of-school hours, but the real problems are the trainees who are not able to furnish any part of their personal expenses, and who are handicapped in a manner that makes part-time employment or outof-school work very difficult and uncertain.

The working value of a maintenance fund was first brought to our attention by the advantages we received from our maintenance clause in the Wisconsin workmen's compensation act. We found that the $10 a week furnished from that source oftentimes made a suitable rehabilitation program possible, when without this fund, or one to take its place, an injured workman would not be able to spend the time to complete a training course.

Every rehabilitation worker has had the experience of spending a lot of time and considerable energy working out a suitable training program, only to have his plans crushed when the personal expenses of the trainee become an insurmountable obstacle.

While this paper was being prepared, a letter written from Eau Claire, Wis., arrived at our office, a portion of which I am quoting:

My father thinks they have paid out a lot for me already. Now they have decided that if it does not cost them anything, they won't try to stop me from getting a good education, so I may be able to help myself better in the future. I certainly would be grateful if this could be done.

About the same time a letter arrived from Taylor, Wis., a part of which is being quoted:

I have not the money to go to school with, and no chance to work, so I I can't see my way to school. I would like to go, as I make no headway here.

In both of the above-mentioned cases, the provision for maintenance in the Wisconsin rehabilitation act saved the day. It was only necessary to provide $200 in the first case and $100 plus a part-time job in the second case in order to work out a suitable maintenance program for those two people.

We have found that funds must be furnished from somewhere, in varied amounts, in order to meet the personal expenses of a large number of our people if we are to train persons who are unable to finance their own programs. It seems reasonable to argue that this expense is fully as important as is the school expense, because without maintenance, it is impossible to start many of our best school training programs.

We have some splendid examples in our past experiences of people who were unable to support themselves before taking training and were therefore unable to save enough funds to carry them through a training period, who are now able to hold good positions and help support those on whom they were dependent before they came to us. A very large percentage of our prospective trainees find a budget of their personal expenses out of their reach. People who are able to

finance their own education do not come to us for assistance. The principal reason why people seek our services is the lack of funds to carry out their programs without assistance. Giving a large number of these people the information that we can take care of their school expense, but that they must look after their own personal expenses is putting our services entirely out of their reach, and crushes the hopes that have been aroused by news of the fact that the State has made provisions to train physical handicaps in a suitable occupation. Wisconsin has recognized the importance of maintenance by placing a clause in our workmen's compensation act, and another in the Wisconsin rehabilitation act, and the Wisconsin Legislature saw the maintenance problem so clearly during the session of last year, that an emergency appropriation was passed to handle several Wisconsin cases that were pending for want of maintenance. Our experience indicates to us that a maintenance provision is absolutely necessary to carry out a successful rehabilitation program, and we therefore urge a national movement to place maintenance provisions in the compensation and rehabilitation acts of the several States.

Chairman FOSTER. I am going to ask Mr. Nichols, of Kentucky, to talk to us on "Methods of placement in small towns." Mr. Nichols.

METHODS OF PLACEMENT IN SMALL TOWNS

H. W. NICHOLS, Rehabilitation Supervisor, Kentucky

Mr. Chairman, ladies, and gentlemen: I am placed in an embarrassing position because of two facts: First, I was expecting the gentleman from Montana to be present to discuss this topic and I expected to follow him and say, "The gentleman did well and I approve what he said," which I am sure he would have done had he been here; and second, if you learned philosophers who have been engaged in this work for four or five years, can not give us definite information, you could not expect one with only three or four months experience to say anything worth while.

This question of placement is, to my mind, one of the biggest problems with which rehabilitation workers have to deal. Especially is it so as to placement in small towns where industries and positions are few. The ultimate aim of any program of rehabilitation is successful placement.

There are two kinds of people in our field of endeavor to be placed, those with training and those without training. It seems to me that placement without training is only temporary, because if a person is not trained for his job he will probably lose it in the course of time to the one who has been trained. It seems, therefore, that training is very essential to successful placement. If a person is sufficiently trained for a job, the placement then insures permanent placement,

from the fact that he may lose a certain place while engaged in his trade but there will be another waiting for him.

I believe our programs should be formulated so as to guarantee permanent placement—that is, a position somewhere through life at the job for which the trainee has been trained. Sometimes it is possible to have a position in mind before the person enters training some definite objective in view. This is a safe way, but not always practicable. We might say that the successful placement of any rehabilitant is the final test of any rehabilitation program.

In considering the objective, we must take into account the following points:

First. The person. He should be studied by means of surveys and otherwise. This takes some time and careful thought. I can not go into detail to explain, but the study of the person should be in detail.

Second. Opportunities in small towns. Some small towns have more opportunities for employment of handicapped people than others. A list of these opportunities should be made.

Third. The locality or the place should be taken into consideration.

Fourth. The characteristics of the small town should help to determine a training program for successful placement. Fifth. The relation of the small town to the surrounding country and other neighboring towns and cities help to determine this factor of placement.

I earnestly believe that placement should be on a business basis, so that when you go to an employer seeking a position for a trainee you will be able to say: "Here is a person well trained, who will render you service and earn the wage you pay." When our placement is built on a sound program, then we will gain the plaudits of the whole world for a piece of reconstruction well done. We should not depend upon sentimental fraternalism or charity for successful placement.

Chairman FOSTER. We have had no discussion of "Training methods" and I think we are fortunate in having Mr. S. S. Riddle, of Pennsylvania, to lead this discussion. Mr. Riddle.

TRAINING METHODS

S. S. RIDDLE, Director, Bureau of Rehabilitation, Pennsylvania

Mr. Chairman, ladies, and gentlemen: The principal methods of training utilized in rehabilitation are employment training, or training on the job, to qualify a disabled person for a suitable task; cor

respondence school, evening school, or tutorial instruction for disabled persons in conjunction with definite employment related to the training; institutional training to qualify disabled persons for suitable employment at the completion of the course; and tutorial instruction with general guidance and assistance in the establishment of a disabled person in a commercial, agricultural, or mechanical business enterprise.

The possibilities for training vary, of course, in communities and in the several States. Opportunities that may exist in one section can not be compared with opportunities for training in another section. Training conditions for rehabilitation in New Mexico are vastly different from training conditions in New York or in Pennsylvania. Local factors govern the procedure.

Eliminating local considerations, there is one common ground on which we all meet-the individual, human nature. First comes age. The older groups we can not generally train in any ambitious fashion; the younger groups we can.

In Pennsylvania, a State rehabilitation project was in existence a year before the Federal act. Pennsylvania's legislation was enacted as a definite supplement to the workmen's compensation act and restricted rehabilitation to persons injured by industrial accidents. Of course, acceptance of the Federal act brought in the. "otherwise group," but after a year we had gathered a heavy load of persons injured in the mines and other more rugged types of employment throughout the State of Pennsylvania. Therefore the prospects for extended training were low on a percentage basis of our whole registration, and I think the prospects are still lower to-day among our registrants on account of the age of the individuals. The average age of the registrants in Pennsylvania runs close to 40 years. A high percentage are illiterate in English. Many of them are foreign born.

Training, then, in the majority of cases with us of necessity is of a superficial character-training for some particular task that almost anybody could learn to do after being instructed on the job for a comparatively short time.

One must also consider the domestic responsibilities of the registrants. There are unquestionably in every State, disabled individuals who could be trained and would go far if considered in the abstract. They have mental capacity; they may have had a highschool education; they may have been out of school for four years, and may have worked in tasks that give a fair remuneration. You find they live in a town of perhaps 2,000, a mining community where they have fairly good earning capacity back in the mines, or in a large steel plant, but limited opportunities for other types of em

83530-26- -6

ployment in their community and also carry the responsibility of a fairly large family. Necessity for early return to employment for support of the family precludes, in such cases, ambitious training programs that would otherwise follow.

Chairman FOSTER. I am sorry to have to stop Mr. Riddle, but our time is short. New York has a model law on "Second injuries." We will now hear from Mr. Endres on this subject. Mr. Endres.

SECOND INJURIES

Jos. J. ENDRES, District Director of Rehabilitation, Syracuse, N. Y.

You have heard so much this morning covering the subject of "Second injuries," first from Mr. Andrews and then Mr. Angove's paper that little remains for me to say on this subject.

You have heard from both of these men the points covered by our New York State law and the satisfactory parts in it from a rehabilitation standpoint. There are a few places I wish to emphasize which pertain to the actual working conditions of this law.

Mr. Angove has stressed the employers' attitude toward replacement. We find that the employer can be sold on the idea of rehabilitation and replacement readily. In fact, the chief matter we have to guard against is a too liberal attitude on the part of the employer. I mean by this that various concerns are very apt to be so anxious to get the injured man back to work that in many cases not enough thought is given the proposition from the standpoint of the injured workman, his mentality and his aptitudes.

The National Safety Council in many ways has shown the danger of not having made the proper selection and training of men for various hazardous jobs, particularly around high-speed machinery; therefore, it is a part of our job to see that in replacing these men (especially unskilled persons of a low mental grade) that all of the factors which are apt to become a part of a future risk be eliminated as far as practicable.

We have had very little experience with second-injury cases in New York State and thus far we have not had any trouble in dealing with employers; perhaps, because of the actual conditions of the law itself. I believe that is all I can say to supplement any previous remarks.

Chairman FOSTER. We will have Mr. Leslie S. Wood of New York to speak to us on "Methods of placement in large cities." Mr. Wood.