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the point

So what you really have in your general health programs and to a certain degree in the categorical is that in many cases the Federal money only represents 1 percent of their total expenditures, so that it becomes a very small factor really in the big States as far as the support is concerned. It is an important factor because any money is important these days, but it is a relatively small factor. However,

Senator COOPER. I am thinking of a situation where, because of the facilities those States have, they probably have more advanced programs in those fields. Then, in a State like Wyoming do you think the cutting of their funds which would probably result from the change of this formula would possibly affect the programs which can perhaps only be carried on successfully in those larger States where they have better hospital facilities, like cancer control?

Mr. ROCKEFELLER. I think the answer would be “Yes,” if there would be only a support program based on the equalization formula found in the Hospital Survey and Construction Act. However, that is only a part of it. The extension and improvement grant is allocated on a population basis. Therefore the big States would get more money because of larger population, and that money would be applied for the improvement of their program. So that they will benefit proportionately more here because of the larger populations that they have. That will create a balance.

Senator COOPER. It will correct inequities? Mr. ROCKEFELLER. That is correct. So the answer to your question is that the new formula would not adversely affect it. Senator COOPER. I have another question. Secretary Hobby. May I add one thought there, Senator? Senator COOPER. Yes. Secretary Hobby. In the application of the Hill-Burton formula, in the Hospital Survey and Construction Act our experience demonstrates that these so-called rich States were not deterred in their hospital construction. In the States with lesser fiscal capacities, however, the

programs were greatly helped. That has been the experience in hospital construction as among the States.

Senator PURTELL. Mrs. Secretary, may I say--and this may be helpful to Senator Cooper, although I am not sure that it will be-but it may be if I asked this question now: Is it not true in the long run, and in the overall picture, that every State will be better off financially, that is, the financial participation will be greater than it is today? Also have you some figures that will demonstrate that so that we can include them in the record? I believe you do have some.

We have one set of figures which I received from your Department, and I think we ought to have it in the record. Secretary HOBBY. Could we submit that for the record ? Senator PURTELL. Yes. I am sure it would be a help and it will be included, if there is no objection. I have one here and that is the reason why I mentioned it.

(The document referred to is as follows:)

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, WASHINGTON NOTE.— The attached tables have been prepared to show the fiscal effect of the President's recommendations in respect to Federal grants to States for health services and facilities, vocational education, vocational rehabilitation, and maternal, and child health, and welfare services. The explanatory notes indicate the assumptions which have been made in the preparation of the tables. The budget levels for fiscal year 1955 have been used, for purposes of comparison, in the 1956 table.

It should be particularly noted that the second table, labeled “Projected Impact of Legislative Recommendations—Fiscal Year 1956,” is not intended to be a prediction of the budget recommendations of the President for fiscal year 1936 except in the case of vocational rehabilitation. The levels of appropriations in fiscal year 1956 will be determined through the regular budget process in the light of all circumstances existing at the time of the budget recommendation, The maximum authorizations for the five programs as proposed in the bills to carry out the President's recommendations are as follows: Hospital construction.

$210,000,000 Public health services

(9) Maternal and child health and welfare.

41,500,000 Vocational rehabilitation. Vocational education

36,000,000 1 No limit.

Projected impact of legislative recommendations, fiscal year 1956— Federal grants to States for health services and facilities, vocational education,

vocational rehabilitation, and maternal and child health and welfare services (covers 6 programs which will use, if proposed legislation is

enacted, the basic allotment formula of the Hospital Construction Act) Important: This table presents, upon the basis of certain assumpcions, the fiscal effect of proposed now legislation covering Federal grants-in-ald for health services and facflities,

the exception of "Surveys for hospital con-
struction" and "Vocational rehabilitation." (The hospital survey money is a nonrecurring appropriation for 1955. The vocational rehabilitation figures for 1956 reflect the Presi-
dent's recommendation that the funds for this program be markedly increased during the next

several years.) The figures contained in this table represent allotments to the
States. In the event that any State should not appropriate sufficient funds to match the Federal allotments in accordance with the proposed formulas, the full allotment would
not be available to the State. Since the actual 1956 figures will be determined through the budget and appropriations process in 1956, the 1956 figures presented in this table are
purely hypothetical and are only for the purpose of indicating the approximate effect of the proposed new legislation.

Hospital construction program

Public health

Maternal and child health and

welfare

State

Chronic

disease
facilities :

Nursing
homes :

Diagnostic
or treat-

ment
centers

Rehabili- Other hos

tation pital con-
facilities struction

Total hos-
pital con-
struction

Support:

Extension

and
improve-
ment 3

Total

Support :

Extension

and
improve-
ment :

Total 1

United States total.. $20,000,000 $10,000,000 $20,000,000 $10,000,000 $50,000,000 $110,000,000 $12, 707, 781
Alabama

706, 408 353, 204 706, 408 353, 204 1, 797, 282 3, 916,506 428, 772
Arizona,

125, 361 62, 681 125, 361 62, 681 318, 951 695, 035 103, 986 Arkansas. 423, 292 211, 646 423, 292

211, 646 1,076,964 2,346, 840 275, 084 California

810, 232 405, 116 810, 232 405, 116 2,061, 436 4, 492, 132 511, 879 Colorado.

165, 461 82, 731 165, 461 82, 731 420, 976 917, 360 112, 320 Connecticut

140,814 70, 407

140, 814 70, 407 358, 267 780, 709 100, 247 Delaware

100,000 50,000 100,000 50,000 200,000 500,000 42,921 District of Columbia

100,000 50,000 100,000 50,000 200,000 500,000 57,080 Florida.

491, 285 245, 642 491, 286 245, 642 1, 249, 954 2, 723, 808 309, 624 (teorgia

707,915 353, 957 707, 915 253, 957 1, 801, 115 3,924,859 424, 404 Idaho.

100,000 50,000 100,000 50,000 215, 009 515,009 72, 520 Itinois

622, 885 311, 443 622, 885 311, 443 1,584,779 3, 453, 435 404, 483 Indiana

459, 780 229, 890 459, 780 229, 890 1, 169, 799 2,549, 139 290, 586 Iowa..

314,659 157,329 314, 659 157,329 800, 572 1,744, 548 203, 858 Kansas

260, 574 180, 287 260, 574 130, 287 662, 966 1, 444, 688 169,072 Kentucky

611, 102 305, 551 611, 102 305, 551 1, 554, 801 3, 388, 107 378, 869 Louisiana.

526, 382 263, 191 526, 382 263, 191 1, 339, 251 2,918, 397 317, 947 Maine

140, 911 70, 455

140, 911 70, 455 358, 513 781, 245 93, 808 Maryland

248, 579 124, 289 248, 579 124, 289 632, 447 1,378, 183 158, 041 Massachusetts

440, 638 220, 319 440, 638 220, 319 1, 121, 096 2, 443, 010 283, 483 Michigan

633, 026 316, 513 633, 026 316, 513 1, 610, 580 3, 509, 658 405, 454 Minnesota

392, 696 196, 348 392, 696 196, 348 999, 118 2,177, 206 251, 341 Mississippi. 558, 080 279, 040 558, 080 279, 040 1, 419, 898

3,094,138 357, 970 Missouri

485, 490 242, 745 485, 490 242, 745 1, 235, 211 2, 691, 681 316,514 Montana.

100,000 50,000 100,000 50,000 200,000 500,000 67, 080 See footnotes at end of table.

5,000

28, 667

662, 409
26, 192 120,000 218,085

8,854 226, 939
74, 843 232, 884 313, 567 22, 913 336, 480
142, 076 425, 559 438, 726 38, 733 477, 459
198, 755 604, 209 741, 137 62, 991 804, 128
89, 513 340, 854 496, 211 29, 141 525, 352
64,388 422, 358 773, 457 25, 106 798, 563
120, 177 436, 691 532, 411 33, 728 566, 139
25, 000 92,080 198, 375 6,023 204, 398

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Projected impact of legislative recommendations, fiscal year 1956-—-Federal grants to States for health services and facilities, vocational education,

vocational rehabilitation, and maternal and child health and welfare services (covers 5 programs which will use, if proposed legislation is enucled, the basic allotment formula of the Hospital Construction Act)-Continued

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United States total

$21, 661, 616 Alabama.

764, 542 Arizona

132, 887 Arkansas.

483, 629 California

885, 963 Colorado

190, 345 Connecticut

147, 233 Delaware

104, 999 District of Columbia

122, 678 Florida.

551, 859 Georgia

965, 621 Idaho.

97, 509 Illinois

693, 680 Indiana

503, 921 Iowa

365, 759 Kansas.

276, 843 Kentucky

334, 565 Louisiana

589, 869 Maine

157,369 Maryland

273, 345 Massachusetts

496, 565 Michigan...

694. 674 Minnesota

450, 506 Mississippi

625, 094 Missouri.

560, 876 Montana

81, 729 Nebraska.

182, 364 Nevada

50,000 New Hampshire

80, 229 New Jersey

417, 550 New Mexico.

133, 476 New York

1,062, 697 North Carolina

959, 596 North Dakota

103, 221 Ohio.

772, 920 Oklahoma

445, 261 Oregon

180, 072 Pennsylvania.

1, 205, 038 Rhode Island

96, 264 South Carolina

503, 687 See footnotes at end of table.

+30.8
+37.3
+31.8
+29.9
+23.1
+23.9
+ 13.4
+32.5

+3.2
+28.9
+16.D
+30.4
+16.8
+46.1
+30.8
+34.5
+37.2
+30.9
+35.8
+5.7
+46.9
+27.1
+37.9
+32.9
+33.9
+29.4
+27.4
+43.7
+39.5
+35.2
+21.7
+29.8
+33.3
+23. 1
+43.6
+29.2
+20.1
+31, 4
+25. 3
+28.0

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