the United States the mosquito that carries yellow fever. The estimated total cost of this program over a five-year period is $45,000,000. While the Committee was im- pressed. with the argument that this program should be carried out in the interest of maintaining good relations with. Central and South American countries, the Committee was also impressed with ‘the fact that we have not had an outbreak of yellow fever in the United States since 1907 even though these mosquitoes have been present continu- ously, and with the fact that we have an excellent vaccine against the disease, The major part of the increase allowed is approximately $5,000,000 to further implement the community immunization pro- gram. Of 20.3 million children under “ive in this country, only 6.4 million have received vaccinations that they need against poliomyelitis, diphtheria, tetanus, and whooping cough. The vaccination assistance act of 1962 authorizes grants to States to cover part of the cost of intensive immunization programs against these diseases. The Com- mittee is of the opinion that this program should proceed as expedi- tiously as possible and has approved the full amount requested. Community health practice and research.—The Bill includes $28,- 608,000, a reduction of $3,040,000 from the request, and an increase of $2, 332, 000 over the amount ‘appropriated to this account for 1963; however, on a comparable basis, the amount recommended is $324, 000 less than the amount available for 1963. The net reduction from the amount available for 1963 is composed of $2,000,000 from the $15,- 000,000 budgeted for general health grants to the States: disallowance - of $40, 000 budgeted for an increase in allowance for indirect costs of research under project grants; an increase of approximately $1,200,000, of the requested increase of $2,200,000, for the new health program for migrant workers, funds for 12 new positions for work to improve medical care administration, and. funds required for mandatory cost increases. Control of tuberculosis —The Bill includes $6,828,000, the amount of the request, and $165,000 less than was appropriated to this account for 1963; however, on a comparable basis, the Bill represents an in- crease of $45,000 over what was available for 1963, which is required to cover mandatory i increases in cost. The Committee has real concern over the current degree of effec- tiveness of tuberculosis control efforts in the United States. In 1959, LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 19 the Arden House Conference on Tuberculosis proposed measures that could lead to a massive reduction in the tuberculosis problem in the United States... The Committee has been told that eradication would save the country an estimated $750,000,000 a year. Tuberculosis claims more lives than any other communicable disease. In view of these facts, the Committee believes that serious thought should be given to a study of the tuberculosis problem similar to that made by the Surgeon General’s Task Force on Eradication of Syphilis. Control of venereal diseases —The Bill includes $9,588,000, the amount of the request, and $1,588,000 over what was appropriated to this account for 1963; however, on a comparable basis, the increase is $1,994,000. The most significant item of increase is $1,560,000 for expansion of grants to States to provide for intensification of the program in an attempt to eradicate syphilis as a major public health problem. This increase is in accordance with recommendations of the Special Task Force appointed by the Surgeon General to consider the syphilis problem and develop recommendations for an elimination program. The Task Force’s report was submitted approximately 1 year ago and this is the first budget submission since the Public Health Service has had the advantage of these findings. Dental services and resources.—The Bill includes $6,218,000, a re- duction of $9,000 from. the request, and an increase of $3,212,000 over the amount appropriated for 1963; however, on a comparable basis, the increase is $776,000. The increase is composed of several items the most significant of which is $335,000 for training grants. The problem posing the greatest threat to dental health is the in- creasing shortage of dental manpower. Greater utilization of auxil- iaries is one way to help resolve the problem, by enabling the dental practitioner to use his time more effectively and productively. These training grants are made to dental schools to increase the number of students who will receive training in the use of auxiliaries, develop an intensive evaluation of the present program, teach students to train their own dental assistants, and provide for limited experimentation with the extension of dental auxiliary functions. The reduction from the request is the amount budgeted for increased indirect cost allow- ances in connection with research grants. Nursing services and resources.—The Bill includes $11,217,000, a reduction of $28,000 from the request, and an increase of $2,779,000 over the amount appropriated to this account for 1963; however, on a comparable basis, the increase is $336,000. The major part of the increase is approximately $200,000 needed to continue research grants started in previous years, and mandatory cost increases. The reduc- tion is the amount budgeted for increasing the allowance for indirect costs in connection with research grants from 20 to 25 percent. Hospital construction activities —The Bill includes $177,914,000, $1,600,000 less than the request, and $48,306,000 less than the amount appropriated for 1963. The reduction of $1,600,000 is the amount budgeted for financing research projects after fiscal year 1964. The major factor in the reduction below the appropriation for 1963 is a reduction from $150,000,000 appropriated for general hospital con- struction in 1963 to $100,000,000 included in the Budget and in the Bill for 1964. 20 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS George Washington University Hospital —The Bill | includes $2,500,000, the amount of the budget request. This amount is esti- mated to be necessary to assist in the expansion and improvement of the facilities of the George Washington University Hospital, as authorized by the act of May 31, 1962 (Public Law 87-460). Under the authorization the Federal funds may not exceed 50 per cent of the cost of this expansion and improvement of facilities. ENVIRONMENTAL HEALTH The Committee has been intensely interested in the problems of environmental health and the. Federal: programs in this ‘area over a long period of time. It has specifically sought, through a number of actions, to secure greater emphasis on this problem of such major im- portance to the public health. Four years ago this Committee re- quired of the Public Health Service a full report on the current state of these environmental problems, the needs that had to be met, and the Public Health Service plans and recommendations in this area. ‘The Committee has also supported the regrouping within the Public Health Service to provide for more effective relationship and common direction of its various environmental health activities. It has under- taken to provide increasing support for these major programs. The Committee also is favorably disposed toward the concept of a major environmental health facility, the establishment of which seems quite clearly to bean essential component of a national environmental health program. Congress...appropriated. $785,000 in the 1961 appropriation act for the planning of an Environmental Health Center. This was followed by inexcusable procrastination, indecision, and confusion in the executive branch. Last year it was testified that the site could be announced “tomorrow”. This year no site had been selected and no assurance could be given the Committee as to when it would be selected. Last year it was estimated that the staff. at the Taft Center in Cincinnati would be: halved when the new center.is established. This year. the: Committee was told ‘the level of staffing at Cincinnati would not be reduced. In addition there has been bickering on the part of some who would like to be considered leaders in the field of certain phases of environmental health who have openly opposed the Center or have dammed it with faint praise. In view of this the Committee has reluctantly deferred further appropriations, as mentioned under ‘Buildings and facilities’, until the executive branch comes: n with firmer plans and there is better evidence of support and cooperation on the part: of those interested in the various phases of environmental health. As this Committee sees the Public Health Service program evolving at the present time, it would appear to involve several discrete parts individually related to the major environmental hazards in respect to air, water, radiation, food protection, occupational health, etc. Each of these areas presents special problems in respect to control, involve various forms of regulatory activity, and require programs of meas- urement, testing, and relevant research. This diversity of activity obviously will require special emphasis upon coordination of program development and direct and close working relationships amongst the LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 21 several program parts and the various mechanisms employed in the conduct of them. The Committee feels, however, that there has not emerged thus far in the development of the concept of the Service’s environmental health program, an adequate distinction between the basic underlying scientific activity essential for the long-term development of programs in this field and the various mechanics through which the programs are conducted. The Committee is convinced that there is a consider- ation here vastly more fundamental than problems of coordinating several related but essentialiv separate technical activities. Based on the discussions in the hearings, the Committee nas the impression that the Public Health Service has not given sufficient attention to the basic considerations of science that underlie the fundamental phenomena. common to all the major environmental health problems. The basic issues here relate to the fact that American science is far behind in these environmental problems and that, furthermore, there are very broad areas of scientific effort that must be undertaken to gain an adequate basis of fundamental knowledge to permit progress in the solution of these complex problems. The Committee feels that even the scientific description of the basic nature of these prob- lems has been inadequate. It feels that not enough thought has been given to the possibility that what is needed, most importantly, is a major effort directed toward the development of a new field of scien- tific study which would encompass but far transcend the traditional disciplines of pharmacology and toxicology. Such an effort would be centered upon the very broadest approach to the study of what may well be the most important set of phenomena bearing upon continued life on this planet, namely the induction of biologic change by the action of exogenous chemical and physical forces: Study of this phenomena would appear to present formidable problems since, for the most part, what is being dealt with are the changes that may occur over long periods of time as a result of continued exposure to low concentrations or trace levels of chemicals, radiation and other con- taminants and toxicants. However, the understanding of the nature of this process consti- tutes, in the Committee’s view, the kind of fundamental knowledge essential to the development of meaningful environnrental controls, regulatory programs and the evolution of effective protection and treatment techniques. The Committee would like to see a further elaboration of this set of concepts by the Public Health Service in respect to its plans for the environmental health program generally and in terms of the specific role to be played by the Environmental Health Center. The develop- ment of this field of scientific effort might be approached much in the manner that was utilized by the National Institutes of Health in furthering the development of biophysics over the past several years. Environmental health sciences.—The Bill includes $4,224,000 for this new appropriation account, a reduction of $22,000 from the request. Since, in 1963, other appropriations are financing activities to the extent of $2,236,000 which will be transferred to this account in 1964, the increase proposed in comparable activities for 1964 is $1,988,000. 22 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS The primary emphasis will be placed on research grants for which the Bill includes an increase of $1,630,000. In accordance with the Committee’s comments included in the immediately preceding section it will be expected that special emphasis be given to the field of toxi- cology and other basic research. Aur pollution.—The Bill includes $12,954,000, a reduction of $44,000 from the request, and an increase of $1,885,000 over the amount appropriated for 1963. There is no doubt that the problems of air pollution control are growing greater every year. Many people feel that we are never going to be able to adequately cope with the problem without better control measures for which legislation has been intro- duced by several Members. Whether or not new programs are au- thorized, the Committee is of the firm belief that adequate support should be given the currently authorized research and training pro- gram, and has approved the full budget request with the exception of $44,000 budgeted for increased allowances for indirect costs in con- nection with research projects. Milk, food, interstate and community sanitation—The Bill includes $9,009,000, a reduction of $70,000 from the request, and an increase of $473,000 over the amount appropriated to this appropriation account for 1963; however, on a comparable basis, the increase proposed in the Bill for 1964 is $1,230,000. The significant increase is approxi- mately $1,100,000 for research grants. The committee will expect that special emphasis be given to research in the field of toxicology. Occupational health—The Bill includes $4,590,000, a reduction of $31,000 from the request, and $468,000 more than was appropriated for 1963. Most of the increase is composed of an increase for financ- ing research grants. During 1963 funds for this purpose were so lim- ited that only four new grants are being financed in this very impor- tant field. The funds provided for 1964 will permit the financing of approximately 15 new grants. Radiological health—-The Bill includes $18,745,000, a reduction of $31,000 from the request, and an increase of $2,870,000 above the amount appropriated for 1963. A well established responsibility of the Public Health Service is the development and conduct of a balanced program to protect the pub- lic from the hazards of radiation exposure from all sources. The major elements of such a program are (1) the identification and measurement of sources of exposure, (2) the evaluation of effects of exposure on man, and (3) the development and application of methods of reduction and control of such exposure. In carrying out this program, the Public Health Service provides technical and financial assistance to States in the planning and operation of their radiological health programs, con- ducts research into the various scientific aspects of the problem, oper- ates a nation-wide surveillance system, carries on a prograno for train- ing radiation specialists and technicians; and a number of related special projects. Nuclear testing by both the Soviet Union and the United States has had a serious impact on these activities. It has required superimposi- tion of urgent new program requirements, to adequately deal with fallout problems, on existing programs, designed to meet radiological health problems growing out of peaceful applications of nuclear en- ergy, as well as expanding use of medical and dental X-ray equipment and other sources of radiation. The increase requested in the budget LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 23 and approved by the Committee calls for a general strengthening of the entire program. Water supply and water pollution control.—The Bill includes $27,921,000, a reduction of $2,059,000 from the request, and an increase of $3,214,000 over the amount appropriated for 1963. $2,000,000 of the reduction is applied against the “Comprehensive program for water pollution control’, for which an increase $2,428,000 was budgeted. The Committee recognizes the importance of this activity but there are already 324 positions and over $434 million being utilized for this purpose. The Committee feels that a credible and timely job can be done with the additional $428,000 provided for this purpose in the Bill. Other significant increases in the budget which have been approved by the Committee are increases of $1,900,000 for research and training grants and $722,000 for expansion of enforcement activities. ‘The latter increase involves the addition of 60 positions for this work, which is approximately one half of all the increase in personnel allowed for activities carried on under this appropriation. Grants for waste treatment works construction.—The Bill meludes $90,000,000, a reduction of $10,000,000 from the request, and the same amount as was appropriated for 1963. Hospitals. and medical care-—The Bill includes $49,962,000, a reduction of $76,000 from the request, and an increase of $1,142,000 above the amount appropriated for 1963. The budget included a requested increase of $76,000 and 11 positions for research activities which the Committee has not allowed. It is the desire of the Com- mittee that none of this reduction apply to research at the Carville Hospital. The major part of the increase allowed is composed of $264,000 necessary to establish three pediatric units in order to main- tain accreditation, and $332,000 for drugs and medical supplies which have reached a dangerously low level. Foreign quarantine actiwities—The Bill includes $6,456,000, a reduction of $660,000 from the request, and an increase of $545,950 over the amount appropriated for 1963. The reduction is accounted for by the disallowance of $660,000 requested for rental of space at international airports. This is for rent that has not been paid in the past and no convincing evidence was presented to the Committee that a change should be made in the future. The major part of the increase allowed is to cover mandatory cost increases and $348,400 for 25 additional positions to perform medical examination of visa applicants abroad. A charge is made for such medical examination and the proceeds are deposited to miscellaneous receipts of the Treasury. So far this program has been self sufficient and the Committee was told that it would continue that way. In 1957 the Public Health Service Act was amended to provide that the Public Health Service would be reimbursed by shipping companies for overtime costs of quarantine inspections of maritime shipping during non-business hours (generally between 6 o’clock p.m. and 6 o'clock a.m.) if the shipping company requested such off-hour inspections. The shipping companies have benefited by this law in that ships arriving from international ports could proceed through quarantine clearance immediately upon arrival and thence proceed to their berths where unloading could commence without delay. The alternative would be to lie at the quarantine anchorage for all or part 24 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS of the night and await their turn in the morning when inspections are normally commenced. Tt has been brought to.the attention of the Committee that this legislation has been interpreted to apply only to overtime services by full-time employees, exclusive of independent contract personnel performing similar duties as required. Physicians in private practice are engaged by. contract to perform quarantine inspections on a flat fee basis without any difference in compensation for night, Sunday or holiday inspections. Although the shipping companies are perfectly willing to pay the costs of additional compensation in order to obtain. inspections by such contract physicians promptly during off-hours, they are excluded from the benefits of the overtime legislation. The Committee believes that this limitation is not what was in- tended by Congress—that the term “employees” in this legislation is not used in any technical setise to exclude independent contractors performing similar duties, nor was there any intent to limit the provi- sions to full-time employees. In the opinion of the Committee physicians, or others, performing such inspectional services on an uregular basis at odd hours under contract should be considered covered by the overtime legislation as enacted, both for purposes of extra compensation for services during the hours specified in Section 364(c¢) of the Public Health Service Act and for purposes of reimburse- ment by carriers. NATIONAL INSTITUTES. OF HEALTH : This year, as it has in the past, the Committee studied the Presi- dential budget request for the National Institutes of Health with the highest degree of interest and with painstaking thoroughness. The Committee makes no apology for its special interest in these health research programs. There are no other programs coming before this Congress for assessment and approval that so clearly and so totally relate to ends good in themselves; and none that can and do contribute more significantly to the happiness and well being of all our citizens, including generations not yet born. In past years, probing by the Committee has disclosed that Presi- dential requests were not taking into account urgent national health needs, and clearly were not rising to current opportunities to meet those needs. The Committee has never wished to assert its own judgment in technical matters of this complexity, but it has felt impelled to present for Congressional consideration a series of pro- gram proposals that more adequately measure up to the best scientific assessment of what could and should be done in support of research to improve the Nation’s health. Out of these considerations grew a pattern for Committee review of NIH appropriations. The Committee listens carefully to a num- ber of the Nation’s leading biomedical scientists, testifying as inde- pendent witnesses, and solicits from them their professional evalua- tion of needs and opportunities in health related research. The Committee draws also on the professional judgment of the leading scientist-administrators at NIH, both in direct testimony and as reflected in preliminary budget requests developed by individual Institutes. Such budgets assess actual opportunities from a realistic scientific point of view, without dilution by the myriad of administra- tive or competing program considerations that determine overall agency budget proposals. The Presidential budget request then can LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 25 be evaluated against these two baselines. To assess progress or problems in individual programs, the Committee requests and studies a considerable volume of special reports and statistical analyses. The Committee also requests studies in depth of major program determi- nants, such as the Manpower Report prepared last year, which pro- jected needs for scientific personnel in health related research through 1970. The record of Committee hearings on the NIH appropriations characteristically runs to about one thousand pages each year, and does again this year. A study of the record will clearly reveal that neither whim nor intuition of the Committee play a role in program determinations—teliance is placed on the best-informed_ scientific judgment available in the Nation. The record bears abundant testi- mony to the wisdom of program support levels established by the Committee in recent years; the proof is in the citation of the many solid gains to health and to knowledge derived from the research supported, MANAGEMENT OF PROGRAMS _In view of criticisms of the administration of the grant programs of the Public Health Service, and specifically those of the National Institutes of Health, the Committee ascertained the actions taken in response to these criticisms. It probed specifically for evidences of inadequacy, laxness, and ineptness in these administrative processes. The Committee received, during the course of the hearings, an exten- sive report from the National Institutes of Health, included in the hearings record, which detailed numerous specific actions to improve administration during the course of the past year. These actions related in part to criticisms and recommendations made by the Inter- governmental Relations Subcommittee of the House Committee on Government Operations. This Committee was impressed by the con- tribution made by the Intergovernmental Relations Subcommittee to improvement of the administration of research grants. The Com- mittee was also favorably impressed with the solid improvements made by the National Institutes of Health in its administrative pro- cedures and policies. The Committee is convinced that through this experience there is evolving a sound framework of policy and operating philosophy for the conduct of these programs. Clearly reflected also is the prime responsibility to administer the appropriated funds with clear regard for the achievement of the purposes for which they are appropriated and with careful concern for the efficiency and effective- ness of the expenditure by grantee institutions and individuals. The Committee has been concerned, however, with reports that it has received, that the steps taken by the National Institutes of Health seriously threaten the freedom of scientists, and that they constitute evidence of Federal control over science. The Committee would be most concerned if, indeed, this were the case. The Committee is sensitive to the fact that over zealous response to criticism might result in unneeded restrictions. However, the Committee is con- vinced that what has taken place is a needed and proper clarification of the necessary conditions which accompany the use of large sums of public monies. The rules reflect the inherent obligations associated with a system of support for research through the device of grants for research projects. Furthermore, the Committee supports the view 97129—63-——4 26 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS that the investigators and institutions who are recipients of these funds must demonstrate their capability to utilize them with integrity and prudence and with due regard for the achievement of the public purpose for which they are made available. Clear demonstration of such capability and integrity must be the basis upon which public confidence will continue to rest. At the same time, the Committee directs the Public Health Service to exercise a high degree of vigilance that its actions not diminish the basic independence and integrity of our institutions of higher learning, and the essential conditions of scientific freedom. General research and services, National Institutes of Health.—The Bill includes $163,869,000, a reduction of $805,000 from the request, and an increase of $4,043,000 over the amount appropriated for 1963; however, on a comparable basis, the increase is $8,888,000. The Committee was pleased to learn of the substantial progress made this past year in research in the sciences basic to medicine, particularly in such fields as genetics, in which scientists have made major contributions to the understanding of the manner in which genetic information is transmitted and coded within the cell. This work, which the Committee has been assured has important implica- tions for many developmental and other disorders, is being supported on a broad front by the National Institute of General Medical Sciences: Among the many gains in basic biological research reported to it, the Committee notes also the new knowledge acquired in studies of the hormone ACTH and of the role of the little-understood tyhmus gland. As explained to the Committee, the structure of the compli- cated ACTH molecule has been deciphered. A portion of it has been synthesized and proved to have greater ability to break down solid fats in living animals than the natural hormone. It is expected that in time other parts of this hormone may be adapted to other uses. Studies of the thymus gland have disclosed that this organ has an important role in immune reactions by which men and animals reject foreign proteins and grafts. The thymus also appears to inhibit or promote growth by adjusting the balance between two opposing substances which it secretes simultaneously. The Com- mittee understands that two of the investigators contributing to these highly significant studies have won major awards for their work, and are among the outstanding scientists who have been grantees of the Institute for substantial periods of time. The Institute’s research training and fellowship programs play a key role in the strengthening of scientific effort in medicine and biology. They have not only contributed to the support of a large number of young scientists, but have been extended to embrace new and emereg- ing disciplines where there is a pressing need for highly trained research workers. The importance of these training programs, covering such fields as cell biology, genetics, biophysics, biomedical engineering and the basic behavioral sciences, cannot be overemphasized. The Committee believes that this Institute’s programs, the most broadly based of any at the National Institutes of Health, are of critical importance to all of the medical and biological sciences. These programs—for which moderate increases have been provided in 1964—cut across the categorical areas of study, and provide the foundation on which the main lines of research into specific diseases must be based. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 27 The Bill provides $40,919,000 for the support of general clinical research centers, special resources centers, general research support grants, and regional primate centers. Since July 1962, these programs have been administered by the new Division of Research Facilities and Resources. For hearings this year, the Committee requested and studied closely a detailed progress report on each of these special programs. Similar reports will be required for next year’s hearings. The Committee notes with satisfaction the increasing flow of research accomplishments from the general clinical research centers, of which 39 are now in full operation. These centers appear to be measuring up to expectations in every respect. The regional primate centers program has added three new primate projects this past year, to its original four. Thus it has a much better regional coverage in areas of high demand. Of the seven, two are in the Northwest, one in the Southwest, one in the Midwest, one in the East and two in the South. In their work with subhuman primates, scientists are discovering an increasing number of physiological and biochemical similarities to humans, thus enabling man to gain new knowledge with which to exercise increasing control over his own health and well-being. General Research Support Grants, initiated in FY 1962 for schools of medicine, dentistry and public health, were extended in 1963 to other health professional schools and certain nonprofit research organizations heavily engaged in health-related research. ‘The Com- mittee is pleased to have received assurance that these grants are in fact assisting insitutions to develop the better balanced research and research training programs envisioned when the program was started. Division of Biologics Standards.—The Bill includes $4,787,000, the amount of the request, and an increase of $840,000 over the amount available for comparable activities in 1963. This appropriation level reflects the significant increase in the volume and diversity of biological products due to the rapid scientific advances being made in microbiology, particularly in virology and immunology. With the emphasis on research by industry, the devel- opment of new products is proceeding at an accelerated rate. To meet this, the Division must continue to expand its control operations and to augment its research facilities to include lines of investigation relevant to such new developments. At present, the Division is responsible for the control of 193 specific products used in the prevention and cure of human disease. These include blood and its many derivatives; therapeutic serums; antitoxins; and of particular interest, vaccines, which have a direct bearing on the health of our children, the protection of adults, and even the strength of our armed services. The Committee commends the Division on its effective administra- tion of these control measures which require the painstaking design and development within a research context of rigid but practical standards for the production and testing of these products. For example, the development by the Division of regulations for the measles vaccines, recently licensed for commercial use, called for an extensive array of controls since there are three products involved— the inactivated vaccine, the live vaccine, and standardized gamma globulin for use with the live vaccine. The production of live vaccines by tissue culture methods has necessarily expanded the testing program of the Division. One of 28 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS the problems encountered in this type of vaccine production is the occurrence of adventitious viruses, many of them previously unknown. Much of the work of the Division during the past year has been con- cerned with the development of testing methods for the exclusion of the simian agent, SV—40, from monkey kidney tissue culture prepara- tions. The development by the Division of a continuous cell line derived from a particular type of monkey cells is one approach to testing for adventitious viruses. The cell line, now in its 125th passage, remains sensitive to SV—40, and its susceptibility to other viruses indicates that it can be used to test for a variety of viral agents. Chick embryo tissue culture, used for the propagation of measles virus, presents a similar challenge, since a number of adventitious viruses are known to be present in fowls, and experience with this type of tissue culture is relatively limited. The Committee notes with approval the manner in which the Division has used to good: advantage research opportunities in other countries. The study recently completed in West Africa added ma- terially to the knowledge of the use of live, attenuated measles vaccine, demonstrating that the 750 thousand Upper Voltan children, despite their different environment and greater vulnerability to natural measles, responded in a similar manner to American children given live measles vaccine. In New Guinea, Division investigators are cooperating with Australian workers in a study on prevention of tetanus in the newborn by prior immunization of the mothers. It was reported to the Committee that broad-based, comprehen- sive research directed toward the improvement of testing procedures for the control of blood products are being continued. These studies include research on freezing, storage at various low temperatures, thawing and drying of the many elements of whole blood and the protein fractions of plasma. Presently, there is much interest in the components of the blood coagulation system. Some of the products under development have immunological or biological activities for which there are no established criteria. Research is being carried out on some of the fundamental characteristics of these coagulation components in order to obtain information on which to base control tests. Information was provided on the considerable progress being made by the Division in studies on poison ivy extract, as well as ragweed pollen. It is anticipated that current work on the latter will furnish basic information applicable to the establishment of standards for a product to protect against the allergic reactions of an estimated 10 million hay fever victims in this country. The Committee recognizes that the Division’s research must in- clude a diversity of projects, all product-oriented, with their scope and intensity directed toward the provision of information essential to the continuous improvement of testing methods for products now in com- mercial use, and the development of requirements for the licensing of new products. The Committee feels that the increased appropriation requested for the Division will enable it te fulfill its rapidly expanding testing and control obligations. _ National Institute of Child Health and Human Development—The Bill authorizes expenditures of $34,000,000 in 1964, the amount requested for the newly established Institute. The funds are to be provided by transfer from other NIH appropriations. This new LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 29 Institute is authorized by Title IV of the Public Health Service Act, as amended by Public Law 87-838, approved October 17, 1962. The Committee understands that the new Institute will give major attention to study of the continuing process of growth and develop- ment that characterizes all biological life from reproduction and prenatal development through infancy and childhood and on into the stages of adulthood and old age. Specifically, the new Institute will strive to develop more effective research efforts in such areas as the biological, physiological, and behavioral aspects of human reproduc- tion, growth, and development; studies of the prenatal and perinatal period in human development; obstetrical and pediatric problems not directly related to the specific disease interests of the categorical In- stitutes; studies on the biological, medical, and behavioral aspects. of the aging process; and studies in special problem areas of human de- velopment, such as mental retardation. The Committee was informed that the initial organization of the new Institute will include the staff and functions of the Centers for Research in Aging and Child Health, which were formerly located in the National Institute of General Medical Sciences. Additional program components of the new Institute will be established by trans- fer from other Institutes of a broad but selected group of research and training activities, for which the new Institute will be able te provide a more meaningful focus. Certain key problems have already been identified for early atten- tion by the Institute. Research relating to prematurity and other factors associated with mental retardation will be emphasized. Also serious. consideration is being given to ways to advance research and research training in gerontology. In 1964, the Institute plans to ssume direction of the Pediatric Training Program now supported by the National Institute of Arthritis and Metabolic Diseases, and the Developmental Sciences Training Program now administered by the Institute of General Medical Sciences. The Committee hopes that the creation of this new Institute will lead to a significant increase in the pace and effectiveness of the research attack on a wide range of fundamental health related prob- lems. These problems range from easing the ills of the aged; to eliminating the tragedies of infant deaths, mental retardation and malformations at birth. The Committee will look forward with particular interest to the development of this program during its first full budget year and will expect a full report on its progress in organization, program evaluation and the direction of further effort, during the course of next year’s bearings. National Cancer Institute—The Bill includes $144,340,000, a reduction of $774,000 from the request, and $11,402,000 less than the appropriation for 1963; however, on a comparable basis, the reduction below 1963 is $1,085,000. The Committee learned with interest of the important administra- tive and organizational actions taken by the Nathonal Cancer Insti- tute in recent months, to puruse new opportunities and to develop fresh leads provided through cancer research. It noted the Director’s organization of the Institute’s top level management staff into a scientific directorate and the establishment, under the directorate, of two standing committees to develop and expedite programs for research on cancer causation and prevention, and 30 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS on diagnosis and treatment. Also, the organization of two new task forces to lead intensive investigations of viruses suspected as causes of human cancer, and to concentrate on improving treatment of acute leukemia patients, was viewed by the Committee as a sign that in these areas, at least, there is real possibility of early major gains in the struggle against cancer. The Committee was interested in the progress which has been made during the past year in the promising field of virus-cancer research. To date, no human cancer-causing virus has'been found. However, a group of human viruses that have not yet been linked with specific disease, as well as some animal viruses, have been found to cause bizarre changes in human cells growing in tissue culture. Some of the human adenoviruses, which cause acute respiratory illness, have also been found to produce tumors in hamsters. The Committee was informed by the Director of the Institute that the research area of top priority for the National Cancer Institute is carcinogenesis—the induction of cancer by agents, such as viruses, acting either alone or in concert with other environmental agents. The Committee is aware of the special problems relating to facilities for integrated activities on carcinogenesis, and therefore recommends that the increased funds requested for this purpose be allowed. The problem of early diagnosis of cancer continues to be an area of special concern to this Committee, as it is to all those interested in cancer research. One of the most recent and much needed develop- ments along this line is a simple method for detecting cancers of the kidneys and bladder before symptoms appear. Further development of this technique may help reduce mortality from kidney and bladder cancers which take an estimated 13,000 lives a year. Another step in this area is the contract that the Institute has awarded to the Health Insurance Plan of New York, to evaluate the efficacy of the x-ray procedure called mammography, mentioned in last year’s hearings as a possible tool for detecting early breast cancer. It was also encouraging to learn of Institute plans to strengthen re- sources for diagnostic research through the establishment of a Lab- oratory of Experimental Clinical Pathology, which will conduct in- vestigations, and plan and direct extensive field trials and instru- mentation projects. The on-going search for new and better drugs for the treatment of cancer reached a turning point during the past year: the volume of materials being screened has been reduced, but the original three- tumor screen has been broadened in the hope that more compounds of wider use against several different kinds of cancer will be discovered. Also the chemotherapy program. will seek to develop methods of screening for drugs effective against viruses, on the assumption that viruses will one day be proved to cause some human cancer. Some of the earlier problems in the chemotherapy program, such as recruitment of qualified physicians for this collaborative venture and the availability of patients, have been solved substantially. The Committee feels certain that Institute plans will also provide solutions to new problems arising, such as the need for more adequate data processing and communication. The outlook for major gains in the months ahead is particularly bright in the area of the care and treatment of patients with acute leukemia. The Committee shares with the Institute the hope that this segment of the cancer problems will scon yield to accumulating LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 31 improvements such as the new drugs and additional supportive therapy which have grown out of this year’s research. Mental health activities —The Bill includes $177,288,000, a reduc- tion of $12,808,000 from the request, and an increase of $33,689,000 over the amount appropriated for 1963; however, on a comparable basis, the increase over 1963 is $34,070,000. The Committee was pleased to finally receive a budget plan for implementation of the major recommendations of the Joint Commis- sion on Mental Illness and Health—some two years after the rendering of its Final Report to the Congress. The substantial increase for the Mental Health Institute in 1964 reflects mainly additional effort in support of the Report’s recommendations. This historic study was made possible by specific action of the Congress authorizing “on objective, thorough and nationwide analysis and re-evaluation of the human and economic problems of mental illness.” The Com- mittee has been impressed by the enthusiastic response and the wave of support for positive action that the Report has provoked throughout the Nation. In accepting the challenge at the Federal level, the President in his State of the Union Message this year said, ‘I believe that the abandonment of the mentally ill and the mentally retarded to the grim custody of mental institutions too often inflicts on them and on their families a needless cruelty which this Nation should not endure.” The Committee has heard convincing testimony from a wide variety of expert and informed witnesses concerning the immediate need for and timeliness of a national action program against mental illness. The Committee views the 1964 mental health budget pro- posals as a first step in that direction—an important first step within the larger context of the overall national program proposed by the President in his Special Message on Mental Illness and Mental Retardation. Over the years, this Committee and the Congress as a whole have seen fit to contribute to the gradual and orderly establishment of a solid foundation for the eventual mounting of such an all out attack on mental illness. The Committee has followed the growth of the — Institute’s programs with great interest. It has viewed with general approval, the progress that has already been made in the training of mental health manpower, in the support and conduct of research, and in community and technical assistance programs. That such expansion has already paid off is clearly illustrated by the further drop for the seventh straight year in the number of patients in State hospitals. However, there are still some 18 million of our people with some form of mental disorder. There are still some 516,000 patients in State hospitals and these patients alone cost the taxpayer over $1 billion just to maintain, and this largely on a custodial rather than a treatment basis. The Committee, expects therefore, that the increased funds which will be available in 1964 will be utilized in development of an action program that will meet the challenge of the Joint Commission Report. The Committee would emphasize that such a program must be mounted through the combined efforts of all levels of government together with the private sector. At the Federal level, the current programs with their comprehensive scope and unified approach should serve as a logical baseline for the implementation of this expanded effort. 22 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS The Committee continues to view mental health manpower as a high priority area of effort. It will expect. the Institute to continue to accelerate its training efforts on a broad base, for both professional and non-professional personnel to provide services to the mentally ill, and for scientific personnel in the research area. The substantial in- erease provided in training funds for 1964 will support this accelerated effort. The Committee will expect continued emphasis to be given to the general practitioner program and to the evolving new program of in-service training for non-professional personnel. -In the research area, the Committee recognizes that. continued orderly growth is essential to an ultimate understanding of the causes of mental disorders and as a basis for effective prevention. It will expect the Institute to maintain appropriate balance as between. basic and applied research approaches and to further imaginative research approaches to such difficult problems as alcoholism, delinquency and drug addiction, and the relevant scientific disciplines... The Bill in- creases research grant funds available in 1964 for most research pro- gram areas. i Progress has been made in the establishment of the National Clear- inghouse for Mental Health Information for which initial funds were provided last year. The rapid communication of research findings and their prompt and effective application is considered: essential to continued forward progress in the field of mental illness.. The Com- mittee will expect the Institute to proceed carefully with. the further development: of this program and to keep the.Committee fully in- formed with respect to its status. The Committee has heard extensive testimony concerning the wide- spread upward surge of interest throughout the country in the plan- ning of comprehensive, State-wide mental. health programs. It views the planning grants authorized by the Congress last year as a needed stimulus to such forward progress and has provided funds for the continuation of this program for a second year. The Committee made a reduction of $12 millon in the budget request of the Institute by deferring the appropriation requested for a new program of Hospital Improvement Grants. The Committee was generally favorable to what it understood to be the objectives of this. proposal, namely to demonstrate new and improved methods of care and treatment in our State institutions for the mentally ill and mentally retarded. However, the Committee was concerned. with the lack of definitive details concerning the operation of the program’ in terms of guidelines, relationship to existing activities, ‘criteria as to qualification requirements, review mechanism and _ particularly the nature and extent of State and local participation. Furthermore, it is the Committee’s understanding that the program is of a transi- tional nature in relationship to other broad program proposals in the meatal health field currently pending legislative action. National Heart Institute. The Bill includes .$182,404,000, a reduc- tion of $1,220,000 from the request, and a reduction of $14,994,000 from the amount appropriated for 1963; however, on a comparable basis, the amount in the Bill is an increase of $3,130,000 over 1963. The Committee was interested to learn of the substantial contribu- tions to basic knowledge of the cardiovascular system and its functions made during the past year by heart research. Research has also led to improved methods of diagnosis and treatment, so that more and LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 33 more people are benefiting from the national investment in heart research. _Although heart disease continues to be the Nation’s leading killer, accounting for about 947,210 deaths in 1962, encouraging develop- ments were reported in the statistics of heart disease. [for instance, there has been a 33 percent decrease in the death rate from hyper- tension in all age groups. Research in heart disease clearly is begin- ning to pay off. Continued progress, which the mereased funds provide for, will mean increased human and economic savings. in the field of atherosclerosis, the ranking heart killer, new basie and clinical findings of value were reported. In connection with atherosclerosis and cholesterol, the Committee noted iast year that it was. imperative to delineate the interrelationships among diet, cho- lesterol, and other causative factors, in the development of heart disease. The Committes learned that there is emphasis in research on hormonal factors, stress, genetics, and other implicated causes. Especially with regard to research on the role of hormones in cardio-- vascular disorders, the Committee received excellent and heartening: testimony from one of the Institutes grantees who reported that studies have shown the ability to cut the death rate, in a selected group of men, 50% or better through the use of hormones under experimental conditions. The Committee will expect that adequate funds will be applied to follow-up studies to determine the feasibility and value this might have in general practice. The Committee was pleased to learn also that there is now under-- way a carefully planned, cooperative investigation in six U.S. centers: to determine the feasibility of methods of lowering cholesterol in the diet. In view of the widespread interest in diet as a possible means to control or reduce heart disease, the Committee will follow closely the progress of this feasibility study, and will expect careful assessment. of results. The Committee learned of further progress In the treatment of hypertension, through new compounds for lowering and controlling blood pressure. The vast problem of hypertension, however, has not yet been solved, as the Committee well realizes. Moreover, from the evidence brought to its attention, it would appear that there is an apparent need for greater interest, involving various scientific dis- ciplines, in hypertension. The Committee trusts that the Institute and the National Advisory Heart Council will devote’ particular attention to encouraging and planning for research in this area, The Committee was told of progress toward the day when irrepar- ably damaged human hearts can be totally replaced by small mechani- cal pumps. The proved practicality of heart-lung machines and of artificial blood vessels and other substitute parts for the heart has led research workers to believe that miniature blood pumps may be designed for installation within the body. Research has already commenced toward this end and several prototype prosthetic hearts have already undergone preliminary animal trials. The Committee believes that the tremendous potential of this challenging research opportunity should be sought most extensively and intensively. . Because many research problems of aging are closely involved with heart and blood vessel research, the Committee has been disappointed at the slow pace of progress in planning for a comprehensive new research resource for the Institute, the gerontology facility to be built 34 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS on land donated for the purpose by the City of Baltimore. The TInstitute’s aging research program there is of particular interest to the Committee, because it exemplifies effective cooperation among city, State, and Federal and private researchers and organizations Jointly concerned with aging problems. This is the pattern of cooperative support of research activity that the Committee would like to see followed in other critical research areas. Good progress was reported in the development of clinical research centers, providing a multidisciplinary focus of techniques and facilities upon complex research problems. The Committee is heartened to see that this area of research promise, which it has long encouraged, is moving into a new state of growth and realization of its potential. Finally, in the area of training for heart research, the Committee notes that the needs and demands for research manpower continue to increase. While programs of support through Institute training and fellowship awards are returning dividends to the Nation’s pool of scientific manpower, the Committee believes that greater efforts are required. The budget proposed will provide increased funds for this purpose. National Institute of Dental Researech.—The Bill includes $19,689,000, a reduction of $120,000 from the request, and $1,510,000 less than the amount appropriated for 1963; however, on a comparable basis, the amount in the bill is an increase of $926,000 over 1963. The Committee was pleased to learn of the advances in research on diseases of the teeth and their supporting structures, advances which have already made sizeable contributions to the dental health and welfare of our people. However, since diseases of the oral cavity remain a major public health problem in the United States today, this Committee views as essential the continued and deliberate ex- pansion of dental research, both in the Institute and throughout the country. Testimony before this Committee has brought out that the moderate budget increase proposed for dental research in 1964 will suffice to sustain substantial upward progress and to pursue the main research opportunities currently identified. The importance of the research carried out through this Institute is unmistakable. One disease, tooth decay, is probably the most prevalent disease condition we have, affecting 90 percent of our children. To date, research has provided significant new knowledge regarding the mechanism of these diseases and the clues which may lead to future prevention. The Committee notes that it has been demon- strated that a strain of streptococcus can induce decay of teeth in certain kinds of animals. In other animal studies, it has been shown that periodontal disease can be transmitted from one animal to another, and a bacterial factor has been identified. Other studies in the Institute point to a possible viral factor in periodontal disease, and to identification of bacteria in the calculus (tartar) which is its precursor. The additional funds available for research grants in 1964 will permit further additions to our knowledge of these problems. The Committee was impressed also with the thorough documenta- tion of the long research on water fluoridation and the completion of a 17-year study in a community which has had such fluoridation. It is also gratified at the progress that is being made to develop means LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 35 of providing fluoride in rural or other areas where communal water supply cannot be fluoridated. The findings of Dental Institute scientists that fluoride tends to make the crystals of bone more perfect and more stable have striking implications. Since teeth and bone have much in common, these findings would seem to point the way for the first time to an under- stending of the way in which fluoride works. ‘The use of fluoride for certain kinds of bone disorders may also be an eventual outcome of this productive research. In the field of cleft palate research, the Committee notes that two research centers have been established, and three more are scheduled to be set up in this area within the next few months with support. from the Dental Institute. These are in addition to the many individual projects in some thirty research institutions which now seek to deter- mine the causes of such congenital abnormalities, as well as methods of treatment and rehabilitation for afflicted children. The Committee is particularly interested in research and rehabilitation efforts in this field. Witnesses before the Committee made it clear that the development of dental research broadly requires special action. There is an em- phatic need for programs and facilities to attract the basic science personnel without whose efforts dental research will not advance as it should. On the basis of testimony received, the Committee believes that the most promising mechanism for the further expansion of dental research would be through Dental Research Institutes, established within a general university environment, in several of our leading biomedical research centers across the Nation. In time, perhaps five or six such Institutes could be developed. Such an approach would overcome a number of the conditions that have limited success of dental research in the past: the lack of adequate research facilities in many dental schools; the inevitable stress on service and_ teaching rather than research in such schools; and the relative physical isolation of many dental schools from the cross-fertilizing stimulus to be found in a general university research community. NIE witnesses testified that the program mechanisms and the authority for setting up such dental research institutes already exist, and: discussions toward creation of such institutes have been initiated with several universities across the Nation. The Committee believes that the development of a firm program in this area should be given high priority. The program for training dental scientists has not progressed at the rate expected by the Committee. It is obvious that the need of dental schools and universities, particularly those newly established or now developing, for research and teaching personnel must be met through the training of new dental research scientists. The increased training funds for 1964 will contribute to this purpose, but cannot alone meet apparent needs. The suggested Dental Research In- stitutes, by providing an adequate base for training of true scientists within the profession, certainly would contribute significantly to the long-range solution of the problem. The Committee recognizes, however, that the pace at which such Institutes can be developed will 36 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS depend to an important degree on the ability to provide initial scientific staffing. Arthritis and metabolic disease actimities —The Bul includes $113,- 679,000, a reduction of $1,038,000 from the request, and an increase of $i0, 391 ,000 over the amount appropriated for 1963; however, on a comparable basis, the merease is $10,781,000. The National Institute of Arthritis and Metabolic Diseases, origi- nally created for the study of arthritic disorders and metabolic diseases such as diabetes, currently supports research in a wide variety of human ills. These include diseases of blood, bone, the liver and the gastrointestinal tract, as well as a number of inherited. disorders. The Committee was told of progress made in the field of diabetes, both in clinical and in basic research, including the evelving concept of prediabetes which appears to be leading to a new era in diabetic research and treatment... This new line of research was given strong impetus by scientists who have devised a group of test procedures to find. the prediabetic individual before his blood sugar levels become abnormal. Positive disagnosis of prediabetes could mean earlier treatment for the patient and the hope of delaying or possibly pre- venting the eventual emergence of frank diabetes. A series of outstanding “laboratory accomplishments in gout, one of the rheumatic diseases, was reported to the Committee. Con- tinuing studies by Institute scientists have clarified the exact nature of the physiological event that takes place when a gouty patient suddenly develops an acute arthritic attack. The scientists have now discovered how the age-old drug, colchicine, works to interrupt the acute, painful attacks. of gout. The Committee was particularly interested in the report on. a newly-found metabolic disease, histidinemia. It learned how team- work by clinicians and biochemists defined the cause of this disease. First, two separate groups of clinicians, one of which was supported by the Institute, detected several children with a disease which appeared biochemically similar to PKU (phenylketonuria). The ‘Institute-supported group of scientists then suggested that the meta- bolic defect in this new disease might be due to lack of the enzyme histidase. Institute scientists added to the investigatory circuit by demonstrating this to be true. The Committee hopes that the scientists will soon complete the circuit by finding a cure for this oe the main, presently known manifestation of which is ‘a speech elect Dramatic findings in the fields of gastroenterology have been noted by the Committee with interest. One significant development is the so-called stomach-freezing technique for the treatment of duodenal ulcer, which inhibits the hydrochloric acid-producing cells of the stomach and thus permits healing of the ulcer without resorting to surgery. Another achievement of interest is the development of silicone foam molds which act as reliable diagnostic tools for detecting lower bowel diseases. The Committee feels that research in. diseases of the gastrointestinal tract is extremely important and hopes that the support the Institute is giving to this field with the increased funds available will continue to show rewarding results. A continuing study of the so-called ‘genetic code” has resulted in several new findings. The code, embodied in the chemical structure of LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 37 certain cell-constituents, is the mechanism through which hereditary information is perpetuated from generation to generation, and which permits living matter to reproduce itself systematically. Recent studies have shown its applicability to mammalian cells, indicating that at least part of the genetic code is universal. Cystic fibrosis is a disease in which the Committee has had a long interest. This is a serious disorder found primarily in children and adolescents and exhibits as one of its manifestations an abnormality of sweat secretion which is used as a diagnostic aid in this disease. Research in cystic fibrosis has been marked by several interesting results. One of these is the finding through new diagnostic tests that individuals who are symptom-free carriers of this genetically-deter- mined disease, also have a degree of abnormality of sweat secretion. This work has also led to the belief that a considerable number of per- sons with respiratory or intestinal symptoms hitherto not ascribed to cystic fibrosis may actually have this disease, in partial or modified form. The Committee recognizes that research on this disease, as on diseases of the skin, is arduous and that results will not come over- night. The increased funds available should allow for continued study on these important problems. Allergy and infectious disease activities—The Bil includes $68,- 723,000, a reduction of $503,000 from the request, and an increase of $2,581,000 over the amount appropriated for 1963; however, on a comparable basis, the increase is $4,128,000. The Committee was pleased to hear of the progress in the National Vaceine Development Program, which is centered in the N ational Institute of Allergy and Infectious Diseases. This endeavor is a major collaborative effort, employing the combined resources of government, academic institutions, and industry, designed to speed the day when vaccines against the “common cold” and other viral respiratory diseases will be available to the public. So far, six contracts have been awarded to pharmaceutical firms for the develop- ment and production of prototype viral vaccines, while eleven vaccine evaluation centers have been established to conduct clinical and field testing. Some experimental vaccines have already been produced and are currently being tested. Additional funds will provide for anticipated acceleration of clinical and field testing and for the devel- opment of specialized resources common to the needs of this program. While there is no expectation of the development of vaccines against this whole group of diseases in the immediate future, the groundwork is being laid. Hopefully, it will lead to effective multiviral vaccines within the next few years. Another major collaborative project moving along at a significant pace is the Virus Reagents Program. This work will soon be providing reliable virus reference reagents for use as standard references by laboratories throughout the world. More than one hundred reagents are currently in production, and many more will be available by the end of this year. Arrangements are now in progress for endorsement of these preparations by the World Health Organization as interna- tional reference reagents. Increased funds will provide additional working reagents for day-to-day testing in selected research projects. Only a few years ago resistant staphylococcal infections posed one 38 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS of medicine’s greatest threats and was of deep concern to the Com- mittee. Substantial progress in this area has resulted in a number of drugs which are effective against resistant strains of staphylococcus which are now available to the practitioner. Through the coordinated efforts of the pharmaceutical industry and of the Institute, scientists may have found a long-acting compound to combat malaria. One injection of the experimental drug, desig- nated CI-501, has protected human volunteers from malaria infection for over a year. This protective period is ten times as long as that given by any conventional drug now used to suppress the disease. The importance of this development can be considerable and can have a profound effect upon the worldwide campaign to eradicate malaria, which still infects 200 million and kills 2 million annually. Research in the increasingly active field of allerey-immunology has been given greater emphasis. Basic research in this little-understood area is being conducted both at Bethesda and at academic institutions throvgh some 300 grant-supported investigations. The Institute was fortunate enough to be able to recruit one of the world’s foremost immunologists to head its intramural program. One of the major stumbling blocks in allergy research has been the lack of standardized allergens. If investigations in this area are to continue at a significant pace, it is imperative that large quantities of standardized allergens be made available to investigators. To date, the Institute’s career staff in allergy research has been extremely small. With the amount recommended in the bill, this deficiency can be at least partially remedied. Neurology and blindness activities —The bill includes $87,675,000, a reduction of $732,000 from the request, and an increase of $4,169,000 over the amount appropriated for 1963; however, on a comparable basis, the increase 1s $8,468,000. The Committee reviewed with interest the increased emphasis which the Institute has given this past year to the disorders of com- munications—speech, language, and hearing—and to the various dis- orders of vision. These are handicaps affecting millions of Americans, young and old, and clearly should receive more attention. Since the potential ability to control deafness far exceed present performance, present knowledge should be refined, through research, in order that hearing loss in infants and preschool children can. be detected readily through the use of simple, reliable screening tests. Many disorders thus detected can be treated through present research advances. In other instances, hearing aids can make possible the normal development of language in children between the ages of 3 and 6 years. Jack of such diagnosis and treatment often prevents preschool language development and sometimes unnecessarily places children in the category of the mentally retarded. A variety of treatments for language disability are developing but no critical evaluation of these treatments has been made. Steps should be taken, therefore, to develop a program for the evaluation of this therapy. In view of the number cf persons of all ages affected and the com- plexity of the problems relating to hearing, speech, and language, the Committee believes that consideration should be given to the estab- LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 39 lishment of a broad-based research center for the study of human communicative disorders. Such a center should mamtain an ap- propriate balance between clinical and basic research, emphasize prevention as well as treatment, and include many disciplines directly and indirectly related to disorders of communication. It could, moreover, be used to train researchers and technicians, and to act as an information gathering and disseminating center. The Institute’s study of model reporting areas, by States, is pro- viding much needed information on the incidence of various types of blindness. As detailed information on incidence becomes available, the need to detect and treat such disorders as amblyopia in children may become increasingly apparent. It is estimated that as many as 4 million persons have little use of one eye because of this disorder. Little information appears to be available concerning the blind- retarded and other multiple handicapped persons and a general lack of interest is shown in this group of seriously handicapped. The gathering of information on the magnitude of this problem should be encouraged by the Institute in order that an action program may be formulated, with the hope of eventually making possible a more normal life for these individuals. The Committee has studied the Institute’s status report on the Collaborative Perinatal Project and notes the reported accomplish- ments and several possible courses of future action. The Com- mittee requests that more definitive recommendations be provided early next year. In addition, immediate steps should be taken to hasten the analysis and dissemination of data already collected by the Project. The Committee believes, also, that the Institute should develop a coordinated program for the clinical evaluation of drugs used during pregnancy, with the Project as a focal point; it should further extend the study of viruses in pregnancy, and effect a much closer working relationship between the Project and the Institute’s Laboratory of Perinatal Physiology in Puerto Rico. The Committee is interested in the Institute’s research program in Puerto Rico and hopes that the construction of the new building at the Puerto Rican Medical Center, authorized by the Committee last year, will be expedited. Present Institute research activities should provide a focal point for inter-American neurological and sensory research programs, and the Committee suggests closer co- ordination with the Medical School of the University of Puerto Rico, on a day-to-day basis, in developing such plans. As reported to the Committee, the most common cause of hospitali- zation of children is accident and injury, with a significant proportion of those admitted suffering from head and brain injuries. Increased funds included in the Bill will enable the Institute to sponsor a more extensive head injury program. At this time, when an increasing emphasis is being placed on the problem of mental retardation, the Committee wishes to continue to encourage the Institute in its research relating to the underlying structure and function of the brain, and to disorders of the nervous and sensory system of infancy and childhood. Knowledge gained in this basic research by scientists, whose lives are devoted to study of the brain, is esséntial to progress in the prevention and treatment of those neurological disorders which may lead to mental retardation. 40 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Only as well trained investigators are available throughout the country, at all medical centers, can an all-out attack be made on neurological and sensory disease. Progress has been made in the training area, but a great shortage still exists. The further extension of the Institute’s training programs would be a constructive step. Grants for construction of health research facilities—The Bill includes $50,000,000, the amount of the request, and the same amount as was appropriated for 1963. The Bill thus provides the maximum amount authorized under the Public Health Service Act. The Committee is much concerned that this level of funding so clearly does not measure up to national needs for construction of additional research facilities. As of December 31, 1962, known demand, representing applications in hand or known to be in process, approximated $133 million. This does not include totals for institutions which had declared their intention to submit applica- tions, but had not yet submitted construction costs estimates. These figures, of course, provide no index to the real national needs for re- search construction, but relate only to immediate plans of the relatively small number of institutions in the fortunate position of being able to raise matching funds. Scientific activities overseas (special foreign currency program).—The Bill includes $4,000,000, a reduction of $2,647,000 from the request, and an increase of $1,200,000 over the amount appropriated for 1963. The Committee is convinced that this is an excellent program. It uses foreign currencies which are controlled by the United States but which are surplus to the United States’ other requirements. There is no doubt that good results have been obtained and are being ob- tained from projects financed with these funds. However, the Com- mittee has been concerned with this particular program, and all of the programs carried in the bill financed with these currencies, because of the extreme lag between the time funds are appropriated and the time they are put to use. Fer instance, in this particular program, the Committee found that the carryover of funds into 1962 would have been sufficient to finance all projects approved during that year. In other words, none of the appropriation of $9,000,000 made for that year was required for projects approved during the year. There has been some improvement in this phase of the program or the Committee would have made further reductions. It is believed however, that the amount. carried in the bill will be sufficient to finance all worth- while projects that can be approved in 1964. The Committee intends to look very carefully into the details of the operation and administration of these programs because it is convinced that there must be faulty procedures and unnecessary road blocks in the way of orderly program execution. National health statistics —The bill includes $5,949,000, the amount of the request, and an increase of $799,000 above the amount appro- priated for 1963. National Library of Medicine —The bill includes $4,074,000, the amount of the request,.and an increase of $739,000 over the amount appropriated for 1963. A large part of the increase, approximately $300,000 will be for nonrecurring costs of purchasing a computer for the ‘Medical Literature Analysis and Retrieval System.’”’ However, LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 41 there is also an increase to finance 25 additional positions, also a part of this new system which will vastly improve the speed and efficiency with which medical literature can be made available to scientists and others needing it. Retired pay of commissioned officers.—it is estimated that $6,436,000 will be spent under this indefinite appropriation for 1964, an increase of $652,000 over expenditures estimated for 1963. These funds 20 to pay retirement benefits to retired commissioned officers, and for medical care of dependents and retired personnel under the Depend- ents’ Medical Care Act. This appropriation finances no administra- tive activities. All payments made from these funds are required by law and are beyond administrative control. Salaries and capenses, Office of the Surgeon General_—The Bill includes $6,091,000, the amount of the request, and $241,000 above the amount appropriated to this account for 1963; however, on a comparable basis, the increase is $428,000. Aside from mandatory cost increases, which amount to approximately $250,000, the only substantial in- crease is $156,000 for personnel management, which has been criti- cized many times in the past as being deficient.. The increase for this function is in line with the recommendations of a special com- mittee selected to review the Public Health Service’s personnel sys- tem. This Committee was headed by former Secretary Folsom. SAINT ELIZABETHS HOSPITAL Salaries and expenses.—The Budget contained a proposal, which the Committee has accepted, to make this an indefinite appropriation but with an overall limitation on the amount of the budget for the hospital. The overall limit which was requested and has been ap- proved by the Committee is. $27,413,000. This compares with esti- mated obligations for the current fiscal year of $25,617,000, or an increase of $1,796,000 of which over $1,500,000 is for mandatory cost increases. Under this proposal, Saint Elizabeths Hospital would, at the begin- ning of the year, know definitely the amount of the annual budget and would be able to plan their operations more efficiently. Under the current arrangement the total amount of the operating budget is not known until the end of the year when the amount of reimbursements from the District of Columbia and others can be definitely claculated. Since reimbursements make up approximately 75 percent. of. their total budget, this makes planning very difficult. Also under the new proposal, the amount of reimbursement will indirectly determine the amount of the Federal appropriation, since the Federal Government will pay the difference between these reim- bursements and $27,413,000. Thus the rate of reimbursement be- comes a very important factor. While the Committee has approved the principle involved, it is in strong disagreement with the proposed level of reimbursements from the District of Columbia, which accounts for over 90 percent of total reimbursements. Currently the District of Columbia reimburses the hospital on a straight pro-rata share of costs per patient (excluding certain research and training costs) for all District patients with the 42 WLABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS exception of prisoners which have always been excluded from the calculation of the District’s retmbursement for reasons beyond the understanding of this Committee. The proposal in the budget was to calculate the reimbursement from the District of Columbia on the basis of the per patient cost at the median of the top ten percent of State hospitals. Since the Congress has attempted to make St. Elizabeths a model mental hospital the St. Elizabeth costs are higher than the median of the ten highest states. Thus this new method of calculation would give the District of Columbia a windfall of some- where between $2% and $3 million, depending upon the details of the method of calculations and assumptions made. The Committee has approved the principle involved in the new appropriation language and approves the use of the median per patient cost in the ten highest cost States, but directs that the legal authority already available be utilized to require reimbursement from the Dis- trict of Columbia for all District patients including prisoners. This will result in an estimated increase in reimbursements from the Dis- trict of Columbia of $2,362,000 above what was estimated in the budget. The following table shows the financing for the hospital currently estimated for 1963, the financing proposed in the President’s budget and the financing required under the Bill. 1964 Column (2) 1963 financing adjusted to financing (President’s | include D.C, budget) prisoners ® @) (4) Federal appropriation_._.._.--...----------~-------------+---+ $6, 332, 000 $9, 716, 000 7, 354, 000 District of Columbia (reimbursement) -__-__.-.--.------------- 17, 694, 000 15, 908, 000 18, 270, 000 Other reimbursements--_-.-.--.---.-------+----- eee eee eee 1, 691, 000 1, 789, 000 1, 789, 000 Total, program____-_-_-.2-.------ one eee eee nines 25, 617, 000 27, 418, 000 27, 413, 000 District of Columbia reimbursement rate per patient day_-.-.. 10. 30 9. 49 9. 49 The hospital has been experiencing increasing difficulty in securing services from Gallaudet College for deaf patients. This is due to the increasing demand on their facilities by Gallaudet’s own increasing enrollment. It was testified that adequate facilities could be estab- lished at the hospital at a cost of approximately $50,000. The Committee will expect that this be done within available funds. Buildings ant facilities —The Bill includes $627, 000, the amount of the request, and $7,468,000 less than was appropriated for 1963. The amount recommended is for several repair and improvement proj- ects that appeared to the Committee to be well justified. SOCIAL SECURITY ADMINISTRATION Limitation on salaries and expenses, Bureau of Old-Age and Survivors Insurance (trust fund) —The Bill includes authorization to spend $317,900,000 from the trust fund, the amount of the request, and an inerease of $31,501,700 over the amount made available for 1963. Approximately $12,000,000 of the increase is necessary for mandatory cost increases, mostly pay and postage increases, and $3,340,000 is necessary to restore the contingency reserve to $10,000,000. $3,340,- 000 was used for a Internal Revenue Service enumeration project not directly connected with the regular work of the Bureau. The trust LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 43 fund is to be reimbursed for this cost. The remainder of the increase is necessary due to the continued expansion of the Old-age and survivors insurance program. Grants to States for public assistance.—-The Bill includes $2,725,000,900 a reduction of $175,000,000 from the revised budget request, and $13,300,000 less than the amount appropriated for 1963. The Com- mittee had serious doubts in its mind concerning the proper level for this appropriation. It is quite obvious that if there are as many ineligibles, proportionately, on the welfare rolls throughout the United States as was indicated by a study made in the District of Columbia, a considerably larger cut could be made in this appropriation. Other factors which would indicate that certain savings could be made in this program are the new rehabilitation features of the program which are almed at removing welfare recipients from the rolls, an anticipated slight improvement in the unemployment situation during the coming vear, and an improvement in general welfare administration under the liberalized training program that has been incorporated into the pro- gram financed by this appropriation. On the other hand, those who should be experts in the field, testified that they feel sure that the situation in the District of Columbia is not at all typical, and that the result from the rehabilitation and training program will be rela- tively slight for the next year or two. The Committee believes that it has arrived at a good middle ground with the recommendations included in the Bill. Grants to states for training publie welfare personnel —The Committee has again denied the request for a special training program for training public welfare personnel. Under the last amendments to the Social Security Act the Federal government matches on a 75 to 25 percent basis for training under the programs financed from “Grants to States for public assistance.”’ The Committee was not convinced that an additional separate training program is required. Assistance for repatriated United States nationals.—The Bill includes $467,000, a reduction of $33,000 from the request, and the same amount as was appropriated for 1968. Since activities costing ap- proximately $65,000 have been transferred to ‘Salaries and expenses, Bureau of Family Services” in 1964, the Bill actually provides for a $65,000 increase for the remaining activities. Salaries and expenses, Bureau of Family Services -—The Bill includes $4,756,000, a reduction of $644,000 from the request, and an increase of $882,500 over the amount appropriated for 1963. The amount allowed will be sufficient for mandatory increases in costs and to put on a full year basis the 50 new positions allowed for a portion of 1963 in the Supplemental Appropriation Bill as it passed the House. None of the additional 31 positions requested for 1964 have been allowed nor have any of the 45 new positions disallowed in the Supplemental been reinstated. Grants for maternal and child welfare.-—The bill includes $86,943,000, a reduction of $57,000 from the request, and an increase of $7,648,000 over the amount appropriated for 1963. The major part of the in- crease is for the child day care services program, authorized by the Public Welfare Amendments of 1962, and for an expansion of the program for research, training, or demonstration projects in child welfare. The reduction of $57,000 is the amount budgeted for in- creased allowances for indirect costs in connection with research projects. 44. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS Salaries and. expenses, Children’s Bureau-—The bill includes $3,401,000, the amount of the request, and an. increase of $445,500 over the amount appropriated for 1963. Approximately $300,000 of the increase is for mandatory increases in costs and to annualize new positions authorized for only a portion of the year in 1963. Cooperative research or demonstration projects in Social Securtiy. — The Bill includes $1,455,000, a reduction of $545,000 from the request, and an increase of $355,000 over the amount appropriated for 1963. International Social Security Association meeting—The Bill includes $95,000, the amount of the request. Last year $11,000 was included in the 1963 appropriation for “Salaries and expenses, Office of the Com- missioner”’ to plan for this meeting. The International Social Security Association is essentially a professional organization and is very im- portant in its technical field. Every three years a general assembly is conducted by the Association as a vehicle for the exchange of informa- tion on significant developments in social security and to conduct the more important business affairs of the organization. Previous general assemblies have been held in Austria, France, Mexico, England, and Turkey. The next meeting is planned to be held in the United States in October, 1964. The Committee feels that the amount requested is comparable to the costs incurred by host countries for the last two conferences, taking into consideration the number of participants and other factors. Research and training (special foreign currency program).—The Committee has disallowed the request for $1,200,000. "This is con- sistent with the action of the Congress last year on a similar request. Salaries and expenses, Office of the Commissioner.—The Bill includes $1,025,000 and authority to transfer $554,000 from the OASI trust fund; the amount of the requested appropriation, and a reduction of $48,000 from the amount requested by transfer; and $289,300. and $118,900, respectively, over the amount available for 1963. The reduction of $48,000 was volunteered by Department witnesses at the time of the hearings. AMERICAN PRINTING HOUSE FOR THE BLIND Education of the blind—The Bill includes $775,000, the amount of the request, and an increase of $36,000 over the amount appropriated for 1963. FREEDMEN’S HOSPITAL Salaries and expenses.—The bill includes $3,880,000, the amount of the request, and $29,000 less than the appropriation for 1963. GALLAUDET COLLEGE Salaries and expenses.—The Bill includes $1,697,000, the amount of the request, and $218,100 over the amount appropriated for 1963. The Committee has received a very large amount of testimony and correspondence concerning the teaching program of Gallaudet College. This has been about equally divided between those having high praise for the program and those bitterly condemning the program. People LABOR-HEALTH, EDUCATION, . WELFARE APPROPRIATIONS 45 on both sides of this controversy appear to be very sincere and dedi- cated to. the effort to improve the educational opportunities of the deaf. It is the belief of the Committee that either the President or the Secretary of Health, Education and Welfare should appoint a cominittee of experts to study not only the teaching program of Gallaudet College, but the whole educational program for teaching the deaf and make a report on its findings as soon as practical. Construction —The Bill includes $2,919,000, the amount of the re- quest, and $1,854,000 more than the amount appropriated for 1963. HOWARD UNIVERSITY Salaries and expenses.—The Bill includes $8,819,000, the amount of the request, and an increase of $884,000 over the amount appropriated for 1963. The increase is for certain mandatory cost increases and an expansion of the staff in line with the continuing increase in enrollment at the University. Construction.—The Bill includes $6,245,000, the amount of the re- quest, and an increase of $714,000 over the amount appropriated for 1963. The major item provided for in the Bill is construction of a men’s dormitory, which will cost approximately $3,300,000, to re- lieve the housing shortage that already exists under the current en- rollment.. Also included is $1,725,000 for the purchase and clearing of the site known as Griffith Stadium. OFFICE OF THE SECRETARY Salaries and expenses, Office of the Secretary—The Bill includes $2,833,000 and authority to transfer $467,000 from the OASI Trust Fund; a reduction of $85,000 from the appropriation requested, and the same as the amount requested by transfer; and an increase of $115,100 and $91,850, respectively, over the amounts provided for 1963. - Funds were requested for 27 additional positions. The action of the Committee is a denial of 7 of these additional positions including ‘four for the Assistant Secretary. Salaries and expenses, Office of Field Administration.—The Bill includes $3,734,000 and authority to transfer $1,337,000 from other accounts; a decrease of $100,000 from the appropriation requested, ‘and. the same amount as requested by transfer; and an increase of $273,600 and’a decrease of $200,750, respectively, from the amounts available for 1963. The Committee has again disallowed funds, in the amount of $90,000, for assistants to regional directors and secre- tarial help for such assistants. Also disallowed is $9,700 for a position “to adequately provide and improve management analysis services.” The Committee has allowed 15 positions for clerical work in connection with increased workload due to operating agency expansions and ten additional auditors to meet the workload impact resulting from additional grants-in-aid under new and expanded legislation. Surplus property utilization.—The Bill includes $950,000, the amount of the request, and an increase of $60,050 over the amount appropriated for 1963. , Salaries and expenses, Office of the General Counsel—The Bill inchides $975,000 and authorization to transfer $900,000 from other 46 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS accounts; a reduction of $80,000 from the appropriation requested, and the same amount as requested by transfer; and an increase of $143,000 and $160,750, respectively, over the amounts available for 1963. There is no doubt that new legislation, changes in drug regulations, and general expansion of the Department's activities have placed an additional workload on this office. However, especially in view of the fect that 20 additional positions were allowed for 1963, the Committee is of the opinion that the amount allowed in the bill is sufficient to provide good legal services for the Department. Juvenile delinquency and youth offenses—The Biil includes $6,700,000, a reduction of $6,500,000 from the request, and an increase of $890, 000 over. the amount appropriated for 1968. The reduction results from the disallowance of funds requested for financing projects beyond the end of fiscal year 1964. Salaries and expenses, Office of Aging.—The Bill includes $545,000, the amount of the budget request, and_ $48,000 more than is being spent on these activities during 1963. The 848, 000 increase is all for mandatory increases in cost, Educational television facilities —The Bill includes $5,000,000, a reduction of $2,000,000 from the request, and an increase of $3, 500 000 over the amount appropriated for 1963. The Committee believes this to be a good program, but in view of the fact that there has been no experience to date the Committee believes that the amount con- tained in the bill, plus the $1,500,000 contained in the Supplemental Appropriation Bill, 1963 is a reasonable amount for the next 14 months. In view of the newness of this program the Committee did not reduce the maximum amount of $285,000, proposed in the budget, for admin- istrative expenses. The Committee wishes to make it clear that this is a maximum amount and the Department will be expected to incur no administrative expenses that are not clearly required for efficient program operations. GENERAL PROVISIONS The Committee has retained in the Bill the provision, which limits to 20% the maximum amount that may be paid to a recipient of a research grant for indirect costs. The Committee desires that the Department exercise care that payments not exceed actual costs where indirect. costs are less than 20%. Especially in connection with purchases of expensive equipment, windfalls would result from application of a straight 20% allowance. TITLE TITI—NATIONAL LABOR RELATIONS BOARD Salaries and expenses.—The Bill includes $22,060,000, a reduction of $1,000,000 from the request, and an increase of $1,031,000 over the amount appropriated for 1963. Since fiscal year 1958 there have been increases in this appropriation every year, usually of rather substantial amounts. The appropriation for fiscal year 1958 was $9,384,800. The amount recommended in the Bill is an increase of over 130 percent in six years. While the workload has gone up during the same period, the Committee is convinced that the Board can handle the workload well and expeditiously with the amount allowed. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 47 TITLE IV-—NATIONAL MEDIATION BOARD Salaries and expenses.—The Bill includes $1,956,000, the amount of the request, and an increase of $10,850 over the amount appropriated for 1963. TITLE V—RATLROAD RETIREMENT BOARD Salaries and. expenses (trust fund limitation).—The Bill includes authorization to use $10,900,000 from the trust fund, the amount of the request, and an increase of $994,000 over the amount made avail- able for 1963. Included in. the Bill is $887,000 for the purchase of electronic equipment to further increase staff productivity. The re- maining amount of the increase over 1963 is not sufficient to cover mandatory increases in cost. This will necessitate a reduction in the’ number of positions from 1,171 in 1963 to 1,148 in. 1964. This reduc- tion is made possible by such increases in productivity, since there is no reduction in workload. TITLE VI—FEDERAL MEDIATION AND CONCILIATION , SERVICE Salaries and expenses.—The Bill includes $5,540,000, a reduction of $400,000 from the request, and an increase of $344,700 over. the amount appropriated for 1963. The amount included in the Bill is $1,634,600 more than the original appropriation for fiscal year 1961, or an in~ crease of over 40% in 3 years. The Committee is convinced that a good job can be done with the funds contained in the Bill. TITLE VII—INTERSTATE COMMISSION ON THE POTOMAC RIVER BASIN Federal contribution.—The Bill includes $5,000, the amount of the budget request, and the same as the amount appropriated for 1963. TITLE VIII—UNITED STATES SOLDIERS’ HOME Limitation on operation and maintenance and capital outlay.—The Bill contains authorization to spend $6,622,000 from the Soldiers” Home permanent fund, the amount of the request, and an increase of $349,600 over the amount made available for 1963. LIMITATIONS AND LEGISLATIVE PROVISIONS The following limitations and legislative provisions not heretofore carried in connection with any appropriation bill are recommended: On page 13, in connection with Food and Drug Administration, sala- ries and expenses: compensation of informers; payment for publication of tech- nical and informational materials in professional and trade journals; and rental of special purpose space in the Distriet of Columbia or elsewhere; 48 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS On pages 13 and 14, in connection with Food and Drug Administra- tion: REVOLVING FUND FOR CERTIFICATION AND OTHER SERVICES For the establishment of a revolving fund for certification and other services, there is hereby appropriated the aggregate of fees (including advance deposits to cover. such fees) paid during the fiscal year 1964, and each succeeding fiscal year, for services in connection with the listing, certification, or in- -spection of certain products and the establishment of tolerances for pecticides, in accordance with: sections 406, 408, 506, 507, 702A, and 706 of the Federal Food, Drug, and Cosmetie Aet, as amended (21 U.S.C. 346a, 356, 357, 372a, and 376), and the unexpended balance of such fees (or advance deposits) heretofore appropriated shall be credited to such revolving fund. Thais fund shall be available without fiscal year limitation for salarves and expenses necessary to carry out the Secretary’s responsibilities nm connection with such listings, certifications, inspections, or establishment of tolerances, including the con- duct of scientific research, development of methods of analysis, purchase of chemicals, fixtures, furniture, and scientific equipment and apparatus; expenses of advisory committees; refund of advance deposits for which no services have been rend- ered: Provided, That any supplies, furniture, fixtures, and equip- ment on hand or on order on June 80, 1963, and purchased or ordered under appropriations for ‘Salaries and Expenses, Certification, Inspection, and Other Services,” shall be used to capitalize the revolving fund. On pages 35 and 36, in connection with Saint Elizabeths Hospital, salaries and expenses: such amount as may be equal to the difference between the amount of the reimbursements received during the current Jiscal year on account of patient care provided by the hospital during such year and $87,418,000. On pages 39 and 40, in connection with Social Security Administra- tion: INTERNATIONAL SOCIAL SECURITY ASSOCIATION MEETING For expenses necessary for organizing, and holding in the District of Columbia, during calendar year 1964, the Fifteenth General Meeting of the International Social Security Associa- tion, including advances without regard to section 8648 of the Revised Statutes, as amended (31 U.S.C. 529); personal services without regard to civil service or classification laws; employment of aliens; hare of passenger motor vehicles; printing and bind- ing without regard to section 11 of the Act of March 1, 1919 44 U.S.C. 111); rents in the District of Columbia and elsewhere; and not to exceed $14,000 for official reception and representation expense, $95,000, to remain available until June 80, 1966. PERMANENT APPROPRIATIONS, GENERAL AND SPECIAL FUNDS Agency and item Appropriated, 1963 Estimates, 1964 Increase (+), decrease (—) Office of Education: Payments to States and Territories for colleges of agriculture and mechanic arts (act of Mar. 4, 1907)__.---------------------------------------- Payments to States for promotion of vocational education (act of Feb. 23, VOUT) on eee $2, 550, 000 $2, 550, 000 |.-.-------- 7, 161, 000 7, 161, 000 |.-..---22.-2- eee 9, 711, 000 9, 711, 000 |... SNOLLVINdOUddVY FUVAIGAM ‘NOLLVOOdS ‘HLIVAH-wOaVI 87 TRUST FUNDS [Not a charge against general revenue] Agency and item Appropriated, 1963 Estimates, 1964 Increase (-), decrease (—) DEPARTMENT OF LABOR Bureau of Employment Security: Unemployment trust fund__.___-.__ 8. Bureau of Employees’ Compensation: Relief and rehabilitation, Longshoremen’s and Harbor Workers’ Compensa- tion Act, as amended___.__--._.---e- ee Relief and rehabilitation, Workmen’s Compensation Act, within the District of Columbia__..-.--- 2-28 Administration of the District of Columbia Workmen’s Compensation Act_. Bureau of Labor Statistics: Special statistical work.-__._.__._______...___.__ $4, O41, 762, 000 25, 000 10, 000 291, 000 44, 000 $4, 286, 017, 000 25, 000 10, 000 304, 000 4-$244, 255, 000 Total, Department of Labor__._-__.._-._ 228 4, 042, 132, 000 DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Office of the Secretary: President’s Council on Aging -_.-_.--.2-- 2 Hearings and appeals survey.---.........._-._-_..__..____.._......_. Public Health Service trust funds...._......_....___..__...-_._........ St. Elizabeths Hospital patients benefit fund__._._.._______..._..__._....... Social Security Administration: Federal disability insurance trust fund_.........._-.-.______._...-__- 6, 000 10, 000 292, 000 1, 000 1, 140, 856, 000 13, 780, 810, 000 222, 000 1, 000 1, 176, 138, 000 15, 506, 210, 000 +35, 282, 000 +1, 725, 400, 000 14, 921, 975, 000 16, 682, 577, 000 +1, 760, 602, 000 0S SNOLLVIUdOUddY TUVATIEM ‘NOILLVOOaE ‘HLIVaH-vOavt RAILROAD RETIREMENT BOARD Railroad retirement account___._-_.---------------------------2---------7-- 1, 111, 300, 000 1, 157, 300, 000 +46, 000, 000 Limitation on Railroad Unemployment Insurance Administration fund___~----- 9, 489, 000 9, 578, 000 +-89, 000 Total, Railroad Retirement Board_---------------------------------- 1, 120, 789, 000 1, 166, 878, 000 +46, 089, 000 Total trust funds, all agencies__--..--------------------------------- 20, 084, 896, 000 | 22, 135, 811, 000 | +2, 050, 915, 000 SNOLLVINdOUdAY TUVATEM ‘NOILVONGE “HLIVAH-YOavVt tg COMPARATIVE STATEMENT OF THE APPROPRIATIONS FOR FISCAL YEAR 1963, AND THE ESTIMATES AND AMOUNTS RECOMMENDED IN THE BILL FOR FISCAL YEAR 1964 TITLE I—DEPARTMENT OF LABOR Bill compared with— Appropriations, 1963 (inciudes funds Agency and item in supplemental Budget estimates, | Recommended in Appropriations, 1963 appropriation bill 1964 the bill for 1964 (ineludes funds Budget estimates, as passed House) in supplemental 1964 appropriation bill as passed House) BUREAU OF LABOR STATISTICS Salaries and expenses__.._._._____-_.. $14, 590, 250 $18, 585, 000 $16, 485, 000 | +$1, 894, 750 — $2, 100, 000 Revision of Consumer Price Index____.._______.___. I, 364, 350 1, 3820, 000 1, 320, 000 — 44, 350 |_o- Total, Bureau of Labor Statistics__...._______ 15, 954, 690 19, 905, 000 17, 805, 000 | +-1, 850, 400 | —2, 100, 000 BUREAU OF INTERNATIONAL LABOR AFFAIRS Salaries and expenses.__..._....--._-_..__.-.-.. 808, 750 935, 000 882, 000 +73, 250 — 53, 000 OFFICE OF AUTOMATION AND MANPOWER Salaries and expenses_..___._..._..__.________.._.. 810, 450 ne —810, 450 |_---_-_ OFFICE OF MANPOWER, AUTOMATION, AND TRAINING Manpower development and training activities. ______ 70, 147, 250 165, 000, 000 140, 000, 000 | +69, 852, 750 — 25, 000, 000 Area redevelopment activities....-...-.. 11, 060, 000 11, 093, 000 9, 000, 000 — 2, 060, 000 — 2, 093, 000 Total, Office of Manpower, Automation, and Training... 2-2 eee 81, 207, 250 176, 093, 000 149, 000, 000 | +67, 792, 750 — 27, 098, 000 GG SNOLLVIUdOUddY AYVAIGM ‘NOLLVOOda ‘HLIVGH-wo0ayT BUREAU OF APPRENTICESHIP AND TRAINING Salaries and expenses_________._------------------- BUREAU OF EMPLOYMENT SECURITY Limitation on salaries and expenses__...-.---.-------- Limitation on grants to States_._...-..----- + Unemployment compensation for Federal employees and ex-servicemen_-__.---.......--.---------------- Mexican farm labor program: Compliance activities....._.____.___----------- Salaries and expenses.______.-_.--------------- Total, Bureau of Employment Security _.------ BUREAU OF VETERANS’ REEMPLOYMENT RIGHTS Salaries and expenses____._._..-.------------------ BUREAU OF LABOR STANDARDS Salaries and expenses..._.._..-------_----.--.----- OFFICE OF WELFARE AND PENSION PLANS Salaries and expenses__..___._-__.-------.--------- BUREAU OF LABOR-MANAGEMENT REPORTS Salaries and expenses._-_____.-.-.-.--------------- 5, 212, 200 5, 460, 600 5, 460, 000 +247, 800 [ 11, 935, 860] [ 400, 000, 000] [ 13, 430, 000] [ 432, 570, 000] [ 12, 640, 000] [ 350, 000, 000] [+704, 140] [ —50, 000, 000} [—790, 000] [—82, 570, 000] 149, 000, 000 | 119, 000,000 | 110, 000, 000 | —39, 000, 000 | —9, 090, 000 1, 387, 256 870, 000 870, 000 —517, 250 |---- [2, 048, 500} [1, 135, 000]} [1, 135, 000]| [—913, 500]|____.... 150, 387, 250 | 119, 870,000 | 110, 870, 000 | —39, 517,250 | —9, 000, 000 652, 000 790, 000 790, 000 +138, 000 |.--2-- 888 2 4, 685, 550 3, 470, 000 3,470,000 | —1, 215, 550 |...-.-2- (3) 1, 720, 000 1, 565,000 | +1, 565, 000 — 155, 000 5, 923, 900 5, 900, 000 5, 900, 000 —23, 900 |... 22 1 Transferred to “Office of Manpower, Automation, and Train- ing Py ? Includes $1,300,000 appropriated under the head “Welfare and pension plan reports activities’ but transferred to this appropria- tion. 3 Funds for 1963 included in ‘Salaries and expenses, Bureau of Labor Standards.” SNOLLVINdOUddY TUVATIM ‘NOLLVONGE ‘HLIVaH-wOdvI eg Comparative statement of the appropriations for fiscal year 1963, and the estimates and amounts recommended in the bill for fiscal year 1964—Continued TITLE I—DEPARTMENT OF LABOR—Continued Agency and item Appropriations, 1963 Gneludes funds in supplemental appropriation bill as passed House) Budget estimates, 1964 Recommended in the bill for 1964 Bill compared with Appropriations, 1968 (includes funds in supplemental appropriation bill as passed House) Budget estimates, 1964 BUREAU OF EMPLOYEES’ COMPENSATION Salaries and expenses......--.------------22 22 eee Transfer from longshoremen’s trust fund_...-....-.---- Employees compensation claims and expenses.______- Total, Bureau of Employees’ Compensation. ___ WOMEN’S BUREAU Salaries and expenses_..__.---------.--__._---__-_- WAGE AND HOUR DIVISION Salaries and expenses.....-.--_---------.-2----_-- OFFICE OF THE SOLICITOR Salaries and expenses_..________._.-.---...----_--- Transfer from unemployment trust fund_..-.....-_.--- Total, Office of the Solicitor._...2-..-2-2 2. $3, 981, 800 | $4,285,000 | $4, 285,000 | +$303, 200 |_____.________ [57, 860] (60, 000] [40, 000] [+2, 140])-----.-------- 65, 071,000 | 53, 838, 000 | 53, 838, 000 | —11, 233,000 |.--__.-__.___- 69, 052, 800 | 58, 123,000 | 58, 123, 000 | —10, 929, 800 |__....._.____- 980, 050 785, 000 785, 000 —145, 050 |-----. 18, 273,600 | 19,300,000 | 19,300,000} +1, 026,400 |......._._.___ $4,361,700 | $4,570,000 | $4,570,000} +$208, 300 |.___.________- [124, 850] [ 127, 000] [ 127, 000] [+2, 150]|----...---__-- 4, 570, 000 +208, 300 |..-.----- 4, 361, 700 4, 570, 000 VS SNOLLVINdOUddVY GUVAIGM ‘NOLLVONaGA ‘HLIVaH-woavt OFFICE OF THE SECRETARY Salaries and expenses___-_-__---------------------- 2, 093, 450 2, 664, 000 2, 364, 000 +270, 550 — $300, 000 Transfer from unemployment trust fund_....-.-.-.---- [135, 800] [ 138, 000] [ 188, 000] [+2, 200]|_----.-------- Total, Office of the Seeretary______.-_-.-.---- 2, 093, 450__ 2, 664, 000 2, 364, 000 +270, 550 — 300, 000 TRADE ADJUSTMENT ACTIVITIES i Salaries and expenses___._-..---------------------.. 100, 000 7, 635, 000 4, 000, 000 -+3, 900, 000 — 8, 635, 000 Total appropriations, Department of Labor___.| 360, 453, 550 427, 220, 000 384, 884, 000 | +24, 480, 450 | —42, 336, 000 TITLE II—_DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE FOOD AND DRUG ADMINISTRATION Salaries and expenses______.----------------------- $29, 064, 700 $35, 805, 000 $35, 805, 000 | +86, 740, 300 |-..-.----_-2 2. Certification, inspection, and other services________----- [1,981,000]; [_--------- Ji fe eee eee ]] [—1, 981, 000]|_--------____- Building and facilities. ..-...---.------------------|-------------- 18, 300, 000 4, 347, 000 +4, 347, 000 | — $8, 953, 000 Total, Food and Drug Administration_____.__- 29, 064, 700 49, 105, 000 40, 152, 000 | +11, 087, 300 — 8, 953, 000 OFFICE OF EDUCATION Promotion and further development of vocational education_---_-----------------------------.--- 34, 716, 000 34, 756, 000 34, 756, 000 +40, 000 |-----------_-_ Further endowment of colleges of agriculture and the mechanic arts_--__--.--_--------------~--------- 11, 950, 000 11, 950, 000 11, 950, 000 |_..---..------]-------------- Grants for library services. .__.---.---------------- 7, 500, 000 7, 500, 000 7, 500, 000 |_-.-----------|-------------- Payments to school districts__..---.---------------- 282, 322, 000 104, 466, 000 104, 466, 000 |—177, 856, 000 |----------._-- Assistance for school construction.-.-.-------------- 63, 686, 000 23, 800, 000 23, 740, 000 | —39, 946, 000 — 60, 000 Defense educational activities_--.-..------.-------- 229, 450, 000 | 229, 620, 000 | 229, 620, 000 +170, 000 |-.------------ SNOLLVINdOUddY AUVATIGM ‘NOLLVOOaS “HLIVaH-yoaVvT gg Comparative statement of the appropriations for fiscal year 1963, and the estimates and amounts recommended in the bill jor fiscal year 1964—Continued TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1963 (includes funds in supplemental Budget estimates, 1964 Recommended in Bill compared with— Appropriations, 1963 appropriation bill the bill for 1964 (includes funds Budget estimates, as passed ILouse) in supplemental 1964 appropriation bill as passed House) OFFICE OF EDUCATION —continued Expansion of teaching in education of the mentally retarded__-_._____------------.---- 2 eee $1, 000, 000 $1, 000, 000 $1, 000, 000 |---.-----. 2 -|--- ee Expansion of teaching in education of the deaf__._.__ 1, 500, 000 |_-------__-__-|-------------- —$1, 500, 000 |.--.------_--- Cooperative research... eee 6, 985, 000 17, 000, 000 11, 506, 000 +4, 515, 000 | —$5, 500, 000 Educational research (special foreign currency pro- gram) ____ 2 ene 400, 000 800, 000 500, 000 +100, 000 — 800, 000 Foreign language training and area studies....._.._._|..-..--___-.- 2, 560, 000 1, 500, 000 +1, 500, 000 —1, 000, 000 Salaries and expenses_....._____.--------2.------- 12, 645, 000 16, 261, 000 14, 761, 000 -+- 2, 116, 000 —1, 500, 000 Total, Office of Hducation.__-..--....---.- 652, 154, 000 449, 653, 000 441, 293, 000 |; —210, 861, 000 —8, 360, 000 OFFICE OF VOCATIONAL REHABILITATION — Grants to States... eee 72, 940, 600 88, 700, 000 88, 700, 000 | +15, 760, 000 |.-----_._----- Research and training..-_.__. 2. ee 25, 500, 000 36, 830, 060 31, 816, 000 +6, 310, 000 — 5, 920, 000 Research and training (special foreign currency pro- gram) 2, 000, 000 3, 000, 000 2, 000, 000 |_.-.-- —1, 000, 000 9¢ SNOLLVINdOUddY DUVATAM ‘NOILVOOGS ‘HLIVaH-sOdVvt Salaries and expenses__.-_...--- =e Total, Office of Vocational Rehabilitation. __.__ PUBLIC HEALTH SERVICE 4 Buildings and facilities._.._.--.---_------~2_ 2 _- Accident prevention.._____-..--------.----~------- Chronie diseases and health of the aged________-..__- Communicable disease activities__--..-----.-------- Community health practice and research___-.__._ 2... Control of tuberculosis. ____..-.------------------- Control of vencreal discases_____-_.---------------- Dental services and resources.__-------------------- Nursing services and resources_____-_---------------- Hospital construction activities___....-------------- George Washington University Hospital.___-..-_-___- Environmental health sciences______-.-------~.----- Air pollution. _______-_----.---------------------- Milk, food, interstate, and community sanitation—___- Occupational health_________._____--_----- 2. eee ‘A significant reorganization of functions among the appropria- tions of the Public Health Service is reflected in the President’s This table shows 1963 appropria- A table appears on pages 14 and budget for 1964, and in the bill. tions as they were actually made. 2, 486, 000 2, 905, 000 2, 905, 000 +419, 000 |...2- eee 102, 926, 000 | 131, 435,000 | 125, 415, 000 | +22, 489,000 | —6, 020, 000 33, 200,000 | 19,072,000 | 13, 811, 000 | —-19, 389,000 | —85, 261, 000 3, 668, 000 4, 857, 000 4, 163, 000 +495, 000 —694, 000 22,942,000 | 55,907,000 | 53, 377, 000 | +30, 435,000 | —2, 530, 000 15, 492,000 | 30, 429,000 | 25, 405,000 | +9, 913,000 | —5, 024, 000 26, 276,000 | 31, 648,000 | 28, 608, 000 | +2, 332,000 | —8, 040, 000 6, 998, 000 6, 828, 000 6, 28, 000 165, 000 [oo 222 8, 000, 000 9, 588, 000 9, 588,000 | +41, 588, 000 |_.____22 2. 3, 006, 006 6, 227, 000 6, 218, 000 | +3, 212, 000 —9, 000 8, 438,000 | 11,245,000] 11,217,000] +2, 779, 000 — 28, 000 226, 220,000 | 179, 514,000 | 177, 914, 000 | —48, 306,000 | —1, 600, 000 doen eee eee 2, 500, 000 2, 500, 000 | +2, 500, 000 |..------ woe nee 4, 246, 000 4,224,000} +4, 224, 000 —22, 000 11, 069,000 | 12,998,000] 12,954,000 | +1, 885, 000 —44, 000 8, 536, 000 9, 079, 000 9, 009, 000 +473, 000 —70, 000 4, 122, 000 4, 621, 000 4, 590, 000 +468, 000 —31, 000 15 of the report, which is similar to this table, but shows the 1963 appropriations as they would have been, if made on the basis of the functions to be financed under the respective appropriation in 1964. SNOLLVINGOUddY GUVATIGM ‘NOILVONdE ‘HLIVEH-yOaV'L Comparative statement of the appropriations for fiscal year 1968, and the estimates and amounts recommended in the bill for fiscal year 1964—Continued TITLE IiDEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Appropriations, 1963 Bill compared with— Gneludes funds Agency and item in supplemental Budget estimates, | Recommendedin |Appropriations, 1963. appropriation bill 1964 the bill for 1964 CGneludes funds Budget estimates, as passed House) in supplemental 1964 appropriation bill as passed House) PUBLIC HEALTH SERVICE—continued Radiological health..........__.----------..-_-_-- $15, 875, 000 | $18,776,000 | $18, 745, 000 | +$2, 870, 000 —$31, 000 Water supply and water pollution control_.._._______ 24, 707, 000 29, 980, 000 27, 921, 000 +3, 214, 000 — 2, 059, 000 Grants for waste treatment works construction..._____ 90, 000, 000 100, 000, 000 90, 000, 000 |-_-..__--_-_ ee — 10, 000, 000 Hospitals and medical care.._______.---- ee 48, 820, 000 50, 038, 000 49, 962, 000 +1, 142, 000 — 76, 000 Foreign quarantine activities_____......2...-_---___- 5, 910, 050 7, 116, 000 6, 456, 000 | + 545, 950 ~—- 660, 000 National Institutes of Health: General research and services___._.___..-___-_____ 159, 826, 000 164, 674, 000 163, 869, 000 -+4, 043, 000 — 805, 000 Biologics standards___..______-------...-_.--__|--.---------_- 4, 787, 000 4, 787, 000 +4, 787, 000 |_--..2-- Le Child health and human development.__________]______2_2--- (5) () 6) jee eee National Cancer Institute__..._.__-___..______- 155, 742,000 | 145,114,000 | 144, 340, 000 | —11, 402, 000 —774, 000 Mental health activities......____-_---. 22-2 8. 148, 599, 000 190, 096, 000 177, 288, 000 | +33, 689, 000 — 12, 808, 000 National Heart Institute._..-_.__-- ee 147, 398, 000 133, 624, 000 132, 404, 000. | —14, 994, 000 —1, 220, 000 SNOLLVINdOUddVY DUVATIM ‘NOLLVONG “HLLIVaH-uoOgv. National Institute of Dental Research__-_-..---_- Arthritis and metabolic disease activities____----- Allergy and infectious disease activities ----~---- Neurology and blindness activities. _------------ Grants for construction of health research facilities - Subtotal, National Institutes of Health..--_~-- Scientific activities overseas (special foreign currency program)... __---.-----------~------------------ National health statistics. ___--.------------------- National Library of Medicine__._------------------ Retired pay of commissioned officers..---------------- Salaries and expenses, office of the Surgeon General___ Total, Public Health Service_-_~------------- ST. ELIZABETHS HOSPITAL Salaries and expenses__-_--.----------------------- Salaries and expenses___.-------------------------- Buildings and facilities_____..--------------------- Total, St. Elizabeths Hospital__.---.-.-------- 5 Both the budget and the bill include a language provision to 21, 199,000 | 19,809,000} 19, 689,000 | —1, 510, 000 —$120, 000 108, 388, 000 | 114,717,000 | 118, 679, 000 | +10, 291,000 | —1, 038, 000 66, 142,000 | 69, 226, 000 | 68, 723, 000 | +2, 581, 000 — 503, 000 83, 506,000 | 88, 407,000 | 87, 675,000 | +4, 169, 000 —732, 000 50, 000, 000 } 50, 000, 000 | 50, 000, 000 |.-.--.--------|.------------- 930, 800, 000 | 980, 454,000 | 962, 454, 000 | +31, 654,000 | —18, 000, 000 2, 300, 000 6, 647, 000 4, 000, 000 | +41, 200,000] ~2, 647, 000 5, 150, 000 5, 949, 000 5, 949, 000 +799, 000 |..------.----- 3, 335, 000 4, 074, 000 4, 074, 000 +739, 000 |_......------- (5, 784,000]| [6, 436, 000]| [6, 436, 000]) [+652, 000]|-.------------ 5, 850, 000 6, 091, 000 6, 091, 600 4-241, 000 |.--.-.-------- 1, 511, 209, 050 |1, 597, 884, 000 |1, 546, 058, 000 | +34, 848, 950 | —51, 826, 000 6, 332, 000 |....-..-.-----|.------------- —6, 332, 000 |__.-. ee oon eee [9, 716, 000]} —[ 7, 354, 000]| [+7, 354, 000]| [—2, 862, 000] 8, 095, 000 627, 000 627,000 | —7, 468,000 |.....--------- 14, 427, 000 627, 000 627, 000 | —13, 800, 000 |.__.-__------- transfer $34,000,000 to this institute from the appropriations for I 1964 available to the other institutes. Onan ‘ELLIVAH-YOdv 1 ELV SNOLLVINdOUddY THUVATAM ‘NO 6g Comparative statement of the appropriations for fiscal year 1963, and the estimates and amounts recommended in the bill Jor fiseal year 1964—Continued TITLE IIL—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1963 Gneludes funds in supplemental appropriation bill as passed House) Budget estimates, 1964 Recommended in the bill for 1964 Bill compared with— Appropriations, 1963 Gneludes funds in supplemental appropriation bill as passed House) Budget estimates, 1964 SOCIAL SECURITY ADMINISTRATION Limitation on salaries and expenses, Bureau of Old-Age and Survivors Insurance (trust fund) Grants to States for public assistance__-...__.______. Grants to States for training publie welfare personnel_ Assistance for repatriated U.S. nationals.-__________. Salaries and expenses, Bureau of Family Services_____ Grants for maternal and child welfare.__....________ Salaries and expenses, Children’s Bureau_-_.___._____ Cooperative research or demonstration projects in social security_...-____.--2 20 ee International Social Security Association meeting ____ Research and training (special foreign currency pro- gram) [ $286, 898, 300] 2, 738, 300, 000 467, 000 8, 878, 500 79, 295, 000 2, 955, 500 1, 100, 000 (7) [ $317, 900, 000] 6 2,900,000,000 2, 000, 000 500, 000 5, 400, 000 87, 000, 000 3, 401, 000 2, 000, 000 95, 000 1, 200, 000 [$317, 900, 000] 2, 725, 000, 000 467, 000 4, 756, 000 86, 943, 000 3, 401, 000 1, 455, 000 95, 000 [+ 831,501,700] — 13, 300, 000 +882, 500 +7, 648, 000 +445, 500 +355, 000 +95, 000 — $175,000,000 —~2, 000, 000 —33, 000 — 644, 000 —57, 000 —1, 200, 000 09 " SNOLLVIGdOUddV FUVATEM ‘NOLLVOOGE “ELIIVEH-wo0gyT Salaries and expenses, Office of the Commissioner: Appropriation.._.----.----..----------------- Transfer from OASI trust fund__---....-__------ Total, Social Security Administration..______-- AMERICAN PRINTING HOUSE FOR THE BLIND Education of the blind___--_-.---.-.----...--------- FREEDMEN’S HOSPITAL Salaries and expenses_____..---------------.------- GALLAUDET COLLEGE Salaries and expenses____....---------.------------ Construction____._._----------------------------- Total, Gallaudet College.....---------- 220. HOWARD UNIVERSITY Salaries and expenses___....-._-.------------------ Plans and specifications.....____._----------------- Construction___..-.---. 0 2 - ee ee- 6 Reflects a reduction of $50,000,000 contained in H. Doe. No. 83. 735, 700 1, 025, 000 1, 025, 600 +289, 300 |_---- 28 [ 435, 100] [602, 000] [554,000]| [+118, 900] [—48, 000] 2, 826, 726, 700 3, 002, 621, 000 2, 823, 142,000 | —3, 584, 700 |—179, 479, 000 739, 000 775, 000 775, 000 +36, 000 |--.-- 8 3, 909, 000 3, 880, 000 3, 880, 000 —29,000 |.0---- 1, 478, 900 1, 697, 060 1, 697, 000 +218, 100 |... 1, 065, 000 2, 919, 000 2,919,000 | +1, 854,000 |..._____._-__- 2, 543, 900 4, 616, 000 4,616,000 | +2,072, 100 |..__..-------- 7, 935, 000 8, 819, 000 8, 819, 000 +884, 000 |_..----..----- 86, 000 |... Jee —86, 000 |. nee 5, 581, 000 6, 245, 000 6, 245, 600 +714, 000 |---------_-_-. 13, 552,000 | 15, 064, 000 15, 064,000 | +1, 512, 000 |-.--- ee Office of the Commissioner,” for 1963. 7 $11,000 was appropriated for this purpose in “Salaries and expenses, GM ‘NOLLVOOGS “ELLVIVEH-UOdVI HUVAT dddiV SNOLLVIUdO [9 Comparative statement of the appropriations for fiscal year 1968, and the estimates and amounts recommended in the bill jor fiscal year 1964—Continued TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Appropriations, 1963 (includes funds Bill compared with— opmapeion a OFFICE OF THE SECRETARY Office of the Secretary: Salaries and expenses_____________.-.2.2-2---_- $2, 717, 900 $2, 918, 000 $2, 833, 000 +$115, 100 — $85, 000 Transfer from OASI trust fund... [ 375, 150] [467, 000] [ 467, 000] [+91, 850]|_-....-2 2 oe Office of Field Administration: Salaries and expenses_________-_-__-..._--__-__- 3, 460, 400 3, 834, 000 3, 734, 000 +273, 600 — 100, 000 Transfers...--.------------------------------ [1, 587, 750] [1, 837, 000]| [1,387,000]| [—200, 750]|.__.-.._..-_- Surplus property utilization. __.______--.-....-___L- 889, 950 950, 000 950, 000 +60, 050 |-.-.-----._2.- Office of the General Counsel: Salaries and expenses.____..--_-.-------------- 832, 000 1, 055, 000 975, 000 +143, 000 — 80, 000 Transfers. - 2 ee ee ee [ 739, 250] [900, 000] [ 900, 000} [+ 160, 750])-----.-.-- _. Juvenile delinquency and youth offenses______._____- 5, 810, 000 18, 200, 000 6, 700, 000 + 890, 000 — 6, 500, 000 Salaries and expenses, Office of Aging-_..-....-.-----|------ ( » nonce 545, 000 545, 000 +545, 000 |---.--2------ 69 SNOLLVINGOUddVY DNVATIGM ‘NOILVOONGG ‘HLIVaH-woOdv'T Educational television facilities__..._......---------- 1, 500, 000 7, 000, 000 5, 000, 000 +3, 500, 600 — 2, 000, 000 Total, Office of the Secretary_.._..------------ 15, 210, 250 29, 502, 000 20, 7387, 000 +5, 526, 750 — 8, 765, 000 Total, direct appropriations, Department of Health, Education, and Welfare_.__--.----- 5, 172, 461, 600 |5, 285, 162, 000 |5, 021, 759, 000 ;—150, 702, 600 | — 268, 403, 000 Indefinite appropriationg____....-.---.--.---------- 7, 715, 000 16, 152, 000 18, 790, 000 +6, 075, 000 — 2, 362, 000 Total direct and indefinite appropriations, De- partment of Health, Education, and Welfare-|5, 180, 176, 600 [5, 301, 314, 000 [5, 035, 549, 000 |—144, 627, 600 | — 265, 765, 000 TITLE III—NATIONAL LABOR RELATIONS BOARD Salaries and expenses.._.--_------------------------ $21, 029, 000 $23, 060, 000 | $22, 060, 000 | -+ $1, 031, 000 — $1, 000, 600 TITLE IV-NATIONAL MEDIATION BOARD Salaries and oxpensces..__-_------------------------ $1, 939, 150 $1, 950, 000 $1, 950, 000 | +$10, 850 |-.---.-------- TITLE V—RAILROAD RETIREMENT BOARD Salaries and expenses (trust fund imitation) _..-----~~- [89, 906, 000]| [810, 900, 000]| [$10, 900, 000], [+ $994, 000]|.------------- TITLE VI-FEDERAL MEDIATION AND CONCILIATION SERVICE $5, 195, 300 $5, 940, 000 $5, 540, 000 +$344, 700 — $400, 000 Salaries and expenses. --.------------------------- 8 Financed under “Salaries and expenses, Office of the Secretary” and “Salaries and expenses, Office of Field Administration” in 1963. SNOILVINdONddV ANVATAM ‘NOLLYOONaH ‘HU IVaH-woOaVvT Comparative statement of the appropriations for fiscal year 1963, and the estimates and amounts recommended in the bill jor fiscal year 1964—Continued TITLE VII—INTERSTATE COMMISSION ON THE POTOMAC RIVER BASIN Agency and item Appropriations, 1963 CGneludes funds in supplemental appropriation bill as passed House) Budget estimates, 1964 Recommended in the bill for 1964 Bill compared with— Appropriations, 1963 (includes funds in supplemental appropriation bill as passed House) Budget estimates, 1964 Federal contribution. __..__...-..-2---2 $5, 000 $5, 000 $5, 000 TITLE VIIL—UNITED STATES SOLDIERS HOME Limitation on operation and maintenance and capital outlay. _.-.-.----- eee [86, 272, 400] [ $6, 622, 000] [86, 622, 000] [ + $349, 600] Total, direct appropriations...__._.._-..---__- Total, indefinite appropriations__._.__..______ Grand total__..---- eee --- 5, 561, 083, 600 7, 715, 000 5, 743, 337, 000 16, 152, 008 5, 436, 198, 000 13, 790, 000 — 124, 885, 600 +6, 075, 000 —307, 139, 000 —2, 362, 600 5, 568, 798, 600 5, 759, 489, 000 5, 449, 988, 000 — 118, 810, 600 —309, 501, 000 O v9 SNOLLVIN@OUddV TUVAIAM ‘NOLLVOOAGH “ELIVIH-soay1