which now give children of some States advantages over those in other States, which favor children of high income families over those of low income families; which protect white children better than Negro children and others in minority groups; which provide for some crippled children and make no provision for others. These inequalities are to be found in the reports received by the Children's Bureau.

Perhaps the most widely known of the child health activities of the National Congress of Parents and Teachers is the Summer Round-Up of the children.

Begun in 1925, this project is a systematic plan for making sure that children are in good physical condition and are as free as possible from remedial defects before they enter the first grade.

The program includes a spring canvass of the local community to locate the children who will be entering school in the fall; a personal visit to the parents to inform them of the value of medical and dental examination; and an examination by physicians and dentists to discover whether the child is in good physical condition. This examination is usually worked out in cooperation with local health agencies. During the summer months following the examination, follow-up visits are made to the homes to urge parents to consult the family doctor and dentist for advice and treatment of their children's defects. A final check-up is then made to see whether these recommendations have been carried out. Parents are urged to be present at all examinations. In recent years the summer round-up program has been broadened to include a sustained program of continuous medical and dental supervision for children of all ages. The most disheartening phase of this project is the inability of our lay workers to obtain both adequate funds and professional personnel to follow up the examination by the correction of defects found. No child should be denied the right to have his physical defects remedied because of the inability of his family or his community to provide this service.

As an organization we are interested also in the social services provided for children. At our recent convention, the attention of State congresses was called to programs for better foster care for children and the care of children who are detained in the jails of this country. In too many places, facilities, funds, and personnel are lacking for these purposes or are far too inadequate.

Over a period of years our organization has repeatedly requested adequate support for the Children's Bureau which administers the programs for maternal and child health, for crippled children, and for child-welfare services under the Social Security Act.

We believe that a firm foundation has been laid for services in behalf of children and that much has been accomplished by State agencies and communities with the limited funds allowed them.

However, if effective health and welfare services are to be provided for all children, the programs must be expanded and the appropriations increased for effectively administering and carrying out these programs.

Therefore, we urgently request the Members of the Senate Com. mittee on Education and Labor to give favorable consideration to the purposes of S. 1318, the Maternal and Child Welfare Act of 1945, Senator PEPPER. Senator Fulbright, do you have any questions?

Senator FULBRIGHT. You heard the testimony of the preceding witness, Mrs. Cook?

Mrs. Cook. Yes, sir.

Senator FULBRIGHT. There seems to be some difference of opinion on its purpose. There is no difference in the purpose. That we all

agree to, I think.

I would like to have your view about that approach. As to the idea of a coordinated agency; what do you think about it?

Mrs. Cook. I can give you only my personal opinion, because in our organization we always make a study of any plan that is proposed, and after a period of time we get the reaction of different States to this plan, and the President's reorganization plan did not come to our attention in sufficient time for us to give it thorough study. So, I cannot state any opinion for the organization as a whole on the matter.

In

However, I can say that we have always, as an organization, stood for the maintenance of the Children's Bureau and their services. our recent convention in Denver, when we found that the President's reorganization plan was to move the Children's Bureau from one agency to another, our board of managers did take this action in that they telegraphed President Truman and also the Federal Security Administrator to maintain the services of the Children's Bureau intact in moving it from one agency to another.

That is, without including the child labor force in which we want rightfully to remain in the Department of Labor.

We thought his directive, in his reorganization plan, was not specific enough. We thought that it should be made more specific in relation to the change from one department to another.

Senator FULBRIGHT. That plan, as I understand it, has just been acted on by the committee over in the House and will come over here, I think, in the near future.

We must have it before the 16th of July.

If this should be in conflict with that, I wondered if that would suit your purposes, if that other plan is adopted-that is, to coordinate all of them under the Federal Security Agency.

Mrs. Cook. I cannot understand Mrs. Meyer's opinion in respect to the fact that the services of the Children's Bureau cannot be maintained intact and still be under one head-one director.

Our organization has always believed that service to children should be separate from those to adults in that if possibly they were combined they might be relegated to the background and be less effective.

Senator FULBRIGHT. You disagree with the idea that the program should take care of the whole family. You think it ought to be separate, and the children should be considered separately?

Mrs. Cook. We do not approach our educational problem in that light.

Senator FULBRIGHT. This health program, you think, should be the same?

Mrs. Cook. Yes; our organization adheres to the policy that all the Federal grants-in-aid should be distributed through the Federal, State, and local agencies which are set up for a specific purpose.

Senator FULBRIGHT. Do you think these appropriations provided for here are adequate?

Mrs. Cook. I cannot answer that, sir, because I am not familiar enough with that, but I assume so in that we have always come before the Appropriations Committee as an organization and asked for those appropriations which the Children's Bureau had submitted to the Budget Committee.

Senator FULBRIGHT. That is all.

Senator PEPPER. Could you just answer one question for me, Mrs. Cook?

What I understood you to say, Mrs. Cook, was that you thought that it was all right and proper, no doubt, for all of these funds to be administered by the Federal Security Agency?

Mrs. Cook. Yes, sir.

Senator PEPPER. But, in the Federal Security Agency itself, they might be so related to the Children's Bureau that the Bureau might be maintained as an entity and might continue to give of its special knowledge and experience to the program?

Mrs. Cook. Yes, sir; as an organization we have always looked to the Children's Bureau for advice. They have given us quite fine help prior to and during the war period in calling our attention to programs of different types and to the needs of children in our communities, and I note in Mrs. Meyer's testimony she said that they did not bring anything to our attention until they were required by different States to look into a national program. I believe that the Children's Bureau, at the very beginning of the war, did call out attention to the wartime needs of children.

I remember Miss Lenroot and other members of the Children's Bureau coming before our board of managers' meeting, which we held in lieu of our 1943 convention, calling our attention to those dangers which would result from mothers working, to child care centers, to juvenile delinquency, and to child labor. They have given us quite a number of ideas which we, as lay people, tried to carry out in our communities; to arouse public interest in children's needs.

Senator PEPPER. Do you have any questions, Senator Donnell? Senator DONNELL. Mrs. Cook, you stated, as I understood you, that you supported and favored the general purposes of S. 1318? Mrs. Cook. Yes, sir.

Senator DONNELL. I am wondering if you desire to express yourself as to whether or not you favor the bill itself, as it is written, not merely to its purposes but to the contents of the bill. Or, whether there may be some amendments of some type which you think should be made to that bill?

Mrs. Cook. I think the amendments which Senator Pepper mentioned in his opening remarks are very fine, because it seems to me that the Children's Bureau service can be maintained intact, even though it were put under any Federal agency.

Even in the proposed plan, I believe that this bill could be so amended that all these services could be put into any Federal Health Bureau which might later come out of Congress.

• I do believe that we should not delay in passing this bill-a bill of this type, because the children do not wait to grow up. They grow up continuously, and they need help and they need it immediately, and I think that this will bridge the gap, as Senator Pepper recommended.

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I think it could be correlated with any national health bill which might later be approved.

Senator DONNELL. In substance, then, am I correct in understanding that you do favor this bill with the amendments that Senator Pepper has read here today?

Mrs. Cook. Yes, sir.

Senator DONNELL. May I ask you also about this fundamental question that was referred to by Mrs. Meyer, and I think possibly by yourself: this bill provides

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.

I am wondering what your view is as to whether or not these benefits should be available to all mothers and children without regard to the financial need on the part of those mothers and children.

Mrs. Cook. We administer our public education program on that basis, and I think our health program should be thought of in the

same way.

Senator DONNELL. So, you would favor the extension of these services and facilities, under this bill, to all mothers and all children throughout the United States, regardless of the financial need?

Mrs. Cook. Yes, sir; and I believe that you will find in the local communities, in our own program of this type, it has worked out, that those who are financially able, do avail themselves of this service, and do give the financial aid, if it is necessary.

We have found that so in our work in the dental clinics and the eye clinics-those who are able to pay do make contributions.

It does provide a plan whereby you are able to concentrate in areas and thus you are able to provide the services at more nominal fees, even for those who are able to participate.

Senator DONNELL. Are these services, as you understand the bill, limited in any way, or do they constitute all medical, nursing, dental, hospital, and related services and facilities which are required for any sick children and for the correction of defects?

Mrs. Cook. Yes, sir. I also understand that it is possible, under this bill, to correlate the program as to the social needs of the child from the psychiatric standpoint as well as the physical.

Senator DONNELL. Do you favor, Mrs. Cook, its extension by the Federal Government to every child in the United States free of charge, provided the election shall have been made that that child is to receive these benefits of all these services, medical, nursing, dental, hospital, et cetera, without any expense to the children, and at the expense of the Federal Government, with such participation as the States themselves may have?

Mrs. Cook. Yes, sir.

Senator DONNELL. That is to say, you would favor free service for all of the children from the Federal Government together with the State participation?

Mrs. Cook. We believe that the physical needs should be met, just as the educational needs should be met with some Federal responsibility, with the major part left to the States, and local communities.

Senator DONNELL. That leads me to the next question, and that is, under this bill, is there any provision that you find in here which

guarantees that the major part of the financial participation will be left to the States?

Mrs. Cook. No; there is no matching feature that I could see in the bill.

Senator DONNELL. I think there is not, either.

I concur with your view.

Under section 103 (a), with reference to "Approval of State Plans," it is provided that:

A State plan for maternal and child health services under this title must(1) provide for financial participation by the State.

Is there anything you know of in the bill that provides how much financial participation is to be had by the State, whether it should be large, small, or medium, or any amount?

Mrs. Cook. No; I did not see anything in there that would indicate that.

Senator DONNELL. Would you think, Mrs. Cook, that it would be advisable for our committee to consider whether this bill should be so amended as to require a major participation by each State before it would be entitled to receive any Federal assistance?

Mrs. Cook. Yes; I think that might be advisable.

Senator PEPPER. Would you clarify what you mean by "major part"?

Senator DONNELL. I will ask Mrs. Cook here whether, in your opinion, do you think it would be advisable that the States should be required to contribute at least 50 percent of the cost, or do you think that a smaller participation by the States would be satisfactory?

Mrs. Cook. I think we might look at it from the viewpoint of the educational bill, which is proposed, that local communities and States should be required to have a minimum program, and we should use some plan such as that to determine it instead of a percentage basis.

Senator DONNELL. As to this language in 103 (a)-there may be a further modification, but, as I read it, it does not provide for the State furnishing any specific amount whatsoever, or any percentage. It simply says that a State plan must provide for financial participation by the State.

Mrs. Cook. That would evidently be set up by the Administrator. Senator DONNELL. There is nothing in this language, nor is there anything anywhere else in the bill that specifies whether the contribution by the State shall be $1 or $1,000,000.

Mrs. Cooк. That is right.

Senator DONNELL. And you think that some attention should be given by the States to whether there should be an amendment to cover that point?

Mrs. Cook. Yes; also, an equalization of opportunities plan should be made and be set up in each State.

Senator DONNELL. And you think it would be well for us to give consideration to that question, also?

Mrs. Cook. Yes, sir; I do.

Senator DONNELL. Do I understand from your answer that you have not given, nor have you undertaken to make an estimate of the cost for the administration of this plan?