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S. 1606, title I, part B

S. 1318

CONDITIONS FOR APPROVAL OF A STATE PLAN-continued

as

tablishment and maintenance of per- operation of the plan, including methods sonnel standards on a merit basis, ex- relating to the establishment and maincept that the Chief of the Children's tenance of: Bureau shall exercise no authority with (a) Personnel standards and selecrespect to the selection, tenure of office, tion on a merit basis (except that the and compensation of any individual Chief of the Children's Bureau shall exemployed in accordance with such ercise no authority with respect to the methods) are necessary for the selection, tenure of office, and compensaproper and efficient operation of the tion of any individual employed in acplan.

cordance with such methods).

(6) Standards for professional personnel rendering services (established by the State agency after consultation with professional advisory committees appointed by the State agency).

(c) Standards for hospital and other similar types of care.

(d) Right of beneficiary to free choice of available physician, hospital, clinic, or health-service agency, and the right of physicians, hospitals, or clinics to refuse to accept cases.

(e) Maintenance of high quality of care by providing for

(1) Adequate remuneration for the persons or institutions providing seryices or care.

(2) Such use of health centers, hospitals, clinics, and health-service agencies, public or voluntary, as will achieve satisfactory distribution and coordination of preventive, diagnostic, consultative, and curative services furnished by general practitioners, specialists, publichealth personnel, and laboratories.

(3) Postgraduate training of professional and technical personnel.

(f) Payments to physicians on a per capita, salary, per case, or per session basis, or in the case of consultations or emergency visits on a fee-for-service basis.

(9) Purchase of care from public or voluntary hospitals and other health service agencies on a basis related to

cost of providing such care. 6. Cooperation with medical, health, 6. Cooperation with medical, health, nursing, education, and welfare groups hospital, nursing, education, and weland organizations.

fare groups and organizations, and with any agency in such State charged with administering State laws providing for vocational rehabilitation of physically

handicapped children. 7. That the State agency will make 7. That the State health agency will such reports, in such form and contain- make reports, in such form and containing such information, as the Secretary ing such information as the Chief of of Labor may from time to time require, the Children's Bureau may from time and comply with such provisions as he to time require, and comply with such may from time to time find necessary to provisions as the Chief of the Children's assure the correctness and verification Bureau may from time to time find necof such reports.

essary to assure the correctness and

verification of such reports. 88975—46—20

S. 1606, title I, part B

8. 1318 CONDITIONS FOR APPROVAL OF A STATE PLAN-continued 8. That the State agency shall have 8. Adequate dissemination of infor. authority to make and publish such mation in the State with regard to the rules and regulations as are necessary services and facilities available under for the efficient operation of such serve this title. ices, having special regard for the quality and economy of services.

9. That the State make provision for

(a) A general advisory council appointed by the State agency and composed of members of the professions or agencies, public and voluntary, that furnish care or services under the State plan, and of other persons representing the public who are informed on the need for and problems related to the provision or receipt of crippled children's services : Provided, That whenever the State health agency administers the program of services to crippled children, the same general advisory council shall serve both the maternal and child-health and crippled children's programs.

(6) Technical advisory committees appointed by the State agency composed of medical and other professional groups concerned with the administration or operation of the State plan.

10. Opportunity for the beneficiaries, as well as those furnishing services, for a fair hearing before the State health agency on matters affecting their interests.

11. State plan is made a part of the State plan for services for crippled children submitted in accordance with the provisions of title V, part 2, of the Social Security Act when the same State agency is administering both State plans for services for crippled children.

Child-welfare services State plan, to be approved, must make provision for the following:

1. Financial participation by the State.

2. Same, except for addition of provision for appropriate coordination of the plan with the general public-welfare program of the State public-welfare agency. (State public-welfare agencies may develop agreements or cooperative arrangements with other State agencies whose functions include the provision of services related to the services furnished under the State plan.)

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3. Same, except that "methods of administration” refer to those as are found necessary by the “Chief of the Chil. dren's Bureau" for the proper and efficient administration of the plan.

10 S. 1318, sec. 303.

S. 1606, title I, part B

S. 1918

CONDITIONS FOR APPROVAL OF A STATE PLAN-continued

4. Same, except that the “Chief of the Children's Bureau” is substituted for the “Secretary of Labor."

5. A State-wide program, including at least guidance and social service to or in behalf of children who are dependent, neglected, or delinquent, or in danger of becoming neglected or delinquent, or for extension of the program each year so that such guidance and service will be available to all children in need thereof, in all political subdivisions of the State, not later than July 1, 1955.

6. For appropriated cooperation with State and local agencies, public and private, concerned with child health, education, child welfare, and related subjects. (State public-welfare agencies may develop agreements or coop erative arrangements with other State agencies whose functions include the provision of services related to the seryices furnished under the State plan.:)

7. As services and care are furnished under the plan they shall be available to all children without discrimination because of race, creed, color, or national origin, and without residence requirements.

8. Same.

9. State plan is made a part of the State plan for child-welfare services submitted in accordance with the provisions of title V, part 3, of the Social Security Act.

NOTE. Section 301 provides for the development of plans jointly with the Children's Bureau.

DETERMINATION OF AMOUNT TO BE GRANTED TO INDIVIDUAL STATES

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1. Maternal and child health.-All 1. Maternal and child health.-AlFederal grants must be matched by State lotments to States shall be determined or local funds on a variable grant plan. as follows: No allotments are made because pay- (a) Each State shall be allotted, on ments to States are in proportion to a dollar for dollar matching basis, out the total of public funds expended by of sums appropriated each fiscal year, the State under an approved plan. The such part of $5,000,000 as the Secretary proportion, or percentage, of total ex- of Labor finds that the number of chilpenditures to be made from State funds dren under 21 years of age in such States is based on the financial resources of bore to the total number of children the State. The formula is as follows: under 21 years of age in the United

(a) Financial resources of the sev- States in the latest calendar year for eral States shall be measured by per which the Bureau of the Census has capita income.

available statistics. (b) The non-Federal proportion, or (6) The amount remaining, after the percentage, shall not be less than 25 sum under (a) above has been depercent or more than 50 percent of the ducted, is allotted without matching total expenditures under the State plan. after taking into consideration for each

(c) The non-Federal proportion for State such factors aseach State whose per capita income is (1) The number of mothers and of

11 S. 1606, secs. 125 and 127 ; S. 1318, secs. 102, 104, 202, 204, 302, and 304.

S. 1606, title I, part B

S. 1318 DETERMINATION OF AMOUNT TO BE GRANTED TO INDIVIDUAL STATES—continued greater than or equal to the per capita children under 21 years of age in the income of the continental United States State for whom the services and care and for the District of Columbia, are to be made available, and the cost Alaska, and Hawaii shall be 50 percent of furnishing such services and care. of the total expenditures under the (2) The special problems of maternal State plan and for Puerto Rico and the and child health. Virgin Islands it shall be 25 percent. (3) The financial need of the State

(d) The non-Federal proportion for for assistance in carrying out the State States whose per capita income is less plan. than the continental United States shall be 50 percent of the per capita of the State divided by the per capita income of the United States, but not less than 25 percent of the total expenditures under the State plan.

2. Services for crippled children.- 2. Services for crippled chil enSame as for maternal and child health Allotments to States shall be determined (see above).

as follows:

(a) Each State shall be allotted, on a dollar for dollar matching basis, out of sums appropriated each fiscal year, such part of $2,500,000 as the Secretary of Labor finds that the number of children under 21 years of age in such State bore to the total number of children under 21 years of age in the United States in the latest calendar year for which the Bureau of the Census has available statistics :

(6) The amount remaining, after the sum under (a), above, has been deducted, is allotted after taking into consideration for each State such factors as

(1) The number of crippled children under 21 years of age in the State for whom services and care are to be made available and the cost of furnishing such services and care.

(2) The special problems of crippled children.

(3) The financial need of the State for assistance in carrying out the State plan.

3. Child-welfare services.-Allotment. to States shall be determined as follows:

(a) Each State shall be allotted, out of sums appropriated, such part of $10,000,000 (for the fiscal year ending June 30, 1946 and June 30, 1947) as the Secretary of Labor finds that the number of children under 21 years of age in such State bore to the total number of children under 21 years of age in the United States in the latest calendar year for which the Bureau of the Census has available statistics, provided :

(1) That beginning with the fiscal year ending June 30, 1948, the total amount available for allotments to individual States under this section shall be three-fourths of the total appropriation for child-welfare services.

S. 1606, title I, part B

S. 1318 DETERMINATION OF AMOUNT TO BE GRANTED TO INDIVIDUAL STATES—continued

(2) States with a per capita income equal to or greater than the per capita income of the United States shall match the above allotment dollar for dollar with State or State and local funds available for expenditure under the State plan.

(3) States with a per capita income less than the per capita income of the United States shall match the amount allotted on a basis that will make the State or State and local contribution not more than 50 percent of the per capita income of the State divided by the per capita income of the United States and not less than 25 percent of the total expenditure under the State plan.

(6) The amount remaining after the sum under (a) above has been deducted, is allotted after taking into consideration for each State such factors as

(1) The number of children under 21 years of age in the State for whom seryices and care are to be made available, and the cost of furnishing such services and care.

(2) The special problems of child welfare.

(3) The financial need of the State for assistance in carrying out the State plan.

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PROCEDURE FOR COMPUTING AND PAYING GRANTS 1. The Secretary of Labor shall, from Same as under section 125 of S. 1606. time to time but not less often than semiannually, estimate the amount to be paid to the State with respect to each State plan for each year or part thereof on the basis of

(a) A report filed by the State containing its estimate of the total sum to be expended under the plan.

(b) Such other data as to estimated expenditures and such other investigations as he may find necessary.

2. The Secretary of Labor shall then certify to the Secretary of the Treasury the amount estimated for each State plan, reduced or increased, as the case may be, by any sum by which the Secreatry of Labor finds that his estimate for any prior period for such State plan was greater or less than the amount which should have been paid to the State for such period.

3. The Secretary of the Treasury shall, prior to audit or settlement by the General Accounting Office, pay to the State, at the time or times fixed by the Secretary of Labor, the amount so certified.

13 S. 1606, sec. 125 ; S. 1318, secs. 104, 204, and 304.

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