il@ It I I l@ i m@ SUPPLEMENTAL APPROPRIATIONS FOR 1966 HEARINGS BEFORE SUBCOAIMITTEES OF TI-IE CONi4lTTEE ON APPROPIIIATIOINS U@ITED STATES S-EX±VTE EIGI-ITY-NINTI-I CONGRESS PIIRST SESSION Priiitled for the u,@ of the Coiiiiiiittee oii Appropriatioiis U.S. GOVEIZN.\IENT PIZINTIING OFI,'ICE 64-551 WASIIINGTON : 19G5 STATEMENTS OF DR. STUART M. SESSOMS, DEPUTY DIRECTOR, NATIONAL INSTITUTES OF HEALTH; DR. WILLIAM H. STEWART, SURGE, ON GENERAL; IIAI,',RY L. DORAN, CHIEF FINANCE, OFFICER; AND JATIES F. KELLY, DEPARTMENT COMPTROLLER i@PPI'OPIZI.fVTION ]@STI.Al.@TE Illtl]GIONAI, i%[EI)ICAL PItOC1,A.\[S "Y'o olit li@litl(! [X of tlt(" l'it7)li(, Ifealtit Sei-i@ice ,I.ct, $-),5.000,000, of ii@-7?,ic7b $,?I/,000,000 81teill i,c))iai)t, (iv(tilablcit)itil Jit@ic 30.196-,, fo@, gi-a)it8 to site7b 2ttibotiitts (iv(iil(tble foi- ol)li!latioit. --------------------------------------------------------------- -------------- $25, WO, 000 Obligatio@is by activities 1966 Iiiereaso or decrease Preseiltly @tvail,,ible l@evisod estiriiite I'osi- Aiiiouii@ Ilosi- Aiiiouiit Posi- Aiiiount tiolis tiolis tioiis (iraiit@s For revioii@it iil(,,(Iical 1)ro,,raliis ----- -------- ------------ ----- -- -$24, (X)O, COO -------- $24,00.o,ooO Direct ol)er@itiotis ------------------------- -------- ------------ 100 1, 0, (X)O 100 1, 000, 000 'I'otzil ol)ligatiojis -------------------- -------- ------------- 100 25,000,000 100 25, 000, WO Ol)litlatio)i,s ?)I/ object 19(ifi IPCIC, pi,eselit y roi,ist!d avitila@)@o estiiiilLt(,@ Increase 9'ot;@il iiiiiill)(,r of I)osil;iotls ------------------------- -------------- 100 100 Full-(;iiiie c,(Itiivalciii@ of ot;li(@r 1)()Sitiolis ------------------------ -------------- 1 1 Averzig(,, iititttl)(,,r of,,ill ciili)lo@'CCS ----------------------------- -------------- 41 4t 11 PersoTizi(31 cotiil)oiisritioii: ilertil@ti)(@lit J)OSII,iolis ------------------------------------- -------------- 424,000 42,1, 000 ,O'itioi)s otli(@r tliiiii I)eriiitlil(,iit ------------------------ -------------- 2,I), 000 25,000 ottior persoajiol coiiipoiis@ttioii ------------------------ --------------- 4,000 4,000 Total 1)ersoniiel coinl)oi)satioii ---------------------- -------------- 453,0001 453,000 12 1'ersojiiiol 1)(,,tiefits - - - --------------------- -------------- 37, 01)0 37@000 21 @iii(I ti,iiii,,,,I)orl;atioii of I)ersons ------ ----------- - - -------------- 50 ot@o 50,000 22 'I'r:ltisl)ort,,)tion of tliiiigs - - - -------------------------- -------------- 2:0(() 2,000 23 Itc,,iit, coillttiijiiic;ttioiis, ,iii(I Utilities ---------------------- -------------- 2(i, 000 26,000 24 l'i,iiii@itig fiii(I i-LI)ro(izictioti -------------------------------- -------------- 24,000 24,000 25 Otli(,,r s(@,rviecs- --- --- -------------- 116,000 115,000 P,,iytiioiit to "Ntitional Iristitutes of Ife,,iltli inaiiage- iiielit food -------------------------------------------- -------------- 230,000 230,000 26 qiil)l)lieg @tik(l Materials ------------------------------------ -------------- 000 13 01)0 31 ----------------------------- -------------- 000 4i Grouts, subsidies, Ltiiti coiitributioils ---------------------- -------------- 24,000,000 24,000,000 Total obligations by object --------------------------- -------------- 25,000,000 25,000,000 232 SUPPLEINIE@NTAL APPI@OPRIATIONS FOR 1966 SUPPLI,-,-,It,,N'I'AL )kPl.'I@OPI@IATTO ,NS FOR 1966 233 of olit@ (@itli(,r I)y oi- NN'lill iii-lioll,;(@ @N@ill @llso I)e j@)6(3 cstlitiate -------- --------------------------------- ----------- liol-illat fiiil(,tiolis @111(I r(@.,I@oli- ---------------------------------- - $2.,-), 00@). 000 zll)o@,(@ @N-ill I.(,(Iuir(@ @til 100 I)ositioll',', l@-liicli, -,Along cli@tiige -- II)(, of tlic@ (@lli(@f, NN'llI Ill, ol"@illiz(@(I @@o @ts to I)i-ovi(le or ------------------------------------- 2.,. 000, 000 @or cooi-(,Iiii@itioii, I)rogrtiii t(,(iliiii(,:il gi,zti,,ts iiiait- for r(,,,,Ioii@ll ilie(II(ial r)i-r)gl@itiliq @ill(I I)I@tililitig till(I Tli(, (listril)til@i(@ii of 1)o@itioit.,; i).i, 2. I)il.eet ---------------------- 2@1.000.000 ill tllis NN,Iii(,Ii r(,st-i-i(,t @,rlii(l(@ --------------------------------------- 1, 000, 00o to @i iti@txiiiiiiiii of Tot,tl cliillgc, -- []](I NN-ill 1)(, Ill older to ii(leilii@it(,, ------------------------- 25,000,000 i@or [Ili,, iie@N' @111(i (-ollll)](@x I)rogi@,li@l. J [TSTIIIIC'ATIOIN Ati,rit0l@IZING LECISI'A'PION Ilt)j@i,ic LAI@, I)I@'i,,;ioli of lt(,gioll, A(,t ill r(@j,,Itioll to 10 (,,Itrl, , l@N of ill(, lliibli(, tlo t@ii(, llttl)li(, ll(,;iltli A(-t (42 U.S.C. cli. 6iV) @iddii)g the of tit, (](Ililoiiqfritioil,; of illl'(@lvilig @@("q of 1)1'091",tit l,4 (if 11(l@irt (ii,;(,a,@, strol<(@, ,Ill(I otl)(',. "Ti,i,i,i, IX---]'I)UCA'I'ION, ANI) 1)]@@%IONST13A'rlO@-S I.\- TIIE l@'IE, 1,DS @lr(@ 'IS @'I'ItOl@E, ANI) IIELA'RFI) I)ISLASLS to in Ili(, 01, ,iiilollg ille(ii(@ill "4(@llool"" ),tT'I'IIOIZIZA'I'ION OF API'liOI)IIIA'VIO@'S fol, of !)Of. (:t) ;tii@liot-iz(,(l to 1)(, @,50.000,000 foi- ili(-@ "("(Is, of (,Ili r i,(@latt,(l fill)(, ",O, $!)O,OOO,O(X) I'(]]- Ill(' (@11(lill, Jiiiie 30, 2. @l'o to Ill(, 1)rof(@,@,@oii @iii(I inch l,le(li(,Ill ill,,4tltlltioll,,; (,,, ill,, .)(;- I i .@iLt!Ol), Ilil'oligil @,00,@( @,111(1,$200,000,0001'or Ilie 'I litlt)tl(@ 01- 11(@ill)l@olit ilist,it@iltiolls, of ilifildi), to their ,Cl of (II, 'IllceS ill LI)(,, (liagiiosi,,; @til(I I)III)Iic (@l@ itoill)l.olill iii.,4itti(iol)S @ill(I ill I)Illlllillg, ill s (,,4. , in ol)crat@iii,(, I)ilot I)ro.j(@ct@,; for tli(- 0 3. ']'o these (,ii(is in eool)e",ttioll Nvitli of I.(,gioll@tl iiiecli(",Il of triiiiiii,, iii(I (Itiiioiistr@itioi) I(!- 'iiiiis I Of fol, out the of this te(I iiii(lcr tlii.,4 ,Ilioll, INTitliolit Ni,ifli fit(' or file iii(,Illo(is (of i-(,iii:tiii for @ll(,Ii 417@iiit@ Until lillflll('il), (if c,,ir(, or I)rofe,,,@ioll,,ti I NA7itli the of til(@ (@ii(i of file(-, liscLl l,eitr folloN)-iii,, tli liscal 1,(@@tr foi, NN,Iiieli tli(@ il)l)rol)riati(@ii is e, ol II- i5z fli@it $24 iiiiilir)ii ill (1111,111L, IF)GC@ groiil)s ill(.Ill(lc, @e@ir ivew )osit-ions request in 1966 'Ill(l otll(,L- @iii(I orgftiiizatioii@,. k(Iiiiiiii,'41:ratil,(, ('Ost.'4 of tll(@ I)rogi-,,iiii ("@ti- ('@ra(le S-,il,,iry ------------------------------------- I co --------- $IC), -@io -------------------------------------------- ------ Ill(, us(, of 91,@iiit@, aii(i foi- til(@, 01)(-.r"ll ioll of l@llot I)I'o - ----- ---------------------------------------------- I (@, 46t) ill this (",Itegoi-y N@@ill for: ( t) 1)1,11)llillg 1111(1/01- gi c io, rtvic,@v- -.@ - - ------------------------- I (@ ;-15 ------ If!, 4 C,@) tf@ I)av til(@ (@Xl)(' 1) I)t:lllllitl" @ill(I ----------------------- 1 (IS-15 ------ It;, 4t@O Of to @ll't-ive, Clii(,f, i,rogr@iiii review ------ --------------------------------- ------ ol,g, 'Illiztttioli "ill(] fol' 1-(-giollt] cIii(@f si,@itistiei,,tii - - ---------------------- ------------------ 1 CIS-15 ------ l@@, 4C)O of 111(@ file(] ,'(,Ol)(" Cliief, teeiiiiic@il I (11 @-15 (,f Ilil(@t l@l-f ol'izfliioll, (2) r(,@eareli adiikijiistr@,it,or -- ------------ ---------------- 4f!O to of ('Xi@till,, I)LI,tttv I)ir(@(@tor- - -- @------ -------------------------------- I (IS-15 ------ I(!, 4i@O Digital fl. viei%@ to tll(, Ecollo i@t ---------------------------------------------------- I (@ll,,-irl ------ I(!, 4CO 11 fol- IIollll(" ]fkllg-'.@tlige !if the E(Ittell't'lor ----------------------------------------------------- I (@ S-111, ------ If;, 4(1(1 grlii@, 1)1-01,i@lof"lt (of ",(, 'Ill(l ('(Illil)l)lllg of Eiigiii(@,@r ------- ----------------------------------------------- I C, S-1 :) ------ iii, @ICIO I !I,(, (,O"t", ;IilplK)I't of qf,,Iff, I() 11 911(1 training, li@ll !(,]It Fiii@iii(,i ti ol)eriitioii@, oflicor ----------------------------------- 2 C@ ',-15 ------ 32, 920 to g,,illii,l-iilg ttl(l g -- ----- ------------------------------ I (@s-ir, ------ I (@, @160 otl)(@r ttll(@ Org@Iiii7,@ltioll 3)letlio,is (@x;tiiiiiier -------------------------- 1 (119-15 ------ I @i, 4flo of t@lle iltil)lie lip,@iltli I)rogr.@iii 4 (; S- 15 8110 lics(!ireli s(.,ipiitist :t(liiiiiiistr@,itor ------------------------------ 4CO ZA AC(@otlllt',ITlt --- --------------- --------------------------------- ol gtTiior (ioor(iiiiator -------------------------------------- ----- 1 OS-15 ------- 16,4(@1) foil to 1)(' @N@ill'ill @NIII A@-ifil for @: 5 (@4S-14 ------- 70, 850 Illifl(,l ------ ---------------------------- I (4S- 14 ------- 14,170 I (IS-14 ------- 14,170 iii(,I,Iio,ls t-x:tiiiiii(,r -------------------------- to]' of Nlif oil I)Otl) ,I f@1)(,I.iltillg I),'[Si,4, (.lot" Nlll. Ptit)li(@ li(,till,li i)roi,,rttni sl)(,ei@ilist ------------------------------ ------- 127, 530 :Ifioll of fl)(@ Illinois 1 (IS-13 ------- 12, 075 Aceoitiittiiit ------- ------------- ------------------------------ 2 C,' S-1 3------- 24, 150 ---------------------------------- to ill(, of 111(@ ].(,gioli:ll fol- I'til)li(i li(,@litli progr@tin ------------------------------ 13 (IS-13 ------- 15@l, 97,5 (@lo])Ill(@lit of 'Ill(l "])I,, .1 , 2 GS-12 ------- 20, 5@)O SI;--- --@ ---------------------------------------- - ------------------------------------------- --- Iiii(igt-l, @tlifily I GS-11 ------- 8, 650 Ailiiliiiisll,@iLive ttssist,itiit --------------------------------------- 2 GS-9 -------- 14, 440 S(,vr(,t[Lrv- .---------------------------------------------------- I -------- 7, 220 of it q(,Cr(@lary ----------------------------------------------------- 12 (J ';-7 -------- 72, (100 I)I'ioi, lo A(] Fil@- stil)ervisor ----------------------------------------------- 2 (is-Cl -------- 11, 010 ----------------------------------------------------- 9 (4 S-6 -------- 49, 5it,5 .0g].@Ill, 1)(@ A(I(Iiti ) Fk-or(,tiiry .---------------------------------------------------- 3 0 S-6 -------- 15, 000 I)illg fill(] (@N"ll.... [I(... (@f Cl@rk-stoiiograj)li(!r ------------------------------------------- 2 GS-5 -------- 10, 000 to cool, (Iiiltlt(@ )Ill" w Cl(,rk-st(,Ilovrttl)lier ------------------------------------------- 2 (3 S-4 -------- S, 9130 3 (I S-4 -------- 13 440 9 fn tll(@ I'('giollfll nl(lllielll I)i-ogrtiiii,4. Alqo for File clork ----------------------------------------------------- I GS-4 -------- 4: 480 fill(] II(] of) 'I 11 (@f I II(' I it-( 4, 005 1, I ;i ii,i I 1, I)e Cltrk ------------------------------------------------ -------- I as- 3--------I crit@i(@al t@o its ,31jecess. C@olltilltlillg fr, -typist 3 GS-3 -------- 12, 015 Clerk -------------------------------------------------- SUPPLEMENTAL APPROPRIATIONS FOR 19C,6 235 234 SUPPLEMENTAL APPROPRIATIONS FOR 1966 STIIVIULATI"TG LINii:s BETWEEN MEDICAL CENTERS AND LOCAL PRACTICE; OF GRANTS FOR I-IrAliT DISEASE, CANCER, AND @STIIOKF PROGITAMS I%IEDICINE Senator .1-liLL. Doctor Sessoms, we are glad to litve you bacli: here,. 1@@A variet of progrtiiis call be su poi-ted uiidei- the terms of this y p and Ic@gislitioii, and tjiese f III 1 ulate the develo Illellt Of creative ),ou may proceed now, sir. ids will stiin Dr. SissoAts. 'rlialilc you, illr. Cli,%iriiitii. p ltl)l)I-Ottclles to estI.L)IiS] I i 11@) effective Iiiil@s betlveeiitlie iiieclictl centers- wlier(3 iieiv advances of I -It is t pleasure to naive this oppor@@Iii@'ty to tp I)P,,tr before you @tiid I 3,oiir coal I-! e- iiedi@tl science are applied to the diaoalosis and iiiittee, @,tiid to request an initial approp itioii to b used iii1treatment of, diseises@aiid the practice of medicine in the local coni- iiiil)lernentii-ig the regioiitl medical programs for lietrt disease iiiuiiities, which Nvill remain the first line in the battleigaiiist disease. '111(l stroke. it is ,t pletstire to ll,%ve Oil lily IlitoposED ACTIVITIES FOR INCLUSION IN AIEDICAL PIIOGRAM 1, who has been close to this legisliLtioli front The t pes of Lotivities which will be included in ,t re ioii,,tl medical I we were fortiiiitte enough to liavg- with us c inter- Director of the Ifetrt, Institute. II include continuing education for me' the re- @iit@ige of I)ersoiiiiel among the iiistitut' I istri u sb ditg- RESEARCH, TRAINING, AND DENtOiNSTRATIWN Or PATIENT CARE giolia.I Prograll-1, support for the iv'der cl liostic tiid treatment technique-,, including tla(3 iiecp-sstry equipment Senator I-IILL. The Surgeon General is with us. You got one (IT the land i@raiiie(I personnel, and the development of new tl)proaclies to the peiis, didn't you, Doctor? i I1, t iiiiig and clinical research. Di-. S'rl,'WART. I certainly did. I)L-obleiiis of @Iiiiical tr,'] Dr. SjpssoAiis. On October 6, the President sio@lled this ]eLyislatioii, USE Ole FUNDS UNDER MEDICAL PIIOGRA',[ which authorized ffr,@tnt,13 for I)Itiiiiiiig, fe@isibility StLd@, ti-id 01 11 -lie law, the funds beiiiz requested today liiz,,itioli of pilot projects for the establishment of regiojitl n IITlider the provisions of t programs of research, trtiiiing, and deiiionstrttiojis of patient ctre III will 'lot be used to interfere with the local 1),@ittei-iis of ])atielit care, the field of heart disease, cancer, stroke, and reltted diseases. I)rofessioii,,tl practice, or the t(lillillis[rtlioii of hospitals. These funds ciii be used fo 1)av the costs of only tli@it patient care incident to re- I'RFSIDENT'S COM3,IISSION ON I-IFART DISEASE, CANCER, AND STItOl@r@; SO:l re] I deinoi-istr,,ttioil. These, fluids will iioL rGI)Iice or tt)soi-b existiii- l@ederal lietltli pro- This important new ,iutliority is tii outgrowth of the iiit-lor recolli- iiieiid,itions of the Presicleiit's Coiiii-nission oil Ifeart Disetse, C-,tllc gi-@tiiis. Tlilstssistalicewilll)rovideLfi-aiiieworkLbtlieregiolii-Ilevel ,@r) IVI'icll will illare(lise the effectiveness of present programs @ well as ,tiid Stroke, ivliieli consisted of 28 outstanding physicians @tiia ptibiie- pi-on@ide increased eii-ipliasis on the difficul@ probleii-is involved iii traiis- spirited citizens. I atielit care. The Comini,@, on Ai-,@ts ,ippoiiited for the purpose of recommending Ititiiil,=,- research results into higher quality p ways to reduce the toll of deitli iiid disibi these terrible GICANTS FOR I'LANNING AND FEASIBILITY STUDIES diseases. The authority iA,Iiieli ivotild be - se appropria- tioiis embodies the thrust of the Corni-nissio, iiieiid,%tioiis. The $25 million I)eiii@ requested today represents ,t ii-iodest be- And if I may, I ivoiild like to describe very riefiy the purposes and I.riiiiiiiig toward the iii-11),!@inei-itatioii of this important new program. provisions of this leaisl,,Ltioli. Although the dis@ribucloii of these funds will not be I-,nowli extwti Seii@itor HILL. Aliriglit,,sir. until we line received applications tnd these a plicatioiis litve beelyl p considered by the Nvtio-iial Advisory Council on -Re,-iorial lvfp-dical REGIONAL CooprRATIvE ARRANGEAFENTS it is our expectation thtt the initial emphasis will be oil @l" . - Dr. The basic purpose of the gt-;tiiis under this iiillioi-itv 'llit's for I)htllllillg"tllcl fetsibili,@,ystuclies. Tll(l Avi(l(lsl)i,ctd iii this I)rogriiii tlt-eady evident tliroul"li- would be to encourage and tss@st iii the planning @tiid esttbl.isliiii(,iit @out the country, ,tiid the existence ot Present efforts lo accomplish some re ioiial cooperative arrangements amolia medical schools, research 9 ioii of the purposes of this River every hope that these funds institutions, ,tiid liosil)tals which will afFo@cl to I-,lie medical J)rofess' call be'used effectively during the coining months i -n launching the their p- ,L more tbund-,tnt opportunity of m,,tkiiigtvtilal)le to ,,ttielits the I)rograiii. in latest adi,,,tiices in free diaO"I'Iosis and trettlneiit of tilesp, tjor diseases. AvAiLABiLiTy OF Pi UNDS These regional cool)erat@ii,e irrtiiaeineiits will be laiined ,ti-id 0)@ eli",Ited locally, -,Ill(l t,]16 I(.gi.,;].tilioli Coiittijiqt number o@) I?rovi,,iioiis exist I( isoiii.-siticei-obelief i@litititliobc@,iiefit@stotliollcitltliof LlieAineric,,ui emphasize local nutritive (tii(I the cooperation of the medical profes- People wl'icli will steii-i from these regional medical programs malie sion,tiid existiiigmedic,,tl institutioiisi@id,,t(,Yencies. t@lie funds requested a very sound invps-tment. IVitliiii the.geitral fr@ii(leliiies provided-iii the ]are,, the sl)eciFic Coll- Sen,,ttorHiLL. TliisistlieDeBtl@eyCo@ission? t-eiit of a regioiiti medical pi-ogrtm will be determined l@y- tl)is local Di-. SESSO-AIS. Yes, sir. action, ,iccordijig tA? the needs, opportunities, and resources which LVO I)ecti I i ar to that re-oioii - 236 SUPPLEMYNTAL APPROPRI@RIONS FOR 1966 Seiiatot- If ii,r,. It. isiiiy iiiiclei-staiid I iig tlial-,these funds wil I b(- ,tvail. tl)le, not only for the rest. of this fisctl year, bu@ also for the liscal years I)t@.SE,-,SO-jlrs. Tlieliseilyeii-,,tfter;yes,sir. SetiitorlllLL. Is that correct? Di-. SESSOMS. Yes. Senator IIILL. Qi.iestiolis, Senator? NATIONI@L INSTITUTE CIP ,IIENTi@L I-IE,kLT-11 I Seiiat-or B-.-RD. No. STATEMENTS OF DR. STANLEY F, YOLIX, S, DIRECTOR, NA Seiiatorl-IILI,. 'I'liiiilcyouve@yiiiucli,Doctor. TIONAL Dr. SEsso@is. Tliaiik you, Sir. INSTITUTE OF MENTAL HEALTH; DR. STUART @N, SF.SSOMS DEPUTY DIRECTOR, NATIONAL INSTITUTES OIF: HEALTH; DRY PHILLIP L. SIROTKIN, ASSISTANT TO, THE DIRECTOR, NATIONAL INSTITUTE OF MENTAL HEALTH; B. J. SADESKY, EXECUTIVE OFFICER, NATIONAL INSTITUTE or, MENTAL HEALTH; LELANI) B. MAY, HE, AD, BUDGET' MANAGEMENT SECTION,. NATIONAL INSTITUTES OF HEALTH; DR. WILLIAM H. STEWART@ SURGEON GENERAL; HARRY L, DORAN, CHIEF FINANCE OFFICER; AND JAXES, F. KF@,LLY, DE, l'ARTMENT COMPTROLLER \'I'[0@N EST12fATE INATIONAL OP \IENTAL ITEALTII 4id(litioiiil aiiiouiii@ i,,t- 'Nttioiial institute of iliezi@ii I-lealth', $IO,- 700,000, of t(@7tic7i $19,500,000 shall be to aitt the Provisions of Part B of 7'itte 11 of tli(@ 111(@ibttit ],'eta)-(Iatiot Facilities (t,,d co-iiiiii@iitiity Ale@ita,I!Health Ccittel-,v CO)1,3 t),Itctio)i. Act." Aiibotitits a,v(til(tble fo)- obligation 19CC, revised estimate Appropriation ----------------------------------------------------------- $232, 169, 000 Obliti(itioity bli a(,tivity 10f,6 revised Increase or decrease estiiiitito Ciratits: Itostitreli ----------------------------------- -- $94,730,000 Indirect ---------- - (811,000).- stil)l)orL) ------------ -- ... (5,829,0()O) gf)rckil c illielil research centers) - ------ (1,750,000) I I ------ -------------- (Scientific evaluation anci planning) (215,000) ------ (215. 000) ------ --------- Fellows1ii[)S --------- C,4 00 ------ 8,364,000 ------ Training-. --------------------------------- -- @-'- 8'3 10 Stito control y)rograi - -------------------- ------ 86,231,000 ------ 8C,, 231 000 ------ ----------- n----------- ---- ----- @ 6, 760, 000 ------ 6,750:01)0 ------ -------------- Sta(litig, ilietital licaltli facilities ------ ---- ----- ------------ ------- 19,500,000 +$19,500,009 Direct operations: Itel@areli --------------------------------- 17 11,620,000 517 11,620,000 ------ -------------- Collaborative stii(lies --------------------- 165 3,8G4, 000 165 'Fraiiiin@ activities--- 3,8CAIODO ------ -------------- --------------------- 85 1,390, 000 85 1.390,000 ------ -------------- I)roressioiial and technical assistance ---- @- .323 5,157,000 343 5,357, 000 +20 +200, 000 Review and approval of graiits ----------- IV, 3,499, 000 197 3,499,000 ------ ------------ Prograin direct' ion ------------------------ 55 64, 000 55 - 14,100 ------ -------------- Total obligations ------------ ------- 1.342 212.469- 000 I ,4ii9, ?-149 Ica nnn SUPPLEMENTAL APPROPRIATIONS FOR 1966 HEARINGS BEFOIZE SUBCOiNl@flITTEES OF TI-IE C014MITTEE ON APPI@OPIIIkTIO.@-8 UINITEID STKTES S-EXKTE EIGHTY-NINTI-I CONGI@SS ll'InST SESSION 1'riiited for tile ii,@ of tlif-, Coiliiiiittee oii ,@i)i)rol)r:atioxis U.S. GOVEITN@,IENT PIZINTIING 01@FICE 54-551 WASIIINGTON : 1065 1',EGIONAL illl,,DICAL I'IZOGI'AINIS STATEIVIENTS OF DR. STUART IVI. SESSOMS, DEPUTY DIRECTOR, NATIONAL INSTITUTES OF HEALTH; DR. WILLIAM H. STEWART, SURGE, ON,GENERAL; HARRY L. DORAN, CHIL@ r@ FINANCE OFFICER; AND JAMES F. KELLY, DEPARTMENT COMPTRO=R AirnorRIATION l@STI@l:ATE Itl@GIONAL IIEDICAL PItOGItA,,[S "To carry otit Title rX of the Pitblic Ifealth Sei-t)ice Act, $25,000,000, of w7ticit $211,000,000 shaZZ i-cntaiib available itittil Jlt,)te 30, 1067, for graitt8 pit)-8uant to altclb title." A,n?.ouitts available for obligatioib preq(llltly revised estimate Apl)roprintion --------------------------------------------------------------- ------------ $25,000,000 Obligatioits by act,!Vitie3 Increase or decrease Presently available Revised estimato Posi. Amount losi- Amount rosi- Amount tions tions tions Grants for regional medical programs ----- -------- ------------ --------- $24, OM, 000 -------- $24,000,000 Direct operations ------------------------- -------- ------------ 0 Total obligations -------------------- -------- ------------ 100 25,000, 000 100 25, 000, 000 'o, 000, 00, '00 00 '00 Obt-iflatioits by object presently revised Increase available estimate Total number of permanent positions ------------------------- -------------- 100 100 Full-time equivalent of other positions.. ---------------------- -------------- 1 1 Average number of all employees ----------------------------- -------------- 41 41 11 Personnel compensation: Perninnent positions ----------------------------------- -------------- 424,000 424,000 Positions other than permanent ----------------------- -------------- 25,000 25,000 Other personnel compensation ------------------------ -------------- 4,000 4,000 453,000 453 000 Total personnel compensation ---------------------- -------------- 12 llorsotinol benefits ........ ---------------------------- -------------- 37,000 37: O(X) 2 1 Travel and transportation of persons ---------------------- -------------- 50,000 50,000 22 Transportation of tliii)gs ----------------------------------- -------------- 2,000 2,000 23 lloiit, communications, and utilities --------------------- -------------- 26 000 26,000 24 Printing and reproduction -------------------------------- -------------- 24:000 24,000 26 Other services -------------------------------------------- -------------- 115,000 116,000 Payment to "National Institutes of Ifeattli iTLanage- nient fund ....... ----------------------------- ----- -------------- 230 000 230,000 @6 Supplies and materials ------------------------------------ -------------- 13:000 13,000 3L Eqtii )meant -------------------------- --------------------- -------------- 50,000 50,000 ---------------------- -------------- 24,000,000 24,000,000 41 Uran@s, subsidies, and contributions Total obligations by object ----------- - ----------------- -------------- 25,000,000 25,000,000 232 SUPPLEMENTAL APPROPRIATIONS FOR 1966 PLEMENRAL APPROP]TIATIONS FOR 1966 233 SUP Sitiiii)tai-y of c7tatigc8 )r with in-house staff ,Yill also be required, as er by contract 1966 presently available ----- lie carried out eitli ----------------------------------- --- ------- @ill iloriiiLl administrative, and clerical functions. These functions and resl)oli- 1966 revised estimate 2r),ooo,ooo @.it)illties described above will require all estimated 100 positions, which, along tli tile Office of the Chief, will be organized -o as to provide branches or groups Total change ------------------------------ WI Increases: --------------- 25,000,000 for interagency c()ordiuitioii, I)rograiii review, teelini(-al a.@-iist@Lnce, graiit-s 1. Grants for re, ageiiierit and program planning and evaluation. The distribution of I)ositioli,,-, by lonal medical programs --------------------- 24,000,000 @gra(le in this estiinfite reflect,,, a(IiiiiTil-,trative r(@gtilatioii,., which restrict grade 2. Direct operations 1,000,000 levels to it iiiaxiinuiii of GS-15. I-loivev(-r, lii,,,Ii(-r grt(le(l positions -,ire required Total net change requested and will be requested during the operating yeir in order to provide a(le(juate ----------------------------- (lerslilp for this new and complex I)rograiii. 2;), 000, 000 lea JUSTIFICATION AUTTIOltIZING LEGISLATION A separate operating elitity, the Diviqioll of negiollal t' e P 0 .1 PuitLic LAW 89-239 I%f (II ql r. g,-, provisions of -title IX of the I)iiblie Ileiltli Service Aiiieii(Iiii(@iit to tlitt labile I-lealtli Service Act (42 TJ.S.C. ell. (3A) adding tile be establi,41ie,(l to carry out tliL Act In relatioii to regional iiiedicli I)rogrn'liis. The l@iirl)oses of tlles(@ 1)rogr@il"9 folloll'ilig title: involving education, research, tr[Liiiijig, -Ind (leiiionstratiolis of patient, care I, tile fields of heart disease, cancer, trolce, and other relit I a -li,I)UCA-FION, RrSI?AIZCII,'I.'ItAINT.NG, ANi) Di@NiON.STIIATIONS IN TIlr I"IEI,D13 "TITLII i e( (I Ise are as IX follows: .,;t in the 11 AUTILORIZATION OF APPItOPIlIATIONS 1. Through grant,,;, to encourage iii(i asq! Ol,' I-IEAltl? DISI-@ASLC, CANCElt, STltOICE, ANI@ ITELATLD DiSrASEs COOI)er,itive arrangeiiieiit- iiielit of regional alilollg S. .i)itals for research and training and for (Israeli, lie "O of patient care ill I "',,,C. ',)Ol. (a) There :i.i-c iiiii@liot-ize(l to 1)(@ :tl)l)rol)riat(@(1 $:')O,000,000 for the fields of heart disease,, cancer, -strolGICAM who lyts been close@to this legislation front,',.' e were fortttiitW enough -t@liave -with us',, The types of totivities wl@ieli will be included in a, re@ioiial medical I)rogrtlll iiic tor of the I-Ietrt Institute. lude continuing education for medical personnel, inter- chance of personnel among the institutions ptrticiliatilig ill the I-e- pr@gram, support for the wider distribution of the latest dit-g- io RESEARCH, TRAINING, AND DEMONSTRATION OF PATIENT CAItr 9 11 I -io necessary equipment liostic and treatment techniques, including t] Seii,,ttori-i@. luieSilrgeonGener,,tliswitlius. Yougotoneo-Ptile'@@@ "tild trtined persoi-iiiel and the development of iie,%v ,tpproae-lies to the peiis, didn't you, Doctor? problems of eliiiicLl trtiliilig and claim e,,tl research. -WART Dr. STE I certainly did. Dr. SF-ssoiys. On Octo6er 6, the President si(-nied 'bliis leaislttloii,@,@, USE OF FUNDS UNDER INIEI;DICAL I)I(OGRA',[ which authorized artiits for pltiiniiig, feasibility studio, @@d It-' or matron of pilot 5rojects for the est,.tblisliinejit,-of regional nie(ii9clIti,@ ITiicler (Else provisions of the Itw, the funds bein(,, requested today rograms of research, training, and demonstrations of 1),ttient ctre iii ivill not 1)(@ u,,'ed to iiit(-,rfore with the tteriis of i.),,ttiejit cire the field of heart disease, cancer, stroke, tnd rek, ted di-seases. 1)"Ofessioliil I)i-,Lc ice, or tl e -,tdiiiiiiis(-,r@ttioll Ofl),Illlosl)it,,,tls. These funds' ctii be used Eo pay the costs of only tlitt patieiit'rare incident to re- PnFsri)F,NT'S COMMISSION ON I-IFART DISRASF, CANCER, AND STItOICr, seltl:clll te,,tcliiiig,,i,iid dc@,inoiistritioji. Tlies(@ :I'tii)ds will iioL r(@l)],Lcc oi- itl.).,;oi-1) exisLiii,, Federal lietltli pro- This important new ititliori@y is ,tii outgrowth of the iii@L.jor recoiii- (riliLills. Tliisi.-,sist-,aiicewiltl)i-ovideafi-,-Liii(@workLttliei-egioiiLllevel illeiid,ttioii-s of the Presideiit's Con-imissioi-i- oil I-letrb Diseise, Ciiicer,'@ 'i'vliicli will increase tli(3 ell@e(itivelie-gs of prosen proo-r.%iiis as -%vell ts and Stroli:e, which consisted of 28 outstanding physicians Lii@l public-,@ . t provide increased -emphasis oil the difficult problems involved h-i trails- spirited citizens. Hung research results into higher quality patient core. The Commission -was appointed for the purpose of recommending ivays to reduce the toll of de@%tli ,ind distbilft--v j,,tused b 0 te -v tlies rrib e GItANTs roit PLANNING AND FrAS113ILITY STUDIRS di-s-eases. The authority which would be funded by these tpRr@pria-; tions embodies the tlit-ua of the Commission's major recommeilct,%tloiis. The $25 i-nillioii home requested today represents a ii-iodest be- And if I Tm-tv. I -%v(>i-ild like to describe very br' y the purposes -,ilid @giiiiiing toward the iml)!' p iefl einciitttion of this iinport,%nt new rograin. -i ex provisions of tf@s legislation. 'Altliotio@li the distribution of these funds will not be Imowl @tly Senator HmL. All right, sir. metal ii,@ li,%Ne received applications and these tT)plicttions Ila-ve been cotisidered by the National Advisory Council on Regional lvfedical ProgTtms, icis our expectation tlitt the initial eml>l REG10NAL COOPERATIVE ARRANGEMENTS iisis will be oil grati@,-,f(>r tiiiiiii(,r.,iiidfoasibilit,.ysttidieg. Dr. Srsso@rs. The basic purpose of the gr:tTits iiii(.Ier Llii,,; i,iii@liori The ividesl)i-e,,td interest in tlii@ I ro(,r:tiji tlread-Y evident ilirou(,r)i- Y-e,,tiid,tss@st in the i)l-,tiiiiiiLrttid esttblislilyleiit- li would be to oncourtL 0 out t@lic couiitry,,tiid the existence of (@,froris to;tceomplish some reai0lial co( lig(@iiielits unions 1110(l,icitl S(.,Ilool-" of the of this logisliLL, which will tiil'ol.(l to I-,Iie 1011, gives every liol)o tlitt tdicso funds used eirectiv(,@ly duriii,r the coming months in launching the @itil be a more album iitv of m,,tlcin tv-,tilttble to their trial 9 'progriiti. latest ,idv,%n and trettinciit of these major dise,,t@.' AVAII.ADILITY or FUNDS ,err tiigeineiits ivi-11 be planned tiid 0 or (19 on coiittLijis,-t niiiii@r of I-)rovisioiis It-, is our siiieci-o belief! t@liitt tli(@ boundless to the health of- the Ainei-ic,,ui ell i it] ve tiid the cooperation of the itiodic,%l profes-@ i I)c@ol)le %viliell will staiii from these re-lonal medical programs mali:e sion,%n ex institutioiisi-ii(l,,taoncies. t@ tlio funds requested t very sound investment. IVitliin t guidelines provide(l'iii the Iiw, the SI)eciric Con- Senator 1-11-fL. This is the De Btlcey Commission? teiit of ,t r, cal progiitiii will be determined 1)' this local y Di-. SLsso@is. Yes, sir. ,action FLICC( to tll( needs opportunities, tiid resources which ,tro peculiar to i area. 236 SUPPLEMENTAL APPROPRIATIONS FOIZ 1906 Seii,itorl-IILT,. It, is iiiy lin(lei-St,,tndiiig tll,,tt, these funds will be Vvl able, iiot oiily for the rest of tliis'fisc.-tl yetr, but also for the fisctl ye Dr. SESSO',NIS. The fisct] ye-,tr,,tf ter; yes, Sir. Senator I-IILL. IS tli,.it correct? Dr. SEssoms. Yes. Senator IliLL. QueStionS,Seiiator? NATIONAL INSTITUTE 014' 31ENTtlL- HEI@Tll Senator BynD. No. STATEMENTS OF DR. STANLEY F. YO.LLDS, DIRECTOR 'NATIONAL Senator 1-hLL. Tliaiilc you very niucli, Doctor. Dr.SEssomE;. Thaiikyou,sir. INSTITUTE Or, MENTAL HEALTH; DR. STUART @,X. SMSOMS, I 'DEPUTY DIRECTOR, NATIONAL INSTITUTr'S.01?@:.@LTH; DR. PHILLIP L. SIROTKIN,, ASSISTANT TO, THF, DIRE, CTOR, NATIONAL INSTITUTE OF 19ENTAL HEALTH; B. T, SADESKY,' EXECUTIVE OFFICER, NATIONAL INSTITUTE or, MENTAL HEALTH;' T,-PT.AND 13. MAY, HEAD, 13U])GET IvrANAGEIVIENT SECTIONL@NATIONA L INSTITUTES OF HEALTH;'DR. WILIJAM H. STEWART, SURGEON GE, NE, RA.L; HAIt]iY L. DORAN, CHIEF FINANCE OFFICER;, AND F. KE, LLY, DE, PARTME, NT COMPTROLLER JAME -T@ 0. Art I12STIIIATE NATIONAI, t OP AIENTAL IIEALTII "Foi. III ll(l(litioll. nllloiilif 'iN,,ttion,,tl institute of ijealtll,, $19,- 700,000, of it771,icll, $19,500,000 ,;Iiall be to olit tl),e p?.O@,qiolls of part B of little If of tilr Al(,,ittat I?etai-dutioiL lilacititieg a,),d ilictitaz @caltib Cclite"8 Coilst@-itctiotb Act." Alitoitrits avail(tble for obligatio,)i, lgrC, I)resentlY IDGC, revised estlfiialo Al)l)rol)rlttLiori ------------ ............................................. $212@469,Ooo $232,169,000 Oblill(ttioiiv by activity 1061 revised Increase or decrease iiiato Post- Ainount Post-, Aniount Lion, tion aratits: .1tosciireli ------------- -------------------- ------ $84,730,000 ...... $11,7,11,000 s) ----- (811,000) ------ (,S 00 (Aililit,loiliti [ii(lircet cost ------- ------ re.,; stil)l)ort) -------- 20 rill, CiLreli __. (5,820,000) --- ,of)o@ ------ -------------- (Cittegor cit, ciiiiicti research centers) - ------ (1,750,000) (1,750, ------ 000) ------ -------------- I' (Scielitifle evaluation and lilanning) -- ------ (215,000) ------ (215,ooo) ...... .............. Feltowslkit)s ----- ------------------------- ------ 8,3G4,000 ------ ' Vriiiiiing-: ------ --------------------- 8.3r,4 000 ------ -------------- ... ...... 86,231,000 ------ 8C,@ 23 1: 000 ------ -------------- State control program ------- -1 -------- --- @-t 6,760,000 ------ 6,750,000 ------ ---------- f Stafittig, inental liealtli faciliEf@i ------- --- ------ ------------- 2----- 19,500,000 Direct 0I)erfttioiis: +,$19,500,009 Iteseareli ---------------------------------- 517 11,620,000 517 11,620,000 ---- Collaborative St'll(IJCS -------------- lf)5 3 -- -------------- activities , 81;4, 000 165 3,8CA, 000 ------ -------------- ------------- ...... . 85 1,31)0,000 86 .1, 3i)O, 000 .. 1rt)f@siori;ti iiii(i teelltli(.lll ,is ----I-------------- It -s lstance ------ .,323 5 r,7, 000 343 5,357.000 +201 eview ati(i iti)i)roval of grailts -------- --- 107 : @, . +200, 000 1'rograin direction--- 3 99,000 197 3, 4(d9, 000 ................. 65 864,000 55 8G4,000 ------ -------------- Total obligations ..................... 'A 4 9@ -- --- ---