which they discuss in some detail their support for a continuation of the WIC Program.

I though perhaps this correspondence would be useful in considering an extension of the Supplemental Food Program. With best personal wishes, I am Sincerely yours,

Enclosure.

MIKE MANSFIELD.

DEAR MIKE MANSFIELD: The Maternal and Child Health Bureau, myself and other WIC staff and WIC program recipients have become increasingly distressed over the gloomy outlook for Federal refunding of the USDA'S WIC program— The Special Supplemental Food program for Pregnant and Nursing Women, Infants and Children.

We are concerned about the effect the loss of this program, which provides nutrition and health care, will have on Montanans. The WIC program is the first food supplementation program that has been tied directly to health care. Not only are the highly nutritious "prescription" foods and health care through WIC, of direct and immediate benefit to low income, undernourished families, but the long-range results of this preventive health program can save Montana, taxpayers many dollars.

Scientific studies have shown that lack of protein and vitamins in pregnant women leads to low-birth-weight and premature births. These infants are more likely to suffer mental retardation, birth defects and slow learning problems. The average cost of care of an institutionalized person is now considered to be more than $100,000 over the person's life-time. Untold thousands are spent to support handicapped people and people who as a result of malnourishment in their infancy, have severely limited learning abilities. These people cannot contribute to our state's economy.

The WIC program has been an incentive for those eligible to receive maternity and well-child care and it has been a vehicle for nutrition education. After initiating the WIC program on the Northern Cheyenne Reservation, attendance at the well-child clinics increased 164% over a 6 month period. Children needing preventive health care and nutrition counseling were finally being seen.

During the past year, the Montana State Department of Health and Environmental Sciences has spent considerable time and effort in establishing a delivery system that would make the WIC program available in the most populated counties and on our seven Indian Reservations. Now that the program has been established, we are told that it may be abolished. The Administration's proposal to grant blocks of money for food to the states, to be used at their discretion, could eliminate the delivery of necessary foods to pregnant women and infantsthe segment of our population where this assistance can produce the most longrange benefits.

The proposal that block grants be provided to the states needs careful study before adoption. There is no time for that deliberation between now and June 30, 1975, when the WIC program expires. A break in continuity of the WIC program would cause a considerable waste in funds, time and energy, as well as causing a loss in momentum in nutrition and maternal and child health programs in Montana.

A recession is not the time to cut back on programs which help people, partic ularly medically risk groups such as women, infants and children.

The WIC program is a real boost to economy. Almost 90% of the total sixmonth grant of one million dollars is earmarked to purchase highly nutritious foods. That money is spent in Montana Communities.

Please help us save this program which is so vital to Montana's present economy and the future health of her citizens.

Thank you.

Sincerely,

STEVEN KAIRYS, M.D.,

Chief, Bureau of Maternal and Child Health.

RECOMMENDATIONS OF THE WIC SYMPOSIUM

I. RECOMMENDATIONS OF WORKSHOP NO. 1 "WIC PROGRAM FINANCE ISSUES"

A. This workshop finds that the administrative, fiscal and humanitarian concerns arising under the Child Nutrition Act of 1966, as amended, have been largely addressed under the proposed National School Lunch and Child Nutritin Act Amendments of 1975 (S.850 and its counterpart H.R. 4103). This workshop endorses the elements of these amendments with the following exceptions: 1. A member of a low income population should be defined as one who is eligible for free or reduced rate medical care under any federal, state, local, public or private health care service program.

2. The term "pregnant and lactating women" as defined by Section 16, (g) (1) of the proposed National School Lunch and Child Nutrition Act Amendment of 1975 should be amended to include women to one year post-partum and should be further amended by substituting the term "women" for the word "mothers" wherever the latter occurs in said definition.

3. The term "administrative costs" should be amended throughout the text to read "operational costs".

4. All rules and regulations promulgated pursuant to Section 16 of the National School Lunch and Child Nutrition Act Amendments of 1975 should be drafted within sixty days after the passage of this law and should be submitted to the National Advisory Council on Maternal, Infant and Fetal Nutrition, and to the state and local agencies, for review and comment within thirty working days of this date and prior to publication in the Federal Register.

5. Cost-of-living adjustments should be included in the legislation to permit automatic budgetary response to external fiscal pressures caused by inflation.

B. This workshop finds that the United States Department of Agriculture has promulgated rules and regulations for the implementation of the WIC Program that are directly contrary to the intent of Congress and detrimental to the best interests and health needs of the people of the United States, and that, therefore, the Congress should increase its oversight function to insure Departmental compliance and implementation of the will of the legislative branch.

C. This workshop finds that all supplemental applications should be funded for implementation on January 1 or July 1 only. Notification of funding status should be made within six weeks prior to funding.

D. This workshop finds that the states should be permitted flexibility in adjusting the food package supplied to reflect cultural or other dietary differences among the populations served, such adjustments being allowed for at least one-half of the total allotment available to the client.

E. This workshop finds that the Congress should exercise all due speed to enact the necessary legislation to continue the WIC Program to prevent interruption of service to the women, infants and children of this nation.

II. RECOMMENDATIONS OF WORKSHOP NO. 2 "MEDICAL EVALUATION AND ASSESSMENT OF NUTRITIONAL RISK"

A. The WIC Program should remain as a component to a health care delivery system.

B. It is paramount to maintain the highest quality medical records possible within each WIC program.

C. Section 16 (f) of S.850 should be revised to read as follows:

"State or local agencies or groups carrying out any program under this section shall maintain adequate medical records for ongoing surveillance of the nutritional assistance provided under this section, for the purpose of assisting Congress in determining the appropriate role and methods of examining the benefits of the nutritional assistance provided under this section. The Secretary shall convene an advisory committee...".

III. RECOMMENDATIONS OF WORKSHOP NO. 3 "WIC ELIGIBILITY CRITERIA" A. This workshop wishes to emphasize its support of the view that the WIC Program is a preventative program first and a remedial program second.

B. With respect to the above statement, this workshop recommends in particular that WIC eligibility shall not be limited to persons who demonstrate or have an actual history of nutritional deficiency.

C. Neither the state agency nor the United States Department of Agriculture shall impose on projects more restrictive eligibility criteria than those stated in

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the law. An example of such an excessively restrictive eligibility criteria would be that an individual be required to demonstrate a preexisting nutritional deficiency.

D. Benefits under section 16 of the proposed National School Lunch and Child Nutrition Act Amendments of 1975 shall be made available to women one year post partum and for infants up to age six.

E. Change Sec. 16. Section 17 (g) 4 of the proposed National School Lunch and Child Nutrition Act Amendments to read exactly as Section 17 (f) 4 of Public Law 92-433. The existing law reads as follows:

"(4) Competent professional authority' includes physicians, nutritionists, registered nurses, dietitians, or State or local medically trained health officials, or persons designated by physicians or State or local medically trained health officials as being competent professionally to evaluate nutritional risk."

F. Benefits under Section 16 of the proposed National School Lunch and Child Nutrition Act shall be made available to migrant worker families.

G. WIC program grantees shall provide or contract for prenatal health services. H. A state/local advisory committee with consumer representation should be established to determine, among other things, the selection of foods of the nutritional supplement for various ethnic groups.

THE WIC SYMPOSIUM

Hunger and malnutrition are both old problems in the United States which in recent months have been exacerbated to the critical stage by a faltering economy. High employment rates like Detroit's core city statistic of 52% go hand in hand with pitiful scenes of mothers begging for beans to feed their children and elderly citizens filching snacks in supermarkets in a battle to survive. Our nation is now faced with the choice between taking action to help hungry Americans feed themselves or not taking action and instead rationalizing our failure to show human concern for humans in need. Will we invest our resources in training programs of urban police departments to quell food riots or will we instead get food into the empty stomaches which fire this desperate violence?

On Thursday and Friday of last week (3/13 and 3/14) in Ann Arbor, Michigan at the University of Michigan's School of Public Health administrators of a supplemental food program for pregnant and nursing women, infants and children (the WIC Program) gathered from around the nation to discuss and formulate an action response to our nation's hunger problem. Reviewing legislative proposals for the future of the WIC Program now being debated before Congress, these administrators made clear their desire to see that a WIC Program is funded which makes sense to both the administrators and the public they serve. [See recommendations attached.]

But, where does this program which now serves the needs of over a half million high risk mothers and their children stand on the Ford Administration list of budgetary priorities? Answer: rock bottom. The budget proposal made by the Administration for fiscal year 1976 allocates no funds specifically intended to continue the WIC Program. Instead, all the Child Nutrition Programs (included here is the School Lunch Program), the Special Milk Program, and the WIC Program are to be funded out of a block grant of $1.7 billion according to Mr. Ford's budget. Under existing legislation the School Lunch Program alone will cost $1.8 billion in FY 1976. This really all amounts to a very simple question of values. Mr. Ford likes the idea of a "turn-around defense budget" even when the cost will be malnourished children and malnourished pregnant women, and most tragically, cases of mental retardation directly attributable to poor diet.

Congress is now taking action to make it clear that the Ford Administration's budgetary priorities need to reflect human needs other than new war toys. Nevertheless, it is true that the American hunger issue gets prime consideration from Congress only when the public demands it. Accordingly, the administrators at the WIC Symposium felt one way public demand could be brought to a focus on Congress was through Senate field hearings on the WIC Program legislative proposals. Those participating in the WIC Symposium hereby formally request that Senator Herman Talmadge (D-Georgia), chairman of the Senate Agriculture and Forestry Committee (the Senate authorizing committee for the WIC legislation) hold field hearings on the WIC proposal S. 850 not later than April 8,

1975. Senator Talmadge has been supportive of this legislation before. We hope he understands that his strong support is needed again if the WIC Program is to meet a need which is growing daily.

Senator DOLE. I made an opening statement yesterday. I think we heard some very good witnesses. We heard the Department witnesses, and we heard about their block grant approach. I asked the basic question: Would the opposition to that program be the same if the funding were increased to take care of the $700 million?

It seems to me everybody is focusing on that rather than the block grant approach. I pointed out that it is rather difficult to focus on the administration's proposal, since we do not have it before us. Hopefully it will be forthcoming, but I do not really see much chance for passage. I plan to introduce today a bill to continue for 1 year all the child nutrition programs under the National School Lunch Act and the Child Nutrition Act of 1966, which I think indicates that there is broad support for the programs in this committee.

I would only caution as I did at the earlier hearings that there are budgetary limits. As a member of the Budget Committee-and I think as every American understands, we are faced with a $60 to $100 billion deficit in fiscal year 1976. It is going to call for some restraint, maybe more input from the States, and maybe other changes, but I do not believe that anyone wishes to see any deterioration of the programs. Maybe we can somehow tighten them up. That is an obligation we have also.

I do not have anything further to add, except that we are pleased to have the witnesses, and I assume with as many as we have that there will have to be some time limit involved.

Senator CLARK. Yes, there will be.

Senator DOLE. We will miss our own lunch.

Senator CLARK. We will have a 10-minute limit and then questions. I might just say for the benefit of the witnesses-before I turn to Senator Leahy-that we are going to start with a panel of four people who now are at the table; next, we will hear from David Goldberg, and then another panel including Harold Poors, George Robinson, and Philip Hunt; in order, we will then proceed to Rabbi Gorodetsky, Mrs. Nobel, Dr. Allen, Colonel Reiss, and Dan Lynch.

Senator Leahy.

Senator LEAHY. Thank you, Mr. Chairman.

I had the privilege to fill in for the chairman here earlier this week in part of the hearings on this program. I can speak first from a fairly parochial view point, having looked at the program in Vermont, and I have seen how extremely well it is working in Vermont.

The testimony we took the other day, as the chairman knows, showed. I think, a very, very definite need for the program. I simply would like to state that I am one of those Senators who fought in what I hope was a successful effort to enlarge that category of Senators who feel that this program is very definitely needed.

Senator CLARK. Good. Thank you.

Now, the first panel we are going to hear from is a panel of four who are here at the table, Mrs. Charlotte Wilen, Georgia Council on Maternal and Infant Health in Atlanta; Mildred Kaufman, administrator, Nutrition Section, Florida Division of Health, Jacksonville, Fla., Dr. Alvin Mauer, St. Jude Children's Research Hospital, Memphis,

Tenn., representing the Committee on Nutrition of the American Academy of Pediatrics; and Mike McManus, president, Interaction, Seattle, Wash.

So if you would each proceed perhaps in the way in which you would prefer, or in the order in which I have introduced you. You will each have up to 10 minutes, and then after we have heard from all four, we will have a discussion with some questions.

Thank you.

STATEMENT OF CHARLOTTE WILEN, GEORGIA COUNCIL ON MATERNAL AND INFANT HEALTH, ATLANTA, GA.

Mrs. WILEN. I would like to request that to insure keeping within the 10-minute time limit, that my entire testimony

Senator CLARK. All of the testimony that's submitted today will be put in the record in its entirety. I think the summary is a good idea. Mrs. WILEN. I am Charlotte Wilen, one of 14 members appointed by the Governor of Georgia serving on the Council of Maternal and Infant Health which was created by the 1972 Georgia General Assembly as an official legislative advisory council for the State of Georgia on all matters pertaining to maternal and infant health.

Therefore, it is my privilege to be Georgia's official representative, and it is on their behalf that we would wish to express our appreciation to this committee and to the leadership of Senator Talmadge for your sincere, dedicated interest and superb effort in support of what we think is one of the most vital issues to the future of our country's health and the quality of life of our future citizens.

There is a desperate need for WIC in Georgia. The special supplemental food program for low-income pregnant and nursing women, infants, and young children. Nutrition is now universally recognized as a vital environmental factor affecting human mental and physical development and health.

The nutritional status for the population of Georgia remains for the most part unknown. However, our high rate of teenage pregnancy, premature births, and failure to thrive in infancy imply the existence of nutrition deprivation and malnutrition.

Approximately one-third of Georgia families have an income below poverty level, and one-third of the expectant mothers are classified as low income.

The American Public Health Association has determined that lowincome mothers show the greatest nutritional depletion after preg nancy. Low-income women also show a higher incidence of maternal morbidity and mortality and produce more infants who die or have handicapping conditions.

One in 11 Georgia children is born prematurely with low birth weight, 511⁄2 pounds or less. These children are more likely to be underdeveloped, either physically or mentally.

According to the most recently published vital and morbidity statistics for the State, 16.5 percent of the mothers giving birth were 18 years of age and under, where the health risk factors including nutrition to mother and child is the greatest. Approximately 25 percent, or 24.000 births, of all Georgia babies born in 1971 were high risk. Senator CLARK. What was that figure again?