directed toward better understanding among physicians. The American Medical Association's Washington News Letter of December 1960 expresses that group's interest and its general position in support of medical assistance for the aged. In 1961, after preliminary discussion between staff of the Bureau of Family Services and representatives of the American Hospital Association, the association appointed a committee to meet with the Director of the Bureau of Family Services to discuss matters of mutual interest. This group has met three times with the Bureau. The American Hospital Association undertook to canvass hospitals to determine common problems, which were then explored in meetings with the committee. Plans were worked out to maintain effective relations between the American Hospital Association and the Bureau. Also, it is planned to hold a jointly sponsored series of regional meetings, the first of which will be held in Denver, Colo., on March 21 and 22. The technical medical staff of the Bureau, in the Division of Medical Care Standards, has prepared guides as well as handbook (regulating) material to assist State agencies in planning for and administering medical services for recipients. The staff of this division has participated in a number of national and regional meetings. The technical medical staff also assists States to consult with State aging staff, and on occasion with representatives of the State medical society and State hospital association. These consultations have related to possible ways to implement a medical assistance for the aged program in the State. At the present time, 25 States plus Puerto Rico, Guam, and the Virgin Islands have programs of medical assistance for the aged in operation. The following material includes a table which shows the action taken by the States to date to implement the Kerr-Mills provisions, and the steps which have been taken by the Department to assist in this implementation: REPORT FOR JANUARY 31, 1963-ACTIVITIES OF THE 54 JURISDICTIONS TO PUT INTO EFFECT THE NEW PROGRAM OF MEDICAL ASSISTANCE FOR THE AGED B. Plan submitted; not in effect, none. Puerto Rico South Carolina Virgin Islands C. Legislation enacted; plan not yet submitted, 1 State: New Jersey (effective July 1, 1963). Ď. Legislation in process to give basis for program or to provide appropriation, four States-bill introduced: Indiana, Ohio, and South Dakota. Nevada (bill being drafted). E. Need legislation, 17 States: Other status: F. Have authority for medical assistance for the aged program not yet im plemented, 4 States: Georgia: Enacted 1961; no funds available. Iowa: Enacted 1961; no appropriation. New Mexico: Plan withdrawn; no appropriation. Virginia: Enacted 1962; appropriation effective January 1, 1964. 1 Plans of these States are approved. 1. Basic implementing activities Prior to and directly after the passage of the medical assistance to the aged bill on September 13, 1960, much material was prepared and consultations held to discuss programing for medical care for the aged. The more pertinent actions during this period were June 28, 1960.-A statement from Commissioner William L. Mitchell to J. A. Kieffer, Assistant to the Secretary, summarizing "Medical Care of the Aged Areas of Needed Information." This was prepared by Mrs. Ida C. Merriam, Director, Division of Program Research. September 15, 1960.-A letter from the Secretary, Department of Health, Education, and Welfare, to all Governors and others regarding the Social Security Act Amendments of 1960. November 27, 1960.-American Medical Association Medical Services Conference on Federal-State medical care programs for the aged, Washington, D.C. Several papers on the background and status of title VI of Public Law 86-778 were presented, including one by Commissioner William L. Mitchell on "What We Can Do and Cannot Do Under the Law." (A summary of this speech was prepared for the record on July 5, 1961.) April 20, 1961.-Summary information on State implementation of the KerrMills bill. July 14, 1961.-A statement from Miss Goodwin to Commissioner Ball on comments on statements on medical assistance to the aged being prepared for use in congressional hearings. November 9, 1961.-Letter from Wilbur Cohen to Representative T. B. Curtis regarding medical assistance to the aged programs. 2. Publications "The Social Security Amendments of 1960," Wilbur Cohen (published in Public Welfare, October 1960). "Public Assistance," reprint from annual report, 1961. "Report on Medical Care Under Public Assistance" (October 1960-61), to Ways and Means Committee, March 15, 1962. "Characteristics of State Public Assistance Plans Under the Social Security Act," 1962, PA Report No. 49. "Medical Aids for Older Persons Through Public Assistance" (questions and answers), BPA 1960. "Activities of 54 Jurisdictions To Put MAA in Effect," October 31, 1960, December 20, 1960, and additional weekly reports on progress. "Annual Statistical Report of Medical and Remedial Care Provided Through Public Assistance Vendor Payment," December 1960. 3. Technical medical consultation Consultation in policy interpretation and ways and means of providing medical care for the aged has been held in each regional office and approximately half of the State departments of public welfare. 4. Institutes on medical care in which staff members participated July 1961: University of Michigan, “Training Institute on the Administration of Medical Care for the Needy" (the Bureau was a cosponsor). Region IX: San Francisco, February 1962, “Planning for Assistance To Accomplish Program Purposes." Region IV: Atlanta, May 1962, "Administration of Medical Care Programs for the Needy." 5. Conferences and meetings National Health Council, Miami, March 1960, "Health Care of the Aged and Role of Public Assistance Agencies in Working With the Ill Aged." American Hospital Association: "Provision of MAA and Their Relations to Hospitals," Chicago, September 1960. "Workshops on Principles of Payment for Hospital Care," Chicago, March 1961. "Medical Care of the Aging," Chicago, January 1962 (minutes dated March 20, 1962). Annual Conference of Secretaries and Officers, California County Medical Society, Los Angeles, February 1962, panel, "Quality of Medical Care." Southeast State and Territorial Health Officers, Gulfport, Miss., April 1962, “Joint Responsibilities and Relationship of State Health and Welfare Agencies in Developing Medical Care Standards for Welfare Recipients." North Carolina Association of Nursing Homes and Homes for the Aged, April 1962. American Public Health Association, Miami, October 1962. American Hospital Association, Utilization of Hospitals for Aged, Chicago, October 1962. National Council on Aging, moderator of panel on "Health" at seminar on "Protective Services for Older People," March 1963. 6. Papers presented by MCSD staff members Alabama Public Health Association Medical Care Section, Mobile, March 1961, "Medical Care for the Aged." "Services to Persons Needing Nursing Home Care," APWA region, Memphis, September 1961. "The Viewpoint of Public Assistance," Institute on Financing Nursing Home Care, ANHA, Cleveland, September 1961. APWA National Biennial Round Table Conference, Chicago, November 1962, "Medical Assistance for the Aged." "The Medical Assistance for the Aged Programs," AMA, Denver, November 1961. APWA, Southwest Region Conference, Dallas, March 1962, "Health Happiness in Old Age." Annual meeting, Texas Society on Aging, November 1962, panel on "Vendor Medical Care for the Aged." "Kerr-Mills in Action, 1962," AMA, Los Angeles, November 1962. 7. State letters regarding MAA program, March 1960–January 1963 400 "Services to Older People," PA Report No. 38. 431 437 451 453 463 Social Security Amendments of 1960 (Public Law 86-778), implementation of law. Public Law 86-778, Social Security Amendments of 1960, correction in attachment C to State letter No. 31. "Medical Assistance for the Aged, Periodic Statistical Report," Form PA Bureau leaflet, "Medical Aid for Older Persons Through Public Assistance." 466 "Public Assistance-1960," reprint from the annual report of the U.S. Department of Health, Education, and Welfare. 468. Inquiry on implementation of Public Law 86-778. 469 "Medical Assistance for the Aged, Forms and Instructions for Submitting Estimates and Reporting Expenditures." 486 "Medical Assistance for the Aged, Financial Eligibility." 501 "Casework With the Aging," a reprint. 504 "Financial Eligibility: Medical Assistance for the Aged." 518 Institutional status. 525 Publication: "Public Assistance Under the Social Security Act," revised edition. 531 Handbook supplement, "Medical Assistance for the Aged." 532 "Home Health Aid Services-Vendor Payment for Medical Care." 556 "Characteristics of State Public Assistance Plans Under the Social Security Act: Provisions for Medical and Remedial Care," PA Report No. 9. 561 Report: "Medical Care Under Public Assistance" (March 15, 1962, report to Congress). 564 571 Publication: "Casework Services in Public Assistance Medical Care." 578 "Cost Estimates for Program of MAA." 584 "Public Assistance-1961," reprint from the annual report of U.S. Department of Health, Education, and Welfare. 593 "Forty-two-Day Provision Regarding Persons in a Mental Institution as a Result of a Diagnosis of Tuberculosis or Psychosis," title I, OAA and МАА. 603 Reports: "Cooperative Action Between State and Local Health and Welfare Agencies." 616 "Aid to the Aged, Blind, or Disabled, or Such Aid to Medical Assistance for the Aged," title XVI. 617 New title XVI: "Aid to the Aged, Blind, or Disabled, or for Such Aid and Source: Prepared statement submitted by Secretary Celebrezze, at hearings held by subcommittee of the Committee on Appropriations of the House of Representatives, to consider his Department's budget for fiscal 1964. APPENDIX B FEDERAL PERCENTAGE AND FEDERAL MEDICAL PERCENTAGE FOR OLD-AGE ASSISTANCE AND MEDICAL ASSISTANCE FOR THE AGED, BY JURISDICTION APPENDIX C ESTIMATED POPULATION AGED 65 AND OVER HAVING INCOMES OF LESS THAN $2,000, NUMBER OF MEDICAL ASSISTANCE FOR THE AGED RECIPIENTS, AND NUMBER OF RECIPIENTS PER 1,000 POPULATION AGED 65 AND OVER HAVING INCOMES OF LESS THAN $2,000, BY JURISDICTION, 28 JURISDICTIONS HAVING MAA PROGRAMS, DECEMBER 1962 Does not include data for Guam and the Virgin Islands; basic data not yet available from Bureau of the Census. 'Not available; see footnote 1. APPENDIX D SUMMARY OF KERR-MILLS MAA PROGRAMS AND OAA PROGRAMS Provisions, by Jurisdiction, of Plans, June 1, 1963 ALABAMA Aged in population (April 1, 1960), 261,000 Medical assistance for the aged Program.-Legislation enacted in 1961, effective in 1962; service began February 1, 1962. Eligibility.-Income: Net income in cash or readily negotiable resources may not exceed, for single person, $1,200 a year; for married couple, $1,800. (Excludes from considerarion income "in kind,” e.g., food produced for home consumption.) Assets: (1) Real property: House and land which is assessed as a homestead is exempt from consideration; other real property may be held if producing a net cash income. (2) Personal property excluded from consideration as available |