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The Department's program is, therefore, to encourage communities to provide adequate front-line resources for the prevention, early diagnosis and treatment of mental illness and retardation. To this effect, we have requested a budget of $414,174,039, excluding reappropriations, for the coming biennium. This represents an increase of some 120 million dollars from General Revenue Funds over the last biennial appropriation.

I, therefore, request your support for the Mental Health Amendment of 1967 under H.R. 6431 which extends the construction and staffing of community Mental Health Centers under Public Law 88–164 and Public Law 89–105. If we are to diminish the serious, crippling effects of mental illness and retardation, and to increase the social competence and potential of our citizens, it will be through the efforts of these bills, providing service at the local level in conjunction with state efforts. In our ever-changing society, it will be those services provided by our staffs and our communities in the centers of populations where people live, trade, and congregate that will make the significant impact on our everchanging, ever-exploding society. Society, because of its size, because of its gross potential, because of the very nature of its technological explosion, creates a multitude of problems and stresses on its citizens. These stresses must be dealt with through treatment, prevention and rehabilitation. These services must be added to our growth as a nation and as a society which cares for its own on its own home front. Thank you. Sincerely,

OTTO KERNER, Governor.



Raleigh, N.O., April 4, 1967. The Honorable HARLEY STAGGERS, Chairman, Interstate and Foreign Commerce Committee, House of Representa

tives, Washington, D.C. DEAR CONGRESSMAN STAGGERS : Adoption of S. 1132 (H.R. 6431) will enable North Carolina to continue implementation of its long-range plan to establish community-based services for the mentally ill and retarded.

Since the Facilities Construction Act (Public Law 88–164) was adopted in 1963, North Carolina has made considerable progress toward that objective. Under this act, Federal funds have been committed for construction of four comprehensive community mental health centers. Two of these will be in the eastern section of our state, one is in the Piedmont and one will be in the western section of our state. The latter is designed as a combination mental health-mental retardation facility to be housed in the same structure.

A number of other communities are in various phases of developing their plans for a comprehensive center. We estimate now that fifteen additional comprehensive community mental health centers can be established during the next biennium, provided funds are available.

Currently our recommended state budget, now before the Legislature and expected to pass, appropriate state funds sufficient to provide the state matching portion for construction of the fifteen new centers. Many of the communities already have their portion set aside.

The state simply could not support its own and the Federal share of this program. We are already putting about all we can afford into support of our mental health program. Currently, North Carolina is spending forty million dollars a year on its mental health program. For the next two years I have recommended an increase of 22.8 percent per year in mental health appropriations, the largest single portion of which will go to community mental health centers. I point this out to emphasize that we in North Carolina are not abdicating our financial responsibilities and shifting them to the Federal Government.

Our mental health program in North Carolina is in a very critical transitional period. We are making a concerted effort to build up our community programs with the resulting need for increased budgetary support, while still carrying the same responsibilities for maintaining a high standard of care in our state hospitals which currently receive over 12,000 admissions each year. Until we work through this period to the point that community programs are numerous enough to enable significant numbers of patients to be treated at home

instead of entering our state hospitals, continued Federal support for community mental health development is essential if we are to continue to move forward.

Many of our communities in North Carolina are just now moving into the final phases of the rather long and involved process of community organization through which an application for construction funds is developed. This has been a time-consuming process in North Carolina for two reasons. First, it has involved bringing together multi-county groups for joint planning and negotiation. Secondly, because we decided to tie in our comprehensive community mental health centers with general hospitals, our center construction plans have had to be phased into the long-range plans (under Hill-Burton) for hospital development. In some cases it is possible to do this quickly but in many others it may involve a period of several years.

Let me emphasize that the process of community development and involvement which has come about as plans for a community mental health center take shape has been very healthy and stimulating for our state. The people of our communities have responded to this challenge by working together to a degree that has been inspiring. So, while North Carolina has used only a portion of the Federal construction funds originally allocated to us, there has been no lack of interest or work by our people. And now many of our communities are ready to move forward. The funds simply must be made available so that the plans and hopes for a comprehensive community mental health center may become a reality.

Equally as important as the "bricks and mortar” part of this Act is Section 3 of S. 1132 which extends the staffing grant program (P.L. 89–105) through fiscal 1972. This is absolutely essential in order to help the new community mental health centers bear the initial burden of employing the new personnel which their effective operation requires. Recruiting and hiring of professional mental health personnel cannot be done quickly. They are in great demand and in scarce supply. While we are committed in North Carolina to meeting the manpower shortage through expanded training programs and opportunities, it again takes a period of several years before these training programs can begin to bridge the gap.

Our long-range mental health plan in North Carolina envisions the eventual establishment of thirty-two comprehensive community mental health centers. Each of these is going to require a full staff of qualified personnel. I can think of no more productive and creative way for Federal tax dollars to be used than in helping these communities meet some of the initial financial strain of acquiring the staff needed to carry out our responsibilities toward the mentally ill and retarded.

May I sincerely urge your favorable consideration of S. 1132 which will do so much to help our state through this very crucial period in its mental health program development. Sincerely,

DAN MOORE, Governor.



Bismarck, N. Dak., April 3, 1967, The Honorable HARLEY O. STAGGERS, Chairman, Committee on Interstate and Foreign Commerce, House Office Building, Washngton, D.C.

DEAR CONGRESSMAN STAGGERS : It is my understanding that hearings will be held soon on extension of the Community Mental Health Centers Construction and Staffing Acts and the grants authorizations as provided for in H.R. 6431 and a companion bill S 1132. This is to inform you that I strongly support this proposed legislation.

North Dakota has been able to provide care, near their home, for many patients suffering from mental illness through two new Centers, located in Grand Forks and Bismarck, during the last several months. Two other Centers, located at Fargo and Minot, will open within the near future. These four centers eventually will provide care for patients for approximately 60% of our state's population.

This marked progress could not have been accomplished without the assistance from federal funding through the Community Mental Health Centers Acts. In addition, construction funds have been made available for the St. Michael's

Hospital in Grand Forks and for the Neuropsychiatric Institute at St. Lukes Hospital in Fargo.

I believe that a continuation of this program, as embodied in H.R. 6431 and S. 1132, will be of great benefit to North Dakota and to all other states in the nation in meeting the mental health needs of our citizens. I respectfully request your Committee's favorable consideration. I appreciate this opportunity to submit my views. Sincerely,

WILLIAM L. GUY, Governor.

Olympia, Wash., April 1967.
Chairman, Interstate and Foreign Commerce Committee,
House of Representatives, Washington, D.C.:

As Governor of the State of Washington I want to convey to you my wholehearted support of H.R. 6431 entitled the "Mental Health Amendments of 1967.” I have observed closely the salutary effects of the original federal laws providing financial support for the construction and staffing of community mental health centers. I think it is fair to say that the concepts embodied in those laws, and the opportunities they have made possible, have stimulated degrees of interest, enthusiasm and support at all levels which would have been long delayed, if forthcoming at all, in the absence of a national posture and national leadership.

While our state and its several communities have moved a great deal, it would be unfortunate, indeed disastrous, if federal support were to be withdrawn at this time. Community mental health programs are quite costly. As a result they require the assurance of substantial amounts of public funds from state and local sources to supplement those from the federal government. Because ours is a biennial legislature, only now have we reached the point where these monies might be made available. With combined federal, state and local funding, I expect to see considerable progress in the years just ahead. To the extent that any part of this funding is diminished, we may expect a set back in our programs. We are not yet ready to carry the entire program alone.

DANIEL J. Evans, Governor.


Montpelier, Vt., March 31, 1967. The Honorable HARLEY STAGGERS, Chairman, Interstate and Foreign Commerce Committee, House of Representatives, Washington, D.O.

DEAR MR. STAGGERS : I understand that your committee will hear testimony on April 4th and 5th on H.R. 6431, a proposal to extend authorization for construction and staffing of community mental health centers, I urge you and the members of your committee to support the utilization of this beneficial program.

The Mental Retardation Facilities and Community Mental Health Centers Act of 1963 has had direct and indirect effects on many facets of mental health programs in Vermont. It has stimulated program development which would otherwise have been difficult if not impossible.

The northeastern part of our state, a sparsely populated and economically undeveloped area, has been the recipient of both construction and staffing grants to develop a comprehensive community mental health program, the scope of which would have been unimaginable and unrealizable without the provisions and funds available through this federal legislation. This has been brought about by citizen interest within the area and by the stimulation of professional imagination which the act has made possible.

Under the terms of Public Law 88–164 the Bennington area has received a grant for construction of additional facilities to their existing clinic building which is presently being strained beyond its capacities. These funds will not only enable an expansion but will strengthen the program and bring it even more closely into the orbit of comprehensive mental health services to meet the needs of the people in this area.

Under another title of the same act, our state operated training school for the retarded in Brandon has received a grant for construction of a pre-placement cottage for boys and men which will aid the transition from the institution to the community. We expect that this too will have a major effect on the total program for mentally retarded persons in Vermont.

I know there are many areas throughout the United States which will reap benefits equal or similar to those which we are beginning to see in Vermont and I urge your favorable consideration of the legislation to continue necessary aid to ease a major health problem throughout all of our states. Sincerely,

PHILIP H. HOFF, Governor.


Des Moines, Iowa, March 31, 1967.
Chairman, Interstate and Foreign Commerce Committee,
Washington, D.C.

DEAR SIR: I sincerely hope that Federal legislation, H.R. 6431, continues to support the Community Mental Health Centers program. Also, that the proposal to extend for five years authorization for construction and staffing of Community Mental Health Centers will be approved. Sincerely,

J. O. CROMWELL, M.D., Director, Division of Mental Health.


Wilmington, Del., March 31, 1967.
Chairman, Interstate and Foreign Commerce Committee,
House Office Building, Washington, D.C.

DEAR CONGRESSMAN STAGGERS : As Commissioner of Mental Health for the State of Delaware and representing the Board of Trustees of that Department, I endorse H.R. 6431 which will extend for five years the financial support required for the construction and staffing of Community Mental Health Centers.

Those of us who are engaged in the day-to-day and long-range development of programs for patients are convinced that Community Mental Health Centers are essential if we are to achieve our primary purpose of providing rapid and effective treatment for that substantial percentage of our population which suffers from mental illness.

Recently, I was asked to supply two basic reasons for my position favoring the support of the Community Mental Health Center plan as envisioned in the present legislation.

I replied that, first, Federal assistance is needed because under present tax structures there are not sufficient funds for local and State governments to provide the services that are needed in a Community Mental Health Center.

And, second, the Community Mental Health Center plan makes it possible to treat the patient close to his home and close also to all of the resources he will need for rehabilitation.

There are, of course, many other reasons. Our Delaware State Mental Health Plan includes as a major development for the future the establishment of these centers to cover the entire State.

It is likely that some members of this honorable Committee, as well as others attending the hearing, have seen the new documentary picture, "Bold New Approach," which was premiered in the New Senate Office Building on March 21 under the sponsorship of Senator Lister Hill. This picture daramtically portrays the advantages of the Community Mental Health Center. The ability of the facility depicted to receive and begin immediate treatment for the two patients is most striking.

A succession of Congresses has shown strong interest in the problems involved in mental therapy in the onrushing 20th Century. What is proposed in House

Resolution 6431 is far-sighted and is in keeping with creative legislation of recent years in this field.

The bill extends the construction program through 1972, a wise move, since it gives planners in the States a chance to look ahead and plan carefully. It extends the staffing program, a basic requirement because competent staffing is the heart of modern treatment programs. This legislation would also permit recipients to use funds for the acquisition of existing buildings--and for the remodeling or alteration of existing buildings. It further requires that State mental health plans must include enforcement of adequate community center standards.

This bill, if enacted into law, will assist in the improved treatment of many thousands of men and women suffering from mental illness. It will mean that they will be able to return to their families more swiftly and with more assurance that their rehabilitation will be successful. Thank you for permitting me to take this much of your time. Sincerely,



Indianapolis, Ind., March 31, 1967. The Honorable HARLEY STAGGERS, Chairman, Interstate and Foreign Commerce Committee, House of Representatives, Washington, D.C.

DEAR CONGRESSMAN STAGGERS: I am writing to express the State of Indiana's support for H.R. 6431 which extends federal programs for the construction and staffing of community mental health centers.

Indiana's Plan for Development of Comprehensive Mental Health Services, developed by the Indiana Mental Health Planning Commission, strongly recommended the continuation of federal programs for both construction and initial staffing. In point of fact, the Commission's recommendations and subsequent legislation were predicated on continuation of federal support. It was the initial federal legislation, first for planning, then for construction, and finally for initial staffing that inspired the State of Indiana to move strongly into the community mental health progam.

Important measures passed by the 95th Indiana General Assembly show the state's willingness to participate with the Federal Government and County Governments in the development of desperately needed community programs for the mentally ill and retarded. One measure replenishes the state's matching fund for construction and operation of community centers to the extent of approximately $10,000,000 over the next four years, the money to come from a portion of cigarette tax revenues. Another act broadens the definition of community centers for the mentally ill and retarded, gives counties permission to issue bonds as well as levy a 10 cent property tax to finance facilities, and says that counties may support a center in a neighboring state that serves Indiana residents.

Indiana has truly put into practice the philosophy expressed in the late President Kennedy's mental health address to the Congress in which he called for a sharing of the responsibility and cost among the three major subdivisions of government-Federal, State and Local Governments. Every region in the state is actively planning for community mental health services. Our state hospitals are rapidly readjusting their treatment programs to become an integral part of these expanding community programs. By June 30, 1967, Indiana should have five approved mental health centers.

At least three more applications will be submitted during the 1968 fiscal year. It would be disastrous to the mental health program in Indiana if federal support was to stop with the end of the present authorization which is June 30, 1967.

The Indiana Mental Health Planning Commission and all interested agencies, organizations and individuals join with me in requesting approval of all sections of HR 6431. Sincerely yours,

J. R. GAMBILL, M.D., Acting Mental Health Commissioner.

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