Two-year periods are used because of the biennial appropriations in many of the States.

In the third and fourth years, the Federal Government would match 50-50 with the State or local communities. In the fifth and sixth year, as the program had become established in the States and the people had either found that it is something useful to them or decided it was not, the Federal share would drop to 25 percent and the State share go up to 75 percent.

Taking this total here, it would not be that the Federal Government's share of all the State's expansion would slide out. It would simply slide out of the individual project which would be presented by the State in its State plan. As the money was released here, and more here, this money would be available to the same State to undertake other new projects. So it would act as a catylist in developing new programs and getting them started, or extending existing programs in new geographical areas. In an important sense, this part of the formula would accomplish the same objective which the Congress had in mind in establishing the categorical grants, but it would do it. on a more flexible basis and allow the States to take more initiative through the preparation of State plans. They could at any time, if they wanted, transfer a program from here to the support phase of their program and include it in their State plan under support rather than under extension and improvement, thus giving them flexibility and initiative, and thus permitting also the variation in needs by categories to be determined by the States rather than by an arbitrary formula from the Federal Government.

Then we come to the last phase which the Secretary explained-the special projects to assist in financing of special projects of unique promise, reflecting this increased interest in research and the application of new discoveries in science and, second, to meet special problems of national or regional concern, such as the problem of the flow of migratory labor, where certain States are hit more directly than others and where an overall program in the region is needed; and then to assist in combating unusually severe public health problems in specific geographical areas, where there is an epidemic of some kind.

I would just like to say in closing that from year to year the Congress could determine the amount of money to go into these different areas. In some periods there might be an opportunity for a more rapid expansion of the programs under extension and improvement; in others the support might be more important. This would give both the States and the Congress an opportunity to see clearly just where the funds were going and for what purpose and to determine the needs as they actually existed.

It would alsc, as the Secretary pointed out, simplify the structure and give greater flexibility and opportunity to achieve more clearly the congressional purpose and objectives as expressed in the various bills that have already been enacted.

I thank you, Mr. Chairman.

The CHAIRMAN. Any questions, gentlemen?

Mr. PELLY. Mr. Chairman, may I ask one question at this point? The CHAIRMAN. Mr. Pelly.

Mr. PELLY. Mr. Rockefeller, as I understood, it would be permissive to transfer funds from extension and improvement into support. Could you explain that a little more fully?

Mr. ROCKEFELLER. Yes; I can explain why some States might want to do it.

Let us say that a new drug had been developed for the treatment of a certain disease. That drug is going to be used, and they wanted to set up in a State a new clinic for that purpose. The State could use extension and improvement grant funds for that purpose if they included that in their State extension and improvement program for the year. They could get $3 Federal for $1 State funds for the first 2 years of that program.

Now, the next 2 years would be on a 50-50 basis. Let us say they had some other program that was more important to them and they also wanted to get started on it. This first program may have received public acceptance so that they felt that it could become part of their permanent State health program. They might well transfer that first program to their total program that comes under the support program relationship with the Federal Government. In the lowincome States, they would get 66% percent of the cost in the matching formula from the Federal Government and would have to pay 33% percent of the cost themselves.

So they would be better off in moving that over, so far as they were concerned, and therefore, might do so unless they were already overmatched.

Mr. PELLY. Thank you.

Mr. ROCKEFELLER. It gives again a flexibility in meeting their own needs and programs.

Mr. THORNBERRY. Mr. Chairman.

The CHAIRMAN. Mr. Thornberry.

Mr. THORNBERRY. Mr. Rockefeller, may I ask this question in connection with two grants, that seem important to me: The extension and improvement grant and the special projects grant. Who determines whether the States are to obtain funds for those particular projects.

Mr. ROCKEFELLER. The State would prepare, in both the support grant area and in the extension improvement area, its own State plan and that would be discussed with the Surgeon General and on the basis of that plan the States would include the items which they wanted under both the support and extension and improvement programs.

So that the initiative is with the State in figuring out how that State will allocate its funds and how it will best meet its own problems with the funds that would be available under those two formulas. Mr. PRIEST. Mr. Chairman, will the gentleman yield?

Mr. THORNBERRY. Yes.

Mr. PRIEST. Are the States required, every 2 years, to modify State plans under this new proposal?

Mr. ROCKEFELLER. I beg your pardon.

Mr. PRIEST. Is the State plan required, just as it is under the hospital construction plan, to modify every 2 years?

Mr. ROCKEFELLER. Under the hospital construction program, the State is required to submit a modification of its State plan each year. Under this grant-in-aid legislation a State plan is also required. It is the feeling that it would help pull together some of these problems at

the local level, where all of the factors could be considered and balanced and weighed among themselves.

Mr. PRIEST. And that State plan, of course, is subject to modification as the State agency may desire and the Surgeon General or Secretary may approve.

Mr. ROCKEFELLER. That is right, sir. And, I think that the experience under the Hospital Survey and Construction Act has been so satisfactory in that respect and the progress that has been made in viewing the problems in their totality in the area, that it gives great promise of helping to carry this forward.

Mr. PRIEST. Thank you, Mr. Thornberry.

Mr. THORNBERRY. Another question. Mr. Rockefeller, I understand from your explanation under these support programs, and the extension support program, that that definitely depends on what Congress appropriates, as to what would be available to each State, based upon the two formulas that you have there.

Mr. ROCKEFELLER. That is right.

Mr. THORNBERRY. Now, under the special projects no particular amount would be allotted to any State, but the Surgeon General would determine what type of project would be supported, what project would be approved and where they would be financed; it would be entirely up to the Surgeon General.

Mr. ROCKEFELLER. That is correct.

Mr. THORNBERRY. The States would have no control over it.

Mr. ROCKFELLER. No; but the projects which came to the Surgeon General for his approval would be those initiated by the States. They would be projects for which the States wished financial assistance in various areas where their needs were and where they felt important developments were going on which gave great promise to the Nation as a whole.

Mr. THORNBERRY. All right. Thank you.

Mr. SPRINGER. Mr. Chairman.

The CHAIRMAN. Mr. Springer.

Mr. SPRINGER. Mr. Rockefeller, I just want to be sure that the philosophical approach to that bill is that you are putting more responsibility upon the States to make their decisions.

Mr. ROCKEFELLER. That is right.

Mr. SPRINGER. Now, is your experience such that all of the 48 States in the past were shown that they have enough programing and ability to handle this kind of a thing at their own level?

Mr. ROCKEFELLER. Oh, I think very definitely.

Mr. SPRINGER. In all 48 States?

Mr. ROCKEFELLER. I think very definitely. The degree of imagination and initiative and responsibility obviously varies, as it does in any group of people, but I would think that the Secretary's feelings on this are that it will increasingly encourage the development of initiative and responsibility as they have to sit down among themselves in a State with the local communities to consider their problems and come up with the answer.

Mr. SPRINGER. Rather than approaching it from the standpoint of the Federal Government saying categorically, "You can have just this much money for cancer; this much more for heart control; and this much for venereal disease control," and so on. Is that the thinking behind this bill?

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Mr. ROCKEFELLER. You put your finger right on it. It will be done in the States rather than have the Federal Government doing it. Of course, there is an arbitrary formula that divides the money among the States.

Mr. BEAMER. Will the gentleman yield?

Mr. SPRINGER. Yes.

Mr. BEAMER. May I ask you, Mr. Rockefeller, if perhaps the purpose and the aim of this bill are to restore more of this authority to the States?

Mr. ROCKEFELLER. I think that is a fair statement.

Mr. BEAMER. Is that not one of the objectives toward which all of us are working?

That is implied, is it not?

Mr. ROCKEFELLER. Absolutely.

Mr. BEAMER. Thank you.

Mr. ROGERS. Will the gentleman yield?

Mr. SPRINGER. Yes.

Mr. ROGERS. Did I understand you to say that the State projects or programs originated with the Surgeon General or with the States? Mr. ROCKEFELLER. I think that I am going to have to explain that. The projects themselves really originate throughout the country in the States or local areas or with private nonprofit groups. These projects would come up for the attention of the Surgeon General from the local areas. He would make the determination as to which one would be most advantageous to the Nation as a whole to have supported from the Federal Government or where the problem is more urgent

Mr. ROGERS. It has to originate in the State or local community? Mr. ROCKEFELLER. That is correct. In other words, it would not be a Federal project. It would be a local or State project which would be assisted by the Federal Government.

The Secretary, Mr. Chairman, wants to make a comment.

Secretary HOBBY. That was just in relation to the other question, but you answered it satisfactorily.

Mr. WILLIAMS. Mr. Chairman. Will the gentleman yield?

Mr. SPRINGER. Yes, I will yield.

The CHAIRMAN. Had you finished?

Mr. SPRINGER. Yes, I had finished.

The CHAIRMAN. I will recognize Mr. Williams.

Mr. WILLIAMS. Mr. Rockefeller, you mentioned specifically migratory labor, in connection with certain problems that might arise which could be met by these special projects. Could you give us a hypothetical case?

Mr. ROCKEFELLER. I was thinking of the health aspect of migratory labor; the problems that the States are confronted with in connection with the stream of labor moving north and returning south, and I know that it is a matter of great concern.

Mr. WILLIAMS. I did not know exactly what you meant by that, and I would like to have an explanation of just what type of problem that would be.

Mr. ROCKEFELLER. The health care of these individuals as they come through a State, places an unusual burden on the States through which they pass. The Surgeon General along with the Chief of the Children's Bureau and others within the Department are deeply

interested in that and hope to cooperate with the States in the development of more effective care in all of these fields, including education of these people who come in.

Mr. WILLIAMS. My understanding was that that money would be used to take care of special persons, whether they are Jamaicans coming into New York, or wetbacks coming into Texas.

Mr. ROCKEFELLER. I have not heard that applied to the first category; at least I have not heard them described in New York as migratory labor. We have them as permanent laborers. I think maybe the Surgeon General ought to speak on this. He is here.

Dr. SCHEELE. Mr. Williams, it could be used for that type situation. It might be used in connection with tuberculosis. It might be used in connection with diagnosing disease in an area in connection with some unique problem. The sum of money available in our program might not be sufficient to do a complete job in connection with the health problems, of migratory laborers, but this is the type thing for which we might give assistance to the States.

Mr. HESELTON. Mr. Chairman.

The CHAIRMAN. Mr. Heselton.

Mr. HESELTON. Is there any provision in existing law with regard to special projects, or is that new?

Mr. ROCKEFELLER. There is a flexibility in the law relating to certain of these six programs which has permitted the Surgeon General to use funds for special projects and also as we showed here in the Children's Bureau allocation. So there has been experience with special project money which has proved tremendously productive in getting at new problems and developing new methods and techniques, and on the basis of that splendid development the Secretary recom

mended its inclusion in here.

Maybe the Surgeon General would like to say something on this subject.

Dr. SCHEELE. We do have special project grant funds for venereal disease control at the present time and also special project funds in cancer control.

Mr. HESELTON. In looking over the bill I do not find any provision for an advisory council such as is contained in the Hospital Construction Act. Is that left out for any reason or is there any reason why you have not utilized that program?

Secretary HOBBY. The State and Territorial health officers, Mr. Heselton, would be as fine an advisory committee of this kind as could be obtained. I think the best, because they will be the people directly concerned. As you know, the Surgeon General is charged under the law with the duty of consulting at least once each year with the State and Territorial health officers. As I recall the experience, there has only been one time when a regulation has been issued to which they had not agreed.

So, with this particular type of thing, where every State is concerned, I think that the Surgeon General has the best advisory committee possible in the State and Territorial health officers.

Mr. HESELTON. I have in mind that portion of the program which might have to do with either basic research or applied research, such as was in the bill that the committee brought out.

Secretary HOBBY. I think that is a very good question, Mr. Heselton. I wonder there I am thinking out loud, and I will refer the