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This table (fig. 6) shows the status of the program and the number of grants that have been made for the 3 years that we have authorization. I emphasize the difference between grants made and centers funded, because in some cases the center receives both types of grants; so that the number of centers funded would be different from the number of grants made.
The white columns indicate construction. In fiscal 1965 we were able to fund 93 centers with 93 grants. The total is the same, since only construction grants were authorized.
In fiscal year 1964, 54 staffing grants were made and a cumulative total of 194 construction grants had been made. In fiscal year 1967 there will be a total of 131
staffing grants and 294 construction grants. Mr. ROGERS. Are those total?
Dr. YOLLES. They are not additive, Mr. Rogers, because of the overlap. These are the numbers of centers funded. (See fig. 7.) In fiscal year 1965 there were 93; in fiscal year 1966, 188 centers funded; and by the close of business this year in 1967 there will be 286 centers funded, serving a population of 47.2 million persons in the United States.
Mr. Brown. They do overlap but they are not additive, is that right?
Dr. YOLLES. The numbers of center grants added to the number of construction grants are not additive, because some centers receive both.
Mr. Brown. Does the 194 include part of the 93?
NUMBER OF CONSTRUCTION AND STAFFING GRANTS UNDER PRESENT AUTHORITY
Dr. YOLLES. Yes, sir.
Dr. YOLLES. Yes. These grants have been awarded. This is just a cumulative total of the grants that will have been made by 1967.
Mr. Brown. Some of your fiscal 1965 have been completed?
Dr. YOLLES. We are including it in the total numbers that of grants have been made. It is still included. The 93 are included in this.
Lastly, this table (fig. 8), presents the status of the authorization, appropriations, and obligations of the program, both for construction and for staffing. You will notice that, in 1965 and 1966, we obligated $34.3 million of the $35 million which was appropriated.
By the close of business of this fiscal year we will have obligated the total $50 million authorized and appropriated for construction. At the present moment, about $22 million has been obligated, and by the close of business this year the rest will have been funded.
For 1967 we estimate that we will obligate the total funds that are available. In staffing, we obligated in the first year of the program some $15.2 million. We could have obligated the total amount; but the money became available in the last 4 months of the fiscal year, and we couldn't reach all of the applications that were in the institute.
In 1967, of the $19.1 million which has been appropriated we have pending applications totaling 104 percent of that amount, so that we will not be able to fund all of the applications.
Dr. YOLLES. Of the 1960 funds we estimate that we will use all of the $19.9 million which has been appropriated.
Mr. JARMAN. I think it might be appropriate at this time to ask Mr. Cohen, now that you are on that chart, for a little more information as to funding for the future.
Of course, there is nothing new about the phrasing of the bill but the bill does provide a stated amount and then it says: and such sums as may be necessary for the next four fiscal years.
Could we get additional information on that, Mr. Cohen ?
I would be glad to submit for the record, Mr. Chairman, the proposed estimates that the Department has made with regard to the future funding over that 5-year period, both for the construction and for the staffing based upon, of course, the experience we have had up to date.
(The information requested follows:)
Proposed estimates for future funding for construction and staffing, 1968–72
Fiscal year Fiscal year Fiscal year Fiscal year Fiscal year Cumulative
Construction: Authorization - $50,000,000 $60,000,000 $70,000,000 $80,000,000 $90,000,000 $350,000,000 Staffing: Authorization. 30,000,000 26,000,000 32,000,000 36,000,000 38,000,000 162,000,000
Dr. YOLLES. Mr. Chairman, there is one final chart that I would like to point out. That is the distribution of the community mental health center grants that have been made. (See fig. 9.) The little triangles indicate the construction grants and the circles represent the staffing grants.
There is good distribution across the country.
Mr. ROGERS. Have these charts been reproduced for the committee in the testimony?
Dr. YOLLES. They will be available.
Mr. JARMAN. Before general questioning starts, Mr. Cohen, would Dr. Stewart have any comment to make at this time or would you prefer simply to answer questions?
Dr. STEWART. I think it would be better to just answer questions. Thank you very much.
Mr. JARMAN. For the subcommittee we want to thank you gentlemen for being with us for what I think is a very good explanation of a very important subject.
There is one question that we would like to clarify for the hearing record: Last year, this committee passed legislation which was signed by the President as Public Law 89-749. This legislation establishes a State health planning agency which is to do comprehensive health planning for the entire State.
Under the mental health legislation which the Congress passed in 1963, a State plan is required for construction of these centers and this plan is required to be administered by a single State agency.
I wonder if you would clarify for the subcommittee the intended relationship between the comprehensive State health planning agency established under Public Law 749 and the operations of a State agency administering the mental health plan.
Mr. COHEN. I will ask the Surgeon General to reply to that, Mr. Chairman.
Dr. STEWART. Mr. Chairman, the intention is that the planning under specific plans such as the mental health planning agency would be complementary to comprehensive health planning. We have in each State in the country planning which is going on toward a specific target or health problem, or the provision of a specific set of services, or the development of a specific set of resources, such as hospitals.
We have planning for mental health services, for mental retardation services, for the development of hospitals. Many of the States have done planning toward the development of the number of physicians in their States and the number of nurses in their States, but nowhere do we have the information in such a way that one can relate all the plans together as to the total development of the services in the State and the total development of the resources in the State.
It is conceivable for a State to be planning the development of specialized services which, when combined, will exceed the State's ability to produce these services because it exceeds the number of physicians or the number of hospitals or the number of dollars available for capital or for operations, either private or public.