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Public Health Service

Short title

Appalachian Regional Development Act of 1965--
Social Security Amendments of 1965:

Grants for mental retardation programs.
Grants for research on children's emotional illnesses -
Mental Retardation Facilities and Community Mental
Health Centers Construction Act Amendments of 1965.
Community Health Services Extension Amendments of
1965:

Community immunization grants.

Programs for domestic agricultural migratory workers.
Grants and other programs under sec. 314(c).
Grants to schools of public health..

Special project grants for community health services.
Health Research Facilities Amendments of 1965.
(Grants for Gorgas Memoria' Laboratory)...

Heart Disease, Cancer, and Stroke Amendments of 1965.
Motor Vehicle Air Pollution Control Act..

Solid Waste Disposal Act..

Health Professions Educational Assistance Amendments of

1965:

Educational improvement grants.
Construction grants.

Student loans.

Loans to schools.

Scholarship grants.

Medical Library Assistance Act of 1965:

Construction of facilities.

Training grants..

Fellowships.

Research grants and contracts..

Basic resources grants

Regional medical libraries grants.

Publications support..

Establishment of regional libraries.

1967 authorization

1 $69, 000, 000

2,750,000 500,000

2 24, 000, 000

11, 000, 000 8, 000, 000 50, 000, 000 3 5, 000, 000 10,000,000 4280, 000, 000 500,000 90, 000, 000 845,000

14, 000, 000

40, 000, 000 (5)

25, 000, 000 (6)

10, 000, 000 1, 000, 000 500,000 3, 000, 000

3,000,000

2,500,000

1,000,000

2,000,000

1 The single amount authorized to be appropriated through June 30, 1967, is available until expended.

2 Plus amounts required for continuation of grants made in 1966.

3 Included in $50,000,000 above.

The single amount authorized is for fiscal years 1968 and 1969 as well as fiscal year 1967.

$ $480,000,000 for fiscal years 1967-69, of which not more than $160,000,000 may be available before July 1, 1967, and not more than $320,000,000 may be available before July 1, 1968.

$1,500,000 total.

Formula for 1967: To each school of medicine, osteopathy, dentistry, optometry, podiatry, or pharmacy, $2,000 multiplied by o the number of full-time, 1st-year students and 2d-year students of each school.

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Grants for waste treatment works construction...
(b) Grants and contracts for combined sewer systems
pollution control.

Mar. 9, 1965... Appalachian Regional Development Act of 1965.

1 Represents balance of $6,000,000 authorization available through June 30, 1967.

1967 authorization

$150, 000, 000 20, 000, 000

13, 000, 000

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Social Security Amend-
ments of 1965:
Major provisions include:
1. Basic hospital in-
surance program.

2. Voluntary supple-
mentary medical
insurance pro-
gram.

Payments to individuals age 65 and over for the cost of inpatient hospital services (after deductible of $40); posthospital care and home health care (after three days of hospitalization); and outpatient diagnostic services (80 percent after $20 deductible). Payments made for services to individuals not insured under social security and railroad retirement programs to be financed from the general fund. The hospital insurance program will provide protection to about 19,300,000 individuals by the end of fiscal year 1967. During the year, an estimated 4,400,000 individuals will receive services under the program at a cost of $2,300,000,000 including $283,000,000 financed from general funds. Payments to individuals age 65 and over who enroll in the program for physicans' services in and out of institutions (80 percent after $50 deductible). An estimated 15,600,000 individuals will be enrolled in the program by the end of fiscal year 1967. Of this number, about 4,200,000 persons will receive payments totaling $765,000,000 for physicians' and related services. Enrollees in the program pay monthly premiums of $3 and a matching amount is paid from general revenues. The Government's matching share in fiscal year 1967 is estimated at $550,000,000.

3. Benefit increase... 7-percent increase ($4 minimum) in the primary

4. Payments to
students.

5. Payments to wid-
ows at age 60.

6. Definition of dis-
bility.

7. Entitlement to
disability bene-
fits after entitle-
ment to retire-
ment benefits.

8. Transitional-in-
sured status.

insurance amount rates. As a result of this change in the law, an estimated 20,700,000 persons will be receiving higher monthly benefits at the end of June 1967. About $1,400,000,000 in additional benefits will be paid in fiscal year 1967.

Entitlement to children's benefits is continued from age 18 to age 22 for children of deceased, disabled, or retired workers attending school. This change in the law will result in an addi tional 333,000 children receiving monthly bene fits at the end of June 1967 and $215,000,000 in additional benefit payments in fiscal year 1967. Widows are entitled to monthly benefits at age 60 at an actuarially reduced rate. As a result of this change in the law, an additional 186,000 widows will be receiving benefits at the end of June 1967 and $165,000,000 in benefits will be paid in fiscal year 1967. Entitlement to disability benefits may be established if the disability lasts or is expected to last 12 months. This replaces the requirement that a disability must be of long-continued and indefinite duration or expected to result in death. As a result of this change in the law, an estimated 79,000 disabled workers and their dependents will be receiving benefits at the end of June 1967 and an additional $50,000,000 in benefits will be paid in fiscal year 1967.

Entitlement to disability benefits is no longer precluded by prior entitlement to reduced oldage benefits. An estimated 41,000 disabled workers and their dependents will be receiving benefits at the end of June 1967 and $40,000,000 in benefits will be paid in fiscal year 1967 as a result of this change in the law.

Persons age 72 or over who are not fully insured under previous law may be entitled to monthly benefits under transitional eligibility provi sions. As a result of this change in the law, an estimated 315,000 individuals will be receiving monthly benefits at the end of June 1967.

Public Date enacted Law No.

89-97.---

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9. Modification of
earnings (or re-
tirement) test.

10. Payment to trust
funds for military
service credits.

The new retirement test permits an annual earned income of $1,500 instead of $1,200 without a loss of benefits. The range for making a $1 reduction in benefits for each $2 in earnings is raised from $1,200 to $1,700 to $1,500 to $2,700. Above $2,700 benefits are reduced by $1 for each $1 of earnings. This provision is effective for taxable years ending after 1965. This change will result in additional monthly benefit payments of $325,000,000 to 750,000 persons on the benefit rolls.

Reimbursement to the trust funds from the general funds for benefits and administrative costs after Sept. 1, 1950, plus future costs has been authorized in Public Law 89-97 to be made over a 50-year period ending June 30, 2015. An appropriation request for $105,000,000 for fiscal year 1967 has been submitted in accordance with this provision of the amendments. Noncontributory credits for military service during the period Sept. 16, 1940, to Jan. 1, 1957, were granted for social security purposes. The trust funds have been reimbursed for benefits and administrative costs incurred up to Sept. 1, 1950.

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Training of professional $5,000,000.

personnel for the care of crippled children. Grants to States for

public assistance: Increased Federal financial participation.

Federal participation in
payments for aged in
institutions for mental
illness and tubercu-
losis.

Earned income ex-
empted from consider-
ation in determining
need.

Federal participation in
both Old-Age Assist-
ance and Medical
Assistance for the
Aged in same month
for recipient entering
or leaving medical
institution.
Medical assistance pro-
grams (title XIX of
Social Security Act).

Estimated cost in 1967 of new authorizations: $300,400,000.

Authorizes average monthly increase in assistance payments of about $2.50 for needy aged, blind, and disabled recipients and $1.25 for AFDC recipients. Cost in 1967 estimated at $150,000,000.

Authorizes Federal participation in public assistance payments for aged in institutions for mental illness and tuberculosis. To provide assistance for an estimated 45,000 aged persons, this amendment is expected to cost $75,000,000 in 1967.

Authorizes exemption of earned income under certain conditions in determining need in programs for the aged, disabled, and dependent children. Estimated to cost $13,000,000 in 1967.

Authorizes Federal participation estimated to cost $2,000,000 in 1967.

(1) Authorizes expanded medical care grant-in-
aid program, and authorizes more liberal
Federal financing. The estimated cost of
this amendment in 1967 is $240,000,000.
(2) In addition, it is estimated that $37,400,000
of $217,000,000 in released funds will be used
in 1967 to improve medical care for the aged
in States not adopting title XIX. (The
released funds are those which States would
have used for medical care were it not for
the coverage of certain of these expenses by
the new health insurance for the aged pro-
gram (Medicare).)

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EMPLOYMENT DETAIL, FISCAL YEARS 1965, 1966, AND 1967

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1 Does not include 7 positions transferred to Office of Secretary audit on July 1, 1965. Includes 41 positions transferred from OEO, work-study program.

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