doctrine of permanent handicap nor vocational incompetence, but seeks to place the physically handicapped upon the basis of self-support through educational methods adapted to that end. The close of the fiscal year 1930 marked the end of the first decade during which the Federal Government participated in State programs for vocational rehabilitation of the civilian disabled. During the fiscal year 1930 more than 4,500 disabled persons of all types were fitted for and placed in remunerative employment under State programs with Federal participation. These disabled persons were rehabilitated into more than 600 different occupations, ranging from unskilled to highly skilled, including professional and technical employment. At the close of the year more than 20,000 persons were reported to be upon the State rolls in process of rehabilitation. Experience has revealed that the total cost of rehabilitating a disabled person and rendering him self-supporting does not exceed an average of $300, a sum less than that which would be required to support him in idleness for a single year. The original act providing for the participation of the Federal Government in vocational rehabilitation in State programs became effective June 2, 1920, with a limitation of four years. In 1924 Congress extended the provisions of this original act for a period of six years; and in 1930 provided for a further extension of three years, so that at present this extremely valuable and important work of fitting the civilian disabled of the nation for self-support, must, so far as the Federal Government is concerned, come to an end within two years, unless Congress in the meantime provides for its continuation by appropriate legislation. Recurrent uncertainty as to the attitude of Congress with respect to this exceedingly important social service tends constantly to interfere with its progress and orderly develop ment. To-day but four States of the Union are without appropriate enabling legislation necessary to avail themselves of Federal aid in this important and vitally essential work. These four States are Delaware, Kansas, Vermont, and Washington. In Delaware the State educational officials are making an effort to secure legislation which will permit this work to begin in the next fiscal year. In Kansas a special commission was appointed by the governor to study the needs of disabled adults and physically handicapped children, and in Washington social agencies, labor organizations, and educational officials are all seeking to secure the enactment of legislation designed to permit the undertaking of this work. A word as to the character of the rehabilitation program. To begin with, this program is not concerned with the disabled soldiers but with the civilian handicapped; and by handicapped persons is meant such individuals as have been deprived of their earning power through some physical disability or who have never been able to exercise an earning power as a result of congenital or other handicap. Among the causes of such handicaps as are here alluded to are included public and industrial accidents. Real rehabilitation consists in getting an individual into a job for which he is not handicapped. In other words, the rehabilitation service set up under this program of cooperation with the States is made available to all types of the disabled. Special groups, such as tuberculous, blind, deaf, and those with cardiac diseases have in a number of States been given the benefit of special programs devised for their particular needs. The service rendered by this program includes (1) making contact with the handicapped individuals; (2) finding out what he can do; (3) training him so that he can do it; (4) placing him on a job; and (5) following him up to make certain that he can compete on equal terms with normal individuals and with unimpaired earning power in the employment for which he has been trained. It should be understood that the program of rehabilitation as carried on involves cooperation with numerous public and private agencies. As an illustration of the cooperative character of the program may be noted the experience of the rehabilitation service in the District of Columbia during the initial year of its operation, 1929-30, in which year the rehabilitation service cooperated with the United States Public Health Service, the United States Compensation Commission, Washington social service agencies, hospital social service departments, the District of Columbia Board of Public Welfare, and other organizations cooperating on a less formal basis. This sort of cooperation characterizes the work in each of the 44 States which have entered into cooperation with the Federal Government. Under the vocational rehabilitation act of 1920, the Federal Government adopted and has continued the policy of sharing with the States the cost of rehabilitating the disabled. From the success which has attended the program of civilian rehabilitation it can no longer be contended that rehabilitation is not of social and economic value in conserving the man power of the Nation. The possibilities of the program have aroused the imagination of leaders in the fields of education, industrial management, social work, and of organized labor. The rehabilitation forces of the State and Federal Governments have become important agencies of social welfare in providing opportunity for workers who are disabled by accident, injury, disease, or congenital conditions in becoming self-supporting. This The importance of Federal aid in the program is signalized by the fact that regardless of what measures the States may themselves have adapted they seek continuously and increasingly the services of the staff members of the Federal Board for Vocational Education. assistance has taken the form of consultation upon proposed policies and methods of organization. Experience has indicated that a central agency can render a valuable service to the States by disseminating information concerning the particular problems and experience of a State and the program which it may have adopted to meet them. Since the problem of rehabilitation is national in scope, and since it affects so intimately the national welfare, it is imperative to place the entire program upon a permanent basis through appropriate legislation. Through industrial and public accidents alone more than 180,000 persons become disabled in the United States each year, Reliable statistics show that of every 100,000 accidents 762 are fatal; 95,388 result in temporary disability; approximately 100 in permanent total disability; and 3,788 in permanent partial disability. From all causes-accident, disease, and congenital-more than 200,000 persons become permanently disabled in the United States every year. Accidents occur in the factory, on the farm, on the street, and in the home. For every work accident there are two public accidents, and each year finds the number of accidents increasing. In the wake of these accidents distress follows surely and rapidly. When accidents happen to the breadwinners of the family the result is frequently distress to wives and mothers and children. It is not merely the personal distress, however appalling that may be, which constitutes the problem, but the effect upon industry, the community, and the State as well. Industrial accidents alone cause an annual loss of more than a billion dollars, in addition to the indirect losses of many millions of dollars paid under State compensation laws-a charge upon industry affecting the earnings of both employers and employees. In every State there are institutions for the helpless, and to maintain such unfortunates a sum of from $300 to $500 per individual per year is requisite. But the loss which the community sustains in the destruction of happiness and self-dependence of the individual is far greater. The inability of a person to earn his own living or to support his dependents brings discouragement and a loss of morale which may well threaten the welfare of the State. Vocational rehabilitation is the means by which a disabled person may be fitted for remunerative employment, the objective being to establish or reestablish an individual in a definite employment consistent with his physical, mental, and vocational capacities upon an economic competitive basis, rather than upon the basis of charity or tolerance. The gain from rehabilitation has been repeatedly and successfully proven. In a Southern State in one fiscal year the average weekly wage at the time of the disablement of all persons rehabilitated during the year was $9.21. After rehabilitation this wage increased to $21.75. Of the group, 77 per cent had no earning power during the period of disablement, while 30 per cent had never worked prior to rehabilitation. In a mid-western State the res ts of a 5-year period are as follows: Total number of disabled persons rehabilitated.. 1,036 $499, 208 $1, 159, 948 $481 $1, 119 $242 $637 On the basis of this return a corresponding gain characterizing the results in the States generally will represent an increase in the annual earning power of the 45,000 persons rehabilitated since the beginning of the program in 1920 of approximately $27,000,000. The cost of maintaining these persons without rehabilitation would have been approximately $13,000,000 a year. This has been accomplished at a total expenditure during this period of less than $12,000,000 of local, State, and Federal funds. A rapidly developing phase of general educational programs in the States is that which contemplates special service for handicapped children. Special classes, schools, and facilities are being provided, including provision for vocational guidance as well as for prevocational and vocational training. Whatever may be established as a basis for the justification of the program of rehabilitation so far as it applies to our adult population, there certainly can be no question of the urgency of such a program for the needs of the physically handicapped children of the Nation. The care, cure, and education of our physically handicapped children is justified by every principle of the national concept of a democratic government. Reliable statistics indicate that there are in the United States approximately 250,000 physically handicapped children mostly located in the rural districts. Many of these children suffer from handicaps of such a character as prevent their attendance upon school and the consequent inability therefore of acquiring such training as the public school has to offer. Since in innumerable cases these handicaps are removable and when removed enable these children to acquire the education, either general or vocational, or both, to which as children of a Republic they are entitled, it is apparent that every effort should be made to accord them such opportunity. A pressing need at this time is for some action by the Congress indicating whether or not the Federal Government's participation is to be continued. Progress in the future will depend largely upon what action is taken by the Federal Government. The programs of vocational education, rehabilitation, and the restoration of the physically handicapped children of the Nation and the development of those programs indicate conclusively that although we have at times regarded this form of service from the viewpoint of the economic in terms of dollars and cents they nevertheless involve a far greater and more fundamental concept-namely, the conservation of the human resources of the Nation and the welfare and happiness of the men, women, and children of the Nation. Education designed to confer upon the masses of the people the ability to secure the blessings which must come from gainful and stable employment, the training of the youth of the Nation in the means of making a livelihood, and the restoration to health and earning capacity of those who through no fault of their own have become dependent, are primary considerations. The results of these programs speak for themselves in terms of human happiness, welfare, and the removal of such social injustice as may arise not from unequal distribution of wealth but from an unequal distribution of opportunity. Each of these programs represents an attempt on the part of the Congress, acting in cooperation with the States, to correct a situation of obvious social disparity. Each of these programs also represents the assumption on the part of the National Government of its proper share of responsibility for remedying these situations. The Congress has been confronted within the year with problems affecting directly the welfare and happiness of the people. As never before the Congress has been made pertinently familiar with the distress and unhappiness resulting from a lack of knowledge of our economic structure and our industrial organism, and in its attempt at solution has sought aid upon all sides. Here indeed is strikingly revealed a fundamental interrelationship between education and physical capacity and gainful occupation which has been but partly recognized in the past. The demand has arisen from the people themselves, and such expenditures as Congress has made in the past, but a small part indeed of the total can be regarded but as an investment in the human resources of the Nation itself. The Nation, the States, and the local governments are all interested in the education of our citizenship for vocational efficiency, in the vocational rehabilitation of our disabled civilian adults, and in the restoration of our physically handicapped children. The Nation must participate liberally in the promotion of these programs and their more liberal maintenance in the future. The work should be stimulated and encouraged by appropriate legislation. о |