THE WASHINGTON AREA COUNCIL ON ALCOHOLISM, INC., Hon. JOHN DOWDY, Chairman, House District Subcommittee No. 3, DEAR CONGRESSMAN DOWDY: The Washington, D.C., Area Council on Alcoholism takes this opportunity to inform you of its wholehearted support for the enactment of HR 3972, which would enable the District of Columbia to participate in the health and medical assistance benefits made available by the Social Security Amendments of 1965, Public Law 89-97. The enactment of the 1965 Social Security Amendments established, as a matter of national policy, Federal aid for improved programs of medical assistance. The enactment of HR 3972 would permit the District of Columbia to share in this Federal aid. The majority of the States (twenty-eight) and U.S. territories have, at this time, new medical assistance plans approved under Title XIX of the Social Security acts. Some of these States, like the District of Columbia, have had to seek revision of the statutory framework of their tax-supported health care programs before they could meet the conditions of approval under the new Federal grant program. HR 3972 would authorize the Board of Commissioners of the District of Columbia to establish by regulation the policies and procedures that are necessary steps to take to meet the requirements under Title XIX of that act. The Washington, D.C., Area Council on Alcoholism therefore strongly supports enactment of HR 3972. We earnestly urge your favorable consideration for HR 3972. Very truly yours, THERESA ABBOTT STATEMENT OF SOUTHWEST HEALTH COUNCIL, APRIL 4, 1967 To the Honorable 90th Congress of the United States of America: It is an honor and a pleasure for me, a representative of the Health Council of Southwest Washington, D.C., to come before you in support of Title XVIII and Title XIX of the Social Security Act. Here in the southwest area where there are over 23,000 people now living with almost nonexistent medical service to meet the needs of all the residents of this area, where there is a cross section of both high and low income families with a mixture of some of the most affluent of our Nation and some of the most impoverished in Washington, D.C. We the Health Council wholeheartedly support Title XVIII and Title XIX of the Social Security Act, because we the Council are concerned about the health problems of every one and the economic status of our community and with coming under Title XIX. We would be able to meet the needs of all our people with comprehensive health service in southwest Washington where there are at the present residing twenty-six Congressmen and our most Honorable Vice President Hubert Humphrey, and scores of impoverished families of ten children or more with incomes of less than $2,500 to families of as much as $75,000 and more. The Health Council is asking to please put better medical services in the Southwest Clinic for the needs of the southwest community. Sincerely, Mrs. HELEN WALKER, Chairman, Southwest Health Council. Hon. JOHN DOWDY. SOUTHWEST Crusade for BETTER WELFARE, April 3, 1967. DEAR SIR: Please give us the health clinic back so we can use it. We need the clinic to service the poor people in our community. To help solve some of these problems we have today, give us the birth control clinic so there won't be too many children to suffer. We are poor and not able to pay more. We too want the best health for our children. A health clinic in southwest will mean so much to us. Death knocks on any door, but if a comprehensive health clinic was here we could avoid some of those deaths. It's a tragic waste to educate the minds of children and neglect the physical condition of their health that helps in the future. Less than half of our S. W. reidents have health needs. One thing you can be sure there is a problem, and we need the clinic to strengthen and improve our health needs. Having a health clinic in S.W. will solve some of the problems out of poverty. For example, having a child with glaucoma and watching eye condition grow worse when you could have walked to the health clinic and they could tell you where and what to do. Blessed are the poor. Don't let us suffer. We have suffered enough. Please give us the health clinic in S.W. Your truly, To Whom It May Concern: SHIRLEY TINCH, Ways and Means Chairman. APRIL 3, 1967. I feel that the services of the clinic should be restored due to the fact that the people of low income find it hard to make arrangements to carry children to the hospital for small injuries such as earache, throat trouble, etc. This clinic would serve these small injuries and would be most convenient for the people of the community. LENORA RUDGER. Hon. JOHN DOWDY: I would like to have a health clinic in southwest because I have four children and I have to take them all to the clinic when they get sick. I am unable to take them most of the time because I am on Public Assistance and I don't have carfare and I am not in good health myself. Mrs. CAROL REDD. COLUMBIA LIGHTHOUSE FOR THE BLIND, Hon. JOHN DOWDY, DEAR CONGRESSMAN DOWDY: We, of the Columbia Lighthouse for the Blind, wish to express our support for the Enactment of H R 3972, to enable District of Columbia to participate in the medical assistance benefits made available by the Social Security Amendments of 1965, Public Law 89-97. In the course of our activity with the community, we frequently encounter poor people, who for one reason or another, are unable to meet the present eligibility requirements for medical assistance. Lacking the resources of their own to pay the cost of medical care, their medical needs are going unmet. We believe that the Enactment of H R 3972, enabling the District of Columbia to share in improved health services as made possible by the enactment of the Social Security Amendment of 1965, will go far in helping to promote good health in our community. We sincerely hope that the House District Subcommittee No. 3 will favorably consider the Enactment of H R 3972. Very truly yours, J. ARTHUR JOHNSON, Executive Director. Hon. JOHN DOWDY, FLORENCE CRITTENTON HOME & HOSPITAL, INC., Chairman, House District Subcommittee No. 3, House of Representatives, Washington, D.C. DEAR CONGRESSMAN DOWDY: On behalf of the Board of Managers of the Florence Crittenton Home and its supporting membership of 900 women we wish to express our strong support for the enactment of HR 3972, "to enable the Dis trict of Columbia to participate in the health and medical assistance benefits made available by the Social Security Amendments of 1965, Public Law 89-97". We especially urge the enactment of this bill to enable citizens of the District to share in the improved programs of medical assistance made possible under such a guarantee. The Florence Crittenton Home is a special agency dealing with unmarried mothers and their infants, the high risk situations for which this bill was intended as an assurance of sustained medical care. Of our 345 girls whose babies were born in 1966 90% were under 24 years of age, 60% were 19 years and under. Over 60% of the girls were residents of the National Capital area, 51 being from the District of Columbia. We know there are many girls in the District who need the protection of good medical care over and above those we serve and we cannot urge too strongly your support to make such care available. We thank you for whatever support you can give to the enactment of this bill. Very sincerely, LEORA L. CONNER Mr. Dowdy. I'm sorry we couldn't personally hear you all. As to the remaining witnesses, we will hear you 2 weeks from today, at 10 a.m. Until that time, this hearing will be adjourned. (Whereupon, at 12:05 p.m. the hearing was adjourned to reconvene at 10 a.m., Tuesday, April 18, 1967.) MEDICAL CARE TUESDAY, APRIL 18, 1967 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE No. 3 OF THE COMMITTEE ON THE DISTRICT OF COLUMBIA, Washington, D.C. The subcommittee met, pursuant to notice, at 10 a.m., in room 1310, Longworth House Office Building, Hon. John Dowdy presiding. Present Representatives Dowdy (chairman), Fuqua, Fraser, Springer, Horton, and Zwach. Also present: James T. Clark, clerk; Hayden S. Garber, counsel; Donald Tubridy, minority clerk, and Leonard O. Hilder, investigator. Mr. DOWDY. We will continue hearings on the bills H.R. 3972 and H.R. 6818. The first witness we have this morning is Mrs. Anthony Schwartz, president of the League of Women Voters of the District of Columbia. STATEMENT OF MRS. ANTHONY SCHWARTZ, PRESIDENT, LEAGUE OF WOMEN VOTERS OF THE DISTRICT OF COLUMBIA Mrs. SCHWARTZ. The League of Women Voters of the District of Columbia very much appreciates this opportunity to appear before your committee in support of H.R. 3972 and H.R. 6818. The league believes this to be among the most important pieces of legislation ever considered by your committee. Its enactment would enable the District to share in the Federal aid for improved programs of medical assistance that was made available as a matter of national policy by the enactment of the Social Security Amendments of 1965. Some 28 States now have new medical assistance plans approved under title XIX of that act. A number of these States-like the Districthave had to seek revision of the statutory framework of their tax-supported health care programs before they could meet the conditions of approval under the new Federal grant program. H.R. 3972 would authorize the Board of Commissioners of the District of Columbia to establish by regulation the policies and procedures that are necessary steps before the District can obtain the Federal matching grant that first became available on January 1 of last year. The District of Columbia Department of Public Health, as the administering agency of the District, has developed a title XIX plan for medical assistance which has been given general approval by the Board of Commissions and is now under preliminary review by the Department of Health, Education, and Welfare. This plan was worked out by the District of Columbia Health Department with the assistance of the Public Health Advisory Council and a special ad hoc committee 75 76-307-67- -6 set up by the Council for that purpose. This committee, which has worked over a period of many months, is broadly representative of the providers of health services and of the community at large. (The league is particularly aware of the magnitude of this citizen effort because one of its members was an active participant.) The plan that has been proposed would earn the District about $8.4 million in additional Federal funds at its fiscal year 1967 level of expenditures. As a measure of "medical indigence" the plan would establish an exempt income scale that in the first year of operation$4,200 for a family of four-would appreciably enlarge the target population. In future years, as financing permitted, the income scale would be progressively raised until it reached a more realistic measure of ability to meet today's medical care costs $4,800 for a family of four is the figure currently projected by the plan. The league is aware that the enactment of H.R. 5710, now under consideration by the Committee on Ways and Means (the proposed Social Security Amendments of 1967), could mean a substantial curtailment of the potentially eligible population under the District's proposed title XIX plan. But whatever the coverage in early years, there are important advantages in qualifying for the title XIX grants-for the District, for the eligible population group, and for the community as a whole. In addition to augmented Federal financial participation, the policies embodied in the District's proposed plan promise real gains in the health "package" we buy with our tax dollars. There would be increased opportunities for early and improved health care and preventive services for those who now reach District health facilities as costly emergency cases. Subject to limitations of available funds, the plan would offer a full range of services with the objective of progressive steps toward the 1975 goal set by the Federal act-"comprehensive care and services to substantially all individuals who meet the plan's eligibility standards with respect to income and resources, including services to enable such individuals to attain or retain independence or self-care." Moreover, a fully implemented free-choice "vendor payment" policy could improve geographical accessibility of services; provide more reasonable reimbursement and more stable support for important community resources for personal health care; and foster a more effective partnership between voluntary and public providers of health and medical services. Thank you for this opportunity to present the league's views on this proposal. We earnestly urge your favorable consideration for H.R. 3972. Mr. Dowdy. Thank you, Mrs. Schwartz. The next witness is Mr. John Greenwood, past president, Optometric Society of the District of Columbia. STATEMENT OF DR. JOHN GREENWOOD, PAST PRESIDENT, OPTOMETRIC SOCIETY OF THE DISTRICT OF COLUMBIA Mr. GREENWOOD. Thank you. Good morning, Mr. Chairman, members of the subcommittee, my name is John Greenwood, I am an |