The decrease of $108,825 for this activity in 1967 reflects the net effect of (a) a reduction of $172,000 due to nonrecurring expenses included in the 1966 estimate for such items as the administrative survey of the Bureau, other contractual services for visual aids, internal training activities, etc., and (b) an offsetting increase of $63,175 which includes net annualization funds of $25.000 for continuation of the 1966 budget and $38,175 for five new positions in 1967.

Continuing responsibilities in coordinating and directing Bureau activities are indicated in the scope of the work included under the foregoing major program activities. Other bureauwide administrative activities include: Budget administration, administrative accounting and auditing, and other financial manage ment functions; personnel management; general services (including records management); and other management functions, such as forms control, work planning and reporting, committee management and management appraisal activities.

In addition to emphasis placed by the director's office on achieving better administration of the Federal-State programs, considerable attention will continue on making internal Bureau_operations as effective and productive as possible with minimum manpower. Bureau responsibilities and workload have increased rapidly in recent years, there is an acute need to study the effectiveness of present Bureau organization, work processes, and related administrative methods to assure that resources available to the Bureau make a maximum contribution to effective management of program responsibilities. During the latter half of fiscal year 1966, it is planned to request an outside management firm to make a survey of various aspects of Bureau management. Recommendations from the survey will be utilized to streamline and improve the Bureau's administrative framework wherever necessary to enable it to meet the demands of today's public assistance programs as effectively as possible.

The comprehensive work which must be undertaken on the report of the Advisory Council on Public Welfare is another example where sustained attention by the director's office will be required in 1967.

Internal Bureau staff development is another activity which is being emphasized to assure the best utilization of professional and facilitating staff. The Bureau has a coordinated, intensive training program that endeavors to reach all new employees as well as other staff.

Increase of five positions. The Bureau does not have staff for long-range planning that should be undertaken on the complex of Federal-State programs for which it is responsible. Funds are requested for five positions (three professional and two clerical) for the establishment of a high-level program planning and analysis staff responsible for installation of a system for long-range planning and evaluation of program effectiveness. This staff, advisory to the Direr tor, would permit the relating of resources to problems and would be responsible for conducting continuing analysis of operations to evaluate accomplishments to goals. The staff would provide the focal point for the development of realistic statements as to program goals and identification of criteria for the measurement of progress. This would include the development of a system for provision of management data necessary for decisions in planning operations. The staff would engage in regular quantitative analysis of operational and subprogram activities not only to measure performance against plan but to ascertain cost effectiveness and to develop alternate courses of action to achieve objec

BUREAU OF FAMILY SERVICES, SALARIES AND EXPENSES

New positions requested, fiscal year 1967

Program policies and standards:

Digital computer systems adviser.
Assistance standards specialist.
Child health care specialist..
Health insurance specialist
Homeinaker specialist.
Medical assistance methods specialist (2)
Medical economist.
Statf derelopment specialist (2)
Welfare services specialist..
Secretary (6).
Clerk-typist.

Total (18)
Review State plans and grants, evaluate State operations:

Chief, Civil Rights Ünit.
Regional medical officer (2)
Civil rights specialist (14)
Social administration adviser
Administrative review specialist (10)
Civil rights specialist (1).
Family services technician (4).
Medical care administration specialist.
Regional administrative and fiscal methods specialist (4).
Administrative review assistant.
Administrative assistant..
Secretary
Secretary
Clerk (6).
Secretary (6).
Clerk-typist (2)

Total (56)..-
Research and statistics:

Public welfare research analyst (3)
Research analyst..
Research analyst.
Clerk.

Total (6).

60, 809

THURSDAY, MARCH 10, 1966.

CHILDREN'S BUREAU

WITNESSES

MRS. KATHERINE B. OETTINGER, CHIEF, CHILDREN'S BUREAU
ARTHUR J. LESSER, M.D., DEPUTY CHIEF, CHILDREN'S BUREAU
GORDON FORTNEY, ADMINISTRATIVE OFFICER
DR. ELLEN WINSTON, COMMISSIONER OF WELFARE
ROY L. WYNKOOP, EXECUTIVE OFFICER, WELFARE ADMINISTRA-

TION
ELMER W. SMITH, DEPUTY EXECUTIVE OFFICER, WELFARE AD-

MINISTRATION
JAMES P. CARDWELL, DEPARTMENT DEPUTY COMPTROLLER

GRANTS FOR MATERNAL AND CHILD WELFARE

Program and financing

(In thousands of dollars)

1965 actual

1966

1967 estimate estimate

Program by activities:

1. Maternal and child health services.
2. Crippled children's services.
3. Child welfare services
4. Research, training, or demonstration projects in child welfare.
5. Special project grants for maternity and infant care
6. Special project grants for health of school and preschool children
7. Training of professional personnel for the care of crippled children
8. Research projects relating to maternal and child health and crippled

children's services 10

Total obligations (object class 41.0). Financing: 25 Unobligated balance lapsing-------40

New obligational authority (appropriation).. Relation of obligations to expenditures: 71 Total obligations (affecting expenditures). 72 Obligated balance, start of year. 74 Obligated balance, end of year. 77 Adjustments in pired accounts. 90 Expenditures.

4,000 187,000

121, 224

228, 900

Program by activities:

1. State and local health services for children.
2. State and local social services for children
3. Technical assistance to States and communities for juvenile delin-

quency programs
4. Research in child life and services for children
5. Information for parents and others working with children
6 Mental retardation services for children.
7. Administration

Total program costs, funded.
Change in selected resources 1.

10 Total obligations...-

Financing: 25 ('nobligated balance lapsing

New obligational authority. New obligational authority: 40 Appropriation 41 Transferred to “Operating expenses, Public Buildings Services."

General Services Administration (76 Stat. 728). 43 Appropriation (adjusted).

Mr. FOGARTY. The committee will now come to order and we will take up the request for the Children's Bureau. Mrs. Oettinger, you may proceed.

GRANTS FOR MATERNAL AND CHILD WELFARE

Mrs. OETTINGER. May I first speak to grants for maternal and child welfare?

The 1967 estimate of $228,900,000 represents an increase of $41,900,000 over the $187 million appropriated for the fiscal year 1966.

The $5 million increase requested for maternal and child health services and a comparable increase requested for services for crippled children will help States in their efforts to extend these essential health services to mothers and children in additional parts of the State as the 1965 Amendments to the Social Security Act, which authorized the increases, require. The increases will also help to meet the constantly increasing costs of providing services. The overall $100 million requested for these basic health services, together with State and local funds provided under the programs will make it possible for approximately 2 million infants to attend well baby clinics, 400,000 mothers to receive prenatal care and 500,000 children to receive care under the crippled children's program. It is expected that $8.5 million of the amount requested for the two programs will be earmarked for services for mentally retarded children.

MEDICAL AND HOSPITAL CARE FOR PROSPECTIVE MOTHERS

The Congress, in 1963, authorized project grants to provide medical and hospital care for prospective mothers who have or are likely to have conditions associated with childbearing which increase the hazards to the health of mothers or their babies. Goals of these projects include concentrated efforts to reduce the incidence of mental retardation caused by prematurity and complications of pregnancy among low-income groups, to increase the number and accessibility of prenatal clinics and to provide good quality hospital care for the mothers and their babies. Babies in poor families have a much better chance for a healthy start in life because of this new program

program through which many receive quality care in nurseries located in teaching hospitals. More than 50,000 mothers in low-income families have been admitted to these maternity care programs aimed at reducing prematurity, mental retardation, and birth defects. The budget contemplates the continuation of this program at the level of the full authorization, $30 million a year.

а

COMPREHENSIVE HEALTH CARE SERVICES FOR CHILDREN AND YOUTH

In 1965, the Congress again demonstrated its interest in child health by authorizing another 5-year program of special project grants, this one to provide comprehensive health services for children and youth. This program places emphasis on the early identification of children of low-income families who should receive continuing health supervision and medical care; on removing barriers to medical care and on assurance that our advancing medical knowledge leaves