GRANTS TO STATES FOR MATERNAL AND CHILD WELFARE

APPROPRIATION ESTIMATE

Grants to States for maternal and child welfare: For grants to States for maternal and child-health services, services for crippled children, and childwelfare services as authorized in title V, parts 1, 2, and 3, of the Social Security Act, as amended (42 U. S. C., ch. 7, subch. V), $30,000,000: Provided, That any allotment to a State pursuant to section 502 (b) or 512 (b) of such Act shall not be included in computing for the purposes of subsections (a) and (b) of sections 504 and 514 of such Act an amount expended or estimated to be expended by the State.

Amounts available for obligation

(Balances for June 30, 1954, are as certified under sec. 1311, Public Law 663)

1 1952 allotments to States were available for payment until June 30, 1954.

STATEMENT BY CHIEF, CHILDREN'S BUREAU, SOCIAL SECURITY ADMINISTRATION, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

SALARIES AND EXPENSES, CHILDREN'S BUREAU

The 1956 estimate for salaries and expenses of $1,796,500 provides an increase of $199,150 for the Bureau's juvenile delinquency program. This increase includes $49,228 for continuing on an annual basis the 17 positions and related expenses for this program made possible by the supplemental appropriation in 1955. It also includes $149,922 for 26 new positions and related expenses to round out the Bureau's juvenile delinquency program in providing technical aid to States and communities, conducting studies of delinquency control, and statistical reporting of juvenile delinquency.

In developing the 1956 estimate adjustments have been made to provide for absorbing within-grade increases and the additional cost to the Bureau of group life insurance on an annual basis.

Child population increasing

A primary consideration in planning for 1956 has been the continuing increase in the child population. In 1953, as shown by the attached chart, there were 52 million children. By 1956 it is estimated that there will be approximately 4.5 million more children than in 1953. By 1960 the Bureau of the Census esti

mates there will be 62 million children under 18 years of age. Of particular significance in developing plans for the work of the Bureau for 1956 is the fact that the number of children between the ages of 10 and 17 years will increase more rapidly in the next few years than the number of children in younger age groups. Functions of the Children's Bureau

The first law, the basic act of 1912, establishing the Bureau for the purpose of investigating and reporting upon all matters pertaining to the welfare of children and child life among all classes of the people. The second law is the Social Security Act. Since 1935 the Bureau has also had responsibility for administering grants to the States, authorized by this act, for maternal and child health, crippled children's, and child-welfare services. The purpose of these grants is to help the States to extend and strengthen these services, especially in rural areas.

The Bureau's functions under these two laws balance, reinforce, and stimulate each other. The Bureau's research workers turn up new ways of providing more and better care and services for children and bring together information and the results of research by others which will benefit the health and welfare of children and mothers. Such knowledge is carried to public and voluntary agencies and to the public by the total professional staff of the Bureau. In the day-to-day administration of the Bureau's programs of grants to States, new and different problems calling for research come to light. Through this combination of functions, the development of good health and welfare services for children is facilitated.

In carrying out these functions, the Bureau stresses multiprofessional teamwork, both within the Bureau and in its work with States and national organizations. Regional staff carry forward this concept of teamwork in their working relationships, staff meetings, and visits to the States. For example, the regional childwelfare staff assist the health staff in the development of provisions within the States for foster family care for crippled children. The nutritionists on the regional health staff assist the child-welfare representatives in working with children's institutions. Similar and continuing cooperative teamwork occurs among the specialists in the central office of the Bureau in developing guides and other publications on care and services for children.

Emphasis in 1955 and 1956

During 1955 and 1956, the Bureau is giving emphasis to the problems of four groups of children. The development and carrying out of these program emphases involve the staff of all divisions of the Bureau.

Delinquent youth.-Statistics for 1953 show that the number of delinquent children coming before juvenile courts in 1953 totaled about 435,000. This figure is an all-time high, exceeding the previous high of 400,000 reached during World War II.

Children of migratory agricultural workers.-These children, whose number is roughly estimated to be from a half million to a million, belong to families who follow the crops and pass into and through one State after another. No one State feels that it can take responsibility for their health, welfare, and education. The Children's Bureau, working with the Office of Education, the United States Public Health Service, and the Bureau of Public Assistance, has undertaken a pilot project to assist the 10 States involved in the east coast migrant stream to do interstate planning for services to migrants. A plan of State action for 1955 was developed in May 1954 by a conference of representatives of health, education, and welfare departments in these 10 States as well as representatives of local voluntary groups engaged in work with migrants. The regional child health and welfare staff of the Bureau are working with these States to aid them in developing and carrying out this plan.

Black market in babies.-Because of the seriousness of this situation, the Bureau has been studying the problem with a view to determining steps that can be taken to eliminate it. Advice is being sought from legal, medical, social work, and other professional groups, from adoptive parents, and law-enforcement agencies. Legislative problems are being explored. Thus far, the Bureau's exploration reveals that the number of babies sold for adoption through a middleman represents only a fraction of the number of babies adopted without adequate legal, medical, and social safeguards. Facts are being brought together, drawing on the experience of all groups concerned not only with the black market in babies but with other more numerous and often serious problems resulting from adoptions which take place without adequate protection of the welfare of the baby or of his natural and adoptive parents.

Mentally retarded children.-In 1955 and 1956, the Bureau will give special attention to the development of community health and welfare services for young mentally retarded children. Little attention has been given these children of preschool age, but if their abilities are to be fully developed, it is necessary to start early. If diagnostic work and followup health and social casework services were provided, many parents would be able to care for these children at home and plan for their care through other facilities as they grow older. Parents' groups are becoming much more active in seeking better opportunities for these children than now exist.

Next, I want to discuss briefly some of the major activities of the Children's Bureau and what we hope to accomplish in 1956.

Development of State and local health services for children

The Division of Health Services is responsible for that part of the Bureau's program which is concerned with health services for mothers and children. It administers grants to States for maternal and child health, and crippled children's services authorized by title V, parts 1 and 2, of the Social Security Act.

In carrying out these responsibilities the Division develops program policies for approval of State maternal and child health and crippled children's plans; reviews and approves State plans and evaluates the services provided; provides consultation services to State and local agencies responsible for maternal and child health programs and crippled children's programs, both public and private; consults with educational institutions in meeting the need for trained personnel; works with State and national voluntary organizations concerned with the health

of mothers and children; prepares program recommendations and guides for the development of services, and outlines the methods which have been found most effective in bringing services to mothers and children which are the outcome of new scientific discoveries.

The work of the Division is carried on by staff in the central office and in eight regional offices. Major responsibility for the development and preparation of program materials is carried by the central office staff. The regional staff work with State agencies responsible for administering the maternal and child health, and crippled children's programs, and with other agencies, institutions, and organizations on matters related to health of mothers and children. This staff reviews and gives Bureau approval to State plans for these services, and provides consultation service to State agencies in carrying out the States' plans.

Crippled children's agencies are especially interested in recent research developments in arm prostheses because of the very considerable number of children who are born without hands or arms or who lose them through accidents. In 1 large State it is estimated that there are 250 such children.

The Division has been working with the Army Prosthetic Research Laboratory of the Walter Reed Army Medical Center to see if a hand comparable to the adult hand could be developed for children. During 1954 and 1955, the Division has worked with the Michigan Crippled Children's Commission in developing the dies required to manufacture such children's hands in three sizes. During 1955 it is expected that such prostheses will become available for many children who have arm amputations. How children learn to use arm prostheses will be an essential study that will need to be carried out in 1955 and 1956. The Division will seek ways to have such a study made.

Specialized health programs on which the Division continues to work with the States include programs for premature infants, children with epilepsy, cerebral palsy, hearing impairment, cleft palate, and for children who are blind.

Pamphlets and bulletins to be prepared in 1955 and 1956 for professional workers in maternal and child health and crippled children's services include: hospital programs for children in need of long-term care; health services for children in institutions; community health services for mothers and children; and community programs for preschool mentally retarded children. Pamphlets planned for parents include such publications as "The Child Who Is Orthopedically Handicapped; If Your Child Must Go to the Hospital; The Child Who Is Mentally Retarded.

Development of State and local social services for children

The Division of Social Services has primary responsibility for activities related to the development of State and local social services for children. The major activities of the Division in carrying out this responsibility include:

1. Administration of the child welfare services grant-in-aid program under title V, part 3, of the Social Security Act, This includes (a) development of policies for approval of State plans and instructions for preparation of State plans, (b) joint planning with State agencies in development of State plans, and (c) review and action upon State plans.

2. Development of guides, recommendations for practice, and informational materials in relation to (a) the child welfare program as a whole, including organization and administration, training programs, child welfare legislation, and community organization and planning for child welfare programs; and (b) specialized services within the child welfare program, such as social services to children in their own homes, homemaker services to unmarried mothers, fosterfamily care, adoption, and group care in institutions of various types.

3. Consultation to and cooperative work with national, State, and local agencies, public and voluntary, in relation to social services for children and youth. The central office staff of the Division carries responsibility in each of the abovementioned major activities. The field staff gives consultation within assigned regions to national, State, and local agencies, public and voluntary, in relation to-social services for children. They are also responsible for review and approval of State plans for the child welfare services grant-in-aid program developed by the States with the help of the Bureau.

The Division has a small staff of consultants in specialized services within the child welfare program. This staff is responsible for keeping abreast with developments in their respective fields, and for preparation of new materials when needed. They also augment the consultation service of the regional staff through visits to States and local agencies upon request.