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Center and the Robert A. Taft Sanitary Engineering Center. In Conjunction with the latter course, a seminar on botulism will be held in Cincinnati.

I hope this answers your questions, but if I can be of any further assistance, please feel free to call on me. Sincerely yours,


Surgeon General. Mr. JARMAN. Mr. Rogers.

Mr. ROGERS. Mr. Chairman, I notice from the tables for measles that you have made considerable progress with the vaccination program against measles, Dr. Stewart.

Dr. STEWART. Yes, sir.

Mr. ROGERS. From 1963 to 1964, when you almost hit 32,000 cases, you are now down to 2,000?

Dr. STEWART. That is correct. This year we are having our measles eradication campaign which the President announced and we are having great success and hope to reach our goal of eradication.

Mr. Rogers. I notice that where you have a vaccine for, I presume, the regular measles as distinguished from german measles, that there are more of the common cases than there are of the german measles ?

Dr. STEWART. Well, there have always been more of the regular measles than the german.

Mr. ROGERS. I mean, even with the vaccine.
Dr. STEWART. There is no vaccine for german measles.
Mr. ROGERS. But we have it for the common measles ?
Dr. STEWART. That is correct.

Mr. ROGERS. Yet with the vaccine program we still have more of those than of the german measles ?

Dr. STEWART. It is more common than the german measles. Regular measles is a universal disease. Everybody has it. German measles is a less common disease. It occurs across a period of time.

Mr. ROGERS. I understand that. The point I am making is that here we have a vaccine and we have had quite a number take the vaccine, I presume?

Dr. STEWART. This is correct.
Mr. ROGERS. Or we wouldn't have made such progress since 1963.
Mr. CARTER. Mr. Chairman, will the gentleman yield?
Mr. ROGERS. Yes.

Mr. CARTER. That was only made available in 1966 publicly so that we could hardly expect immediate eradication. I want to assure the gentleman that according to the best authorities I know of it will be eradicated within the next year.

Dr. STEWART. Mr. Rogers, if this occurs it will be the first time in the history of man that we have eradicated a disease in a 2-year or 3-year period. Mr. ROGERS. How long has the vaccine been available? Dr. STEWART. About 3 years. Mr. ROGERS. So this is most encouraging?

Dr. Stewart, now I would think that you would keep us advised just as you did in these other vaccines so that the Congress could appropriate whatever money is necessary for the german measles. I assume that could be done?


Mr. ROGERS. Would the Department give us sufficient time to know? Dr. STEWART. Yes, if we have the time ourselves.

Mr. ROGERS. As soon as you have indications of a breakthrough, you would let us know?


Mr. ROGERS. You would have to come to get money for trial tests, anyway?

Dr. STEWART. Correct.
Mr. ROGERS. Thank you.

Let me ask one or two other questions. Who determines the contributions to be made by the State or the local interest in building a community mental health center?

Dr. YOLLES. It is done by the applicant himself. The applicant for construction grants will apply to the State for approval before the application can be submitted to the Federal Government.

Mr. ROGERS. I don't know if you got the thrust of my question. In some States I understand they may require a 50-percent contribution by the local interest to get a matching amount. Some other States may have 66-percent Federal grant and only 3313 local.

Who makes the determination that varies this from State to State?

Dr. YOLLES. The Federal matching or the Federal percentage is actually determined by the Federal Government in terms of the relative need of the State.

Mr. Rogers, are you talking about the total Federal percentage applicable?

Mr. ROGERS. In each State. For instance, in Florida, I understand you can get more than 50-percent contribution for projects within the State of Florida.

Dr. YOLLES. That is the Federal percentage.

Mr. ROGERS. Whereas in another State they may get 66 percent within that State. Who determines that figure?

Mr. COHEN. That is determined by the Secretary, based on figures from the Department of Commerce. That is a mathematical determination.

The relationship of the States per capita income to the national per capita income is derived from the Department of Commerce figures and promulgated by the Secretary according to these Department of Commerce figures.

Mr. ROGERS. I thought we, under the law, had given him some additional authority.

Mr. COHEN. Once that is determined, then a State has an option between taking that uniform rate, whatever it is, and applying that same percentage to all projects or having a variable rate for various projects.

That is a determination that is made according to the statute by the State agency.

Mr. Rogers. So the State actually determines how they will participate whether it will be on an overall figure for all of their projects or whether it will vary.

Mr. COHEN. They have a choice to make after the actual rate for the State is determined by the Federal Government. They may choose to make the rate uniform on all projects, or they might create a variable rate for different projects.

Mr. ROGERS. That would be the maximum you mean?

Mr. COHEN. That would be the rate. Then the State may determine if it wants as an alternative a variable that comes out to approximate that total rate. Mr. ROGERS. Now,

is it generally an advantage to have a set rate or a variable rate. What has been the experience ?

Dr. YOLLES. The pattern has varied, Mr. Rogers, with the various States. In some cases where there is a great need in some parts of the States where there is an inability to match Federal funds for the construction of projects it would be to the advantage of the State to have variable matching funds.

In other cases, the State makes the determination that it would be to the State's advantage to have a uniform rate.

Mr. COHEN. Actually, Mr. Rogers, this goes back to the Hill-Burton Act, because this same formula and alternative is in the Hill-Burton law. The economic and the statistical data would probably suggest that the better way would be to allow each political subdivision to have a Federal matching percentage based upon its fiscal ability. In any big State, and I am sure in your State, there is a tremendous variation from urban to rural and big cities to small cities. Because we don't have that data for every county or metropolitan area, Congress established a percentage formula of 1 percent for the States but then gave the States the alternative to meet their own kind of situation.

Mr. ROGERS. Let me ask you this: In section 507 grants to Federal institutions you say this has been done by a point of order appropriate language?

Mr COHEN. Up until now, yes.
Mr. ROGERS. Why is the Department of Justice as such put in ?
Mr. COHEN. Because of the Bureau of Prisons.
Mr. ROGERS. You have the Bureau of Prisons listed ?

You say Bureau of Prisons and then you say Department of Justice and to St. Elizabeths Hospital and the Veterans' Administration.

I can understand the Veterans' Administration but why the Department of Justice as such?

Dr. STEWART. I think, Mr. Rogers, that is the way it is written. It means the Bureau of Prisons of the Department of Justice.

Mr. ROGERS. So you have no objection to changing that?
Mr. ROGERS. Thank you, Doctor.
Thank you, Mr. Chairman.
Mr. JARMAN. Mr. Brown?
Mr. Brown. I have no questions.

Mr. JARMAN. Thank you gentlemen for a very able presentation this morning.

The subcommittee will stand adjourned until 10 o'clock tomorrow.

(Whereupon, at 12:10 p.m. the hearing was recessed to reconvene at 10 a.m., Wednesday, April 5, 1967.)





Washington, D.C. The subcommittee met at 10 a.m., pursuant to recess, in room 2123, Rayburn House Office Building, Hon. John Jarman (chairman of the subcommittee) presiding.

Mr. JARMAN. The subcommittee will come to order. We will continue the hearings on H.R. 6431. I think the only comment that the Chair would make at the beginning of the hearings this morning is, that we do have seven witnesses. We do intend to try to finish the hearings this morning. So that, I hope that both witnesses and members of the subcommittee will take note of that time limitation that we have.

Our first witness this morning is Mr. Bert Seidman, director of Social Security Department, AFL-CIO.



My name is Bert Seidman. I am director of the Social Security Department of the AFL-CIO, and I am very pleased to have the opportunity to testify here this morning on behalf of the AFL-CIO on the amendments to the Community Mental Health Centers Act, H.R. 6431. With me is Mr. Richard E. Shoemaker, who is assistant director of the AFL-CIO Social Security Department.

We appear here this morning in support of the amendments proposed by the distinguished chairman of the full committee, Congressman Staggers, in H.R. 6431, which extends authorization to continue Federal financial support for the construction and staffing of community mental health centers. H.R. 6431 also includes authority for grant recipients to use funds for the acquisition of existing buildings rather than just the expansion, remodeling, and alteration of such structures. We also support the amendments which would authorize project grants to Federal institutions and the provision for the estabsishment of a contingency account to meet unforeseen needs.

Mr. Chairman, the AFL-CIO appeared in 1963 in support of the Community Mental Health Centers Act (Public Law 88–164) and



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