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Exhibit 75. The Emergency Care Program for Wives and Babies of Our Page

Enilsted Men, by Allan M. Butler, M. D..

316

Exhibit 76. Preliminary Monthly Statistical Report on the EMIC Pro-

gram, April 1946, by the Children's Bureau, United States

Department of Labor.

321

Exhibit 77. Ten Years of Progress in Reducing Maternal and Infant

Mortality, by Marjorie Gooch, Sc. D., Division of Statis-

tical Research, Children's Bureau, United States Depart-

ment of Labor.--

326

Exhibit 78. Providing Continuity of Maternity Care in the Rural Areas, as

the Private Physician Sees It, by Clyde Allison Boice, M. D. 338

Exhibit: 79. Health Needs of Sehool-Age Children and Recommendations

for Implementation, by a subcommittee of representatives

of Federal governmental agencies whose programs affect the

health of the school-age child...

347

Exhibit 80. Huran Valley Children's Center, a Guidance Service for

Children and Youth, submitted by Sam Whitman, acting

director, Ypsilanti, Mich

358

Exhibit 81. Why 500 Turned Out Good, 500 Bad, a summary of a study of

juvenile delinquency conducted by Sheldon and Eleanor

Glueck of Harvard University, by Louis M. Lyons, Boston

Daily Globe, March 12, 1946.

361

Exhibit 82. Report of the Probation Officer of_the Juvenile Court of St.

Louis, Mo., 1945, submitted by Frank X. Reller, chief pro-

bation officer

364

Exhibit 83. Wanted-A Plan for Meeting Children's Dental Health Needs,

by Vern D. Irwin, D. D. S., director of dental health,

Minnesota Department of Health --

367

Exhibit 84. How Our Tax Policy Affects the Low Income Groups, a speech

by Hon. Albert J. Engle, United States House of Repre-

sentatives, March 19, 1946----

371

Exhibit 85. Letter of July 3, 1946, from Dr. Harry Gordon, assistant

professor of pediatrics, Cornell Univesrity Medical College-- 386

Exhibit 86. Telegram of July 2, 1946, from Dr. John P. Peters, secretary,

the Committee of Physicians for the Improvement of

Medical Care..

388

Exhibit 87. Letter of July 28, from Sylvia C. Kline, secretary, Baltimore

Section, National Council of Jewish Women.

388

Exhibit 88. Letter of June 24, 1946, from Dr. John McK. Mitchell, Rose-

mont, Pa..

388

Exhibit 89. Telegram of July 10, 1946, from Dr. Wilfred Haughey, Battle

Creek, Mich.

389

Exhibit 90. Telegram of July 10, 1946, from Edna Hansen, Henry Booth

House, Chicago, Ill.

389

Exhibit 91. Letter of July 9, 1946, from Dr. L. F. Foster, secretary, Mich-

igan State Medical Society-

389

Exhibit 92. Letter of July 9, 1946, from Elizabeth S. Magee, National Con-

sumers League, Cleveland, Ohio...

390

Exhibit 93. Telegram of July 11, 1946, from Dr. Harold J. Law, Associa-

tion of American Physicians and Surgeons.

390

Exhibit 94. Letter of July 2, 1946, from Capt. Watson B. Miller, Adminis-

trator, Federal Security Administration.---

391

ALPHABETICAL LIST OF WITNESSES AND THOSE SUBMITTING

STATEMENTS
Addes, George F., United Automobile Workers, CIO, Detroit, Mich.-- 279
Aikin, Mary M., Eaton Manufacturing Co., Cleveland, Ohio

282
Allen, Dr. Frederick H., Philadelphia Child Guidance Clinic, Philadelphia,
Pa.

237
Arnold, Frances P., Girls' Friendly Society of the U. S. A., New York,
N. Y..

274
Atwater, Dr. Reginald M., American Public Health Association, New
York, N. Y..

265
Ballard, Russell W., director, Hull House, Chicago, Ill..

29, 42
Benton House Settlement, Chicago, Ill_

280
Boice, Dr. Clyde Allison, Washington, Iowa.

338
Bolt, Dr. Richard, lecturer in public health, University of California,
Berkeley, Calif.

90
Bousfield, Dr. M. O., Supreme Liberty Life Insurance Co., Chicago, Ill.. 218
Bracken, Floyd, recording secretary, Lodge No. 799, Brotherhood of Rail- Page
way Carmen of America, Lincoln, Nebr..-

275
Brown, Col. James B., Valley Forge General Hospital, Phoenixville, Pas- 216
Butler, Dr. Allan, Harvard Medical School, Boston, Mass.

109, 316
Camalier, Dr. G. Willard, legislative committee, American Dental Associa-
tion, Washington, D. Ć.

111

Christman, Elisabeth, National Women's Trade Union League of America,

Washington, D. C.-

278

Cook, Mrs. Stanley, national chairman of legislation, National Congress of

Parents and Teachers, Washington, D. C.-

22

Corbin, Hazel, Maternity Center Association, New York, N. Y.

271

Congress of Industrial Organizations, Washington, D. C..

Cornely, Dr. Paul B., Howard University, Washington, D. C.--

218

Davis, Dr. M. Edward, obstetrician, Chicago, Ill.

101

Davis, Dr. Michael M., Committee for the Nation's Health, Washington,
D. C...

264
Dilley, Fred C., Fraternal Order of Eagles, National Child Health Com-
mission, Brazil, Ind.

288

Eliot, Dr. Martha, assistant chief, Children's Bureau, United States De-

partment of Labor.

175, 205

Elliot, Daniel R., Welfare Federation of Cleveland, Cleveland, Ohio.. 286
Engle, Hon. Albert J., United States House of Representatives...

371
Firger, Mrs. Harry (Ella), Parents' Federation of Greater Boston, Boston,
Mass.

273
Foster, Mrs. James W. (Edith), Owensboro, Ky-

227
Foster, Dr. L. F., secretary, Michigan State Medical Society, Lansing,
Mich.

389

Fox, Mrs. Michael, New York, N. Y.

226

Frothingham, Dr. Channing, Faulkner Hospital, Jamaica Plains, Mass...

217

Gerson, Dorothy, Detroit Nursery School Association, Detroit, Mich. 283

Glueck, Sheldon and Eleanor, Harvard University, Cambridge, Mass.- 361

Gooch, Marjorie, Division of Statistical Research, Children's Bureau,

United States Department of Labor

326

Gordon, Dr. Harry, assistant professor of pediatrics, Cornell University,
Ithaca, N. Y.

386

Gourley, Lawrence J., legal counsel, Department of Public Relations,

American Osteopathic Association, Washington, D. C.---

200, 206

Green, William, president, American Federation of Labor, Washington,
D. Ć.

277

Hall, Gladys E., American Dietetic Association, Chicago, Ill.

269

Hansen, Edna, Henry Booth House, Chicago, Ill.

389

Haughey, Dr. Wilfred, Battle Creek, Mich-

389

Helmholz, Dr. Henry F., Mayo Clinic, Rochester, Minn.

92, 213

Hodge, Prof. Harold C., University of Rochester School of Medicine and

Dentistry, Rochester, N. Y.

216

Holt, Dr. L. Emmett, Bellevue Hospital, New York, N. Y.

216

Hopkirk, Howard W., Child Welfare League of America, New York, N. Y.. 282

Houlton, Ruth, National Organization for Public Health Nursing, Inc.,

New York, N. Y.

242

Howard, Dr. Joseph H., Obstetrician on behalf of the American Medical
Association, Washington, D. C.

93
Hunter, Mrs. W. E. (Ruth B.), Bethlehem Creche and Settlement, Chi-

281

Hymes, James L., National Association for Nursery Education, Garden

City, Long Island, N. Y...

280

Irwin, Dr. Vern D., director of dental health, Minnesota Department of

Health..

367

Jacobs, Mrs. David (Beatrice), League of Women Shoppers, Inc. (New
York Chapter), New York, N. Y

274
Jacobs, Mrs. Eveline B., National Society for Crippled Children and
Adults, Inc., Chicago, III.

42
Johnson, Charles S., Fisk University, Nashville, Tenn.

288
Jones, Mrs. Alfred Winslow (Mary Carter), Women's City Club of New
York, Inc., New York, N. Y..

274

Kane, Mary G., Cleveland, Ohio.

287

Kepecs, Jacob, Jewish Children's Bureau of Chicago, Chicago, Ill.

281

Kline, Sylvia C., National Council of Jewish Women, Baltimore Section,

Baltimore, Md.

388

Leeper, Mary E., executive secretary, Association for Childhood Education,

Washington, D. C..

40, 283

cago, Ill...

cago, Ill..

Lenroot, Katherine, chief, Children's Bureau, United States Department Page

of Labor

128

Low, Harold I., Association of American Physicians and Surgeons, Chi-

390
Lowder, Virgil E., Department of Social Service, Church Federation of
Greater Chicago, Chicago, Ill-

281
Lyons, Louis M., Boston Daily Globe--

361
MacLean, Dr. Basil C., Strong Memorial Hospital, Rochester, N. Y.

221
Magee, Elizabeth S., executive secretary, National Child Labor Commit-
tee, Cleveland, Ohio..

390
McCall

, Dr. John Oppie, the Murray and Leonie Guggenheim Dental
Clinic, New York, N. Y.

241

Meyer, Mrs. Eugene, Washington, D. C.--

11

Miller, Dr. O. L., Medical Arts Building, Charlotte, N. C.----

223
Miller, Watson B., Administrator, Federal Security Administration.

391
Mitchell, Dr. Harold H., Long Island City, N. Y.

219
Mitchell, Dr. John McK., Rosemont, Pa---

388
Moore, Hon. Arthur E., judge of probate, Oakland County, Pontiac, Mich. 227
Nelson, Atley O., Washington Spastic Children's Society, Seattle, Wash.-- 224
Noyes, William W., chairman, board of selectmen and board of health,
Bridgewater, Mass.-:

270

Oppenheimer, Dr. Ella, director, Bureau of Maternal and Child Welfare,

District of Columbia, Washington, D. C.--

105

Osgood, Argilla R., Ipswich, Mass..

220

Oxholm, Mrs. Theodor, Spokesmen for Children, Inc., New York, N. Y.- 273

Palmer, Dr. C. L., Medical Society of the State of Pennsylvania, Pitts-

burgh, Pa

222

Park, Dr. Edward A., Johns Hopkins Hospital, Baltimore, Md.

214

Pepper, Claude, Senator (D., Florida).

10

Perkins, Dr. William, Council of Social Agencies, Philadelphia, Pa--

262

Peters, Dr. John P., secretary, Committee of Physicians for the Improve-
ment of Medical Care, New York, N. Y.--

388
Powers, Dr. Grover F., Yale University School of Medicine, New Haven,
Conn.

214, 215
Reese, Curtis W., Abraham Lincoln Center, Chicago, Ill.

282

Reikord, M. K., Illinois Children's Home and Society, Chicago, Ill. -- 281

Reller, Frank X., chief probation officer, juvenile court, St. Louis, Mo.--- 364

Richman, Leon H., Cleveland Chapter of the American Association of

Social Workers, Cleveland, Ohio--

284

Rogers, Dr. Robert W., Plainfield, N. J..

216

Sellers, Mrs. R. O. (Katherine W.), Department of Social Service, Church

Federation of Greater Chicago, Chicago, Ill. -

290

Sleeper, Ruth, National League of Nursing Education, New York, N. Y..

252

Staupers, Mabel K., National Association of Colored Graduate Nurses, Inc.,

New York, N. Y.

252

Steuer, Wilbur A., National Lawyers Guild, Cleveland Chapter, Cleveland,

Ohio.no

287

Stevenson, George, National Committee for Mental Hygiene, New York,

N. Y

238

Taylor, Holman, State Medical Association of Texas, Fort Worth, Tex.-- 222

Turner, Mary B., St. John's Day Care Center, Cleveland, Ohio.

284

Vaughan, Mrs. Eleanor, vice chairman, Congress of American Women,

New York, N. Y.-.

121

Wall, Dr. Joseph S., chairman, committee on legislation, the American

Academy of Pediatrics, representing the American Medical Association,

Washington, D. C..

51

Walls, Dr. R. M., Bethlehem, Pa---

240

Webb, William C., children's dental clinics of the Philadelphia Mouth
Hygiene Association, Philadelphia, Pa---

263, 264
Wedel, Mrs. Theodore'o., United Council of Church Women, Washington,
D. Ć.

290

Welt, Mrs. Joseph M., National Council of Jewish Women, Inc., New York,

N. Y...

270

Whitman, Sam, acting director, Huron Valley Children's Center, Ypsilanti,

Mich.

358

Wisan, Dr. J. M., chief, division of dental health, New Jersey State Depart-

ment of Health, Trenton, N. J..

241

Woolsey, Dr. Ray T., Utah State Medical Association, Salt Lake City,

Utah

223

Wright, Abigail, head resident, Garibaldi Institute, Chicago, Ill..

281

Zummak, Leon K., Lutheran Śervice Center, San Antonio, Tex.

291

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MATERNAL AND CHILD WELFARE

FRIDAY, JUNE 21, 1946

UNITED STATES SENATE,
COMMITTEE ON EDUCATION AND LABOR,

Washington, D.C. The committee met' at 3 p. m., pursuant to call, Senator Claude Pepper presiding.

Present: Senators Murray (chairman), Pepper, Fulbright, Aiken, and Donnell.

Senator PEPPER. The committee will be in order.

We have called the committee to hold this hearing at this time to discuss the merits of S. 1318, a bill to provide for the general welfare by enabling the several States to make more adequate provision for the health and welfare of mothers and children and for services to crippled children, and for other purposes.

A copy of the bill will be inserted into the record at this point. (The bill is as follows:)

[S. 1318, 79th Cong., 1st sess. ] A BILL To provide for the general welfare by enabling the several States to make more

adequate provision for the health and welfare of mothers and children and for services to crippled children, and for other purposes

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Maternal and Child Welfare Act of 1945."

TITLE I-MATERNAL AND CHILD HEALTH SERVICES

APPROPRIATION

Sec. 101. For the purpose of enabling each State to provide and maintain services and facilities to promote the physical and mental health of mothers during the maternity period, and of children, including medical, nursing, dental, hospital, and related services and facilities required for maternity care, preventive health work and diagnostic services for children, school health services, care of sick children, and correction of defects and conditions likely to interfere with the normal growth and development and the educational progress of children, and to develop more effective measures for carrying out the purposes of this title, including demonstrations and the training of personnel for State and local maternal and child health services, there is hereby authorized to be appropriated for the fiscal year ending June 30, 1946, the sum of $50,000,000, and for each year thereafter a sum sufficient to carry out the purposes of this title. The sums authorized under this section shall be used for making payments to States which have submitted to and had approved by the Chief of the Children's Bureau, State plans for developing such programs and providing such care and services.

ALLOTMENTS TO STATES SEC. 102. (a) For the fiscal year ending June 30, 1946, and for each year thereafter, the Secretary of Labor shall allot to each State, out of the surs appropriated pursuant to section 101, such part of $5,000,000 as he finds that

1

the number of children under twenty-one years of age in such State bore to the total number of children under twenty-one years of age in the United States, in the latest calendar year for which the Bureau of the Census has available statistics.

(b) For the fiscal year ending June 30, 1946, and for each year thereafter in addition to the allotments made under subsection (a), the Secretary of Labor shall allot to the States, out of the sums appropriated pursuant to section 101, the amount remaining after the amount allotted under subsection (a) has been deducted, taking into consideration for each State such factors as (1) the number of mothers and of children under twenty-one years of age in the State for whom service and care provided for in section 101 are to be made available, and the cost of furnishing such services and care to them, (2) the special problems of maternal and child health, and (3) the financial need of the State for assistance in carrying out the State plan.

APPROVAL OF STATE PLANS

SEC. 103. (a) A State plan for maternal and child health services under this title must

(1) provide for financial participation by the State;

(2) provide for a State-wide program or for extension of the program each year so that a State plan adequate to carry out the purposes specified in section 101 will be in effect in all political subdivisions of the State, not later than July 1, 1955; ..

(3) provide that as services and facilities are furnished under the plan they shall be available to all mothers and children in the State or locality who elect to participate in the benefits of the program, and that there will be no discrimination because of race, creed, color, or national origin, and no residence requirements;

(4) provide for the administration of the plan by the State health agency or for the supervision of the administration of the plan by the State health agency, and for appropriate coordination of the plan with the general publichealth and medical-care program of the State health agency: Provided, That in carrying out the purposes of this title, the State health agency may develop agreements or cooperative arrangements with other State or local public agencies whose functions include the provision of services similar or related to the services furnished under the State plan;

(5) be made part of the State plan for maternal and child-health services submitted in accordance with the provisions of title V, part 1, of the Social Security Act;

(6) provide such methods of administration as are necessary for the proper and efficient operation of the plan, including methods relating to the establishment and maintenance of (A) personnel standards on a merit basis, except that the Chief of the Children's Bureau shall exercise no authority with respect to the selection, tenure of office, and compensation of the individual employed in accordance with such methods, (B) standards for professional personnel rendering medical, dental, nursing; and related types of care or service and standards for hospitals and other institutional care and services, such standards to be established by the State health, agency after consultation with professional advisory committees appointed by the State health agency, and (C) such methods of administration of medical care as will insure (1) the right of mothers and children, or persons acting in their behalf, to select, from among those meeting standards prescribed by the State health agency in accordance with methods set forth in the State plan, the physician, hospital, clinic, or health service agency of their choice (provided that the physician, hospital, clinic, or health service agency selected may refuse to accept the case), and where no such selection is made, the State plan shall set forth the method by which care will be made available; (2) a high quality of care by providing for adequate remuneration for the persons and institutions providing medical care and related services; opportunities for postgraduate training of professional and technical personnel ; and such use of health centers, hospitals, clinics, and health service agencies, public and voluntary, as will achieve the satisfactory distribution and coordination of preventive, diagnostic, consultative, and curative services for mothers and children furnished by general practitioners, specialists, public health personnel, labora

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