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Rosenn, Max, secretary of public welfare, Commonwealth of

Pennsylvania..

Smith, Hon. Hulett C., Governor, State of West Virginia___

Ulett, Dr. George A., director, Division of Mental Diseases,

State of Missouri.

Subcommittee on Public Health and Welfare: Correspondence of
1963 re botulism, between the subcommittee, the Food and Drug
Administration, and the Public Health Service..

66

MENTAL HEALTH CENTERS CONSTRUCTION ACT

EXTENSION

TUESDAY, APRIL 4, 1967

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON PUBLIC HEALTH AND WELFARE,

OF THE COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

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

Mr. JARMAN. The subcommittee will please be in order. The hearings today are on H.R. 6431, the Mental Health Amendments of 1967, introduced by Chairman Staggers at the request of the administration. This bill would extend the current program of grants for the construction and initial staffing of community mental health centers; would authorize research, training and demonstration project grants to be made to Federal institutions; and would authorize establishment of a contingency account for the Department of Health, Education and Welfare.

This committee has been active in the field of mental health legislation for over 20 years now, beginning with the initial legislation establishing the National Institute of Mental Health.

In 1955, this committee initiated the Mental Health Study Act of 1955 calling for the establishment of a program of research and study of our resources, methods and practices for diagnosing, treating, caring for, and rehabiltating the mentally ill.

A Joint Commission on Mental Illness and Health was established pursuant to this legislation and the Commission made its final report on December 30, 1960. The Commission recommended establishment of community mental health centers to provide care for the mentally ill close to their homes in a community setting.

The report of this Commission was studied by the executive branch and the Congress and in 1963, President Kennedy recommended to the Congress the enactment of legislation providing Federal matching grants for construction and initial staffing of community mental health centers. Hearings were promptly held on this legislation and legislation was enacted in October 1963 authorizing matching grants for construction of community mental health centers.

In 1965, President Johnson recommended the enactment of legislation providing matching grants for initial staffing of community mental health centers; and this legislation became law in 1965.

The authorization for matching grants for construction is due to expire June 30 this year, and the authorization for grants for initial

1

staffing is scheduled to expire June 30, 1968; therefore, prompt action on this legislation is required in order that orderly planning may

continue.

(The bill, H.R. 6431, and department reports thereon, follow :)

[H.R. 6431, 90th Cong., 1st sess.]

A BILL To amend the public health laws relating to mental health to extend, expand, and improve them, and for other purposes

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Mental Health Amendments of 1967".

GRANTS FOR CONSTRUCTION OF COMMUNITY MENTAL HEALTH CENTERS

SEC. 2. (a) Section 201 of the Community Mental Health Centers Act (42 U.S.C. 2681) is amended by striking out "and $65,000,000 for the fiscal year ending June 30,1967" and inserting in lieu thereof, "$65,000,000 for the fiscal year ending June 30, 1967, $50,000,000 for the fiscal year ending June 30, 1968, and such sums striking out "1967" and inserting in lieu thereof "1972".

(b) Section 207 of such Act is amended (1) by striking out "three", and (2) by striking out "1967" and inserting in lieu thereof "1972".

GRANTS FOR INITIAL STAFFING OF COMMUNITY MENTAL HEALTH CENTERS

SEC. 3. (a) Section 221 (b) of the Community Mental Health Centers Act (42 U.S.C. 2688a (b)) is amended bp striking out "1968" each place it appears and inserting in lieu thereof "1972".

(b) The first sentence of section 224 of such Act is amended by striking out "and $30,000.000 for the fiscal year ending June 30, 1968" and inserting in lieu thereof "$30,000,000 for the fiscal year ending June 30, 1968, and such sums as may be necessary for the next four fiscal years". The second sentence of such section is amended by striking out "five" and inserting in lieu thereof "nine".

MISCELLANEOUS AMENDMENTS RELATING TO CONSTRUCTION OF COMMUNITY

MENTAL HEALTH CENTERS

SEC. 4. (a) Section 401 (e) of the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 (42 U.S.C. 2691) is amended by inserting "acquisition," after "new buildings.".

(b) Paragraph (7) of section 204 of such Act (42 U.S.C. 2684), is amended by inserting before the semicolon at the end thereof "and, effective July 1, 1969, provide for enforcement of such standards with respect to projects approved by the Secretary under this part after June 30, 1967".

PROJECT GRANTS TO FEDERAL INSTITUTIONS

SEC. 5. Effective July 1, 1968, title V of the Public Health Service Act is amended by adding after section 506 (42 U.S.C. 224) the following new section:

"GRANTS TO FEDERAL INSTITUTIONS

"SEC. 507. Appropriations to the Public Health Service available for research, training, or demonstration project grants pursuant to this Act shall also be available, on the same terms and conditions as apply to non-Federal institutions, for grants for the same purpose to hospitals of the Service, of the Veterans' Administration, or of the Bureau of Prisons, Department of Justice, and to Saint Elizabeths Hospital."

ESTABLISHMENT OF A CONTINGENCY ACCOUNT

SEC. 6. (a) In order to facilitate the more efficient and effective administration of the programs of the Department of Health, Education, and Welfare, there is hereby created in the Treasury of the United States a contingency account which shall be available to the Secretary of Health, Education, and Welfare without fiscal year limitation for use as provided in this section.

(b) There is authorized to be deposited in the contingency account established by subsection (a), to the extent authorized in annual appropriation Acts, the amount of any general fund appropriation to the Department for a fiscal year (beginning with appropriations for the fiscal year ending June 3, 1967) which, at the end of the period for which such appropriation is available for obligation, remains unobligated, but only to the extent such deposit, when added to the sum then in the account, will not increase such account to more than $50,000,000. The amount so deposited shall be based on estimates made at the time of the termination of availability of the appropriation, with subsequent adjustments (to be made no later than the close of the fiscal year following the year in which the deposit was made) being made to take account of errors in such estimates.

(c) The Secretary is authorized, to the extent provided in annual appropriation Acts, to draw upon the contingency account established by subsection (a) whenever he determines that such action is required to fulfill his responsibilities and that delay pending further appropriations by the Congress would be contrary to the public interest, but only if such withdrawal is required to carry out a purpose which the Secretary determines is significant and only if the need for such withdrawal could not reasonably have been anticipated at the time the Budget was submitted to the Congress. Funds withdrawn pursuant to such a determination may be transferred and merged with the appropriation or appropriations the Secretary determines to be appropriate. Each such determination shall be subject to the following limitations

(1) no amount may be so used during any fiscal year for a purpose for which funds were requested in the Budget for such year but for which funds were not appropriated for such year;

(2) no amount may be so used for any activity or purpose which is not otherwise authorized by law;

(3) the amounts so used pursuant to any such determination for any fiscal year may not exceed $15,000,000; and

(4) no amount may be so used in any fiscal year for any purpose if amounts were so used during both of the two preceding fiscal years for the same purpose. (d) The Secretary shall, at least ten days prior to the use of any funds pursuant to each determination under this section, notify the Appropriations Committees of the Congress of such determination: and on or before July 31, 1968, and on or before July 31 of each succeeding year, the Secretary shall transmit to the Congress a full report on operations with respect to the fund established by subsection (a) during the fiscal year ending on the June 30 preceding such July 31.

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,
Washington, D.C., April 5, 1967.

Hon. HARLEY O. STAGGERS,
Chairman, Committee on Interstate and Foreign Commerce,
House of Representatives, Washington, D.C.

DEAR MR. CHAIRMAN: This letter is in response to your request of March 14, 1967, for a report on H.R. 6431, a bill "To amend the public health laws relating to mental health to extend, expand, and improve them, and for other purposes." The bill, to be cited as the "Mental Health Amendments of 1967," would extend or amend the provisions of the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 in four respects:

(1) The authorization for grants for the construction of community mental health centers would be extended for five additional years-through fiscal 1972. For Fiscal 1968, $50 million would be authorized for this purpose, and for each of the remaining four fiscal years such sums as may be necessary.

(2) The authorization for grants for initial staffing of community mental health centers would be extended for four additional years also through fiscal 1972. For fiscal 1968, $30 million would be authorized for this purpose (the amount now authorized for fiscal 1968) and for each of the remaining three fiscal years such sums as may be necessary.

(3) Section 401 (e) of the Act would be amended to permit construction grant funds to be used for the acquisition of existing buildings as well as for the construction of new facilities.

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