THE AMERICAN PUBLIC HEALTH ASSOCIATION INC.. Congressman WILBUR MILLS, Chairman, House Committee on Ways and Means, DEAR MR. MILLS: In the name of the American Public Health Association I wish to bring to your attention one concern of our association relative to H.R. 10032, presently under consideration by your committee. This relates to the proposed authority for welfare departments to provide rehabilitation services to recipients of public assistance. This is the apparent purpose insofar as we are able to interpret the bill. Several alternative mechanisms are outlined in the bill, but the discretion as to choice would be that of the Secretary, Department of Health, Education, and Welfare. We have been increasingly perturbed by the steady fragmentation of health services which are financed in whole or in part by Federal contributions. Re habilitation, it must be remembered, is both a process and an end but aecomplished, in the case of physical rehabilitation, by medical procedures. Most States are currently involved in providing medical as well as vocational rehabilitation to their citizens. It would seem preferable to the American Public Health Association that the bill clearly state that existing State health services, facilities, and resources should be utilized unless service from such facilities and resources are not available or inappropriate. We respectfully request that your committee give consideration to this fundamental point. Sincerely yours, BERWYN F. MATTISON, M.D., UNITED COMMUNITY FUNDS AND COUNCILS OF AMERICA, INC., Hon. LEO H. IRWIN, Chief Counsel, Committee on Ways and Means, MY DEAR MR. IRWIN: I send you herewith a copy of a resolution adopted by the board of directors of United Community Funds and Councils of America on May 6, 1960. You will notice that this resolution expresses the concern of our board of directors with several problems toward the solution of which various provisions in H.R. 10032, now under consideration by the Ways and Means Committee, are directed. It is the earnest wish of our organization that whatever legislation is forthcoming from the committee's deliberations will be designed to deal adequately with these urgent problems. I would appreciate it if you would see to it that the members of the Ways and Means Committee learn of our interest and concern. Respectfully yours, LYMAN S. FORD, Executive Director. POSITION STATEMENT ON PUBLIC ASSISTANCE Approved by board of directors, United Community Funds and Councils of America, May 6, 1960 The board coverage social welfare programs, such as public assistance, are primarily the responsibility of government. Voluntary agencies provide many specialized services aimed at strengthening the family and enriching community life. Thus governmental and voluntary agencies are complementary. Both should build upon the dignity and self-respect of the individual and should develop services for the rehabilitation of those who can become self-supporting, productive members of society. Public assistance programs without arbitrary restrictions such as residence or place of birth should be available in all parts of the country on the basis of need. While public assistance is primarily the responsibility of State and local governments. Federal participation has produced some degree of uniformity throughout the country for specific categories of need. There has been inequity. however, for those needy persons not falling within these categories. The Federal Government should take leadership in studying and seeking, with the several States and voluntary social welfare interests, an equitable and common solution to this problem. Mr. LEO H. IRWIN, COMMUNITY SERVICE SOCIETY, Chief Counsel, Committee on Ways and Means, We are releasing the attached statement, "Public Welfare-A Benefit to All," which represents our views, for your information and reference in considering public welfare issues. ALICE R. MCCABE. PUBLIC WELFARE A BENEFIT TO ALL-A STATEMENT BY THE COMMITTEE ON PUBLIC In its brief history, our Nation has grown to a might and wealth never before known. Freedom and opportunity have challenged the initiative and energies of the people with unmatched effect. For many it is a world in which to succeed; for some it is a world in which to fail. For great numbers it is a life of well-being and fulfillment; for others it is a life of distress and defeat. For all it is a dependence on each to contribute as nearly to capacity as possible if this Nation is to endure and continue to grow. Nothing is so costly as human failure in a world such as this. To the end that these losses be contained and diminished, there are many programs and services. Among these the public welfare program, a giant in size, offers great promise if properly conceived and executed. Public welfare in New York City includes (1) public relief or assistance to individuals and families, (2) care of children in institutions and foster homes, (3) care of persons in public and private homes for the aged, (4) care and custody of juvenile delinquents in local and State facilities, (5) hospital care of indigent persons, (6) medical aid for the medically indigent aging, (7) day care for children, and (8) community recreational programs for the aging. In recent months public welfare has been under attack from some quarters. The chief target has been the public assistance program (item 1 above). It is this aspect of the public welfare program with which this statement is chiefly concerned. WHAT PUBLIC ASSISTANCE IS In 1935 the Social Security Act became Federal law. The Social Security Administration, created by that enactment, maintains a program of partial financial support to the States for assistance to those elderly individuals, those blind, those disabled, and to those dependent children in their own homes who are destitute and in need of outside aid to live. New York State contributes to this program of aid to these four categories of cases, and our local government also shares substantially in the responsibility for the program. New York has a fifth category of general assistance cases, in the home relief program, for whom no Federal aid is provided. This last program is totally supported by the State and city. Nine out of ten public assistance cases in New York City are cases of aged, disabled, or blind persons, or of children under 18 together with the adults caring for them. All of these fall within existing federally aided programs. The largest category of assistance cases is that of aid to dependent children. It is here that children under 18 are granted assistance should they be without parental support due to the death, absence, or physical or mental incapacity of a parent. Assistance also is given in such an instance to a "caretaker" parent or other adult relative who maintains a home for the children. Home relief is a State and local program for those who are destitute but not eligible for one of the federally supported categories. For example, families, in which the fathers' earnings are insufficient even for the necessities of life, may receive supplementary aid under this program. A destitute family, in which the father is temporarily unemployed, may also receive help within this program, if unemployment insurance benefits are insufficient or exhausted and no other resources remain. Over the years there has been much discussion about Federal categorization of assistance. It has been held that it has needlessly elaborated the administration of public welfare and brought about unfortunate rigidities in executing the program. Some experts recommend elimination of categorization; others have proposed a fifth Federal category to bring Federal financial participation into the State home relief program. Meanwhile, as a temporary measure, the Congress last year amended the aid to dependent children program to permit relief payments to families in which the fathers are present in the home, but unemployed and destitute. This amendment was passed as an aid to the States during a phase of higher unemployment. The local government actually administers the assistance program, meeting standards fixed by the State and Federal Government. In New York public assistance largely is administered simply as a program of financial grants. Each applicant must declare his destitution and cooperate in an investigation to certify his eligibility. Of course this investigation must be done thoroughly and competently. Once financial need is established only bare necessities for living are provided. In 1956 the Congress amended the Social Security Act to authorize payments to the States, not only for financial grants, but also for rehabilitation services to aid wherever possible in the prevention of chronic indigence and family deterioration and to assist in the restoration of relief recipients to self-support. This basic and constructive amendment is still without general implementation for lack of appropriated funds and qualified personnel. There has been much talk about the amount by which an assistance grant is increased to a mother on ADC who has another child. Cited here is the weekly budget for a mother with one, two, and three young children.1 1 Budget from 1961 New York City Department of Welfare Allowances, Nov. 15, 1961. The additional weekly grant upon the birth of the second child is $4.25 and upon the birth of the third child, $4.10. Also cited is a case of a family of six on supplementary assistance. The head of the household, a husband and father of four children, earns $50 weekly. This Nation now has had 26 years of experience with the public assistance program and a review at this time seems to be in order. Our own experience in a large voluntary nonsectarian agency suggests that the community must act to strengthen the program and its administration. We are firmly of the view that the public welfare program in the main has met its responsibilities as well as could be expected, considering limited budgets and a narrow conception of function. But much more is now needed in public welfare. This important instrument for helping families in need itself needs support and reinforcement. Communities are faced with great increases in juvenile violations and with substantial numbers of deeply troubled and recalcitrant families, described often as multiproblem or hard-core families. Housing officials are distressed by them, the schools are disrupted by them, the police and courts are busy with them daily. A variety of panaceas are proposed from every quarter, for everyone is concerned. No one should overlook the fact that many of these disturbing individuals and families are public assistance cases. Yet too little has been said and done about broadening the responsibilities of the public welfare department to deal more deeply, more broadly, more effectively with these problems. The public welfare department must rise to this challenge, or at great expense the public will have to expand staffs in public housing, schools, courts, police, corrections. All these in a fragmentary way would then be trying to make up for what the welfare department should be doing and could do best. That the department be able to assume social responsibilities reaching beyond mere certification of financial need, a large, well-trained staff is necessary. This still appears the least expensive way to meet the problems before this city and other communities. We are troubled, too, about decent, honest impoverished persons, about dependent children, about the infirm and handicapped needy who are not getting the aid to which they are entitled-carfares for necessary visits, special school expenses for some, prompt deposits on newly found and scarce apartments. Many families' appeals are neglected until a voluntary agency demands response to legitimate requests. It should not be necessary for a voluntary agency to do these things, and yet it must when the public department is harassed, overworked, with a poorly trained, too small staff hoping here and there over too large caseloads. We are further distressed about the unrealistic, inadequate budgetary standards of eligibility. A number of persons, probably greater than any social agency knows of directly, are denied assistance when on any reasonable standard they are clearly in need of help. For the public welfare department to deal effectively with the problems in public assistance, as they are known to a voluntary social agency, necessitates at this time a redirection in the public program and a budget for a staff adequate in size and quality. PANACEAS WITHOUT REMEDY In recent months many "easy" solutions have been proposed to cut costs, sometimes out of misinformation and sometimes out of a lack of sympathy with public assistance generally. Vouchers, not cash.-It has been said that persons on relief are not capable of handling their own money affairs, and that vouchers, rather than cash, should be given them. In this way, allowances for food could not be misapplied. Nothing in experience supports this proposal as a general policy, and much speaks against it. If there is a problem of mismanagement, it is the occasion to help the family learn how to handle its own affairs. As a rule, it helps not at all to take all responsibility from the family, especially if there is hope of returning the family eventually to independent living. Further, where vouchers have been used, there has been frequent abuse by merchants who cash the vouchers and deduct a "charge." It is to be added that the State department of social welfare may in the uncommon individual instance authorize voucher assistance where this form of help appears necessary. Limit relief to residents.-Each year the State legislature receives proposals to impose a residence restriction on the granting of public assistance. The economy has made it necessary for large numbers of families to move about as industrial conditions change and as labor demands in farming rise and dwindle with the seasons. The constant movement of people, though necessary to our economic well-being, has been misapprehended by some who see great numbers crowding into this State seeking a life of ease and ill-gotten gain at cost to the public treasury and at no cost to themselves. To these observers a residence restriction would discourage movement into this State. It is yet to be demonstrated anywhere that persons in substantial numbers are coming to obtain easy relief money; and to discourage persons to move with labor demands would be economic folly. The problem is a national one, requiring Federal solution. To put the problem in proper perspective: Newburgh, N.Y., has asserted that it has become a victim of large numbers coming there for relief. Actually, in 1960 Newburgh spent $205 for relief for newcomers in the State less than a year. No relief to mothers of illegitimate children.—It is presumed in some quarters that there are some idle women who bear children illegitimately to increase their assistance grants. The budget material above clearly shows how little is to be so gained, $4.10 a week more for the third child; almost anything else would be more profitable. Be this as it may, it also is thought that the threat of removal of the grant if the mother again becomes pregnant would deter a woman from illicit and irresponsible conduct. Penalties would fall heaviest upon the children in the family who would be deprived of support, along with their mother, or would be torn from the home even though this is ill advised on other grounds. To anyone who knows this problem directly this appears no solution, for not everyone is deterred by the possibility of future penalties. Apparently only the law abiding are so deterred. The social problem of illegitimacy is complex and in its causes not related to the availability of welfare grants. Whatever is known about the problem suggests the necessity of close work with unmarried mothers by competent and well-trained personnel. Let the able-bodied work for their relief checks.-A commonly held impression is that there are substantial numbers of employable persons who prefer relief to work and are on the relief rolls. This view is erroneously held. Having alleged that the welfare caseload was swollen with the indolent indigent, the Newburgh administration found only the single case of an employable man who was forced to remain home with his five children during his wife's illness and hospitalization. |