867TH CoNGRESS HOUSE OF REPRESENTATIVES ( Revorr 1st Session No. 309 DEPARTMENTS OF LABOR, AND HEALTH, EDUCATION, AND WELFARE, AND RELATED AGENCIES APPROPRI- ATION BILL, 1960 Aprit 28, 1959.—Committed to the Committee of the Whole House on the State of the Union and ordered to be printed Mr. Fogarty, from the Committee on Appropriations, submitted the following REPORT [To accompany H.R. 6769] The Committee on Appropriations submits the following report in explanation of the accompanying bill making appropriations for the Departments of Labor, and Health, Education, and Welfare, the National Labor Relations Board; the National Mediation Board including the National Railroad "Adjustment Board, the Railroad Retirement Board, the Federal Mediation and Conciliation Service, the Interstate Commission on the Potomac River Basin, and the United States Soldiers’ Home. The budget estimates forming the primary bases of consideration by the Committee will be found in the budget for 1960 on the folowing pages: Pages Department of Labor. ...-..--.----------- eee eee nee 769 to 792, inclusive Department of Health, Education, and Welfare....-.--~- 581 to 652, National Labor Relations Board_.w..-..-...--.--.------ 183 to 184, ” National Mediation Board_._-.-...--...--------------.« 184 to 185, ” Railroad Retirement Board_.._...-.----.---..--.------ 188 to 189, » Federal Mediation and Conciliation Service._._..._......- 167 Interstate Commission on the Potomac River Basin______. 176 to 177, inclusive United States Soldiers’ Home_._._: 2-2-2 eee ee 564 to 565, The detailed tabulation at the end of this report reflects each amount included in the bill for 1960, the corresponding budget esti- mate, and ‘the amount available for the fiscal year 1959 with appro- priate comparisons. 34006 2 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS SUMMARY OF ESTIMATES AND APPROPRIATIONS _ The following table compares, on a summary basis, the appropria~ tions for 1959, the requests for 1960, and the amounts carried in the bill: Bill for 1960 compared with— Appropria- | Budget esti- Department or agency tions, 19591 -} mates, 1960 | Bill for 1960 Appropria- | Budget esti- tions, 1959 mates, 1960 Department of Labor_-..--.--.-- $599, 249, 100 | $570, 227, 000 | $547, 114, 500 |—-$52, 134, 600 | —$23, 112, 500° Department of Health, Edu- cation and Welfare. .._-...---- 3, 244, 298, 281 |8, 167, 080, 581 |3, 348, 472, 281 |+4+-104, 174, 000 | 4-181, 391, 700 National Labor Relations Board. 18, 256, 600 14, 230,000. 14,230, 000 +978, 400: |... _ National Mediation Board.._. 1, 341, 800 1, 357, 000 1, 357, 000 -+-15, 200 |. Railroad Retirement Board (9, 374, 300) (9, 460, 000) (9, 460, 000)} - (+85, 700) Federal Mediation and Con- ciliation Service._.------.----- 3, 878, 600 3, 949, 000 3, 905, 400 +26, 800 Interstate Commission on the Poto- mac River Basin_.....-..----. 5, 000 5, 000 §, 000 |... | eee ence U.S. Soldiers’ Home.. (5, 531, 500)| (10, 948, 000)] (10, 948, 000 | (-+-5, 416, 500) |-..-..-----.-. Total... .------nnneeeeee-- 3, 862, 029, 381 |3, 756, 848, 581 |8, 915, 084, 181 | +53, 054, 800 | +158, 235, 600 1 Includes funds contained in Second Supplemental Appropriation Bill, 1959, as passed the House, TITLE I—DEPARTMENT OF LABOR OFFICE OF THE SECRETARY Salaries and expenses.—The bill includes $1,611,000, a reduction of $10,000 from the request, and an increase of $20,500 above the amount appropriated for 1959. The reduction of $10,000 is the sum requested for reimbursement to the Civil Service Commission to cover the De- partment of Labor’s share of the cost of the “Career Executive Board”. The Committee directs that none of the funds contained in the bill be used for the support of this Board’s activities. OFFICE OF THE SOLICITOR Salaries and expenses —The bill includes $2,695,000, the amount of the request, and $73,200 above. the amount appropriated for 1959. The sum allowed will provide for expansion of interpretation and legal advisory services needed in connection with the new Welfare and Pension Plan Disclosure. Act and the longshoremen’s and harbor workers’ safety program. BUREAU’ OF LABOR STANDARDS Salaries and expenses ——The bill includes $2,488,000, a reduction of $192,000 from the request and $763,400 above the amount appro- priated for 1959. The budget proposed an increase of $417,000 for expanded safety activities under the amendment to the Longshore- men’s and Harbor Workers’ Compensation Act; and an increase of $445,000 for registration and disclosure of welfare and pension plan data under Public Law 836 of the 85th Congress. The Committee is convinced that the funds approved will provide for adequate adminis- tration of these two relatively new programs. Included in the amount. allowed in the bill, is an increase of $9,000 to provide for a slight expansion of the excellent work of the President’s Committee on Employment of the Physically Handicapped. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS. 3 BUREAU OF VETERANS’ REEMPLOYMENT RIGHTS Salaries and expenses.—The bill includes $592,000, the amount of the request, and $8,600 above the amount appropriated for 1959. BUREAU OF APPRENTICESHIP AND TRAINING . Salaries and expenses.—The bill includes $4,047,000, the amount of the request, and $54,500 above the amount appropriated for 1959. The amount allowed is sufficient to cover mandatory increases in costs. BUREAU OF EMPLOYMENT SECURITY Salaries and expenses.—The bill includes $7,262,000, the amount of the request, and $170,200 above the amount appropriated for 1959. For several years this Committee has encouraged the Department of Labor and the Department. of Health, Education, and Welfare to do something concrete concerning migratory labor rather than simply studying the problem. The Department of Labor should be con- eratulated in making a start in this direction; however, much remains to be done. The Department of Labor’s responsibility for real action in this area lies largely within the Bureau of Employment Security. The Committee will expect the Bureau to intensify its efforts-insofar. as they are able to do so within the framework of existing legislation, and if it is felt that additional legislation is necessary the Committee will expect the Department to make appropriate recommendations to Congress. The Committee has in mind Mexican farm labor, but also, and more especially, domestic migratory labor. It is unthink- able that American citizens should not be afforded at least as much protection by their Government as it gives to Mexican farm laborers. Grants to States for unemployment compensation and employment service administration—The bill includes $315,819,000, a reduction of $12,865,000 from the request, and a reduction of $9,781,000 from the appropriation for 1959. The increase requested in the budget included $700,000 for equipment. A comparison of the operating budget for 1959 with the 1959 budget presented to the Committee last year, showed that there had been a shift from equipment to other objects, including salaries, after the original budget was sub- mitted. The Committee has noted with disapproval, in this and other agencies in the bill, a tendency to absorb budget reductions in categories such as equipment, where expenditures can be post- poned for a year, and then come back the following year with a request for increased appropriations to take care of the shortage which was created. To grant such increases is to nullify, to that extent, the action taken by the Congress the previous year. The Committee has disallowed the $700,000 increase requested for equip- ment, a requested increase of $2,165,000 for “Increase in costs due to greater normality in operations’, and has made a further reduction of $10,000,000 for savings estimated to result from the considerable improvement in the unemployment situation that is currently being predicted by the Department. Unemployment compensation for veterans and federal employees.— The bill includes $125,000,000, a reduction of $10,000,000 from the request, and a reduction of $35,800,000 from the appropriation for 4 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 1959. As in the foregoing item, the reduction of $10,000,000 is made on the basis of the Department’s more optimistic predictions concern- ing the general unemployment situation. Compliance activities, Mexican Farm Labor Program.—The bill includes $873,000, the amount of the request, and $357,300 above the amount appropriated for 1959. $350,000 of the increase in this appro- priation represents a transfer from the appropriation “Salaries and expenses, Mexican Farm Labor Program”. ‘There has been a cor- responding decrease in the latter appropriation. This adjustment is for the purpose of making a more realistic division between those activities of a compliance nature, which are financed from general funds of the Treasury, and other activities, which are financed by the growers through a revolving fund. The balance of the increase is made up entirely of mandatory increased costs. Salaries and expenses, Mexican Farm Labor Program—tThe bill includes $1,336,700, the amount of the request, and $330,300 less than the amount appropriated for 1959. ‘The net decrease is made up of a decrease of $350,000, explained in the preceding paragraph, and in- creases in mandatory costs estimated for 1960 in the amount of $19,700. BUREAU OF EMPLOYEES’ COMPENSATION Salaries and expenses.—The bill includes $3,080,000, the amount of the request, and $38,100 above the appropriation for 1959. BUREAU OF LABOR STATISTICS . Salaries and expenses.—The bill includes $9,419,500, a reduction of $45,500 from the request, and $1,459,500 above the appropriation for 1959. Over $700,000 of the increase above 1959 is accounted for by the net difference between the cost of work transferred from the De- partment of Commerce to the Department of Labor in connection with the collection and tabulation of monthly data on labor force em- ployment and unemployment, and the cost of work transferred from the Department of Labor to the Department of Commerce in connec- tion with construction statistics. A decrease of the same amount is reflected in the Department of Commerce budget for 1960. Approxi- mately $350,000 of the increase is to cover mandatory increased costs in 1960, leaving $400,000 for program increases. The major item in this area is approximately $200,000 to increase the frequency of pricing and to expand the list of items and number of price quotations felt to be necessary to improve the consumer price index. In last: year’s report, the Committee expressed its interest in having the city worker’s family budget. brought up to date. The Commis- sioner advised the Committee that this budget and the budget for an elderly couple should be priced by sometime this Fall. The Com- mittee wishes to reiterate its interest in the pricing of these two budgets and will expect that this be accomplished on schedule. Revision of the Consumer Price Index.—The bill includes $230,000, the amount of the request, to initiate a revision of the Consumer Price Index in 1960. The last revision was completed in 1952. The Committee is convinced that changes in spending patterns and other factors since that time make it necessary that a general revision be accomplished if the Index is to have maximum usefulness, The pre- LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS ‘5 liminary estimate of the total cost of revising the Index is $4,600,000 and the Commissioner advised the Committee that ne estimated it would take approximately five years to accomplish this project. While the Committee certainly wants a thorough and careful job done, it is hoped that the Bureau will make every reasonable effort to shorten this time as the last revision was accomplished in approxi- mately 3% years. WOMEN’S BUREAU Salaries and expenses—The bill includes $509,000, the amount of the request, and $7,400 above the amount appropriated for 1959. WAGE AND HOUR DIVISION Salaries and expenses —The bill includes $11,489,000, the amount of the request, and $163,700 above the amount appropriated for 1959. The Committee was informed that the Department is discontinuing the annual review of wages in Puerto Rico and the Virgin Islands and, instead, planning to make these reviews on a biennial basis. The Committee is convinced that a biennial review of these wages is not frequent enough to afford the desirable degree of protection to the workers in this area, and to the industries on the mainland who must compete with low wage industries in Puerto Rico and the Virgin Islands. It is therefore the desire of the Committee that these wage reviews continue to be made on an annual basis. TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE AMERICAN PRINTING HOUSE FOR THE BLIND Education of the blind.—The bill includes $400,000, the amount of the request, and the same amount as was appropriated for 1959. FOOD AND DRUG ADMINISTRATION Salaries and expenses—The bill includes $13,800,000, $2,000,000 above the amount requested, and $2,928,000 above the amount appro- priated for 1959. This is the only agency that the people of the nation can look to for protection from unsanitary, unhealthful, or dangerous foods, drugs and cosmetics. In view of the obvious importance of this work, Secretary Hobby appointed a citizens committee to make recommen- dations to her concerning any improvements which should be made in these activities. This advisory committee, which was appointed in 1955, was made up of top officials from the food, drug, and cosmetic industries, as well as members representing the public. Their report recommended a three- to four-fold expansion of the Food and Drug Administration in a period of from five to ten years starting with fiscal year 1957. Their report including this recommendation was endorsed by many national associations, representing the industries affected as well as a great many organizations representing the public more generally. The budgets for 1957, 1958 and 1959 barely met the minimum of the range of progress recommended by the Citizens Committee. The 6 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS budget submission for 1960 falls far short of even meeting this bare minimum, There is a serious question that even the recommendations of the Citizens Advisory Committee are adequate to do the job under current conditions. Every year there are substantial increases both in the number of products on the market and in the number of estab- lishments covered by the Act. A recent survey indicates that there are 84,000 establishments subject to supervision under the Act; 320,000 public eating places subject to regulation; 56,000 retail drug stores dealing in prescription drug sales subject to the Act; and 16,000 producers of raw fruits and vegetables who are subject to the Act. When one considers these facts it is obvious how thinly spread are the regulatory activities of this agency. The findings of the Citizens Committee should be reviewed to determine their current degree of validity. FREEDMEN’S HOSPITAL Salaries and expenses—The bill includes $3,190,000, the amount of the request, and $99,000 above the amount appropriated for 1959. GALLAUDET COLLEGE Salaries and expenses.—The bill includes $904,000, $12,000 above the request, and $55,000 above the appropriation for 1959. The Committee was amazed at the action taken in the budget to reduce the school’s request for supplies to the point that there would not be as much money available for food for the students as is available in 1959, despite an anticipated increase in the number of students. The Committee is therefore recommending that the $12,000, by which this portion of the school’s original request was cut, be restored in the bill. Construction.—The bill includes $300,000, $150,000 above the request, and $177,000 above the appropriation for 1959. As a result of this Committee’s action in 1953 and 1954 a construction program to modernize the school was initiated. After considerable delay this con- struction program finally began to show real progress during the last year. Itis disappointing to the Committee that the last stage of the program which is estimated to cost approximately $2,000,000 was com- pletely deferred by the budget. The only item included in the budget was $150,000 for the most pressing repairs needed for preservation of existing buildings. The Committee recommends an additional $150,000 for athletic fields, which are now completely non-existent, and appear to be the most essential of the items in the final stage of the construction program. HOWARD UNIVERSITY Salaries and expenses —The bill includes $4,617,000, the amount of the budget request, and $266,700 above the appropriation for 1959. Plans and specifications —The bill includes $21,000, the amount of the budget request, and $102,000 below the amount appropriated for 1959. This amount is estimated to be necessary for a survey of the steam and electrical production and distribution system at the Uni- versity. LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 7 Construction of auditoriwm—Jine arts building —The bill includes $860,000, the amount of the request for the liquidation of contract authority given the University by previous legislation. OFFICE OF EDUCATION Vocational education —The bill includes $33,702,081, $1,100,000 above the budget request, and $1,083,500 above the amount appro- priated for 1959 after deducting the amount of $1,131,500 transferred to the Public Health Service for increased pay costs in the Second Supplemental Appropriation Bill, 1959. The action of the Committee restores to $4,000,000 the amount contained in the bill for extension and improvement of practical nurse training. The budget submission had reduced this amount to $2,900,000 which would in effect hold this very worthwhile and popular program to the current level of operation and prevent any expansion in 1960. Colleges of Agriculture and the Mechanic. Arts —The bill includes $2,501,500, the amount of the request, and the same amount as was appropriated for 1959. Grants for library services.—The bill includes $6,000,000, $850,000 above the request, and the same amount as was appropriated for 1959. It is estimated by the Office of Education that there will be approxi- mately $1 million of funds previously appropriated which will remain unobligated at the end of fiscal year 1959 and be carried forward to 1960. Thus, with the amount recommended there will be approx- imately $7 million available for this program next year Payments to school districts —The Dill includes $163,957,000, $21,657,000 above the request, and $13,957,000 above the amount appropriated for 1959. The amount recoramended in the bill is the amount estimated by the Office of Education to be necessary to pay 100 percent of entitlements under the law. ‘Assistance for school construction.—The bill includes $61,135,000, $22,635,000 above the amount requested, and $14,265,000 less than the amount appropriated for 1959. As in the previous item, the amount recommended is the amount estimated by the Office of Edu- cation to be necessary to pay 100 percent of entitlements under the authorizing legislation. The Committee action on this and the preceding item reflects its feeling of responsibility to provide the affected school districts with the funds that Congress, by its action on the basic legislation last _ year, has led them to believe would be forthcoming. The Committee recognizes that these school districts have planned the financing of their school systems with the expectation that they would receive these funds. "Thus, to make reductions now would be unfair and would certainly disrupt many educational programs. However, it Is also the Committee’s belief that serious consideration should be given the basic legislation with a view to possible revision to remove from eligibility, or considerably reduce the entitlements of school districts in areas where it is highly questionable that the Federal activities have an adverse effect on the financing of the school system. The Committee has in mind areas such as those around Washington, D.C., where children of parents who work on Federal property but pay local taxes that support the school system, just the same as do their neighbors who do not work on Federal property, are none-the-less 8 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS included in the count of children for which Federal payments under these two programs are made. Defense educational activities —The bill includes $150,000,000, the amount of the request, and $34,700,000 above the amount appro- priated for 1959. Expansion of teaching in education of the mentally retarded.—The bill includes $1,000,000, the amount of the request for this new pro- gram which was authorized by the last session of Congress. Salaries and expenses —The bill includes $12,800,000, the amount of the budget request, and $3,172,500 above the amount appropriated for 1959. The largest part of the increase is due to the Office’s new responsibilities under the National Defense Education Act. The Office of Education is certainly to be complimented for the expeditious way that it has inaugurated this vast and complex new program. OFFICE OF VOCATIONAL REHABILITATION Grants to States —The bill includes $51,900,000, the amount of the request, and $300,000 above the amount appropriated for 1959. It should be pointed out in connection with this item that there is a transfer of part of the program previously financed under this appro- priation to the appropriation “Research and training’’, so the actual increase for grants to States is $4,900,000 above the amount appro- priated for 1959. Research and training —The bill includes $12,500,000, the amount of the request, and $7,700,000 above the amount appropriated for 1959. As mentioned in the preceding paragraph there has been a transfer from the appropriation “Grants to States’, amounting to $4,600,000, thus the actual increase in the research and training activities is $3,100,000. This transfer between these two items is for the purpose of consolidating like activities under one appropriation. Salaries and expenses.—The bill includes $1,738,000, the amount of the request, and $223,000 over the amount appropriated for 1959. This increase provides approximately $10,000 for mandatory cost increases and $210,000 for additional positions and supporting services necessary to adequately administer this very important and expanding program. The Committee reiterates its opinion that in the expansion of staff priority should be given to the field offices. PUBLIC HEALTH SERVICE ENVIRONMENTAL HEALTH PROBLEMS Over the past several years a number of environmental factors affecting health have become increasingly significant. The develop- ment of industrial processes and industrial products has taken place at a rate so rapid that direct and indirect effects on the health of the worker, the user of the processed product, and the general environ- ment have not been adequately evaluated. The considerably ex- panded use and diversity of sources of radioactive products is a technical development of particular significance to health. The continued growth of gigantic metropolitan complexes has created special problems related to communicable diseases, problems of mental health, and, to a certain extent, has made it increasingly difficult to deliver health services. Related to the growth of metro- politan areas and the expansion of industrial production are the in- LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 9 creasing problems of air and water pollution and their effects on the een of the population, which are at present inadequately under- stood. The U.S. Public Health Service is now doing work in this general field under several different appropriations, and in several different organizational units. These are identified in various parts of the budget as radiological health, sanitary engineering, accident preven- tion, some aspects of mental health, control of communicable diseases, occupational health, etc. The Committee believes that this is a field where problems are almost inevitably going to increase and that a very thorough study to determine the most efficient organization of our public health and medical research resources to cope with these prob- lems is overdue. In view of the above, the Committee requests that the Public Health Service make a thorough study of the environmental health problems and the most efficient organization of our facilities to meet these needs, and have a report prepared for submission to the Com- mittee by January 1, 1960, so that the Committee may have an opportunity to study it before holding hearings on the 1961 Budget. Assistance to States, general.—The bill includes $22,497,000, the amount of the budget request, and $1,142,000 less than the amount appropriated for 1959. ‘The 1959 appropriation included $2,000,000 for grants for public health training. No appropriation for this pur- pose is included in the bill due to the fact that authorization for this program expires June 30, 1959. The Committee was told that the Department anticipates asking for extension of this legislation. The bill for 1960 includes an increase of $550,000 for grants to schools of public health, thus bringing the appropriation for this item up to the full amount of $1 million authorized in the basic legislation. The Committee’s attention has been called to the career development program of the Division of Public Health Nursing. Little, if any testimony has been given on this subject by the Public Health Service officials. The Committee hopes this is not an indication they feel such a program is unimportant, and expects more information on it during next year’s hearings. Control of venereal diseases —The bill includes $5,400,000, an in- crease of $727,000 over the amount requested, and the same amount as was appropriated for 1959. The Committee was especially sur- prised at the reduction which was made in this estimate in the budget presented to Congress. Contrary to the situation which would be indicated by this action, the incidence of venereal disease, which had been declining, has not only leveled off, but has actually started in- creasing during the recent past. This increase has occurred even more in the teenage range than in other age groups. With this fact amply documented, the Committee could see but one course open to it, which was to correct the obvious inadequacies of the budget at least to the point of restoring this appropriation to the 1959 level. Control of tuberculosis.—The bill includes $5,452,000, the amount of the budget request, and $1,049,000 less than the amount appro- priated for 1959. ‘ Communicable disease activities —The bill includes $8,015,000, the amount of the budget request and $1,125,006 over the amount appro- priated for 1959. The program increases are made up of $260,000 for intensification of development of the fluorescent antibody tech- nique for disease diagnosis, $245,000 for studies and assistance to H. Rept. 309, 86-12 10 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS control staphylococcal infections, which have been on the increase during the last few years and many of which defy treatment with the usual antibiotic drugs, and $127,000 necessary for expenses incident to moving to the new Communicable Disease Center buildings which will be completed at Atlanta, Georgia during the next fiscal year. The Committee is especially pleased that the Public Health Service has finally shown some real enthusiasm for the development of the fluo- rescent antibody technique for fast diagnosis of disease. This Commit- tee was very much impressed with the potentials of this technique two years ago, and said in its report “it is hard for the Committee to understand why so little interest has been shown in the development of this technique by the U.S. Public Health Service when many ex- perts in the field feel that it is a development, which, if perfected, could revolutionize diagnostic procedures.” This year, two years later, Dr. Anderson, Chief of the Communicable Disease Center, stated in his prepared opening statement, “* * * among recent developments the fluorescent antibody diagnostic technique remains paramount in significance toward revolutionizing practices in labora-~ tory diagnosis.” Samtary engineering activities —The bill includes $14,590,000, an increase of $315,000 over the request, and $1,334,000 over the amount appropriated for 1959. The amount in the bill includes $400,000 for the Arkansas-Red River water quality conservation project begun in 1958. This project was budgeted to be continued at an annual rate of $85,000, which would mean that it would take many years to com- plete the project. It appears to the Committee, especially after hear- ing excellent testimony from the people most knowledgeable on this subject, that the most efficient procedure would be to complete this project at the rate recommended in the bill. The Committee has gained the distinct feeling that activities con- cerned with milk and food sanitation and inspection of interstate carriers has been so over-shadowed by the larger programs of air pollution control and water supply and water pollution control as well as the expanded program of radiological health, that they have not received anywhere near the attention which is due them on the basis of their importance. The Committee expects that, within the amount provided, additional attention be given to this division’s activities in connection with interstate shipment of milk, shellfish sanitation, and inspection of interstate carriers. - The Committee also recommends that in the preparation of the budget for 1961 serious consideration be given to setting forth separ- ately in the budget all water pollution control activities, and all air pollution control activities. This will give everyone concerned a much clearer picture of what is being spent on these activities, than is shown when they are partially amalgamated under the general title “Sanitary engineering activities,” and partially set out separately. Grants for waste treatment works construction—The bill includes $45,000,000, an increase of $25,000,000 over the amount requested and the same as the amount which was appropriated for 1959. The budget for this item was completely unrealistic in view of the needs, It was brought out during the hearings that it would take three and one-half years at the rate of appropriations recommended for 1960 just to finance the applications for grants that are currently on hand. Grants for hospital construction. —The bill includes $143,700,000, an increase of $42,500,000 over the request and $42,500,000 less than LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 11 the amount appropriated for 1959. or this item, also, the budget submission was so completely out of line with the obvious needs ‘and demands for this program, that it could not, under any circumstances, be accepted by the Committee. The budget was based on providing only sufficient additional hospital facilities to take care of the increase in population and the loss of hospital facilities through destruction, such as by fire. There was no allowance made for replacing obsolete hospital facilities, and there was no provision for making inroads into the enormous backlog of need that exists. The plans submitted by the State agencies administering this program estimated, as of December 31, 1958, a total need for an additional 1,119,000 hospital and nursing home beds. For a nation that prides itself in not only being the most wealthy nation in the world, Tut in putting the welfare of the individual on the highest level, it is unthinkable that we should continue to let a condition like this exist, where people are deprived of good medical care when it is within our power to make it available to them. Salaries and expenses, hospital construction services.—The bill in- cludes $1,604,000, the amount of the request, and $31,000 less than the amount appropriated for 1959. Hospitals and medical eare—The bill includes $45,600,000, the amount of the budget request, and $5,024,000 less than the amount appropriated for 1959. ‘The decrease in this appropriation is ac- counted for by the fact that no funds are included for professional nurse training grants, since the legislative authority for this program expires on June 30, 1959. There was included for this purpose $6,050,000 in the 1959 appropriation. The Department has indi- cated that it will seek an extension of this legislation, which, if ap- proved by Congress, will likely result in a supplemental request to be considered later this session. The amount provided in the bill includes an increase of $934,900 for operation of hospitals. ‘This represents the first step in bringing the medical care given in these Public Health Service hospitals to the level felt by groups of outside professional personnel who reviewed their operations, to be the minimum for good medical service. During the hearings, it was stated that increases at this level for three more years after 1960 would accomplish this purpose. The Committee was pleased with the progress reported in research activities at the Carville, La. leprosarium, for which additional funds were provided in the 1959 appropriation. Everyone interested in this subject seems to be of the opinion that a research program in the U.S. Public Health Service hospitals would result not only in advances in medical research but in making it easier to secure and retain the services of competent doctors and thus improve medical services. An expansion in research efforts should be possible with the increase for hospital operations provided in the bill. The Committee was impressed with the testimony concerning the work of the Division of Nursing Resources and hopes that efforts will be made to facilitate this important work. Foreign quarantine activities —The bill includes $4,460,000, the pam of the request, and $112,000 over the amount appropriated or 1959. Indian health activities —The bill includes $45,500,000, an increase of $2,000,000 over the request, and $3,173,000 over the amount appro- priated for 1959. Last year the Committee held the appropriation 12 .LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS for this activity to the level of 1958. This was done largely because of some alleged shortcomings in the administration of the program which the Committee thought should be corrected before there was any further expansion to take care of what obviously is a great unmet need. On the basis of personal observations of operations in the field, the reports which have come to the Committee recently, and the testimony received on the 1960 budget, the Committee is convinced that these shortcomings have largely been corrected. In view of this fact, in view of the obvious need, and in view of the testimony by a great many experts in this field, that an adequately supported attack at this time will result in solving the problem sooner and saving money in the long run, the Committee has approved an increase of $2,000,000 above the amount requested. It is the desire of the Committee that major emphasis be placed on building up the staff of professional medical personnel in the hospitals and clinics. It is also the desire of the Committee that none of the increase over 1959 be used to augment the current staff of social workers. It has been called to the attention of the Committee that in some States nonreservation, medically indigent Indians are not given med-~ ical care on the same basis as the rest of the population. Some States and localities avoid responsibility for the care of nonreservation Indians who are unable to pay for their own medical care and give them no recourse but to go back to the reservation to establish residence and receive medical care through the Federal Government. On the other hand, Indians are counted as part of the total population of each State and so qualify the States for a larger share of Federal funds under grant programs such as the grant for general health purposes under the appropriation “Assistance to States, general.” The Com- mittee considered the possibility of including a provision in the bill which would bar any State which allows such discrimination from receiving any Public Health Service grants which are based on total population including Indians. It is believed, however, that such a step should not be necessary to correct this situation. The Committee does expect to receive a report on any changes in this regard when the Public Health Service presents its budget for 1961. Construction of Indian health facilities —The bill includes $4,587,000, an increase of $1,500,000 over the request, and a reduction of $1,237,000 from the appropriation for 1959. One of the very important factors in good morale for the personnel charged with field activities of the Indian health program is good housing. From personal observation, and repeated testimony on this subject, it is obvious that good housing does not exist at many stations. It was testified in connection with the budget for 1960 that the funds for personnel housing would not even allow the agency to break even. In other words, the need at the end of 1960 would be greater than the need is now. The Committee there- fore has added $1,500,000 specifically for this type of construction. NATIONAL INSTITUTES OF HEALTH _ The budget and the written detailed “justifications” and explana- tions of the budget were the worst and most confusing that have been LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 13 submitted to the Committee since the establishment of the National Institutes of Health. In dollars, the budget for 1960 was exactly the same as the appro- priations for 1959. In the numerous press conferences that have been held, the Executive branch has attempted to convince the people that this budget would provide for the same level of activity in 1960 as in 1959. In the detailed analysis of the budget that was presented to the Committee in the form of so-called justifications, and in the early testimony before the Committee every attempt was made to mislead the Committee into thinking that this was true. ‘As the hearings progressed the Committee was able, bit by bit, to elicit the true facts concerning this budget. Whereas in earlier testi- mony the Committee had been told that increased costs would amount. to $5,000,000, when these costs were subjected to analysis during subsequent hearings, it was testified that increased costs will actually amount to over $15,000,000. (Thus, for this reason alone, the research and training in the National Institutes of Health would have to take avery distinct backward step were the Executive budget to be enacted. In-earlier testimony the Committee was led to believe that there were sufficient funds in the budget so that 15 percent could be used for new research projects. During the hearings with the National Institutes of Health concerning the details of this matter it was determined that the budget actually lacked more than $2,000,000 of being adequate just to finance the continuation of projects now in progress and the approved applications that are now on hand. Té was found that the written ‘justifications’ submitted to the Committee had literally hundreds of incorrect figures. The differ- ences between the true situation and the supposed facts and figures set forth were far from inconsequential. Time after time where the justifications indicated that the 1960 budget provided for an increase in a research or training activity, it was found that not only was the mere not as great as set forth but that actually there was a decrease instead. By the time the Committee had concluded its hearings, it was abundantly clear that the people whose responsibility it was to prepare’ these. “justifications” had been placed in an impossible position. They had obviously been assigned the task of making it appear that’ the budget represented progress in the field of medical research when the true facts are that in a desperate attempt to present, on paper, a balanced budget, the Bureau of the Budget, or someone in authority had even gone so far as to set back the medical research program. The Committee does not believe that the people of this nation youd permit such a backward step if the true facts were known to them. In reviewing the. testimony of the Secretary at the opening of the hearings, it is noted that on at least fifteen separate occasions he indicated that the budget for the National Institutes of Health was not necessarily final. He also indicated that he hoped to be able to work out within the Executive Branch a final figure to present to the Committee by the time he appeared on the budget for his own office,. which was at that time scheduled for about two weeks later. With the hope that a better budget would be forthcoming the Com- mittee continued with hearings on other portions of the Department’s budget and, when these were concluded, recessed for about a month. 14 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS No additional word was received concerning an amendment to the budget, so the Committee resumed hearings and found, six weeks after the Secretary’s statements concerning his hope to work out a definite and final figure for the National Institutes of Health budget, ae he had not even submitted a formal proposal to the Bureau of the udget. During the course of the hearings with officials of the National Institutes of Health it was found that they had, on February 3, 1959, submitted a proposal to the Department which they considered to be a conservative estimate of the additional amount of funds which would be necessary to continue progress in the field of medical re- search and traming. This proposal for all the Institutes totaled approximately $57,000,000. From the hearings and the detailed information submitted to the Committee concerning this budget it was obvious that the proposal was truly conservative. As a matter of fact, the budget amendment recommended by the National Institutes of Health is not quite as large as appears on the suriace since funds were included in this proposed amendment not only for increased research and traiming activities but also for increas- ing the amount of overhead to be allowed on research projects from 15 to 25 percent. This amounted to approximately $14,000,000, thus leaving about $43,000,000 for actual increases in research and training. The Committee has allowed $50,000,000 over the sum requested in the formal Executive budget. This is somewhat less than the February 3d estimate by the National Institutes of Health. However, the Committee is allowing no increase for overhead expenses, so it is slightly more than they estimated for research and training activities. The National Institutes of Health have over the years amply demonstrated wisdom, foresight, integrity, and good judgment in the administration of medical research and training programs. The Committee expects that these high standards of administration will continue and has therefore allocated the $50,000,000 increase among the Institutes in the same proportion as the individual Institutes were allocated funds under the February 3d proposal. The following table sets forth the pertinent figures by Institute: Bill compared with— Appropria- Estimates, Recom- Institute tions 1959 1960 mended in bill for 1960 | 1959 appro- { 1960 estimate priations General research and services..-_| $28,974,000 | $28,974,000 | $36, 404,000 | +$7, 430,000 | -+-$7, 430, 000 75, 268, 600 75, 218, 000 83, 308, 000 | +8, 040, 000 +8, 090, 000 52, 419, 000 52, 384, 000 60, 409, 000 | +7, 990, 000 £8, 025, 000 -| 45, 618, 000 45, 594, 000 52, 744,000 | -1-7, 131, 000 -+7, 150, 600 National Cancer Institute__ Mental health activities... National Heart Institute. Dental health activities._._..... 7, 420, 000 7, 420, 000 9, 725, 000 | -+-2, 305, 000 +2, 805, 000 Arthritis and metabolic disease activities__-.---.-.----.----~-- 31, 215, 000 31, 215, 000 387, 790, 000 | +6, 575, 000 +46, 575, 000 Allergy and infectious disease -activities...---_--.------------ 24, 071, 000 24, 071, 000 30, 286,000 | +6, 215, 000 -++6, 215, 000 Neurology and blindness activ- iti 29, 408, 000 29, 403, 000 33, 613, 000 | -+-4, 210, 000 +4, 210, 000 294, 883, 000 | 294,279,000 | 344, 279,000 | +49, 896,000 | +50, 000, 000 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 15 ECONOMIC ASPECTS The only reason given the Committee for the critically curtailed budget was the necessity for curbing inflation and balancing the budget. Actually, it is difficult to conceive of anything more anti-inflationary than a successful medical research program. Tt is obvious that disability is doubly inflationary—it reduces tax revenue, on the one hand, and it increases the expenses of government, on the other. It is equally obvious that medical research, which re- duces disability and lengthens productive life, is doubly anti-inflation- ary—it increases tax revenue, on the one hand, and decreases the expenses of government, on the other. The Committee’s action to add $50 million to the Executive budget and thus provide for the con- tinued progress of this medical research program is clearly an anti- inflationary action. In view of the statements that have been made to becloud the true facts, the Committee is setting forth on the following pages, in more detail than usual, the accomplishments of the recent past and the prospects for the future which will further substantiate the above assertions. General research and services—-The, bill includes $36,404,000, $7,430,000 above the request, and $7,430,000 above the amount appropriated for 1959. The greatest proportion of the funds in this appropriation support the work of the Division of General Medical Sciences. At present, the Division carries out its work entirely through extramural grant operations. It is difficult to overstate the importance of fundamental research. Tn a real sense it is the foundation for all medical research, since the progress of fundamental investigations ultimately determines the success of clinical and applied research and practice. In turn, the continual expansions in clinical and applied: research impose con- stantly heavier needs for basic knowledge. Indeed, it appears that two of the most important limiting factors in medical progress may be the fund of fundamental biological information and the supply of investigators in the basic medical and biological sciences. “Recent. fundamental investigations have revealed new information about cellular reproduction, which is important in the study of cancer. Other work is focused on genetics, seeking to explain how detrimental effects, such as those produced by radiation, are transmitted from one generation to another. In another field, research supported by this Division has succeeded in producing proteins from amino acids— a work which holds great promise for helping to explain the trans- formation of non-living into living matter. The NIH Center for Aging Research is financed by this appropria-~ tion. This research is moving forward effectively on a very broad front with work in the biological sciences, the clinical sciences, and the behavioral and social sciences. The vastly increasing numbers of 16 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS older persons make it imperative that this work continue to receive expanded support. Another small but important activity financed with these funds is the program of nursing research fellowships and grants. The Com- mittee has provided sufficient funds in the bill so that this important program can be adequately financed. This appropriation also supports the activities of the Division of Biologics Standards. Many infectious diseases, such as smallpox, diphtheria, typhoid, and yellow fever, once devastated whole popu~ lations. Today these diseases are almost unknown in the United States largely because we have developed biological products that can be used for their prevention. Many other biological substances pro- tect the lives and well-being of our citizens: poliomyelitis and influenza vaccines, immune serum globulin, and allergenic extracts. Because most biological products are derived from living organisms, they are potentially dangerous if improperly prepared and tested. Close surveillance of production and constant improvement in quality is essential. The development of realistic standards for these products and the exercise of proper control over them is the responsibility of the Division of Biologics Standards. While the basic procedures for producing safe and satisfactory vac- cines are now well established, both the microbiologist and the manu- facturer of biological products are continually attempting to produce new products and to develop new methods for improving existing ones. To keep abreast of such developments, the Division maintains an active research program. Physical reference standards, prescribed standards and testing procedures are all developed to a point where adequate control can be maintained over new products as they become available for commercial use. For example, a simplified method of measuring the potency of poliomyelitis vaccine in a quantitative man- ner, using chicks instead of monkeys, has been developed after two years of intensive study. The chick test provides a reliable measure of potency for all three vaccine types, and is a far less complex assay procedure than the monkey test. The Division has worked closely with industry in the development of adequate measures for the control of quadruple antigen preparations for the simultaneous immunization of children against diphtheria, tetanus, whooping cough, and poliomyelitis. This product will pro- vide effective immunization against all four diseases in infancy. National Cancer Institute —The bill includes $83,308,000, $8,090,000 above the amount requested and $8,040,000 above the amount appro- priated for 1959. The bare statistics on the number of deaths from cancer each year are discouraging to many people. Admittedly, there is a very great deal still to be accomplished and it is undoubtedly going to take many years before this disease, or group of diseases, is conquered; However, there are so many encouraging developments in the research of this Institute that to curtail the program now would be gross. foolishness. The importance of early diagnosis cannot be overemphasized, for with the knowledge we now have many more people could be cured LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 17 if their condition were diagnosed in its early stage. In last year’s report the Committee stated: Considering the rate at which medical science has advanced over the past ten years, it is plausible to believe that in the decade ahead simple, accurate tests for cancer, such as a blood test, may make the early detection of cancer simple and be usable as a routine tool of the physician and public health worker. A special program was set up in fiscal 1959. The Committee is encouraged by the creation of a voluntary cooperative program which has brought together leading people from a number of special scientific areas which might bear upon the discovery of these much needed cancer diagnostic tests. The Committee will expect continued emphasis to be put on this activity and will expect a detailed report on accomplishments next year. Research on the relationship of viruses to cancer has produced a nuraber of accomplishments that appear to be of far-reaching signifi- cance. The S-E polyoma virus, first reported only a few years ago, is now the focus of a sizable research endeavor. Studies have shown that this single virus causes multiple tumors in mice and produces cancers in rats and hamsters as well. A vaccine that protects ham- sters from the virus’s tumor-inducing action has been developed and proved to be 98 percent effective. An animal cancer virus that causes leukemia in 10 weeks in 100 percent of injected mice has been reported. The agent was obtained from a solid mouse tumor but thus far has produced no form of cancer other than leukemia. As yet, there is not absolute proof that any form of human cancer is caused by a virus. However, in the past decade, many new human viruses which have not yet been correlated with diseases have been found. A great deal of new information has been brought to light about the intricate nature of cells and about the chemical similarities of viruses and cell components which are carriers of heredity. Virus particles have been seen in electron micrographs of human leukemic tissues. If a synthesis of knowledge produced by studies such as these should produce conclusive evidence of the presence of viruses in human cancer, and if, furthermore, viruses should be established as causative agents, a truly remarkable milestone will have been achieved. It would then likely be possible to develop vaccines with which to immunize against the cancers caused by these viruses. Chemotherapy continues to be an active and promising area of cancer research. There are now 20 chemical compounds in use by doctors throughout the country against 30 forms of human cancer, and 78 more chemical compounds are now being distributed to clinical investigators in many hospitals throughout the United States in more than 100 separate clinical programs through the Cancer Chemotherapy National Service Center. It seems clear that the last five years of tooling-up this gigantic program are now paying off, and that physi- H, Rept. 309, 86-1——3 18 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS cians ultimately will be armed with a number of drugs much more effective than the 20 or so standard agents that even now are quite useful in treating various forms of cancer but, unfortunately are only temporarily effective. These few examples represent the progress that is being achieved in the broad field of cancer research. Each, if brought to fruition, could work a profound change in the impact of cancer, both as an individual tragedy and as a matter of the most serious economic concern to the Nation. The committee was impressed with testimony regarding the need for the establishment of cancer centers in ten or more places in the country. The Committee was told that such centers would accelerate progress in many phases of cancer research, and particularly in the evaluation of new methods of diagnosis, in the study of anti-cancer activity of new chemical hormones and antibiotics which are coming in such large numbers from the recent research of the Cancer Chemo. therapy national program, and in the combined use of newer surgical techniques, radiotherapy and chemotherapy, in patients with ad- vanced cancer. It will be expected that a thorough study of this matter be made and that the National Institutes be prepared to make recommendations regarding this matter in connection with the 1961 budget. Mental health activities—The bill includes $60,409,000, $8,025,006 above the amount requested, and $7,990,000 above the appropriation for 1959. Recent figures presented to the committee indicate that mental illness costs this country a minimum of $3 billion a year. Despite the staggering economic losses, the committee received heartening evidence of remarkable progress against mental illness. Over the past three years, there has been a drop of 13,000 patients in State mental hospitals. At the end of 1958 there were 52,000 fewer mental patients in all mental institutions than might have been expected on the basis of the rising curve from 1945 to 1955. Just the annual money savings resulting from this reduction amount to much more than this entire appropriation if calculated on the most conservative basis. It costs an average of $1,500 a year to provide little more than custodial care for each patient in a mental hospital and in institutions where good care and service is given the costs are much higher. Restored to a useful life this same person is earning his own living and paying taxes. Medical research that can increase our ability to prevent chronic mental illness is the only way of eventually cutting down on the Nation’s multi-billion dollar annual bill for care of the mentally ill, The complex problem of effective treatment is now being tackled systematically, utilizing biological, psychological, and sociological approaches in a coordinated manner. The recently inaugurated intensive, systematic search for new and better drugs has already brought at least one new chemical agent which promises a safe and effective treatment for severe mental depressions. Another drug, a new tranquilizer, is proving effective in bringing extremely regressed patients to the point where they can be reached by therapy and rehabilitation. Broad evaluative studies of drug therapy promise more precise knowledge of effective treatment. The drugs themselves are being used in a wide variety of experiments to learn more about the structure and function of the central nervous system and the LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 19 relation between brain and behavior, between neuro-physiclogical processes and disorders in thinking. Intensive studies of the psychological aspects of mental illness have brought increased understanding of the way in which patterns of family relationships are related to abnormal behavior. Particularly for schizophrenic patients, this new approach has brought progress in effective treatment of mental illness. It is widely known that critical shortages of psychiatric personnel continue to hamstring efforts to return additional thousands of mental patients to productive lives in the community. The budget request in the training area would have made it necessary to go backward. instead of going forward toward meeting this pressing need. ‘This has been corrected by the increase recommended in the bill. Last year the Committee increased the budget request for 1959 to start a new program in this area, the general practitioner training program. Inaugurated only this fiscal year, it has been received with unprecedented enthusiasm by the medical profession. Despite the newness of the program, the Institute has been unable to finance many of the applications from all parts of the country. Since the family physician is dispensing the greatest quantity of the new drugs, it is absolutely vital that he receive the psychiatric education he so avidly seeks. It will be expected that this program be expanded in 1960. JUVENILE DELINQUENCY Juvenile delinquency is a problem of great magnitude in terms of parental distress, economic burden, and loss of future potentially useful citizens. The problem is one about which parents, teachers, the courts, civic groups, and other organizations have all expressed con- cern. But there seems to be no coordinated effort to do anything about it, and no one group accepts responsibility for giving leadership in efforts to prevent or ameliorate the problem. While juvenile delinquency may seem to some to be peripheral to medical and biological research, it is apparent to this committee that many of our scientists are, as they should be, increasingly turning their attention to study of the behavioral sciences. Such studies should include inquiry into the psychological, emotional, and environmental factors leading to deviant behavior in youth. From such knowledge can come means for preventing juvenile delinquency. In the Department of Health, Education, and Welfare we have the Children’s Bureau and the National Institute of Mental Heaith, both with interest, experience and resources in the fields of child behavior, child welfare, and child psychology. It would seem that a collabora- tive effort by these two agencies, one oriented to research in behavioral, psychological and psychiatric sciences, and the other oriented to re- search in sociological science with emphasis on child welfare, could lead to methods for helping reduce the tragic social burden that juvenile delinquency represents. Accordingly, the Committee calls upon the National Institute of Mental Heelth to use such portions of the increased 1960 funds as may be necessary to undertake a most careful and thoughtful study of what can and should be done in future years in the field of juvenile delinquency. It asks the Institute to take primary responsibility in 20 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS this field and assumes that funds available under Title V of the Health Amendments Act of 1956 can be used for such purposes. It assumes that the Children’s Bureau can also participate under its existing authorities. The Committee further asks that the National Institute of Mental Health submit a detailed report by January 1, 1960, in- cluding both substantive and fiscal proposals, so that the report may be considered by the next session of Congress and its appropriate committees. National Heart Institute —The bill includes $52,744,000, $7,150,000 above the request, and $7,131,000 above the amount appropriated or 1959. Probably no other field of research has been pointed to more frequently by the “doubting Thomases” some of whom still claim that we are not getting results for the taxpayers’ money that is being spent for medical research. To anyone who knows the facts, to anyone who had the opportunities the Committee has had of receiving detailed testimony from the leading doctors in this field both inside and outside government, it is obvious that the returns for the invest~ ment have actually been unusually high. This research has resulted in lives saved and lengthened, in suffering and disability relieved, and in the economic benefits of decreased medical care and increased productivity. Progress in congenital heart disease continues to be notable. In striking contrast to the situation only a few years ago, many congenital heart defects can now be completely corrected by surgery or greatly improved. With development and refinement of the “open heart” operation, using the technique of hypothermia or “ice-bath” surgery or an artificial heart-lung machine, additional heart abnormalities are being added to the list of those remediable. The scope and safety of open heart surgery has been increased by the recently developed technique of deliberately stopping heart action during the period of operation by injection of a chemical. Important advances have also been made in diagnosis, including a new technique of using minute quantities of harmless radioactive gases for detecting and precisely locating congenital defects. Previous methods required many samples of blood and could not be used in infants because of their small blood reservoir. The new method wholly avoids the necessity of taking bleod samples. Advances in the surgical treatment of rheumatic heart disease pa- tients whose mitral valves have been damaged by rheumatic fever have also saved and lengthened thousands of lives. New approaches to other valvular conditions are being developed and may result in further achievements. Considerable progress against rheumatic fever has resulted in the past few years from the knowledge discovered by research that prompt and adequate treatment of streptococcal infections with antibiotics can forestall most first attacks and that prophylactic treatment can prevent recurrences.. A great problem in preventing first attacks, however, has been the lack of a rapid, accu- rate way of identifying the strep infections. A new test, currently undergoing field trials, appears to be a promising answer. With the new technique, in which fluorescent antibodies attach themselves to streptococci if present in a throat specimen and cause them to glow under ultraviolet light, positive and rapid identification can be made, Research in the use of drugs, diet, and surgery has brought encour- aging progress in the treatment of hypertension. The most dramatic LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 21. advances have been in drug therapy. A few years ago there were no effective agents for reducing high blood pressures. ‘Today drugs are available which, used singly or in combination, can lessen the severity of hypertension in most patients and adequately control the condition in many. None of these is ideal, however, and the search continues for an agent which will produce the favorable effects on blood pressure without undesirable side-reactions. A new approach to the problem hag resulted from basic research on serotonin and epinephrine, These substances, which influence blood pressure, heart rate, and other in- voluntary functions, are destroyed in the body by an enzyme, mono- amine oxidase. Studies of a powerful drug that counteracts this enzyme have shown that it produces marked lowering of blood pressure in patients with hypertension. Its favorable effects are similar to those of certain drugs currently in use, but it does not produce their unwanted side-effects. While it is too early to determine its place in therapy, the findings indicate that monoamine oxidase inhibition is a promising area of exploration. Arteriosclerosis, with its serious consequences such as heart attacks and strokes, is one of the major unsolved problems in medicine. While considerable advances have been made in the management and treat- ment of its complications, including such developments as the use of anticoagulants in coronary disease, arteriosclerosis itself has remained essentially baffling. In the past few years, however, research has uncovered clues that appear to be significant. Studies relating to diet, fat metabolism, hormones, heredity, and other possibly causal factors have been productive. The association between fats and diet and arteriosclerosis have been particularly strengthened by many investi- gations. A recent technical development promises to be of great importance in furthering research on this aspect of the problem, which has been impeded by the lack of suitable methods for analyzing fats in the diet and in fatty deposits in the blood vessels. The usefulness of gas chromatography has been limited because the means for de- tecting fatty acid vapors have not been sensitive enough. Anew detec- tion device, based on the properties of electric discharge in helium gas, has been developed which may overcome this obstacle. The new device is approximately 300 times as sensitive as those hitherto available, and will make possible much fruitful research that could not be done a few months ago. It is hard for the Committee to understand a budget submission that would obviously seriously hamper this type of progress. Dow- ever, it was developed in the hearmgs that the budget would fall short by almost $2,000,000 of financing just the continuation of cur- rent projects under research grants plus the approved grants now on hand but unfinanced due to lack of funds, and, of course, no funds would be available for new project applications that will be submitted during the next year. The Committee believes that adequate pro- vision is made in the bill to correct this situation and to assure a continuation of the type of progress set forth above. Dental health activities —The bill includes $9,725,000, $2,305,000 above the amount requested, and $2,305,000 above the amount appro- priated for 1959. The economic significance of dental disorders to the nation is clearly illustrated by the simple statistics. The cost of dental care is well over 1% billion dollars per year. It is difficult to estimate how much 22 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS mere this cost would be if it were not for just one phase of research in this field—the research in the effect of fluorides on tooth decay. Itis certainly being on the conservative side to say that the annual savings amount to many times the annual appropriations to this Institute. Though the causes of oral disease still elude dental investigators, many leads developed recently are now under intensive study. For example, limited data from laboratory studies indicate that dental caries in experimental animals is transmissible and that it might be considered a contagious disease under certain conditions. These and other significant observations have opened for consideration the influence of bacteria on caries susceptibility. In the field of germ-free studies, it is now well established that germ-iree rats do not develop dental caries even when maintained on diets which consistently produce severe caries in conventional animals. In recent studies by this Institute’s scientists, dental caries has been successfully produced in germ-free animals by inoculating them with a single pure strain of streptococci bacteria isolated from rats with caries. ‘Theso findings suggest that this family of bacteria, together with others, hitherto ignored in studies of the causes of tooth decay, definitely warrant further study. In the field of nutrition, current and past investigations using cer- tain mineral phosphates as a dietary supplement to bread have con- sistently demonstrated an inhibiting effect on both the severity and incidence of tooth decay in test animals. A better understanding of this relationship and its application as a dental public health measure needs to be explored in large-scale clinical tests. At essentially the same stage of progress that the waterborne fluorides were in the begin- ning years of research, these phosphate studies are showing similar potential as an effective dietary control of human dental caries. With these promising leads, and with the appropriation for this Institute amounting to considerably less than one percent of the annual cost of the disorders with which it deals, it seems almost inconceivable that a budget would be submitted that would cut back the level of activities. That such a budget was submitted is clearly shown by the Committee’s hearings. The Committee will expect that, with the increase recommended in the bill, adequate support will be given the follow-up of these research findings. Arthritis and metabolic disease activities.—The bill includes $37,790,000, $6,575,000 above the amount requested, and $6,575,000 above the amount appropriated for 1959. Research progress against the rheumatic and metabolic diseases, including arthritis, rheumatism, gout, diabetes, and disorders of the gastrointestinal tract, has continued during the past year. Significant advances continue to be made and the benefits are cumulative. Over balf a million diabetics, for instance, are now using oral medication, eliminating the need for hypodermic syringes. Findings and develop- ments in rheumatic disease research enable victims who might once have become hopeless cripples, to go about their daily business and continue to lead useful lives. The chronic, lifetime diseases under study by this Institute are among the most bafiling and difficult facing medical science today. That is why, though important and impressive developments have been and will continue to be made which are immediately applicable to the treament of specific diseases, it is necessary that this Institute LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 23 continue to emphasize the importance of basic research. It is basic research which will provide the new knowledge which will lead to the ultimate answers. Arthritis in particular poses a growing problem in our aging popu- lation. It is significant that a recent study of those over 60. years of age showed that 97 percent become victims of some form of arthritis. it is now ten years since the discovery of the effectiveness of cor- tisone in the treatment of rheumatoid arthritis, and improvements in corticoid and other antirheumatic drugs continue te be made. A new steroid drug, dexamethasone, is now on the market. In tests at the Institute it has been shown to be more potent than previously used drugs in the treatment of rheumatoid arthritis. Although it is not free of side effects, it is a step forward. Work of a more basic nature during the past year has been directed toward determining the precise nature of the “rheumatoid factor” which is present in the blood of rheumatic patients, and a new and accurate method has been developed to measure it. As a result of this Committee previously recommending appropri- ation of more funds than were requested and suggesting that this Institute start a program in gastroenterology, good progress has also been made in that field. The Committee will expect that this Institute continue to place emphasis on the development of better oral medication for diabetes, the relatively new program in gastroenterology, and the even more recent research program on cystic fibrosis which the Committee had started last year. Allergy and infectious disease . activities—The bill includes $30,286,000, $6,215,000 above the request, and $6,215,000 above the amount appropriated for 1959. Infectious and allergic diseases are tremendously costly in terms of dollars and human distress. Acute respiratory diseases, to mention a single group, are by far our most prevalent illnesses. In a single year, there were 284 million cases involving disability or medical attention, according to a recent report by the National Health Survey. The respiratory diseases alone cost industry billicns annually, reduce the effectiveness of our schools, and represent a yearly medical bill of about $3 billion. Appropriations to this Institute have assisted in the development of vaccines in this area and, if this research is adequately supported, it is only a matter of time until vaccines will be available to protect against many respiratory diseases. It is apparent that the economic burden of respiratory disease far exceeds the probable cost of the medical research which would prevent much of it. Promising research is also in progress on a vaccine for tuberculosis. The Committee has received reports on this for the last three years but progress has been disappointingly slow. It is hoped that the increase provided in the bill will be used in part to speed the develop- ment of this vaccine. Allergic diseases are the third most prevalent of all chronic illnesses. By conservative estimates, 17 million of our people are afflicted, many with serious disabilities. Recent progress has been made in purifying allergy immunizing agents and in improving treatment techniques but this research has been sadly neglected until very recently. The Com- mittee expects some added work in this area under the increase pro- posed in the bill, 24 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS It is becoming increasingly obvious that antibiotic therapy has by no means provided a panacea in the area of infectious diseases. ‘The recent emergence of staphylococcal strains resistant to antibiotics is regarded by many hospitals as the most immediately urgent of all problems in this area. These infections are hazardous, often deadly, and they greatly increase the cost of medical care. The number of deaths from staphylococcal septicemia, or blood poisoning, has increased almost 200 percent since 1949. Only a beginning has been made in understanding the mechanisms of antibiotic resistance and of infection by the staphylococci. In this, as in so many other areas of medical research, the budget failed to give recognition to the need under the policy of holding to the 1959 level, dollarwise, without regard to Increased costs, needs or any other factor. The Committee believes this has been corrected in the bill. Neurology and blindness actimties—The bill includes $33,613,000, $4,210,000 above the request, and $4,210,000 above the amount appropriated for 1959. There are some 200 disorders that afflict the central nervous system or the eyes and ears. They constitute the third ranking cause of death and the leading cause of permanent disability. Included are some of mankind’s most dreaded afflictions: cerebral palsy, muscular dystrophy, multiple sclerosis, Parkimson’s disease, epilepsy, and many conditions causing blindness and deafness. While this is a relatively new Insti- tute, the progress made in the past few years in getting intensive research and necessary research training underway is heartening and has brought these activities to the point where expansion in the next fiscal year is both possible and critically needed. Hlowever, it should not be inferred that there have not been actual accomplishments as well as a base laid for the future. Certainly the accomplishments of this Institute offer proof of concrete accomplish- ments for the money invested. These accomplishments have been’ great not only from a humanitarian point of view but from a straight dollar and cents point of view. The taxpayer has clearly gotten his money’s worth many times over. The results of increased expendi- tures have clearly been anti-inflationary. The wisdom of adequate investments in research on neurological diseases is shown by a few illustrations of the cost of these illnesses and examples of how research is already paying off. Epilepsy, with some 1,700,000 victims in the United States, has been estimated to cost the nation more than $80,000,000 annually. Because of new medical and surgical treatments, developed through research, approximately 80 percent of epileptics can now be helped and can be capable of regular productive employment. These people are no longer a drain on the economy but are producing and paying taxes. Another illustration is in the field of blindness. An estimated 70 million people have some eye defect, with 334,000 “legally” blind and 1,300,000 blind in one eye. Glaucoma and cataracts are a severe problem and afflict individuals increasingly as they age. During the recent past, however, much progress has been made. Perhaps, the most outstanding concerns retrolental fibroplasia, which has been the prime cause of blindness among infants. Research conducted with funds from this appropriation found the cause, and, in one year, New York City hospitals reported a 78 percent-drop in blindness in prema- ture babies. For all practical purposes, this disease has now been LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 25 eliminated. Again, leaving aside the wonderful advance this is from a humanitarian point of view, the savings in dollars and cents would undoubtedly pay the entire cost of this Institute’s activities. There are some 4.5 million persons who are mentally retarded and 500,000 or more have cerebral palsy. The cost of care for cerebral palsy victims has been estimated at $216,000,000 a year, and estimates show $5,000,000,000 in tax revenue alone is lost from the cerebral palsied from what would be produced by an average adult productive life span of 30 years. Research findings are already making some inroads on this enormous loss and further gains can be expected from greater knowledge through research. Very recent scientific advances further emphasize the pay-off potential’ from research investments. New knowledge has been developed concerning the formation of the nerve fiber sheath that disintegrates in multiple sclerosis and on the synthesis of a chemical that makes up part of the sheath. New leads also have recently been found to mongolism, which involves some 4,200 children born each year with this condition, through new techniques in the tissue culture of body cells from bone marrow. Tt has also been learned that there are many more cases of jaundice of the newborn, which causes brain damage, than had been thought— a discovery which may permit remedial steps early in life. Further progress has been made in central nerve tissue regeneration, in im- provements in hypothermia or lowered-temperature surgery for brain tumors and accidents, and in new operations for eye cataracts and the treatment of retina conditions by a method known as light coagulation. Progress has been made through studies in hearing and speech disorders, with new surgery devised and with basic knowledge devel- oped on the nerve pathways by which the brain controls the sensi- tivity of hearing. Brain tumor detection is expected to be aided by the further development of a new device found to be nearly 90 percent effective; this diagnostic aid is passing into the stage of clinical use. These are indications of progress in diseases by which an estimated 20,000,000 Americans are afflicted. They show real accomplishments from which the people and the Nation are benefiting right now. And they indicate vastly greater accomplishments and greater benefits for the future if we are willing to make the modest investment to assure progress instead of taking the obviously backward step proposed in the budget. Again the Committee believes this has been corrected in the bill it recommends. Grants, construction of research facilities—The bill includes $30,000,000, an increase of $10,000,000 over the request, and the same amount as was appropriated for 1959. It has become increasingly obvious as progress has been made in this program that the authorization of a maximum appropriation of $30,000,000 is woefully inadequate so far as meeting the need is concerned. It is almost inconceivable that, with this situation existing, the Budget would recommend that even that amount be reduced in the appropriation. It was testified that every cent of the appropriations made to date have already been obligated and no additional applications can be financed until funds carried in this bill are made available. It was testified that the total of the unfinanced applications on hand plus the formal notices of intention to apply for these grants totals almost $77,000,000. It is thus obvious that even the amount provided in the bill will fall far short of financing applica- 26 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS tions now under consideration, let alone providing for any new applications which are initiated in 1960. It was repeatedly testified both by officials of the Public Health Service and by some of the nation’s leading research doctors outside of government that the current shortage of adequate research facilities is hampering the total research program of the nation. It was also testified that these Federal funds are matched on an average of about five to one; thus an additional appropriation of $30,000,000 will mean approximately $180,000,000 of additional or more nearly adequate research facilities. In the opinion of the Committee, this is one of the most important items in the budget for the Public Health Service. Construction of animal quarters, Hamilton, Montana.—The Com- mittee has disallowed $150,000 requested for this item. There was no explanation of the reason for the Administration deviating from its construction policy with regard to this item which was considered in connection with the bill for 1959, but which was deleted by the House-Senate conference committee. Research facilities, construction and site acquisition —The bill in- cludes $150,000, the amount requested, for acquiring a site outside the metropolitan area for large animals necessary for the research program of the National Institutes of Health. Operations, National Library of Medicine.—The bill includes $1,566,000, the amount of the budget request, and $40,000 over the amount appropriated for 1959. Salaries and expenses —The bill includes $5,816,000, the amount of the request and $150,000 over the amount appropriated for 1959. 8ST. ELIZABETHS HOSPITAL Salaries and expenses.—The bill includes $3,715,000, the amount of the request and $308,000 above the amount appropriated for 1959. The major part of the increase is to cover mandatory costs and the cost of staffing the new maximum security building. Major repairs and preservation of buildings and grounds.—The bill includes $330,000, the-amount of the request, and $243,000 over the amount appropriated for 1959. SOCIAL SHCURITY ADMINISTRATION Salaries and expenses, Bureau of Old-Age and Survivors Insurance.— The bill includes authorization to spend $191,600,000 from the Trust Fund, the amount requested, and $20,379,000 over the amount ap- proved for 1959. All of the increase is due to mandatory cost items and increases in workload with the exception of $10,000,000 which is included as a contingency fund. The bill contains language which limits the use of this fund to just the one purpose of processing increased claims work- loads that could not be anticipated in the budget estimates and only after maxiraum absorption of these costs had been achieved. This contingency fund will make it possible to avoid some of the serious backlogs of work that have built up in the past due to unforeseeable increases in workload caused by such things as changes in basic legis- LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 27 lation which often precede by several weeks or even months, the sup- plemental appropriations to take care of the increased workload. Grants to States for publie assistance-—The bill includes $2,033,- 500,000 the amount of the request and $75,540,000 above the amount appropriated for 1959. Under the basic social security legislation this is practically a contractual obligation against the Federal Govern- ment if the estimates submitted by the Department are accurate. On the basis of the detail submitted to the Committee and the hearings on this subject the Committee could see no reason to question them. Salaries and expenses, Bureau of Public Assistance-—The bill con- tains $2,345,000, the amount of the request, and $178,500 above the amount appropriated for 1959. Salaries and expenses, Children’s Bureaw.—The bill includes $2,- 300,000, the amount of the budget request and $128,000 above the amount appropriated for 1959. Grants for maternal and child welfare —The bill includes $46,500,000, an increase of $3,000,000 over the request and $1,500,000 over the amount appropriated for 1959. Only last year the Congress approved an increase of $5,000,000 in each of the three categories, Maternal and Child Health Services, Crippled Children’s Services, and Child Welfare Services. Many Members of Congress and leaders in this field felt that due to the substantial increase in child population since the previous increase in authorizations, and the seriousness of the problems dealt with under this program, the increases in the au- thorization should have been still larger. The budget gave no recog- nition whatsoever to the increased need or to the recent action of ‘Congress in increasing the authorization for appropriations. The Committee will expect the Children’s Bureau, both in the ad- ministration of these grants, and in connection with activities under the salaries and expenses appropriations, to intensify efforts to assure that all children, regardless of their ability to pay, receive the benefits of poliomyelitis vaccinations. Salaries and expenses, White House Conference on Children and Youth.—The bill includes $200,000 the amount of the request and $50,000 above the amount appropriated for 1959. The Committee was surprised to learn that there are some States who use Federal funds made available to them under the appropriation “Grants for maternal and child welfare,” rather than their own State funds, to finance the State conferences which precede the White House Con- ference. The Committee feels that the Social Security Administra- tion should discourage this practice. Certainly if these conferences are important to the children and youth of the State, then the State should be willing to bear this small cost from their own funds. The Committee is especially opposed to the use of any Federal funds to pay the travel costs for delegates to attend the White House Con- ference in Washington, D.C. Grants for social security training and studies —The Committee has not allowed the request for $1,785,000 for this new program. Salaries and expenses, Office of the Commissioner.—The bill includes $337,000 and authority to transfer $276,000 from the OASI trust fund, the amounts in the request, and a reduction of $5,000 and an increase of $7,500 respectively from the amounts appropriated for 1959. 28 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS OFFICE OF THE SECRETARY Salaries and expenses —The bill includes $2,061,000 and authoriza- tion to transfer $302,500 from the OASI trust fund, a reduction of $90,000 and $15,560 respectively from the request and an increase of $90,006 and $15,500 respectively above the amounts appropriated for 1959. Office of Pied Administration—The bill includes $2,735,000 and authority to transfer $926,000 from the OASI trust fund, the amount in the requests and an increase of $178,000 and $54,800 respectively over the amounts appropriated for 1959. The only program increase of significance is for auditors necessary to audit the payments made under the grant-in-aid programs which have expanded substantially during recent years. As a result of the Committee having been advised that the Depart- ment had under consideration, in connection with another Federal agency’s activities, the possibility of realigning their field organiza- tion, questions were raised about this matter during the hearings. It was testified that there are no funds in the 1960 budget submission for any major realignment of the field operations. Inasmuch as any such reorganization not only directly involves the expenditure of funds but may well have an even greater indirect influence through its effect on the efficiency of program operations, the Committee will expect that no such reorganization be accomplished without a prior submission of the particulars to this Committee. Office of the General Counsel.—The bill includes $589,700 and authority to transfer $537,200 from other accounts, a reduction of $29,390 and $8,800, respectively, from the request and an increase of $29,300 and $8,800, respectively, above the amounts appropriated for 1959. Surplus property utilization.—T he bill includes $703,000, the amount of the request and $16,600 above the amount appropriated for 1959. White House Conference on Aging.—The bill includes $452,000, the amount of the request and $438,000 less than the amount appropriated for fiscal year 1959. There has been much talk during the last several years concerning the problems of the aging in this country but so far tangible action to do something about solving these problems has been hardly noticeable. All groups interested in this problem, in fact the whole Nation, is look- ing to this conference to be the greatest forward step that has yet been made. The Committee was pleased to note that the Department is recog- nizing the importance of this conference to the extent that the Under Secretary is personally spending a considerable amount of her time on the preparations for the conference and that the very able Special Staff on Aging is concentrating on this ahead of all of their other ac- tivities. The Committee trusts that the Department will maintain and.even intensify their activities so as to assure that this is the best possible conference. The Committee also recognizes that it is even more important that the States and localities take an active part in the preparations for the LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS 29 national conference.- It is hoped that the Department will make special efforts to encourage active participation in the planning of this conference at these levels where any action programs that may be developed will eventually have to be carried out. In this connection it is hoped that the States and localities will be sufficiently cognizant of their responsibilities that they will not depend to any large degree on the relatively small Federal grant to finance their activities in preparing for and participating in the White House Conference. As mentioned in connection with the White House Conference on Children and Youth, the Committee would look with disfavor upon the use of Federal funds to pay the travel expenses of delegates to the national conference. TITLE ITT—NATIONAL LABOR RELATIONS BOARD Salaries and expenses —The bill includes $14,230,000, the amount of the request and $973,400 above the amount appropriated for 1959. The amount provided is sufficient only to cover mandatory cost in- creases and to provide stflicient funds to support for the full fiscal year 1960 the new positions which were provided for in 1959 for only a portion of the year. No new positions are anticipated under the Committee’s recommendation. TITLE IV—NATIONAL MEDIATION BOARD Salaries and expenses —The bill includes $1,357,000, the amount of the budget request, and $15,200 above the amount appropriated for 1959 TITLE V—RAILROAD RETIREMENT BOARD The bill includes authorization to use $9,460,000 from the trust fund, the amount of the request and $85,700 above the amount al- lowed for 1959. In the hearings with the Railroad Retirement Board last year there was considerable discussion concerning the legal obligations of the Federal Government to reimburse the Railroad Retirement Trust Fund for military service credits due under the Railroad Retirement Act. The Committee was disappointed that the budget for 1960 did not include funds for this purpose. The Committee will expect that the Railroad Retirement Board and the Bureau of the Budget make a thorough study of this, and that the 1961 budget include provision for discharging the Federal Government’s obligations under the law. TITLE VI-FEDERAL MEDIATION AND CONCILIATION SHRVICE Salaries and expenses —The bill includes $3,905,400, a reduction of $43,600 from the request, and $26,800 more than the appropriation for 1959. The reduction recommended is equal to the nonrecurring expenses for rents and equipment which occurred in the current fiscal year. 30 LABOR-HEALTH, EDUCATION, WELFARE APPROPRIATIONS TITLE VII~INTERSTATE COMMISSION ON THE POTOMAC RIVER BASIN Federal contribution.—The bill includes $5,000, the amount of the request, and the same as the amount appropriated for 1959. TITLE VIII—U.S. SOLDIERS’ HOME Limitation on operation and maintenance and capital outlay.—The bill includes authorization to utilize $10,948,000 from the permanent fund, the amount of the request, and $5,416,500 over the amount authorized for 1959. The increase is accounted for largely by the amount of $5,587,000 earmarked for construction of a new domiciliary building and a hospital wing to enable the home to care for the in- creasing membership. This compares with $434,630 which was carried in the appropriation for 1959 for construction activities. Limrrations anp Lueisnative Provistons The following limitations and legislative provisions not heretofore carried in connection with any appropriation bill are recommended: On page 10, in connection with “Bureau of Employees’ Compensa- Hon, Employees’ compensation claims and expenses”, Department of abor: Provided, That, in the adjudication of claims under section 42 of the said Act of 1916, for benefits payable from this appropria- tion, authority under section 82 of the Act to make rules and regulations shall be construed to include the nature and extent of the proofs and evidence required to establish the right to such benefits without regard to the date of the injury or death for ‘which claim is made. On page 11, in connection with “Bureau of Labor Statistics, Revision of the Consumer Price Index”, Department of Labor: including temporary employees at rates to be fixed by the Secre- tary of Labor without regard to the civil service laws and Classification Act of 1949, as amended On page 32, in connection with “Social Security Administration, Limitation on salaries and expenses, Bureau of Old-Age and Sur- vivors’ Insurance”, Department of Health, Education, and Welfare: Provided further, That $10,000,000 of the foregoing amount shall be apportioned for use pursuant to section 3679 of the Revised Statutes as amended (81 U.S.C. 665), only to the extent necessary to process claims workloads not anticipated in the budget estimates and after mazimum absorption of the costs of such claims workload within the existing limitation has been achieved PERMANENT APPROPRIATIONS, GENERAL AND SPECIAL FUNDS Agency and item Appropriated, 1959 Estimates, 1960 Increase (++), decrease (—) Office of Education: Payments to States and Territories for colleges of agriculture and mechanic arts (act of Mar. 4, 1907).-..------.------- $2, 550, 000 $2, 550, 000 j---.-...------------ Payments to States for promotion of vocational education (act of Feb. 23, 1917)-.-.-----.------------------------ 7, 188, 331 7, 188, 331 |-------------------- Total... .-- +--+ ee wee eee ene eeene 9, 688, 331 9, 688, 331 |-.--.--------------- SNOLLVINGOUdIY WUVAITEM ‘NOILVORGR “ELVIVEH-SOaVI Te TRUST FUNDS [Not a charge against general revenue} Agency and item Estimates, 1959 Estimates, 1960 Increase (-+), decrease (—) DEPARTMENT OF LABOR Bureau of Employees Compensation: Relief and rehabilitation, Longshoremen’s and Harbor Workers’ Compensation Act, as amended Relief and rehabilitation, Workmen’s Compensation Act, within the District of Columbia_..2..-..-.20-.---u-- Administration of the District of Columbia Workmen’s Com- pensation Act... nee ee ne eee Bureau of Labor Statistics: Special statistical work...........-.. Total, Department of Labor......-__--.---- sue ee DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Freedmen’s Hospital, conditional gift fund_....-.....-..--...-_. Patients’ benefit fund, Public Health Service hospitals... 022 Public Health Service conditional gift fund_......-..-..--.. $71, 500 $71, 500 |ow. 5, 000 5,000 |. 243, 600 243, 600 |..-.--.---- 57, 839 5, 181 —$52, 658 377, 939 325, 281 —52, 658 8,074 |e —8, 074 25, 000 25,000 |... ------ 125, 000 102, 000 —23, 000 6, 000 6,000 |. 600 600 |_oo wee ee 1,017 |... —1, 017 165, 691 133, 606 —32, 091 oe SNOILVINdOUddV GUVAIEM ‘NOLLVOOGE ‘HLLIVaH-WOaver RAILROAD RETIREMENT BOARD Railroad retirement account...-..---.--...-----4= Railroad Unemployment Insurance Administration Fund__..-.-.. Total, Railroad Retirement Board_.....-~. Total trust funds, all agencies.........--..- 778, 133, 992 815, 460, 000 +37, 326, 008 9, 513, 940 8, 527, 002 — 986, 938 787, 647, 932 823, 987, 002 +36, 339, 070 788, 191, 562 824, 445, 883 +36, 254, 321 SNOLLVINdGOWUddY GUVAIIGM ‘NOLLVOOa “ELLUIVEH-uoaVT && COMPARATIVE STATEMENT OF APPROPRIATIONS FOR 1959, ESTIMATES FOR 1960, AND AMOUNTS RECOMMENDED IN THE BILL FOR 1960 TITLE I—-DEPARTMENT OF LABOR Agency and item Appropriations, 1959 1 Estimates, 1960 Ea Tth in bill Bill compared with 1959 appropriations 1900 estimate 4 OFFICE OF THE SECRETARY Salaries and expenses_...---.-.--------=-- $1, 590, 500 $1, 621, 000 $1, 611, 000 +$20, 500 + $10, 000 OFFICE OF THE SOLICITOR Salaries and expenses__.--...-.--------=- 2, 621, 800 2, 695, 000 2, 695, 000 +73, 200 |_----.--------. BUREAU OF LABOR STANDARDS ° Salaries and expenses.....-.------------- 1, 724, 600 2, 680, 000 2, 488, 000 -++768, 400 —192, 000 BUREAU OF VETERANS’ REEMPLOYMENT RIGHTS Salaries and expenses......-------------- 583, 400 592, 000 592, 000 +8, 600 |--.--2-----.---- BUREAU OF APPRENTICESHIP AND TRAINING Salaries and expenses_.....-.-.----..---- 3, 992, 500 4, 047, 000 4, 047, 000 +54, 500 |_..----.-------- BUREAU OF EMPLOYMENT SECURITY Salaries and expenses....------- wenn eee ee 7,991, 800 7, 262, 000 7, 262, 000 +-170, 200 |-.------.--.---- Grants to States..-..-. Lee ean eee ee Loo mm 325, 600, 000 328, 684, 000 315, 819, 000 —9, 781, 000 —12, 865, 000 SNOLLVIUGOUddY TUVAITM ‘NOILVOOaS “ELLIVEH-yOSVI © VE Unemployment compensation for veterans and Federal employees. ....---.---.--- Mexican farm labor program: Compliance activities.....-..---~< oe Salaries and expenses (transfer from revolving fund)_...-.-..------- = Total, Bureau of Employment Seeurity..--------.-.-------- BUREAU OF EMPLOYEES’ COMPENSATION Salaries and expenses: Direct appropriation.......----.-<.--+ Transfer from War Claims Fund.._..- Employees’ compensation fund (indefinite)- Total, Bureau of Employees’ Com- pensation_......------.---.---- BUREAU OF LABOR STATISTICS Salaries and expenses_....-.--.-.-----...-- Revision of the Consumer Price Index_..-. Total, Bureau of Labor Statisties._.- WOMEN’S BUREAU Salaries and expenses.....-.-------2------ 160, 800, 000 135, 000, 000 125,000,000 | —35, 800, 000 —10, 000, 000 515, 700 873, 000 373, 000 +357, 300 |..--.-------- eae [1, 667, 000] [1, 336, 700] [1, 336, 700] [—330, 300]}_..----.------_. 494, 007, 500 471, 819, 000 448, 954,000 | —45, 053, 500 —22, 865, 000 3, 041, 900 3, 080, 000 3, 080, 000 +38, 100 |o-2---nnnnneno ee [51, 090] [51, 700] [51, 700] [+610]|-.-..----------- [71, 900, 000] [62, 000, 000] [62, 000, 000]} + [—9, 900, 000]|....-.---...---. 3, 041, 900 3, 080, 000 3, 080, 000 +38, 100 |..-.---.-------- 7, 960, 000 9, 465, 000 9, 419, 500 +1, 459, 500 —45, 500 ve eeeeecnecene 230, 000 230, 000 +230, 000 |... 7, 960, 000 9, 695, 000 9,649,500 | +1, 689, 500 —45, 500 501, 600 509, 000 509, 000 +7, 400 |_.------------ ee 1 Includes funds contained in the Second Supplemental Appropriation Bill, 1959, as passed the House. SNOLLVIUAOUdAY WUVITIM ‘NOLLVONGE SHLVIVEH-SOaVI cE Comparative statement of appropriations for 1 959, estimates for 1960, and amounts recommended in the bill Sor 1960—Con.; TITLE I—DEPARTMENT OF LABOR—Continued Bill compared with— Agency and item Appropriations, 1959 1 Estimates, 1960 Recommended in bill 7 1959 appropriations 1960 estimate WAGE AND HOUR DIVISION Salaries and expenses___.....-----ee-0---- $11, 325, 300 $11, 489, 000 $11, 489, 000 + $163, 700 |_-20202 02k. Total, direct appropriations. _______ 527, 349, 100 508, 227, 000 485, 114, 500 — 42, 234, 600 — $23, 112, 500 Indefinite appropriation..........-....._- 71, 900, 000 62, 000, 000 62, 000, 000 —9, 900, 000 [-_-- 2 Total, direct and indefinite appropri- ations, Department of Labor. __._ 599, 249, 100 570, 227,000 547, 114, 500 — 52, 134, 600 — 23, 112, 500 TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE AMERICAN PRINTING HOUSE FOR THE BLIND Education of the blind__...-...-..0-___.- $400, 000 $400, 000 $400, 000 |..---.--- |e ween eee FOOD AND DRUG ADMINISTRATION Salaries and expenses._........----.-0---- 10, 872, 000 11, 800, 000 13, 800, 000 +$2, 928, 000 +$2, 000, 000 Certification and inspection__....-....-.- [1, 380, 000] [1, 410, 000] [1, 410, 000] {+30, 000]|.---2--2 ee Total, Food and Drug Administra- : tion_ ~~. eee 10, 872, 000 11, 800, 000 18, 800, 000 +2, 928, 000 +2, 000, 000 FREEDMEN’S HOSPITAL Salaries and expenses......-.-.----ne0--- 3, 091, 000 3, 190, 000 3, 190, 000 +99, 000 |..-2- 9& SNOLLVIUdOUddVY FUVATGM ‘NOILVOOGS ‘HLIVaH-wogvtT GALLAUDET COLLEGE Salaries and expenses... ane sat ne Construction......0-.022 lo eee eee HOWARD UNIVERSITY Salaries and expenses............ tween Plans and specifications......-.2-..-.-2.- Construction of auditorium—fine arts building. ..-.---.-.-.---------------- Total, Howard University OFFICE OF EDUCATION Grants for library services.......-------- Payments to school districts_.........--.- School construction.......---.2...------ Expansion of teaching in education of the mentally retarded___.....------.-...-- Salaries and expenses__.......2..--0e----- Total, Office of Hducation.........- 849, 000 892, 000 904, 000 +55, 000 +12, 000 123, 000 150, 000 300, 000 +177, 000 +150, 000 972, 000 1, 042, 000 1, 204, 000 +232, 000 +162, 000 4, 350, 300 4, 617, 000 4, 617, 000 +266, 700 |.....----------- 123, 000 21, 000 21, 000 — 102, 000 |... eee 163, 000 860, 000 860, 000 +697, 000 |... 4, 636, 300 5, 498, 000 5, 498, 000 +861, 700 |... 22-22. eee 232, 618, 581 32, 602, 081 33, 702, 081 +1, 083, 500 +1, 100, 000 2, 501, 500 2, 501, 500 2, 501, 500 |e eee eee 6, 000, 000 5, 150, 000 6, 000, 000 |......---------- +850, 000 150, 000, 000 142, 300, 000 163, 957,000 | +13, 957, 000 +21, 657, 000 75, 400, 000 38, 500, 000 61, 135,000 | —14, 265, 000 4-22, 635, 000 115, 300, 000 150, 000, 000 150, 000, 000 +34, 700, 000 ween eee ew wenn nee 1, 000, 000 1, 000, 000 +1, 000, 000 |....------------ 9, 627, 500 12, 800, 000 12, 800, 000 4-3, 172, 500 |....-----.--- eee 391, 447, 581 384, 853, 581 431, 095, 581 +39, 648, 000 +46, 242, 000 ? Includes funds contained in the Second Supplemental Appropriation Bill, 1959, as passed the House. 2 Excludes $1,131,500 transferred to Public Health Service in Second Supplemental Appropriation Bill, 1959. GH-YOavt a ‘ALI’ SNOLLVINdOUddV DUVATGM ‘NOLLVOOAa LE Comparative statement of appropriations for 1959, estimates for 1960, and amounts recommended in the bill for 1960—Con. TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Ageney and item Appropriations, 1959 1 Estimates, 1960 Recommended in bill Bill compared with— ‘ for 1900 1959 appropriations 1960 estimate OFFICE Of VOCATIONAL REHABILITATION Grants to States_.....-----------+------ $51, 600, 000 $51, 900, 000 $51, 900, 000 +$300, 000 |_..0-2-.---.-.. Research and training...-.-.-.-.-------- 4, 800, 000 12, 500, 000 12, 500, 000 +7, 700, 000 |_-..-2-.-.-.--.- Salaries and expenses.-...-.-.----------- 1, 515, 000 1, 738, 000 1, 738, 000 + 223, 000 |--ow Le Total, Office of Vocational Rehabil- tation... ene ee eee nen 57, 915, 000 66, 138, 000 66, 138, 000 +8, 223, 000 [-...2-.--- eau PUBLIC HEALTH SERVICE Assistance to States, general............-- 23, 639, 000 22, 497, 000 22, 497, 000 —1, 142, 000 |-_oee Grants and special studies, Alaska_...-.-- 2, 188, 500 |. ne nee en een ee een — 2, 188, 500 |. Construction of mental health facilities, Alaska_._2.2 22 -.-e nen e eee ene 6, 500, 000 |---| eee eee ee — 6, 500, 000 |_- nen nae Control of venereal diseases........-.---- 5, 400, 000 4, 673, 000 5, 400, 000 wowace neeeeeenne +$727, 000 Control of tuberculosis.......0......--.-- 6, 501, 000 5, 452, 000 5, 452, 600 —1, 049, 000 |_oee Communicable disease activities.....-..-- 6, 890, 000 8, 015, 000 8, 015, 000 +1, 125, 000 |__-- wee Equipment, Communicable Disease Center-_ 1, 700, 000 |_-__._-..-------|----- eee —1, 700, 000 |. Sanitary engineering activities_........-.-- 13, 256, 000 14, 275, 000 14, 590, 000 +1, 334, 000 +315, 000 88 ‘NOILVONGT “HLIVEH-MOIVT SNOILVIUdOUddV TUVTIEM Grants for waste treatment works con- struction... 0.2 - en eee eee eee Grants for hospital construction.-.......--- Salaries and expenses, hospital construc- tion services..-.------.--~~----------- Hospitals and medical care..__..._..----- Foreign quarantine activities. .....-...---- Indian health activities....-....-.------- Construction of Indian health facilities..._ National Institutes of Health: General research and services.-.----..- National Cancer Institute_...-...-.-- Mental health activities_........------ National Heart Institute.......---.-- Dental health activities............--- Arthritis and metabolic disease activi- Allergy and infectious disease activities Neurology and blindness activities. .- Grants, construction of research facili- ties... ene ene ee nee 45, 000, 000 186, 200, 000 1, 635, 000 50, 624, 000 4, 348, 000 42, 327, 000 5, 824, 000 28, 974, 000 75, 268, 000 52, 419, 000 45, 613, 000 7, 420, 000 31, 215, 000 24, 071, 000 29, 403, 000 30, 000, 000 20, 000, 000 101, 200, 000 1, 604, 000 45, 600, 000 4, 460, 000 43, 500, 000 3, 087, 000 28, 974, 000 75, 218, 000 52, 384, 000 45, 594, 000 7, 420, 000 31, 215, 000 24, 071, 000 29, 403, 000 20, 000, 000 45, 000, 000 143, 700, 000 1, 604, 000 45, 600, 000 4, 460, 000 45, 600, 000 4, 587, 000 36, 404, 000 83, 308, 000 60, 409, 000 52, 744, 000 9, 725, 000 37, 790, 000 30, 286, 000 33, 613, 000 30, 000, 000 — 42, 500, 000 —31, 000 —5, 024, 000 +112, 000 +3, 173, 000 —1, 237, 000 +7, 430, 000 +8, 040, 000 +7, 990, 000 +7, 131, 000 +2, 305, 000 +6, 575, 000 +6, 215, 000 +4, 210, 000 sew en eee ena 1 Includes funds contained in the Second Supplemental Appropriation Bill 1959 as passed the House. -+ 25, 000, 000 +42, 500, 000 +2, 000, 000 +1, 500, 000 +7, 430, 000 +8, 090, 000 +8, 025, 000 +7, 150, 000 +-2, 305, 000 -+6, 575, 000 +6, 215, 000 +4, 210, 000 +10, 000, 000 SNOLLVINdOUddY TUVTIGM ‘NOLLVOOGGE. “ELLIVaH-HOaVI 68 Comparative statement of appropriations for 1 959, estimates for 1960, and amounts recommended in the bill for 1960—Con. TITLE I—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1989 1 Estimates, 1960 Recommended in bill Bill compared with— for 1960 we ee 1959 appropriations 1960 estimate PUBLIC HEALTH SERVICE—continued National Institutes of Health—Continued Construction of animal quarters, So Hamilton, Montana__....22....---|---ceuncece cee $150, 000 |. ene el eee ~~ $150, 000 Research facilities construction and site acquisition........---...---.--|-.-.--------- 150, 000 $150, 000 +$150, 000 |_-- oe Construction of dental research build- ING... wee ee ene ee $3, 700, 000 |_...-2- ween |e eee —3, 700, 000 j_.o oe General office building....--...022o.. 9, 625, 000 |_| eee —9, 625, 000 |__-2 ee Operations, National Library of Medicine_. 1, 526, 000 1, 566, 000 1, 566, 000 +40, 000 |e ene Construction of library facilities. ._ eon 6, 950, 000 |_2 een eee nn (pee eee —6, 950, 000 |... ene Retired pay of commissioned officers (indefinite appropriation) _.....-....._- [1, 627, 000] [1, 753, 000] [1, 753, 000] [+126, 000]/---------_ Salaries and expenses__........_._-.__-..- 5, 666, 000 5, 816, 000 5, 816, 000 +150, 000 |_o0 ee Total, Public Health Service.....__ 753, 882, 500 596, 324, 000 728, 216, 000 25, 666, 500 +131, 892, 000 GM ‘NOLLVOOGS “HINVEE-YOgVI OF UdOUddVY TAVLI SNOLLVI ST. ELIZABETHS HOSPITAL Salaries and expenses_.....-------------- Major repairs and preservation of build- ings and grounds_____.-. 2 enw Construction, continued treatment build- SOCIAL SECURITY ADMINISTRATION (Salaries and expenses, Bureau of OASI (trust funds). .222--.- eee eee Construction, Bureau of OASI (trust funds) 0.0022 ee ee ee Grants to States for public assistance___..- Salaries and expenses, Bureau of Public Assistance... .----- eee ne eee ne eee Salaries and expenses, Children’s Bureau.._ Grants for maternal and child welfare....- Salaries and expenses, White House Con- ference on Children and Youth........- Grants for social security training and studies. ._.---.-2-- eee 3, 407, 000 3, 715, 000 3, 715, 000 +308, 000 |-.-.....-.-.---. 87, 000 330, 000 330, 000 ++ 248, 000 |... ne 125, G00 |_...-----.----~-]---.---.-------- —125, 000 |-....-....-..._. 3, 619, 000 4, 045, 000 4, 045, 000 +426, 000 |......-.-------- [171, 221, 000] [191, 600, 000] [191, 600, 000]) [-+20, 379, 000]|_..---...----e an [1, 210, 000]|-.-...---2 2 nf ewe eee eee e ee [—1, 210, 000}]-.-.-.-.-.--2--. 1, 957, 960, 000 2, 166, 500 2, 172, 000 45, 000, 000 150, 000 2, 033, 500, 000 2, 345, 000 2, 300, 000 43, 500, 000 200, 000 1, 785, 000 2, 033, 500, 000 2, 345, 000 2, 300, 000 46, 500, 000 200, 000 +75, 540, 000 +178, 500 +128, 000 +1, 500, 000 +50, 000 1 Includes funds contained in the Second Supplemental Appropriation Bill 1959 as passed the House. +3, 000, 000 — 1,785, 000 GH-YOavT SNOILVIUdOUddY GUVAIEM ‘NOILVOOad “HIV TP Comparative statement of appropriations for 1959, estimates for 1960, and amounts recommended in the bill for 1960—Con, TITLE II—DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE—Continued Agency and item Appropriations, 1959 1 Estimates, 1960 Recommended in bill Bill compared with—~ ‘for 1960° : 195° appropriations 1960 estimate SOCIAL SECURITY ADMINISTRATION—con. Salaries and expenses, Office of the Commis- sioner: Appropriation.....--..--.------2--- $342, 000 $337, 000 $337, 000 $5, 000 |... Transfer from OASI trust fund_--J___- £268, 500] [276, 000] [ 276, 000] ~f+7, 500]}--0 22k Total, Social Security Administra- tion... eee eee 2, 007, 790, 500 +77, 391, 500 OFFICE OF THE SECRETARY Salaries and expenses: Appropriation. .----.---.--- aon - Transfer from OASI trust fund_-__._. Office of Field Administration: Appropriation...-.---22 22 le _ Transfer from OASI trust fund__..._. ‘Office of the General Counsel: ++ $1, 215, 000 Appropriation....2 ane 1, 971, 000 [ 287, 000] 2, 557, 000 {871, 200] 560, 400 2, 088, 967, 000 2, 151, 000 [318, 000] 2, 735, 000 [926, 000] 619, 000 2, 085, 182, 000 2, 061, 000 [302, 500] 2, 738, 000 [926, 000] 589, 700 +90, 000 [+15, 500] '-£178, 000 [+-54, 800]]_. —90, 000 [—15, 500] +29, 300 oP SNOILVIUdOUddY DUVATEM ‘NOILVOOaa “HLIVaH-yoaVvT Transfers......------- ++ --e ne newer ene Surplus property utilization._.....-------- White House Conference on Aging-.._.-... Total, Office of the Secretary._._..- Total, direet appropriations....--_- Indefinite appropriations_..-------------- Total, direct and indefinite _appro- priations, Department of Health, Education, and Welfare_...-.---- [528, 400] [546, 000] [537, 200] [+8, 800] [—-8, 800] 687, 000 703, 000 703, 000 +16, 000 |_...--.----.---- 890, 000 452, 000 452, 000 ~438, 000 |... -----n-- nnn ee 6, 665, 400 6, 660, 000 6, 540, 700 —124, 700 —119, 300 3, 241, 291, 281 | 3, 163, 917,581 | 3, 345, 309,281 | +104,018,000 | +181, 391, 700 3, 007, 000 3, 163, 000 3, 163, 000 +156, 000 |_.22 2-22 3, 244, 298, 281 8, 167, 080, 581 3, 348, 472, 281 +104, 174, 000 TITLE III—NATIONAL LABOR ‘RELATIONS BOARD Salaries and expenses.....-----+---------- $13, 256, 600 $14, 230, 000 $14, 230, 000 +$973, 400 |_.-----------... TITLE IV—NATIONAL MEDIATION BOARD Salaries and expenses_.--.-.--------------+ $1, 341, 800 $1, 357, 000 $1, 357, 000 | ++ $15, 200 |._--.--------2-4 TITLE V—RAILROAD RETIREMENT BOARD Salaries and expenses (trust fund limita- [$9, 374, 300] [$9, 460, 000] [$9, 460, 000] [+$85, 700]|_--.:..---.------ tion) .._..------------- eee ee eee ne 1 Includes funds contained in the Second Supplemental Appropriation Bill 1959 as passed the House. SNOILLVIGdOUddY AUVATEM ‘NOTLLVONa ‘HIIVEH-YOdvt &V Comparative statement of appropriations for 1959, estimates for 1 960, and amounts recommended in the bill for 1960—Con. TITLE VI—FEDERAL MEDIATION AND CONCILIATION SERVICE Agency and item Appropriations, 19591 Estimates, 1960 Bil. compared with— Recommended in bill for 1960 1959 appropriations 1960 estimate Salaries and expenses...._....----------- $3, 878, 600 $3, 949, 000 $3, 905, 400 -+$26, 800 ~— $43, 600 TITLE VII--INTERSTATE COMMISSION ON THE POTOMAC RBIVER BASIN Federal contribution....0....-.----.---- $5, 000 $5, 000 $5, 000 Saw e eee ween TITLE VIII—U.S. SOLDIERS’ HOME Limitation on operation and maintenance and capital outlay... 2202202028 Total, direet appropriations, all titles of the bill_._-_2-- 2 Total, indefinite appropriations, all titles of the bil. Grand total.....02--.2-_-_ [$5, 531, 500] [$10, 948, 000] [$10, 948, 000) [+ $5, 416, 500] 3, 787, 122, 381 3, 691, 685, 581 3, 849, 921, 181 +62, 798, 800 +158, 235, 600 74, 907, 000 65, 163, 000 65, 163, 000 —9, 744, 000 |_---- 2. 3, 862, 029, 381 38, 756, 848, 581 3, 915, 084, 181 +538, 054, 800 +158, 235, 600 ' Includes funds contained in the Second Supplemental Appropriation Bill, 1959, as passed the House. oO vY SNOLLVINdOUddVY FUVATEM ‘NOLLVONGE “HLIVaH-wOaVT