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Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida.
Georgia
Idaho..
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana.
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada.
New Hampshire.
New Jersey
New Mexico.
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island

See footnotes at end of table.

$23,000,000

714, 625
141, 597

455, 223
1, 475, 878

202, 822
260, 282
132, 530
175, 500

638, 345
1, 237, 892

76, 723
1. 056, 146

456, 824
348, 121
278, 972
176, 948
606, 525
115, 634
291, 262
318, 348
859, 304
397, 803
475, 305
558, 701
118, 549
194, 318
30, 885
64, 630
444, 919

137, 713
1, 279, 951

980, 756
109, 988
598, 251
474, 446

261, 139
1, 411, 494

102, 575

$163, 990, 618

5, 282, 095
1 080, 770
3, 405, 103
7, 715, 222
1, 522, 950
1, 601, 103

765, 463
1, 059, 046
3,952, 263
6, 474, 327

870, 218
6, 416, 059
3, 477, 335
2,784, 493
2, 101, 761
4, 324, 441
4, 163, 663
1, 144, 115
2,656, 715
3, 344, 966
5, 635, 465
3, 142, 093
4,365, 857
3,982, 130

843, 157
1, 473, 332

657, 565

751, 086
3, 266, 998
1, 128, 330
8, 522, 752
6, 744, 444

957, 265
5, 921, 444
3, 162, 510
1, 621, 809
9, 114, 951

890, 793

28. 2
33. 6
24.8
22. 2
21.1
14.4
39.8

7.7
19.2
14.2
31.5
14.9
38.1
25.8
30.3
29.1
23. 2
31.9

.7
27.9
22. 2
31.5
25. O
27.7
37.3
27.0
47.5
40.9
25.6
24.1
12.1
28. 2
27.6
32. 6
23.8
22.5
24.8
26.4

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I. I thought that might be along the line you were

1,097, 700

107, 500
358, 700
128, 500
509, 800

135, 200

88, 600
469, 700

Public health

grants

00.

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az I have one other question. I know most poor
- voking for money and searching for money. Do
of danger in this in that there is any tendency to
a percentage of support into these poor States, or
oyut the approval of the Department ?
. It would depend on the level of the appropria-
re? The level in support and in extension and im-
yerial projects.

That is the tendency for local governments to get saya yg costs on somebody else's back.

I think the Secretary's point is very important. 2. 20 sar over how much it gets in support grants, - till determine what funds will be allocated to "ne-part grant program. Then the money would

to the Hill-Burton formula, so that it would go ill get their share automatically. *2 Take that list with Public Health on it. Would

Twithin the State of making a plan within the ple, to channel its funds more into its operating was under general health, than it would be in the have termed categorical! Let us say in research,

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Piscal year 1955: State breakdown of proposed grants to States in 1955, assuming enactment of proposed legislation for programs which will use,

i proposed legislation is enacted, the basic allotment formula of the Hospital Construction Act- Continued

$17.500.000 estimated in a

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759,94
3, 543
166, 620

680 280 1

100,000

2 That would really be up to the State health offilappuse, working with the governor and the county

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Iris a great temptation, though, to get rid of some alle any control or possibility of reviewing those ver. I will let Dr. Scheele answer that particularly; * the State plan. I would like him to simplify that

. - Tye States would be required to submit their plans Polieve our working relationship with them is such with them on a friendly basis and avoid that very

You recognize there is always that possibility.
Pasir

. This has always been a problem and it is a We have $10 million in the general-assistance grant, We found them very good about not using that

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E-tint fins lon 1911s for all tinent grants to states
1935 Bulut oli'. Till stats and cinnt 1on basis of current lormulae
• Excludes $1.5%., "prextielund B" for allotinents for secial projects, contained in

Tentstive alone w
Health Siriine Art in mented

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at with that money today. So this is not new, but it se bands from, and also in the budgets in TB and venereal

et certain administrative expenses they wanted and the bars on this chart show they have been in

State

x State and local money into those special programs.

See footnost end of table

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That is right. They are actually overmatching and will very much to public health.

Toenal grant to cover those programs which are testify later on this. It is the statement for the

-ht that might be along the line you were

ne other question. I know most poor or money and searching for money. Do er in this in that there is any tendency to lage of support into these poor States, or ne approval of the Department? ould depend on the level of the appropria'he level in support and in extension and imal projects. it is the tendency for local governments to get y costs on somebody else's back. I think the Secretary's point is very important. no say over how much it gets in support grants, Ś will determine what funds will be allocated to iree-part grant program. Then the money would ng to the Hill-Burton formula, so that it would go would get their share automatically. R. Take that list with Public Health on it. Would bility within the State of making a plan within the cample, to channel its funds more into its operating y, perhaps under general health, than it would be in the ich you have termed categorical? Let us say in research,

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EFELLER. That would really be up to the State health offimine, I suppose, working with the governor and the county ople. ir Cooper. It is a great temptation, though, to get rid of some operating costs. Id you all have any control or possibility of reviewing those

ams?

situation happening

cretary Hobby. I will let Dr. Scheele answer that particularly; he does review the State plan. I would like him to simplify that. Dr. SCHEELE. The States would be required to submit their plans for approval. I believe our working relationship with them is such that we could talk with them on a friendly basis and avoid that very Senator Cooper. Yon recognize there is always that possibility. Dr. SCHEELE. Yes, sir. This has always been a problem and it is a problem today. We have $10 million in the general-assistance grant, and they can do it with that money today. So this is not new, but it is an old problem. We found them very good about not using that money just to cover up certain administrative expenses they wanted to relieve State funds from, and also in the budgets in TB and venereal terested in getting State and local money into those special programs.

The white parts of the bars on this chart show they have been inMr. ROCKEFELLER. That is overmatching. just won't use the Federal grant to cover those programs which are

Dr. SCHEELE. That is right. They are actually overmatching and not going to add very much to public health. Someone is going to testify later on this. It is the statement for the Senator COOPER. The reason why I asked that is for this reason:

disease and mental health.

I think there is some evidence.

Fiscal year 1933: State breakdowon of proposed grants to Statos in 19.53, assuming enactment of proposed legislation for programs which

erill use, if proposed legislation 18 enacted, the basic allotment formula of the Hospital Construction Act-Continued

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11, 246, 256
1. 27, 9:30
1,004, 399
5, 791, 246
2, 606, 003
3,749, 482
4, 295, 760
1, 040, 233

982, 521
1, 123, 031
5,583, 154

578, 582

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174,527
WW2, 279

392, 328
582, 771
188,654
129, 654
158, 654
538, 626
40,000

l'uerto R.
Virgin Islands

137, 341
354, 490

78,156
52, 440
146, 995
394, 338

103, 456

724, 663

939, 549
4, 298, 902

269, 080

"It is assumed that these programs, remmen led by the President, will become effec-
tiron Jul 1.174.17 off. - 1457 * re vmider det

Tit! all !!!,I* * I, od 1955 bulet estimate under title VI of the Pulic
Hralt! ! linii

E-m' I slim!. 10minuts for allt nyt grants to stales Included in
193 Bulirt oli non minut. 1o' loss of current formular

Frilules $1.**.500 "rrerie und B" bor botinents for serial projets, contained in

1955 Budget of the United States under present title V of the Social Security Act, as
urnenied

* Assumes $3 million special project grant distributed on basis of population for "sub-
stollal nationwide expansion" and excludes $500,000 for grants on an individual project
Basis

Includes $7,138,330 permanent appropriation under Smith-Hughes Act, and
$17.500.000 estimated in 1953 Budget of the United States under the (feorge-Barden Act.

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vid very much to public health. ping to testify later on this. It is the statement for the me. The reason why I asked that is for this reason: e Peleral grant to cover those programs which are

Dat is right

. They are actually overmatching and

per ne State and local money into those special programs. auto of the bars on this chart show they have been in

from, and also in the budgets in TB and venereal fire up certain administrative expenses they wanted

We found them very good about not using that **th that money today. So this is not new, but it To have $10 million in the general-assistance grant, im-it. This

has always been a problem and it is a Fou recognize there is always that possibility. si rith them on a friendly basis and avoid that very

were our working relationship with them is such 2. Dom States would be required to submit their plans of the State plan. I would like him to simplify that. wer. I will let Dr. Scheele answer that particularly;

ate any control or possibility of reviewing those 12 kr in a great temptation, though, to get rid of some 1.pie, working with the governor and the county

perial projects. 22 That would really be up to the State health offi

are termed categorical? Let us say in research, pups under general health, than it would be in the ople to channel its funds more into its operating

within the State of making a plan within the Take that list with Public Health on it. Would vuld get their share automatically. as to the Hill-Burton formula, so that it would go "Pre-part grant program. Then the money would

will determine what funds will be allocated to .. 10 say over how much it gets in support grants, 1. I think the Secretary's point is very important. ***ing costs on somebody else's back.

That is the tendency for local governments to get up? The level in support and in extension and im:. It would depend on the level of the appropria

put the approval of the Department?
-1 percentage of support into these poor States, or
vizs danger in this in that there is any tendency to
risking for money and searching for money. Do
z I have one other question. I know most poor

a

Ii. I thought that might be along the line you were

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health people.

Senator PURTELL. I thought that might be along the line you were talking about, Senator.

Senator Cooper. I have one other question. I know most poor States are always looking for money and searching for money. Do you think there is any danger in this in that there is any tendency to channel too large a percentage of support into these poor States, or could they do it without the approval of the Department? Secretary Hobby. It would depend on the level of the appropriation, Senator Cooper. The level in support and in extension and improvement, and in special projects.

Senator Cooper. That is the tendency for local governments to get some of their operating costs on somebody else's back.

Mr. ROCKEFELLER. I think the Secretary's point is very important. The State really has no say over how much it gets in support grants, because the Congress will determine what funds will be allocated to that phase of the three-part grant program. Then the money would be divided according to the Hill-Burton formula, so that it would go to them and they would get their share automatically.

Senator COOPER. Take that list with Public Health on it. Would there be a possibility within the State of making a plan within the State? For example, to channel its funds more into its operating costs, let us say, perhaps under general health, than it would be in the programs which you have termed categorical? Let us say in research, perhaps?

Mr. ROCKEFELLER. That would really be up to the State health officer to determine, I suppose, working with the governor and the county

Senator Cooper. It is a great temptation, though, to get rid of some of those operating costs.

Would you all have any control or possibility of reviewing those programs!

Secretary Hobby. I will let Dr. Scheele answer that particularly; but he does review the State plan. I would like him to simplify that.

Dr. SCHEELE. The States would be required to submit their plans for approval. I believe our working relationship with them is such that we could talk with them on a friendly basis and avoid that very situation happening. Senator Cooper. You recognize there is always that possibility. Dr. SCHEELE. Yes, sir. This has always been a problem and it is a problem today. We have $10 million in the general-assistance grant, and they can do it with that money today. So this is not new, but it is an old problem. We found them very good about not using that money just to cover up certain administrative expenses they wanted to relieve State funds from, and also in the budgets in TB and venereal disease and mental health.

The white parts of the bars on this chart show they have been interested in getting State and local money into those special programs. I think there is some evidence. Mr. ROCKEFELLER. That is overmatching. Dr. SCHEELE. That is right. They are actually overmatching and just won't use the Federal grant to cover those programs which are not going to add very much to public health. Senator COOPER. The reason why I asked that is for this reason : Someone is going to testify later on this. It is the statement for the

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