APPENDIX Department of Health, Education, and Welfare, Secretary's Advisory Final report, May 1964. Page 307-409 Exhibit 1-Hon. John W. Gardner, Secretary, press release of Au- 419-437 Exhibit 3-Report of July 24, 1970 from Advisory (Rome) Committee to Secretary, HEW, on transfer of St. Elizabeths.- - - 438-483 Exhibit 4-Committee to Develop Plans for Unitization of St. Elizabeths, review of proceedings, October 30, 1970---- 485-498 Exhibit 5-HEW memo of June 29, 1973 on status of St. Elizabeths 499-500 501-506 Exhibit 7-Minutes of 5-year Planning Committee meeting, September 19, 1974 507-508 Exhibit 8-Report on study of personnel, October 2, 1974... 509-533 1974. 534-535 Exhibit 10-Review of unitization in public mental hospitals, February 4, 1975.. 536-573 Exhibit 11-Personnel management evaluation at St. Elizabeths 574-581 Exhibit 12-Minutes of 5-year Planning Committee meeting, April 3, 1975.. 582-583 Exhibit 13-Briefing document, mental health training at St. Elizabeths, April 9, 1975. 584-755 Exhibit 14-District of Columbia dollar liability for treatment of its residents at St. Elizabeths Hospital in fiscal year 1976---Exhibit 15-Sources of funds for research and training.. 756 757 Exhibit 16-Explanation of the St. Elizabeths Hospital financing Attachment 1-Discharge of patients now living in foster homes on convalescent leave status_. system Exhibit 17-Consequences of not obtaining accreditation---. 758-760 760 763-842 843-844 Attachment 2-Statement on foster care for the Mayor's Advisory 845-849 Attachment 3-Evaluation report on foster care, July 21, 1970---- 850-864 867 Attachment 5-Alternatives to hospitalization for the aged. --- 902-908 District Government: Coppie, Comer S., special assistant to the Mayor, reply to questions of Chairman Diggs, on May 7, 1975 910 Information from Joseph P. Yeldell, Director, Department of Human ST. ELIZABETHS HOSPITAL MONDAY, APRIL 28, 1975 HOUSE OF REPRESENTATIVES, COMMITTEE ON THE DISTRICT OF COLUMBIA, Washington, D.C. The committee met at 9:45 a.m., on April 28, 1975, at St. Elizabeths Hospital, Hon. Charles C. Diggs, Jr., (chairman) presiding. Present Representative Diggs, Delegate Fauntroy, Representatives Harris, Gude, Biester, and Whalen. Also present: Robert B. Washington, Jr., chief counsel; James T. Clark. legislative counsel; Ruby Martin, associate counsel: Mark Mathis, minority counsel; and Edward L. Cleveland, Dorothy M. Anderson, Wilbur Hughes, Nelson F. Rimensnyder, and Janice Lookner, professional staff. STATEMENT OF THE CHAIRMAN Mr. Dices. The committee will come to order. Legislative and oversight jurisdiction over St. Elizabeths Hospital was transferred from the House Education and Labor Committee to the District of Columbia Committee, effective January 1975. We have called these hearing as a part of our effort to understand the operations, programs, and problems of this hospital. St. Elizabeths has a long and distinguished history of excellence in the areas of mental health treatment, research, and innovations. The committee will seek to determine to what extent that record of excellence exists today, and if not, why not. St. Elizabeths, through both its inpatient care facilities and programs, and its Area D Community Mental Health Center, is an integral part of the mental health delivery system for the residents of the District of Columbia. The committee wants to know whether the operations and programs of the hospital, the Area D Mental Health Center and the District government are adequately meeting the mental health needs of this community; and, if not, what steps must be taken to assure that the community's needs are met. St. Elizabeths is a Federal facility which provides services to specifically identifiable Federal beneficiaries throughout the Nation. The committee is anxious to learn whether these Federal beneficiaries and potential beneficiaries are receiving and will receive the kind of high quality service envisioned by the Congress in establishing and supporting this facility; and if not, what steps must be taken to fulfill the congressional intent. Staff of this committee has been collecting data on St. Elizabeths fo several months, and have advised me that the descriptions and com munity assessments of St. Elizabeths are varied and wide ranging. Or one end of the spectrum the institution is characterized as one of the finest institutions for the mentally ill in the world. On the other enc of the spectrum are those who say that the hospital is an unsafe and dangerous place, which itself must undergo major program and physical surgery before it can possibly administer to the ills of others. Like most extremes, the truth probably lies somewhere in between. That is what these hearings are all about-to learn the facts about the quality of services at this hospital *** its facilities, its programs, its operations, whether it is indeed fulfilling its congressional mission relative to District of Columbia residents and the designated Federal beneficiaries. These hearings mark the beginning of an inquiry by the Congress into the status of a Federal facility that has not undergone congressional scrutiny for 12 years. I think it is important to stress that this facility has not undergone congressional scrutiny for 12 years. It is undertaken with an open and receptive mind about the issues and problems and options for solution. These hearings are undertaken in a spirit of cooperation with all of the parties involved in the operation of this facility. Indeed, I wish to thank the Secretary of Health, Education, and Welfare, and the staffs of the National Institute of Mental Health and of St. Elizabeths for their cooperation and for making this facility available to the committee for these hearings. We felt that it was important to have these hearings on the site so that there can be more sensitivity and more relevance to the whole framework of this inquiry. Before calling the first witness, I would urge all the witnesses and others concerned about this hospital to think about the range of options available to make St. Elizabeths the best possible mental health delivery institution in the Nation. That is, by all historical accounts, what it was and what this committee believes it ought to be today. I would now like to recognize the gentleman from Maryland, the ranking minority member, for such opening statement as he would care to make. STATEMENT OF REPRESENTATIVE GUDE Mr. GUDE. Thank you for taking the time and effort to have these hearings on the grounds of St. Elizabeths. As you have noted, these are the first congressional hearings on the hospital, aside from regular appropriation hearings, since the early 1960's. Much has occurred in the past decade in the field of mental health, most particularly the dramatic trend toward community-based treatment. Therefore, there is much ground for us to cover today and tomorrow to assure ourselves that St. Elizabeths has been and will be in the forefront of this trend. We approach these hearings with no particular bias, but rather with a view toward sounding out those most closely involved in the hospital-Federal and local officials, public interest groups and employees as to their feelings on the state of affairs at St. Elizabeths, and how its operations may be improved so that it may best carry out |