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tenance of 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 any individual employed in accordance with such methods;
(7) provide that the State public-welfare agency will make reports, in such form and containing such information as the Chief of the Children's Bureau may from time to time require, and comply with such provisions as the Chief of the Children's Bureau may from time to time find necessary to assure the correctness and verification of such reports;
(8) provide for appropriate cooperation with State and local agencies, public and private, concerned with child health, education, child-welfare and related subjects; and
(9) provide for a program of training for personnel rendering child. welfare services. (b) The Chief of the Children's Bureau shall approve any plan which fulfills the conditions specified in subsection (a).
PAYMENT TO STATES
SEC. 304 (a) From the sums appropriated therefor and the allotments available under section 302 (a), the Secretary of the Terasury shall pay to each State which has an approved plan for child-welfare services, for each fiscal year or part thereof, beginning with the fiscal year ending June 30, 1916, an amount which shall be used exclusively for carrying out the purposes of the State plan, and which for States whose per capita income is equal to or greater than the per capita income of the continental United States, as determined by the Secretary of Labor on the basis of data available from the Department of Commerce, shall be matched dollar for dollar by State or State and local funds made available for the purposes of this Act as set forth in section 301, and for States whose per capita income is less than the per capita income of the continental United States, shall be matched by State or State and local funds to the extent required to bring the State contribution to an amount not less than 25 per centum of the total expenditure for a period under this subsection and not greater than the percentage which bears the same ratio to 50 per centum as the per capita income of the State bears to the per capita income of the continental United States. (b) The method of computing and paying such amounts shall be as follows:
(1) The Secretary of Labor shall, from 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, under the provisions of subsection (a) of this section, such estimate to be based on (A) a report filed by the State containing its estimate of the total sum to be expended in such year or part thereof in accordance with the provisions of subsection (a), and (B) such other data as to such estimated expenditures, and such investigation as he may find necessary.
(2) The Secretary of Labor shall then certify to the Secretary of the Treasury the amount so estimated for each State plan, reduced or increased, as the case may be, by any sum by which the Secretary of Labor finds that his estimate for any prior fiscal year or part thereof for such State plan was greater or less than the amount which should have been paid to the State under subsection (a) for such year or part thereof; except that such increases or decreases shall not be made to the extent that such sum has been applied to make the amount certified for any prior year or part thereof greater or less than the amount estimated by the Secretary of Labor for such prior year or part thereof.
(3) The Secretary of the Treasury shall, prior to audit or settlement by the General Accounting Office, pay to the State, in such installments and
at the time or times fixed by the Secretary of Labor, the amount so certified. (c) The Secretary of Labor shall from time to time certify to the Secretary of the Treasury the amounts to be paid to the States from the allotments available under section 302 (b) and the Secretary of the Treasury shall, prior to audit or settlement by the General Accounting Office, make payments of such amounts at the time or time specified by the Secretary of Labor.
Sec. 305. When used in this title the term "Child-welfare service
(1) guidance and social service to or in behalf of children pendent, neglected, or delinquent, or in danger of becoming ne
w or delinquent;
(2) placement, supervision, and maintenance of children in foster family homes;
(3) temporary care of children who are dependent, neglected, or delinquent, or in danger of becoming neglected or delinquent, especially in areas where children would otherwise be detained in jail or would be deprived of necessary protection and shelter or study of their special needs;
(4) specialized services needed to strengthen and improve the programs of public institutions caring for children;
(5) care in foster-family homes or day-care centers of children whose mothers are employed or whose home conditions require care outside their own homes during any part of the twenty-four-hour day, including auxiliary services necessary to assure proper use of day-care facilities and to safeguard children receiving care;
(6) payment of the cost of returning nonresident children to their own communities, if such return is desirable and the cost cannot otherwise be met; and
(7) cooperation with appropriate State and community agencies in improving conditions affecting the welfare of children.
OPERATION OF STATE PLANS
SEC. 401. In the case of any State plan for maternal and child-health services, or for services to crippled children, or for child-welfare services, which has been approved by the Chief of the Children's Bureau, if the Secretary of Labor, after reasonable notice and opportunity for hearing to the State agency administering or supervising the administration of such plan, finds that in the administration of the plan there is failure to comply substantially with any provision required by section 103, or section 203, or section 303, respectively, to be included in the plan, he shall notify such State agency that further payments will not be made to the State under such plan (or, at his discretion, that further payments will not be made to the State under such plan for services in which there is such failure) until he is satisfied that there is no longer any such failure to comply. Until he is so satisfied he shall inake no further certification to the Secretary of the Treasury with respect to such plan for such State or shall limit further certifications to services in which there is no such failure.
STUDIES AND INVESTIGATIONS
SEC. 402. The Children's Bureau shall make and aid the financing of such studies, demonstrations, investigations, and research as will promote the efficient administration and operation of this Act.
APPROPRIATION SEO. 403. There is hereby authorized to be appropriated for the fiscal year ending June 30, 1946, the sum of $5,000,000 for all necessary expenses of the Children's Bureau in administering the provisions of this Act, and in developing and promoting effective measures for carrying out the purposes of this Act, including studies, demonstrations, investigations, and research, the training of personnel for Federal, State, and local service, and the payment of salaries and expenses of personnel detailed at the request of State agencies to cooperate with and assist such agencies in carrying out the purposes of this Act, and there is hereby authorized to be appropriated for each fiscal year thereafter a sum sufficient to carry out the purposes of this title.
TITLE V-GENERAL PROVISIONS SEC. 501. The Chief of the Children's Bureau, with the approval of the Secretary of Labor, shall make and publish such rules and regulations as may be necessary to the efficient administration of this Act.
SEC. 502. The Chief of the Children's Bureau shall submit each year to the Congress a full report of the administration of this Act.
Sec. 503. When used in this Act, the term “State" means any State of the United States, the District of Columbia, or any Territory or possession of the United States.
SEC. 504. If any provision of this Act, or the application thereof to any person or circumstance, is held invalid, the remainder of the Act and the application of such provision to other persons or circumstances shall not be affected thereby.
Senator PEPPER. This bill would enable the States to make more adequate provision for the health and welfare of mothers and children and for services for crippled children by providing Federal grants-in-aid to the States for comprehensive preventive, diagnostic, and curative services for all mothers and children who elect to participate.
The services called for in this bill are no innovation in our Government. They are an extension of programs which have been developing for 10 years under the Social Security Act. It is time now to expand these programs to their maximum.
The need for an expanded program is pressing and all too apparent. The well-being of our children and our Nation demands that we act now. Individual families alone cannot buy good medical and mental health for their children. Income stands in the way for many millions of families. Even in the relatively good year of 1941, two-thirds of our children lived in families with incomes of less than $40 a week. A great proportion of these children are in large families. But families with comfortable incomes frequently find themselves faced with impossibly heavy financial burdens in their efforts to provide their children with the medical care they need. The place where families live is another block to good care for great numbers of children. Health services and medical care in rural areas are pitifully meager. Professional people, and particularly the highly specialized ones, naturally are attracted to big centers of population where the finest facilities are located.
I am not going to recite to you all the evidences of our neglect of the health and well-being of our children. The list is too long. I am certain that our witnesses, who have an intimate knowledge of child health and welfare, will supply us with further information.
President Truman, in his message to Congress on a national health program, recommended a program for maternal and child health. He outlined as a major task for Congress and the American people a program to assure thatno American child shall come to adult life with diseases and defects which can be prevented at an early age and further stated that the health of children, no less than their education, is a public responsibility.
Congress, in its consideration of legislation for maternal and child health and welfare, must keep in mind that such legislation must fit into the plan for health and medical care of the entire population.
I recommend that the Senate insert into S. 1318 a new make this relationship clear,
Sec. 2. The Congress finds, and experience has shown, especially during the war, that there is need for expansion of maternal and child welfare seryices through aid to the States, and declares that immediate action by Congress is required to meet these needs.
It is further declared to be the policy of the Congress that the special services for the health of children and their mothers during the maternity herein provided for should form a part of any national health program to be authorized by the Congress and should be coordinated with and fitted into any such program.
A total of $100,000,000 is allotted for the first year of operation; $50,000,000 of this would be for maternal and child health; $25,000,000 for the care of crippled children. I believe that it would be wellpending the formulation of a national health program—if S. 1318 were amended to make specific the amounts which would be available in the second year; that is, $75,000,000 for maternal and child health, and $40,000,000 for crippled children.
There is no objection to the transfer of the Children's Bureau to the Federal Security Agency. However, in order to assure the most effective treatment of children, it would be desirable that a single administrative unit administer maternal and child health and welfare functions. I believe the services provided under the proposed act can be integrated with other services of the Federal Security Administration. It is my hope that these hearings will bring out to the fullest extent the need for this bill and prove to Congress and to the people that solid national support for this program for improved maternal and child welfare and its passage is a “must.”
Now, we are exceedingly fortunate in having Mrs. Eugene Meyer, truly one of the best informed ladies in our country, to come and give us her views about this bill, or any aspect of the subject which she would be good enough about which to inform us.
STATEMENT OF MRS. EUGENE MEYER
Mrs. MEYER. Thank you very much, Senator. I also want to thank you for telegraphing me while I was out of town in order to tell me that these hearings were taking place, otherwise I would not have known about it.
Unfortunately, I have to catch a train with my husband, and I cannot disappoint him. He is the busy member of the family now.
Therefore, with your permission, I would like to read my statement. After I have read my statement, I will answer any questions, provided I have some time left.
Mr. Chairman, careful consideration of bill S. 1318 to increase the grants-in-aid for maternal and child health, crippled children, and child welfare under the administration of the Children's Bureau' is of utmost importance. With the objectives of the bill, the improvement of child care throughout the country, nobody is in disagreement. On the contrary, most public and private welfare officials have long felt that the Federal Government and especially the Children's Bureau is lagging far behind in its understanding of our Nation-wide responsi. bility to childhood.
The Federal Government, for many years, has followed, not led, the most progressive sections of the country, both in theories and in the practice of child welfare. Even the emergency maternity and infant care program which constituted the Children's Bureau's only Nationwide war program, was the result of pressure from many States, which initiated such maternity measures before the Children's Bureau ever thought of launching its national program.
We are now facing a great national emergency. Deep unrest is abroad in the land. The war migration of families and individuals has increased rather than abated. The destructive impact of total war upon the family, the shameful neglect of children in every war center, the lack of the most elementary services for children in great areas of our country, have brought about social conditions that threaten our national stability.
What we are faced with is the need for a national coordinated health, education, and security program of which the child is a part that cannot be treated in isolation from the welfare of the community as a whole.
The acute and growing social disintegration with which we are confronted calls for statesmanship of the highest order. The President exhibited such statesmanship when he responded to an active Nation wide trend and the expressed authorization of Congress also and issued an Executive order for the reorganization of all Federal education, health, and welfare activities and recommended their orderly coordination in a new Federal Government.
It is well to remember that President Roosevelt had the same objectives in view, and the report that he had made and issued in 1939 is still one of the best statements on the subject, and actually is much better than I could make, Senator,
The Congress also has responded to the crisis by initiating various bills to improve the facilities for health and welfare and for various kinds of health and social insurances.
Therefore, it is impossible to consider the provisions of S. 1318 without studying some of its major provisions and their effect upon the Nation-wide health and welfare program that is in process of development.
Nowhere in the testimony of the Children's Bureau or other proponents of this bill do we have any estimate of what the proposed maternal and child-health service will cost over the years.
Even a very superficial consideration of probable costs is enough to show that the $50,000,0000 appropriation proposed by this bill for maternal and child health has absolutely no relationship to the actual costs.
Let us begin with the probable cost of maternity care. There are about 21,2 million infants born each year. On the basis of experience under the EMIC program, we can estimate that 75 percent of the expectant mothers will take advantage of this proposed free maternity care. At a cost of $88 per case, which is the figure arrived at under the EMIC program, the cost for maternity care alone will total $165,000,000 per annum.
As to medical care for children under 18, let us again assume that only 75 percent of parents will seek to avail themselves of the services provided under this program. There are over 41,000,000 children