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Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: Donated Historical Materials Collection/Office of Origin: Frieden, Lex, Collection Series: Government Records Subseries: Government-created Organizations OA/ID Number: 52008 Folder ID Number: 52008-004 Folder Title: CST [Committee on Science and Technology] - Panel Documents (1) [1977-1978] [2] Stack: Row: Section: Shelf: Position: G 5 2 2 1 COMMITTEE ON SCIENCE AND TECHNOLOGY U.S. HOUSE OF REPRESENTATIVES WASHINGTON, D.C. 20515 February 1, 1978 Mr. Lex Frieden 9667 Meadowvale Houston, Texas 77042 Dear Mr. Frieden: Enclosed is the final draft of the report to the Committee on Science and Technology by the Panel on Research Programs to Aid the Handicapped. It has been forwarded to Chairman Olin E. Teague for his perusal and comment; it will be forwarded to the members of the Committee prior to publication by the Government Printing Office as a "Committee Print" document, which will then make it available to the general public. In behalf of the Committee and the Committee staff who worked with you on this study, we want to express again our sincere appreciation for your contribution as a Panel member and want you to know that it was a great pleasure to work with you in this important endeavor. As this study concludes with the issuance of this report, our real work on the Committee and staff begins to peak with the consideration of this report and the implementation of your recommendations. We look forward also to working with you in this process and trust that our mutual efforts will result in a more effective utilization of our vast scientific and technolog- ical resources for the benefit of handicapped people everywhere. Aherm Technical Sherman Sincerely, Romfat E. Consultant Roodzant COMMITTEE ON SCIENCE AND TECHNOLOGY U.S. HOUSE OF REPRESENTATIVES WASHINGTON, D.C. 20515 MEMORANDUM DECEMBER 15, 1977 TO: Panel on Research Program to Aid the Handicapped FROM: Sherman E. Roodzant As a small token of his appreciation for your assistance to the Committee and the Panel on Research Programs to Aid the Handicapped, Chairman Olin E. Teague has requested that I forward the enclosed calendar. We on the Committee staff join with him in sending you warmest regards and best wishes for a Happy Holiday Season and a healthy and successful New Year. Enclosure CONTRACT AGREEMENT THIS AGREEMENT is made and entered into this 28th day of June , 1977 Science and Technology by and between the Committee on of the U.S. House of Representatives, hereinafter referred to as the Committee, and Mr. Lex Frieden , (Name of contractor) hereinafter referred to as the Contractor, subject to the approval of this Agreement by the Committee on House Administration of the U.S. House of Representatives. It is hereby agreed that the Committee under authority of House Resolution 297 approved March 2 19.77 P 95th Congress, retain the Contractor to render the follow- , ing services: as set forth in page 2 attached hereto, which is incorporated and made a part hereof. It is understood, however, that the Chairman of the Committee, reserves the right to terminate this Agree- ment at any time. In such cases, the payment shall be based upon work performed. The Committee further agrees to pay the said Contractor for all such contractual services rendered, a sum not to exceed $3,000 at $125.00 per day plus, authorized traveling expenses. It is further agreed that payment for such contractual services may be paid on a partial basis from time to time and in such amounts as the Chairman of the Committee may approve. The Contractor further agrees and warrants that it: 1. Has not employed any person to solicit or obtain this Agreement for any commission, per- centage, brokerage, or contingent fee; 2. Will save the Government harmless from liability in performance; 3. Will release no information obtained in carrying out the provisions of the Contract without prior consent of the contracting Committee; 4. Will not subcontract or assign elsewhere any of the work or service involved without prior consent of the contracting Committee: and 5. Will not discriminate in its performance of this Agreement because of race, creed, color, sex, or national origin and shall comply with all laws appertaining to the compensation for labor. The Contractor further agrees and warrants that it will fully complete its services to the Committee hereunder not later than the 31st day of December , 1977 , unless said date shall be extended by mutual agreement of the parties to this Agreement with the approval of the said Committee on House Administration. No Member or Delegate to Congress, or Resident Commissioner, shall be admitted to any share or part in this Contract or to any benefit that may arise therefrom. Approved by the Committee on House Adminis- Committee on Science and Technology tration of the U.S. House of Representatives: Chairman Ranking Minority Member Chairman Contractor (Individual or Partnership) Dated: (Address) (Address) Contractor (Corporation) [CORPORATE SEAL] (Business Address) By: (Title) (To be submitted in quintuplicate to the Committee on House Administration) (See instructions on the reverse side.) Contract Agreement Page 2 Olin E. Teague, Chairman John W. Wydler, Ranking Minority Member Contractor - Lex Frieden PANEL ON RESEARCH PROGRAMS TO AID THE HANDICAPPED I Purpose There is a need for further study of the problems of the handicapped, to identify how we might more effectively utilize our vast scientific and technological resources to benefit the handicapped. Toward this end the Committee has authorized a panel to be retained as consultants, heretoafter referred to as the "Panel" or "Panel member (s) for the purpose of subjecting this matter to further study and rendering a report to the Committee on their findings. II Method of Study The Panel will convene and meet in Washington, D. C. or other mutually agreeable locations on three to five occasions in executive and open work- shop sessions, during the course of this study. A comprehensive, select group of handicapped citizens, as well as expert government, medical and biomedical engineering representatives, will meet with the Panel to convey their ideas and recommendations. Additionally, the Panel members may conduct individual analytical research and investigative procedures necessary to individually contribute their views and recommendations in the final report to the Committee. The Panel will be assisted by one member of the Committee pro- fessional staff and the necessary clerical support. III Length of Study The Panel will convene on or about August 1, 1977 and complete their efforts on or before December 31, 1977. It is expected that the Panel members will dedicate some 20-24 days to this effort, 8-10 days in Panel and workshop sessions and the remainder in related individual research effort. IV Study Results In addition to the individual reports prepared by the Panel members, the Panel will compile a record of its proceedings and findings and render to the Committee a summary and comprehensive report of its recommendations. OLIN E. TEAGUE, TEX., CHAIRMAN JOHN L. SWIGERT, JR. EXECUTIVE DIRECTOR DON FUQUA, FLA. JOHN W. WYDLER, N.Y. WALTER FLOWERS, ALA. LARRY WINN, JR., KANS. HAROLD A. GOULD ROBERT A. ROE, N.J. LOUIS FREY, JR., FLA. PHILIP B. YEAGER MIKE MC CORMACK, WASH. BARRY M. GOLDWATER, JR., CALIF. FRANK R. hammill, JR. GEORGE E. BROWN, JR., CALIF. GARY A. MYERS, PA. DALE MILFORD, TEX. HAMILTON FISH, JR., N.Y. COMMITTEE ON SCIENCE AND TECHNOLOGY JAMES E. WILSON WILLIAM G. WELLS, JR. RAY THORNTON, ARK. MANUEL LUJAN, JR., N. MEX. RALPH N. READ JAMES H. SCHEUER, N.Y. CARL D. PURSELL, MICH. U.S. HOUSE OF REPRESENTATIVES ROBERT c. KETCHAM RICHARD L. OTTINGER, N.Y. HAROLD C. HOLLENBECK, N.J. JOHN P. ANDELIN, JR. ToM HARKIN, IOWA ELDON RUDD, ARIZ. SUITE 2321 RAYBURN HOUSE OFFICE BUILDING JAMES W. SPENSLEY JIM LLOYD, CALIF. ROBERT K. DORNAN, CALIF. REGINA A. DAVIS JEROME A. AMBRO, N.Y. ROBERT S. WALKER, PA. ROBERT (BOB) KRUEGER, TEX. EDWIN B. FORSYTHE, N.J. WASHINGTON, D.C. 20515 MINORITY COUNSEL: MARILYN LLOYD, TENN. MICHAEL A. SUPERATA JAMES J. BLANCHARD, MICH. TIMOTHY E. WIRTH, COLO. STEPHEN L. NEAL, N.C. THOMAS J. DOWNEY, N.Y. DOUG WALGREN, PA. June 28, 1977 RONNIE G. FLIPPO, ALA. DAN GLICKMAN, KANS. BOB GAMMAGE, TEX. ANTHONY c. BEILENSON, CALIF. ALBERT GORE, JR., TENN. WES WATKINS, OKLA. RICHARD A. TONRY, LA. Mr. Lex Frieden 9667 Meadowvale Houston, Texas 77042 Dear Mr. Frieden: Thank you for accepting my invitation to serve with the Panel on Research Programs to Aid the Handicapped. Your in- terest and dedication in this area and your generous assis- tance to the Committee is deeply appreciated. Enclosed is a formal Contract Agreement which must be endorsed and executed prior to submittal and approval by the Committee on House Administration and the convening of the Panel. This contract provides for consultant fees and the authority to reimburse you for any necessary travel expenses. Please endorse the five (5) copies of the Contract Agreement form at the line designated "Contractor", sign and date page 2 attached thereto, and return as soon as possible in the enclosed, preaddressed envelope. An extra copy is enclosed for your records and a completed copy will be provided to you on or before the first Panel meeting, which has been tentatively scheduled for August 1st and 2nd, 1977. If you have any questions regarding this contract or the Panel, please do not hesitate to contact Mr. Sherman Roodzant of the Committee staff (202) 225-5029 or 225-6371. Thank you again for your participation in this very important program. Sincerely, Olin { Teague OLIN E. TEAGUE Chairman Enclosure OLIN E. TEAGUE, TEX., CHAIRMAN JOHN L. SWIGERT, JR. DON FUQUA, FLA. JOHN W. WYDLER, N.Y. EXECUTIVE DIRECTOR WALTER FLOWERS, ALA. LARRY WINN, JR., KANS. ROBERT A. ROE, N.J. LOUIS FREY, JR., FLA. HAROLD A. GOULD MIKE MC CORMACK, WASH. BARRY M. GOLDWATER, JR., CALIF. PHILIP B. YEAGER GEORGE E. BROWN, JR., CALIF. GARY A. MYERS, PA. FRANK R. HAMMILL, JR. DALE MILFORD, TEX. HAMILTON FISH, JR., N.Y. COMMITTEE ON SCIENCE AND TECHNOLOGY JAMES E. WILSON RAY THORNTON, ARK. MANUEL LUJAN, JR., N. MEX. WILLIAM G. WELLS, JR. JAMES H. SCHEUER, N.Y. CARL D. PURSELL, MICH. RALPH N. READ U.S. HOUSE OF REPRESENTATIVES RICHARD L. OTTINGER, N.Y. HAROLD C. HOLLENBECK, N.J. ROBERT C. KETCHAM TOM HARKIN, IOWA ELDON RUDD, ARIZ. JOHN P. ANDELIN, JR. JIM LLOYD, CALIF. ROBERT K. DORNAN, CALIF. SUITE 2321 RAYBURN HOUSE OFFICE BUILDING JAMES W. SPENSLEY JEROME A. AMBRO, N.Y. ROBERT S. WALKER, PA. REGINA A. DAVIS ROBERT (BOB) KRUEGER, TEX. EDWIN B. FORSYTHE, N.J. WASHINGTON, D.C. 20515 MARILYN LLOYD, TENN. MINORITY COUNSEL: JAMES J. BLANCHARD, MICH. MICHAEL A. SUPERATA TIMOTHY E. WIRTH, COLO. STEPHEN L. NEAL, N.C. THOMAS J. DOWNEY, N.Y. DOUG WALGREN, PA. RONNIE G. FLIPPO, ALA. June 20, 1977 DAN GLICKMAN, KANS. BOB GAMMAGE, TEX. ANTHONY c. BEILENSON, CALIF. ALBERT GORE, JR., TENN. WES WATKINS, OKLA. RICHARD A. TONRY, LA. Mr. Lex Frieden 9667 Meadowvale Houston, Texas 77042 Dear Mr. Frieden: I am grateful for your participation on the Committee's recent Panel on Research Programs to Aid the Handicapped and I would like to ask you to serve again as a member of a new consultant Panel group which I am appoint- ing to advise the Committee in this area. The function of this Panel will be to conduct a study and examination of the requirements for legislative implementation and further analysis, as appropriate, of the earlier Panel's findings and recommendations. I would also like the report of the recent White House Conference on Handicapped Individuals to be included for consideration in your deliberations. I would anticipate a report from this Panel to include findings and recommendations for specific legislative measures which will have a positive effect on the lives of handicapped individuals. I would expect that the Panel will convene and commence its efforts around the 1st of August and will want to meet three to five times here in Washington, D. C. or various other locations prior to the culmination of its efforts by the end of the year. Subject to the wishes of the Chairman and the members of the Panel, I would also expect the Panel to receive briefings by representatives of various professional, government, and consumer groups interested in this endeavor and to review the documents and publications relevant to the subject. As a member of the Panel you will be eligible for a consultant fee of $125 per day and your travel expenses will be reimbursed to you. Mr. Sherman Roodzant, a member of the Committee professional staff, will assist you and the Panel in its efforts, on a full-time basis. He can be reached by telephone at (202) 225-5029 to answer any questions you may have. Mr. Lex Frieden June 20, 1977 page 2 I believe the work of the Panel will make an important contribution in brightening the future of hundreds of thousands of our handicapped fellow Americans and neighbors around the world; and I hope you will be able to accept this invitation. Please telephone Mr. Roodzant at your early con- venience indicating your desire to serve on this Panel, in order that he might expedite the necessary administrative paperwork. Thank you for your consideration in accepting this challenging responsibility. Sincerely, Olm E Teague OLIN E. TEAGUE Chairman OLIN E. TEAGUE, TEX., CHAIRMAN JOHN L. SWIGERT, JR. DON FUQUA, FLA. JOHN W. WYDLER, N.Y. EXECUTIVE DIRECTOR WALTER FLOWERS, ALA. LARRY WINN, JR., KANS. ROBERT A. ROE, N.J. LOUIS FREY, JR., FLA. HAROLD A. GOULD BARRY M. GOLDWATER, JR., CALIF. PHILIP B. YEAGER MIKE MC CORMACK, WASH. GEORGE E. BROWN, JR., CALIF. GARY A. MYERS, PA. FRANK R. HAMMILL, JR. DALE MILFORD, TEX. HAMILTON FISH, JR., N.Y. COMMITTEE ON SCIENCE AND TECHNOLOGY JAMES E. WILSON RAY THORNTON, ARK. MANUEL LUJAN, JR., N. MEX. WILLIAM G. WELLS, JR. JAMES H. SCHEUER, N.Y. CARL D. PURSELL, MICH. RALPH N. READ U.S. HOUSE OF REPRESENTATIVES HAROLD C. HOLLENBECK, N.J. ROBERT C. KETCHAM RICHARD L. OTTINGER, N.Y. TOM HARKIN, IOWA ELDON RUDD, ARIZ. JOHN P. ANDELIN, JR. SUITE 2321 RAYBURN HOUSE OFFICE BUILDING JIM LLOYD, CALIF. ROBERT K. DORNAN, CALIF. JAMES W. SPENSLEY JEROME A. AMBRO, N.Y. ROBERT S. WALKER, PA. REGINA A. DAVIS ROBERT (BOB) KRUEGER, TEX. EDWIN B. FORSYTHE WASHINGTON, D.C. 20515 MINORITY COUNSEL: MARILYN LLOYD, TENN. MICHAEL A. SUPERATA JAMES J. BLANCHARD, MICH. TIMOTHY E. WIRTH, COLO. STEPHEN L. NEAL, N.C. THOMAS J. DOWNEY, N.Y. August 8, 1977 DOUG WALGREN, PA. RONNIE G. FLIPPO, ALA. DAN GLICKMAN, KANS. BOB GAMMAGE, TEX. ANTHONY c. BEILENSON, CALIF. ALBERT GORE, JR., TENN. WES WATKINS, OKLA. RICHARD A. TONRY, LA. Mr. Lex Frieden 9667 Meadowvale Houston, Texas 77042 Dear Mr. Frieden: I am pleased that the Panel on Research Programs to Aid the Handicapped has begun its activities and I am grateful for your participation in this important Committee activity. I look forward to meeting with you at the next Panel meeting scheduled for 9:30 a.m., September 12-13, 1977 in Room 2325 of the Rayburn House Office Building. Dr. William A. Spencer, Panel Chairman, and Adm. M. D. 'Dick' Van Orden, Panel Vice Chairman, met with Mr. Roodzant on August 5th to organize Panel sub- committees pursuant to the wishes of the Panel. Enclosed is a list of the study groups and your individual assignments. In addition, Dr. Spencer and Adm. Van Orden have asked that each Panel member critique the enclosed report of the previous Panel. Please review the findings and recommendations of this report, indicating your concurrence or disagreement, and your assessment of the need to develop additional data and findings relative to this Panel's recommendations. This critique should be delivered to Mr. Roodzant prior to August 26, 1977 in order that the study group assigned with reviewing the validity of findings may have ample time prior to the next meeting to analyze these viewpoints. It is hoped that each study group will meet prior to the next full Panel meeting and be prepared to render a report on its activities to the full Panel. Study group meetings will be called by the study group chairmen in cooperation with Committee staff. I want to thank you again for your participation in this study. Best wishes for continued success in this effort and all your endeavors. Sincerely, Olin E Jergue OLIN E. TEAGUE Chairman Nov. 15, 1977 Research Programs to Aid the Handicapped Lawrence A. Scadden, Ph. D. notes. Legislation must be enacted which will provide a stronger mandate to NASA for providing managerial services, coordination of a comprehen sive research program on an inter-agency basis, and for the conduct of research itself directly related to the identified needs of the handicapped populations of the nation. The enactment legislation must also hold inviolate existing agencies and budgets dealing with program for the handicapped populations, both research programs and service delivery programs. NASA, as the lead agency, can provide management function through the allocation of additional funds to existing agenci for specific research projects and/or service programs. Such expendat can stimulate cooperation, communication, and quality programs based on merit. The legislation must insure the involvement of qualified handicap] individuals and consumer organizations at all levels in the research program process. The establishment of a cogncil of handicapped individuals, manufacturers, research professionals, and governmental agency representatives should be established by statute to advise the NASA division director in program selection, design, and implementation NASA, as the lead agency for increasing the magnitude and quality of research programs to aid the handicapped, should have a specially identified, defined, and established division dedicated solely to the research programs for the handicapped population. This division canno exist as a sub-division of the existing technological utilization bran unless the budgetary restrictions are significatly changed. Currently approximately ten million NASA dollars are applied to technological utilization and only about 400,000 of these dollars can be classified as being assigned to rehabilitation type programs. These figures may } only approximate or totally incorrect, but the numbers are miniscule il comparison to the overall NASA budget. The sum allocated for research programs for the handicapped must be significantly higher if the lead agency is to impact RSA, VA, NIH, and other agencies involved in resea programs for the handicapped currently. The director of the newly created NASA division for research programs for handicapped individuals must be knowledgeable in managemeı techniques, naturally, but he must first First have expertise in the needs of handicapped individuals, in existing service delivery mechani and must be extremely conversant with professional and consumer groups involved with the handicapped population. Finally, NASA, at its highes administrative levels, must be ready to accept this new mandate and authority, or the entire program should be moved elsewhere or the stausquo of 1977 reluctantly reestablished. LT. # RSA NIH NEW VA NASA NSF REG. BODY Wt. VALUE 668 406 6.35 6.5 6.46 3.4 5.43 1 I (15) 1002 60.9 95.3 97.5 96.9 51. 81.5 5.5 443 304 5.18 6.43 456 5.37 2 (8) A4 35.4 30.8 41.4 51.4 36.5 42.9 5.43 3,06 7.4 5.43 726 320 4,86 3 (7) 41.5 21.4 52.5 41.5 50.8 23.6 34.0 4.37 4.53 4 (16) 94.9 5.37 8.56 462 69.9 4.06 f 72,5 85.9 136.9 73.9 4:18 64.9 4.37 5.3 5 (7) 4.37 7.62 3.16 28.8 4.46 30.6 37.1 30.6 53.3 22.1 443 31.2 6 (7) 456 5.57 243 31.0 31.9 818 27.5 362 39 5.06 513 57.3 5.46 7.33 25.3 5.0 35.4 1 (6) 6.6 30.8 32.8 44 4.4 30.0 5.0 39.6 (7) 3.81 4.62 26.4 8 537 4.37 30.0 7.5 3.62 26.7 475 32.3 37.6 30.6 52.5 (7) 64 25.3 5.12 33.2 9 5.92 5.25 44.8 6.06 451 35.8 41.4 36.75 557 6.37 42.4 31.9 10 (13) 4.31 60 39 82.8 656 643 56.0 3.18 2.8 78. 85.3 11 (7) 5.43 4.31 84 3.62 41.3 37.3 525 0.06 38.0 30.2 3.93 25.3 36.75 56.4 362 27.5 25.3 n #1 1.9 1.0/22 623 563.5. 437.2 553.5 543.8 721.5 384.8 454.7 / Y (1) 1 11) 8. # 10 6 # 6 # #8 # 8 L # L# #6 # 6 #5 # 5 #4 # 4 #3 # 3 #2 # 2 #1 # 1 TOTALS 1 4 1 2 / E 4 / 1 / 1 RSA 1 1 3 / 1 I 4 / 3 / E NIH 2 2 3 / / / 5 1 / / 1 / Agency New 3 3 1 I / 2 5 1 I / / VA Э 6 / 1 1 1 3 2 1 2. Z / NASA 1 1 1 1 1 / 2 4 1 / 5 NSF - 3 3 2 1 1 / 2 1 / 4 Body Regulatory / # # 2 TOTALS New Regulatory RSA NIH Agency VA NASA NSF Body #1 - / 2 / / 2 3 #2 2 / / / / 2 / #3 2 3 - 2 - - / #4 / 3 / - / / / #5 2 3 2 5 2 7 3 #6 4 3 2 2 / 2 / #7 3 2 2 3 2 - - #8 - - - 2 2 2 2 #9 / - - 1 - - 3 / - # 10 3 - 5 - / 2 #3 TOTALS New Regulatory RSA NIH Agency VA NASA NSF Body #1 / 5 - - / 2 5 #2 2 2 / - - / 2 #3 - 4 - 1 / 4 - #4 2 - - / 2 3 / #5 3 3 2 8 - 4 - #6 2 / / / / / - #7 - / / 3 2 - 2 #8 / - 4 / / - 2 #9 3 - 2 1 / - - # #10 2 - 3 / 6 - 3 in (2) € E C C / - - #4 TOTALS New Regulatory RSA NIH Agency VA NASA NSF Body #1 / / / / / 2 3 #2 / / 2 / - 2 / #3 - 4 2 / - 3 2 # 4 2 5 / / - / 2 #5 4 / 5 - / 3 4 #6 - - / 2 2 2 3 #7 2 - 2 3 3 2 2 #8 2 / / / / / / #9 2 - - 1 3 - - #10 / / / - / 8 - - 3 - - - 1 - #5 TOTALS New. Regulatory RSA NIH Agency VA NASA NSF Body #1 3 3 2 2 / 5 4 #2 3 ( / / / / / #3 2 4 / 3 / 2 / #4 / 3 / 3 - 3 2 #5 3 / 3 2 1 H / #6 2 2 1 / / / #7 - - - 3 / 1 2 #8 1 2 3 / 3 - 2 #9 - - / - 3 - / #10 2 / / 5 - - I 1 - 3 - - - € / # 6 TOTALS New Regulatory RSA NIH Agency VA NASA NSF Body #1 2 3 / 2 / 2 2 #2 / / / 3 - 4 2 4 3 - #3 4 - 2 3 #4 3 / / / - 2 / #5 2 2 4 / / 5 / #6 / 2 / / 1. , - 1 - #7 - - / 3 / 2 2 #8 / / 1 2 1 Z 3 / #9 / I - / 3 / / # 10 / / 3 - 7 - / 2 8 D D 2 h C C - 1 G / L = M OT# - / / / / / 6 # - N Z E 1 2 / / 8# / - / / - / - L# - H / 2 / / / 9 # / 2 1 - to Z Z #5 - I / 2 1 / / # - / / 7 / / #3 1 - / 1 1 / 2 - #2 E H 7 I 7 3 I T# Body NSF NASA VA Agency HIN RSA Regulatory New TOTALS L # TOTALS # 8 New Regulatory RSA NIH Agency VA NASA NSF Body #1 5 2 / 2 - 4 / #2 / / 1 - - / 2 #3 3 4 / 5 / 2 2 #4 / 2 / - 3 3 3 #5 2 / N 5 / 3 2 #6 - 3 Z 3 N Z 3 #7 2 3 / / - / / #8 / / / - 4 1 / #9 / - / 1 1 - / - #10 - - 3 / 4 0 / # #10 6 # 6 # # 8 # 8 #7 # 7 9 # 9# #5 # 5 #4 # 4 #3 # 3 #2 # 2 #1 # 1 TOTALS 4 1 / I 2 / H / / 1 / RSA I I 2 1 2 2 4 2 / 2 / NIH / / 3 4 1 / 1 / 2 / / Agency New 1 / 1 2 ( 2 G H 2 1 / VA 1 4 2 3 1 1 / / / / 2 NASA 1 / 3 1 / 2 2 1 2 2 3 NSF / / 3 / / 2 2 2 2 / 2 1 Body Regulatory b # # 10 TOTALS New Regulatory RSA NIH Agency VA NASA NSF Body #1 / 2 - / / 4 5 #2 - / - 1 - / 4 #3 3 2 2 - 5 3 - #4 / 3 - / 2 2 - #5 5 4 3 - 2 2 3 #6 2 4 5 2 / - / #7 2 - 2 2 3 / - #8 - / / 2 / 1 - #9 2 I - 4 2 - 1 #10 2 / / - 3 - / VM 3 # // TOTALS New Regulatory RSA NIH Agency VA NASA NSF Body #1 / 3 / / - 3 3 #2 2 2 3 3 / 2 4 #3 / - / / 1 / / #4 / 2 / / 2 3 2 #5 5 5 Z 2 - 3 0 #6 / 2 / / / 2 - #7 - / - 2 4 2 \ #8 3 / 5 2 - - / #9 - - 1 / - - 2 - #10 2 / 2 - 6 / INSTRUCTION SHEET FOR PREFERENCE RATING TO ACCOMPANY THE LIST OF FACTORS TO BE RATED AND A PREFERENCE RATING SHEET WHICH EXAMINES POTENTIAL ALTERNATIVES FOR A NEW EMPHASIS ON R&D FOR THE HANDICAPPED Part 1. Information Sheet Explanation of why we should identify our subjective impressions: A generic solution for a greatly enlarged national effort to bring the benefits of science and technology to the handicapped person was accepted. There is need for an effort to be funded and authorized for cooperative undertakings among agencies of the executive and legislative branches of government and the private sector. A larger research and development program must be accomplished. This would include a balance of basic and applied research to solve urgent research problems that can be de- rived from the needs of the handicapped. Methods are needed for development, transfer and delivery of knowledge, methodologies and hardware that exist or are newly discovered. Distribution of simple and complex technology, devices and systems that will impact the handicapped person's health, his ability to function and would aid in his penetration of social impediments and architectural barriers to his physical mobility must be provided. The panel has concentrated on the physically and sensory-impaired person including the paralyzed and amputee, the deaf and blind or deaf/blind person as the meaning of physi- cally handicapped. The panel has accepted the 'needs' statement and present findings of the original panel report with some additions from the White House recommendations and other recommendations generated by this new panel. At the last meeting there was acceptance of the general recommendations of the first panel only insofar as the concept of the need for some sort of governance or trusteeship. Technical support and the regular involvement -2- of handicapped consumers, professionals carrying out research, and practitioners is also appreciated. The need to implement the usage of research findings and the distribution of devices and assistive systems was included. How to use other resources such as industry and inventors was also highlighted. Four implementary alternatives were defined. (I) Augmenta- tion of an existing agency within government into a lead agency or (2) the establishment of an entirely new entity within a government department (with authority and appropriations) or (3) the establishment of an activity connected with committees of Congress as occurs with some regulatory agencies, or (4) leaving the status quo but augmenting appropriations and existing authorities if indicated. Discussion and consideration of an autonomous approach, a lead agency approach, or a new agency approach generated the need to make a subjective judgement essential for selection of a specific solution that could be set into motion by new legislation. A concensus among the panel members, representing as they do a variety of perspectives, is essential for guidance and acceptability by the Committee of Science and Technology. In the view of the Chairman of the Panel, what is desired as the consequence of any new initiative is fairly certain. The solution sought is a general one in which authority and operation of an activity will justify and implement the means, the resource allocations, and the development of research both basic and applied. Technical information and know- ledge transfer should be accomplished. The availability and accessibility of bene- fits of science and technology for the handicapped persons in the United States should be the practical result. Results should be responsive to their needs, conditions, -3- and priorities. Their active involvement in the process and their judgements of utility of the solutions provided would be used. Management of such a process requires availability of current information and knowledge. This must be derived from systematic participation of those persons affected, the handi- capped, those providing solutions, the researchers, those utilizing such solu- tions, the practitioners, and those authorizing them from both the executive and legislative branches of government. The problem to be addressed now is what is the best specific solution to achieve this broad goal. To arrive at a better understanding of similarities and differences in preference among the panel members for specific solutions, it is essential to: (I) characterize the factors which comprise 'success' elements for such an undertaking and, (2) analyze those factors in context of the organizational alternatives. A personal estimate of the likelihood of achievement of each of these success requirements for each specific alternative needs to be made. Since subjective judgements are involved, all such ratings will be estima- tions. Lack of first-hand experience with each alternative, personal interest and commitment to particular solutions for organization and management of major efforts, or lack of know- ledge about a particular alternative account for some of the difficulties. Estimating pre- ferences for non-existing alternatives is particularly hard. The purpose, therefore, of prefer- ence estimation is to take each alternative, one at a time, and try to avoid comparing all the alternatives simultaneously to the same preference factor. This is later accomplished by a ranking process. After the process is completed in rating sheets by each individual anony- mously, the aggregate individual ratings should disclose either a very wide difference of pre- -4- ference, or clusters of preferences likelihoods, or reasonable agreement for the panel as a whole. The extent of concensus among US greatly influences our readiness to come up with a specific solution, which we agreed we must do. We also know that subjective judgements of what is the 'best' solution alternative in our collective judgements should then be evaluated for political and operational feasibility. To do this we need also to assume the existence of some governing body representing or linking the executive and legislative branches of govern- ment, consumers, professionals carrying out research, practice-oriented professions. A second assumption is that it is possible to provide a governing body with a legislated authority over policy, performance, funding priorities, control of the general direction and scope of substantive R&D programs. This is necessary in the initial phases. The breadth or scope and depth of the needed advice, consultative and evaluative effort cannot be provided entirely by an internal staff to any agency. The scope and expertise re- quired in this field is too large. Regular peer review and ad hoc advice is not sufficient. Accordingly, some process of communication and networking and collaborative effort has to be structured and high technology support is needed to carry out the kind of task-oriented studies, evaluations, planning, estimations and recommendations on adequacy of follow-up. The collection of current knowledge and information about the handicapped and their status in a regular process is urgently needed. Using them for specification of needs and for prioritizing their needs and judging the effectiveness of solutions afforded has to be con- ducted in a regular way. A controlled and organized ongoing activity is, therefore, necessary to replace the usual standing or ad hoc committee functions of the past. The solution being addressed now is, thus, how to make this requirement and its achievement -5- specific enough so that a law with authorities and appropriations, administrative locations, etc. can be specified. To establish the success factors that could be rated by each of us, a number of key ideas have been developed. They also offer a logical framework for establishing the success factors. These key ideas include: the need for proper input (so adequately addressed in the original panel report and in the recommendations of our committee review findings and the previous panel recommendations.) Involvement is a very important idea because of the necessity to achieve a coordinated and representative effort. Flexibility and adaptability of the program through responsiveness to feedback from those affected is clearly another element. The necessity of having a structure within government capable of organizing, managing and supporting an augmented effort and coordinating existing efforts is an un- doubted requirement. Leadership, both within and outside of government, must somehow be established on the basis of credibility. Another key idea has been the importance of adequately and accurately informing for commitment all of those who make possible a success- ful effort of this magnitude. The need for acceptance and usage of a regulatory or guiding body with adequate authority for policy development has already been discussed. Fiscal priority determinations and support of technology and personnel to grapple with a broad, multi-purpose effort is clearly required. The principle of developing and protecting the new program whose capacity will be much less than the responsibilities incumbent to it should be self-evident. This leads to the absolute importance of holding harmless what exists in research and develop- ment in our country at the present time and building on them rather than replacing or destroying them. The resources are so small this would be tragic. -6- Finally, unless and until there is usage and impact of the outcomes produced, the basic needs originally identified will never be resolved. A lack- of availability and accessibility of even what is known today for those in such dire straits as the handicapped will continue to be the status quo. These key ideas and their related success factors as statements are shown in the attached listing. These will be used for ranking estimations according to the attached agenda for the next meeting. Please examine these factors and add your own and prepare to discuss any of them. Also, note the rating sheets to be used, the explanations and the format of alternatives. At the meeting of November 14 and 15, we will discuss the approach to the next stage - how to deal with political and practical realities. KEY SUCCESS ELEMENTS FOR MAJOR NATIONAL EFFORT TO IDEAS BRING BENEFITS OF SCIENCE AND TECHNOLOGY TO THE HANDICAPPED 'Proper Input' Potential to get and use input from the handicapped on their needs and priorities 'Involvement' Potential capability to involve key persons in other activities which affect program operations and success 'Feedback, Likelihood of revision of operations from feedback from handicapped, Responsiveness, researchers and others regarding program benefits and deficits Flexibility, and Adaptability' 'Organize and Likelihood to be able to organize and to manage the program's Manage and scope, depth and balance of emphases Support' Multi-discipline, multi-purpose, multi-professional public/private effort having compatibility with agency's philosophy and practices Technological support for information gathering; processing; net- working; for communication system for needs input and user informa- tion output Internal capability for managing basic and appliedresearch hardware development, testing, distribution, and technical and knowledge transfer capabilities. External access to knowledge sources, technical information within and outside of government 'Leadership Potential capability to develop and retain leadership posture internally and within government and externally in the public sector Credibility' 'Informing Likelihood of strengthening and sustaining Congressional, Presidential for and public interest and commitment Commitment' 'Regulation Probable acceptance of governance of an autonomous body (a council, and trusteeship or board for policy, program and fiscal priority and Guidance overview. (how much on what) 'Developing Likelihood of developing and safeguarding and incrementing a and new program with fiscal capacity less than the responsibilities Protecting including: the New' Top level administrative support potential Attracting and holding new personnel for programs Justifying budget growth in executive and legislative branches of government 'Holding Likelihood of the alternative to protect and augment existing Harmless what R&D funding in other agencies, departments, etc. dealing with Exists and the handicapped. Building on it' 'Outcome Potential to transfer and stimulate practice usage of existing and Usage and newly procured knowledge, methods and technology Impact' Potential for impacting the service delivery system, conceptually, methodologically and quantitatively Potential for impacting the educational system for practi- tioners and their updating conceptually and procedurally Developing methods, procedures, systems for pilot testing, evaluation, production, marketing and distribution, and maintenance of hardware Other Criteria You Suggest: (Please list below) GENERAL CAVEATS Any alternative is not likely to succeed without continuity of commitment for authority and money from Congress, priority in the executive branch of government and leadership people responsible for the program. ALTERNATIVES SAMPLE EXECUTIVE LEGISLATIVE DHEW OTHER Regulatory would Body R Z New V N Z Attached to S 1. Agency A A S Committee A H S F of Congress A A = Personal preference estimation on a I to 10 for each alternative. The larger the number the stronger your estimate of the likelihood that this success factor could be achieved in the alternative's setting. Rate each on their own without directly comparing to another alternative. Rating Use N.A. in a column if you cannot decide or estimate or believe it is not possible to estimate. avg- (=lyA) N.) SAMPLE ALTERNÁTIVES EXECUTIVE LEGISLATIVE DHEW OTHER Regulatory Body R N New V N N Attached to S 1. { Agency A A S Committee A H S F of Congress A B = Rank order all alternatives with I being the least. best and 7 the worst. service Ranking Use N.A. in a column if you cannot decide or estimate or believe it is not possible to estimate. aug lowest score= lighest choice. ALTERNATIVES POTENTIAL TO GET AND USE INPUT FROM THE HANDICAPPED ON THEIR NEEDS AND PRIORITIES EXECUTIVE LEGISLATIVE DHEW OTHER Regulatory Body R Z New V Z Z Attached to S | Agency A A S Committee A H S F of Congress A This needs little explanation since it has been an accepted requirement of the previous panel and testimony. The problem, however, of getting input has not been addressed in its $ 6 ? a I 4 4 5 technical dimensions or social considerations, particularly patronizing attitudes felt by the handicapped and the sensitivity to lack of opportunity for self-representation of their needs and conditions. The usefulness of solutions being offered to them in the service system is a larger issue than insufficient R&D. The context of this judgement deals with the elements of feasibility, practicality, technical knowledge and procedures, experience in procuring informa- tion from persons who have never previously had opportunity, experience or practice in this kind of participation - W 2 ALTERNATIVES POTENTIAL CAPABILITY TO INVOLVE KEY PERSONS IN OTHER ACTIVITIES AFFECTING EXECUTIVE LEGISLATIVE PROGRAM STRUCTURE AND SUCCESS DHEW OTHER Regulatory Body R N New V N N Attached to S { Agency A A S Committee A H S F of Congress A This considers the complex area of viability of the lead agency concept in and among government agency and department structures. The possibility of effectively involving key persons in other agencies of government in a coordinated manner and reaching out and find- ing persons in the legislative branch of govern- ment who can assist with insights and judgements in practical, political priorities is a dimension of 'involvement'. Finding resources for research program activities in the private sector, mostly external to government itself; and to be able to provide forums and other methods for researcher participation in a planned and participating manner that will help provide the needed inputs to a trusteeship is also the context of 'involve- ment' ALTERNATIVES LIKELIHOOD OF PROGRAM REVISION FROM FEEDBACK OF HANDICAPPED RESEARCHERS AND EXECUTIVE LEGISLATIVE OTHERS REGARDING PROGRAM BENEFITS AND DEFICITS DHEW OTHER Regulatory Body R N New V N N Attached to S } Agency A A S Committee A H S F of Congress A Feedback is built into the concept of a technically and operationally supported information and know- ledge seeking and consultative process to assist the governing trusteeship or body. The quality of appropriate policies and overview evaluations of agency program performance is related to quality of input. The preference estimation considers likelihood that revisions reflecting the character of operational effectiveness on the handicapped, R&D needs, or lack thereof should stimulate appro- priate revisions. Policy changes without implemen- tary follow-through are ineffective. Flexibility and adaptability in existing or proposed alternative locations are the hallmarks to be searched for in the probable administrative performance of each alternative carrying out the program LIKELIHOOD TO BE ABLE TO ORGANIZE AND ALTERNATIVES MANAGE THE PROGRAM'S SCOPE, DEPTH AND BALANCE OF EMPHASES EXECUTIVE LEGISLATIVE (These components are to be separately estimated then averaged for a total score) DHEW OTHER Regulatory Body R N New V. N N Attached to S { Agency A A S Committee The likelihood of achieving a multi-purpose, A H S F of Congress multi-disciplined public/private effort that A is compatible with the alternative's philosophy of organization and operation Availability of experienced personnel and technological support or the potential for development for such support for the information processing, communication networking and development of a distribution system for needs and input and for user information output Internally, experience in the arrangements and methods for procuring knowledge (software) and for hardware research and development and distributional expertise. Externally, the degree of sophistication in getting access to sources of knowledge, the quality of such sources, access to rehabilitative engineering developments of hardware, their manufacture and distribution Note: Some alternatives may have equal preference in your thinking. Average Score POTENTIAL CAPABILITY TO DEVELOP ALTERNATIVES LEADERSHIP INTERNALLY WITHIN GOVERNMENT AND EXTERNALLY EXECUTIVE LEGISLATIVE DHEW OTHER Regulatory Body R Z New V N N Attached to A number of related features require estimation S 1 Agency A A S Committee of the probability of orchestrating a national A H S F1 of Congress commitment within government including executive A and legislative domains. Political savvy and commitment to usage of input and feedback from the handicapped constituency, the research professionals and practitioners is crucial. The ability to provide leadership to other existing activities and agencies comprises the 'lead agency' idea. Changing all present legislative authorities and executive activities and coalescing them into a new effort seems difficult to accomp- lish. The judgement of leadership potential depends upon knowledge of the character of existing agencies, other authorities, their regula- tions and operations, especially growth potential proportionate to needs of their "clientele'. ALTERNATIVES LIKELIHOOD OF STRENGTHENING AND SUSTAINING PRESIDENTIAL, CONGRESSIONAL EXECUTIVE LEGISLATIVE AND PUBLIC INTEREST AND COMMITMENT DHEW OTHER Regulatory Body R N New V Z N Attached to S | Agency A A S Committee A H S F of Congress A The context is howwell informing for commitment, the ability to develop a process of informing, and the development of public and professional rela- tions and timely communication and involvement in the Office of the President, the Congress will be carried out. A sustained commitment for streng- thening and gradually augmenting program opera- tions according to the successes achieved and the benefits derived from increasing resources and capacities. Innovative mechanisms of gaining and holding public interest and commitment involving research and development efforts to understand attitudes must be possible. This item has old and new elements. ALTERNATIVES EXECUTIVE LEGISLATIVE PROBABLE ACCEPTANCE FOR POLICY PROGRAM FISCAL PRIORITY GOVERNANCE AND OVERVIEW BY AN AUTONOMOUS BODY (A Council, Trustee- ship or Board) USAGE AND FOLLOW-THROUGH ON SUCH GUIDANCE DHEW OTHER Regulatory Body This is probably the most difficult judgement to R N New V N N Attached to make because it has two untested ideas. First, S { Agency A A S Committee there is 'lead agency' concept with an independent A H S F or autonomous governing process regulating it. of Congress A This need not impair agency operation and follow- through Second, effectiveness of an outside body linking executive, legislative and the private sector participation is not certain. Policy guidance by an executive group to afford timely communication for program emphasis and fiscal priority judgements are usually internal to an agency (with usage of various advisory or directive bodies). These two untested requirements make this item an important one to estimate. Any specific alternative location would have to grapple with this process or have. built into it sufficient capability, commitment and authority to conduct these processes. Guidance can be suggested for priorities of the program, internally, with good communication and leadership. There is no counterpart in government except for for ad hoc or standing advisory committees. These rarely have sufficient support for complex kinds of judgements and prioritizations or even evaluation of the effectiveness of the advice rendered. ALTERNATIVES LIKELIHOOD OF DEVELOPING AND SAFE- GUARDING A NEW PROGRAM WITH FISCAL EXECUTIVE LEGISLATIVE CAPACITY LESS THAN THE RESPONSIBILITIES DHEW OTHER Regulatory Body R Z New V N N Attached to S { Agency A A S Committee A H S F of Congress A Top level administrative support potential. It is very unlikely that a new program could survive the bureaucratic processes without this at the 'Secretarial' level Attracting and holding new agency personnel. The style of procurement and attractiveness of the agency to acquiring professional people within and outside the government is the con- text Justifying budget growth in the executive branch of government within the Office of Management and Budget) and within the legislative branch of government in the various overview and appropria- tion committees of Congress is the strength sought in this item Total ALTERNATIVES EXECUTIVE LEGISLATIVE LIKELIHOOD OF THE ALTERNATIVE EXAMINED TO PROTECT AND AUGMENT EXISTING R&D FUNDING IN OTHER AGENCIES AND DEPART- MENTS DHEW OTHER Regulatory Body R N New V Z N Attached to S 1 Agency A A S Committee A H S F of Congress A This item is critical because the magnitude of effort is so small in our present activities that 'holding harmless' what exists and building on them must be a consequence of any alternative recommended. Any successful organizational alternative must not diminish or replace existing appropriations. Some modification of existing agency authorities might be needed for insurance of a balance of emphasis among the lead agency and those being led. This capability requires sage political and executive judgement and cooperation and presidential endorsement. With- out this protection and building on the 'hold harmless' principle, the panel's recommendation, if implemented, could have a very negative effect on our current national effort. ALTERNATIVES POTENTIAL TO TRANSFER AND STIMULATE USAGE EXECUTIVE LEGISLATIVE OF EXISTING AND NEWLY PROCURED KNOWLEDGE METHODS AND TECHNOLOGY (Separately estimated components) Potential for impacting the service delivery DHEW OTHER system. This is envisioned as an impact which will have conceptual dimensions in kinds of services that are appropriate for handicapped Regulatory people; methodologically, in the kinds of proce- Body R N New V N Z Attached to dures to be used for information and technology S { Agency A A S Committee transfer, and quantitatively in how well the A H S F numbers of people afforded services would be of Congress A increased. Relevant connection with the service delivery system is essential, particularly the components of public or private rehabilitation service delivery system, e.g., state agencies, professional organizations and rehabilitation facilities, hospitals, etc. Potential for impacting the educational system for practitioners and the training that is used in their updating. Introduction and adoption of con- ceptual and procedural changes in practices for methods of treatment and management based on new knowledge is implied. Ability to revised methods for selection of persons to benefit from new technical developments and devices is included. Promulgation of advanced training procedures and establishment of model demonstrations, 'experiment' stations, etc., is included. Continued on next page, please. POTENTIAL TO TRANSFER AND STIMULATE USAGE ALTERNATIVES OF EXISTING AND NEWLY PROCURED KNOWLEDGE METHODS AND TECHNOLOGY (Page 2) EXECUTIVE LEGISLATIVE DHEW OTHER Regulatory Body R Z New V Z N Attached to S } Agency A A S Committee A H S F of Congress Ability to develop methods, procedures and systems A for pilot testing, systemation, evaluation, initial production support, marketing, distribution, and maintenance of a variety of devices (simple and complex) is expected. Outcome usage impact is most important; evidence exists already on the failure to transfer and use existing knowledge and technology. The reasons have not been widely studied, nor have solutions been devised. Lack of transfer and usage of what is known, as solutions become more complex, requiring greater changes in practice, greater involvement and knowledge of the user and maintenance of follow-up methods have not been accomplished in a 'systems' sense. The general problem of the gap between knowing what to do and having that available and used must be solved. Average Score SMITH-KETTLEWELL INSTITUTE OF VISUAL SCIENCES and DEPARTMENT OF VISUAL SCIENCES UNIVERSITY OF THE PACIFIC 2232 Webster Street San Francisco. California 94115 (415) 567-0667 & 563-2323 August 19, 1977 To: Mr. Sherman Roodzant From: Lawrence A. Scadden, Ph.D. Re: Validation of the 1976 Science & Technology Report I will attempt to test the soundness of the primary recommendation offered by the 1976 Panel on Research Programs for the Handicapped by applying the single recommendation to the problem areas delineated in the report. 1. Assessment of needs: The establishment of a National Council for Research and the Handicapped might be able to enhance the identification of the needs of the handicapped and the prioritization of these needs if adequate and appropriate representation of the target population and of consumer organizations is achieved. Such representation is more a problem of process than either function or authority. The selection of these representatives to serve on the Council would undoubtedly result in the naming of highly respected, visible, and articulate individuals who are, for the most part, already involved in providing input to the agencies providing research funds. The creation of a Council would serve here only to insure this input. Although consumer participation in the setting of research needs is currently possible, I believe that the recommendation for a national Council would insure improved participation and thereby aid in remedying the identified problem area. 2. Imbalances in research activities: The previous panel identified a number of problem areas related to perceived imbalances of various elements within the broad framework of research. Four of these identified imbalances might be improved through improved coordination by a national council. These areas are: (1) Balance between basic and applied research, (2) Balance between simple and complex solutions, (3) Equitable distribution of research resources to all handicapped groups, including age groups, and (4) Improved balance between vocational and nonvocational rehabilitation activities. The major question relating to the potential efficacy of such coordination would be the authority of the Council to carry out this primary function. It seems doubtful that any council could insure a complete elimination of these perceived imbalances because there are so many autonomous funding agencies involved. Legislative appropriations may not be in balance to permit achievement of the Council's goal in any given year. It seems that the Council would need to be as much an advisory body for Congress as a coordinating entity Mr. Sherman Roodzant -2- August 19, 1977 for executive branch agencies. I have severe reservations as to the potential of a national council achieving the results necessary to meet the problem of imbalance in research programs for the handicapped. Improved input to congressional committees on science and technology and the handicapped as well as increased cooperation and communication between executive branch agencies must be achieved whether a national council is established or not. The creation of a new entity with increased authority does not seem to be sufficient to insure such enforced communication. I think that we are dealing with two separate problems: One dealing with input to Congress, and one dealing with inter-agency communication. I have one final comment to offer concerning inter-agency communication and coordination. It is not always a benefit to have a number of agencies with very specific jurisdictions. Frequently, researchers have found that innovative ideas will not be considered by one agency while being considered and supported by a second. Strict jurisdictional distinctions may lead to the suppression of innovation. 3. Factors limiting research for the handicapped: The previous Panel presented a substantial array of factors which appear to have negative impact upon research for the handicapped. The first two (insufficient funds and too many authorities which exist without clear coordination) could best be attacked by a Council if the Council had direct influence upon legislative appropriations. An advisory committee representing consumers, scientists, physicians, practitioners, and industry might be formed to advise appropriate legislative committees concerned with the handicapped, science and technology, and appropriations. The creation of a super-authority to coordinate the affairs of 103 already existing, autonomous authorities seems unmanageable and probably unacceptable to the existing authorities. A national Council, as proposed by the previous Panel, probably could positively impact on the remaining factors identified as limiting research for the handicapped. Such a Council, with sufficient visibility and respect, could improve communication between governmental, private, and volunteer agencies dealing with the handicapped. I believe that such a Council, as proposed by the previous Panel, should be established within a quasi-governmental body such as the National Academy of Science. This Council could serve as an advisory body for Congress and the executive branch, and it could assist by providing peer review for various granting agencies. However, I see communication to be the primary function which can be best served by this entity. The dissemination of information between scientists and to both practitioners and potential consumers has been identified by the previous panel and by many other organizations as being potentially the most important need currently facing the area of research programs for the handicapped. Mr. Sherman Roodzant -3- August 10, 1977 The extensive telecommunication system proposed by the previous Panel is one which needs implementation at the earliest possible date. I believe that this program will require the highest level of both science and technology and can rightfully be considered by the U.S. House Committee on Science and Technology as a priority item within its own agenda. I will make brief reference to the other two major findings of the previous Panel. Insufficient sharing of information and knowledge: the sharing of information and knowledge can best be achieved through the establishment of the communication network mentioned previously. The barriers impeding utilization of research and development results by the handicapped are areas which need close scrutiny. Several of these areas cannot be handled by a national council as proposed in the previous report. The establishment of regional locations for prescription, training, maintenance, and supply can only come through enactment of new legislation. Similarly, the availability of such devices can only come through proper appropriations permitting the purchase by the consumers or by appropriate providers. I do not see that a single solution, especially one referring to a single national council on research for the handicapped, can address all of these barriers. I suggest that the current Panel take a close look at these particular problems and make new suggestions. S. American Coalition of Room 817, 1346 Connecticut Avenue, N.W. o (202) 785-4265 Citizens with Washington, D.C. 20036 Disabilities Inc. Congressman Olin E. Teague Chairman Committee on Science and Technology U. S. House of Representatives Washington, D. C. 20515 Dear Congressman Teague: It has been my pleasure to review, as a member of the present Panel on Research Programs to Aid the Handicapped, the report of the previous Panel. It is in my opinion an excellent report which addresses some of the most serious concerns I have had over the past few years and proposes some exciting solutions with which I feel quite comfortable from my perspective as ACCD Director. In particular, the finding of the previous Panel that research programs on behalf of disabled individuals are fragmented and poorly funded has been a continuing source of frustration for ACCD. It is only too true that efforts on behalf of this population historically have focussed upon parts of the problems with which disabled people wrestle daily, that this fragmentation compromises the capability of governmental and private sector research programs to resolve perplexing problems, and that the amounts authorized, appropriated, and allocated in both sectors are far from sufficient to do justice to the problems. The recommendation of the Panel for a body which comprises consumers, private researchers, and governmental representatives is responsive to a long-standing concern of mine: that disabled people have great difficulty obtaining a voice in the making of decisions vitally affecting their lives. This recommendation, therefore, has my wholehearted support. The finding of imbalances in recipient emphases, of counterproductive competitiveness, and of limited access to services is equally a valid one. There is, as the report notes, no major service and technical aids. information center available to help disabled individuals become acquainted with advances in research and practice which have the potential to help them live more independent lives. These problems are in large part due to the lack of adequate consumer involvement in the selection of research targets, in the evaluation of research findings and products of development efforts, and in the dissemination of results. Teague, 2 A major problem identified by the Panel that the fragmentation of effort on behalf of disabled persons produces unnecessary gaps and duplications is another source of continual frustration for me. I cannot count the number of studies that have, for example, addressed the auditory needs of deaf persons but I search in vain for a solid body of evidence emanating from studies on the needs of these persons for visual information. Similarly, I have seen innumerable studies on the precise problems in manipulation of certain persons with physical impairments but few on their personal and social problems. Again, I have read many studies focussing upon what is wrong with disabled people, but few on how their abilities may be used maximally. There have been cases where one agency has developed over a period of years a research protocol which has led to a steady series of advances only to have another agency subsequently make the startling discovery that the t problem has been overlooked entirely. For all of these reasons, I commend the previous Panel, particularly Panel Chairman Spencer, for a cogent and highly relevant report. I do have some reservations with the récommendation as made. My primary concern is that only one recommendation is proposed. The Congress is asked to accept or reject the "National Council for Research and the Handicapped" as a whole. I would greatly prefer a series of graduated recommendations so that the Congress may determine which of the proposals it feels it may support at any given time. It is my understanding that the structure which is proposed contains within it many component recommendations, and for this reason my comment may lack validity, but I wish to stress my belief that several options should be set forward for consideration. To take just one example, the possible location of the proposed Council was subject to considerable debate. It is possible that the Panel may wish to recommend that its primary choice is for placement as an independent body, following the report of the previous Panel, but that if this proves impossible, placement within the Executive Office of the President would be preferred over an interagency committee approach. Alternatively, the Panel may wish to suggest that a beginning be made within or without government through which a more permanent and more desirable location may be developed. As I have indicated, one of my deepest concerns is with adequacy of consumer involvement. The report of the previous Panel goes further than most such reports with which I am familiar in structuring consumer participation. But does it go far enough? Will disabled people in fact be able to become involved in the assessment of needs, identification of priorities, evaluation of results, and dissemination of findings? The previous Panel said little on the subject of research and technology to aid disabled children and youth, yet a great deal of work has been done in this area. I believe we need to look at this body of research to see whether the recommended structure wouldrrequire modification to encompass work that would be of benefit to these individuals. Teague, 3 Finally, I was somewhatadisturbed to read the hearings record alongside the report of the previous Panel. because there often were instances where I could not find evidence from the witnesses which related directly to or appeared to have generated the findings; alternatively, many of the concerns raised by witnesses are not mentioned in the Panel's report. With respect the latter, the demonstration by many witnesses that they misunderstood the role of research and development in the totality of habilitation and rehabilitation programming appears sufficient justification. But the first continues to bother me: I see little evidence that people consulted by the Panel were asked to address the eventual product the recommended National Council for Research and the Handicapped and for this reason I do not feel that a consensus for the proposal has in fact been established. This is, perhaps, a task for the present Panel. In any event, I would strongly support an effort to achieve such consensus, particularly from disabled people and their organizations. Allow me to conclude by expressing my satisfaction with the procedure adopted by the Committee. Appointing a Panel of experts heavily weighted with disabled cpeople themselves appears to me, on the basis of the high quality of work performed, to be an excellent and often-overlooked process for a legislative body to adopt. That it worked so well is a powerful recommendation that a similar procedure be followed in the actual performance of the work proposed; i. e., in the National Council. Sincerely yours Frank G. Bowe, Ph. D. Developmental Disabilities Law Project University of Maryland Low School / 500 West Baltimore Street Baltimore. Maryland (301) 528-6307 Director: Marcia Pearce Burgdort Deputy Director: bisan a Leviton September 19, 1977 Stoff Attorneys: Donald N Bersoff Nanc, B Shuger Savid Simonson Director Mr. Olin E. Teaque, Chairman of Social Work: Committee on Science & Technology :- 20 K Neison Director of Research: U. S. House of Representatives Robert L Burgdorf Jr Suite 2321 Administrative Rayburn House Office Bldg. Assistants: Washington, D. C. 20515 and B Gayhardt Annelle Wingfield regional Attorneys: Dear Mr. Teague: not! Smith 44m 11 Coffine. Although my expertise concerns the legal rights ashingtee 00) of handicapped persons and not the area of science and filed M Coster technology, I would like to submit the following comments 41 Mercerolo Virginia) on the April 1977 Report of the Panel on Research Programs to Aid the Handicapped. It is clear to me from my work with handicapped clients that there has not been enough research done to show the very positive aspects of potential of handicapped persons to lead independent lives. I found the panel's findings to be accurate and to focus on the primary problems facing handicapped individuals today. First, I would like to review the various recommendations of the panel and secondly, to make some suggestions. I. Review of Recommendation I think the most important point that was made in the panel's findings is that there has not been the proper development or input from consumers in either determining their own needs or in assessing the effectiveness of the service delivery system to meet these needs. If there is one thing that I can contribute to the panel, it is this; that the prime consideration for the providing of service or for doing research on behalf of the handicapped citizens is that handicapped individuals must be involved themselves. They cannot be relegated to a token advisory role. They must participate actively in any kind of planning, provision of services, or research programs as well as in the evalu- ation process. The panel's report strongly suggests that this should be an important factor in determining future research efforts and gives great support to the principle of consumer involvement. I would simply like to underscore the importance of this contribution to have actual Mr. Olin E. Teague Page 2 September 19, 1977 participation from knowlegeable handicapped individuals. I do not feel confident to comment on the suggestion that there should be a balance between basic and applied research; however, I do completely agree with the panel's suggestion that the research and the products of this research should be made accessible and available to handicapped persons. It seems very clear that regardless of what type of research is done or the balance between complex and simple technological solutions, the value of the research is greatly diminished when the results are not made accessible to handicapped individuals. In addition, I agree with the panel's recommendations concerning the present inbalance in research emphasis that special note should be given to the fact that there must be corrective action taken to change the imbalance which currently tends to exclude some important portions of the disabled population from major research efforts. The report also notes that there is incomplete research on some handicapped people such as developmentally disabled persons, and elderly persons. The report stated that the principle focus at the present time is on working age adults. I would like to suggest that the committee staff follow up on some of the very valuable research that has been done concerning children and developmentally disabled persons especially by the Bureau of Education for the Handicapped and also by the Office of Dev. Disabilities at HEW. I think both these agencies, and especial- ly B. E. H., has done a tremendous amount of research that has been very supportive of the consept that handicapped persons should be enabled to maximize their potential so as to live as independently as possible. I do think that the panel's suggestion that certain groups have been left out of certain kinds of research projects is correct. I also feel that where research has been done concerning the needs of particular handicap population, that these results need to be communicated more broadly so that other disabled persons can get benefits from the information and solutions that have been developed. The panel further suggests that another type of research that is necessary is research into the need to change social attitudes. As an advocate, I recognize clearly the need to inform the public about, not only the human and legal rights of handi- capped persons, but also the great potential that these individuals have to contribute to our society. I think that this is extremely important, and I would suggest that in any attitudinal study that careful study/analysis be given to the work done in the last 7 years by the legal advocates on behalf of handicapped persons. The legal rights movement, or the civil rights movement, if you will, has utilized the courts to establish the right of handicapped persons. The courts have held that they are in fact equal citizens and should have full access to all the opportunities our society provides. I suggest that research on social attitudes Mr. Olin E. Teague Page 3 September 19, 1977 need also look at the more informal ways that change could be accomplished in our society. Also, I would hope that when the research is completed, for example, in an area such as how to utilize science and technology to remove architectural barriers in buildings and in transportation systems, that the solutions and the technology can be translated into womewhat simple language, so that the average administrator or person who is responsible for implementing the changes can also make use of the technology. Example, what does a 5% graded ramp mean? How do you judge or measure it? Although I am not experienced in assessing the amount of dollars that are spent in research on behalf of handicapped persons, it is clear that in comparison with the amount of funds set aside for total federal health care, that they are an infinitesimal percentage and, therefore, cannot adequately address the needs of this population. I can comment, however, on the fact raised by the panel that there is no existing mechanism tc provide team work in the public sector for the various agencies that are conducting research on behalf of handicapped persons, and to the best of my knowledge, there is no counterpart in the private sector either. This makes the ability to communicate the discoveries and solutions uncovered through science and technology much more difficult. It certainly impedes progress, which could only be enhanced by the sharing of information with public agencies that currently have responsibility for various research programs on behalf of the handicapped. Finally, I find it rather sad that there has been so little effort directed towards ways of improving consumer knowledge of, and accessibility to scientific devices that would significantly change these individual's lives. Perhaps of even more concern is the fact that so few efforts have been made to change the behavior of practitioners to accept or use new concepts and technologies. Often one will find that social workers, doctors, psychologists, even educators will put barriers in the way of the individual that will make it much more difficult, and in many instances impossible, for the person to live an independent life. This true in spite of the fact that the technology and the methodology for helping such a person cope in a normal environment has been proven very successful. Therefore, I am in strong agreement with the basic findings of the panel concerning: 1. the need for consumer input concerning research programs. 2. the need for a more balanced and cooperative approach to research programs that will benefit all types of handicapped persons. 3. the need for sharing information with the handicapped individual himself. 4. the Mr. Olin E. Teague Page 4 September 19, 1977 need for communicating and coordinating research findings within both the public and private sector. II. Suggestions I would like to make some comments about some various concerns that I have, and then I will address the recommend- ations of the Panel. One of the concerns that I have is that in the body of the report was a mention that a disability becoming register should be kept. Frankly, this has the potential of one of the most negative things that could happen. Lists of disabled persons have been made in the past and, once they became labeled disabled, mentally retarded, "crippled", or blind; too often, people automatically stereotyped them. The individual is then viewed only for his or her handicap and is not allowed to maximize his or her own individual potentials. In addition to this stereotyping or "classification", information concerning disabilities that is really basically private and priveleged information, was often shared among public agencies and access given to indivduals and who had absolutely no business knowing the medical histories personal facts relating to individual handicapped person. Therefore, I am quite concerned about what is meant here by a disability register. Clearly, a method of assessing how many disabled persons we have in our society and the type of services they need should be developed. Perhaps this could be done through the Census Bureau by asking rather detailed questions relating to whether there is a disabled person in the household, what kind of disability does the person have as a result of the particular disability? I think it's the functional kind of disability that we would be interested in keeping a register of, but there must be adequate protections for the removal of any personally identifiable information on individual request. Secondly, I noticed throughout the report the term rehabilitation was often used. The prefix "re" indicates that you are restoring or returning an individual to his full capacity or to "normal" life. In the field of developmental disabilities there is another term which is equally important, that is, habilitation. It is important for the panel to keep in mind that many of our disabled citizens have been disabled from birth or during the developmental period and are not being returned to some past state of normality. I raise this point because it is important that this Committee must not think soley in terms of those individuals who have lost particular abilities that they once had. Thirdly, it is clear from the information in the report, as well as from the testimony that was presented to the panel, that there were not representative from certain disability groups Mr. Olin E. Teague Page 5 September 19, 1977 such as mental retardation, epilepsy, cerebral palsy, learning disabilities, or autism (developmental disabilities). I would suggest that the committee staff go quickly about compiling some of the information on these other interest groups that might be helpful to the present Panel's deliberations. One source of information which I will enclose with this letter which hopefully will be helpful is the document prepared by the President's Committee on Mental Retardation entitled "Mental Retardation Century of Decision" a report to the President, May of 1976. The basic purpose of the report is to project to the year 2000 to determine what mentally retarded individuals might optimumly expect from our society. I think that there are certain sections and comments specifically on research that might be helpful as well as an overview of current issues in mental retardation. Chapters include: 1. full citizenship and legal rights 2. prevention of right to be well born 3. prevention of right to a good start in life 4. the main service systems 5. public attitudes 6. the role of government 7. Century of Decisions costs and results 8. goals projected recommendations I would suggest that there may well be similar kinds of plans pro- ducted by the Office of Developmental Disabilities, HEW, that might be helpful to the present Panel's deliberations. In addition, the Bureau of Education for the Handicapped, which I mentioned earlier, is required under a new federal law, P.L. 94-142, the Education for all Handicapped Children Act, to do a survey of each and every handicapped child within each state throughout the country. This headcount information may be very helpful because there will be some kind of breakdown among the numbers reported as to what types of services individuals might need. In fact, I read with great interest Dr. Edward Martin's letter to you commenting on the first Panel report, and I feel that his suggestions had great merit. It was interesting to note that his own agency in reviewing the needs of handicapped persons in regards to research had uncovered some of the exact same problems that the Panel's report centered on. His agency's response was to address each of these problems with an individual solution. However, I find the Panel's suggestion of an autonomous agency made up of representatives from both the public and private sectors to be a much more viable solution to the problem facing handicapped persons and their utilization and maximization of science and technology. III. Recommendations It would seem to me from my experiences working with government agencies, that because there is no overall mandate for agencies to cooperate, it is almost impossible Mr. Olin E. Teague Page 6 September 19, 1977 for them to work together to solve the problems facing handi- capped persons. In addition, there is a real need to involve the private sector in utilizing science and technology to the issues raised by the Panel. Therefore, I endorse the Panel's suggestion for a national council for research for the handi- capped. I recognize clearly that there might be political problems in making this a salable concept, and I also recognize that more work is necessary in order to clearly draft legislation that would make this nation council a reality. Hopefully that is one of the projects that the ongoing Panel will take up. I think some specific comments on the proposed structure and function of the nation council that I can make are as follows: (1) that the listing of government agencies which should be included, have left out the Bureau of Education for the Handicapped and the Office of Developmental Disability as well as the President's Committee on Mental Retardation; (2) that in designating types of persons that might be included from the private sector, hopefully people with background in advocacy on behalf of handicapped persons, could be included; and (3) under the powers section, the power of representatives of the non-governmental agencies was too weak and should be strengthened in any later proposal. In addition, the responsibilities section needs to be made more strong so that the implementating agency will be able to implement the goals of such a national council. Thank you again for the opportunity to participate with the panel. I am very enthused about the work that the Panel is doing, and hope very much that we can bring some new enthusiasm to the efforts and recommendations of the orginal Panel. Thank you very much for your concern. Sincerely, Marcia Burgdorf Marcia Pearce Bayday day MPB/drh Enclosure PHONE: (202) 628-1037 Hanger J. E. HANGER, INC. 40 PATTERSON STREET, N.E. WASHINGTON, D.C. 20002 August 15, 1977 Mr. Sherman E. Roodzant Technical Consultant Committee on Science & TEchnology U. S. House of Representatives Suite 2321 Rayburn House Office Bldg. Washington, D.C. 20515 Dear Mr. Roodzant: In response to the letter of Congressman Teague dated August 8, 1977, I have reviewed the Report of the Panel on Research Programs to Aid the Handicapped. After careful study, I find that I am in disagreement with some of the re- commendations as developed by the original Panel. Let me make it clear that I fully appreciate the tre- mendous task that confronted the original Panel and I feel that many of their recommendations will be useful as we proceed to define more clearly some of the research efforts that will improve the plight of the handicapped. My strongest criticism of the Panel's Report lies in two (2) areas: 1. I do not feel that the creation of a super- agency such as the "National Council for Research and the Handicapped" is either politically feasible in the climate of today's government of potentially workable. 2. Although charged by the Committee to identify research programs that will assist the handi- capped, I find that the Report does not address itself directly to this subject, but only re- commends it as a high priority item for the proposed National Council. Although I do feel that coordination and information exchange among those organizations currently working for the handicapped would be extremely beneficial, I do not believe that the formulation of still another agency would be the answer to significant improvement in this area. I whole- heartedly agree with the recommendations of Dudley S. Childress, Ph.D., that this effort could be spearheaded through the Executive Office of the President. Other exist- ing agencies such as HEW and V.A. also appear capable of taking over such a function. AFFILIATED Hanger FACILITIES IN PRINCIPAL OF THE STATES AND CANADA 2 It was very clearly brought out by the original Panel Report that the many problems relating to the handicapped are quite complex and extremely varied in nature, depending on the particular affliction. This being the case, it is my suggestion that we do not attempt to look at the problems of the handicapped as a whole, as I believe was the case with the original Panel. I suggest that we isolate various categories of disabilities and find out what the major prob- lems are today. Through this route, we can set priorities and hopefully accomplish more in a shorter period of time. My solution to uncovering these high priority needs would entail going directly to either the consumer organi- zation, association, medical, paramedical, or private/govern- mental research agency involved with each particular segment of the handicapped population. Here we can find the people that are dealing on a daily basis with each particular class of affliction and these are the people that should hold the key to what the most pressing problems are. As an example, I would suggest that in the area of prosthetics and orthotics, The American Orthotic and Prosthetic Association, The American Academy of Orthotists and Prosthetists, and the Veterans Administration be consulted. Through this approach we should be capable of identifying existing technology and the state of the art in specific areas and also, identifying the problem areas presently being encountered which need acceleration and further research and development. In conclusion, I feel we cannot treat the handicapped as a whole but must break down their problems and the solu- tion to these problems into specific disability areas. The information sought by the Committee on Science and Technology in its original charge to the Panel is definitely available and obtainable. Thank you for this opportunity to pass along my comments to the original Panel's Report. Very truly yours JOSEPH M. CESTARO Immediate Past President American Academy of Orthotists and Prosthetists paralyzed veterans of america PVA Charleved by United States Congress 7315 Wisconsin Ave., Suite 300-W, Washington, D.C. 20014, (301) 652-2135 A CRITIQUE ON THE FINDINGS AND RECOMMENDATIONS OF THE FIRST PANEL ON RESEARCH PROGRAMS TO AID THE HANDICAPPED BY JAMES E. SEYBOLD, NATIONAL RESEARCH DIRECTOR, PVA As a member of the original Panel on Research Programs to Aid the Handicapped, I still fully support and concur with the Panel's find- ings and recommendations. And I strongly believe in the primary recom- mendation to create a National Council for Research and Development. and the Handicapped. The unresolved question is, of course, its lo- cation. I personally favor the Council working out of the Committee on Science and Technology in some fashion since the Committee has the oversight authority on all R & D activity except Defense. A strong connection with the Committee would lend the high visability and credibility envisioned for the Council. Just how or where within the Committee it could be established required more study. In view of the problems yet to be resolved, assuming the Council ap- proach remains valid, the attached article by Jurgen Schmandi which appeared in the July 29, 1977 issue of Science deserves due considera- tion. In his article, "Federal Reorganization: Science and Tech- nology,' he lists six principles of organization and management in relation to science and technology to consider. They are sound pieces of logic to incorporate in any long range planning of the proposed Council. To further emphasize my support and commitment, I wish to comment on some of the correspondence Congressman Olin E. Teague received, copies of which were furnished to this Panel. Donald J. Miller's letter states in the last sentence of the second paragraph that "My concern with this particular report is that it calls for new action without really addressing solutions that already exist within the law or already exist within agencies currently funded by the government." The Panel did indeed address itself to these existing solutions. In fact, the third, fourth and fifth paragraphs of the Preface (III) hits this immediately. In essence the report announces that there are pro- grams which are ongoing, however, they are fragmented, uncoordinated as a whole, chopped into cubbyholes of some agency's turf and shut off from contact with related or other complementary programs, and the han- dicapped individuals for whom they were designed get piecemeal services. Perhaps Nevada is unique in this respect, but it is an example of an isolated example. Mr. Miller is correct in his assumption in the first paragraph, page two, when he asserts the Panel's report implies "that agencies that are in existence now are neither able nor capable of performing this function" (overview). It does not exist as a totality for all R & D activity for the handicapped. Referring Mr. Miller's and others reference to a lead agency, it was the opinion of the majority of the Panel that any lead agency, no matter where it was or how it was structured, would be ineffective and run counter to agency tradition. Agencies historically tend to expand and acquire new domains, not to cede any of its territory to another agency. And, of course, there was the impending threat, backed by existing examples, where a viable unit of government was put under the purview of such a lead agency only to become buried, isolated and forgotten in the layers of the agency's bureaucracy. In the first paragraph of page two, Dr. James C. Folsom, Director of the ICD Rehabilitation and Research Center, extends this argument for a lead agency even further by questioning the need and ability of a quasi- governmental non-profit corporation (National Council for Research and Development and the Handicapped). Again it was an expressed concern of the Panel that civilian sector participation within a lead agency would be muted and dominated by the agency itself. Folsom's suggestion of the use of the White House Conference on Handi- capped Individuals in the third paragraph of page is an interesting ap- proach, however, I would like to see the final report of that Conference first, and fully examine its structure. Referring to the Panel's three supportive suggestions, point 3, Folsom fails to see their relevancy to the five charges given to it. Again, the Panel saw the immense problem and realized they could not be addressed as such because there was no data base to draw from. The Panel did not know how many people with what kinds of disabilities existed, or where they were (in order that a program of needs and priorities could be developed). Nor was the extent of the present state-of-the-art known (so the program could move forward instead of backwards). Also, the parameters in which the Panel was allowed to function under the Committee on Science and Technology's Rule x(7) (r) was hard pressed to stay within its limits. Congressman Olin E. Teague's letter of March 31, 1977, P (VII) of the report stated: "This investigation was initiated in an effort to identify the needs and problems of the handicapped, and to determine how this nation's vast scientific and technological resources might be better directed towards addressing these needs and problems. " The key words relating to scientific and technological resources were what the Panel had to bear in mind although other needs such as medical, rehabilitative, psychological, etc., were also identified. In short, the scope of the Panel's findings and recommendations was made as broad as possible. Now other elements of the handicapped population want and need to be heard, i.e., special education, developmental disabilities, aging, etc. It is a very complex problem. Individuals who are now responding to the Panel's report have been astute in the segments of the report which directly relate to their particular cause or programs. This response and criticism is indeed gratifying because if anything, the Panel's report has elicited an awakening and a call for action to become involved in this, the "decade of the disabled." But again, the need to support basic and applied research and technology in all phases in the paramount keystone in attacking the surmounting problems of the handicapped. The scope of the Panel should be expanded so no group of disabled individuals is left out in a national commitment, but it must be done in proper perspective to the total problems con- fronting the handicapped. 29 July 1977, Volume 197, Number 4302 SCIENCE AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE Federal Reorganization: Science and Technology Science serves its readers as a forum for the pre- As plans for the reorganization of the government are drafted and redraft- sentation and discussion of important issues related to the advancement of science, including the presentation ed, rumors about changes in the organization of science and technology of minority or conflicting points of view. rather than by publishing only material on which a consensus has been programs abound. It seems timely. therefore, to consider some general prin- reached. Accordingly. all articles published in Science- ciples of organization and management in relation to science and technology including editorials, news and comment, and book re- views-are signed and reflect the individual views of the in government which should be kept in mind as new arrangements are authors and not official points of view adopted by the sought. AAAS or the institutions with which the authors are af- filiated. Mission agencies need strong R & D programs. The vast majority of fed- Editorial Board erally supported R & D activities is intended to enhance specific policy 1977: WARD GOODENOUGH. CLIFFORD GROBSTEIN. goals. There are few policy missions, if any. that will not benefit from a well- H. S. GUTOWSKY. N. BRUCE HANNAY, DONALD KEN- NEDY, NEAL E. MILLER. RAYMOND H. THOMPSON designed research program. This includes research and development proper 1978: RICHARD E. BALZHISER. JAMES F. CROW, as well as policy and evaluation research. It also includes development of HANS LANDSBERG, EDWARD NEY. FRANK W. PUTNAM. MAXINE SINGER, PAUL E. WAGGONER. F. KARL WIL- institutional linkages for diffusion and extension and, where appropriate, LENBROCK social demonstrations. Both programmatic and regulatory agencies need Publisher R & D activities directly related to their policy missions. WILLIAM D. CAREY Mission agencies need their own science policies. There is no single mod- Editor el for organizing and managing an agency's R & D program, for the appro- PHILIP H. ABELSON priate mix of private and public involvement, for the use of internal or exter- Editoral Staff nal R & D capabilities. for establishing linkages between policy planning. Managing Editor Business Manager program implementation, and the R & D function. What makes sense in the ROBERT V. ORMES HANS NUSSBAUM Assistant Managing Editor case of Defense is unlikely to work in Agriculture, and vice versa. Agencies Production Editor JOHN E. RINGLE ELLEN E. MURPHY must learn from each other, but there is no substitute for developing agency- News and Comment: BARBARA J. CULLITON, Editor: specific R & D strategies in response to agency-specific responsibilities and PHILIP M. BOFFEY, LUTHER J. CARTER. CONSTANCE HOLDEN. DEBORAH SHAPLEY. NICHOLAS WADE. JOHN environments. WALSH. Editorial Assistant. SCHERRAINE MACK Mission agencies need basic research. R & D programs of individual mis- Research News: ALLEN L. HAMMOND. Editor: GINA BARI KOLATA. JEAN L. MARX. THOMAS H. MAUGH II. sion agencies must not be restricted to applied work or to exclusive concern WILLIAM D. METZ. ARTHUR L. ROBINSON. Editorial with short-term solutions. Mission agencies. instead. must be organized and Assistant, FANNIE GROOM Associate Editors: ELEANORE BUTZ. MARY DORF- funded in such ways that they can support basic research in their broad MAN, SYLVIA EBERHART. JUDITH GOTTLIEB areas of responsibility. Without such a policy the research work of agencies Assistant Editors: CAITILIN GORDON, RUTH KUL- will become stale. STAD. Lois SCHMITT. Book Reviews: KATHERINE LIVINGSTON. Editor: LIN- A central science policy capability is needed. Science advice for presiden- DA, HEISERMAN. JANET KEGG tial decision-making will take on different organizational forms under dif- Letters: CHRISTINE KARLIK ferent Presidents and for different issues. However. it would be a grave Copy Editors: ISABELLA BOULDIN. OLIVER HEAT- WOLE mistake if the need for a strong science policy capability had to be rediscov- Production: NANCY HARTNAGEL. JOHN BAKER: YA ered every few years. The range of issues to be decided by the President. Li SWIGART. ELEANOR WARNER: JEAN ROCKWOOD. LEAH RYAN. SHARON RYAN many of them with important scientific and technological components. re- Covers. Reprints. and Permissions: GRAYCE FINGER. quires a stable White House capability with access to the best available Editor: CORRINE HARRIS. MARGARET LLOYD scientific and technical information. Guide to Scientific Instruments: RICHARD SOMMER Assistant to the Editors: RICHARD SEMIKLOSE Promotion and regulation should be separate. We have learned. over Membership Recruitment: GWENDOLYN HUDDLE time, that the two functions of promoting and regulating innovation should Member and Subscription Records: ANN RAGLAND not be kept under the same organizational roof. The recent congressional EDITORIAL CORRESPONDENCE: 1515 Massachu- setts Ave.. NW. Washington. D.C. 20005. Area code decision providing for separate organizations responsible for promotion of 202. General Editorial Office. 467-4350: Book Reviews. new energy sources and for regulation of safety and impact indicates the 467-4367: Guide to Scientific Instrument, 467-4480: direction to follow. News and Comment. 467-4430: Reprints and Per- missions, 467-4483: Research News, 467-4321: Cable: Administrative controls must not become ends in themselves. There Advancesci. Washington. For "Instructions for Contrib- utors." write the editorial office or see page xi. Science, should be more emphasis on quality control of work proposed or completed 26 March 1976. BUSINESS CORRESPONDENCE: Area Code 202. and less concern with administrative red tape. With regard to quality con- Business Office. 467-4411: Circulation. 467-4417. trol. recent studies support the claim that peer review ensures high stan- Advertising Representatives dards of performance in scientific research. Agencies should extend the areas Director: EARI J. SCHERAGO of funding decisions subjected to peerreview. Other forms of administrative Production Manager: MARGARET STERLING control tend to become counterproductive. There is disturbing evidence Advertising Sales Manager: RICHARD 1.. CHARLES that increased reporting requirements and tacked-on civil rights and equal Sales: NEW YORK. N.Y. 10036: Herbert L. Burklund. 11 W. 42 St. (212-PF-6-1858): Scotch I'l MNS. N.J. 07076: opportunity rules. however well intended. result in formalistic arrange- C. Richard Callis, 12 Unam Lane (201-889-4873): Ciii- ments which endanger creativity and the willingness to take risks. Unless CAGO. In. 60611: Jack Ryan. Room 2107. 919N. Mich- igan Ave (312-DF-7-4973): BEVEREY Hurs. CAME. this trend can be reversed and a bond of mutual trust is rebuilt between 90211: Winn Nance. III N. Ca Cienega Blvd. (213-657- 2772): DOBST V1. 05251: Fred 11: Dieffenbach. Kent those funding R & 1) activities and those performing these tasks. we will Hill (S02 867-5581) pay the same high price in reduced originality and productivity that other ADVI RHSING CORRESPONDI NCF Room 1740. 11 ". 42 St., New York. N.Y. 10036. Phone: 212-PRE-6- nations have paid before.-JURGI N SUBMANDI. Lyndon B. Johnson School 1858. of Public Affairs. University of Texas. Austin 78712 1 September 1977 Mr. Sherman E. Roodzant Technical Consultant Committee of Science and Technology House of Representatives Suite 2321, Rayburn House Office Building Washington, D. C. 20515 Dear Mr. Roodzant: As requested by Chairman Teague's letter of 8 August 1977, I have studied the report of the previous Panel, dated April 1977, and have formed some opinions which I will discuss in the following critique. I must apologize in advance for not having the depth of understanding of the Panel members who prepared the report. My feeling of in- adequacy in the face of the obviously large amount of information marshalled by the previous Panel is perhaps shared by other members of the current Panel; however, with adequate time and study we can hope to appreciate better the reasoning behind the items of the report being critiqued. My first impression is one of amazement at the wealth of information provided by the report. The Panel ac- complished a monumental task in assembling, reviewing and organizing the data into a very informative report in a short time. It can certainly serve as a basis for the work of the present Panel and can give us a running start on the job we have to do. I did note several points, however, which strike me as counter-productive and which we should consider carefully in providing our report. These are discussed below: 1. The findings presented are largely negative in nature, and set a complaining or critizing tone which influences the reader adversely. While it is true that much of the information justifies criticism and needs to be set forth, there should be some positive results somewhere to be mentioned in the findings. 2. There is only one recommendation, and that one of questionable practicality. While the recommended solution to the management problem may be an ideal one, it may not be attainable in the pragmatic, Mr. Sherman E. Roodzant Page 2 political environment facing the program. Technical problems, as differentiated from purely management ones, are hardly mentioned in the report. Perhaps there should have been other recommendations which could have been acted upon even though the management problem (which seems to be the major one) is placed in the "too hard" category. 3. The report concentrates on "rehabilitation", which means different things to different people. It is certainly a most important area, but I would think that the allied areas of "prevention" and "cure" should be covered as well. The cure of disabiling conditions is the ultimate goal of much scientific research, and steady progress is being made. It would be unwise to generate false hopes, but equally unwise to discourage (through neglect) the research that may produce breakthroughs of great significance, even though they may be years in the future. Near term applications are important; research leading to future applications is equally important. Such re- search as Dr. Saliba's use of heparin in treating severly burned patients, theuse of sodium valproate to treat epilepsy, Dr. Polis' experiments with prostaglandin X (PGB-x) and Dr. White's use of evoked cortical potentialsin diagnosis of visual defects can lead to improved treatment and even cure of some disabling conditions. Even more exciting, and perhaps more near term, are the research programs of Dr. Sidman, Dr. Becker, Dr. Aguayo and others on the cure of paraplegia, including research on neural tissue transplants, nerve tissue regeneration, nerve fiber growth, and eventually regeneration of limbs. The previous report devoted too much attention to care and too little to cure research. 4. The report is too long. It contains a wealth of material from other sources which is needed to es- tablish a frame of reference. But it also contains discussions of requirements, for the proposed Council, suggestions for its operations, and for development of a data base and communications system - all of which are interesting, but not directly related to the "Charge to the Panel", page IV. 5. I found no positive efforts (or recommendations) to begin collection of much of the information which the report Mr. Sherman E. Roodzant Page 3 indicated was needed. Perhaps a series of recom- mendations could have resulted in initiation of G.A.O. studies to obtain the needed information. (Finding A.1., activity (a) page 22, suggestion 2, etc.) 6. Finally, I found little correlation between the report and the Charge to the Panel, Scope items 1, 2 and 3. In particular, Scope item 5: recommendations to the S & T committee for possible action in the area of R & D, seems to be inadequately addressed. Although my criticism may seem strong, it is offered with a constructive intent. The present Panel should benefit from the previous report and should focus its attention on the deficiencies so that both reports may form a cohesive whole. The previous report is a significant achievement, and its preparers may well be proud of it. Our challenge is to do equally well in the following report. Sincerely, a M. D. Van Orden MDVO: LEX FRIEDEN 9667 MEADOWVALE western union Mailgram UNITED U.S.MAIL HOUSTON TX 77063 2-013172E248 09/05/77 ICS IPMBNGZ CSP WSHB MGM TDBN HOUSTON TX 256 09-05 0151P EST CONGRESSMAN OLIN TEAGUE ATTN SHERMAN ROODZANT US HOUSE OF REPRESENTATIVES 2311 RHOB WASHINGTON DC 20515 DEAR CONGRESSMAN TEAGUE, THE FOLLOWING COMMENTS ARE IN RESPONSE TO YOUR AUGUST 8 REQUEST TO PANEL MEMBERS FOR THEIR OPINION OF THE PREVIOUS PANEL REPORT. AS A MEMBER OF THAT PANEL I FEEL AS IF MY OPINIONS ARE CLEARLY EXPRESSED BY THE REPORT. I CONTINUE TO CONCUR WHOLEHEARTEDLY WITH THE NOTION THAT SOME TYPE OF PERMANENT COORDINATIVE OVERSIGHT STRUCTURE MUST BE IMPOSED ON PRESENT RESEARCH EFFORTS RELATING TO THE HANDICAPPED IN ORDER TO ORCHESTRATE AND MAXIMIZE THE POTENTIAL BENEFITS OF THIS RESEARCH. SUPPORT FOR THIS IDEA CONTINUES TO ARISE FROM PROJECTS SPONSORED BY THE WHITE HOUSE CONFERENCE, THE OFFICE OF HANDICAPPED INDIVIDUALS, THE NATIONAL SCIENCE FOUNDATION, THE NATIONAL PARAPLEGIA FOUNDATION, AND THE AMERICAN COALITION OF CITIZENS WITH DISABILITIES, I BELIEVE THE PRIMARY TASK OF THE PRESENT PANEL SHOULD BE TO SPECIFY THE PARAMETERS OF SUCH A BODY OR STRUCTURE AND TO OPERATIONALIZE THE CONCEPTS MORE CLEARLY. ADDITIONALLY, I BELIEVE THAT WE SHOULD EMPHASIZE THE POINT THAT ADDITIONAL FUNDING FOR CERTAIN PROGRAMS AND PROJECTS SUCH AS A NATIONAL INFORMATION GATHERING AND DISSEMINATION SYSTEM IS GREATLY NEEDED AT THE PRESENT TIME. FINALLY, I WOULD LIKE TO RECOMMEND THAT THE PANEL STUDY CAREFULLY THE PRESENTATION ON INTERGOVERNMENTAL COORDINATIVE PROBLEMS MADE BY DOCTOR DAVID WALKER AT THE OHI CONFERENCE ON THE COORDINATION OF PROGRAMS SERVING HANDICAPPED INDIVIDUALS, JANUARY 23-25, 1977. I LOOK FORWARD TO MEETING WITH YOU ON THE PANEL AGAIN EARLY NEXT WEEK. YOURS TRULY LEX FRIEDEN 13:51 EST MGMCOMP MGM The White House Conference on Handicapped Individuals (202) 382-3275 TTY (202) 382-3724 30 August 1977 Mr. Sherman E. Roodzant Technical Consultant Committee on Science and Technology U. S. House of Representatives Washington, D.C. 20515 Dear Sherman: This is a reply to Mr. Teague's letter of August 8th requesting a critique and recommendations of the Panel on Research Programs to aid the handicapped. In considering the previous Panel's report and the sense of the deliberations and recommendations of the White House Conference on Handicapped Individuals I am guided by one major concern. That is that the result of such research should as far as possible be practical and within the reach of disabled individuals. It should be meaningful to change their lives and to assist them to achievable goals such as employment, independent living, education, transportation. The average disabled individual will not be benefitted by a device which is SO expensive no one can afford it or the cost of maintenance and repair. I am proposing that the Panel consider recommendations of two programs which will be responsive to the needs expressed at previous meetings and at the White House Conference on Handicapped Individuals. 1. Research Fellowships Establish a program of Federal Research Training Fellowships designed to explore new methods of utilizing research findings for the benefit of handicapped persons. The emphasis of such training would be on the transfer of science and 1832 M Street, N.W. / Suite 801 / Washington, D.C. 20036 Mr. Sherman E. Roodzant 30 August 1977 Washington, D.C. page 2 of 2 technology information to practical application. Consideration to be given to naming the Fellowship for Mr. Olin E. Teague. 2. Coordination of Science and Technology Information. Support a mechanism that will coordinate information about application procedures, financial support and review process for Federal grant programs in the area of science and technology. And also to support the dissimination of information of research programs in science and technology as they relate to the handicapped field. This should include the encouragement and coordination of programs sponsored by private industry which has great resources to be encouraged towards this end. Support for both these programs can be by transfer of funds to existing HEW activities. The Research Fellowships can be supported as part of the RSA Training Grant Program. The Information Coordination can use the existing authority in the HEW Office for Handicapped Indivisuals (PL 93-112, Sec 405 (a) (4) ) I am hopeful that these recommendations will be helpful to the Panel in reaching their final recommendations. With my very best wishes. Sincerely yours, Handi Henry Viscardi, Jr. mj HEALTH NOITY DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE GREAT so PUBLIC HEALTH SERVICE USA NATIONAL INSTITUTES OF HEALTH BETHESDA. MARYLAND 20014 Mr. Sherman E. Roodzant Technical Consultant Committee on Science and Technology U.S. House of Representatives Suite 2321 Rayburn Office Building Washington, D.C. 20515 Dear Mr. Roodzant: Mr. Teague recently sent the Report of the Panel on Research Programs to Aid the Handicapped and asked that I review the findings and recom- mendations of the report, indicate concurrence or disagreement, and give an assessment of the need to develop additional data and findings relative to the panel's recommendations. I have reviewed the report and the opinions of the two dissenting panelists and find that I agree with the majority recommendations. NIA has recently been interested in bioengineering enhancement for the elderly and finds the field to be extremely fragmented. The described Council should help remedy this condition. I think that the described Council should be established by Congress and report in to the President. I was pleased by the attention that was drawn to the fact that the principal focus to date has been on the needs of working-age adults with insufficient attention to children and the elderly. I look forward to working with the other panelists as my currently excessively busy schedule permits. When I cannot personally participate in meetings I shall ask Leroy E. Duncan, Jr., M.D., NIA's Special Project Officer, to represent me. Sincerely yours, RobetN.Buths Robet N. Butles Robert N. Butler, M.D. Director National Institute on Aging NASA National Aeronautics and Space Administration Washington, D.C. 20546 Reply to Attn of KT SEP 2 1977 Mr. Sherman E. Roodzant Technical Consultant Committee on Science and Technology U.S. House of Representatives Suite 2321 Rayburn House Office Building Washington, DC 20515 Dear Mr. Roodzant: As requested by Congressman Teague in his letter dated August 8, 1977, I have enclosed my comments pertaining to the report of the Panel on Research Programs to Aid the Handicapped. I have expressed some concern on the proposed approach to the basic problem and look forward to discussing this subject at our next meeting. Sincerely, Ray Raymond P. Whitten Chief, Biomedical Applications Division Technology Utilization Office Enclosure Comments on Report of the Panel on Research Programs to Aid the Handicapped to the Committee on Science and Technology U.S. House of Representatives-Ninety-fifth Congress: I. Principal findings of the panel A. Assessment of needs- well done B. Imbalances in research emphasis 1. Definition is mandatory- this statement may be true for mission agencies but cannot be generalized to all agencies unless there is a major change in mandates. 2. Definition study is needed to document position and lay out strategy. 3. This statement is far too general to be useful. Three things are needed here. (1) Definition of what is needed (independent study); (2) Government re- strictions on co-developing with industry removed so that federal agencies can cost share with manu- factures to expedite technology transfers and share some of the initial risk capital; (3) Ability to organize which agency is doing what and where to go for services. 4. Agreed- but one needs to conduct a proper study to organize the various aspects of this problem and prepare a plan for implementation. 5. Agreed- there needs to be one mission agency. This agency must manage by objectives. It must be struc- tured to understand the full problem, to conduct special systematic studies and coordinate research. Coordination is not meant to direct. The mission agency should be able to: (1) properly describe/ define the major problems facing the handicapped; (2) rank order; (3) promulgate annual statements and (4) cost share development programs with other agencies whose technology base may help provide solutions to those obstacles impeding progress. C. Limiting factors in research for the handicapped 1.b. This statement needs to be vastly expanded and documented. 1.c. Is lacking proper perspective and concluding recommendation. Chart page 4 This chart should be redone to contrast and compare expeditures per capita and general expeditures for Health Care. 2.a.&b. A case can be made here but the problem should be documented and specific to the issue to be meaningful. A special study contract is needed to properly pull it together. D. Highly Endorse E. Generally agree; however, funding to transfer technology quickly is hampered by government regulations on pro- curement procedures and/or contracting. There are few cases where technology can be directly transferred. The venture capital of industry is again a major issue. More precise information is needed to defermine the potential market and identify users. Again a proper study is needed to document the problem areas. In addition to all of the above, the impact of the FDA. regulations need to be associated with a precise prob- lem statement for each category of concern. The cost and effort required to meet the FDA requirements could far exceed the engineering development. Funds are not readily available to meet this burden. A mission agency for this purpose is almost a necessity and so is the mandate to couple this service with the advocating manufacturer. II. Implications of the Finding and Development of a Recommenda- tion and III. Recommendation Paragraph 3 page 7. "There is also a need to expand the depth and scope of R&D. Commensurate with the needs of the disabled. II This statement should not stand alone. There is a need to better define the problem; put it in proper perspective and dissem- inate a well written problem statement with co-funding opportunities. "Getting widespread usage of the practical results is a most glaring need. " Well said! Paragraph 4 page 7. Don't feel this is a fair statement. From our viewpoint the proper emphasis on a single agency in the government has been lacking. This should be the first step in re- direction. Paragraph 2 page 8 and general comments pp. 9-10 Don't agree that this is the next logical step. A paid for consultant group might be the focus as a complimentary aid to the specific mission agency. This group would identify problems and recommend priorities to a government consortium rather than direct or review-tangential efforts. Page 11-13 This could be a useful structure for the mission agency; with the non-government body being reduced to the role of a consulting council. ROBERT FULTON COMPANY FLYING RIDGE NEWTOWN, CONNECTICUT 06470 24 August 1977 Olin E. Teague, Chairman Committee on Science and Technology U.S. House of Representatives Suite 2321 Rayburn House Office Bldg. Washington, D.C. 20515 Dear Mr. Teague: This will reply to your letter of 8 August, 1977, requesting that the present Panel members critique the Report submitted by the first Panel. Having been a member of that first Panel and some- what closely involved with preparation of the Report, I feel too close to the subject to render an objective opinion. I therefore took the liberty of requesting a number of individuals who are highly interested and qualified in the subject to give me their considered views of the matter which I herewith pass on for consideration. They were very much in agreement with the findings and recommendations of the Report. The conducting of further investigation would no doubt simply reinforce the data and conclusions already arrived at. The question of how to implement the recommendations they did not attempt to answer since it is an issue which even the Panel and the Committee are going to find difficult to solve. They were in general agreement, however, that its implementation could be a tremendous boon to the world of the handicapped, the sooner the better. page 2 There was also general agreement among my critics" that an effort be made to present it in easier to read terms. One of them stated that in order to comprehend it at all she found it necessary to go through a "decoding process" which, as you will see from the attached, required a great deal of time and effort. I enclose it herewith with the thought that it may help those concerned with writing the next report to avoid the same problem. In a reaction similar to that of virtually all the witnesses who appeared before the first Panel, each critic had thoughts about how funds could be expended to aid in their specific areas of interest. To accomplish this with the maximum efficiency and efficacy is, of course, the purpose of the Report's major Recommendation without the implementation of which there is no orgainzation or system broad enough in authority or evaluating capacity to determine an optimum program from need to research to delivery and serviceability. It would seem that the primary issue before the present Panel is not one of what needs to be done but rather of how to do it. The first Panel did not create anything. It investigated and reported the facts as they are and made a logical recommendation for a course of action: the creation of a combined government and private enterprise organization capable of integrating their already extensive but disassociated efforts to help the handicapped through a well planned program ranging from the first step of determining needs all the way through research, production, distribution and servicing. In the world of the non-handicapped such a system creates and perpetuates itself by the sheer economic forces of demand and supply but in the world of the handicapped the forces are too scattered and still too disorganized to get the system off dead center. A major organizational impetus is required to provide the inertia to produce an eventually self sustaining system. page 3 The time is right. There is a subconscious recognition on the part of the public of the magnitude of the issue. It now needs a place to go that can pull it all together --- numbers, needs, funds, programs, production incentives, deliverability, servicability and education, all with a total follow-through momentum. This Panel has the opportunity to formulate this organization, determine its form, its place, its resources, its mechanism, and to present it in such a way that it can achieve legislative enactment. Very truly yours, ROBERT E.FULTONER. President REF, Jr./jf Enclosures Report of the Panel on Research Programs to Aid the Handicapped to Comm. on Science & Techn. (House) 4-77 Summarized by Audrey R. McMahon Preface: Primary question: How can a research program of science & technology be put to work for the handicapped? Secondary questions 1. Needs, numbers?? handicaps?? 2. Where is the "art" at now? No sound answers available. All plans fragmented; no wholistic plan. Concern individualized & spotty results not enduring change. Broader view required. Context of handicapped's perspectives must be understood & the magnitude of simple things. The CHARGE Study how Research (or applying knowledge)- Scientific & Technological- can be used in programs. Scope to include (not limited to): 1. Identify application of technol. In programs & development. 2. Identify problem areas now being addressed which need more heat. 3. Identify problems not addressed needing investigation. 4. Identify problems in application & transfer of technology to use. 5. Recommend actions which could be "ameliorating". What is their relationship to distribution of results? 2. Spencer's letter: Value of consulting handicapped themselves; need visibility, credibility & authority. Need to reintegrate citizens. Need new laws, reaffimation of faith in handicapped humans. Existing laws inadequately enforced. New coalitions to be effective. FINDINGS OF PANEL Research interpreted as: means to attain not only knowledge, but methods, techniques devices, equipment & systems of benefits potential. Interpret position & needs of handicapped consumers= "Needs". A. Needs 1. Data on population lacking; so can't plan. 2. Need feedback from handicapped on needs and evaluation of service delivery systems. B. Research emphasis 1. Too much "applied" & not, flexible balance with basic research. 2. Too much emphasis on high technology solutions not low cost devices. 3. Availability must be programmed in with development efforts. 4. Target groups now working age adult only. insufficient emphasis on Developmentally disabled child. 5. (Re) Integration- Developmentally disabled child & aged. a. motivation b. barriers C. transport d.. evaluation of living arrangements. 3. C. Too little money applied: huge benefits of: 1. R & D potential overlooked can't test & evaluate- can't build prototypes- 2. Scattering of authorities among Fed. no overall steering. 3. a) Difficult to research environment of handicapped with multivariables. b) Methodology of research unsatisfactory. c) Few researchers & some areas unexamined. D. Need more info exchange; avoid duplicates a) Gov/Voluntary b) better info on rehab methodology & linkage of source. c) Speed up int'l info access. Diversity of societal elements & multiple disciplines. Need interaction of time dependent, and sequential activites, involve Public, private & industry teamwork. E. Handicapped can't use results of research 1. Not available; when technical research is completed matter bogs down Person can't afford or doesn't know about devices. a) we need service & aids info center office of handicapped not effective. b) Need regional assist centers tied to R & D engineering & training centers family physician needs referral help. 2. Help consumer & practioner keep up to date re/concepts & technology. 4. II IMPLICATIONS OF FINDINGS Negative findings serve to show reasons for non progress. A single solution sought. Teamwork, public & private at every R & D phase, rather than piecemeal approaches to remedy diverse specifics. Connections needed to forge more dynamic interaction between science & technology and consumers and researchers. Get USE of results. First order requirement= criteria for performance evaluation of R & D results and value of R & D priorities. Consumer input on a planned & integrated basis essential. Computerized communication suggested. Creation of' a new level, between government and consumer for centralization and integration is necessary. Using criteria for evaluation, and establishing a research agenda is high priority. Committee on Science & technology as oversight body get more creative. Develop model research effort as prototype for coordination among the many areas of science & technology. At pinnacle of priority list is the need to develop national research agenda and a process for its implementation. Immense aggregate cost of disability not realized (hidden problem). Effecient services will reduce dependency and justify major effort. Present programs too samll & limited to get federal attention. Panel advises establishment of new strong overview and coordinating entity. Credibility must be jointly established by, the handicapped, administrators, and researchers. III Recommendation An overview entity should be established. With purpose to unite public & private ways and means for research and development. It should: 1) Conduct ongoing assessment of number and needs of handicapped. 2) Provide systematic planning. 3) Provide enhanced implementation of R & D. 4) Conduct an evaluation of usefulness of R. 5) Evaluate availability of results. 6) Insure flow of science & technol to handi. These should reduce the difficulties in lives of handicapped & harvest their competencies. These objectives should be national commitment. IV "National Council for Research and the Handicapped" Should consist of two bodies under one Director, appointed by the President. Council would produce coalition of Gov't & private activities to develop a major national research effort responsive to the needs of. the handicapped. 5. The Government body to include rehab administrators & agenices (to be chosen by head of agency & the council director). The "council would serve as liaison between agencies represented and coordinate efforts & promote whilization of scientific & tech. activities for the handicapped. 15 agencies listed. The non Government body would be an organized forum for consumers, professional disciplines and private agencies and others with impacting interests (industry & labor & voc. Rehab. plus foundations). The Powers: to coordinate "territories". Reps. of Governmental bodies can call upon their parent agencies to cooperate, but the non-Gov't body depends on the "People-power" of those envolved. Coordinated action where appropriate, and input. The functions: to "foster confluence; streamline info exchange using communication technology & develop "state of the art" info. Council Functions (Services offered) a) Statistics on handicapped. b) Frame work for evaluation. c) Balancing need/solution, resources, cost, time. d) Incorporating handicapped consumer. e) Evaluation of research needs, capabilities, priorities. f) Cost of feasibility of R & D agenda plus distribution of results. g) Assessment of program performance re R & D in Government & non- Government efforts. Cet better efficiency by coupling education & training with scientific developments. Information network: For: Handicapped= info re/services. provides= state-of--art updates. researchers= Int'l technical data bank. Financing: Initial Federal funding will required for the first 5 years for salaries & equipment and technologies. Funding will decrease as saleable services develop. Private funding will sustain certain activities like review of private programs. Responsibilities: 1. Extend basic & applied research, technical development, and usage of results. 2. Report on and analyze effectiveness of R & D implementation. 3. Promote public information on needs of handicapped and benefits to society of rehabilitation. Explain the commitment. (cont'd) Location The panel gave much thought to where the "National Council for Research and the Handicapped" might be located. As an eutity joining the two bodies; 1. government and 2. all the other sectors a neutral ground is necessary. Among the options discussed were five government offices and four examples of existing non governmental organizations or consortia, the pros and cons of each were explored. No specific recommendation was put forth. Probable success factors. 1. The researcher himself must be free of the business and organizational part of the process and have opportunity to propose his own solution and methods. 2. While consumer participation and advocacy are essential the merit and method of proposed research must be professional decisions. 3. Increased funding and capabilities should develop the nations research capacity incrementally. 4. Priorities should be weighed in terms of optimal goals and realistic R & D objectives within the review of available methods & technology. 5. Consumer understanding and realistic expectation must be josted by inclusion in planning & evaluation and by a responsive information system. 6. "Representation" means utilizing appropriate people selectively in a systematized progression with intent for representatives to progression work and act. 7. Initial adequate funding equates historically with quality of future success. 8. The hypothesis is that cooperation & synergism will result from public & private groups orchestrated partnership. Feedback performance will enchance accountability. 9 & 10 Let the process not throttle research creativity and the qualities of leadership and commitment. (cont'd) VI Supportive Suggestions 1. Fragmentation and limitations of scope among agencies and lack of effective transfer of research outcomes was noted as a primary council concern. Priorities for application of research & technology are needed and criteria from evaluation of the functioning of the Council itself are first objectives. Seven "How to" steps are listed. 2. Major emphasis- substantial increases in Government research, development and utilization and funds. 3. Develop data base and ,info system for 1. professionals 2. services information to consumer. Implementation of a computer based clearing house would be similar to one already authorized, but on an expanded basis. Needs and means were itemized. VIII Future Activities of the Committee on Science and Technology The committee may want to test the concept expounded by the panel. How to implement and finance the plans needs study. The reaction of consumer groups could be considered. The plan could be reviewed from a worlwide perspective. Post legislative interests have fallen short of achieving objectives. Gaps exist between legislated interests and administrative efforts to put knowledge & technologies to work. An extension of the committee efforts is warranted to monitor the impact implementing authorities are achieving. IX References X Appendix EAD aw/3-11 Critique of the Report from the Panel on Devices for the Disabled, Committee on Science & Technology, U.S. House of Representatives Jan Little August 24, 1977 Having studied both the report of the panel and Robert E. Fulton's preliminary report, it seems most effective to form a critique by setting forth the two main areas of concern with which the panel must deal and then commenting upon the recommendations of the panel and evaluating the validity of those recommendations as they fit in the framework of the outline. Area of Concern I. - Determination of need A. Determination of a valid definition of "handicapped", cataloguing what these handicaps are and which should be dealt with in this panel's deliberation. B. Determination of a valid population of individuals with these handicaps. This census would ideally be sorted into categories determined in the first step. C. Realistic determination of needs and collation of these needs into usable categories; i.e. prosthetics, electronic aids for communications, mobility, activities of daily living, etc. D. Establishment of a source of input to determine needs and development of a structure to deliver this input. E. Collation of what exists in terms of equipment, delivery systems, information systems and research programs. Area of Concern II. - Program Development A. Establishment of the form which any authority or council growing out of the panel's work will take. B. Determination of how the above authority will interact and coordinate with the over 100 other government agencies that now deal with the handicapped. C. Who and what will this authority comprise and how will it function. Critique of panel report (Little) -- 2 D. Who will be used to carry out programs of this authority -- government, non-profit organizations, private enterprise. E. What incentives will be offered for program participation. F. How will limiting and penalizing legislation now affecting equipment and devices for the handicapped be handled. Having set forth the framework, we can now examine the various portions of the study. Determination of a valid definition of the handicaps to be served While this process may seem elementary, it is critical in this writer's mind because personal past experience has indicated that lack of definition of what handicaps are and how they are manifested has led to ignoring very real needs, ie., communications. While determination of handicaps and the number of people effected by these handicaps may well be furnished by work resulting from the White House Conference, it is a necessary foundation for further action by the panel. Without definition of what handicaps are to be dealt with, a great deal of extraneous input may be received and have to be sorted. Establishment of a realistic population (marketing) of handicapped people While establishing a valid census of handicapped individuals is mentioned in the panel report, provision for accomplishing this most critical step must be made. This writer thoroughly agrees with Robert E. Fulton's comments on the futility of trying to deal with estimates of handicapped that range from 10,000,000 to 150,000,000. Development of any programs which may lead to manufacturing will be impossible without realistic marketing. Manufacturing (production) is a critical step between concepts developed by research people and delivery of an actual item to the end consumer. If our efforts are to be successful, all steps of the research-to-consumer process must be considered from the beginning. Efforts to establish programs without realistic populations would be unsuccessful. Realistic determination of needs and collation of those needs into working categories This area is dealt with in the panel report and is closely related to the previous areas. Again, this writer Critique of panel report (Little) -- 3 does not feel the total answer to the problem has been presented. As an individual who has been a partial quadriplegic for 25 years, who has worked with biomedical engineers in research for the handicapped, who has dealt extensively with marketing of medical equipment, I feel qualified to issue several cautions: The handicapped consumer is not particularly prepared to define his own needs. 1) He is frequently judging need from his own unique patterns of paralysis, life-style, self-image and value priorities. 2) He is frequently quite naive of engineering, materials and marketing limitations. The United States is still more attuned toward a system of free enterprise than socialism. Therefore, a delivery system could most easily be developed within the system of free enterprise. Experience has shown that the highly individualistic needs of the handicapped have to be interpreted in categories of equipment so some extent of mass production can be utilized. While a totally customized piece of equipment may be very suitable for one individual, one standard model of a device which can be slightly modified to meet the needs of many is more practical in terms of production, marketing and final utility to the disabled individual. Costs in the medical equipment industry are already high because few, if any, items can be produced on a true mass scale. Collation of needs in equipment into like categories might help in program development and in controlling manufacturing costs. It would seem that determination of needs and collation of those needs into working categories should be included as a priority for the panel's work. Establishment of an input source It is the feeling of this writer that no real provision has been made for this step in the panel report. Without specific structure, some regulations defining who can provide input and how it will be provided, any efforts made in more advanced parts of this project will either be wasted or, at best, very inefficient. Some system to establish validity of requests and to weight the overall need for these requests must be established. It seems that the establishment of an input source relies on the development of a realistic population and enummeration of various types of disabilities. Critique of panel report (Little) -- 4 Collation of what exists in terms of equipment, delivery systems, information systems and research programs During various phases of the panel's investigations leading to the report, the fact that there is no organized plan of delivery of technological aids to the handicapped (nor even a disorganized plan) is brought out. I personally feel the problem has been understated! Bits and pieces of technology, equipment development, information services and delivery system are scattered geographically, functionally and departmentally throughout government, non-profit and profit agencies. It may well be that services available for the handicapped may be several decades ahead of what we think they are -- if what does exist could be sought out, catalogued and put in logical order. Several projects now exist to discover what exists, where it is and how it may be made available to the handicapped. Two such projects that come immediately to mind are Accent on Information, being conducted by Accent on Living, Bloomington, Illinois, and a similar project being done by the Arthritis Foundation, New York, N. Y. There are certainly other such projects which could be coordinated and used as a basis for work by any authority this panel might form. Examination of these projects should show which ones have the best structure for such a study already developed. Perhaps such an organization could be utilized under contract. Other existing sources of information should be utilized as well. For example, American Spinal Injury Association (ASIA) has spent a great deal of time developing a system for gathering statistics on spinal cord injury that are coordinated in definition and procedure of reporting. Although the topic is touched upon in the panel report, more emphasis should be given to the development of a system of gathering and organizing facts about the many areas that concern the handicapped including incidence, services, technology and equipment. Perhaps this project will grow out of the White House Conference and can be coordinated with the panel's work. The development of a means to produce a mechanism to establish meaningful exchange of information about research, technology, services and equipment is a huge task. It is also the basis for any other work this panel may do. While the cybernetic system developed by the panel seems to aim at a solution to this most critical problem, more examination of mechanics of this task are needed to determine the validity of the model. Critique of panel report (Little) -- 5 The above points were addressed to some degree in the panel report. It seems, however, that the final assessment of feasibility depends on the amount of emphasis placed on each of these points and the development of the actual mechanics for accomplishing these goals. PROGRAM DEVELOPMENT Establishment of the form of authority A number of good alternatives have been presented. To this writer, placement of the authority seems secondary to the need for this authority to be as streamlined as possible, be subject to annual review for reappropriation of budget and be separated from HEW. Streamlining is needed if the authority is to avoid be cumbersome and ineffective. Annual review could prevent adding this authority to a long list of agencies and offices which may have outgrown their usefulness but still exist because no one has thought to dissolve them. Removing this authority from HEW might provide it with the opportunity to be a watch-dog group that could have some effect on the over 100 departments and agencies that now deal with the handicapped, many of which are under HEW. How the above authority will interact and coordinate with the over 100 other government agencies now dealing with the handicapped The writer is most pessimistic about the feasibility of this objective. Most of these agencies and departments have established concrete domains which are guarded against outside intervention and change. Moving these agencies to surrender part of their autonomy and enter into cooperation with others seems a task which will require monumental amounts of tack and diplomacy. Whether or not the goals of the panel in establishing needs and developing programs can be accomplished without coordinating the more than 100 agencies is doubtful, but it may have to be attempted. Who and what will the authority comprise and how will it function The panel report indicated that representatives would be drawn from 14 government agencies, various civilian groups, professional organizations and societies, labor, industry, foundations and "other entities". It would seem that such a group would be unwieldy and quite probably inefficient. While it would be fair to allow all of these sectors of government and industry to be heard, this writer has grave doubts that an organizational plan can be developed to utilize such an assembly. Critique of panel report (Little) -- 6 Concern for where the council or authority should be placed within the current governmental structure seems less important to this writer than how the proposed council will function. If properly organized and notivated, the authority will function where ever it is located. If organization and motivation are lacking, placement alone will not suffice to make the authority function. Failure of the authority to function even after it has been established is a major concern. One has only to look at the Architectural and Transportation Barriers Compliance Board, which was established by Congress in 1973. While far fewer people, representing far fewer agencies were involved in the ATBCB and while the duties of the Board were clearly defined and while the regulations it was to enforce were enacted legislation, the nature of the Board was so cumbersome that it failed to issue one citation until March 29, 1977 -- four years after its inception. Even then, the Board's action may have been prompted by the forthcoming White House Conference. Where will supporting efforts come from to carry out programs initiated by the authority A great amount of effort will be needed to translate the efforts of research, fostered by any authority which results from this panel into items readily acquired by the disabled consumer. Although, through NASA, there is precedence for the federal government to contract from private industry for manufacture, there is no system known to this writer of the federal government assuming production and marketing of product intended for private citizens. Past efforts to utilize government sponsored research in developing marketable product produced by private enterprise are limited. Some have been disasterous. A case in point is the Overly-Bressler stand-up wheelchair. Consumer input showed that it was important that disabled individuals be able to come to an upright position. A wheelchair was designed that would bring a paralyzed individual to his feet utilizing a series of counter-balanced springs. Two things resulted. Industry engineering and production experience were ignored. The consumer's love affair with being in an upright position faltered and died when the consumer saw the chair and learned the limitations -- such as decreased mobility, inability to transport the wheelchair and the extremely strange appearance of the Overly Bressler. The product died in early youth -- and was nearly followed by the demise of its foster parent company. The writer has more first-hand experience in bringing research to commercial availability in the situation of Critique of panel report (Little) -- 7 various means to control the steering of a motorized wheelchair. Intended for a small number of individuals whose needs are intense but whose numbers are small, these controlling systems include sip and puff, tongue control, minimal pressure control and ross motor movement control. These controls have been made available to the consumer at less than $400.00. However, a great deal of the time, effort and money to do so has been written off by the corporation. This has been done partly through miscalculation about what was involved in bringing the product from research to market and partly because the company is considering returns in the intangible areas of professional satisfaction, prestige and building of reputation. Other commercial firms may be reluctant to do SO. Another problem in this process is that domestic manufacturers are restricted from exporting by current export regulations and costs. Perhaps some tax credits for companies investing in such projects should be considered. The area of offering incentive to manufacturers and marketers of products needed by the disabled should be explored. At the moment, there is climate in manufacturing of products for the disabled which can only be described as negative. The pressure for reduced costs is being put upon a market that is small, extremely customized and very demanding in terms of quality control and product liability. Marketing of these products is a nightmare at best. No good means exists to reach the potential consumer with new products (or even established ones, for that matter). Consumers rarely have disposable funds which theycontrol and must rely on convincing third party carriers of their needs. Advertising and sales promotion are extremely expensive in terms of potential return. All of these factors are combining to force the small manufacturer out of business. It is this small manufacturer or distributor who can serve the needs of the handicapped. The panel must investigate this area thoroughly. Manufacturing and distribution are crucial parts of the proposed delivery system which will carry technology to the handicapped. SUMMARY This writer agrees that the goals the panel has set forth are valid and critical to the health and well-being of handicapped individuals. The proposals put forth are, for the most part, valid. Two areas seem to call for more definitive solutions: the actual management and structure of a very large panel attempting to function in an area where established, traditional agencies exist; and the forms of aid needed to encourage private enterprise to participate in the overall program to provide relatively low cost equipment utilizing available technology.