Page images
PDF
EPUB

of the project will be reevaluated, and a full-service pharmacy could then be installed in the health center. I consider this a reasonable request and I have urged that it be honored.

This proposition, however, has been rejected by the Office of Economic Opportunity. That Office has stated that the proposal can hardly be considered more than a declaration of intent and that it is far too vague to merit serious review. That Office further suggests that months of additional negotiation and spadework would be necessary before this proposal could be sufficiently imaginative, innovative, and sophisticated enough to be included in a comprehensive health center project.

I call to your attention the tremendous struggle the small businessman has in his fight for survival. The small businessman in Baltimore, and I think in the State, and possibly in the Nation, feel that no one really cares about him, that he is sort of the lost man, and the only ones we are really interested in is the survival of big business. I can tell you this from the standpoint of the grocer, the pharmacist, the retail merchant, and everyone else. And this is why we established a committee on small business in Baltimore City a number of years ago, and we started to revitalize our areas.

In many instances, he is not well organized and must depend on his congressional Representatives and/or local council to protect his interest. He does not have the facilities to submit sophisticated proposals to Government agencies in the pursuit of his protection.

The letter that we received from OEO seemed to indicate that the proposal made by the pharmacists, in summary said this:

This letter can be regarded as a letter of intent. In its present form it is unacceptable. In my opinion it constitutes a routine vendor program with some suggested but poorly thoughtout additions. Clearly months of negotiation and spadework will be necessary before this proposal could be sufficiently imaginative, innovative, and sophisticated to be included in a comprehensive health center proposal.

Mr. SMITH. Who is that from?

Mr. SCHAEFER. From the Director of Health Services, Office of Community Action Program.

You know, the small businessman does not have a tremendous staff that he can look to to prepare an imaginative, sophisticated proposal. He cannot call on a group of people and say, "Prepare for me all of these things that will meet a criterion that might be established by a congressional group, or by an agency of the Government." He has to rely on trying to stay in business, to work, to survive. And what he needs is some help from governmental agencies-if they have to be imaginative, innovative, sophisticated-some help should come from the governmental agency to help them prepare on these guidelines, and not always force it on the small man to work up. The level should be up here, aiding the small businessman. And I find just the opposite in this proposal.

Mr. SMITH. At which level is that?

Mr. SCHAEFER. This is the Office of Economic Opportunity, Director of Health Services, Office Community Action Program. This comes from Washington.

As the Congressman said, it must be noted that the small businessman, including the pharmacist, pays his fair share of the taxes that

allow such projects as the comprehensive neighborhood health cente to come into being.

In other words, he pays the taxes so that you can put these projects into being, so that you can put him out of business. And sometimes tais is a round robin that is very difficult for a small businessman that is trying to survive to understand.

I am of the opinion that it is clearly not the intention of Congress to thwart any constructive ideas that may be made by local repre sentatives concerning pending projects. I know that veiled threat do not have congressional approval. I submit to you an example of such a communication. From a letter received from the Office of Economic Opportunity I quote:

I sincerely hope that the present differences can be resolved and that ne conditions will be attached in the City Council's review of the grant that wil cause us to re-examine our stance.

Now, if that is not a veiled threat, that unless the city council of Baltimore accepts the proposal exactly as submitted-in other words in a rubber stamp proposal-I don't know what it means.

Mr. SMITH. Who is that from?

Mr. SCHAEFER. Director of Health Services, community action pr gram, also on the Washington level.

Now, it is my understanding-and I might say that I was on the committee that established our local community action agency-it was my understanding that the city council and all governmental agences involved in OEO projects, or involved in programs, would have an opportunity to examine them, and make constructive suggestions. Mr. SMITH. What is the date of that letter?

Mr. SCHAEFER. January 11, 1968.

I would also like to quote a more recent statement than thatthe newspaper, local press of yesterday, "Schaefer Stand Seen Hurting Poor." Anyone who objects to an OEO program immediately is hurting the poor. This is exactly the opposite of my intention and my o record in the city of Baltimore. But any time you oppose a progra you are immediately attempting to hurt the poor, and this sometimes causes great embarrassment and pressure.

Doctor *** Director of Office of Economic Opportunity. Health Progra said that Baltimore must accept the program in its totality or the funds est marked for the program will revert to the Federal government. This is a gr danger, the doctor said, that if there is no meeting of the minds, and Council des not accept the proposal with the inclusion of the pharmacy, we will withdraw the grant and send the money back to the Treasury. We made the grant good faith. We thought that there would be no problem with the pharmaceutica industry. We cannot spend the first nickel until the Baltimore City Cou votes the acceptance of the program.

The council has accepted the program except for the pharmaceuti>aspect, which is a small portion of the entire picture--a small portio of the entire medical center is the pharmaceutical.

A local Office of Economic Opportunity official suggested that if the Cou failed to pass the measure, the center might be financed with a direct gr by OEO to Providence Hospital,-

In direct contravention of what we have as far as the law is o cerned, as I understand congressional intent, where a is supposed to be consulted on some of these matters.

political ar

These are saying if the city council does not pass this, and if they make a suggestion, any suggestion at all, we will bypass them and let the grant go directly to OEO.

Mr. SMITH. If you have copies of those two letters, we will put those n the record.

(The two letters referred to appear at the end of this testimony.)

Mr. SMITH. The reason I ask the date is that we are going through a transition period here. As of January 11, under the law, city councils were not supposed to be able to control the local CAP agency's proposal. However, we are under a new law now since that time, where the city council could have some voice in determining the membership of the CAP agency.

Mr. SCHAEFER. The city council law has always made it mandatory that OEO programs come through the city council.

Mr. SMITH. Well, your own local law could not contravene the Federal law which prohibited local councils and political arms from usurping certain decisions of the local selected CAP group. It was supposed to be taboo for politicians to have anything to do with the local CAP program.

Mr. SCHAEFER. I do not think it is always taboo for the politicians to have some interest in this, and I think Congress found that to be true, and possibly modeled their law after ours.

Mr. SMITH. But until the law has changed, that was the law.
Mr. SCHAEFER. The law now is that we can have some say in this.
Mr. SMITH. That is right.

Mr. SCHAEFER. I won't debate the point, except to say that no program that ever came before the city council was rejected. We made some very valuable and intelligent suggestions, all of which were incorporated, and all of which were adopted and found to be workable. Mr. SMITH. Anyway, what I am trying to get clear is whether you were in an argument with your local CAP agency as to what should be in their plan, or was it something coming from Washington, telling the local CAP agency they had to do something they didn't want to do: which was it?

Mr. SCHAEFER. I did not follow-what you are saying is that we did not have any right up until January 11.

Mr. SMITH. What I am trying to find out is this. Were you in agreement with your local CAP agency as to what should be in the plan? Mr. SCHAEFER. Except for the pharmacy.

Mr. SMITH. But they were in disagreement on that point, too.

Mr. SCHAEFER. That is right. No our local agency just took it as is. Our local CAP agency accepted the proposal as it. That is with the pharmacy included. The city council

Mr. SMITH. They agreed with you, in other words?

Mr. SCHAEFER. No, they disagreed with us. when it came into the city council for approval, even though Congress may have said that no local group, that is, local political arm, up until the law was changed-said that you cannot object-we, in setting up our agency, thought that it was proper, saying any OEO money to come in, the city council would be given an opportunity to say whether they thought it was good or bad. Give it not a veto power, but just to give an opinion as to this. All the opinions of the council, and I might say all the projects given to us

were approved by the council, with some modifications, all of which were all right. When we wanted to modify this slightly, to leave out the pharmacy, of course then OEO said "You are going to accept it is is, and unless you do, there will be no project."

Mr. SMITH. When you say OEO, do you mean the local CAP agency! Mr. SCHAEFER. No, the Federal agency.

"*** said Federal officials had agreed to sanction the proposal with the proviso the pharamcy be excluded on a 6-month trial basis," but it was rescinded by Washington.

We came over with the mayor of the city, and we thought we had an agreement whereby the proposal made by the local pharmacies would be acceptable. However, when we left we were elated everything was al right. When we got back, we got a letter saying "You are going to take it as is."

dif

From my own experience I have found that there is a great ference between the agency as established in Washington and how operates under the conditions that prevail in a city. No survey was made by Office of Economic Opportunity of the pharmacies in the area. The only thing that was suggested was "that Office of Econom Opportunity knows best." It would certainly appear that Office of Economic Opportunity has ignored the charge it has been given under title 42, sections 2701 and 2970, where we read:

It is the sense of the Congress that it is highly desirable to employ the resources of the private sector of the economy of the United States in all su efforts to further the policy of this chapter * and * the director and the heads of any other Federal departments or agencies to which the conduct of pro grams described in this chapter have been delegated shall take such steps as may be desirable and appropriate to insure that the resources of private enterprise are employed to the maximum feasible extent in the programs described in this chapter

It certainly is clear to me that two Federal agencies, the Select Co mittee on Small Business and the Office of Economic Opportunity, an working at cross-purposes. The congressional committee attempting to aid small business-the Office of Economic Opportunity in this i stance, working against the interest of the pharmacists in a local com munity. It is ironic that the Office of Economic Opportunity sho insist that a pharmacy be established in the health center to the detr ment of the local pharmacists, when the Office of Economic Opp tunity has established a Small Business Development Center for th purpose of helping small business in Baltimore. This appears to me t be in direct opposition-one to the other.

Now, that is the prepared statement that I have.

I would like to say, when I talked with our mayor late last nightand I would like to enter into the record a letter signed by the may directed to the chairman of the committee:

DEAR CONGRESSMAN DINGELL: The longstanding controversy over the pharma in the Provident Comprehensive Neighborhood Health Center should be resol I support the position that a limited service pharmacy under the supervision a licensed pharmacist should be established in the Center to meet the "in ho or on site requirements of the Center for diagnosis and treatment, I fur support the position that prescriptions prescribed by medical practitione (physicians, dentists, et cetera) at the Center are to be given to all pat who are then to have these prescriptions compounded or dispensed at commet pharmacies of their choice in accordance with a vendor system at no charge the patients.

A Pharmacy Committee, composed of equitable representation from the Maryland Pharmaceutical Association, the Provident Center and the CAA, would develop guidelines and standards for pharmacy services for patients of the Center.

At the end of a six month period of operation under these proposals, a Pharmacy Committee, to be established, would evaluate the status of pharmaceutical services in meeting the needs of residents of the target area and make its recommendations.

I hope that some equitable compromise can be obtained so that the Provident Comprehensive Health Center can be moved forward.

Sincerely,

THOMAS J. D'ALESANDRO III, Mayor.

He is supporting the compromise we submitted many months ago. Things should be resolved. There is no reason it cannot be resolved with some compromise on the part of OEO. We now find ourselves in the position "You will take this as is, accept it as is, you will make no recommendations no matter what it does to the small businessman of Baltimore City, and if you do not accept it, we will give the money back to the Treasury."

I do not think that would be acceptable to elected representatives on any level, Congress, State, or local.

Mr. SMITH. In the case of the vendor plan that you were proposing be accepted, was there a flat charge per prescription, or was there anything said?

Mr. SCHAEFER. All that will be developed by the pharmacist. And we have many of our pharmacists here today in support of this opposition.

Mr. POTVIN. Mr. Chairman.

Mr. SMITH. Mr. Potvin.

Mr. POTVIN. Mr. Schaefer, first of all let me say, sir, this is not the first time you have appeared before subcommittees of this committee, and it is always a very real pleasure to hear you.

Congressman Dingell asked me to apologize to you for the fact that he is ill and unable to attend. He asked me to commend you for your very sincere and diligent interest in the welfare of small businessmen in your community.

Would you, sir, like to go a bit into the possible impact that the establishment of this in-house pharmacy would have on pharmacists of the area, or will this be covered subsequently?

Mr. SCHAEFER. This will be covered. I would only be repeating what will be said.

Mr. POTVIN. Could you perhaps give us some insight into the tax revenue portion of possible impact?

Mr. SCHAEFER. Well, I cannot give you the exact amount, except to say that we see in Baltimore City-when we first appeared with youthat the small businessman in the city was giving up, as far as the city was concerned, they were either going out of business, they were withdrawing from Baltimore City, because they felt that the city council, city government, and the local government just were not interested in them.

Just the opposite has now happened. We poured some money into the various areas on parking, we have been able to increase the tax base of the merchants. Restoration has been made to store fronts, business people are starting to consolidate. More small business-the dropoff on

« PreviousContinue »