process, because this part of the law creates a compulsion which we believe inconsistent both with the insurance aspects of the benefit and with the stated intent of encouraging rehabilitation and return to useful living. In this connection we believe sincerely that compulsion and rehabilitation are mutually incompatible and that only a voluntary approach to rehabilitation, without fear of the loss of benefits, can ever lead to successful restoration. We have, in previous Congresses, asked Mr. Anfuso of Brooklyn to present a measure which would contain this intent, and proposed wording that we felt would make for a simple amendment. Apparently, this was not the consensus of the committee reviewing the original introduction of the disability section of title II. We do sincerely hope that this Congress and, in particular, this committee may recommend such changes.

While there are many other areas of service for blind persons which require the expenditure of public money and the action of State or Federal legislatures, we do not believe that bills covering these problems are before you. For example, there is a very real interest in the area of work for the blind in improving and expanding library services to blind persons, so that braille books, talking books, and other devices and equipment will be available to blind persons on a convenient and local basis, essentially within each State rather than, as now, on a regional basis. This is such a complex matter that it has been our hope that the Library of Congress itself might propose an adequate solution in the form of new legislation.

Then, too, there is the problem of the unusual increase in the number of blind children in our country over the past 20 years due to a unique condition (retrolental fibroplasia) developing in premature babies. This very serious cause of blindness, happily, has been conquered by research by the medical profession, but there are large numbers of blind children still either about to enter school, or part way through elementary and secondary school years, who need and should have some special services. Because of the nature of the American Association of Workers for the Blind we have, insofar as possible, encouraged the development of such programs as are needed within each State without special Federal help. It may be, however, that within the framework of legislation already passed and under consideration by Congress, concerned with the preparation of teachers and teachers of teachers for exceptional children, we may request some special help in this area, for one of the crying needs in this program for children, aside from books and material and equipment, is the skilled, professionally trained personnel for which there is such demand and competition in all areas of education.

We are grateful to this committee and to Congress for all that they have done over the years. It is our hope that after you have considered these bills before you, you will act with generosity and dispatch to help in the resolution of all of the problems that are now confronting our field of work.

Thank you again for the privilege of being here, not only for the legislative committee of the American Association of Workers for the Blind, but for the Industrial Home for the Blind of Brooklyn.

Hon. CARL ELLIOTT,

THE INDUSTRIAL HOME FOR THE BLIND,
Brooklyn, N.Y., March 16, 1959.

Chairman, Subcommittee on Special Education, Committee on Education and Labor, House of Representatives, Washington, D.C.

DEAR MR. ELLIOTT: I cannot tell you how sincerely I regret the contingency which made it impossible for me to present a few additional comments on Friday last in the afternoon. I can appreciate fully the demands of the House of Representatives on all of its Members, and only feel sorry that I was unable to return today in accordance with your invitation.

Miss Allen and Mr. Backstrom assured me that my statement for the American Association of Workers for the Blind on the broad question of problems concerned with blindness would be entered in the record, and I am writing this brief note simply to add the one or two brief comments which I would have preferred to have made personally to you and your committee.

First, may I say again how much I regret the apparent controversy that seems to reign over Mr. Baring's bill, H.R. 14, and the many identical bills that have been presented on the same subject. We cannot help but feel that such discussions as your committee has listened to over the past week can create nothing

but confusion and misconceptions about what is actually taking place in work for the blind in the United States. For this reason, if for no other, and there are many reasons why this measure should not be passed, we believe that the study commission bills which your committee has been reviewing can and should answer many of the questions that have been raised by the past week's hearing, by instituting a program of on-the-spot observation of actual programs of service for blind persons in effect in every State and territory.

I had hoped to suggest that Mr. Matthews' bill, H.R. 1855, which is most acceptable to the American Association of Workers for the Blind, could be improved by one or two of the features contained in both your own bill and in the bill presented more recently by Mr. Fogarty, H.R. 5243. In particular, we believe that it might be useful to identify the problem areas to be studied, as contained in the Fogarty bill. We believe, too, that the Fogarty bill is more realistic in its request for appropriation to cover the scope of the study.

Your own bill, we think, is more precise in some of its wording as to the purpose of the bill.

Referring to the scope of the study itself, it is the feeling of our committee that unless a large enough staff is engaged to complete on-the-spot studies in each State in a relatively short period of time, the period of the study may be so protracted as to be of very little use in any immediate remedy to the blind of the United States for whatever problems do exist. There have been many suggestions made as to how the study might be conducted. One of these is that the commission employ a staff of 30 skilled persons for a period of 6 to 8 months, with a month or two for orientation to the problem of the study itself, and each team of 3 persons thereafter assigned to a State for a full month's observation and reporting. This group of 30 could thereafter be dismissed from service and an analytical team, including the executive director for the study and as many others as might seem necessary, put to work in the analysis of the findings of the teams.

We believe that the amount of money proposed by Mr. Fogarty's bill would encompass this possibility, but that it might be difficult to make this type of study for the amounts of money contained in your bill and Mr. Matthews' bill. The one hope that we do have is that no ivory tower study shall be considered and no investigating committee sitting on complaints and gripes shall be established. We cannot help but feel that such approaches do nothing to remedy problems that exist. We all feel that there are problems and that the study will point them out in detail. We feel that any inquiry should encompass, in addition to the public services available on a Federal and State level, the scope, purpose, and meaning of such organizations as are now proposing such types of legislation, such as the American Association of Workers for the Blind and the National Federation of the Blind. We would like such a study to truly identify who these groups represent and their real purpose for existence.

Again, with sincere regret for not having been able to tell you this in person on Friday, March 13, believe me.

Faithfully yours,

GEORGE E. KEANE,

Chairman, Legislative Committee, American Association of Workers for the Blind.

Mr. ELLIOTT. I now recognize the gentleman from New Jersey, Mr. Daniels, to introduce Dr. Joseph M. Babcock, who will be our next witness.

Mr. Daniels?

Mr. DANIELS. Mr. Chairman, the next witness comes very, very highly recommended to me by his colleagues in the State of New Jersey who called at my congressional office on Saturday last when I was home visiting the district, and I would like at this time to introduce to the committee Dr. Joseph M. Babcock, who has been a practicing optometrist of many years' standing in Portsmouth, Ohio. He is the director of the Department of National Affairs of the American Optometric Association, has been a practicing optometrist for over 40 years in Portsmouth, Ohio, State secretary for 20 years, has been very, very active in local civic affairs, president of the local chamber of commerce and for 16 years has been in charge of the De

partment of National Affairs of the American Optometric Association. I am happy and pleased to introduce Dr. Babcock.

Mr. ELLIOTT. Would you care at this time also to introduce the gentleman with him?

Mr. DANIELS. The gentleman with him is William MacCracken, attorney for the American Optometric Association, a man who served in the Hoover administration and since that time has been engaged, I understand, quite successfully in the practice of law with his associates in the city of Warren.

Mr. ELLIOTT. Thank you very much.
You gentlemen may proceed.

STATEMENT OF DR. JOSEPH M. BABCOCK, PORTSMOUTH, OHIO, DI-
RECTOR, DEPARTMENT OF NATIONAL OPTOMETRIC ASSOCIA-
TION; ACCOMPANIED BY WILLIAM P. MacCRACKEN, ATTORNEY
AT LAW, WASHINGTON, D.C.

Dr. BABCOCK. Mr. Chairman and Mr. Daniels, my name is Joseph M. Babcock. I reside in Portsmouth, Ohio, where I have been engaged in the practice of optometry for more than 40 years. I have been in charge of the Department of National Affairs of the American Optometric Association for the past 16 years, during which time I have also served as secretary to the Ohio State Optometric Association.

Our national association, like most others in the health field, is composed of individual members in each of the 49 States and the District of Columbia. In most instances the individual joins the local or State association and at the same time becomes a member of the national organization. There are two groups which provide professional service essential to the care and preservation of the vision of the American people. No doubt most of the members of this committee are familiar with the services performed by these two groups. However, for the benefit of those who may not have this information at their fingertips, may I submit the following by way of introduction. The optometrists constitute the group especially trained to examine the eyes of their patients for defects in vision. When these are caused by conditions which either partially or wholly require medication or surgery, the patient is referred to a physician or ophthalmologist. In civilian life between 60 and 70 percent of those seeking professional advice for their visual problems consult optometrists. In all 49 States and the District of Columbia, either by statute or by regulation having the force of law, a person now seeking an original license to practice optometry in any one of these jurisdictions must be a graduate of an approved school or college of optometry, each of which requires a minimum of 5 years of study at the college level, 3 of which are devoted exclusively to their specialty.

The ophthalmologists are the other group. They are physicians who have taken postgraduate work in the eye and have passed examinations given by the American Board of Ophthalmology. They are especially trained to perform eye surgery and to treat diseases of the eye, as well as to refract.

It is my understanding that there are two groups of bills which are being considered. The larger group deals with the right of the blind to organize for the purpose of representing the blind in their dealings

with State and Federal agencies administering programs for their benefit. While I am not a lawyer, it would seem to me that the right exists at every level of our government. However, if those citizens who are totally devoid of sight, or come within the legal definition of blindness, believe that the passage of this legislation would facilitate their efforts to improve the administration of the various programs for the benefit of the blind, then by all means we endorse the enactment of one of these bills.

The other bills, one of which I understand was introduced by the chairman of the subcommittee, would authorize the appointment of a temporary National Advisory Committee or Commission for the Blind. In view of the substantial sums of money which are being expended by the various governmental agencies, National, State, and local, augmented by funds contributed by the general public and private foundations, it seems logical to our association that such study should be made, and we strongly recommend the passage of one of these bills.

While we support the creation of a temporary committee to study and report on the problems relating to blindness, we believe that it is in the best interests of the blind, and the Nation as a whole, that the optometric profession should be represented on the Commission or the Committee and, therefore, Mr. Chairman, I am taking the liberty of suggesting amendments to your bill, H.R. 356, and that of Congressman Wainwright, of New York, H.R. 3390. These two bills have been selected because they are typical of the bills dealing with this subject. The chairman's bill, H.R. 356, provides for a Commission of 21 members. Congressman Wainwright's bill, H.R. 3390, provides for a Committee of nine members. We would recommend that H.R. 356 be amended by inserting on page 3, at the end of line 4, the word "optometry," and on page 3, line 18, after the word "medical" the words "and optometric"; page 4, line 5, strike out "1959" and insert in lieu thereof "1960," and in the same line strike out "1960" where it appears in the printed bill and insert in lieu thereof "1961"; page 5, line 13, strike out "1958" and insert in lieu thereof "1959." These last three suggested amendments are purely technical and need no comment.

In H.R. 3390, we would suggest the following amendments: Page 2, line 9, strike out the word "nine" and insert in lieu thereof the word "eleven"; page 3, line 2, strike out the word "and"; page 3, line 3, strike out the entire line and insert in lieu thereof "(9) one individual who is a duly licensed optometrist; (10) one individual who is a duly certified ophthalmologist; and (11) one individual from the public at large."

There are many reasons why the optometric profession should be represented on the group charged with the responsibility of making the studies provided by these bills.

The first of these is that substantially more than half of the public who seek professional eye care are first seen by optometrists. It is their responsibility, where an eye examination indicates the need for medication or surgery, to refer the patient to a duly qualified physican. In spite of the vitriolic hostility of some of the medical eye practitioners toward optometrists, our members in the interest and the welfare of their patients are constantly referring cases to medical practitioners.

Another reason is that optometrists have pioneered in developing what are sometimes referred to as subnormal vision aids. These include telescopic lenses, microscopic lenses, contact lenses, and other subnormal vision aids.

You heard the testimony of Mrs. Gorden Hardenberg relative to the splendid cooperation which the Alabama blind receive from the optometrists. I think that you will agree that her testimony was particularly impressive in view of the fact that she was accompanied at the hearing by her son, Firmon E. Hardenberg, M.D., who is taking his residency in ophthalmology at the Massachusetts Eye Infirmary in Boston.

The Industrial Home for the Blind in Brooklyn, N.Y., was one of the first organizations to give serious consideration to the optical aids which had been developed by optometrists and the optical manufacturers to improve the vision of the partially sighted. In 1957 they published a survey dealing with this subject from which I would like to furnish you with several quotations. The first from the commentary by Richard E. Hoover, M.D., ophthalmological consultant:

This program could not have attained the popularity which it enjoys and the success indicated in this report without the support, sincere interest, and capabilities of the director, the ophthalmologist, the optometrist, and the service and administrative personnel who gave encouragement, instruction, and help in the use of the aids.

A much needed service has been rendered.

Also from the commentary of Leo Esbin, M.D., staff ophthalmologist:

As an ophthalmologist I have watched with keenest interest the development of the optical aids service at the Industrial Home for the Blind, the more so that the 500 clients served were persons who, on the basis of an ophthalmological examination were found to come within the legal definition of blindness. All of them had had ophthalmological service-some of them very extensive service over a period of years-and most of them had been told that nothing more could be done to improve their vision.

Against this background, it was surprising to find that 68 percent of the group had obtained a useful increase in visual acuity through the use of optical aids. In order to conserve time I will not quote all that the survey contains pertaining to the role of the optometrist but merely one paragraph which reads as follows:

This is an exacting, time-consuming procedure in which the staff optometrist determines the client's vision problem and brings to bear on it his special refraction technique and his knowledge of ophthalmic lenses and low-vision aids, for the purpose of discovering the appliances and conditions which will enable the client to achieve maximum use of his remaining vision.

The Lions Clubs have for years taken a great interest in the visual welfare both of children and adults, and there has been the closest cooperation between these groups and the local optometrists.

In my own State of Ohio, the Goodwill Industries of Dayton some 2 years ago established a subnormal vision service. The service is intended only for legally blind persons, but any person who has reduced vision but is not legally blind will be cared for at the request of his private practitioner. In carrying out this program Dr. Richard L. Hopping, an optometrist, and Dr. Russell N. Brown, a medical consultant, have worked together harmoniously to the advantage of those suffering from impaired vision. A recent article appeared in Look magazine calling attention to the progress made in this field by