CHIP and the supplemental program have brought remarkable changes to Holmes County. To begin with, where babies were once born at home, today they are born in Holmes County Hospital. Along with their mothers, they receive good medical attention. Today poor people regularly attend health clinics. A CHIP nutrition assistant explains that she never took her children to the clinic when they were growing up. The clinic was not part of her family's world. But she is quick to say that today every family in the county goes to clinics.

Many people recognize the changes, and there is widespread support for CHIP and the supplemental program. The President of the County Board of Supervisors, Mr. B. Taylor, states: "I am 100 percent behind the program *** if kids don't get milk, they will grow up improperly." Taylor knows that many county residents can't afford to buy milk, and he has supported the program since its inception. During the early days of CHIP, Taylor used his influence to see that CHIP staff were allowed to visit all families despite objections from some landowners. Jean McClellan, Director of the County Welfare Department, endorses the program saying that it has helped lower the infant mortality rate and lessened the incidences of high blood pressure.

NEBRASKA

Sponsor: Douglas County: Food Stamp Office, Omaha, Nebr. Serves Omaha and Douglas County-2,000 participants-$2,000 monthly administrative costs.

In Omaha, Similac costs 43 cents a can, evaporated milk cost 28 cents a can, and a 4-pound box of instant nonfat dry milk costs $3.69. Milk in any form is expensive.

But for Nebraskans who live in Omaha, milk is available through the Supplemental Food Program. About 2,000 people participate in the program in Douglas County (Omaha). These Nebraskans are lucky; this is the only supplemental program in the State.

Health professionals throughout Omaha are enthusiastic about the program. Maxine Birch, nutritionist with OB-GYN at the Creighton Health Care Center, states that "it is undoubtedy the best support that dietitians, nutritionists and health officials have had to relate food to health." Dr. Nayak, staff pediatrician at the Clark Street Clinic, explains that milk, juice, and cereal are the basis of infant feeding, and that the supplemental program provides the essential foods needed by infants. Sister Joan Miriam, Supervisor of the Clark Street Clinic, in reference to adequate nutrition for infants and children says, "If you neglect that part, all the medical attention in the world won't help."

The program is administered by Douglas County through the food stamp office. According to Richard Kenney, food stamp director, it costs about $2,000 a month to run the program or just a little over $1 per person. Kenney feels that the program is good, inexpensive preventative medicine.

IOWA

Sponsor: Polk County Department of Social Services, Des Moines, Iowa. Serves Polk County; marginally serves Jasper, Marion, and Warren Counties-1,700 participants-$4,800 monthly administrative costs.

Many people think of food when they think of Iowa. It is hard to imagine that some Iowains don't have enough food when so much of it is grown there. But for families who participate in the Supplemental Food Program, Iowa is not the land of plenty.

Until 1973 many of the supplemental programs in Iowa were administered by Community Action Agencies. CAA's used Emergency Food and Medical Service grants to fund the programs. In the spring of 1973, as a number of EFMS grants expired. the future of many supplemental programs became uncertain. Nationally. EFMS money had been slashed, and local programs in Iowa were feeling the pinch. Eventually, 12 of Iowa's supplemental programs were forced to close. However, 31 programs were able to remain open. Some of these programs were maintained by CAA's, others were transferred to county departments.

The supplemental program in Polk County survived the cut-backs. Until July 1973, the CAA, Greater Opportunities Inc., financed the supplemental program in Polk, Jasper, Marion, and Warren Counties. In July, after sustained pressure from the low income community, Polk County agreed to fund the program and transferred it from the CAA to the Polk County Department of Social Services.

Jasper, Marion, and Warren Counties were not interested in full scale programs; as a result, today there is one distribution day in each of these three counties. Greater Opportunities covers the cost of this marginal activity. Polk County's supplemental program is located in the basement of an old high school gym not far from downtown Des Moines. The staff has been with the program since the early days of OEO funding. They run an efficient program providing food, nutrition education, and an excellent social service referral system.

Marilyn Russell, Director of Polk County's Public Health Nursing Association, has met families whose resources are so depleted at the end of the month they are forced to depend solely on the food they get through supplemental program.

Ms. Russell shakes her head when she talks about the vicious cycle that begins when a baby does not have enough to eat. She recalls an infant who at 6 months had a low iron count, and at a year was underweight. During her second and third years the child was frequently sick. Ms. Russell men-. tions the likelihood that the child may have difficulty in school, and how this will trigger another set of problems. Ms. Russell knows that some babies at Broadlawn, Des Moines's city hospital, are born into the cycle by mothers who are themselves still caught in the cycle. She stated, "We ought to be able to get in there and break this cycle." The supplemental program is a good beginning.

CONCLUSION AND RECOMMENDATIONS

Sally Gatewood and Susie Edwards were born on the same day in two Washington, D.C., hospitals. Four years later they are happy, healthy little girls. Sally's health is no surprise. But Susie's health is a big surprise. She is much healthier than either her 5-year-old sister or her 6-year-old brother. Sally is the first one in her family to participate in the Supplemental Food Program. She is the first child her mother has taken to well-baby clinics and pediatric clinics. There are thousands of children like Sally who are healthy today because they participate in the supplemental program.

The Supplemental Food Program is an extremely valuable health program. In many clinics it is a vital aspect of comprehensive health care. The program introduces hundreds of families to health clinics and initiates their involvement in regular preventive health care activity.

Doctors, nurses, program administrators, and participants are horrified by the possibility that the Supplemental Food Program might end.

The Children's Foundation feels it would be dangerous to abandon the program. The Foundation strongly believes that the Supplemental Food Program must continue, and recommends:

That the policy of closing Supplemental Food Programs when food stamp programs begin be immediately rescinded;

That programs restricted to serving mothers and infants be expanded to include children through age five;

That quotas placing arbitrary ceilings on participation be eliminated; That USDA substitute equivalent foods when shortages occur; That administrative funds for programs be provided by USDA, and That the program be expanded to areas which have no Supplemental Food Program.

The May 1971 USDA policy of closing Supplemental Food Program when food stamp programs begin must be rescinded immediately. It is illogical, unfair, and probably illegal. The 14,000 participants of the 84 programs in commodity distribution counties should not be forced out of the supplemental program by the beginning of the food stamp program. Today 108 programs in food stamp areas operate successfully without the warehouse system of the family commodity programs.

The April 1970 USDA policy of restricting participation to infants and mothers in 32 programs must be revoked. It severely limits the potential effectiveness of the programs. All eligible children under six ought to be allowed to participate and benefit as they are in the other 175 programs.

The April 1969 policy of imposing quotas and arbitrarily limiting participation must end. Such quotas are prohibited in the major children's food service programs. Furthermore, this contradicts the President's commitment that no American child will go hungry. Programs must include all the eligible mothers and children in the program area.

USDA must provide equivalent substitutions when shortages occur. If there is a shortage of an item, USDA must purchase a substitute item which provides the same level and kind of nutrition. For instance, if evaporated milk is not available, formula must be purchased.

The initial policy refusal to provide administrative funds must be reversed. USDA must use its discretionary authority to provide administrative funds. The program must be expanded to areas which have no Supplemental Food Program. As President Nixon said in 1969, "Too many mothers and young babies do not receive life saving care." The White House Conference on Food. Nutrition and Health of 1969 cited low-income pregnant and nursing women and young children as being at the greatest nutritional risk of any segment of our population. Yet, today, only 150,000 nutritionally needy women and young children are being reached.