3, 511, 822

4, 295, 760

4,453, 668

5,000

134,856

703, 238

1,040, 233

978, 135

+39.1

Fiscal year 1955: State breakdown of proposed grants to States in 1955, assuming enactment of proposed legislation for 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 assumptions, the fiscal effect of proposed new legislation covering Federal grants-in-aid for health services and facilities
Vocational edation, vocational rehabilitation, and maternal and child health and welfare services. The assumptions are: (1) That the sums to be appropriated in 1955 are the same
as those contains 1 in the Presl lent's budget for 1955; (2) that the President's legislative recommendations will be enacted and effective on the dates indicated by the appropriate
footnotes. 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 States.

46293-54-pt. 1—19

Senator COOPER. I know. Any place in the United States.

Mr. ROCKEFELLER. The money would go to a specific project or a specific program in a State, and only after the State health officer had been consulted, so that he was in concurrence with the allocation. But there would not be a general distribution of the funds to States. Senator COOPER. There is no formula. It is just a matter of determination by the Department.

Mr. ROCKEFELLER. That is correct.

Senator COOPER. Take the next one. Extension and improvement. Suppose you had $25 million appropriated by the Congress for that, I understand that the apportionment to the States would still be based on the population formula.

Mr. ROCKEFELLER. Exactly.

Senator COOPER. In the States you have a

Mr. ROCKEFELLER. A State plan.

Senator COOPER. Seventy-five percent and twenty-five percent.
Mr. ROCKEFELLER. Seventy-five, fifty, and twenty-five.

Senator COOPER. Over a 6-year period.

Mr. ROCKEFELLER. That is correct. But each year there would be new money available to the State.

Senator COOPER. Now, the support is the one I really wanted to inquire about. I do not understand the formula. Assume $65 million is appropriated by the Congress for support. The formula is changed from the present formula.

Mr. ROCKEFELLER. The formula is changed.

Senator COOPER. That applies to all of your grant-in-aid programs. Mr. ROCKEFELLER. The Secretary will be back tomorrow recommending or supporting legislation on vocational rehabilitation, and you will find the same formula recommended there.

Senator COOPER. Without going into the details by which you arrived at the apportionment to the State, the theory is that the larger States now would receive smaller amounts and the poorer States would receive perhaps larger amounts.

Mr. ROCKEFELLER. We did not develop a formula in the Secretary's office. This was a formula which, I think, one of your committee members is importantly responsible for having developed, Senator Hill. It is a formula on which I know Senator Taft spent a great deal of time. It is apparently the formula which the States feel across the board most effectively reflects what is sometimes called equalization to give special help to those States which have a lower per capita income.

Senator COOPER. I am not from a rich State, but supposing you had a State like New York or Massachusetts, one where there are great hospitals and where they have perhaps started great programs in mental health, cancer, and heart disease. This would mean, I assume, that those States would receive smaller sums.

Do you think that this would affect the programs which they may have already instituted in such fields?

Mr. ROCKEFELLER. I think this chart here is the best answer. The matching formula, as it now exists, is two Federal dollars to one State dollar. This is the average Federal contribution to State and local contributions in the 48 States for general health. Therefore, it would be clear that the wealthiest States would be spending far more or a far larger proportion of Federal to State funds than the average.