Note: These totals do not include funds for special project grants which are intended to be expended at the State and community levels but are not allocated among the States on a formula basis. The assumed amounts of these special project funds which will augment the amounts allocated by formula, as shown in this table, are as follows: Public health, $1,946,000; maternal and child welfare, $3,000,000; vocational rehabilitation, $1,000,000, and vocational education, $1,231,917. 31, 500 It is assumed that these programs, recommended by the President, will become effective on July 1, 1954 (start of fiscal year 1955) as recommended. It is assumed that these programs, recommended by the President, will become effective on July 1, 1955 (start of fiscal year 1956) as recommended. 27, 026 495, 355 3, 511, 822 4, 295, 760 4,453, 668 129, 856 +26.8 5,000 134,856 703, 238 1,040, 233 978, 135 +39.1 104, 356 5,000 109, 356 724, 663 982, 521 918, 322 129,856 +26.7 5,000 134,856 939, 549 1, 123, 031 1,064, 486 +13.3 581, 564 16,884 598, 448 4,298, 902 5, 583, 154 2,500 34,000 269, 080 578, 582 Fiscal year 1955: State breakdown of proposed grants to States in 1955, assuming enactment of proposed legislation for programs which will use. 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 46293-54-pt. 1—19 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-Continued 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. 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. |