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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.

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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.

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

Import ant. 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 elisation, vo ation al 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 Prost 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.

Hospital construction program

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if proposed legislation is enacted, the basic allotment formula of the Hospital Construction Act—Continued Fiscal year 1955: State breakdown of proposed grants to States in 1955, assuming enactment of proposed legislation for programs which will use,

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Senator COOPER. I know. Any place in the United States. have in your general beati prgmans rd to Mr. ROCKEFELLER. The money would go to a specific project or axial thay dass the Falera specific program in a State, and only after the State health officer had percent of their total expenditures, so Lâ been consulted, so that he was in concurrence with the allocation. But-factor really in the big States as far as the 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.

It is an important factor because any namer but it is a relatively small factor. However,

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.

But each year there would be

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. 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 recom mending 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 far larger proportion of Federal to State funds than the average.

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am thinking of a situation where, because of the have, they probably have more advanced proThen, in a State like Wyoming do you think funds which would probably result from the

i would possibly affect the programs which can arried on successfully in those larger States where tal facilities, like cancer control?

I think the answer would be "Yes," if there Sport program based on the equalization formula al Survey and Construction Act. However, that The extension and improvement grant is allobasis. Therefore the big States would get more gr population, and that money would be applied their program. So that they will benefit proer because of the larger populations that they

ma balance.

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