U.S. Department of Health, Education, and Welfare Annual Report 1966 [U.S. Department of Health, Education, and Welfare Annual Report 1966] [From the U.S. Government Publishing Office, www.gpo.gov] Annual Report U.S.DEPARTMENT OF H E ALTH, ED U C ATI 0 N, A N D WELFA R E m/ V\ \z / iZ a ( \ > i ([■ J' ;|H ) °) \t\M VLAd/ M WXzvAA/X?/ S-K^Z 285172 %%. 7 ' s $ 99>i."""BIB 1111 tBOlillif g/ / । /ne* I \ / / k I / k rL.A j >M«/O ! \\ \/J 4 P* -----1_____________y\__Z-yr^AR-^' \ \ ! ' N / --OKLA;; - . ; I \ \ X ; / |TEXAS~~1 (ARKANSAS ^/TeNNESSEE \ \ \ > / ! I /______— ( \ i__( I । L I /^"F1 y\_^x r7 '. / I ___! / \ rfMlantaS^ J - 5—r-^A\X / ; x*'. / ! \ \ X } _____ ___________V__ ALASKA HAWAII viii Contents Page The Secretary's Report....................................... 1 Social Security Administration............................... 5 IFelf are Administration.................................... 33 Public Health Service....................................... 71 Office of Education........................................ 129 Food and Drug Administration............................... 191 Vocational Rehabilitation Administration................... 215 Administration on Aging.................................... 227 Saint Elizabeths Hospital.................................. 235 Surplus Property Utilization............................... 245 American Printing House for the Blind...................... 247 Gallaudet College.......................................... 249 Howard University.......................................... 251 A detailed listing of the contents of this report, by topic headings, will be found on pages 255—262. ix DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE ★ indicates appointment during fiscal year 1966 (see “The Secretary’s Report”). _________ I* SECRETARY ^SPECIAL ASSISTANT __ UNDER SECRETARY mSiinKi FOR CIVIL RIGHTS L. | --- M (PublicAffairs) ASSISTANT TO _J __* OFFICE OF THE SECRETARY ------ PUBLIC INFORMATION --------- OFFICE OF FIELD__ __________ COORDINATION —I_____,--l , I ,, I , , I I ,, I ,, I ASSISTANT * ASSISTANT * ASSISTANT » ASSISTANT * ASSISTANT * ASSISTANT SECRETARY SECRETARY SECRETARY SECREIART SECRETARY GENERAL SECRETARY rnypiDniiFR “ ‘ (MMOoil H’lWA"' COUNSEL FOR COMPTROLLER lHlcalil111) (Legislation) |stitntilic Affairs)! Familf Seriices) Ccarrlination] _ |aOMINISTRAI!!)n| _ OPERATING AGENCIES ■ I . I , I .. 1—~ I I 1,1 ADMINISTRATION PUBLIC NEALTN * OFFICE Of sKlTlflRN FlininNt FOO" *N" JrNBITV WELFARE W Ml*8 SE,tlct EDUCATION | ADMIHISTRATIOn| HOSPITAL |aDMINISTRATIOn| ADMINISTRATION! ^MINISTRATION X The Secretary’s Report Organizations are no better than the people who make them up— and particularly no better than the people who head them. Accordingly, one of the most important things that happened to the Department of Health, Education, and Welfare during the year was a series of new appointments at the top levels of the organization. Of the 23 top posts on the organization chart, 15 incumbents were appointed during the year. These new appointments reflect the outstanding characteristic of 1966: it was a year of unparalleled growth and change. Every agency and almost all the programs of the Department felt the impact of this change. The historic flood of legislation of 1965 included some 30 major acts to establish or expand programs in health, education, vocational rehabilitation, consumer protection, welfare, and social security. Among these were many of the most innovative programs of the Great Society. Organizing for the new programs and putting them into operation represented an enormous challenge to the Department. President Johnson said, for example, that preparations for the launching of medicare constituted the greatest civilian management effort in the history of this country. The work involved in getting the huge programs of the new Elementary and Secondary Education Act underway was almost as impressive. The pages of this annual report reflect the scope of these efforts. The sheer size and scale of the new assignment led to major organizational changes, within the Office of the Secretary and in the operating agencies. They also gave renewed emphasis to the essential unity of the Department’s mission and programs. To help coordinate these programs and to strengthen the administrative capacity of the Office of the Secretary, Congress authorized four new Assistant Secretary posts: for Program Coordination, Health and Scientific Affairs, Education, and Individual and Family Services. This in turn gave rise to a thoroughgoing reexamination of the Department’s pattern of organization. Among the important organizational changes were: • A new Water Pollution Control Administration was created as a separate agency within the Department, following the enact- 1 2 Department of Health, Education, and Welfare, 1966 ment of the Water Quality Act of 1965. Before the year was out, however, the new agency was transferred to the Department of the Interior. • Under authority provided in the Older Americans Act of 1965, a new Administration on Aging was created on July 14, 1965. • Major reorganizations were carried through in the Office of Education, Public Health Service, and the Food and Drug Administration. Authority to reorganize the health activities of the Department required legislative approval. This was obtained in * Reorganization Plan No. 3 of 1966, which the President submitted to the Congress on April 25 and which went into effect on June 25. The leadership, policy guidance, and coordinating functions of the 4 Office of the Secretary were also enhanced by a series of significant organizational measures. For example, the most demanding and controversial task carried through by the Department during the year consisted of its duties in bringing about compliance with title VI of the Civil Rights Act of 1964. To perform this task, the civil rights activities of the Department were completely reorganized. The post of Special Assistant to the Secretary for Civil Rights was created to coordinate the activities of the equal opportunity offices which were established in the agencies. That the Department rose to the challenge is demonstrated, for example, by hospital compliance figures under medicare: On July 1, 1966, when medicare went into effect, 6,418 general hospitals, representing 95.2 percent of the Nation’s hospital beds, were in compliance with title VI and were eligible to participate in the program. Only 350 hospitals, concentrated largely in five States, were unqualified. Another important step consisted of strengthening the field operations of the Department. With the extraordinary growth of HEW it became increasingly clear that the field organization had to be strengthened and given greater scope for effective decisionmaking at the local level. Only in this way is it possible to obtain an appropriate degree of responsiveness to local needs, and an adjustment of our programs to fit the special requirements of each area. Furthermore, the coordination of Federal programs (either within HEW or among Federal agencies generally) at the local level is impossible unless there is strong field representation at that level among each of the agencies involved. These were among the considerations that led to the reorganization of the Office of Field Administration and to its redesignation as the Office of Field Coordination. In another organizational reform, the budget functions were lifted out of the Office of Administration and placed under the newly created post of Comptroller. The Secretary’s Report 3 Action was also taken to improve the Department’s public information operations. For some years the Department had functioned under a tightly centralized information setup which required clearance of publications and press releases in the Office of the Secretary. After a thorough study of this operation, the existing system was abolished and the major responsibility for information policy and practice was decentralized to the operating agencies. One of the most important moves made during the course of the year was the appointment of the Assistant Secretary for Program Coordination, whose task is to create a program planning and budgeting system for the Department of Health, Education, and Welfare. In addition to his responsibilities for installing such a system, the new Assistant Secretary is initiating the kinds of research which will make it possible to proceed more intelligently in setting departmental goals and evaluating programs. The theme of coordinated effort ran through all our activities for the year. It was a major consideration in the reorganizations which took place and was strongly emphasized in launching the new programs. The heads of HEW operating agencies have shown an extraordinary willingness to work collaboratively toward common goals. For example, shaping the medicare program involved wholehearted and impressive collaboration between the Public Health Service and the Social Security Administration. Other new programs required equally close and sustained cooperative endeavor. As the year ended, there was every indication that cooperation between the Department’s constituent agencies was no longer an unsolved problem. They had proved their capacity to work together continuously and effectively. Two problems of coordination remained on our agenda: (1) Teamwork with other Federal departments; and (2) coordination at the community level. A number of positive steps were being taken (such as the above-mentioned improvements of HEW field operations) to remedy this situation. By the end of fiscal year 1966, the Department of Health, Education, and Welfare was operating more than 200 separate programs which in one way or another touch the lives of every American. It was responsible for administering a budget of $9.9 billion. Few of HEW’s programs are carried out entirely by the Federal Government. Well over 90 percent of the Department’s funds are allocated to non-Federal agencies, institutions, and individuals. The work of HEW, in brief, is built on a series of partnerships between the Federal Government on the one hand, and State, local, and nongovernmental groups on the other. The goal of HEW is to strengthen those partnerships, at every level, in the interest of a better life for each individual in our society. 4 Department of Health, Education, and Welfare, 1966 Table 1.—Grants to States: Total grants under all Department of Health, Education, and Welfare programs, fiscal year 1966 [On checks-issued basis] Welfare Vocational Ameri- States Public Rehabili- Adminis- Total Administra- Health Office of tation tration Printing tion Service Education Adminis- on Aging House tration for the Blind Total $5,855,446,472 $3,728,775,223 $386,293,681 $1,581,585,474 $156,526,371 $1,330,723 $935,000 Alabama 163,940, 828 95,848, 779 12, 089, 241 836, 784 2,893, 372 6,725,535 23,156,121 5,126,874 2,352, 499 50,586,620 15, 791,195 23, 939, 716 26,746,803 144, 244, 222 22,602, 085 13,891,767 5,398, 017 496,399 2, 080,602 5,134,600 10,430, 084 2, 331,490 1, 535,574 18,171 201 8,483 10,541 88,897 11,847 20,380 Alaska 20, 213,801 3, 089, 222 22,108, 549 57, 614, 371 579, 726,310 56,888,493 41, 340,814 Arizona 51, 030,722 Arkansas 96,308,350 757,727,134 86,985, 504 59,149, 534 12, 339,442 76,500 81,500 24,715 8, 500 California Colorado Connecticut Delaware 5,447,978 1,476,177 5, 036,631 349, 219 26,827 2,610 District of Columbia 32,338, 360 17, 742,427 3, 790,381 9,323, 037 1,480, 206 6, 029,327 8,456,302 870,916 450,614 6, 228, 350 1, 336, 607 2,101, 648 2,309 27,407 22,488 3,363 1,405 43,921 18,472 13,151 Florida . _ 151,468,646 171,355,731 25, 090,139 20,857, 581 88, 313, 520 97,172,957 8,821,941 11, 023,825 163,435,870 35, 009,175 41,441,273 11,968,194 10, 702,109 3, 547, 712 2, 058,370 11, 086, 870 6, 226, 215 6, 754, 233 44,994,200 54,901,395 11,830, 264 7,323,367 51,141, 531 29, 939, 716 26, 031,855 135,998 100,480 15,943 Georgia .. Hawaii Idaho__ - Illinois 231, 936, 542 72, 530,185 Indiana... Iowa 76, 350,160 8, 000 Kansas .. 64, 635, 071 36,126, 307 4, 081, 253 23,277, 814 1,117,827 14,352 17; 518 Kentucky 139, 868, 899 94, 574, 739 13,316,364 29, 741,622 18, 266, 089 10,488, 637 31,539, 322 30,846, 624 2, 224,227 4,467,960 589,372 2,466,423 2,745, 243 IL 947 16,816 3,162 24,094 31,774 Louisiana. 180, 705, 452 31, 909,148 147, 364,899 18, 004, 917 47,498,154 115,545,452 10, 559,563 2,823, 060 5, 612,883 9,492,387 30,125 Maine Maryland 87,195,541 158,683, 305 54,665 21,825 Massachusetts... Michigan.. 173, 064, 781 106, 737, 739 115,104, 576 78,617, 019 13, 233, 727 7, 617,159 7,177, 035 10,187,919 2,185,194 3,359, 058 40, 789,426 18, 250, 242 26, 068, 077 31,983,178 8,236, 033 14,600,206 3,832,859 2, 238,361 2,452, 895 2,779,359 495,172 766, 544 67i 600 36', 593 14,958 10, 290 13,954 2,911 5,873 Minnesota Mississippi 87,808, 917 52,100, 620 Missouri.. . __ 148,306,828 20,516,217 39,423,294 103,335,168 9,595,237 20,688,488 7,250 1,670 3,125 Montana.. ... Nebraska. Nevada 13,822,922 5,825,862 597,061 6,813,687 584,204 2,108 New Hamp- shire. _ .. 15,050, 543 5,761, 000 64,117,361 3,162,910 12,335,089 5,861,148 48,980,182 261,469 3,254,063 4,016 38,601 New Jersey New Mexico New York _. 128,785,296 50,682,798 487, 667,137 158,304,191 60, 000 14,560 47,499 24,715,104 364,502,218 83,390, 017 2,839,549 25,390,507 13,533,318 22,530,762 86,465,723 55,707,873 578,004 11,170,837 5,645,877 727,583 4; 819 90,353 27,106 1,958 North Carolina. North Dakota.. Ohio 23,882,426 204,313,320 160,537,922 12,580,725 126,923,930 114,361,415 2,291,882 16,760,255 6,520,851 8,279,643 56,381,539 36,708,364 635 40,868 52,436 4,164,112 2,887,578 42,616 7,278 Oklahoma Oregon ... 49,337,497 30,395,228 171,798,135 4,770,042 23,749,525 12,467,508 47,530,274 1,691,266 13,656,486 13,453 64,652 Pennsylvania... 256,894,422 95,350 Rhode Island... 33,753, 022 18,473,686 4,672,911 9,314, 544 1,197,348 88,610 5; 923 South Carolina.. 73,196, 048 28,597,389 9,441, 219 31,592,966 3,553,331 813,551 11,143 3, 012 17,619 37,697 South Dakota... 22,732,432 10,580,151 1,427,759 9,907,959 Tennessee 124,304,122 317,687,195 64, 661,767 191,229,823 9,357,424 21,082,894 46,330,191 99,631,063 3,862,121 5,626, 002 75, 000 79,716 Texas _ _ Utah.. 33,179,139 16,385,370 2,625,608 13,401,020 711,328 50, 994 4; 819 Vermont 13, 641,766 89,294,167 7,682,276 32,481,704 61, 042,274 1,824,850 10,084,768 5,789,960 3,682,233 42,892,012 26,380,410 430,007 3,812,141 2, 243,234 21; 245 L 155 23,542 15,611 Virginia.. ... Washington 95,472,852 1,363 West Virginia... 82,272, 039 47,340, 530 6,686,088 6,113,292 23,525,805 4,705,109 4,230,493 14,507 12,951 Wisconsin. 74,163,927 48, 652,912 15,130,907 23,372 Wyoming 11,043,643 5,105,936 1,003,045 4,431,020 297,185 501,986 1,656 100 Canal Zone. _ _ 297,285 Guam 1,953,441 435,630 198,909 9,372, 594 1,226,430 23,958,374 92,472 2,627,114 87,773 Puerto Rico 64,233, 092 28,270,241 4,769 Virgin Islands.. 1,900,947 728,848 318,912 765,414 Wake Island 325,329 325,329 181,820 18,472.415 Trust territories. 181,820 Undistributed.. 1,942,119 845,389 16,093,830 3,475,315 Social Security Administration Introduction The Social Security Administration administers the Federal social security program, which provides retirement, survivors, and disability insurance, and health insurance for the aged. This program today is firmly established as the basic method in the United States of assuring income to individuals and families when workers retire, become disabled, or die. More than 9 out of 10 people in paid employment and self-employment are covered or eligible for coverage under the program. The provisions of the Federal Credit Union Act are administered by the Social Security Administration’s Bureau of Federal Credit Unions. Under the Federal Credit Union program, groups may secure Federal charters for credit unions. A Federal credit union provides for its members an outlet for investing their savings and a source from which they may borrow easily and at reasonable rates of interest. Developments in Social Security About 83.5 million people contributed to social security in calendar year 1966. Today, 95 out of 100 mothers and children are protected against the risk of loss of income from the death of the family breadwinner. The survivorship protection alone, as of January 1,1966, had a face value of about $700 billion. About 21.7 million men, women, and children—one out of every nine persons in the country—were receiving monthly social security benefits as fiscal year 1966 ends. The beneficiaries include about 14.6 million retired workers and dependents of retired workers, 1.9 million disabled workers and their dependents, and 5.2 million survivors of deceased workers. Of all those who were 65 or over at the beginning of 1967, 89 percent were receiving benefits or were eligible to receive benefits when they or their spouses retire. The proportion of the aged who have this protection increases as time goes by because more people have the opportunity 5 6 Department of Health, Education, and Welfare, 1966 to work in covered employment long enough to be insured. Of those who reached 65 in 1966, 92 percent were eligible for social security cash benefits. Projections into the year 2000 indicate that 96 percent of all aged persons will by then be eligible for benefits under the program. About 19 million people were 65 or over when the health insurance plan enacted in July 1965—popularly known as medicare—went into effect. Nearly all of them were eligible for basic hospital benefits when the program began in July 1966, and more than 90 percent of them had also enrolled for the voluntary supplementary medical insurance which the law provided. What the Program Did in Fiscal Year 1966 Beneficiaries and Benefit Amounts Retirement, survivors, and disability benefit payments in fiscal year 1966 totaled $19.8 billion—19 percent more than the amount paid dur- CHART 1.—21.7 MILLION BENEFICIARIES Numbers by type of beneficiary are in thousands June 1966 Disabled Workers 1,050 Young Widows 480 Wives and Children of Di sabled Workers ______836 Women Workers Retired 4,473 Men Workers Retire -------- 6,987 Wives of Retired Workers 2.64K W i do w s 2,503 — Parents -35 Chi Idren of Retired and Deceased Workers 2,731-^___________ Social Security Administration 7 ing the preceding year. This increase was due partly to the retroactive payment in September 1965 of monthly benefit increases provided by the 1965 amendments for the January-August period. Benefit payments to disabled workers and their dependents were $1.7 billion, 24 percent higher than in fiscal year 1965. Monthly benefits paid to old-age and survivors insurance beneficiaries rose 19 percent to $17.8 billion, and lump-sum death payments amounted to $224 million—about $6 million higher than in the previous fiscal year (chart 2). More than 4.1 million new monthly benefit awards were made in the fiscal year, 943,000 more than the previous record number awarded in 1962. New highs were set for awards of old-age benefits (1,728,000), child’s benefits (1,113,000), and widow’s or widower’s benefits (437,000). CHART 2.—BOTH BENEFIT PAYMENTS AND NUMBER OF BENEFICIARIES HAVE INCREASED RAPIDLY SINCE 19501 Billions of Dollars Millions 25 ------------------------------------------------ 24 ----------------------------------------------------------- Dependents of ___ Disabled Beneficiaries 20 ---------------------------------q—------------- 20------------------------------------------ _____- Disabled Workers ' _____ 16 ---------------------—£| - 16 --------------------------------— — _ . . ourvivors and m ’ Dependents ------ ^2% ___ ■ ^5 or Over m 12----------------------tT 12 \ Children \ and Young 46% %% --- Widows 8 ---------------- ------------------------------- — ---- Retired 4 %% Worker H □ 0 LI.................i. I.. I I I I I I I...________________ □ o II II — •50 ’55 "60 ’65 50 55 60 65 FISCAL YEARS Annual Payments 2 Beneficiaries 3 1 The 1950 amendments made major improvements in the program. 2 Payments in fiscal year. Includes lump-sum death payments. 3 Beneficiaries on the rolls at the end of the fiscal year. 4 Part of the increase in 1966 was due partly to the retroactive payment in September 1965 of monthly benefit increases for the January—June 1965 period. The record number of awards was due mainly to (1) the estimated one-half million benefits awarded to persons 65 and over who had not yet retired but who filed applications to establish entitlement to OASDI benefits in order to qualify for hospital insurance benefits, and (2) awards to persons who qualified for benefits under the 1965 amend- 237-319—67----2 8 Department of Health, Education, and Welfare, 1966 ments, including 527,000 student child’s benefits, 158,000 actuarially reduced widow’s benefits, and 123,000 benefits awarded under the transitional insured status provision, which makes benefits possible for many people 72 or older who had not worked long enough to qualify under the old law. From September 1965 through June 1966, over 855,000 monthly benefits were awarded to persons who qualified solely as a result of the 1965 amendments. The number of monthly benefits in current-payment status increased by 1.6 million (8 percent) to 21.7 million (charts 1 and 2) during the year, and the monthly rate rose $223.7 million (16 percent) to almost $1.6 billion. The sharp increase in the monthly rate was due in part to the higher benefit scale provided in the 1965 amendments. Other factors were (1) the normal growth in the beneficiary rolls, and (2) awards to persons who became entitled to benefits solely as a result of the 1965 amendments. In June 1966 the average old-age benefit being paid to a retired worker who had no dependents also receiving benefits was $80 a month. When the worker and his wife were both receiving benefits, the average family benefit was $142. For families composed of a disabled worker and a wife under age 65 with one or more entitled children in her care, the average was $211; and for families consisting of a widowed mother and two children, the average benefit was $219. The average monthly benefit for an aged widow was $74 in June. The great majority of people now going on the benefit rolls have their benefits figured from average earnings since 1950 instead of since 1936. Among beneficiaries on the rolls at the end of June 1966 whose benefits were based on earnings after 1950, the average family benefit being paid was $88 for a retired worker with no dependents receiving benefits; $149 for an aged couple; $216 for a disabled worker and a wife under 65 with one or more entitled children in her care; $233 for a widowed mother and two children; and $84 for an aged widow alone. Disability Provisions During the fiscal year, a period of disability was established for about 283,000 workers, 29,000 more than the previous high set in fiscal year 1965. The increase resulted partly from workers who were allowed a period of disability as a result of the modified definition of disability provided by the 1965 amendments. For the third consecutive year, the number of persons who met the disability requirements for childhood disability benefits totaled 22,000. The number of disabled workers receiving monthly benefits rose 11 percent in the fiscal year and totaled 1,050,000 at the end of June. Social Security Administration 9 About 836,000 benefits were being paid to the wives, husbands, and children of these beneficiaries—a 19-percent increase. By the end of June 1966, child’s monthly benefits were being paid at a monthly rate of $10.8 million to 207,000 disabled persons 18 and over—dependent sons or daughters of deceased, disabled, or retired insured workers— whose disability began before age 18. About 24,000 women were receiving wife’s or mother’s benefits solely because they were the mothers of disabled persons receiving child’s benefits. Protection Provided INCOME MAINTENANCE At the beginning of calendar year 1966, almost 96 million people had worked long enough in covered employment to be insured for benefits under the program. Some 60 million of these people were permanently insured—that is, whether or not they continue to work in covered jobs, either they are already eligible for benefits or they will be when they reach retirement age, and their families are protected if they die. The remainder, over 35 million, were insured but must continue in covered work for an additional period to be permanently insured. CHART 3.—OF THE POPULATION AGED 65 AND OVER, BOTH THE NUMBER AND THE PROPORTION ELIGIBLE FOR OASDI BENEFITS CONTINUE TO INCREASE (Figures as of January 1) Number (In Mi 11 ions) 25 ........................................................................ —--------------------------- Population Eligible For OASDI Benefits 20.2* 20 --------------------------------------------- \----------------------------------d ------- V 18-5* 18.4** ]6 6 Total Aged Population \ '/%////// 15 ----------------------------------------------------------------------------------------------------- 112 1h6 10 -------- ------------------ ------------------------------------------------------------------------- IT. 5 --------- ------------------'/////>%----------V/70% ------///'/^//^---------------------------- - « o o o . I M M M M 1950 1955 1960 1965 1970 * Includes allowance for underenumeration in the census counts on which population projections are based. * * Includes certain noninsured persons aged 72 andover receiving monthly benefits. 10 Department of Health, Education, and Welfare, 1966 About 95 percent of all young children and their mothers would be eligible for monthly benefits if the breadwinner of the family should die. Of the population under age 65, an estimated 84 million were insured. Some 49 million of them were permanently insured, including about 2 million men and 1.2 million women 62-64 who were already eligible for old-age benefits on a reduced basis. About 56 million of the insured persons under age 65 had worked long enough and recently enough to be protected in the event of long-term and severe disability. At the beginning of 1966,15.6 of the 18.9 million persons 65 or over in the United States were eligible for monthly benefits under the program. Some 75 percent were actually receiving benefits, and about 8 percent would have received them if they or their spouses had not been receiving substantial income from work. About 89 percent of all aged persons will be eligible for benefits at the beginning of 1967, including persons who can receive monthly payments under the provision in Public Law 89-368 (the Tax Adjustment Act of 1966) that provides payments for certain uninsured individuals 72 or over. This proportion is expected to rise to 91 percent by the beginning of 1970 (chart 3). HEALTH INSURANCE The 1965 amendments established two related health insurance programs for people 65 and over: (1) A hospital insurance plan, providing protection against the costs of hospital and related care; and (2) a voluntary supplementary medical insurance plan which helps to pay for physicians’ services and certain other medical and health services not covered by the hospital insurance plan. Nearly all of the 19.1 million persons 65 and over on July 1,1966, were eligible for hospital benefits. As of July 1,1966, the effective date of coverage under the supplementary medical insurance program, an estimated 17.3 million persons 65 and over, representing about 91 percent of the population in this age group, had enrolled for supplementary medical insurance. INCOME AND DISBURSEMENTS Expenditures from the Federal old-age and survivors insurance trust fund during the fiscal year 1966 totaled $18,769 million, of which $18,071 million was for benefit payments, $444 million for transfers to the railroad retirement account, and $254 million for administrative expenses (including Treasury Department costs). Total receipts were $18,461 million, including $17,866 million in net contributions and $595 million in interest on investments. Disbursements exceeded receipts by $309 million, the amount of the decrease in the trust fund during the year. At the end of June 1966, this fund totaled $19.9 billion. Total assets of the old-age and survivors insurance trust fund, except for $2 billion held in cash, were invested in U.S. Government securities Social Security Administration 11 as required by law; $3.5 billion was invested in public issues (identical to Treasury securities owned by private investors), and $14.4 billion was invested in securities of varying maturities issued solely for purchase by the trust fund. The average interest rate, based on the coupon rate and face amount of all investments of this fund at the end of the fiscal year, was 3.54 percent. Expenditures from the Federal disability insurance trust fund during the fiscal year 1966 totaled $1,930 million. Benefit payments accounted for $1,720 million, administrative expenses $183 million, and transfers to the railroad retirement account $25 million. In addition, $1 million was disbursed to vocational rehabilitation agencies to help pay the cost of rehabilitation services furnished to disabled-worker beneficiaries and disabled-child beneficiaries 18 and over, as provided by the 1965 amendments. Total receipts were $1,611 million, including $1,557 million in net contributions and $54 million in net interest on investments. Disbursements exceeded receipts by $319 million, the amount of decrease in the fund during the year. At the end of June 1966, the fund totaled $1,688 million. Assets of the disability insurance trust fund consisted of $1,463 million in U.S. Government securities and a cash balance of $225 million. The invested assets consisted of $313 million in public issues and $1,150 million in securities of varying maturities issued solely for purchase by the trust fund. The average interest rate, based on the coupon rate and face amount of all investments of this fund at the end of the fiscal year, was 3.87 percent. The Federal hospital insurance trust fund was established by the Social Security Amendments of 1965. Contributions to this fund became payable starting in January 1966. Total receipts were $915 million including $909 million in net contributions and $6 million in interest on investments. Disbursements for administrative expenses totaled $64 million. Benefit disbursements began in July 1966. Assets of the hospital insurance trust fund at the end of the fiscal year consisted of $786 million in public issues of U.S. Government securities and a cash balance of $65 million. The Federal supplementary medical insurance trust fund was created by the Social Security Amendments of 1965. Payment of premiums into the fund and expenditures from the fund for benefits and expenses began in July 1966. Legislative Developments During the Year Legislation Enacted The 1965 amendments to social security had greater scope and impact than any previous social security amendments. The increase in 12 Department of Health, Education, and Welfare, 1966 social security benefits, including both cash benefits and health insurance, will be about $6.1 billion in the first full year of operation—• $24.9 billion in 1967 as compared with an expected expenditure of $18.8 billion for 1967 under the old law. These amendments increased cash benefits 7 percent, extended children’s benefits from age 18 to age 22 for those attending school full time, made it possible for widows to get benefits at age 60 (in a reduced amount), lowered the number of social security credits that people 72 and over must have to qualify for benefits, increased to $1,500 a year the amount a beneficiary may earn before any benefits are withheld, brought under social security the earnings of self-employed doctors, provided for coverage of earnings received in the form of tips, and made a number of other improvements. Under a provision in the Tax Adjustment Act of 1966, certain people age 72 and older who are not eligible for regular social security benefits can get a special monthly cash payment of $35. (A woman who is otherwise eligible and who is married to a man who qualifies will get a payment of $17.50.) A person who is eligible to receive a pension, retirement benefit, or annuity under any governmental pension system will have the special payment reduced by the amount of the other governmental payment. In addition, these special payments are suspended for any month for which the beneficiary receives payments under a federally aided public assistance program. People who are now 72 and over, or wTho will attain 72 before 1968, can qualify for the payments without any previous coverage under social security. The cost of making these special payments to people who never worked under social security or who worked very little under social security will be met from general funds of the Treasury, not from the social security trust funds. Uninsured people reaching 72 in or after 1968 will need at least 3 quarters of coverage for each year elapsing after 1966 and up to the year in which they attain 72 in order to qualify. Legislation Considered Proposed legislation designed to effect a measure of coordination between the social security program and the Federal civil service and foreign service retirement systems was recommended by President Johnson’s Cabinet Committee on Federal Staff Retirement Systems after a comprehensive study of the present retirement-system provisions for Federal employees. The Commissioner of Social Security participated in the Committee’s study as the alternate for the Secretary of Health, Education, and Welfare. The Committee’s proposals relating to social security protection of Federal employees were included Social Security Administration 13 in three of the recommendations in its report, which was endorsed by President Johnson and transmitted to the Congress in March 1966. Under one of the recommendations, workers who have employment subject to the civil service or foreign service retirement system but die or become disabled before they are eligible for protection under their staff retirement system or leave the Federal service and do not have protection under the staff retirement system when they die, become disabled, or reach retirement age, would have their service under the staff retirement system credited under social security as though it had been covered work. This recommendation reflects an approach similar to the one that was taken by the 1965 Advisory Council on Social Security and also is similar to the approach taken in a joint report prepared by the Civil Service Commission and the Social Security Administration in 1965. Under a closely related recommendation, employees and their survivors who become eligible for annuities under the civil service or foreign service retirement system would be guaranteed that the payments they receive under the staff retirement system (or, if they are also eligible for social security benefits, under the staff retirement system and social security together) will be at least at the level that would be payable if their Federal service had been covered under social security. The Committee also recommended that those Federal employees who are covered only under a staff retirement system should have health insurance protection after they reach age 65 on the same basis as workers who are covered under social security. This would be accomplished by covering under the hospital insurance provisions of social security the Federal employment of all persons who in the future enter or re-enter Federal service that is now covered only by a staff retirement system and the Federal employment of present employees who desire social security hospital insurance coverage. In the case of employees and annuitants who become eligible for social security hospital insurance under this plan and who desire broader protection than they obtain under social security health insurance (including the supplementary social security medical insurance program), the Committee recommended that the Federal Government make available complementary health insurance designed to maintain protection at approximately the level afforded by the Government-wide high-option plans of the Federal Employees Health Benefits Act of 1959, with the cost of this complementary insurance being shared by the Government and the participants. While these proposals were not enacted in 1966 it appeared likely that they would receive further congressional consideration in 1967. 14 Department of Health, Education, and Welfare, 1966 Future Program Improvements The social security program directly affects just about all Americans, and if it is to remain geared closely to the needs of people, it must continue to be responsive to changing social and economic conditions. Cash Benefit Levels Social security cash benefits are the major reliance of nearly everyone for income security in old age, and, in a great many cases, the sole reliance. The adequacy of social security benefits, then, is critical to the security of older Americans today and tomorrow. Social security benefits are now too low to assure a reasonable continuing income for those who are no longer in the labor force. The average benefit for retired workers 65 and over with no dependents getting benefits is only $82 a month—$984 a year. For a couple both of whom are 65 or over, it is $142 a month—$1,704 a year. Under the measure of poverty recently developed by the Social Security Administration for the country as a whole, a person 65 or over living alone generally needs at least $1,470 a year and an aged couple needs at least $1,850 a year to remain above the poverty level. Even after the increase provided in the 1965 amendments, some 5 million of the 14.6 million people 65 and over who are now getting social security benefits have incomes below this level, and an additional 3 million have incomes that are just above the poverty level. The benefits are also too low for the average worker of the future to maintain a level of living in retirement necessarily related to the level attained while working. If the program is to continue to serve the average and above average worker, benefits must be improved at all levels. The President has asked the Secretary of Health, Education, and Welfare to study ways of making social security benefits more adequate while keeping the program financially sound. Among the proposals that were given attention, in the course of this study, were proposals to provide a special minimum benefit that would be higher than the regular minimum and go to people who had worked under social security for many years. Many people getting social security benefits at or near the minimum payable under the program are workers (or dependents of workers) who were insured on the basis of occasional work in covered employment. There are, however, some people who worked regularly in covered jobs and who nevertheless get low benefits. A special minimum, higher than the regular minimum, for people with long-term coverage under the program would assure more adequate benefits for people who were regularly employed at low wages without Social Security Administration 15 paying benefits well in excess of the regular minimum to people who had insignificant attachment to the program. Also, various proposals were studied for liberalization of the provision in the law, generally referred to as the retirement test, under which benefits are payable in full only if a person’s earnings do not exceed $1,500 in a year. The amount a beneficiary can earn in a year and still get full benefits might well be increased in view of increases in wages and prices that have occurred since that amount was set. Disability Protection The disability insurance provisions, which were modified in several respects by the Congress in 1965, now provide increased protection to workers and their families against loss of earnings when the breadwinner becomes severely disabled. However, one important group is left out of the present program. The 1965 Advisory Council on Social Security recommended that benefits be provided for this group—widows who become disabled before age 62. Since many women recently widowed do not have substantial recent employment, and therefore could not meet the insuredstatus requirements for disability insurance benefits on their own earnings records, many disabled widows cannot qualify for any benefits under the program unless they have in their care a child entitled to benefits or are aged 60 or over. A widow under age 60 with no minor children in her care may ordinarily be presumed to be able to work. However, such a presumption is not valid if the widow is unable to work on account of disability. Under this Advisory Council proposal the widow of an insured worker would be entitled to widow’s benefits regardless of her age if she became disabled before (or within a limited period after) her husband’s death or her entitlement to mother’s benefits ended. In addition, the adequacy of benefit levels is an especially significant aspect of disability protection under the program. The disabled worker beneficiary not only is unable to engage in any substantial gainful activity—and thus unable to supplement his benefits by working— but also has lost his earning capacity before retirement age so that he has had limited opportunity to accumulate savings and other financial assets. Studies are being continued of additional ways to extend disability protection under the program to disabled workers and their families who are not eligible for benefits under present law. Health Insurance While primary attention was given to implementation of the 1965 amendments establishing the health insurance and supplementary 16 Department of Health, Education, and Welfare, 1966 medical insurance programs, these programs have also been under review with a view towards possible legislative recommendations, not only for minor revisions, the need for which is brought out in the operation of the programs, but also for extensions to close the most serious gaps in the protection of the programs. One such gap is the lack of health insurance for social security disability beneficiaries. The 1965 Advisory Council on Social Security recognized that when a worker becomes severely disabled, just as when he retires, he suffers a serious drop in income, accompanied by an increased need for health care. In recommending that health insurance be provided under social security, the Council proposed that this protection be made available to the disabled as well as to the aged. Two bills that would provide health insurance protection for disabled social security beneficiaries were introduced in the 1st session of the 89th Congress, and several were introduced in the 2d session. The extension of health insurance protection to social security disability beneficiaries is among the major proposals that should be considered by Congress. Administering the Social Security Program During fiscal year 1966, the Social Security Administration faced three major administrative tasks: Continuing to improve administration and provide a high quality of service to the public as the number of beneficiaries on the rolls increased; processing increased workloads growing out of the changes the 1965 amendments made in the retirement, survivors, and disability insurance programs; and planning and organizing for implementation of the health insurance provisions of the Social Security Act. Reorganization of the Administration Due largely to the addition of health insurance to the already complex social security programs, the Social Security Administration was reorganized on July 26,1965, to: • Establish new units to administer the hospital and supplementary medical insurance programs. • Provide for greater efficiency and economy, and more fully utilize scarce skills in electronic data processing, by centering responsibility for this function in a single headquarters unit. • Increase the technical support for district offices, payment centers, and State agency operations by assigning responsibility for functional supervision of technical work to specialized bureaus. • Strengthen the administration of the social security program in the field by placing responsibility for coordination and leadership Social Security Administration 17 of all social security activities in a given geographical area under a Regional Assistant Commissioner who would report directly to the Commissioner. Workloads and Administrative Expenses Administering the social security program requires recordkeeping that is without parallel in size and scope. There were 282.5 million earnings items to be posted to social security earnings records, 5 million over the previous year. About 6.8 million new social security numbers were issued, an increase of about 1.8 million; 3.5 million duplicate account number cards were issued because the original had been lost or worn out, almost a half-million increase over 1965. In the claims operation, 4.1 million individuals were awarded monthly benefits, almost 1.5 million more than in 1965, and 1.1 million lump-sum death payments were made. At the end of the fiscal year, monthly benefits were going to more than 21.7 million persons, including about 1.9 million disabled workers and their dependents. As the program grows, the number of actions necessary to maintain the correct names, addresses, and benefit amounts for the millions of social security beneficiaries continues to increase. In fiscal year 1966, 8.4 million separate actions were required to keep the benefit rolls up to date. The total cost of administering the social security program amounted to $501 million. Of the total administrative expense, about $50 million was incurred by the Treasury Department in collecting social security contributions, preparing checks for beneficiaries, and related activities. The administrative expenses chargeable to the retirement, survivors, and disability insurance program amounted to $413 million and were about 2.1 percent of the amount paid during the year to beneficiaries. The remaining administrative expenses, $89 million, represented the expenditures for implementation of the two health insurance programs in fiscal year 1966. Implementation of the 1965 Amendments The most complex of the amendment provisions, the new medicare program for the aged, required extensive administrative preparations and produced unprecedented workloads during the past year. The Social Security Administration was assisted in these efforts by other Government agencies, notably the Public Health Service, the Welfare Administration, the Internal Revenue Service, the Department of Agriculture, and the Office of Economic Opportunity. An extensive public information program was undertaken to explain the provisions to 19 million potential beneficiaries and to enable each 18 Department of Health, Education, and Welfare, 1966 of them to decide whether or not he wished to participate in the voluntary part of the program. To insure that all potentially eligible individuals were informed (direct mailings were used where names and addresses of aged people could be secured), practically all the media of mass communication were used. The mass efforts were supplemented by many other projects, including door-to-door visits in certain areas. Practically everyone reaching age 65 is eligible for hospital insurance under medicare even if he has never worked under social security. Since each person should establish his eligibility during the 3-month period before he reaches 65, special efforts to reach potentially eligible individuals will now be a continuing operation. Arrangements were made with State health agencies to determine whether hospitals and home health agencies met the quality standards for participation in the medicare program. In addition, the Public Health Service made contacts with these institutions to determine whether they were in compliance with title VI of the Civil Rights Act. Contractual and administrative arrangements were made with the Blue Cross-Blue Shield plans and the private insurance companies chosen to serve as intermediaries (or carriers) in dealing with health institutions, physicians, and beneficiaries. In addition, policies and procedures were developed for cost reimbursement, payment of physicians, safeguards against unnecessary or excessive use of services, and many other important aspects of the medicare program. By year-end, an estimated 17.3 million persons age 65 or over had enrolled for supplementary medical insurance benefits; health insurance identification cards had been mailed (some to individuals entitled to both hospital and medical insurance benefits, others to those entitled to hospital benefits only, or to medical insurance benefits only) and well over 10,000 requests from providers to establish eligibility for participation had been processed. Actual administration of the medicare program got off to a good start on July 1, 1966. Manpower and Resources The Social Security Administration had 44,774 employees at the end of the year, an increase of 8,787. The majority are in field installations—21,242 in regional and district offices to provide personal service to the public and 10,176 in payment centers to review claims for benefits and make certifications to the Treasury Department for benefit payments. The Bureau of Data Processing and Accounts, which establishes records, maintains earnings records, and provides central electronic data-processing services, had 6,511 employees. The Bureau of Disability Insurance, which processes claims for disability benefits, had 3,113; the hearings and appeals process employed 1,128; Social Security Administration 19 and the central office headquarters employed 2,030. The newly established Bureau of Health Insurance had 574 employees to make preparations for, and actively supervise health insurance operations. Improvements in Data Processing and Telecommunications During 1966, the Social Security Administration’s complex data-processing systems were expanded and improved to provide for increased workloads, rapid processing of earnings and claims data, and expeditious handling of earnings and claims data, and expeditious handling of earnings record and benefit inquiries. In addition, automatic data-processing systems were designed and put into operation to process the enrollment of individuals for health insurance coverage; to handle the notices of hospital admissions; to process requests for information on eligibility, bills, and payments; and to prepare premium notices and handle premium collections. To facilitate health insurance operations at the local level, each district office is provided with a newly developed microfilm locator record. This microfilm enables it, in a high proportion of cases, to provide health insurance claim numbers and to verify entitlement to hospital insurance and enrollment for medical insurance when a beneficiary is unable to present his health insurance card to a provider of service. For the few cases in which the district office does not have information about the beneficiary—for example, when the beneficiary is traveling outside his own State—the information can still be secured from the nearest district office, which will communicate by wire with the home district office or with the central recordkeeping office. Extensive planning and preparation has been made for the automatic recalculation of benefits of those persons whose total earnings record may support a benefit increase. Programing has been largely completed so that eligible individuals may be identified and their benefits automatically recalculated by computer. The Administration is beginning to operate an optical scanning device designed to read earnings reports submitted by employers and record the earnings information directly on magnetic tape, thereby eliminating the intermediate step of manually key punching this information into punchcards. When the equipment is fully operational, approximately 30 million earnings items will be processed in this manner each quarter. This will enable 140 key-punch operators to be retrained and assigned to other duties. Processing earnings items more rapidly has been materially aided by an increasing number of employers who file their quarterly social security earnings reports on magnetic tape. This saves time and money, for both Government and employers, since the employer is not re 20 Department of Health, Education, and Welfare, 1966 quired to list earnings items on Form 941, and tapes are run through the Social Security Administration equipment and then returned to the employers for their further use. Of the 280 million earnings items received each year, more than 28 million are processed in this manner. Progress in Cost Reduction and Productivity The Social Security Administration’s cost reduction program for fiscal year 1966 resulted in savings of 2,345 man-years and $18.9 million. The major categories of improvement included in this total figure are: Extended use of automatic data-processing equipment to additional operations, $1.8 million; automatic recomputation of benefits, $9.9 million; procedural improvements (such as, improvements in claims development procedures, streamlining of change-of-address procedures), $5.3 million; and organization and management improvements (such as, use of lower graded personnel to handle the more simple interviews in district offices, purchase of computer systems formerly leased), $1.9 million. As a result of these improvements, productivity was increased by 5.6 percent during 1966. Service to the Public One of the most important activities in the Social Security Administration’s program of service to the public is to inform the people of their rights and their responsibilities under the social security program. A major effort during the past year was that of informing the public in meaningful and understandable terms about the complex provisions of the new health insurance program. Pamphlets, notices, posters, instruction booklets, and explanations of the need for action by potential beneficiaries were prepared and printed. Over 120 million booklets about the new programs of health insurance for the aged were printed and distributed; when material on other parts of the law are added, the total for the year was 230 million printed informational items. During the year there was a continuous flow of materials to all the media of mass communication to provide information for the millions who needed to know. The cooperation and assistance of the media of mass communication were requested, and the response was unstinted throughout the year, particularly in the 7-month enrollment period specified in the law, from September 1, 1965, until March 31, 1966. (The period was later extended until May 31.) This period should be recorded as one of exemplary public service for all the media: newspapers presented column after column of space; radio and tele- Social Security Administration 21 vision stations presented both recorded and live programs explaining the law; display organizations presented as much space as could be used by Government-prepared visual materials, and in many cases prepared additional materials. The number of news stories, articles, and broadcasts ran into many hundreds of thousands. Cooperative projects were conducted with hundreds of organizations and agencies that had an interest or an administrative role in the new social security programs. Approximately 1 million of the total inquiries received in Social Security headquarters in Baltimore concerned the health insurance program. The subject of this correspondence ranged from technical health insurance questions to problems about nonreceipt of medicare cards. During fiscal year 1966, district office staff members made nearly 90,000 talks, 194,000 radio broadcasts, and 5,000 live TV appearances, and placed 29,500 exhibits. To handle information requests, health insurance enrollments, and other claims activities, district offices remained open evenings and Saturdays during the peak of health insurance enrollment, District offices are continuing a program of extended hours as an added service to the public; currently, each office remains open an additional 3 hours a week, either on one evening during the week or on Saturday, depending on local needs. In addition, service to the public was expanded through the opening of 9 additional district offices, 74 branch offices, 12 resident stations, and 21 temporary service centers. At year end, there were 625 district offices, 82 branch offices, 37 resident stations, 16 service centers, and 3,361 contact stations to serve the public. Any person with a question about his social security rights or his responsibilities under the social security law may get the answer from any of these offices which is convenient to him. The administration strengthened its quality appraisal staffs and programs in order to continue improvements in the quality of service to the public and to ensure uniformity and equity in the application of claims policies and continuing accuracy of benefit payments. Special quality appraisal staffs are being established, and it is expected that their efforts will do much to enhance and maintain the standards of quality which have always been a Social Security Administration goal. A new evaluation and measurement system—a continuous statistical evaluation of basic claims policies and the way they are implemented, based on complete redevelopment of a small sample of claims—is producing data which can be used to evaluate claims policies and practices and pinpoint problem areas so that necessary corrective actions can be taken. 22 Department of Health, Education, and Welfare, 1966 Administration of the Social Security Program Abroad Major emphasis in the Social Security Administration’s foreign operations has been on a continued and systematic validation of beneficiary rolls abroad by rechecking eligibility of beneficiaries on a country-by-country basis. Validation surveys were completed in Mexico, the Philippines, Spain, and Germany. Special informational materials were provided beneficiaries abroad to inform them of the limitations of the health insurance program outside the United States. Employee Relations Considerable progress was made in the Social Security Administration’s continuing efforts to assure all individuals, regardless of race, creed, color, or sex, equal employment opportunity. Employment of Negroes, especially in the upper grade levels, showed substantial increase. Diagnostic testing and counseling are provided to assist employees at all levels in their personal efforts toward self-improvement. And, in cooperation with local schools and colleges, after-hours adult education programs, with high school and college courses, have been established. During the year, the Social Security Administration participated extensively in the neighborhood youth corps program of the Economic Opportunity Act. During the summer of 1966, 1,037 temporary employees were employed as part of the President’s youth opportunity campaign. Liaison was also initiated with several colleges for the employment of students under the w’ork-study program of the Vocational Education Act. Young people from all of these programs have helped significantly in the handling of the large workloads created by the 1965 amendments. Financing the Program A comprehensive review of the long-range actuarial cost estimates for the retirement, survivors, and disability insurance program, as modified by Public Law 89-97, has recently been completed. These new estimates show that, for the system as a whole over the long-range future, the estimated contribution income is substantially in excess of the estimated benefit cost. The system therefore continues to be financed on an actuarially sound basis, both for the short term and for the distant future. It is difficult to make exact predictions of the actuarial status of a program that extends into the distant future. If different assumptions as to, say, rates of interest, mortality, retirement, disability, or earnings had been used, different results would have been obtained. Social Security Administration 23 Accordingly, no one set of estimates should be looked upon as precise. Future experience may vary from the actuarial assumptions. The cost estimates are continually examined in the light of the latest information available. Even though absolute precision in long-range cost estimating is not possible, the intent that the system be actuarially sound can be expressed in law by a contribution schedule that, according to the intermediate-cost estimate, places the system substantially in balance. The law has such a contribution schedule. Retirement and Survivors Insurance Benefits The level-cost of retirement and survivors insurance benefits after 1966, on an intermediate-cost basis, assuming an interest rate of 3.75 percent and earnings at about the levels prevailing during 1966, is estimated at 7.94 percent of taxable payroll (after adjustments to allow for administrative expenses and interest earnings on the existing trust fund). The level contribution rate equivalent to the graded rates in the law is estimated at 8.83 percent of taxable payroll, leaving a positive actuarial balance of 0.89 percent of taxable payroll. Disability Insurance Benefits The Social Security Amendments of 1956 established a system for financing disability benefits which is separate from the financing of retirement and survivors insurance benefits. The estimated level-cost of the disability benefits (adjusted to allow for administrative expenses and interest earnings on the existing trust fund), on an intermediate-cost basis, is 0.85 percent of taxable payroll. Contribution income has been specifically allocated to finance these benefits; this income is equivalent to 0.70 percent of taxable payroll, leaving an actuarial insufficiency of 0.15 percent of taxable payroll. As indicated above, the new estimates show that the system of retirement, survivors, and disability insurance, as a whole, will have an income from contributions (based on the schedule now in the law) and from interest earned on investments which will be more than sufficient to meet total expenditures into the long-range future (i.e., over the next 75 years). However, the Department recommends an adjustment of the allocation of the total contribution rate between the two parts of the program to make for a more reasonable subdivision of future income, which would, of course, in no way affect the overall actuarial balance of the system. Health Insurance Benefits for the Aged The 1965 amendments established two separate health insurance programs for people 65 and over; these are financed in different manners. 237—319—67—3 24 Department of Health, Education, and Welfare, 1966 Hospital Insurance Benefits For beneficiaries of the retirement, survivors, and disability insurance system and the railroad retirement system, the hospital insurance plan is financed through contributions and a trust fund that are separate from the contributions and trust funds already established for the payment of retirement, survivors, and disability insurance benefits. (Hospital insurance benefits for people who are not such beneficiaries are financed from general Federal revenues.) The level-cost of the benefits (including administrative expenses) over the 25-year period 1966-90 is estimated at 1.23 percent of taxable payroll. The level-equivalent of the graduated tax rates in the law is 1.23 percent of taxable payroll. Accordingly, the hospital insurance program is in actuarial balance. Supplementary Medical Insurance Benefits Persons enrolled in the supplementary medical insurance plan pay a monthly premium of $3, which is matched by an equal contribution from general Federal revenues. These premium rates are estimated to be adequate to meet all costs arising in the period July 1, 1966, to December 31, 1967, and, in addition, to result in the accumulation of a contingency fund. The law provides for appropriate adjustment in premium rates in subsequent years to assure that the program will be soundly financed. Improvements in Hearings and Appeals Activities In fiscal year 1966, the Bureau of Hearings and Appeals handled 23,400 cases; the median processing time was 100 days, the lowest in a decade. Hearings were held on 19,900 of these cases; of the others, about 2,500 were dismissed by the hearing examiner and most of the rest were decided at the request of claimants. This was achieved while continued efforts were being made to improve the quality of evidence upon which decisions are rendered. In disability cases, additional emphasis was placed on the use of vocational and medical expert witnesses. Procedures also were adapted to pay claimants’ travel expenses when it is desirable for them to travel more than 75 miles to a hearing. This is more economical than sending doctors, medical advisers, and vocational consultants (concerned with a claimant’s hearing) to the claimant’s area for the hearing. Staff was added and plans were developed for the processing of cases under the health insurance program during fiscal year 1967, and Social Security Administration 25 interim procedures were adopted during fiscal year 1966 to insure consideration of the Social Security Amendments of 1965 in all pending cases. Administering the Federal Credit Union Program The Bureau of Federal Credit Unions charters, supervises, and examines all Federal credit unions. Its program is fully financed through fees paid by the credit unions for these services; it receives no Federal appropriation. In fiscal year 1966, more than 10,000 regular supervisory examinations were completed, and 643 Federal credit union charters were granted. Federal credit unions increased in number from 11,493 at the beginning of the fiscal year to 11,872 at its end. They operated in all 50 States, the District of Columbia, Canal Zone, Guam, Puerto Rico, and the Virgin Islands. Membership grew 6.7 percent from 8.3 to 8.9 million. Assets increased 11.8 percent to $5.3 billion. Members’ savings rose 11 percent to a high of $4.7 billion, and loans increased approximately 12.6 percent to $4.1 billion. The Bureau continued to advise Federal credit unions about automatic data processing accounting procedures approved for credit union operation. This technical assistance enabled interested credit unions to profit from experience gained by other credit unions which use these systems. Over 350 Federal credit unions now utilize these systems, and many others are contemplating the use of this equipment. In cooperation with the Office of Economic Opportunity and local agencies, the Bureau organized and chartered 74 Federal credit unions to serve low-income groups. This chartering activity among low-income groups more than doubled that of the previous fiscal year. The Bureau also inaugurated “Project Money wise”—a series of special training programs designed to help officials of credit unions in limitedincome areas improve service to members. The training programs teach credit union officials the basic principles of consumer education, family financial counseling, Federal credit union operations, and leadership development. In the War on Poverty, the Bureau assisted with a series of training sessions to familiarize VISTA volunteers with credit unions, their organization, and the part such facilities can play in helping the poor to solve financial problems. 26 Department of Health, Education, and Welfare, 1966 In the field of education, the Higher Education Act of 1965 and the National Vocational Student Loan Insurance Act of 1965 expanded Federal credit union services to members. The former enables Federal credit unions to make insured loans of up to 10 percent of their assets to student members for postsecondary and higher education; the latter permits Federal credit unions to make insured loans of up to 5 percent of their assets to student members desiring vocational training in business, trade, technical, and other vocational schools. The Bureau continued its program of information and training for representatives of foreign countries interested in establishing credit union programs. Representatives from Tanzania, Taiwan, and Kenya received special training in 1966. The Bureau also contributed to the development of foreign credit unions by training Peace Corps volunteers assigned to Latin American countries to assist in organizing and establishing credit unions. During Cooperative Month, October 1965, the Bureau conducted a seminar on “Credit Unions—Partners in American Life,” to give a better understanding of credit union philosophy and operations to the leaders of Government agencies and those in the community. The October 21 seminar coincided with the celebration of Credit Union Day, here and in other countries. Research in credit union operations was furthered by a pilot test of a program to collect monthly information on purposes, security, interest charges, maturities, and other characteristics of loans made by Federal credit unions. A survey of credit union policies on the limitation of share accounts was made to determine to what extent credit unions regulate the inflow of savings by relaxing this restriction. The year-end financial and statistical report for 1965 included a breakdown of the number and amount of share accounts, by size, at Federal credit unions. This information will be useful both in evaluating legislative proposals and in enabling credit union officials to determine liquidity needs of credit unions. For the first time, the 11,000-plus year-end financial and statistical reports were edited and summarized, and tables produced, by electronic data-processing equipment. It is possible with this equipment to compute detailed operating ratios and averages by type of membership and asset-size class of credit union. Such information will prove valuable in the Bureau’s examination program. In line with the greater emphasis being given to analysis in the Bureau’s supervisory examination, a training course on the total analysis process was presented at the regional examiners’ conferences. Social Security Administration 27 A new staff development and appraisal program which, provides an annual concentrated development period for each examiner was inaugurated. The program has the objective of increasing the ability of each employee to perform at maximum capacity in his present position and to develop to his full potential. The Bureau also developed a new promotion plan for examiners, designed to recognize superior ability by a method of formalized consideration throughout the country. Under the revised plan, a more effective method is provided for evaluating all examiners considered ready for promotion. Research Activities To provide the analytic basis for continuous evaluation of the social security system’s effectiveness in providing for economic security and its relation to overall economic and social policy, the Social Security Administration conducts research in the general area of income security. It studies measures of income adequacy, the redistributive effects of social security benefits and financing and their impact on the economy, the relation of health expenditures and insurance benefits to economic security, the effects of existing social security benefit provisions on individual and family security, trends in aggregate social security and social welfare expenditures, the relation of public and private income-maintenance programs, and related questions. Extensive plans were made during the year for long-range research and analysis and the development and maintenance of operations and program statistics relating to the new health and supplementary medical insurance programs. A current medicare survey was launched to obtain continuing information on medical care utilization and costs of aged persons. In a series of studies on family income, the Social Security Administration continued the refinement of its poverty indexes and their application to the different needs of families of different types. The reports were issued in the Social Security Bulletin. Reports on the 1963 survey of the aged, the first nationwide survey of a representative sample of all persons aged 62 and over, and on a survey of mother-child beneficiary groups, were completed and prepared for publication. Both of these surveys were conducted by the Social Security Administration, with the Bureau of the Census acting as its agent in collecting and tabulating the data. Fieldwork was completed for the survey of noninstitutionalized disabled adults under age 65, an extensive study of disabled persons in 8,000 households. 28 Department of Health, Education, and Welfare, 1966 Studies of persons in long-term institutions and of recipients of dependents’ benefits are in the planning stage. Also in the planning stage is a longitudinal study of the aged, which will examine factors related to retirement and explore changes in income, assets, health, medical care, and living patterns after retirement. A survey of all independent health insurance plans was completed, with a breakdown by State on enrollment, benefit expense, administrative expense, and net income of the plans. The Social Security Administration, acting in concert with the Census Bureau and the Internal Revenue Service, continued linking data from the three agencies on a pilot basis. Individual agency policies of confidentiality were preserved by the methodology of the linkage. Research potentials in this type of linkage are of interest not only to the cooperating agencies but also to other Government and academic research groups. Initial analyses planned by the Social Security Administration from the link include the relation of total and taxable earnings covered by social security, the distribution of taxes and benefits by income group, and a number of methodological studies designed to improve the basis for future projections and estimates. A fundamental review of the statistical systems that have developed over the years in the Social Security Administration, alternative ways of meeting statistical objectives, and the most appropriate and effective use of computer technology in research is underway. Special Projects Research grants and contracts, to social scientists in universities and other nonprofit research organizations, supplement the research programs of the Social Security Administration and increase scholarly interest in the study of social security. Among the major areas are studies relating to early retirement and the factors affecting the retirement patterns of various groups; the funding of private pension plans; lifetime earnings and employment patterns; medical expenditures in relation to family income; the economic costs of long-term care in different types of institutions; and trends in attitudes and knowledge about social insurance and social security programs. A study of the utilization of medical services before and after medicare, studies of the impact of the new health insurance program on hospital financing, and other related studies are being carried out for the Social Security Administration under contract arrangements. Social Security Administration 29 The recording of interviews with key persons in the early years of social security history for an oral history project has been completed, and the interviewing of key persons in medicare history has begun. Both of these projects form part of the program to record these events through sound recording on the historical events as they are recalled by the individuals most concerned with these events. Work continues on a series of projects to develop guides to historical social security records. The guides are expected to create an interest in social security history and to assist historians in locating records pertinent to research. Research Publications in Fiscal Year 1966 Monthly and annual publications of the Office of Research and Statistics include the following: Social Security Bulletin, issued monthly. Annual Statistical Supplement. A supplement to the Social Security Bulletin, issued annually. Social Security Programs in the United States. 1966 edition, issued annually. New publications in the research report series included: The Extent of Health Insurance Coverage in the United States. No. 10,1965. 67 pp. Insured and Disabled Workers Under the Social Security Disability Program: Characteristics and Benefit Payments— 1957-63. No. 11,1966. 36 pp. Financial Experience of Health Insurance Organizations in the United States. No. 12, 1966. 64 pp. Old-Age and Sickness Insurance in 'West Germany in 1965. No. 13, 1966. 56 pp. International Activities During the year, representatives of the Social Security Administration participated in the work of a number of the committees of the International Social Security Association (ISSA) in preparing studies in the fields of pensions, administration, and the relation of social security and social services; in the continuing efforts of ISSA to establish a Social Security Abstracting Service; and in the work of American regional social security committees, jointly sponsored by 30 Department of Health, Education, and Welfare, 1966 ISSA and the Permanent Inter-American Committee on Social Security (PIACSS). Two SSA staff members attended the 50th International Labor Conference in 1966 as technical advisers on social security to the U.S. delegation, and represented the U.S. Government on the Conference’s Social Security Committee. This Committee developed a set of conclusions which are expected to lead to the adoption of a new international convention and recommendation on old-age, invalidity, and survivors insurance at the 1967 Conference. Technical assistance on social security was provided to Chile, Iran, Jordan, and Saudi Arabia. A staff member went to the Trust Territories of the Pacific to initiate a study that is expected to lead to some social security protection for the indigenous population. Negotiations were begun with the Canadian Government to explore the possibility of concluding a bilateral agreement to assure pension protection for persons who work intermittently in both Canada and the United States. The program of orientation and training of persons from abroad, in conjunction with the Agency for International Development, included the annual 8-week seminar on administration of social security for foreign experts, which was attended by 23 participants from 13 countries, and short-term orientation and training of about 1 week or less for 1,129 persons from over 65 countries. Summary and Conclusions For the Social Security Administration, fiscal year 1966 began as a year of preparation: major improvements in the Social Security Act were imminent. Even without amendments the social security beneficiary rolls were growing, and workloads were growing with them. Changes made by the 1965 amendments in the established programs of retirement, survivors, and disability insurance were extensive, and presented massive additional workloads to be digested almost immediately : benefits already being paid to more than 20 million people had to be increased; applications from hundreds of thousands of newly eligible people had to be processed; millions affected by changes in the law had to be told about them. But in addition to making changes in the established social security programs, the 1965 amendments established two new programs of Social Security Administration 31 hospital and medical insurance—medicare—to go into operation just 11 months after enactment of the law. It was a year of cooperation: other Federal agencies, State agencies, the national health community, and private and nonprofit insurance organizations were called upon by the new law to join forces with the Social Security Administration to administer the new programs. It was a year of communication: the media of mass communication conveyed millions of items of written, spoken, and graphic information about the new law to the American people. It was a year of action: the millions of benefits already being paid were increased; the newly payable benefits were started; more than 18 million people were certified to be eligible for hospital insurance, and more than 90 percent of those 65 or over enrolled for medical insurance. While it was still June 30, 1966, in the continental United States, the medicare program went into operation across the international date line in Guam, where it was already July 1, 1966. As the fiscal year ended across the continental United States, the medicare program went into operation behind it. The year of preparation paid off. The 1965 amendments were adding an important measure to the economic security of the American people. Table 1.—Federal credit unions: Assets, liabilities and capital, 1965 [Amounts in thousands] Item Dec. 31,1965 Change during 1965 Amount Percentage distribution Amount Percent Total assets/liabilities and capital $5,165,807 100.0 $606,369 13.3 Loans to members _ _ _ 3,864,809 276, 069 112, 668 774, 079 84, 681 53, 501 74.8 515,741 19,677 12, 722 33,461 18, 567 6,197 15.4 Cash _______ _ _ _ _ _ 5.3 7.7 U.S. Government obligations L 2.2 12.7 Savings and loan shares.. _ __ 15.0 4.5 Loans to other credit unions _ _ _ 1.7 28.1 Other assets.. 1.0 13.1 Notes payable _ __. _ _ _ _ ___ _ ___ 95,452 28,692 4, 538,461 267,661 4,788 18, 040 212,713 1.8 16,921 -256 21.5 Accounts payable and other liabilities. .6 -.8 Shares 1._ _ _ _ _ 87.9 521, 068 41,136 -254 13.0 Regular reserve 5.2 18.2 Special reserve for delinquent loans _ _ _ __ .1 -5.0 Other reserves 2 __' __ _ .3 3,283 24,472 22.2 Undivided earnings3 4.1 13.0 1 Includes investments in Federal agency securities—amounting to $11.6 million—authorized under the 1964 amendments to the Federal Credit Union Act. 2 Reserve for contingencies and special reserve for losses. 3 Before payment of year-end dividends. 32 Department of Health, Education, and Welfare, 1966 Table 2.—Federal credit unions: Selected data on operations, by State, Dec. 31, 1965 State Number of credit unions Number o members Total assets (thousands) Amount of members’ shares Amount of loans to members Total (thousands) Average 1 per member Made during 1965 Outstanding as of Dec. 31, 1965 (thousands) Total (thousands) Average 1 Total-. 11,543 8, 640,560 $5,165, 807 $4, 538,461 $525 $5, 081,636 $853 $3, 864,809 Alabama 198 35 95 68 1,142 7 156 313 60 174 271 210 3 167 60 364 438 6 76 94 338 144 163 317 399 53 126 49 111 92 67 34 479 62 998 62 30 651 131 204 1,127 38 28 86 96 189 851 100 2 3 194 180 140 3 59 122,842 36, 977 102,236 34, 055 1,192,932 13,890 121,270 256,242 40,322 358,250 279, 009 153,333 5,274 150, 021 37, 299 162, 263 286,975 5,472 74, 594 45,889 177,475 93,006 146, 004 184,305 558,397 27,002 72, 661 31,212 49,072 65,639 45, 526 27, 098 298, 806 62,160 665,477 57, 547 15, 455 430, 034 85, 669 118,953 650,090 20,681 8,269 74, 428 38,834 135, 650 590, 941 50, 013 1,328 1,598 160,459 133,125 57, 224 1,127 26,150 68,133 24,354 64,641 16, 812 785, 707 5, 521 74,506 190, 679 19, 638 198,216 155, 516 78,118 1, 067 129,168 23,119 87,180 193,017 4,248 51, 543 19,116 101,419 52,770 71,909 96, 251 392,328 12, 202 33,641 17,425 25,840 39,228 29, 450 14,427 165, 975 42, 597 373,375 22, 246 8,166 248,192 50,133 66, 651 353, 777 10,128 3, 692 30,250 22, 073 93, 543 349, 669 33, 268 781 223 77,935 87,883 31,899 667 15, 501 59, 062 21, 004 57, 814 14, 663 693, 993 4,821 65, 816 169,435 17,313 176, 705 135,404 69,237 1,017 114, 819 20, 097 77,324 170,425 3,903 45,320 16, 648 88, 416 46,200 63,175 85, 689 340, 451 10,846 29,175 15, 598 22,817 35,143 24, 696 12,991 145, 595 37,150 329,404 19, 733 7,348 220,886 43, 731 58, 224 306,250 8, 825 3,284 27,042 19, 558 82,174 302, 343 29, 061 671 183 68,114 76,976 27,593 605 13, 696 481 568 565 431 582 347 543 661 429 493 485 452 193 765 539 477 594 713 608 363 498 497 433 465 610 402 402 500 465 535 542 479 487 598 495 343 475 514 510 489 471 427 397 363 504 606 512 581 505 114 424 578 482 536 524 72, 896 27,482 67, 346 24, 515 779,303 6,616 74, 295 154, 586 22,139 191,437 166,105 93,760 1,436 113,065 23,331 80,708 173,312 3,421 48,113 22, 266 96,877 54,272 75, 248 87,107 372,976 10,417 38, 731 15,892 21,849 33, 409 28,234 13,795 133,886 45, 785 333,554 25, 741 8,162 235,266 52, 218 70,124 360, 786 11, 578 2,689 38,164 23, 555 103, 086 391,831 34,360 647 139 79,821 86, 578 34,209 699 13, 820 739 994 957 739 905 381 1,022 865 764 904 756 626 431 1,109 987 753 847 945 1,136 690 785 847 716 719 1,144 816 616 755 847 921 823 781 737 998 868 569 815 883 911 928 821 554 549 540 1, 016 842 829 1, 057 547 535 698 928 815 1,142 953 53,208 20,149 55,819 13,995 636,454 3, 079 58,370 117,225 15,903 156,913 125, 441 61,148 937 84, 054 19,105 60, 906 121,272 2,532 41, 716 14, 772 72, 229 39, 555 58, 247 64,474 312,176 9, 570 27, 530 11,685 20, 297 27,335 25,128 10, 693 102, 604 32, 056 262, 087 18,087 6, 657 172, 613 42,333 53,853 236,956 8,591 1,900 25, 940 16,441 68, 583 280,864 27,692 411 203 58,846 69,988 24,241 518 11,430 Alaska Arizona Arkansas California., _ . _ Canal Zone Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii 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 Puerto Rico ... Rhode Island South Carolina... South Dakota Tennessee Texas ... Utah Vermont Virgin Islands Virginia.. Washington West Virginia Wisconsin Wyoming 1 Based on unrounded data. Welfare Administration Social Legislation enacted in fiscal year 1966 enabled the Welfare Administration, in cooperation with public and voluntary welfare agencies throughout the Nation, to intensify its attack upon the causes of poverty and other social problems. The new medical assistance program, authorized by title XIX of the Social Security Act, became effective January 1, 1966. By the end of the fiscal year, plans for the operation of the program in eight States and Puerto Rico had been approved. Policies and guidelines, developed in cooperation with representatives of the health and medical professions as well as welfare and other groups, had been established and the groundwork well laid for a system that should, within 10 years, assure that high-quality medical care is available to all persons in all age groups who could not otherwise afford the care they need. A possible preview of what may ultimately become available for all children in low-income families, whose unmet health needs have caused nationwide concern, may be seen in the comprehensive child health projects authorized by another 1965 amendment to the Social Security Act. By the end of the fiscal year, grants had been awarded for 14 such projects in 11 States. Conducted in low-income areas by public health agencies, or medical schools, or teaching hospitals affiliated with medical schools, such projects can provide screening and diagnostic services for both preschool and school-age children and insure followup treatment for all who need it but whose parents cannot afford to pay for it. Dental as well as medical and other therapeutic services can be included, with Federal funds paying up to 75 percent of the cost of the project. Combined with authorized increases in Federal aid for crippled children’s services and maternal and child health programs (including special project grants for high-risk maternity groups), the new Federal legislation has made it possible for the Welfare Administration to give more effective help to States and communities than ever before in overcoming health problems which are both a cause and an effect of poverty. 33 34 Department of Health, Education, and Welfare, 1966 Basic causes of poverty were also attacked more aggressively on a number of other fronts: • Through family-centered projects, which operated in 51 jurisdictions during the year, over 15,000 families became self-supporting as a result of receiving intensive help in overcoming a variety of problems which had doomed them to chronic poverty. The services included basic educational and vocational training and work experience for parents of wage-earning age who were so underskilled and undereducated as to be unemployable; day care arrangements for women whose children were solely dependent on them for support; and help with health, marital, money management, and many other problems. > • Through increased attention to the problems of deprived families in big cities, a number of innovative programs were developed in major cities: a program which offers training and work experience to Chicago fathers who had deserted their families, combined with marital counseling, has already mended almost 50 broken homes; a system of satellite service centers in New York is bringing public welfare services into the neighborhoods where they are most needed; and in many States homemaker programs and classes and clubs for mothers are helping extremely deprived women (many of them newly arrived from rural areas) learn the ways of the city and improve their housekeeping, money management, and child-rearing practices. A special study of public welfare problems and practices in six large cities was conducted by the Welfare Administration. Subsequently, a 2-day conference was held with the public welfare directors of State and big-city agencies to lay plans for further improvements in city public welfare services. > • Reduced caseloads, improvement in staff training, and new policies to reduce the amount of time and paperwork involved in administration and the investigation of eligibility have all contrib- , uted to a general rise in the quality of public welfare services throughout the Nation. The result has been an increase in efforts to deal constructively with social problems and a reduction of practices that tended to undermine self-confidence, hope, ambition, and dignity. Staff assistance was given, upon request, to the Advisory Council on Public Welfare, appointed by the Secretary of Health, Education, and Welfare in compliance with a provision of the 1962 amendments to the Social Security Act. The Council issued its report at the end of the fiscal year. Among its findings and recommendations, the Council reported that the most serious shortcoming in public welfare programs remains the Welfare Administration 35 inadequacy of public assistance payments. Almost 8 million citizens must rely on these payments as a principal source of income because they are too old, too young, or too disabled to work. The Council findings were further validated by reviews and summaries of current research on the poor and their problems issued during the year by the Research Division of the Welfare Administration. Bureau of Family Services The Bureau of Family Services is responsible for administering the grant-in-aid programs of financial assistance, medical care, and social services to needy persons. The Bureau helps to develop, maintain, and improve these programs which aid needy people in securing the necessities of life, in meeting health problems, and in achieving as much economic and personal independence as possible. New Legislation Major emphasis of the 1965 amendments to the Social Security Act administered by the Bureau of Family Services is on the development of health and medical care programs for individuals and families who cannot otherwise afford the care they need. Other provisions are designed to improve the Federal-State programs of financial assistance to needy persons. MEDICAL ASSISTANCE—TITLE XIX The new medical assistance program (MA) is an extension of the Kerr-Mills program of medical assistance for the aged (MAA) authorized in 1960; it includes children and certain other adults in addition to the aged. When adopted by all States, it could provide comprehensive, high-quality medical care for those who need it but cannot afford it—about a fifth of the population in the Nation. All recipients of financial aid under other federally aided public assistance programs must be included in the new MA program. States may also include certain other persons who are medically needy. By 1975 a State must include substantially all of the State’s medically needy in a comprehensive program of medical care. The new program became available to States on January 1, 1966; effective January 1, 1970, Federal funds for medical care payments under other federally aided assistance programs will terminate. States adopting this new program will be required to provide broad, high-quality, and equitable medical services for all needy groups covered under the program. As a minimum, after July 1, 1967, five specific medical care services must be furnished—inpatient and outpatient hospital care, skilled nursing home care (adults only), physi- 36 Department of Health, Education, and Welfare, 1966 Gians’ services, and laboratory and X-ray services. Coverage of other services, including drugs, dental care, eyeglasses, or hearing aids, is optional with the States. Significant provisions included in this legislation eliminate or modify certain restrictive conditions of eligibility found in some other categories of assistance, and ensure more effective administration. For example: no durational residence or citizenship requirement is permitted ; an age requirement cannot be imposed that excludes otherwise eligible children under 21 regardless of school attendance; children in foster care can be aided; and the only relatives who can be held responsible for each other are spouses, parents for minor children, or parents for children over 21 if the children are blind or permanently and totally disabled. INCREASED PAYMENTS A new Federal matching formula, effective January 1, 1966, makes it possible for States—without any increase in State funds—to add an average of $1.25 a month to the payment for each needy child receiving aid to families with dependent children (AFDC), and to add an average of $2.50 per month to the payment of each adult receiving old age assistance (OAA), aid to the blind (AB), or aid to the permanently and totally disabled (APTD). INCREASES IN EARNINGS EXEMPTIONS To encourage dependent people to make a greater effort to earn at least a part of the money they need, effective October 1, 1965, States may permit recipients to keep some earnings without having their public assistance payments reduced: up to $50 a month in earnings per child recipient of AFDC but not exceeding $150 a month per family, and up to $50 a month in earnings of a recipient of OAA or APTD. Also, a public assistance recipient can keep $5 a month from any source. A previous amendment permits exemption of $85 a month plus half the balance of earned income of an AB recipient. PATIENTS IN INSTITUTIONS States that make public assistance payments to persons over 65 years of age who are patients in institutions for the mentally ill and the tuberculous are able to qualify for Federal matching funds to help defray the cost of these payments. (Effective January 1, 1966.) Trends in Caseloads and Expenditures In June 1966, federally aided assistance under OAA, AB, and AFDC programs was available in all 54 jurisdictions of the country— the 50 States, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. APTD was available in all jurisdictions but one (Nevada). MAA was available in 38 jurisdictions, and 9 were admin- Welfare Administration 37 istering the new MA program. General assistance (GA), wholly State and/or locally financed, was available in some form for some persons in all 54 jurisdictions. Of the 54 jurisdictions administering AFDC, only 26 had provisions for making payments for foster care of children, 21 made payments to unemployed-parent families, 11 provided money payments to recipients under community work and training programs, and 32 permitted payments to children up to 21 years of age if attending a school or a vocational or technical training course—options provided by previous amendments. CASELOADS Over 8 million persons, or about a fourth of the poor,1 were receiving aid under public assistance programs in June 1966. They included 2.1 million aged persons receiving OAA, 4.5 million dependent children and their parents or other caretakers (including 3.4 million children in 1.1 million families) receiving AFDC, 588,000 disabled receiving APTD, 85,000 blind receiving AB, 195,000 medically needy receiving MAA, 643,000 receiving aid under the new MA program in the States reporting complete data,1 2 and 592,000 receiving GA. There was a 28-percent decrease in MAA, due largely to transfers to the new MA program; an 11-percent decrease in GA; and a 2-per-cent decrease in OAA in June 1966 compared with June 1965. Two programs showed slight increases: 6 percent in APTD, and 2 percent in AFDC. EXPENDITURES By program, total payments from Federal, State, and local funds for June 1966 for OAA were $163 million; AFDC, $158 million; APTD, $48 million; MAA, $28 million; MA, $97 million; GA, $21 million; and AB, $8 million. Most of the programs showed decreases in expenditures compared with a year earlier: 44 percent in MAA, 9 percent in AB, 6 percent in OAA, and 0.1 percent in GA. In addition to expenditures under the new MA program, there was a 5-percent increase in AFDC and a 2-percent increase in APTD expenditures. National monthly average payments were $77 per recipient for OAA, $145 for MAA, $75 for MA, $90 for AB, $81 for APTD, $35 for AFDC ($144 per family), and $35 for GA ($73 per case). The national average assistance payment provides little more than half the minimum amount required by a family for subsistence; in some low-income States it is less than a quarter of that amount. 1 The President’s Council of Economic Advisers classified as “poor” families of four persons whose annual income is less than $3,000, and unattached individuals with incomes under $1,500. See Economic Report of the President, January 1966, p. 111. 2 Most of those receiving care under the MA program also received money payments under another assistance program. 38 Department of Health, Education, and Welfare, 1966 CHART 1.—AVERAGE MONTHLY PUBLIC ASSISTANCE PAYMENT PER RECIPIENT, JUNE 1966 (EXCEPT FOR GENERAL ASSISTANCE. INCLUDES VENDOR PAYMENTS FOR MEDICAL CARE.) OLD-AGE ASSISTANCE z' *0 TO THE BLIND AID TO THE PERMANENTLY AID TO FAMILIES WITH MEDICAL ASSISTANCE A/ GENERAL FOR THE AGED ±Z AND TOTALLY DISABLED 3/ DEPENDENT CHILDREN Mtult-«L ASSISTANCE _/ ASSISTANCE 5y DOLLARS DOLLARS DOLLARS DOLLARS DOLLARS DOLLARS DOLLARS ' 5° '°° 130 0 200 400 600 0 50 100 150 0 50 100 ISO 200 0 25 50 75 0 50 100 150 0 25 50 75 U S AV 7 7 4 7 MB [ U S AV 14 5 9 4 t U S AV 8 9.9 I Us ! U. S. AV. 8 I .3 5 L™ j I 1 U. S AV 3 4 8 6 U I U. S AV. 7 4.8 I Lb U S AV 3 5 09 I .WIS 12 4.4 7 MiB NEV. fizZ 8 2 ^M NEBR 95.19 MB MASS. Tj 2 0 I 81 M KANS 101.57 BMM VT 97.27 BMB OREG 4 0 6 2 ^M CALIF 3 8 3 5 ^M 0HI° 9 4 89 MM LA 19 3 0 8 » IND 99.77 MBB N.MEX. 9 7.06 BM N DAK 4 0 4 2 BBB KANS 3 8 2 4 Mi M0 9 4.06 IND. 184 9 9 M N MEX 9 9.4 2 Mm( R. I. 96.98 tmna KANS. 4 0 3 2 BMB MASS 3 7 2 2 ^M WYO 9 2 09 S. C 6/18 3 70 M OREG. 9 7.60 BBUAI MAINE 9 6.6 3 MM ILL. 4 0 0 5 MM VI 36 83 ^M ALASKA 9 0 2 3 —W KANS. Z/16448 M OHIO 95.18 BMM MD 96 06 MM COLO. 4 0 0 3 MM MICH 3 6 3 7 MB CONN. 90.18 MM N.MEX. 16 4.2 3 M N J 9 3 5 4 MM OKLA. 94 73 XKM MO 3 9 5 3 BM NEV 6/ 3 2 9 4 MB N 1 89 5 5 MB IDAHO 15 3.2 7 M COLO. 93.35 MMM OHIO 92 56 MB IDAHO 3 9 5 2 MB OHIO 2 9 76 Ml LA 8 5 56 MM WASH. 150.22 ■ N.Y. 9 2.30 E9MM HAWAII 90.9 3 BBQ WYO. 3 8 3 3 MM Rl 28 88 M MICH 8 3.89 MM DEL 14 7 3 2 ■ OEL. 89.69 MM N. C. 8 7.8 2 MM MONT 3 6 6 6 IM MINN 2 8 6 2 M N.MEX 83.77 MM OREG 14 4 04 B MD 89.26 BHU DC. 86 3 8 ^M UTAH 3 6 2 3 MM WIS 2 8 4 2 M MAINE 8 3.2 5 ^M WIS 14 2 8 4 B MAINE 89.03 MM DEL 84.8 5 BBM OHIO 3 5 7 4 MB DEL 2 8 0 4 M IDAHO 82.80 MM S. DAK. 13 8 6 6 B MICH 8 7 9 3 BM WYO. 83.3 9 MB MICH. 3 5 5 7 S C 6/2757 M NEV. 5/ 8 2.2 4 BH MONT 138.3 4 B WASH 87 79 BMB ARK. 83 18 MM WASH. 3 5 5 6 CONN 24 19 M 80 26 “■ NC 133.55 B HAWAII 8 7.0 3 MM N.Y. 83.17 MBB ALASKA 3 5.13 M VA 2 2 91 M WASH. 78 50 MM UTAH 117.73 M ALASKA 85.75 SMES COLO. 8 1.18 DM OKLA. 3 4 00 SB ARIZ 2 2 5 3 M S DAK. 77 62 ^M VA 9 2.8 8 ■ WYO. 84.02 BBB S OAK. 80.98 BMB S OAK. 3 3.9 3 MB WYO 2160 IB TEX. 76.53 MM IOWA 8 6.9 3 I UTAH 80.96 MM KY. 80.31 BBM 0. C. 3 3 3 4 BM WVA 2116 SB M0. 76.51 M« N H. 8 1.47 B LA. 80.6 1 MM M0 78.7 9 MM IND 3 3.14 MM NMEX 2019 » OKLA 76 4 7 ^M Rl 73.18 I M0 80.00 MM CONN. 78.14 BM NMEX. 3 2.79 BWI NH I90e£ HAWAII 7 3 6 9 MM ARK. 6 6.2 6 I VA 7 7.2 8 MM VA. 77.6 0 BBM NEBR 3 2.7 8 M MONT 18 3 4 M S"EG- Mt> 4 4 5 8 I DC 76.78 BBM UTAH 76 4 1 MM NEV 5/ 3 2 3 5 BM ALASKA 8I4B VA 7 3.3 9 M V. I 44.04 I N. C 7 5.5 3 Mi N. DAK. 73.9 1 BM PA. 3 172 MB COLO 14 9 8 B UTAH 72.05 BM TENN. 40.3 5 I KY. 7 5.04 MM ILL. 7 3 5 5 MB MAINE 3 156 US® TENN 14 9 3 B NY 7 185 MB KY 3 8.08 I VT. 7 4.7 5 MB OREG. 71.66 Mil OEL. 3 0 40 HBS MISS 14 4 7 B ALA. 7 1.08 BM WVA 30.2 1 I ARK 7 4.08 BBS PA. 71.55 M VT 2 9 07 MB N DAK 13 79 B nt mi SE S DAK 7 3 40 " M0NT 6 9 3 5 “ FRIZ 2854 Ml MAINE 13 6 8 a OEL 69.65 MS MONT 7 3.2 4 BMB MINN. 69.02 MB WVA. 2 7 4 6 M GA I 3 4 6 B N. C. 6 8.4 5 MB N DAK 73 02 MM FLA. 6 8.5 5 Mi N. C. 2 6 90 M KY 12 7 5 B ARK. 66.90 MB ARIZ 7 1.92 MB ARIZ. 66.7 0 BIB KY. 2 6 6 3 BB ALA 12 7 4 S FLA. 6 4 76 Mi TEX 71.59 BKi WASH. 63.7 3 BB VA 2 6 2 8 M N C 10 50 ■ N DAK 6 4.2 4 MH MINN. 7 0.5 5 BM GA. 6 3.2 3 MB M0. 2 5 7 4 M SDAK. 10 3 7 i KY 6 3.85 BM ILL. 69.13 Mffil LA. 60.73 BM TENN. 24.60 ^ PRI007B ARIZ. 62.45 M IDAHO 6 9.0 4 M TENN. 60.5 0 S3 GA. 24 3 0 S!H ARK 4 07 I TENN 6121 MSI ALA. 6 8 9 3 BM TEX. 5 9 00 M LA 2 3.9 7 M GA. 60 64 Ml FLA. 6 8 8 2 BM IDAHO 58.3 1 BBi TEX. 2 1.35 M W. VA. 5 9.5 0 MB S C- 6/ 6 2.4 6 BM W. VA. 57.09 iSH V. I. 2 0 I 3 BM SC 6/57 90 M GA 62.18 BM S.C. 6/56.61 M ARK 17 7 9 M ILL- 54 08 M TENN 60 50 IM ALA. 50.3 5 M SC 6/15 9 4 B MINN. 53 13 M WVA 60 00 id MISS. 45.5 1 M FLA 159 1 B MISS. 4 5 3 1 M MISS 4 8 84 M p. R. 8.78 GUAM 15 6 5 B V. I. 40.68 M P R. 8.7 I I ALA. 12.70 B GUAM 3 5.4 2 M Miss 7.8 9 I P R 8 6 9 j P. R. 4. I I I „ 1/ NOT COMPUTED FOR GUAM AND WYOMING. FEWER THAN 50 RECIPIENTS; NO PROGRAM IN REMAINING STATES. 2/ NOT COMPUTED FOR GUAM AND THE VIRGIN ISLANDS, FEWER THAN 50 RECIPIENTS. 3/ NO PROGRAM FOR NEVADA NOT COMPUTED FOR GUAM AND THE VIRGIN ISLANDS, FEWER THAN 50 RECIPIENTS 4/ data NOT REPORTED BY PUERTO RICO AND CALIFORNIA. 5/ NOT COMPUTED FOR GUAM, FEWER THAN 50 RECIPIENTS; ANO FLORIDA, IDAHO, INDIANA, IOWA, NEBRASKA, OKLAHOMA, OREGON. TEXAS, ANO VERMONT, DATA NOT AVAILABLE. 6/ MAY DATA , JUNE DATA NOT RECEIVED. 7/ INCLUDES SMALL AMOUNT OF MONEY PAYMENTS NOT SUBJECT TO FEDERAL PARTICIPATION. 8/ BASED ON ' DATA INCLUDING AN UNKNOWN NUMBER OF CASES RECEIVING MEDICAL CARE, HOSPITALIZATION, AND BURIAL ONLY, AND TOTAL PAYMENTS FOR THESE SERVICES. Welfare Administration 39 Average payments are not only low, but vary widely from State to State as evidenced in the range of payments for a dependent child in June 1966 from a low of $7.89 in Mississippi (except for $4.11 in Puerto Rico) to a high of $51.44 in New Jersey; and for an old-age recipient from a low of $45.31 in Mississippi (except for $8.69 in Puerto Rico) to a high of $124.47 in Wisconsin. (See Chart 1.) Assistance payments during 1966 represented less than a cent per dollar of total personal income in the Nation during 1966. RELATION TO SOCIAL INSURANCE About half of the OAA recipients and two-thirds of the MAA recipients received assistance to supplement their OASDI benefits under social security in order to meet basic or special needs. The percentage of other types of public assistance recipients who also received social insurance was considerably smaller—18 percent in AB, 14 percent in APTD, and 6 percent in AFDC. The 7-percent increase in OASDI benefits effective October 1, 1965, was deducted as income from most public assistance grants; only 12 States permit the optional exemption of $5 a month. However, an estimated 900,000 aged persons on public assistance in 46 of the 54 jurisdictions were allowed to keep their retroactive “lump sum” social security benefit without deduction from the public assistance grant. About 900,000 recipients of public assistance were identified and had social security account numbers assigned. Program Developments MEDICAL CARE Concerted Bureau effort was directed toward planning for and implementing the new medical care legislation. An ad hoc advisory committee, representing various groups in the health and medical field, and a group of consultants to the Bureau on medical matters assisted in the development of policies interpreting legislative requirements. Planning meetings on policy and desirable relationships among the constituent agencies involved were held with the Public Health Service, Vocational Rehabilitation Administration, the Social Security Administration, and the Children’s Bureau of the Welfare Administration. Working relationships were also established with various national public and voluntary agencies in mental health areas. Official policies affecting the implementation of medical assistance programs under title XIX were issued for State use, and technical assistance was given to States wishing to develop medical care programs. Many State officials came to Washington to discuss their plans, and by the end of the year such meetings had been held with State agency staffs of the 27 jurisdictions that submitted plans or a preliminary prospectus. 237-319—67——4 40 Department of Health, Education, and Welfare, 1966 By the end of the year, 20 jurisdictions had completed plans for initiating medical assistance programs, 9 of which had been approved (California, Hawaii, Illinois, Minnesota, North Dakota, Ohio, Oklahoma, Pennsylvania, and Puerto Rico). One program was initiated on January 1, 1966, but had not yet been approved (New York). The scope of the approved programs was generally broad; the coverage, in terms of numbers of people provided for, tended to be at minimal levels. WORK EXPERIENCE AND TRAINING PROGRAM Title V of the Economic Opportunity Act provides Federal funds to State public welfare agencies for projects designed to raise the employability of needy persons who otherwise would not have the opportunity for constructive work experience and other needed training. Projects developed and administered at the community level provide work experience with public institutions and private employers, on-the-job instruction, vocational courses, literacy training, and instruction in good work habits. Work experience and training is combined with the provision of social services, since most of the hard-core, longtime unemployed are undereducated and often functionally illiterate, untrained with few if any marketable skills, and usually heads of needy families with a multiplicity of problems associated with the extremes of economic, cultural, and educational deprivation. Social services, including family support, medical care, child care, homemaker services, and counseling, are made available to assist such persons in overcoming serious and long standing personal and family problems that interfere with their efforts to become self-supporting and independent. Maximum use is made of other programs contributing to these goals, such as the State employment service and manpower development and training (MDTA) and other training programs; there is also close cooperation with other anti-poverty programs. Trainees are counseled in the selection of training, and after completing a comprehensive program of work experience and training, they are aided in finding jobs. By June 30,1966, after 20 months of operation, 256 work experience and training projects and 55 administrative staff projects were funded; 147 of these (including 9 administrative staff projects) were initiated during fiscal 1966. Projects were in operation in approximately 600 cities, counties, and Indian reservations in 52 jurisdictions. Obligations during the 20-month period amounted to $223 million; $111 million of this amount was expended in fiscal 1966. The average cost of training per individual was about $1,337. W elf are Administration 41 By the end of June 1966, nearly 104,000 persons had taken part in the work experience program. About a third of the 45,800 participants who left the program obtained gainful employment immediately after completing their training; the average monthly income from wages of a sampled group of trainees was $258, a 79-percent increase over the average monthly family assistance grant of $144 received before training. A smaller number (6,000) went into advanced vocational training. In addition to the work experience program, about 20,000 persons participated in the public assistance work and training program set up by a 1962 amendment to the Social Security Act. CIVIL RIGHTS COMPLIANCE Statements of compliance and of implementing methods of administration to ensure compliance with title VI of the Civil Rights Act of 1964 were submitted as plan material by all jurisdictions except Alabama. A hearing on Alabama’s noncompliance was held in October 1965. Reviews were made of State plans for compliance, and a procedure developed for handling complaints. Guide materials on nondiscrimination in federally aided programs were developed for use with States; regional staff investigated complaints and worked with State agencies to remedy problems of noncompliance. Bureau staff participated in State and local reviews of compliance, and helped plan and carry out the Welfare Administration’s intensive review of the operation of civil rights provisions in the Mississippi public welfare program. SOCIAL SERVICES Sustained effort was made to assist States in fulfilling the social service commitments which, under the 1962 public welfare amendments, entitled them to receive increased Federal funds. By January 1, 1966, all 54 jurisdictions were providing social services in the AFDC program; and 41, in the adult categories. Reviews of State operations indicated that some States are providing services to a significant extent, but also showed variations in the tooling-up process for statewide provision of services and difficulties in providing services because of insufficient staff. For example, only half the AFDC families and a tenth of the recipients aided under the adult categories received one or more social services between July and September 1965. The services most frequently provided to AFDC families related to maintaining family life and improving family functioning, health care, and self-support. In the adult categories, the most frequently provided services were health care and protective services. DEMONSTRATION PROJECTS Almost all the $2 million available for demonstration projects was obligated during the year; 79 new applications and 26 continuation 42 Department of Health, Education, and Welfare, 1966 requests were approved. Of the projects active during fiscal 1966, 21 involved direct social services; 28 aimed to strengthen administration and stimulate program development; 10 involved new methods of administration, including the restructuring of agencies; 44 were concerned with staff recruitment, development, or strengthening relationships with social work education; 13 involved new approaches to encouraging education or preparing for self-support; and 3 demonstrated extensions of eligibility or increased assistance payments. Model projects were designed for State use. One model stimulated 41 projects, in 27 States, which financed the summer employment of 121 social work faculty on assignments relating social work education more closely to public welfare. Another model resulted in 7 “Operation Bootstrap” projects to strengthen State agency administration by permitting employment of 91 specialists in social services, homemaker services, volunteer services, staff development, public information, field operations, and medical care administration. REPATRIATION PROGRAM Assistance was provided to 826 destitute or ill Americans returned to this country by the Department of State under legislation enacted in 1960 and 1961. Included were 300 children—with incapacitated parents or unaccompanied—who required foster placement or institutional care, and 212 mentally ill persons, 60 of whom received care at Saint Elizabeths Hospital. Most returned from European countries; 29 were repatriated from Cuba following negotiations with the Swiss Government, and 22 from the Dominican Republic. Assistance to these individuals was provided through State and local welfare departments at ports of entry— meeting repatriates, and arranging for emergency food and lodging, needed hospitalization, and transportation back to their home States. Agreements to participate in the repatriation program were formalized with three additional States (Connecticut, Massachusetts, and New Hampshire), making a total of 13. EMERGENCY WELFARE SERVICES Efforts were continued to develop a national standby program of aid and services to provide the necessities of life to the homeless in the event of national disasters, such as enemy attack. Readiness criteria and objectives were developed and tested with 14 States. Agreements formalizing Federal-State relationships in administering emergency welfare services programs were negotiated with three jurisdictions; leaving only six that had not yet signed such agreements. Manuals on emergency social services, clothing, and lodging were issued; manuals on emergency feeding and on welfare registration and inquiry were nearing completion. Technical assistance was provided to 35 State welfare agencies, with emphasis on interpreting the W elf are Administration 43 role of welfare in national shelter-based civil defense programs. A training syllabus for social services in emergency conditions was issued, and a training course in emergency mass feeding was prepared jointly with the American National Red Cross and the Office of Civil Defense. Administrative Developments STAFF DEVELOPMENT New requirements effective October 1, 1965, set as a floor the requirement of an undergraduate college degree for the beginning professional job in federally aided public assistance programs. States have improved their educational leave programs, but considerably more effort is needed to provide sufficient qualified staff. States will be required, beginning July 1, 1967, to increase the number of students on educational leave from year to year. About 400 persons in State and local agencies were engaged in staff development and training in public assistance and child welfare programs. Workshops were held for newly appointed State staff development personnel, for State specialists on aging, and for State fiscal officers; and an institute was held for local agency directors on group methods in administration. Technical assistance was provided to States in various aspects of staff training, and in establishing undergraduate social welfare sequences. Monographs were prepared on the utilization of social work staff with different levels of education and on the utilization of the auxiliary worker in providing family services. A report on the characteristics of State staff development provisions was issued, and teaching materials were being developed for State use in various areas, including training local administrators and orientation of new workers. NEW POLICIES Regulations were developed for a simplified process of determining eligibility of individuals for public assistance. These regulations curtail harassing investigative procedures, such as night visits to recipients’ homes and illegal searching practices. The regulations consider the assistance recipient as the primary source of information, and provide for the use of a declaration form in applying for assistance. New regulations also require States to simplify their methods of need determination, and prohibit the practice of assuming as income amounts which, in fact, are never received. New policies were issued also on funds matchable as expenditures for administrative costs, including provision for Federal participation in costs of legal representation of assistance recipients who have requested a State hearing on the local agency’s decision about their cases. 44 Department of Health, Education, and Welfare, 1966 ORGANIZATION AND MANAGEMENT A study was made by Harbridge House, Inc., a management consultant firm, of the organization and management of the Bureau. Consideration was also given by the Bureau to substantial changes in regional office workload and functions, and their impact on responsibilities of regional office staff. Several divisions within the Bureau were reorganized to reflect increased responsibilities, and the employee training and development office was expanded to administer a new career development program in public welfare administration for recent graduates of schools of social work. A simplified concept of the State plan for the MA program was developed and, after a period of experience, is to be extended to other programs. Staff guides were prepared on several aspects of policy-making activities, and are in process in other administrative areas. A program planning and budgeting system was introduced, and a project initiated on the development of an organized case classification system applicable to public welfare needs. Work was completed on the conversion of the method of payments for public assistance grants to States from monthly Treasury checks to a letter-of-credit system; substantial interest savings to the Federal Government are expected to result from this change. Technical assistance was provided to States on organizational problems, procedural and paperwork simplification, use of automatic data-processing equipment, improvement in the quality of fiscal operations, statistical reporting procedures, quality control, establishment of local units for welfare services and “one-stop centers,” and other areas of administration and management. Special surveys were conducted in eight State agencies of administrative, fiscal, or organizational problems, and in the five States which include protective payment provisions under the AFDC program. REVIEW OF STATE OPERATIONS “Operation Big City,” a special review of large city public welfare operations, was carried out in six cities—Atlanta, Cleveland, Los Angeles, Minneapolis, New Orleans, and Philadelphia—to learn more about special problems in large urban welfare administration and the agency’s effectiveness in dealing with them. Bureau staff also participated in a followup conference with State and local welfare administrators on urban public welfare administration. Administrative reviews of social services were carried out in 35 States, of Cuban refugee assistance program in 5 States, and of fair hearings in 4 States. Individually planned reviews of special sub Welfare Administration 45 ject areas were also held in. several States. Revisions in the quality control program in public assistance were introduced, and assistance given to States in installing the changes. RESEARCH Reports were issued on the studies made of the characteristics of AB and APTD recipients. Studies of the characteristics of OAA and MA recipients were in process. PUBLIC INFORMATION Work is underway on a motion picture on the key issues of public assistance. Fact sheets and informational pamphlets were developed in new program areas, and others revised to reflect program changes. News releases, exhibits, and other visual aids were prepared; editorial services were given to professional staff; and over 30,000 public inquiries answered. Technical assistance was provided on request to several States, and all States were encouraged to plan programs, including visits to the poor, to help civic leaders get a better understanding of social problems and the community’s resources for dealing with them. Children’s Bureau The Children’s Bureau assists the States, through technical and financial aid, in enhancing and protecting the well-being of children and youth through child health and welfare services. The Bureau also studies many types of conditions affecting the lives of children and youth, makes recommendations to promote better practices in child health, child welfare, and juvenile delinquency, and helps establish standards for the care of children. Legislation in 1962, 1963, and 1965 increased the authorizations for annual appropriations for maternal and child health, crippled children’s, and child welfare services and authorized special project grants for maternity and infant care, comprehensive health services for school and preschool children, research relating to maternal and child health, and crippled children’s services, and training of professional personnel for child welfare services and health care for crippled children. The Bureau in fiscal year 1966 broadened and improved its programs for children with emphasis on the areas of civil rights, mental retardation, family planning, child abuse, youth services, and training of professional workers. 46 Department of Health, Education, and Welfare, 1966 1966 Appropriations The amounts appropriated for the Children’s Bureau for fiscal year 1966 were: Salaries and expenses----------------------------------------- $4, 840, 000 Grants for maternal and child welfare------------------------$187, 000, 000 Maternal and child health services----------------------------- 45, 000, 000 Crippled children’s services----------------------------------- 45, 000, 000 Child welfare services________________________________________ 40, 000, 000 Special projects for maternity and infant care-------- 30, 000, 000 Special projects for health of school and preschool children-- 15, 000, 000 Research projects relating to maternal and child health services and crippled children’s services_________________________ 4, 000, 000 Research, training, or demonstration projects in child welfare- 8, 000, 000 Interdepartmental Committee on Children and Youth The Interdepartmental Committee on Children and Youth is composed of representatives of 37 Federal agencies whose programs affect the well-being of children and youth. The Chief of the Children’s Bureau is First Vice Chairman and Acting Chairman by delegation of the Secretary of Health, Education, and Welfare, who is Chairman. The Bureau also provides the secretariat. The Committee undertook a survey of Federal programs assisting children and youth. The purpose was to prepare a comprehensive inventory of such programs, a compilation and analysis of Federal funds expended for them, and, where possible, statistics on the numbers served. An ad hoc Subcommittee on Youth Activities worked with a counterpart committee of national voluntary organizations in preparing a report for the White House Conference on International Cooperation in December 1965. The Interdepartmental Committee participated with the Council of National Organizations, the National Council of State Committees on Children and Youth, and the National Committee on Children and Youth in the Mid-Decade Conference on Children and Youth held in Washington in April 1966. Two publications were issued: School to Work and Parent and Family Life Education for Low-Income Families. State Committees for Children and Youth The Bureau served as a resource for materials, information, and consultation for 42 established or developing State committees for children and youth. The concern of the State committees during fiscal year 1966 about different aspects of youth life reinforced the Bureau’s emphasis on youth. Welfare Administration 47 Health Hazards of Smoking The Public Health Service National Clearinghouse on Smoking and Health and the Children’s Bureau sponsored a national consultation of youth leaders on the health hazards of smoking. The 3-day meeting produced many suggestions for further activities to help national voluntary organizations working with children and youth provide information and guidance to young people about the health hazards of smoking. The youth leaders recommended that the Children’s Bureau continue to issue publications for young people on smoking. Youth Services The Bureau initiated plans to collect data on problems of youth. This information will be used to mobilize public and voluntary resources in realigning or creating structures that will provide support for youth to have constructive roles in their own homes and contribute to their immediate and broader communities. Physically Abused Children The Bureau continued to highlight the development of medical, legal, and social work programs to protect the physically abused child. Interest in child abuse reporting legislation continued in the States, with the emphasis shifting from enactment to implementation of the laws. In 1966, Mississippi, Virginia, and the Virgin Islands passed new statutes, and Maryland revised a previous law. Forty-nine States and the Virgin Islands had reporting statutes as of June 30,1966. The Children’s Bureau cosponsored two meetings on child abuse in 1966: A roundtable workshop on patterns of parental behavior leading to physical abuse of children, conducted by the University of Colorado Medical Center; and a conference on child abuse and the juvenile courts, held by the Columbia Law School Project on Child Welfare and Legal Authority. Programs of the Bureau RESEARCH IN CHILD LIFE In addition to issuing its own studies and cooperating in joint studies, the Bureau supported research in child health and welfare through two research grant programs. During fiscal year 1966, the Bureau’s intramural research included studies on waivers from juvenile courts to criminal courts, the intake process in public child welfare agencies, and trends in foster care and adoption; an evaluation of a preschool program for culturally deprived 48 Department of Health, Education, and Welfare, 1966 children; and surveys of child care arrangements of working mothers, infant mortality in low-income urban neighborhoods, and probation services and juvenile courts. Some Facts and Figures In 1964,4,027,490 children were born in the United States, or slightly less than the 4,098,020 born in 1963 and 5 percent less than the record number of 4,254,484 in 1957. During the past decade, the number of births each year has been relatively stable: between 4.0 and 4.2 million. When the babies born in the years of high birth rates, 1947-57, reach childbearing age, the number of births will increase. Assuming fertility rates will be somewhat lower than in 1960-63, the Bureau of the Census estimated that 4.72 million babies will be born in 1969-70, 5 million in 1971-72, and 6 million in 1979-80. The child population under 18 years of age numbered 70,432,000 on July 1, 1965. During the past 10 years, the child population under 18 has increased by 15 million—from 55.7 to 70.4 million. In 1955, 34 percent of the population was under 18 years of age; in 1965, 36 percent was under 18. By 1970, the population will include 80 million children under 20 years of age. More than 60 million will be in the school- or college-age group from 5 through 19 years. Youth in the age range 15 through 19 numbered 13.3 million in 1960 and may reach 19.1 million in 1970. In 1965, there were about 38.9 million women aged 15 through 44 years. According to Census Bureau estimates, the number of women in the childbearing age will increase to 42.3 million in 1970, to 46.9 million in 1975, and 51.9 million in 1980. There were 28.3 million families with related children under 18 years of age in the United States in 1965. Of this number, 25 million (89 percent) were husband-wife families, 2.9 million (10 percent) were families with a female head, and 0.4 million (1 percent) were families with a male head. Eighty-eight percent of the children under age 18 lived with both parents, 9 percent with one parent (8 percent with mother only and 1 percent with father only), and 3 percent with neither parent (most of them with relatives). In 1964 (the latest year for which figures are available), births out of wedlock continued to increase: the number rose from 259,400 in 1963 to 275,700 in 1964, and the rate rose from 22.5 per 1,000 unmarried women aged 15 through 44 years in 1963 to 23.4 in 1964. Almost 7 percent of all live births were out of wedlock. In that same year, infant mortality declined 2.7 percent from the 1960-62 average. The rate was 24.8 deaths of children under 1 year of age per 1,000 live births, the lowest ever achieved by the United States. W elf are Administration 49 The death rate in 1964 for children aged 1 through 4 years was 96.1 per 100,000 children of that age as compared with 108.8 for 1960. For children aged 5 through 14 years, the death rate in 1964 was 43.3 per 100,000 as compared with 46.6 for 1960. The main cause of death of children aged 1 through 14 years was accidents other than in motor vehicles. Motor vehicle accidents were the second highest cause of childhood deaths. The number of working mothers with children under 18 years of age continued to grow. In March 1965, about 9.7 million mothers were working, about 200,000 more than a year earlier. About one-third of all mothers with children under 18 were working. There were 3.7 million working mothers with children under 6, and 6 million with older children. About three-fourths of these mothers had full-time jobs. Maternal and Child Health and Crippled Children’s Research Grants The amount awarded for maternal and child health and crippled children’s research grants from fiscal year 1966 funds was $3,977,398 for 30 new projects and continuation of 37 projects. Grants were made to support research in such areas as family planning, nutrition, prenatal influences, prosthetics and orthotics, preventive services, incidence of breast feeding, congenital hand anomalies, galactosemia screening, infant formulas, auditory testing in infancy, hospital care of children, interdisciplinary services for handicapped children, programed instruction in prenatal and infant care, prophylaxis in noncardiac rheumatics, neurological findings and learning deficits in preschool children, and psychological assessment of the preschool child. Child Welfare Research and Demonstration Grants Child welfare research and demonstration grants supported studies and demonstrations in foster care, adoptions, services for mentally retarded children, manpower utilization and training, day care services, services for unmarried mothers, protective services for neglected and abused children, and child care facilities. Of the $3 million available for these grants in fiscal year 1966, $2,999,425 was awarded for 51 projects. Final reports were received on nine studies: “The Training of Personnel for Licensing of Family Homes in Child Welfare,” “The Value of Homemaker Service in the Family With the Mentally Retarded Child Under Five,” “Followup Study of Older Children Placed for Adoption,” “Paths to Child Placement,” “A Study of the Problems of Integrating Physically Handicapped Children With Nonhandicapped Children in Recreational Groups,” “Cost Analysis in Day Care Centers for Children,” “Social Distance and Illegitimacy,” “District of Co 50 Department of Health, Education, and Welfare, 1966 lumbia Junior Village Project,” and “Development of Methodology for Evaluative Research in Child Welfare.” MATERNAL AND CHILD HEALTH AND CRIPPLED CHILDREN’S SERVICES During 1964, State and local public health agencies provided 287,700 expectant mothers with maternity clinic services as part of their maternal and child health services programs. Thirty-seven thousand mothers who had complications of pregnancy received inpatient hospital care, and 8,000 premature infants were cared for in hospital premature centers. About 1,500,000 children (605,000 babies, 678,000 preschool children, 224,000 school children) were seen in well-child conferences. Approximately 8,352,000 school children were screened for visual defects; 5,342,000 for hearing defects; and 3,024,000 for dental defects. Physicians made 2,437,000 examinations of school children. Some 2,996,000 were immunized against smallpox; 4,306,000 against diphtheria; 3,064,000 against whooping cough; and 4,683,000 against tetanus. Booster shots were a regular part of the immunization program. Public health nurses visited approximately 2,860,000 children. The State crippled children’s programs continued to grow. More than 423,000 handicapped children under 21 years of age received services under these programs in 1964, or 7 percent more than in 1963. The rate increased from 5.1 children per 1,000 children under 21 in the population in 1963 to 5.4 in 1964 (which was twice the rate in 1937). Approximately 73,600 children received inpatient hospital care; the average number of inhospital days per child was 19.1. Three-fourths, or 316,000 children, received diagnosis, treatment, and followup care in medical clinics; about one-fourth were treated by physicians in homes or offices. As in previous years, congenital malformations represented the largest single diagnostic category of children served by crippled children’s agencies, about 30 percent of the total. The median age was 8 years, and more than half of the children served were male. State and local public health agencies spent an estimated $123 million in fiscal year 1965 for maternal and child health services. This included expenditures of $88.2 million from State and local funds (72 percent of the total) and $34.7 million from Federal funds (28 percent). State and local crippled children’s agencies spent an estimated $99.7 million in fiscal year 1965 for crippled children’s services. This amount included expenditures of $64.6 million from State and local Wel fare Administration 51 funds (65 percent of the total) and $35.1 million from Federal funds (35 percent). Mental Retardation Services Services for mentally retarded children have expanded rapidly since 1957. States have established clinical services for the diagnosis, evaluation, and followup care of mentally retarded children by a multidiscipline team. Cytogenetic studies and parent counseling were important components of service. A number of medical center mental retardation clinics have developed satellite clinics in neighboring towns. By the end of fiscal year 1966, there were 191 mental retardation clinics, of which 134 were supported in whole or in part by Children’s Bureau funds. Maternity and Infant Care Projects A program of comprehensive maternity care for women in low-income families has been in operation since April 1964. Twenty-six new projects were approved during fiscal year 1966, making a total of 51 maternity and infant care projects, for which a total of $32.7 million has been obligated. Thirty-five of these projects were in urban areas, 16 in predominantly rural areas. Of the 8 cities in the United States with 1960 populations over 500,000 and maternal mortality rates of 50 or more deaths per 100,000 live births, 7 had maternity and infant care projects. Of the total of 21 cities with populations over 500,000, 15 had projects. By the end of fiscal year 1966, 37 projects were giving care to patients ; 14 were recruiting for staff, making arrangements for physical facilities, and negotiating contracts with hospitals or agencies to provide patient care. Approximately 118,000 prospective mothers have been admitted for services under this program. Family Planning State health departments, used maternal and child health funds to provide family planning services as part of their programs and to support training programs such as short-term institutes in population dynamics, maternity care, and family planning. The maternity and infant care projects were the means of extending family planning services for low-income families in some of the major cities. The subject was discussed usually during prenatal visits, and the services were provided at the postpartum visits. The availability of family planning services was credited with more than doubling the number of patients who returned for postpartum care. CHART 2.—INFANT MORTALITY RATE, UNITED STATES, 1964 52 Department of Health, Education, and Welfare, 1966 U. S. average 24. 8 \ U. So median 24. 1 19. 8 - 22. 4 (13 states) 22. 5 - 24.1 (13 states) 24. 2 - 28. 2 (13 states) 28. 9 - 39. 4 (12 states) Number of deaths under 1 year per 1, 000 live births (by place of residence) ALASKA HAWAII D. C. Welfare Administration 53 In fiscal year 1965, 25 States reported spending $1,850,000 from maternal and child health services and maternity and infant care funds specifically for family planning services. It was estimated that $3 million was spent in fiscal year 1966 by 32 or more States for this purpose. CHART 3.—MATERNAL AND CHILD HEALTH SERVICES, 1947-64 Health of School and Preschool Children Projects The 1965 Social Security Amendments authorized a program of special project grants for health of school and preschool children, particularly in areas with concentrations of low-income families. The program includes screening, diagnosis, and preventive services, both medical and dental. Treatment, correction of defects, and aftercare services are provided to children who would not otherwise receive them because of low family income or other reasons beyond their control. By the end of fiscal year 1966, 14 projects in 11 States had been approved, for 'which a total of $14.7 million had been obligated. Three of these grants were to teaching hospitals, five to universities, four to city health departments, and two to State health departments. Two projects serve predominantly rural areas with the objective of bringing university medical services to rural communities. Services for the Multiply Handicapped The children seen in the crippled children’s programs and the mental retardation clinics presented increasingly more complex handicaps, especially neurological handicaps. As a result, the trend was toward INFANTS SERVED BY WELL CHILD CONFERENCES OTHER CHILDREN SERVED----- BY WELL CHILD CONFERENCES MOTHERS SERVED BY MATERNITY MEDICAL CLINIC SERVICE MOTHERS ATTENDING Z PRENATAL CLINICS 900 - 800 - 700 - 600 - ° 500 - oo x 4°0 - i— 300 - 200 - 100- 0 - 0 —I-----d----1-----1-----d-----d----1-----b----d-----d-----F----d----d------d---H------d-----1---- 1947 1949 1951 1953 1955 1957 1959 1961 1963 54 Department of Health, Education, and Welfare, 1966 CHART 4.—CHILDREN SERVED IN THE CRIPPLED CHILDREN’S PROGRAM, 1937-64 450 -r- 400 ■’ 350 - i — 300 - w 1 : ■g . -tv :p- □ : i 250 - • L •• •" • ;• ■ :• • • £ i £ 200 - ' :’-:L " 5 2 U )■ • ’••?• !*.♦»*’**" • "• ' * -J— o number . ^^^r***’ ’• CHILDREN SERVED k 697,300 / PUBLIC VOLUNTARY AGENCIES AGENCIES TOTAL 483,800 213,500 0 50 100 150 200 250 300 Welfare Administration 57 Department of Health, Education, and Welfare, the Office of Economic Opportunity, national voluntary organizations, and State child welfare agencies was called by the Children’s Bureau of the Welfare Administration to consider more effective ways of providing better daytime services for children. Child welfare agencies increasingly became aware that homemakers can strengthen protective services for children. Forty States included homemaker services in their child welfare services plans for fiscal year 1966. Although the States continued to demonstrate an interest in the development of protective services for neglected and abused children, these programs did not expand as fast as the need increased for around-the-clock, 7-day coordinated services. The national emphasis on programs for mentally retarded children was accompanied by increased child welfare services (particularly casework, homemaker services, day care services, and foster family care) for mentally retarded children and their families. Mental retardation content was finding its way into the curriculum of schools of social work, and field instruction placements in community settings rather than in institutions were on the upswing. Cooperative planning and communication between child welfare agencies and other agencies serving the mentally retarded were more in evidence. The Children’s Bureau continued to carry overall responsibility for the child welfare aspect of the Federal Cuban refugee program, which entered its sixth year in February 1966. Approximately 130 agencies in 39 States have participated in this foster care program which has served over 8,000 children. A dramatic change in the number of unaccompanied Cuban refugee children requiring foster care in the United States came as a result of the U.S. airlift from Cuba which started on December 1, 1965. The number of children in foster care was reduced from 1,500 on December 1, 1965, to 727 on May 30, 1966. Only 261 children remained in care in the Miami area. JUVENILE DELINQUENCY SERVICE Police arrested over 1.4 million children under 18 years of age in the United States in 1965, or 47 percent more than in 1960. The population in this age group had increased only 17 percent during the period. Nationally, persons under 15 years of age made up 9 percent of the total police arrests, while those under 18 years of age made up 21 percent of the total police arrests. In 45 percent of the cases where formal charges were preferred, the offenders were referred to juvenile court jurisdictions. Sixty-one percent of juvenile referrals were for auto theft. Young persons were referred to juvenile court 58 Department of Health, Education, and Welfare, 1966 CHART 6.—JUVENILE DELINQUENCY IS STILL INCREASING 1,200 -T- 1,000 -- / 900 - / 800 — 700 — / . 600 — delinquency cases (including traffic) / / 500 - / c I j . ■ rt I delinquency cases o J / (excluding traffic) O 400 -- / W / rt / u / i ? 3 / \ / c 300 — / \ / _ -f- 30,000 | 5 / VZ i I / z I 9 / /' : 8 200 -^ .... . x. + 20,000 child population ; t- zx (10-17 years of age) ' J* । c T 1 5 75 i 1 a l o 100-|- | | |- I I I 1 1 | I I I- I I I I I I I I I I I I I- 4- 10,000 £ 1940 42 44 46 48 50 52 54 56 58 60 62 64 66 jurisdictions after being charged in 52 percent of burglary cases, 45 percent of larceny cases, 34 percent of forcible rape cases, 15 percent of aggravated assault cases, and 7 percent of criminal homicide cases. The Bureau is responsible for developing program plans, guides, and recommendations for services in the field of juvenile delinquency; providing leadership in the development of National, State, and local programs for the control and treatment of juvenile delinquency; providing technical aid and advisory service to public and voluntary agencies and others on method, content, organization, and coordination W elf are Administration 59 of such programs; and assisting in planning broad training programs for professional and nonprofessional staff working with delinquent children. States, bar associations, Governors’ commissions, and legislative commissions sought consultation in 1966 on nearly every aspect of service to delinquent children, including State administrative structure, detention, police methods, training, institutional care, juvenile and family courts, probation services, and aftercare and parole. Bureau staff began comprehensive studies of services to delinquent children in 10 States. Five of these studies had been completed by the end of the fiscal year. The Bureau prepared position papers and background material for the National Commission on Law Enforcement and Administration of Justice, which was created by the President in 1965, and for a similar, short-term commission in the District of Columbia. The Supreme Court of the United States for the first time granted certiorari in two juvenile matters, one of which was decided (Kent v. U.N., 383 U.S. 451), and accepted jurisdiction in a third. Appeals from juvenile courts further focused attention upon basic legal rights and the elements of due process. Standards for Juvenile and Family Courts, issued by the Bureau in 1966, was used as legal resource material in the juvenile matters pending before the U.S. Supreme Court. New and amended juvenile court statutes in many States clarified the right to be represented by counsel. Statutes in California, New York, Ohio, Oregon, Washington, and Wyoming provided for access by counsel to social records and other information insofar as such facts figure in the dispositional phase of the court hearings. Eight State legislatures in 1966 established new courts or reorganized State court systems. Hawaii enacted a new statewide Family Court Act, effective July 1, 1966. Illinois revised juvenile court procedures through its Juvenile Court Act of 1965. This Act made mandatory three separate hearings—detention, trial, and disposition. The Iowa Juvenile Court Act of 1965 provided court-appointed counsel for indigents and gave the criminal court concurrent jurisdiction of all crimes committed by juveniles. Maryland created, in 1966, a new department of juvenile services to contain in one agency the administration of all activities dealing with youth and their problems. The North Carolina Courts Commission bill of 1965 abolished all courts inferior to its superior court on a certain schedule between 1966 and 1971. North Dakota established family courts as divisions of district courts. Utah separated the juvenile court from the State 60 Department of Health, Education, and Welfare, 1966 department of public welfare and established it as a statewide court at the district court level with a juvenile court commission authorized to appoint judges. Vermont created a district court system to replace municipal courts. Some States changed the age of children subject to juvenile court jurisdiction. Arkansas lowered the maximum age of jurisdiction from 21 to 18 years; Kansas raised the age from 16 to 18; and New Hampshire lowered the age from 18 to 17. Lack of staff training remained the greatest barrier to adequate professional services in all States, especially among staff that had the most contact with delinquent youth—police line officers, detention workers, child care staff in institutions, and aftercare personnel. Recognizing the need for training, Congress appropriated funds in 1965 for the Joint Commission on Correctional Manpower and Training. Decisions by the U.S. Supreme Court on law-enforcement procedures in arrest and apprehension also motivated interest in law-enforcement standards and training at the State level. INTERNATIONAL COOPERATION United Nations International Children’s Fund (UNICEF') The Children’s Bureau serves as the focal point for coordinating technical advice from appropriate agencies of the U.S. Government on programs supported by UNICEF. The Executive Board of UNICEF met in Addis Ababa, Ethiopia, in May 1966. This was the second time in 20 years that the UNICEF Board had met in a developing country. The meeting was preceded by visits of small groups of the Board members to selected African countries and a 3-day session on the needs of the African child. UNICEF’s income in 1965 amounted to about $33 million, mostly from voluntary contributions of 117 governments. At the May session of the Executive Board, $28 million was committed to 224 projects, for which the Children’s Bureau obtained and collated reviews from appropriate U.S. agencies. The major policy issue left pending by the Board was UNICEF’s possible role in family planning. Training The Bureau, in cooperation with AID, the United Nations, the World Health Organization, and other agencies, planned training programs for a total of 267 visitors from 77 countries. Forty-two Wel fare Administration 61 specialists received training for 1 month or longer in child welfare, juvenile deliquency, and youth services; 29 in nursing and midwifery; and 27 in other aspects of maternal and child health. Others with interests varying from part-time volunteer work to full-time professional service received training for less than 1 month. The first international training program for nurses and professional midwives to include family planning as an integral part of maternal and Child health care was organized by the Bureau in cooperation with the Graduate School of Nursing, New York Medical College. Five AID-sponsored participants in key nursing and midwifery positions in Latin America and Africa completed the 13-week program. The second such program opened in June 1966 at Emory University School of Nursing for 16 key nurses from 8 nations. Research Grants The Bureau approved 6 new international research grants in the field of maternal and child health, making a total of 19 such projects to be approved since the program began in 1962. A study of prevention of tetanus in the newborn through immunization of the mother was the first to be approved for India. A study in Yugoslavia on the use of contraceptive devices to decrease cases of abortion was the first international research grant in the family planning field to be supported by the Children’s Bureau. International Conference on Inborn Errors of Metabolism The Federal Institute of Public Health of Yugoslavia hosted an International Conference on Inborn Errors of Metabolism in Dubrovnik, May 30-June 3, 1966. Participants from 13 countries included 37 experts engaged in the study of phenylketonuria and other inborn errors of metabolism. The countries represented were Belgium, Germany, Greece, India, Ireland, Israel, Mexico, Pakistan, Poland, Scotland, Sweden, Yugoslavia, and the United States. The conference was the first which the Children’s Bureau had organized and supported using U.S.-owned foreign currency under the interchange of experts program. 62 Department of Health, Education, and Welfare, 1966 Table 1.—Maternal and child health and welfare services: Grants for maternal and child health services, crippled children’s services, and child welfare services under the Social Security Act, by program and State, fiscal year 1966 1 [In thousands] Maternal and Crippled Child State child health children’s welfare services services services United States Alabama _______ _ — $40,558.3 1,090.7 $39,457.8 1, 000.0 $39,826.9 977.2 Alaska ______ __ _______ _ _ _ 203.7 159.6 115.4 Arizona - - - - _ _ - _ _ 561.6 428.9 Arkansas - _______ 606.7 617.2 566.7 California _ _ _ - - _ 2,288.3 1,962.5 2,623.2 Colorado _ __ __ ______ ___ _ 689.2 ' 424.8 417.8 Connecticut - - - - - - - 626.8 384.9 409.6 Delaware _ _ - _ _ _ _ 179.0 175.6 133.9 District of Columbia _ - _ ___ _ 429.3 364.9 156.0 Florida ____ _ __ _ __ 1,523.3 1,039.0 1,207.4 Georgia - _______ _______ _ _ 1,289.5 1,344.6 1,131.3 Guam __ _ _______ ' 105.3 82.9 89.0 II awaii 206.8 391.4 206.8 Idaho _______ _ _ __ _ _ _ — _ _ 197.3 419.3 203.0 Illinois - -- - -__ _ 1,187.5 1,298.3 1,553.4 Indiana - _ _ __ _ _ _ _ __ 744.3 ' 943.5 972.8 Iowa - - - __ _ _ ______ _ _ __ 440.7 987.4 620.1 Kansas __ _ _ _ _ _ _______ ___ _ 338.6 448.6 496.8 Kentucky __________ ______ _ _ _ _ _ 1,241.4 870.3 848.7 ■Louisiana - - - - - -- - - 963.8 973.1 1, 004.5 Maine - - - - - - - - - - 271.8 250.0 257.8 Maryland _ _ - - 784.1 809.6 641.4 Massachusetts - - - - - 855.9 654.3 859.8 Michigan _ _ _ _ _ 1,569.8 1,736.1 1,635.5 Minnesota _ _ _ _ 781.0 ' 959.6 800.3 Mississippi - - - — 917.2 626.6 745.4 Missouri — _ _ _ _ _ — 860.0 757.0 839.0 Montana - - - -- - 196.8 264.2 221.2 Nebraska _ ______ _ __ _ _ _ _ _ — 262.2 309.0 319.8 Nevada _ _ - - - - - - - - -- -- - - 191.8 220.0 122.3 New Hampshire- _ _ ____ 165.3 186.7 176.3 New Jersey _ - ______________ _ _ _ __ _ 613.8 342.0 1,014.6 New Mexico -- - - - - - - 552.1 367.1 332.8 New York _ _ _ _ _ 2,083.0 1,816.8 2,345.1 North Carolina __ _ _____ __ _ 1,570. 4 1,646.6 1,294.0 North Dakota __________ _ _ _ __ _ _ 195.6 207.6 220.1 Ohio _ _______ _ 1,756.1 1,678.9 1,906.0 Oklahoma _ _ ______ ______ _ — _ 549.2 534.2 602.9 Oregon _ - - - - - - - - - - - 420.6 414.7 345.6 Pennsylvania _ _ - -- ______ _ 1,766.6 2,252.7 1,939.4 Puerto Rico _ ______ _ _ __ _ _ 1,085.2 1,079.7 912.3 Rhode Island _ _ _ _ _ _ _ _ _ _ _ _ _ ' 369.0 250.9 224.6 South Carolina _ __________________ 869.8 900.2 771.8 South Dakota 85.0 190.2 231.2 Tennessee 1,187.3 1,039.5 981.8 Texas - 1,781.4 2,159.6 2,382.9 Utah - - 205.0 266.8 317.8 Vermont - 166.7 166.3 144.4 Virgin Islands __ - - - - -- 133.6 127.2 90.8 Virginia 1,224.3 1,223.1 907.4 Washington __ -- 685.7 607.1 593.4 West Virginia - __ - - 595.4 602.0 468.1 Wisconsin - - - 745.5 783.3 883.8 Wyoming 147.2 139.9 134.9 1 Additional grants were made for special projects to. institutions of higher learning and to public or other nonprofit agencies and organizations as follows: Maternal and child health services, $4,084.4; crippled children’s services, $4,720.9; child welfare research and demonstration projects, $2,999.6; research projects relating to maternal and child health and crippled children’s services, $3,977.4; child welfare training $5,000.0; maternity and infant care projects, $24,155.9; and comprehensive health care and services for children of school and preschool age, $14,715.3. W elf are Administration 63 Office of Juvenile Delinquency and Youth Development The Office of Juvenile Delinquency and Youth Development administers the Juvenile Delinquency and Youth Offenses Control Act of 1961. The legislation authorizes grants for demonstration and training projects and provides for technical assistance services. The act was extended through June 30,1967, by Public Law 88-368, signed into law July 9, 1964, and by Public Law 89-69, signed into law July 8, 1965. The Office of Juvenile Delinquency and Youth Development is concerned with innovative projects which may offer new solutions to the problem of delinquency prevention and control. The Office also helps develop experimental training methods and material for personnel who work with delinquent youth. Demonstration Projects Beginning in 1962, the Office of Juvenile Delinquency and Youth Development awarded grants to communities to develop and/or implement comprehensive projects which would provide impoverished, alienated children and youth with greater social, academic, and vocational opportunities and with greater skills to take advantage of opportunities that already exist. Programs were established to provide preschool activities, job training and placement, updated curricula, extended welfare services, consumer education, legal aid, neighborhood organization, and recreation. During 1964, an arrangement was worked out whereby the Office of Economic Opportunity would fund these projects when juvenile delinquency grants terminated. The Office of Juvenile Delinquency and Youth Development now supports special short-term demonstration projects in such problem areas as teenage violence, delinquency among American Indians, narcotics addiction, delinquency among girls, and reintegration of delinquents from training schools into the community. Training Projects The training program is seeking to overcome shortages of trained personnel by providing short-term training for the orientation of new workers serving youth and for upgrading and modernizing the skills of veteran personnel. The training program is also striving to develop new knowledge and to communicate more effectively knowledge that is currently available. During the year, the Office of Juvenile Delinquency supported training centers at five colleges and universities across the country. In 64 Department of Health, Education, and Welfare, 1966 addition to these centers, curriculum development projects have been or are being carried out by 24 organizations. Workshops, institutes, seminars, and related training activities have been conducted by 17 institutions and agencies. To date, over 30,000 persons—from such areas as law enforcement, corrections, education, welfare, and recreation—have been trained in youth work. Technical Assistance Technical assistance services provided by the Office of Juvenile Delinquency and Youth Development have been geared to helping communities and institutions design and carry out demonstration and training programs. The Office has supplied intensive consultation to all communities which have received grants and to numerous other communities which have requested assistance. Cuban Refugee Program A new and orderly relative-to-relative movement of refugees from Cuba began December 1,1965, as a result of President Johnson’s speech on October 3 of that year. The movement is based on a formal agreement between the two governments negotiated by the Swiss Embassy in Cuba representing U.S. interests. Priority is given to close relatives of Cubans already in the United States. Flights arrive twice daily, 5 days a week in Miami, Fla. An average of 865 refugees arrive each week. As of August 31, 1966, over 33,400 refugees had arrived in Miami since the airlift began. Freedom House, a hotel-like facility at the Miami airport, serves as a temporary shelter for those going on to join relatives in other parts of the United States. Children Reunited With Parents Special priority on the airlift is given the parents of unaccompanied Cuban children. Since the airlift began, more than 1,900 parents have been reunited with over 2,200 children who had been sent to the United States previously. Voluntary Agencies Respond to Refugee Need Alerted to the increased need for sponsors due to the airlift, the National Catholic Welfare Conference, Church World Service, United HIAS Service, and the International Rescue Committee—the four national voluntary agencies which participate in the resettlement of Welfare Administration 65 refugees—called for revived efforts on local levels to sponsor refugees in communities throughout the Nation. By November 30, 1965, over 183,000 Cubans had been registered at the Cuban Refugee Center in Miami, and more than 95,000 had been resettled in over 3,000 communities in every State, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands. Since December 1, 1965, over 74 percent of the new registrants have been resettled. The resettled refugee has the means to provide for his relatives, and Cuban civic groups announced their plans to assist new arrivals in their areas. Cubans have been of material value in this way, contributing greatly to the success of program resettlement planning. Voluntary agencies continue with long-range planning, opening new offices, promoting additional sponsorships, and providing adequate planning for the difficult-to-resettle family. Program Appropriations Federal obligations for the Cuban Refugee Program decreased from $46,012,000 in fiscal 1964 to $32,531,598 in fiscal 1965. However, the airlift brought total appropriations for fiscal 1966 up to $42,600,000. Financial Assistance A survey by the Bureau of Family Services, Welfare Administration, revealed that only 4 percent of resettled refugees have required Federal financial assistance, and among those who received such aid, it was needed for an average period of only 11 months. The financial assistance caseload in Miami, after 9 months of the airlift, remained relatively stable. Slight increases were attributable to the medical needs of the older Cuban refugees. As of September 1, 1966, there were 7,113 active financial assistance cases—representing some 11,950 persons—among refugees in Miami. These cases are made up of elderly refugees, the physically and socially handicapped, the sick, and unaccompanied minor children. Many of these cases are receiving counseling, medical, and other services to help prepare them for resettlement opportunities. Training of Professionals Continues The continued training of Cuban professionals assumes more importance as the airlift continues. Cuban teachers, physicians, and dentists are among those who will fill positions in fields with a critical shortage of qualified professionals in the United States. Over 1,900 Cuban-trained physicians have taken medical refresher courses; over 600 Cuban university graduates have received special 66 Department of Health, Education, and Welfare, 1966 courses qualifying them as teachers of Spanish and as librarians. Training in refresher courses has included 345 other professionals. Refugee college students have received $1.6 million in loans to continue their education. Some 93 refugee dentists have been admitted with advance standing to 24 U.S. dental schools through efforts of the Cuban Refugee Program. Over 9 million student-hours of English and vocational training have been provided for Cuban refugee adults in Dade County (Miami) adult education programs. Resettlement Continues As Major Objective The continuation of the airlift will place major emphasis on resettlement efforts. Concurrent with the resettlement of new arrivals, the Miami caseload will continue to receive intensive study and planning to prepare or rehabilitate those families or individuals considered difficult to resettle. The Cuban Refugee Center in Miami will continue to function as the focal point of U.S. activities concerned with the airlift. Operational Programs in the Office of the Commissioner The immediate office of the Commissioner is responsible for broad administrative functions, management, long-range planning, legislative considerations, and public information. In addition, it carries operational responsibilities for social welfare research and international activities. Welfare Research The Division of Research in the Office of the Commissioner provides leadership to advance research related to the field of social welfare. The Division carries out long-range and program-related research, which is integrated with studies undertaken by scholars receiving Federal grants-in-aid. The research staff represents a number of disciplines which include, in addition to social work, sociology, psychology, economics, demography, and history. The Division issues the monthly journal Welfare in Review, a major means of communication between the Welfare Administration and social welfare agencies. The majority of the full-length articles carried in Welfare in Review in 1966, were prepared by the Division’s staff, including “Population Dynamics and Poverty in the United States: Implications for Family Planning Programs”; “Guaranteed Income Maintenance: A Discussion of Negative Income Tax Plans”; Welfare Administration 67 “Spanish.-Americans of the Southwest”; “Cost Benefit Analysis and Social Welfare.” Additional research findings are issued in the form of separate reports. Among the study reports published during the past year are: Growing Up Poor, Welfare Administration Publication No. 13; Low-Income Life Styles, Welfare Administration Publication No. 14; Social Development, Welfare Administration Publication No. 15; Study of Drug Purchase Problems and Policies, Welfare Research Report 2; Social, Psychological, and Economic Aspects of Alcoholism, Welfare Research Report 3; and Approaches to the Measurement of Family Change, Welfare Research Report 4. Studies now underway include, among others: “Spanish-Americans of the Southwest”; “National Study of Family Living Conditions in AFDC Families”; “A Survey of Accepted and Rejected Applicants for AFDC”; “Impact of Economic Dependency on School Achievement, Employment, and Alienation in a Knox County, Tenn., Area Sample”; “Work Incentives: Perceptions of and Responses to, by Subgroups of the Poor”; “Sources and Uses of Information About Public Assistance”; pilot work on the forthcoming national “Medical Care Benchmark Survey”; and a series of investigations focusing on the evaluation of program effectiveness, as well as cost benefit analyses to determine level of efficiency of program operation. As another means of enhancing interest and expertise in social welfare research, the Division sponsored and conducted—in collaboration with the bureaus of the Welfare Administration—the Sixth Biennial Workshop on Public Welfare Research and Statistics. Individual staff members were also active in various professional organizations including the American Sociological Association, the American Psychological Association, and the National Association of Social Workers. Another major function of the Division has been the provision of grants-in-aid for research under section 1110 of the Social Security Act. Under this Cooperative Welfare Administration and Social Security Administration research grants program, 42 initial and continuation grants totaling $1,807,565 were made in fiscal year 1966. These grants supported a wide variety of research relevant to Welfare Administration programs. International Office CONFERENCES The White House Conference on International Cooperation held in Washington, November 28-December 1, 1965, was a major highlight of international activities in the United States. The Conference climaxed a year of discussions by widely representative groups of 68 Department of Health, Education, and Welfare, 1966 citizens, including businessmen, voluntary agency executives, and Government officials. Recommendations ranged from the need for social services for families and children in Vietnam to support for a firm legislative base in the Welfare Administration for international cooperation. Better organizational arrangements were urged for United Nations social welfare activities and for appointment of social welfare experts to U.S. overseas diplomatic missions and those of the Agency for International Development. The International Office provided extensive services for the 17th session of the United Nations Social Commission, which advanced plans for a United Nations Conference of Ministers Responsible for Social Welfare and for regional projects in training and social development to be carried out in 12 different countries; and for the UNICEF Executive Board meeting in Addis Ababa, Ethiopia, which evaluated 60 cooperative projects in social service. The Office also developed policy and technical statements for the Department of State and provided experts for some delegations to the regional economic commissions of the United Nations for Asia and the Far East, Africa, and Latin America. COOPERATIVE RESEARCH Twenty new awards were made through the special foreign currency international research program, bringing the total number of Welfare Administration grants to 54. This was an improvement over the previous year when funds were available for only three additional projects. These awards are administered by oversea universities, social welfare, or health organizations. There is a total of 9 grants in India, 22 in Israel, 3 in Pakistan, 9 in Poland, 5 in the United Arab Republic (Egypt), 5 in Yugoslavia, and 1 in Burma. Included in the new studies is a survey of basic problems of older persons in Yugoslavia, a project which will extend the cross-national study now being supported in Israel and Poland. This research is already producing findings of universal interest in planning community services for older persons. Studies of alcoholism in Poland are the first to be conducted through the international research program. They will focus on problems of alcoholics in industrial centers and the social welfare of children in alcoholic families. A grant for the first international research project on family planning went to the United Arab Republic for a study of social welfare in family planning. The United Arab Republic has one of the highest rates of population growth in the world. Another new study under this program is the cross-national research launched in Poland, Yugoslavia, and Israel on the intake and accomplishment of juvenile courts in delinquency cases. A similar study is being conducted in Puerto Rico. Welfare Administration 69 Universities in the United States are providing consultation services on several of these projects. These include the School of Social Work, University of Michigan; the Florence Heller School for Advanced Studies in Social Welfare, Brandeis University, the Hunter College School of Social Work, City University of New York; the Department of Sociology and Anthropology, University of Illinois; and the Columbia University School of Social Work. The cooperation of these universities extends U.S. expert support for overseas research and affords excellent scientist-to-scientist relationships between the two countries. TRAINING The number of countries sending international trainees to the Welfare Administration increased to 102. There were 34 African countries represented, 20 from Europe, 15 from the Far East and South Pacific, 21 from Latin America; and 12 countries from the Near East, South Asia, and Australia. The variety of training needs expanded, and the Welfare Administration, in cooperation with AID, increased the use of group seminars for this purpose. Seminars were conducted in administration and social planning, in social aspects of urban development, in leadership in social aspects of development planning, and in youth services. At the request of the United Nations and the Department of State, the International Office for the first time organized programs for U.N. Fellows in the field of human rights. Their interests w’ere in social legislation—such as laws relating to families and children and legal rights of indigent persons. Specialists in fields other than social welfare who come to this country show increased interest in orientation in social welfare. The Department of Labor asked for orientation programs for 366 labor leaders and other labor specialists. The Department of State, Bureau of Educational and Cultural Affairs, referred 209 foreign leaders for discussion of social welfare and social development in the United States. Voluntary agencies and other organizations bringing experts in under their own programs referred 185 persons. At the request of the Agency for International Development, the International Office conducted a workshop in Sierra Leone in September 1965 for participants from five English-speaking West African countries. Thirty-eight delegates met and lived together at the Milton Margai Training College in Freetown for a 10-day period sharing ideas and information in regard to volunteers in social welfare. The workshop was intended to stimulate new approaches in social services. A publication based on the proceedings was distributed not only in Africa but in many other countries and has served as a useful manual. 70 Department of Health, Education, and Welfare, 1966 VIETNAM There has been acute concern over the plight of orphaned or homeless children, and a growing awareness that a more adequate social welfare structure is needed to provide both emergency and long-term services. A social welfare officer recruited by the International Office has been added to the AID staff in Saigon. The Welfare Administration, AID, and the voluntary agencies are cooperating to strengthen the program, providing training to Vietnamese welfare officers coming here and briefing experts being assigned to Saigon. RECRUITMENT During the year, 186 social workers indicated their interest in an overseas assignment. There were about 50 openings for which the International Office was recruiting. A staff member of the International Office serves with the screening committee of the Conference Board of Associated Research Councils which selects Fulbright scholars for overseas appointments, advising on placement and assisting on recruitment. American specialists were sent to all geographic areas of the world during the year. A new effort is being made to develop programs for young social workers in order to capitalize on their enthusiasm and interest in international affairs and to give them a chance to learn and test social work methods in other countries. Public Health Service • Iii Little Rock, Ark., last April, two Public Health Service scientists wound up a 2-year experiment at the Arkansas Children’s Colony. The result: The first effective experimental vaccine against German measles, a major cause of mental retardation and other birth defects. • In San Antonio, Tex., ground was broken in March for the South Texas Medical School. It is one of eight new medical schools whose construction is being aided by Federal funds to increase the Nation’s capacity for training physicians and other health professionals. • At U.S. airports receiving international flights, Public Health Service quarantine inspectors gave health clearance to more than 5 million passengers arriving in the United States from foreign countries. Fiscal year 1966 was the first in which air passenger volume exceeded 5 million. • In South Vietnam, on October 23, 1965, Public Health Service surgical teams marked the completion of three years of service aiding noncombatant civilians. In that time, the team had performed 10,000 major operations in provincial hospitals. © In Bethesda, Md., in 1966, the Public Health Service’s National Library of Medicine published for the first time the annual Cumulated Index Medicus^ formerly published privately. For several years, NLM had been producing Index Medicus^ a compres-hensive monthly index to current articles from 2,400 biomedical journals which now reaches 6,000 libraries throughout the world. • In St. Louis, the first in a series of university-based institutes in the environmental health sciences was launched in mid-December with the award of a Federal grant to Washington University. In stations throughout the Nation and in many other parts of the world, the Public Health Service’s 38,000 employees during 1966 carried out the 100-odd programs for which the Service is responsible. With a budget of $2.3 billion, approximately 50 percent of it devoted to the support of health activities in State and community agencies 237-319—67 71 6 72 Department of Health, Education, and Welfare, 1966 PUBLIC HEALTH SERVICE Chief Professional Officers - immediate Office of the ---- Externa! Advisory Groups j _________________________Surgeon General ________________________ Surgeon General ____________ _____ Internal Advisory Groups Office of_______________Deputy Surgeon General__________________and Special Staff_ Surgeon General Assistant Surgeon General ____________________ ----------------------------------- Executive Officer ________________| National Library of Medicine [ Grants Policy Office Office of Equal Health Opportunity Office of Information and Publications Office of International Health Office of Personnel National Center for Health Statistics Divisions: Administrative Services Finance Health Mobilization Internal Audit Public Health Methods ____________________L. r I. . ~ . ..... I________ Bureau of State Services „ ,Bur®apu of . National Institutes Medical Services « of Health Community Health ■ Environmental Health Divisions: National Institutes; Divisions • Divisions Foreign Quarantine Allergy & Infectious Diseases Hospitals Arthritis & Metabolic Diseases ..................■.................... Indian Health Cancer Accident Prevention.; Air Pollution.Child Health & Human Medical Care Administration ; Environmental Engineering and Chief Medical Officer Development Chronic Diseases : Food Protection Coast Guard ' r I kTTi to a H4 Number 2 cc CG O Amount §§§§§§ i i ** i ! 716,400 o S rn Number ? 00 00 00 S CO Q 2 to Amount §§§§§§ is 2,383,350 £ o Number 1 Number of participating State 1 education agencies Program area i £ Deaf Speech impaired and hard of hearing Visually handicapped Emotionally disturbed Crinnled _ Other health impaired Administration of special education Grand total 1 Public Law 89-105 of Aug. 4, 1965, extended coverage of the basic legislation by 3 Involved are 87 institutes in program areas as follows: Mentally retarded 25, deaf defining “State” to include the District of Columbia, Puerto Rico, American Samoa, 9, speech impaired and hard of hearing 12, visually handicapped 6, emotionally Guam, and the Virgin Islands, as well as the 50 States of the Union. Except for disturbed 11, crippled 6, other health impaired 11, and administration of special American Samoa, each State education agency participated in 1 or more program education 7. areas, with 6 of them participating in all 8 areas. 4 Excludes $491,279 covering grants to 47 State education agencies toward their 2 Fellowships for administrators of special education are awarded at post-master’s administrative costs. level: other fellowships may be awarded at any graduate level. Office of Education 151 Assistance to Federally Affected and to Disaster Areas Several new provisions were added in fiscal year 1966 to amended Public Laws 81-815 on school construction and 81-874 on school maintenance and operation. Each of these laws originally focused on needs where federally conducted military and civilian activities place financial burdens on local education agencies by increasing school populations while removing real property from local tax rolls. Public Law 89-77 authorizes construction of school facilities on Federal property in Puerto Rico, Wake Island, Guam, and the Virgin Islands for the benefit of certain children living off the Federal reservation with a parent employed by the U.S. Government. These are the children living in places where English is not the primary language of local schools. Public Law 89-313 authorizes assistance for repair or restoration of school facilities and for assistance on current expenditures in the event the President declares an area to be a major disaster area. Under these provisions in the 1966 fiscal year, 43 claims were received representing a total estimated entitlement of about $6 million for the 2 programs. Public Law 89-313 also liberalized eligibility requirements on assistance for school maintenance and operation for large city school districts. It made them the same as for other school districts. School Construction From the beginning of the program under Public Law 81-815 in fiscal year 1961 through fiscal year 1966, a total of $1,284,643,000 has been appropriated toward school construction. An additional $780 million from State and local sources was involved in these projects. This total of more than $2 billion has provided school facilities to house more than 1.85 million school children. During fiscal year 1966, Federal funds were reserved in the amount of $37,696,427 for 158 school districts for 168 construction projects to help provide 1,690 classrooms and related facilities for 49,185 children. Another $10,315,460 was obligated for construction of school facilities on Federal property to provide classrooms to house an estimated 5,486 children. School Maintenance and Operation Since the beginning of the program under Public Law 81-874 in fiscal year 1951 through fiscal year 1966, some $2.7 billion has been appropriated to assist local education agencies in the maintenance and 237-319—67----11 152 Department of Health, Education, and Welfare, 1966 operation of schools. In the 1966 fiscal year, 4,100 school districts were eligible for $362 million in Federal funds. This sum includes an estimated $8.7 million for 13 large cities eligible for the first time under liberalized eligibility provisions. This assistance amounts to between 5 and 6 percent of the total current operating expenses of eligible school districts. In terms of average daily attendance, it was paid on behalf of 2.16 million of the approximately 14 million children in these school districts. In addition, $22 million in Federal funds in fiscal year 1966 provided schooling for over 48,000 children living on Federal property. These are children for whom such services otherwise were not available. Strengthening State Departments of Education Of the $25 million authorized, $17 million was appropriated for a new program to help States and other eligible parts of the Nation strengthen leadership resources of their education agencies and help identify and meet their education needs. Grants from these funds were made under the various sections of title V of the Elementary and Secondary Education Act of 1965. Eighty-five percent of the appropriation—$14.45 million—was for distribution by formula under section 503 involving the number of public school pupils in the “States”—the 55 parts of the Nation. More than 900 project applications were processed and approved, including amendments, revisions, and substitutions made in light of experience reflecting difficulty in recruiting qualified personnel. More than 85 percent of the projects in this group were in five categories. Applications from 51 “States” requested funds to expand services to local school districts to enhance instruction; 50 were concerned with improving general administration; 48 asked for support to study, plan, develop, and evaluate programs and to coordinate State and local research activities; 46 sought to improve data and statistical services; and 37 wanted grants to improve programs for school accreditation and teacher education and certification. More than 1,800 new positions, including about 1,000 at the professional level, were budgeted by State agencies in roughly these same areas. More than half were for service not previously staffed by State education agencies—primarily in planning and evaluation and in instructional services. The remaining 15 percent of the appropriation was reserved for experimental projects to develop State leadership or to establish services holding promise of solution to problems common to several or all Office of Education 153 States. Most of this sum was granted for 17 multi-State projects and 10 workshops. Some were on such problems as interstate certification of teachers (nationwide coverage) and improvement of public information and communications systems (seven States covering the Nation by regions) . Others related to future design for education (eight Western States), statewide assessment of pupil progress (New England States), and educational opportunities for farm migrant children (six States). As authorized by section 507 of the law, arrangements were worked out for assignment of State agency personnel to the Office of Education staff and Office staff members to State agencies for periods not exceeding 2 years. Eight such assignments were made in fiscal year 1966—two State agency staff members came to the Office and six from the Office were assigned to education agencies in five States—including Puerto Rico. Also under the program, young professional employees of State universities were invited to work for a year in the Cooperative Career Development Project of the Office of Education as research, program, or administrative assistants. Thirty-four such education fellows were scheduled to start training in Federal-State-local relationships immediately after the close of fiscal year 1966. Financial Aid for Students The Office administers several programs under which students receive financial aid to help them pursue their studies. Some are new and others were in existence prior to fiscal year 1966. Educational Opportunity Grants Part A of title IV of the Higher Education Act of 1965 authorizes Federal funds for institutions of higher learning to use in making educational opportunity grants to needy college students who otherwise could not attend college. Grants range from $200 to $800 annually and are available only to undergraduate students. Institutions select the student grantees and make the grants directly to them. Of the $70 million authorized, $58 million was appropriated for this new program. Applications for funds in the amount of $105,519,806 were filed by 1,440 institutions. Awards totaling $57,919,229 were made to 1,419 colleges and universities in the 50 States, the District of Columbia, Guam, Puerto Rico, and the Virgin Islands for use during the 1966-67 academic year in making grants to approximately 134,000 students. The average grant is estimated at $432. 154 Department of Health, Education, and Welfare, 1966 College Work-Study Part C of title IV of the Higher Education Act of 1965 transferred from the Director of the Office of Economic Opportunity to the Commissioner of Education responsibility for administering work-study programs initially authorized by the Economic Opportunity Act of 1964. In fiscal year 1965, the program had been administered under delegation of authority from the Director of the Office of Economic Opportunity to the Secretary of Health, Education, and Welfare, and redelegation to the Commissioner. Initially, the program was limited to students from low-income families. The Higher Education Act of 1965 broadened the scope to include other college and university students needing earnings from part-time employment to pursue their studies. The 1965 legislation also deleted the former requirement that the work be related to the student’s educational objectives while retaining the proviso that it be in the public interest and not result in displacement of employed workers or impair existing contracts for services. Employment may be on or off campus by arrangement between the participating institution of higher education and a public or private nonprofit agency. The program operated in fiscal year 1966 in 50 States, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. Part of the $55,710,000 allocation from the Office of Economic Opportunity in fiscal year 1965 was used for spring semester programs that year. The rest—nearly $43 million—was for programs in the summer and fall of 1965 at 1,120 institutions of higher education. Nearly $32 million of the $99,123,000 available for fiscal year 1966 was obligated for 1,259 institutions to operate programs in the spring of that year for the benefit of about 110,000 students. The rest was obligated for 1,538 institutions to accommodate an estimated 190,000 students in the summer and fall programs in calendar year 1966—that is, in fiscal year 1967. Guaranteed Loans for Higher Education Part B of title IV of the Higher Education Act of 1965 authorizes a program to help students obtain low-cost loans from eligible lending institutions. To induce private commercial lenders to make loans to higher education students, loans are guaranteed by a State student loan agency, a private nonprofit student loan guarantee agency, or— where need is not otherwise met—by the Federal insurance program. Students from homes with adjusted family incomes of less than $15,000 a year are eligible for benefits which offset certain interest costs. The Federal Government may pay up to 6 percent a year to lenders on the balance outstanding on loans while these students are Office of Education 155 pursuing their studies and 3 percent when the repayment period begins. The appropriation for Federal advances for reserve funds of State and nonprofit private programs was $7.5 million for fiscal year 1966. Any of the 55 parts of the Nation entering into an agreement with the Commissioner of Education is eligible to apply for its share of the funds. Advances range from $25,000 to more than $600,000 with amount being based on number in the population aged 18-22. At the end of fiscal year 1966, student loan guarantee agency programs in 25 States had qualified for payment of Federal interest benefits to lenders on behalf of loans to eligible students. An appropriation of $2 million was available in fiscal year 1966 for these interest payments. The appropriation for the Federal insurance program was $500,000. Guaranteed Loans for Vocational Education The National Vocational Student Loan Insurance Act of 1965 authorizes a program to help vocational education students obtain low-cost loans from eligible lending institutions. Purposes and operational aspects of this program are similar to those under the program for higher education students. One exception is the provision for direct Federal loans to be made by the Commissioner to vocational education students. As of the Close of the fiscal year, no appropriation had been made for such direct loans. Initial appropriations for the various other parts of the program were made on May 13, 1966. The program is expected to be operational in school year 1966-67. National Defense Education Loan Funds Fiscal year 1966 was the eighth in which loan funds have been available under the program authorized by title II of the National Defense Education Act of 1958 and related amendments. About a million students have borrowed approximately $834 million from such funds since they were established at participating colleges and universities. In fiscal year 1966, approximately $223.8 million was lent to about 400,000 students enrolled in 1,693 institutions. Federal funds amounted to $179.3 million and institutional contributions totaled $19.9 million. The rest represents repayments which were reloaned. Repayment terms were tightened by amendments made to title II by the Higher Education Act of 1965. The 10-year repayment period begins 9 instead of 12 months after the borrower completes his study. Repayments are to be made monthly, bimonthly, or quarterly as determined by the institutions. 156 Department of 'Health, Education, and Welfare, 1966 Institutions may require minimum payments of not less than $15 a month. They also may levy charges for late payments. Another amendment includes a formula for fund-related administrative expenses of participating institutions to be charged against their loan funds. In addition, the provision for partial loan cancellation for teaching service was amended to increase the amount of cancellation beginning in the 1966-67 academic year for teachers in areas where there are high concentrations of low-income families. Encouraging Utilization of Educational Talent Section 408 of the Higher Education Act of 1965 authorizes contracts of up to $100,000 a year for State and local education agencies and other public or nonprofit organizations and institutions to: • Identify qualified youths of exceptional financial need and encourage them to complete secondary school and undertake post-secondary training; • Publicize existing forms of student financial aid; and • Encourage secondary school or college dropouts with demonstrated aptitude to re-enter educational programs. This talent search program received 133 proposals during fiscal year 1966. The 42 contracts negotiated in 31 States account for obligation of the entire appropriation of $2 million. Higher Education Facilities Authorization increases for construction grants are among amendments to the Higher Education Facilities Act of 1963 by the Higher Education Act of 1965. Another amendment changed the interest rate on loans for construction to a maximum of 3 percent (instead of one related to the going Federal rate). Grants and loans for construction were made to 864 higher education institutions (and their branch campuses) in fiscal year 1966 compared with 525 in fiscal year 1965 before the law was amended. As in the previous year, some institutions received funds under more than one title of the legislation. Table 6 provides detail on each of the 55 political subdivisions eligible to participate in the program. Grants under title I provide up to 40 percent of the development cost for facilities at public community colleges and technical institutes and up to 33)/3 percent for facilities at other higher education institutions. The 241 Federal grants to public community colleges and technical institutes at a total outlay of $104,971,841 for fiscal year 1966 compare with 103 totaling $47,361,808 the previous year. Office of Education 157 The 822 grants to other higher education institutions amount to $362,067,676. These figures compare with 413 grants totaling $177,-000,867 the previous year. Construction grants under title II provide up to 33 A percent of the development cost for facilities at graduate schools or at cooperative graduate centers. The 95 grants under this title in fiscal year 1966 compare with 85 the previous year while the amount of Federal funds involved is the same as last year—$60 million. Loans for construction under title III require that at least a fourth of the development cost be financed from non-Federal sources. The 144 loans totaling $99,789,000 in the fiscal year 1966 compare with 133 amounting to $106,937,000 the year before. 158 Department of Health, Education, and Welfare, 1966 Table 6.—Grants and loans by geographic area to 864 higher education institutions (and branch campuses') in fiscal year 1966 for construction of academic facilities under the amended Higher Education Facilities Act of 1963 Grants for undergraduate facilities (title I) __________________________________________________Grants for graduate Loans for academic facilities (title II) faciliti.’S (title III) States i Sec. 1032 Sec. 1042 Total Number Amount Number Amount Number Amount Number Amount Number Amount (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Alabama ________ _________________ 7 $2,197,582 11 $5,532,271 18 $7,729,853 4 $378,616 2 $1,059,000 Alaska __ _____ _______________________ _________ 1 75,530 1 75,530 1 1,263,094 1 95,000 Arizona . ___ ____________________ 3 821,000 8 3,476,258 11 4,297,258 3 1,237,216 -------------- Arkansas _ _ _ ___________ 3 827,970 13 4,275,762 16 5,103,732 _____________ 5 3,349,000 California________________________ 20 7,762,896 61 40,025,238 81 47,788,134 6 7,477,603 11 5,609,000 Colorado__________________________ 4 1,010,748 7 4,393,683 11 5,404,431 ------------ 1 700,000 Connecticut ___ __________________ 4 1,060,185 13 4,847,442 17 5,907,627 1 465,666 ______________ Delaware__________________________________________ 3 1,080,531 3 1,080,531 2 905,965 -------------- Florida ________ _________________ 8 2,820,958 26 8,840,070 34 11,661,028 2 1,054,055 5 1,957,000 Georgia__________________________ 8 3,387,715 16 5,750,263 24 9,137,978 2 937,967 -------------- Hawaii___________________________ 1 436,809 2 1,248,851 3 1,685,660 _____________ ________________ Idaho____________________________ 3 495,504 5 1,858,259 8 2,353,763 ______________________________ Illinois .. 6 4,213,488 40 18,704,652 46 22,918,140 4 7,500,000 6 4,128,000 Indiana_______________________________ 6 4,544,136 20 7,326,292 26 11,870,428 2 909,954 3 5,095,000 Iowa__________________________________ 4 1,593,661 24 5,987,281 28 7,580,942 1 439,235 9 3,639,000 Kansas________________________________ 8 2,777,465 11 3,485,760 19 6,263,225 1 644,864 4 992,000 Kentucky______________________________ 4 2,020,221 10 5,226,254 14 7,246,475 3 1,700,532 11 9,640,000 Louisiana . _____________________ 5 2,141,225 15 6,517,308 20 8,658,533 ______________ 1 1,088,000 Maine_____________________________________________ 13 2,583,193 13 2,583,193 3 590,884 3 2,895,000 Maryland_________________________ 3 3,596,375 10 3,736,563 13 7,332,938 ____ _________ 1 955,000 Massachusetts_____________________ 1 2,531,150 21 11,329,688 22 13,860,838 2 2,379,666 1 4,860,000 Michigan__________________________ 8 4,977,689 26 16,203,315 34 21,181,004 3 2,069,492 3 1,966,000 Minnesota_________________________ 6 2,401,181 14 7,608,916 20 10,010,097 1 300,000 ______________ Mississippi_______________________ 12 1,623,204 18 4,216,698 30 5,839,902 2 191,186 ______________ Missouri__________________________ 3 2,152,425 16 8,708,455 19 10,860,880 3 1,665,483 1 638,000 Office of Education 159 Montana________ _________________ 4 517,669 10 2,008,059 14 2,525,728 -------------- 1 480,000 Nebraska . ______________________________ 6 4,059,805 6 4,059,805 ------------- 2 2,507,000 Nevada____________________________________________ 2 999,901 2 999,901 _______________________________ New Hampshire_____________________ 1 265,926 4 1,408,696 5 1,674,622 ---------------------------—- New Jersey.___________________________ 3 2,827,247 19 9,491,591 22 12,318,838 2 813,497 5 1,501,000 New Mexico 2 915,370 7 1,946,991 9 2,862,361 1 241,921 1 283,000 New York 8 6,958,281 41 31,464,137 49 38,422,418 6 7,500,000 8 13,750,000 North Carolina... _______________ 10 3,013,290 30 8,554,052 40 11,567,342 -------------- 13 3,653,000 North Dakota __________ 2 521,322 2 853,860 4 1,375,182 ------------- 1 596,000 Ohio______..Z____________________ 3 5,282,494 38 18,437,109 41 23,719,603 12 6,467,939 3 1,369,000 Oklahoma _________________ 6 1,413,489 14 6,034,874 20 7,448,363 ------------------------------ Oregon ______________ 4 1,154,461 16 4,237,738 20 5,392,199 1 186,953 1 150,000 Pennsylvania . Z" ________________ 12 7,874,982 48 18,812,218 60 26,687,200 4 3,033,355 9 7,768,000 Rhode Island_____________________ 2 464,497 9 1,680,683 11 2,145,180 1 730,675 ---------- South Carolina_______________________ 10 1,665,306 14 4,498,460 24 6,163,766 1 198,835 4 2,396,000 South Dakota . ___________________________________ 8 2,246,438 8 2,246,438 ------------ ----------------- Tennessee " 3 2,626,696 19 6,369,038 22 8,995,734 3 1,127,117 2 1,397,000 Texas 20 5,155,703 37 18,445,973 57 23,601,676 6 2,785,461 9 4,627,000 Utah __________ 4 623,697 2 3,017,799 6 3,641,496 3 1,420,300 -------------- Vermont...’.LZ.Z______________________ 3 259,762 6 919,206 9 1,178,968 1 294,741 3 932,000 Virginia ___________ 4 2,107,136 23 7,279,718 27 9,386,854 _____________ 1 23,000 Washington _ - 2 1,788,215 16 6,565,172 18 8,353,387 1 437,653 2 1,030,000 West Virginia - 1 1,141,458 14 3,516,162 15 4,657,620 2 829,806 1 295,000 Wisconsin ____________ 7 2,551,588 15 8,367,962 22 10,919,550 3 1,340,503 7 4,762,000 Wyoming."" W—_____________________ 1 174,951 1 1,030,649 2 1,205,600 ------------------------------- District of Columbia______________________________ 7 2,598,771 7 2,598,771 1 78,166 3 3,605,000 Guam _____________________________ 1 150,000 1 150,000 ------------------------------- Puerto Rico.Ill__________________ 1 207,943 9 4,034,081 10 4,242,024 1 400,600 -------------- Virgin Islands____________________ 1 66,771 -------------- 1 66,771 -------------------------------- Grand total__________________ 241 104,971,841 822 362,067,676 1,063 4 467,039,517 95 60,000,000 144 99,789,000 i Title IV, sec. 401(m) of Public Law 88-204 (Higher Education Facilities Act of 3 Higher education institutions other than public community colleges and technical 1963) specifies: “The term ‘State’ includes, in addition to the several States, the institutes. District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, 4 Includes $10,568,050 which was reallotted during fiscal year 1966 from fiscal year and American Samoa.” 1965 funds. Some of this amount was made available by reductions in previously 2 Public community colleges and technical institutes. approved grants. 160 Department of Health, Education, and Welfare, 1966 Payments to Land-Grant Institutions The Office of Education, made payments totaling $14.5 million in fiscal year 1966 to the 50 States and Puerto Rico for distribution to the 68 land-grant colleges and universities. Part of the payments were from a $2.55 million permanent annual appropriation made by the second Morrill Act of August 30, 1890, as amended. The rest came from the $11.95 million appropriated by Public Law 89-156 of August 31, 1965, for carrying out the provisions of section 22 of the Bankhead-Jones Act of June 29, 1936, as amended. Part of this latter sum—$7.65 million—covers payments in equal shares to the States and Puerto Rico. The remaining $4.3 million covers allotments on the basis of population. Aid for Developing Institutions The program under title III of the Higher Education Act of 1965 is designed to help certain colleges and universities raise their academic quality. These are the ones which have the desire and potential to make substantial contributions to higher education but, for financial or other reasons, are struggling for survival and are isolated from the main currents of academic life. Federal funds are authorized for national teaching fellowships to augment teaching resources of developing institutions. Partial support is authorized for cooperative arrangements enabling developing institutions to draw on capabilities and experience of established higher education institutions and on educational resources of business and industry. Of the $55 million authorized for the 1966 fiscal year, $5 million was appropriated. Approximately $32 million was sought in support of 310 proposals submitted by 262 institutions of higher education in 46 States, the District of Columbia, Puerto Rico, and Guam. Developing institutions requested almost a thousand national teaching fellowships. Proposals for cooperative arrangements focused on student and faculty exchanges, faculty improvement programs, curriculum improvement, student services, visiting scholars, and administration. The first year’s grants were to 127 institutions in 38 States and the District of Columbia for 84 cooperative arrangements and 43 programs involving national teaching fellowships only. Some of the 263 fellowships were part of cooperative arrangements and the rest were separate. The 84 cooperative arrangements involve 115 developing institutions, 66 cooperating institutions, and 9 business concerns. Office of Education 161 National Defense Fellowships During the 1965-66 academic year, 6,270 graduate students were on fellowships authorized by title IV of the National Defense Education Act of 1958, as amended. They were working toward their doctorates in preparation for careers in college teaching. These fellowships were financed from $31.4 million obligated in fiscal year 1965. Most of the fellowships are for 3 years. Grantees continuing studies under awards made in the 2 previous years totaled 3,270. Sixty percent of the 3,000 new fellowships were in the social sciences, humanities, and education and the rest were in the physical and biological sciences and engineering. Numbers and percent by specific academic area were: Academic area Social sciences_____________________________________________ Humanities__________________________________________________ Physical sciences___________________________________________ Biological sciences_________________________________________ Engineering_________________________________________________ Education___________________________________________________ Number of Percent fellowships of total 862 29 730 24 548 18 381 13 269 9 210 7 3, 000 100 Total Support for 10,494 fellows to study under the program in academic year 1966-67 was obligated against the $55,961,000 available for this purpose in fiscal year 1966 funds. Under this expanded program, 6,000 will be starting their fellowships and the others will be in their second or third year. The 6,000 new fellowships bring to 17,500 the grand total of awards made over the 8-year period of the program. Total Eederal support for these fellowships amounts to about $188,335,150. College and Research Library Resources The first Federal grants—totaling $8,413,574—were awarded in fiscal year 1966 under part A of title II of the Higher Education Act of 1965. These grants, to help colleges and universities strengthen their library resources, were awarded to 1,830 institutions in the 50 States, the District of Columbia, Puerto Rico, American Samoa, Guam, and the Virgin Islands. Under the legislation, colleges and universities may receive basic grants of up to $5,000 for the purchase of library books, periodicals, magnetic tapes, phonograph records, audiovisual aids, and other 162 Department of Health, Education, and Welfare, 1966 library materials. No funds were available in fiscal year 1966 for supplemental and special purpose grants also authorized by the law. An appropriation of $300,000 was made for strengthening research library resources. These funds were transferred to the Librarian of Congress in keeping with part C of title II. Librarianship Training One million dollars was appropriated for librarianship training for fiscal year 1966 under part B of title II of the Higher Education Act of 1965. Grants from this sum totaled $898,941 and were made to 24 institutions of higher education. Grants were for 139 graduate fellowships in library and information science (with 52 at the doctoral, 25 at the post-master’s, and 62 at the master’s level) and included $2,000 per fellow to help institutions meet instructional costs. First priority at the post-master’s level was training to help meet the critical shortage of instructors in the schools of library and information service. Community Service and Continuing Education Forty-six State plans and those of the District of Columbia, Guam, and the Virgin Islands became operational under a new program aimed at solving community problems with the help of college and university talent. These plans call for the use of $9,239,258 in fiscal year 1966 funds under title I of the Higher Education Act of 1965. This program, with at least 25 percent of the funds provided from non-Federal sources, supports community services, continuing education, and extension activities to tackle urban, suburban, and rural community problems. Plans from the States and the other political subdivisions include 550 projects involving approximately 310 institutions of higher education. The legislation authorizes latitude in developing programs. Among the plans are those for seminars for community leaders, courses for citizens concerned with such community problems as youth employment opportunities, training for and consultative services to local government officials, and refresher courses for persons in public administration, public health, social work, and urban and regional planning. Office of Education 163 Adult Basic Education Through education agencies of the States and other eligible subdivisions of the Nation, the Office administers an adult basic education program. It emphasizes instruction in communication and computational skills at elementary level for those attaining age 18 whose inability to read or write in English lessens their potential for gainful employment. Classes under this program, authorized by part B of title II of the amended Economic Opportunity Act of 1964, were held in 48 States, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands in fiscal year 1966. Contracts also were negotiated for nine regional institutes to train a thousand teachers of adult basic education in the summer of 1966. The Office of Economic Opportunity made available a $16 million allocation in fiscal year 1966 and then added $5,065 million later in the year. With the Federal share limited to 90 percent, Federal obligations totaled $34,122,227 including a carryover of $14,443,164 from the preceding year. Since the program began in the 1965 fiscal year, 373,338 adults have participated. Federal obligations total $38,291,063, exclusive of a special teacher training award of $1,055 million in fiscal year 1966 and administrative costs of $331,000 the first year and $320,937 the second. Civil Defense Adult Education In the 1966 fiscal year, 49 States, the District of Columbia, and Puerto Rico participated in 12-hour training courses in personal and family survival. All but seven of these political subdivisions also offered 16-hour courses on radiological monitoring (RAMONT). The Office of Education administers the program with funds from the Office of Civil Defense in the Department of Defense and under the Federal Civil Defense Act of 1950, as amended. Contracts are made with the departments of education in the States and the other political subdivisions for conduct of the program. The personal and family survival course focuses on basic principles of civil defense and on actions to save lives in event of nuclear attack. The RAMONT course is on monitoring the radiological hazard from fallout following nuclear attack. A total of 347,718 adults completed (he personal and family survival course (including 6,360 certified as teachers) and 25,902 completed the RAMONT course in fiscal year 1966. Federal allocations for the two programs amounted to $3,648,500. 164 Department of Health, Education, and Welfare, 1966 Vocational and Technical Education The Office of Education administers programs in the field of vocational and technical education under five basic laws. Programs in the first group are under the Smith-Hughes Act of 1917 and the George-Barden Act of 1946 as each is amended, and under the Vocational Education Act of 1963. The first two of these laws authorize Federal funds for programs in particular occupational categories. Without such limitation, the broader act of 1963 aims at the maintenance, extension, and improvement of the earlier programs. “States” eligible to participate include the 55 parts of the Nation. With certain exceptions under the 1963 legislation, Federal funds for programs under these laws must be matched with non-Federal funds. Exceptions through fiscal year 1966 are the work-study programs and the not yet federally funded residential vocational education school program. Programs in the second group are under certain provisions of the Manpower Development and Training Act of 1962 as amended. Finally, the Appalachian Regional Development Act of 1965 includes provision for a program of construction of vocational education facilities in Appalachia. Programs Under Matched Funds Reports from States show continued overmatching of Federal funds. Difficulty in obtaining sufficient State and local funds has been experienced only under the vocational education programs for adults under the 1963 legislation. Ratios for fiscal year 1965—the last year for which figures are available from the States—averaged $2.90 in local and State funds for each Federal dollar. The range extended as high as $5.46. Enrollment in the programs for fiscal year 1965 reached 5,430,611, compared with 4,566,390 in fiscal year 1964. Expenditures totaled $604,645,727, representing $260,974,879 in local funds, $186,734,833 in State funds and $156,936,015 in Federal funds, with the latter being from a total appropriation for these programs of $163,607,455. The estimated enrollment figure for fiscal year 1966 is 5,789,500. Estimated local, State, and Federal expenditures are $867,207,000. Federal appropriations available for fiscal year 1966 totaled $216,902,455 for these matched fund programs. This sum includes $7,161,455 as the permanent annual appropriation for Smith-Hughes programs in agriculture, home economics, and trade and industry. It includes another $29,991,000 for expansion of these programs and for other programs in distributive occupations, $5 mil Office of Education 165 lion for practical nurse training, and $15 million for area vocational education under titles I, II, and III of the George-Barden legislation. The remainder of $159,750,000 is for training, area vocational facilities construction, and ancillary services and activities under sections 4 (a) and (b) of the 1963 act. Not included is the $17,750,000 in Federal funds for part of the cost of vocational education research and training under section 4(c). PROGRAMS FOR THOSE IN HIGH SCHOOL High school students enrolled in some kind of federally aided vocational program in fiscal year 1965 totaled some 2,819,250 or 24.9 percent of all secondary school students. The estimate for fiscal year 1966 was some 3,250,000 or 27 percent. Office of Education projections indicate at least 35 percent will be so enrolled by 1970. A striking change in the secondary school program emerged as many States took advantage of the provision under section 4(a)(5) of the 1963 act and developed area schools to serve a number of constituent high schools. Students alternate between the area school and the high school while retaining identity in and working toward graduation from the latter. PROGRAMS FOR THOSE OUT OF HIGH SCHOOL PREPARING FOR EMPLOYMENT Post-high-school programs are offered in a variety of institutions, including area vocational-technical schools, technical institutes, community and junior colleges, and colleges and universities. Many States are designating community and junior colleges as area vocational education facilities. Enrollment in grades 13 and 14 in fiscal year 1965 reached 207,201. An estimated 700 institutions were offering these programs in fiscal year 1966. Full-time technical preparatory programs, usually 2 years in length, enrolled 71,845 in fiscal year 1965. Some 190 junior or community colleges offered these courses. Forty-five full 4-year colleges also provided technical preparatory instruction. This program continues to train primarily for highly skilled engineering-related technologies. As a result of the 1963 legislation, a number of courses have been started or are planned in research activities, in medical and biological technologies, and in other fields such as electronics, mechanical design, metallurgy, instrumentation, and nuclear and plastic technology. PROGRAMS FOR EMPLOYED ADULTS The 1963 legislation greatly expanded potential for vocational education for adults and, indeed, emphasizes need for such training. Number of teachers for adults’ programs increased from 47,700 in fiscal 166 Department of Health, Education, and Welfare, 1966 year 1964 to 50,620 in fiscal year 1965. Of the latter, 4,592 are full-time teachers. Enrollment in vocational education programs for adults reached 2,378,522 in fiscal year 1965 under the matched fund programs and is expected to exceed 2.4 million for fiscal year 1966. Most of these programs were of a supplementary or upgrading nature. Represented are several hundred occupations. PROGRAMS FOR THOSE WITH HANDICAPS Some of the programs are for persons who have academic, socioeconomic, or other handicaps preventing them from succeeding in the regular programs. Enrollment in programs for persons with special needs was 25,638 in fiscal year 1965. Program development in this area started on a limited basis pending results of surveys, selection and training of teachers, and the like. Indications are that the fiscal year 1966 figure has jumped to more than 380,000. CONSTRUCTION OF AREA VOCATIONAL SCHOOLS Availability of funds for construction of area vocational education schools has been a stimulus to States in overcoming problems caused by lack of adequate physical plants and equipment for vocational education. A total of $107,726,463 was reported as expended for construction of 208 area vocational school facilities in fiscal year 1965. Of this amount, $42,729,943 was in Federal funds. The Federal share is expected to top $60 million toward construction of 200 more schools during fiscal year 1966. At the present rate of construction, a nationwide system of 1,333 area schools is expected to be available by 1970. It is expected that this number will contribute substantially toward the goal of accessible vocational education opportunities for the people throughout the country. ANCILLARY SERVICES AND ACTIVITIES At least 3 percent of each allotment under section 3 of the 1963 act must be used for ancillary services to insure vocational education of high quality. An average of 5 percent was reported for fiscal year 1965. Preliminary reports indicate as much as 7 percent may have been used for this purpose in fiscal year 1966. Types of programs vary. Funds have been used for supervising instruction, training and upgrading of teachers, strengthening State administration and leadership, evaluating programs (including those in relation to projected manpower needs and job opportunities), and developing instructional materials such as curriculum guides. Office of Education 167 Work-Study The $25 million appropriated for fiscal year 1966 under the workstudy program was to enable about 85,000 full-time students to earn income needed to pursue vocational training. During the summer, nearly 7,400 other young people were given opportunity to earn income to help them follow vocational education during the school year. Part-time employment is with the local education agency or another public agency or institution. Construction of Facilities in Appalachia Grants for construction of vocational education facilities in Appalachia are for use in the counties of West Virginia and specified counties in the other 10 States in the region. The $8 million appropriated for this program on April 30, 1965, “is to remain available until expended.” Funds were being used in the 1966 fiscal year for construction of 19 schools in 4 States at an estimated total cost of $11,182,558 of which $6,016,026 is estimated to be from Federal funds. These facilities are scheduled to have a minimum enrollment of 22,800 day and evening students. Manpower Development and Training The Manpower Development and Training Act of 1962 as amended through 1965, authorizes federally supported occupational training for individuals facing particular needs including those in areas of persistent unemployment and in areas undergoing redevelopment. Programs are for those who lose their jobs as a result of automation or technical change, for those who stand to lose their jobs unless they can bring their skills up to date, for unemployed professionals in need of refresher courses, and for those needing training for work in newly redeveloping areas. The Office of Education is concerned with that part of the total program carried out as a result of arrangements agreed upon by the Secretary of Labor and the Secretary of Health, Education, and Welfare. Under ensuing delegation of appropriate authority and responsibility to the Commissioner of Education, the Office contracts with public or private education or training institutions to establish classroom programs when States are unable to provide necessary institutional training. Full Federal financing was applicable to the programs in fiscal year 1966. Local or State employment offices, which determine eligibility for training, approved 148,494 persons for classroom training in the programs other than in redevelopment areas. 237—319—67---12 168 Department of Health, Education, and Welfare, 1966 Counting those already in training when the year began, approximately 162,000 were in the classes during the fiscal year. When it closed, some of this group still were enrolled and about 91,000 had completed their programs. Represented in all were 8,574 projects with 2,690 of this number being in fiscal year 1966. Related Federal funds committed for training under section 231 of the law were $365,972,596, with $130,090,512 being the figure for fiscal year 1966. Federal obligations for State direction and supervision amounted to an additional $15,618,542, with $7,414,335 being the amount in fiscal year 1966. Similar programs started under the Area Redevelopment Act in November 1962, were brought under the amended Manpower Development and Training Act of 1962 by addition of section 241 which took effect on July 1, 1965. One result for programs under section 231 and 241 is conformity as to length of training, daily transportation expenses, and eligibility for increased training allowances. In fiscal year 1966, there were 12,998 persons approved for training in 205 area redevelopment projects at a Federal obligation of $7,957,593 out of $7,977,072 transferred from the Department of Labor. These figures compare with 10,217 enrolled in 290 projects at a Federal obligation of $3,088,389 out of the $3,105,000 available in fiscal year 1965. In fiscal year 1966, projects under section 241 were located in 36 States and Puerto Rico. New Jersey, Ohio, Mississippi, Puerto Rico, and Pennsylvania accounted for the largest numbers approved for training. Library Services and Construction The Library Services and Construction Act authorizes grants to extend public library services in rural and urban areas and for construction of public libraries in places determined to be without facilities for developing library services. “States” covered by the legislation include the 55 parts of the Nation. Basic allotments are made to the States along with additional allotments in proportion to population. State plans for improvement of library services were received from all parts of the Nation except American Samoa and became operative in fiscal year 1966. The 364 construction projects receiving Federal funding during the year represented 1 more than the number initiated the previous year. Local, State, and Federal obligations for library services under title I of the act totaled $135 million in fiscal year 1966 compared with $105.2 million the previous year. The Federal share was $25 million for each year Office of Education 169 Local, State, and Federal obligations for construction under title II of the act amounted to $92.2 million in fiscal year 1966 compared with $99.6 the previous year. The Federal share in fiscal year 1966 was $29.8 million out of the $30 million maximum available compared with $20 million available the previous year. Educational Television Facilities There were 114 educational television stations on the air at the end of fiscal year 1966 compared with 102 the previous year. Another 25 were under construction compared with 14 in fiscal year 1965. Accepted for filing under part IV of the Communications Act of 1934, as amended, were 144 applications requesting nearly $30 million in grants for educational television broadcasting facilities in 46 States, the District of Columbia, and Puerto Rico. This number compares with 33 requesting $9,083,129 in matching Federal funds for facilities in 18 States and the other 2 political subdivisions during the previous year. Approved were 112 grants for a total of $23.3 million for facilities in 41 States, the District of Columbia, and Puerto Rico. The 58 for channel activations and 54 for improvement of existing facilities compare with 14 for activation of new stations and 15 for improvement of existing facilities amounting to a total of $5,941,527 the year before. Approximately 134 million persons were being served by educational television by the end of fiscal year 1966. Schools utilizing various programs of educational television stations enrolled approximately 36 million students. Assistance for Cuban Refugees The Office administers three programs in behalf of Cuban nationals receiving political asylum in the United States. These programs, with support from funds channeled through the Welfare Administration, are carried out under regularized procedures for emergency actions established by the Migration and Refugee Assistance Act of 1962 as amended. U.S Loan Program for Cuban Refugee Students More than 5,500 Cuban refugee students enrolled at 435 colleges and universities in the United States have borrowed over $9 million since the first loans were made in 1961 under the emergency program approved by the President on February 3 that year. Over 3,500 received Federal loans totaling more than $3 million in fiscal year 1966. Repayments to the funds established in the participating colleges and universities amounted to $158,869 during the year and $307,795 170 Department of Health, Education, and Welfare, 1966 since the program began. The 231 starting their repayments in fiscal year 1966 brought the total to 807 who have started repayments since the program began. Projects for Professional Personnel Seven professional programs for a total of 661 Cuban refugees were supported at a I ederal cost of $220,142 in fiscal year 1966. Four were for the professional preparation of teachers of Spanish, one was to train librarians, another provided refresher training for physicians, and the other was a new postgraduate program on basic medical sciences for dentists, pharmacists, and veterinarians. The programs for teachers were at the University of Miami in Florida, the College of Great Falls in Montana, Mount St. Mary’s College in Los Angeles, and Fairleigh Dickinson University in New Jersey. Librarianship training was at Kansas State Teachers College. Programs for health care personnel were at the University of Miami in Florida. Aid to Dade County Public Schools Grants for the elementary and secondary school program were made in fiscal year 1966 to the Dade County Board of Public Instruction for 45 percent of the per pupil cost for Cuban refugee children not receiving public assistance, 60 percent for those receiving such assistance, 50 percent of the annual salary of 90 Cuban teacher aides, the full cost of special instructional materials, and—for construction of school facilities—$600 per child in excess of the number in average daily attendance prior to the latest influx of refugees which began on October o, 1965. Total cost for about 15,000 refugee children in average daily attendance in fiscal year 1966 was about $6 million, including $1 million for construction of facilities for 1,500 children. In the adult English language and vocational training programs, a total of 1.6 million hours of training was provided for some 20,000 participants at a cost of about $1 million. A summer program was operated at a Federal cost of $100,000. It was for 8,000 children and involved support for salaries of 100 certified teachers and 75 Cuban aides plus support for various instructional materials. Science Clubs As authorized under Public Law 85—875, the Office encourages the development and strengthening of State and local leadership in fostering scientific activities among youths—especially through clubs to supplement and enrich classroom studies. State departments of education, colleges, universities, and State academies of science conduct the programs under contract. Office of Education 171 Federal contributions are $5,000 the first year and $2,500 the next with financial responsibility thereafter being assumed below Federal level. In the 1966 fiscal year, programs were assisted in Arizona, Arkansas, Georgia, Kentucky, Minnesota, Ohio, Oregon, Pennsylvania, Texas, Virginia, and West Virginia at an estimated total Federal obligation of $47,740. International Organizationsand Conferences Office activities related to some 30 intergovernmental organizations focused in fiscal year 1966 primarily on the programs of UNESCO, the International Bureau of Education (IBE), the United Nations, the Organization of American States, and the Organisation for Eco-nomic-Co-operation and Development (OECD). In all, 124 staff members were involved in the preparation of policy papers, information, and reports and in review and evaluation activities in connection with these agencies alone. Activities vary widely. Under working arrangements with the Department of State, the Office gradually has been assuming additional responsibility for helping UNESCO with its recruitment for its field program. Full responsibility for this Federal assistance was assumed in fiscal year 1966 in keeping with Government policy to involve a larger number of nationals in the work of international organizations. The Office reviewed the revised text of the proposed Recommendation on the Status of Teachers which UNESCO and the International Labour Organisation have been working on for several years. This draft was prepared for consideration in a special intergovernmental meeting in the fall of 1966 and for ultimate adoption by the governing bodies of the two sponsoring organizations. A UNESCO request to its member States resulted in Office preparation of the report on implementation in the United States of the Recommendation Against Discrimination in Education. It had been adopted on December 14,1960, at UNESCO’s 11th General Conference. The report on Progress of Public Education im the United States of America: 1965-66 was prepared in English, French, Russian, and Spanish editions for the 28th International Conference on Public Education sponsored jointly by UNESCO and IBE. In this report one of a continuing series, a special presentation on “Mathematics Education in the U.S.A.” was included. Office of Education responsibility for appropriate coordination and for preparation of replies to the two major IBE questionnaires in fiscal year 1966 resulted in reports on Organization of Educational Research and Teachers Abroad in English and French editions. Staff members on the U.S. Delegation to the Conference in Geneva participated in international formulation of Recom/mendation No. 58 on “Literacy 172 Department of Health, Education, and Welfare, 1966 and Adult Education” and Recommendation No. 59 on “Teaching of Modern Foreign Languages in Secondary Schools” which the Conference addressed to Ministries of Education. Emphasis on education brought the Office more deeply than ever into U.S. activities in OECD as reflected in part in table 7 which identifies international conferences and meetings in fiscal year 1966 in which Office staff members participated. There were four at the 28th International Conference on Public Education, two at the 31st Council Meeting of IBE, and one at each of the others. Table 7.—International conferences and meetings attended by Office of Ed cation staff members in fiscal year 1966 Date Conference or meeting 1 Place July 5-9, 1965___________ July 12-23,1965__________ July 17, 1965____________ July 20-24, 1965_________ July 21-24, 1965_________ July 28-31,1965__________ Aug. 1-7, 1965___________ Aug. 2-5, 1965___________ Aug. 16-20, 1965_________ Aug. 16-22, 1965_________ Aug. 30-Sept. 10, 1965___ Sept. 6-12, 1965_________ Sept. 8-19,1965__________ Sept. 14-20, 1965________ Sept. 27-30,1965_________ Oct. 4-8, 1965___________ Oct. 18-22, 1965_________ Nov. 8-10,1965___________ Nov. 29-Dec. 5, 1965_____ Dec. 1-3, 1965___________ Jan. 18-25, 1966_________ Feb. 7-15,1966___________ Feb. 21-25, 1966_________ Feb. 23-24,1966__________ Mar. 2-4, 1966___________ Mar. 22-24, 1966_________ Mar. 23-25,1966__________ May 2-7, 1966____________ May 9-10, 1966___________ June 15-17, 1966_________ ‘Meeting of Experts on Educational Abstracting Services, United Nations Educational, Scientific and Cultural Organization (UNESCO). *28th International Conference on Public Education, UNESCO and International Bureau of Education (I.B.E.). *31st Council Meeting, I.B.E_____________________ 13th Triennial General Assembly, international institute of Administrative Sciences. *7th Meeting, Educational Investment Planning Group, Committee for Scientific and Technical Personnel, Organisation for Economic Co-operation and Development (O.E.C.D.). 8th Annual Congress, International Council on Health, Physical Education, and Recreation, World Confederation of Organizations of the Teaching Profession (W.C.O.T.P.). 14th Assembly of Delegates, W.C.O.T.P______________________ 17th International Congress, International Society for Edu-' cation Through Art. 9th Congress, International Federation of Modern Language Teachers. 31st Council Meeting, International Federation of Library Associations. * 2d World Population Conference, United Nations ‘Seminar on Curriculum Reform, Committee for Scientific and Technical Personnel, O.E.C.D. ‘World Congress of Ministers of Education on the Eradication of Illiteracy, UNESCO. 35th Session, International Statistical Institute__________ 11th Assembly, Atlantic Treaty Association_____________ ‘Working Group on Statistics of Education. Economic Commission for Europe and the International Labour Organisation and UNESCO. * 3d Working Conference of Representatives of Higher Agricultural Education, O.E.C.D. * 13th Session, Committee on Scientific and Technical Personnel, O.E.C.D. ‘International Committee of Experts on Literacy, UNESCO * 8th Meeting, Educational Investment Planning Group, Committee for Scientific and Technical Personnel, O.E.C.D. * 4th Meeting, Inter-American Cultural Council, Organization of American States. ‘Expert Meeting on National Planning for Library Services, UNESCO. ‘Expert Meeting on Statistics for Educational Investment Planning, Committee for Scientific and Technical Personnel, O.E.C.D. ‘43d Session, Executive Committee, I.B.E___________________ ‘14th Session, Committee on Scientific and Technical Person'-' nel, O.E.C.D. ‘Working Group on Vocational Training Policies, Manpower and Social Affairs Committee, O.E.C.D. ‘Expert Meeting on Art of Building Educational Models, Committee on Scientific and TechnicalPersonnel, O.E.C.D. International Meeting on Standardization of Terminology for Library Statistics, Statistics Committees, International Federation of Library Associations and International Organization for Standardization. ‘Meeting of the Steering Group for the Proposed Center for Educational Innovation, O.E.C.D. *15th Session, Committee for Scientific and Technical Personnel, O.E.C.D. Paris. Geneva. Geneva. Paris. Oslo. Addis Ababa. Addis Ababa. Tokyo. Uppsala. Helsinki. Belgrade. Frascati. Tehran. Belgrade. Rome. Geneva. Paris. Paris. Paris. Paris. Washington. Quito. Bandol. He de Bendor. Geneva. Paris. Paris. Paris. The Hague. Paris. Paris. 1 Asterisk denotes intergovernmental conference or meeting. Office of Education 173 Foreign Credentials Interpretation Like the many previous reviews of the foreign education credentials interpretation service since the Office began it in 1919, the review in fiscal year 1966 resulted in strong recommendations from across the country to maintain the service despite issuance of self-help educational data guides in the last decade. The reason is the difficulty institutions and agencies have in interpreting credentials from countless and frequently changing different foreign school systems for purposes of certification, licensure, student placement, and the like within the Nation. Except for the period during World War II hostilities, the number of requests for help has risen steadily—from 19 in 1919 to 2,828 a decade ago in fiscal year 1956, and 8,709 in fiscal year 1965, to 9,039 in fiscal year 1966. Contributing to the increase are the steadily rising-numbers of foreign places from which more and more foreign students come and to which U.S. nationals go for study, increases in governmental and nongovernmental grant and other foreign study programs, unsettled conditions in many foreign countries, and the more recent amendments to the Immigration and Nationality Act of 1952. Language and Area Centers and Studies The Office administers foreign language and area studies programs which are carried out at home or abroad or partly on home soil and partly abroad. Designed to strengthen academic instruction in the United States, to promote mutual understanding among peoples of the world, or for dual purposes, each has a different legal basis. National Defense Education Language and Area Centers Critical need within the Nation is the criterion underlying the program under certain provisions of title VI of the National Defense Education Act as amended. There were 98 centers on a total of 61 campuses in academic year 1965-66 as a result of the Commissioner’s continued authority to contract with higher education institutions to establish and operate centers to teach certain modern foreign languages and studies related to understanding of the areas where the languages are used. Institutions received $4.94 million in fiscal year 1965 funds for support of up to 50 percent of the cost of their new and expanded center activities during 1965-66. The amount increased to $5.08 million in fiscal year 1966 funds for such activities in academic year 174 Department of Health, Education, and Welfare, 1966 1966-67, and brought the 8-year total to more than $21 million from lump-sum appropriations for centers and related fellowships and research and studies. Fiscal year 1966 funds are for programs in more than 70 of the nearly 100 languages offered at centers receiving Federal funds. Fifty-five percent of the support is for language instruction and 45 for area studies. First priority languages are Arabic, Portuguese, Chinese, Hindi-Urdu, Japanese, Latin American Spanish, and Russian. Geographic areas represented are Asia, East Asia, South and Southeast Asia, the Asian-Slavic region, the Uralic-Altaic region, Slavic and Eastern Europe, Northwest Europe, the Middle East, Africa, and Latin America. National Defense Education Modern Foreign Language Awards Another provision in title VI of the amended National Defense Education Act of 1958 authorizes Federal funds for stipends for advanced training in a qualifying modern foreign language and related area study. These awards are granted only on “reasonable assurance” that recipients will be available to teach the language at higher education level or render other service of a public nature involving use of the training. Some are for liberal arts college faculty members to study at postdoctorate level at National Defense Education Language and Area Centers in rarely taught non-Western language and area studies as an aid in developing programs in their home institutions. Others are fellowships for graduate study in the summer and the academic year. The rest are awards for intensive summer study at undergraduate level. More than $27 million has been obligated for more than 8,200 recipients over the 8-year period of the program. Awards from fiscal year 1966 funds for use in the summer of 1966 and academic year 1966-67, amount to $6,120,000; namely : 17 at postdoctorate level________________________________________ $172, 973 1,507 at graduate level__________________________________________5, 543, 217 427 at undergraduate level (for summer study only)_______________ 403, 810 Language and Area Training for Mutual Understanding By Executive Order 11034 and subject to primary responsibility of the Secretary of State for Government-wide leadership and policy guidance, the President delegated his authority for cooperation for educational and cultural advancement and mutual understanding Office of Education 175 under provisions in section 102(b) (6) of the Mutual Educational and Cultural Exchange Act of 1961 (popularly known as the Fulbright-Hays Act). This delegation to the Secretary of Health, Education, and Welfare, in turn was redelegated to the Commissioner of Education. Section 102(b) (6) approaches the overall goals of the law through authorization of Federal promotion of modern foreign language and area studies in schools, colleges, and universities. Part of the support is for visits to other countries to help teachers and prospective teachers improve their foreign language skills and increase their knowledge of cultures where the languages are spoken. The rest is for visits by specialists from abroad to help strengthen language and area studies in school systems and State departments of education in the United States. Covering appropriation increased from $1.5 million for fiscal year 1965 to $2 million for fiscal year 1966. Initial obligations against this sum were subject to adjustment as specific awards were worked out. SUMMER SEMINARS AND TRAVEL ARROAD Seven 6-week seminars plus 2 weeks of related cultural travel had been planned by June 30, 1966, for a total of 171 persons at an estimated cost of $308,400. The seminar at the University of Strasbourg is for 25 elementary and junior high school teachers of French. The other 6 are for a total of 146 teachers at secondary or higher level. Cultural focus and location are: Chile—University of Chile; East Africa—Haile Selassie I University; Japan—Sophia University; Lebanon—American University of Beirut; Mexico—University of the Americas; and the Philippines—Ateneo de Manila University. Gradual implementation of policy to involve domestic institutions more fully in cooperative efforts resulted in the Office of Education plan with Sophia University in Japan being made in conjunction with Georgetown University in Washington, D.C. INDIVIDUAL STUDY AND RESEARCH ARROAD Awards totaling $773,382 had been made by June 30, 1966, for 110 prospective college-level teachers of non-Western language and area studies. Most previously had National Defense Education fellowships. Other awards totaling $562,160 were for 48 National Defense Education Language and Area Center faculty members. Most are for linguistic research or materials development for non-Western language teaching and for related area studies. In addition, 21 awards totaling $177,148 were made for 10-month programs in Austria, Brazil, England, France, Italy, Japan, Lebanon, or Spain. This group includes secondary school teachers and supervisors and college instructors in social studies or languages. 176 Department of Health, Education, and Welfare, 1966 LANGUAGE AND CURRICULUM SPECIALISTS FROM ABROAD Fifteen specialists from abroad were recruited under fiscal year 1966 funds to assist in strengthening language and area programs in the United States in school year 1966-67. Their home countries are Bolivia, Colombia, the Federal Republic of Germany, France, India, Mexico, Nigeria, and Peru. Nine State departments of education are to benefit (Delaware, Michigan, Montana, Nebraska, New York, Oklahoma, Texas, Virginia, and Wisconsin). County school systems to benefit are those of Jefferson County, Ky., and Beaver County, Pa. City systems include Salem, Oreg.; Alexandria, Va.; Seattle, Wash.; and Milwaukee, Wis. FOREIGN STUDIES EXTENSION Projects to improve quality of language and area studies instruction also are among those financed in part from foreign currencies derived from the sale of surplus agricultural commodities abroad. Most of them are in the Foreign Studies Extension Program of the Office of Education. Authority stems from the Agricultural Trade Development and Assistance Act of 1954 after certain amendments were made in 1958 and 1959. These are the ones adding subsection (k) to section 104 of Public Law 83-480 and authorizing purchase of certain foreign currencies for the conduct of research and for programs and projects for the promotion of cultural and educational development. Equivalent dollar cost for 21 grants to domestic institutions of higher learning and to professional organizations in fiscal year 1966 stood at $486,372 on June 30,1966. Grants were for projects involving 259 individuals in fiscal year 1967. Eight were for summer seminars in 1966 in Egypt, India, Israel, and Yugoslavia. Another eight for 2% to 13 months were for teams of college professors and administrators to survey curriculum practices in the same countries and in Pakistan and Poland. One was to the State University of New York for a center in India to develop curriculum materials. The others were supplementary or small grants. Teacher Development and Exchange The Office of Education is concerned with administration of certain programs under provisions of the amended Mutual Educational and Cultural Exchange Act of 1961 as a whole. These are the ones con- Office of Education 177 cemed with exchanges and interchanges of working teachers and with exchanges of other educators for training purposes. Some of the participants are in language and area studies; most are not. The President, by Executive Order 11034, delegated his authority for these programs to the Secretary of State. Office of Education responsibility stems from an ensuing interdepartmental agreement approved by the Secretaries of State and Health, Education, and Welfare, and related delegation of authority to the Commissioner of Education. Grants in fiscal year 1966 for projects operative in fiscal year 1967 amount to approximately $1.29 million. Funds are transferred from the Department of State as needed. Teacher Development A total of 632 educators came from 63 countries and dependencies for training and school visitation under the teacher development program in fiscal year 1966. Teachers and administrators numbering 276 from 49 countries participated in the regular 6-month program under which facilities of 10 college-level centers were used. Another 202 educators were involved in a total of 18 short-term projects. The seminar portion of these projects was conducted in 12 training centers. In addition, 3 workshops were held at the University of Puerto Rico for a total of 154 elementary, secondary, and vocational teachers and administrators. Funds were obligated in fiscal year 1966 for the programs in fiscal year 1967. About 600 educators were scheduled for inclusion with 250 in the regular 6-month program, 200 in the special projects category, and 150 in workshops in Puerto Rico. Teacher Exchange Supervisory and administrative services were provided during the summer of 1965 and the 1965-66 school year for a total of 582 teachers under the Teacher Exchange Program. Included were those from foreign lands who were teaching in the United States and those from the United States who either were attending summer seminars or were teaching abroad. Publicity and recruitment during the year resulted in the issuance of 604 awards prior to June 30,1966, to be effective during the summer of 1966 and the 1966-67 academic year. Interchanges of teaching positions were arranged for 120 pairs of teachers from a total of 10 countries. 178 Department of Health, Education, and Welfare, 1966 On a noninterchange basis, 83 teachers from the United States received awards for assignments in a total of 26 countries while 76 foreign teachers from a total of 15 countries received assignments to schools in the United States. Renewals of grants for another year were made for 24 teachers from the United States and for 22 foreign teachers. One hundred foreign language teachers from the United States received awards for summer seminars in 1966 in the Federal Republic of Germany, in Italy, or in Spain. In addition, 39 social science teachers received awards to attend a seminar in India. A fall seminar in India (at the center receiving support under the foreign studies extension grant to the State University of New York) was planned under the Teacher Exchange Program. Financing is under amended Public Law 83-480 at an estimated equivalent of $50,000 from fiscal year 1966 funds. This seminar is for 20 social science supervisors and curriculum directors from State departments of education and large city school systems. It concerns Indian and South Asian history and culture with emphasis on collection, preparation, and use of education materials. Bilateral Technical Cooperation The Office plans and implements an educational training program under foreign assistance legislation and a contract with the Agency for International Development (AID). Plans were made in fiscal year 1966 for 734 participants in fiscal year 1967. Approximately 500 are candidates for degrees with the majority at graduate level. Forty-six countries are represented in the total group with the largest numbers coming from Africa and Latin America. Objectives of these technical assistance projects are to be carried out under arrangements made with 160 centers in the Nation. Other services responded to requests from AID and 13 countries in which their Missions are located. Included were help on recruitment and on transfer and reassignment of AID education advisers, preparation of A Survey of AID Educational Cooperation With Developing Countries, and consultative and support services. Officials of schools and colleges, State departments of education, book publishers, and other groups were brought into the services of consultative nature. Support services included periodic selection and shipment to AID Missions and supply to AID visitors of current education materials on innovations and trends in the United States and on educational philosophy, problems, and developments. Office of Education 179 Secondary and Nongrant Visitor Program A significant and less well-known technical service program is the Secondary and Nongrant Visitor Program. It operates as part of the day-by-day work of the Office without a specifically earmarked appropriation and involves a wide range of services including arrangement of observation and study programs and related itineraries. Approximately 2,000 foreign visitors received these services in fiscal year 1966. Some were “secondary visitors”—those on grants from other agencies of Government who also have interests in the field of education. Othere were referred by Ministries of Education, or by universities, educational research organizations, or other bodies at home or abroad. Research and Related Activities The Office of Education administers a variety of programs concerned with research and allied activities. Most of them are cooperative in nature and conducted outside the Office. Cooperative Research Program The Cooperative Research Program is the oldest, largest, and most flexible of the programs receiving support from the Office for research and related activities which are conducted outside the Office. This program, authorized on July 26, 1954, and activated in fiscal year 1957, underwent considerable expansion during fiscal year 1966 in line with amendments to Public Law 83-531 which were included as title IV of the Elementary and Secondary Education Act of 1965. Some of the support under the legislation now known as the Cooperative Research Act, is for research and development centers, regionally based educational laboratories, and information clearinghouses. Some is for constructing and equipping facilities for educational research and related activities. Some is for training in educational research. The rest is for research projects. RESEARCH AND DEVELOPMENT CENTERS At the close of the 1966 fiscal year, 11 research and development centers—including 5 new ones—were receiving Federal funds through the Office of Education. Nine were receiving funds under the Cooperative Research Act. The other two, though similar in nature, received support under the Vocational Education Act of 1963. Still another, established during fiscal year 1966 as the Center for Urban Education in New York City, 180 Department of Health, Education, and Welfare, 1966 had evolved into a regional educational laboratory before the year was over. Each center concentrates on producing research knowledge to help resolve a particular problem in education. Each center is operated at a university which has demonstrated its competence by bringing interdisciplinary resources to bear on the problem. Each center is building on experience to produce early and long-range results. A center’s name reflects its area of concern. Name, location, and fiscal year in which each began to receive Federal support are as follows: • Learning Research and Development Center, University of Pittsburgh, Pittsburgh, Pa. (1964). • Center for the Advanced Study of Educational Administration, University of Oregon, Eugene (1964). • Center for Research and Development for Learning and Re-Education, University of Wisconsin, Madison (1965). • Center for Research and Development on Educational Differences, Harvard University, Cambridge, Mass. (1965). • Center for Research and Leadership Development in Vocational and Technical Education, Ohio State University, Columbus (1965). • Center for Research, Development, and Training in Occupational Education, North Carolina State University at Raleigh (1965). • Research and Development Center in Educational Stimulation, University of Georgia, Athens (1966). • Research and Development Center in Teacher Education, University of Texas, Austin (1966). • Stanford Center for Research and Development in Teaching, Stanford University, Palo Alto, Calif. (1966). • Center for Research and Development in Higher Education, University of California, Los Angeles (1966). • Center for the Study of the Evaluation of Instructional Programs, University of California, Los Angeles (1966). REGIONAL EDUCATIONAL LABORATORIES Twelve regional educational laboratories, with support under the Cooperative Research Act, were in operation at the end of fiscal year 1966. Seven others were being developed under contracts which anticipate that they will be operational in fiscal year 1967. These 19 will represent all but 2 regions in the country. The District of Columbia-Maryland-Northern Virginia area was working toward negotiation of a contract for development of a laboratory. A feasibility contract was being negotiated to study needs and resources for a laboratory for Hawaii and the Pacific Basin area. The regional educational laboratories are all new institutions. They draw upon colleges, universities, State education agencies, local schools, industry, and other interests for their membership and affiliations and for their planning, operation, and management. Office of Education 181 In fiscal year 1966, about $8.6 million was used for formation and operation of the laboratories. About $1.3 million for construction and equipment was used from the initial $20 million appropriated under the $100 million authorized over a five-year period for these purposes. (The heavy demand for funds for construction and equipment is expected in fiscal years 1967 and 1968.) Differing from research and development centers with their focus on a problem area, laboratories concentrate on helping to bring about and implement beneficial changes in education in a region. Those established in fiscal year 1966, together with regions decided upon by the interests which united to form the new institutional frameworks are: • Southwestern Cooperative Educational Laboratory, Albuquerque (New Mexico, Arizona, Oklahoma, Texas). • Research for Better Schools, Inc., Philadelphia (Pennsylvania, Delaware, New Jersey). • Far West Laboratory for Educational Research and Development, San Francisco (northern California and northern Nevada). • Central Midwestern Regional Educational Laboratory, Inc., St. Louis (Missouri, Illinois, Kentucky, Tennessee). • Midcontinent Regional Educational Laboratory, Kansas City (Missouri, Kansas, Nebraska, and Oklahoma). • Northwest Regional Educational Laboratory, Portland (Oregon, Alaska, Idaho, Montana, Washington). • Rocky Mountain Educational Laboratory, Inc., Greeley (Colorado, Arizona, Idaho, Kansas, Montana, Nebraska, Utah, Wyoming). • Appalachia Educational Laboratory, Charleston (West Virginia, Kentucky, Ohio, Pennsylvania, Tennessee, Virginia). • Southeastern Educational Laboratory, Tallahassee (Florida, Alabama, Georgia). • Upper Midwest Regional Educational Laboratory, St. Paul (Minnesota, Iowa, North Dakota, South Dakota, Wisconsin). • Center for Urban Education, New York (Metropolitan New York City area)—started as a research and development center and evolved during fiscal year 1966 into a laboratory. • Southwest Regional Laboratory for Educational Research and Development, Santa Monica (California, Arizona, Nevada). Those in process of development in fiscal year 1966 are: • Institute for Educational Innovation, Newton, Mass. (New England). • Eastern Regional Institute for Education, Syracuse (New York exclusive of New York City, Pennsylvania). • Regional Educational Laboratory for the Carolina and Virginia, Rougemont (North Carolina, South Carolina, Virginia). • South Central Regional Educational Laboratory Corp., Little Rock (Arkansas, Kansas, Louisiana, Mississippi, Missouri, Oklahoma). • Michigan-Ohio Regional Educational Laboratory, Detroit (Michigan and Ohio). • Southwest Educational Development Corp., Austin (Texas and Louisiana). • Cooperative Educational Research Laboratory, Inc., Urbana (Illinois, Indiana, Michigan, Wisconsin). 182 Department of Health, Education, and Welfare, 1966 EDUCATIONAL RESEARCH INFORMATION CENTER (ERIC) The Educational Research Information Center was established in the Office of Education under another 1965 amendment to Public Law 83-531. The Center coordinates the work of a decentralized network of information clearinghouses or research documentation centers. ERIC acquires, abstracts, indexes, stores, retrieves, and nationally disseminates educational research and research-related information. Specifically, it seeks to provide reliable, current educational information promptly and inexpensively to a wide variety of audiences. The first 12 information clearinghouses in the decentralized network were established in fiscal year 1966. Eight were funded under the Cooperative Research Act and four under other laws. At the specified institutions, each has a different specialty area; namely: • University of California, Los Angeles (junior colleges). • Center for Applied Linguistics, Washington, D.C. (linguistics). © Council for Exceptional Children, Washington, D.C. (exceptional children). • Indiana University (reading). • University of Michigan (counseling and guidance). • Modern Language Association of America, New York City (foreign languages). • New Mexico State University (small schools and rural compensatory education). • City University of New York (school personnel). • Ohio State University (science education). • Ohio State University (vocational-technical education). • University of Oregon (educational administration). • Yeshiva University (disadvantaged). EDUCATIONAL RESEARCH TRAINING Another amendment to Public Law 83-531, in title IV of the Elementary and Secondary Education Act of 1965, authorized funds for training of educational researchers and for strengthening staff and curricular capability for such training. Out of the $50 million in Cooperative Research Program funds for purposes other than constructing and equipping regional facilities, grants totaling $7.2 million were awarded in fiscal year 1966 to 92 institutions in support of 178 training-programs in educational research. This support includes stipends and institutional allowances for trainees and funds for staff and curriculum development. Most of the funded projects were scheduled to begin in the summer or fall of 1966. PROJECT RESEARCH Approximately $26 million in Cooperative Research Program funds was used in fiscal year 1966 for project research and related activities. The 710 new and continuing projects receiving support vary widely in size and complexity. Major interest research areas include curricu Office of Education 183 lum development, administration, teacher training, individualized instruction, and education of disadvantaged, urban, and minority groups. There were 327 small projects involving $7,500 or less in direct support. They were designed to carry out pilot studies and other small-scale research and to attract new researchers from each geographic area. For the most part, Cooperative Research Program support was reserved for projects of types not appropriate under other educational research programs. Vocational Education Research and Training The fiscal year 1966 appropriation for the Vocational Education Research and Training Program was $17.75 million. Approximately 200 new research, demonstration, and training proposals were funded and 48 projects started in fiscal year 1965 received continued support in fiscal year 1966 under this program. Research is in such areas as curriculum development, the personal and social significance of work, personnel recruitment and development, program evaluation, and occupational information and career choice. The 60 summer institutes and workshops which were funded were for training some 2,400 vocational education personnel. The 11 seminars of 1- to 2-week duration were for improving the research competencies of more than 400 individuals concerned with vocational education research and development. Grants to 20 States aided them in establishing State research coordinating units for vocational education. By the end of fiscal year 1966, all except Alaska, Maine, Maryland, South Dakota, Vermont, and Virginia had such units. The Center for Research and Leadership Development in Vocational and Technical Education at Ohio State University was designated as an ERIC clearinghouse specializing in vocational-technical education materials. Approximately $1.5 million was used for new or continued support of 20 adult education research projects relating to adult learning theory and experience, teacher and student roles and problems in adult education, adult literacy programs, and the like. Depending on purpose, some were funded under the Cooperative Research Act and some under the Vocational Education Act of 1963. Media for Educational Purposes Four million dollars was appropriated for fiscal year 1966 for grants and contracts for research and dissemination of information concerning educational uses of media such as radio, motion pictures, other audiovisual equipment and materials, and printed and published 237-319—67----13 184 Department of Health, Education, and Welfare, 1966 materials. This support is authorized by parts A and B of title VII of the National Defense Education Act of 1958, as amended. Obligations for 41 research and experimentation projects amounted to $1.3 million. Another $1.8 million was earmarked for 40 dissemination projects. Seven activities combining research, experimentation, and dissemination were funded with $800,000 of the grand total of $3.9 million obligated. Language Development Research and Studies The Language Development Research and Studies Program became operational in fiscal year 1959 under title VI of the National Defense Education Act of 1958. Since then, 416 contracts have been awarded for surveys and studies, for methods research, and for development of instructional materials (in more than 125 modern foreign languages). I he $2.8 million appropriated for fiscal year 1966 was obligated for 55 new and 8 continuing projects. Two of the new contracts were for ERIC establishments at the Modern Language Association of America in New York City and the Center for Applied Linguistics in Washington, D.C. Foreign Currency Financed Projects A portion of the foreign currencies purchased by the Office under amended Public Law 83^480 and related appropriation legislation financed a range of research and related activities in the field of education. Included are studies of foreign education and educational bibliography and translation projects. In fiscal year 1966, there were 9 continuation projects in India and 15 continuation and 5 new ones in Israel. Discussions were held with the United Arab Republic to stimulate projects. In addition, projects for translating educational materials were underway in Israel, Poland, and Yugoslavia under an arrangement with the National Science Foundation. The Arts and the Humanities The Office’s research program in the arts and the humanities exemplified joint staff leadership and interagency cooperation to channel to these areas some of the research support of several different programs. A total of $2.4 million was obligated from funds under the Cooperative Research Program and the program on media for educational purposes and from appropriated funds for the purchase of foreign currency. The 84 projects newly funded in fiscal year 1966—more than double the number in the previous year—were concerned with music, art, Office of Education 185 theater and dance, museums, and humanities. Another 14 projects received continuing support. Education of the Handicapped The $6 million authorized by section 302 of Public Law 88-164, as amended, was appropriated for fiscal year 1966 for research and demonstration projects in the education of handicapped children and youth. Of this amount, $5,992,316 was obligated to support 92 new and 41 continuing projects to improve learning situations, classroom procedures, and materials. Eight Instructional Materials Centers To Aid Education of the Handicapped account for $1.1 million in fiscal year 1966 funds. These and the two pilot centers set up the previous year, engage in research and development activities to improve teaching materials. They also collect instructional materials and aids (such as Braille books, test kits, tapes, and recording devices), evaluate their effectiveness, and make them available to local schools. Centers are located at the American Printing House for the Blind in Louisville, Colorado State College, Illinois State Department of Public Instruction, Michigan State University, and the Universities of Kentucky, Oregon, Southern California, South Florida, Texas, and Wisconsin. Captioned Films for the Deaf For the 1966 fiscal year, $3 million was appropriated for the program concerned with captioned films for the deaf. Of this sum, $400,000 was obligated for training, $500,000 for research and related activities, and $1.9 million for film production and services. Funds for training were for special summer institutes in educational media for teaching the deaf and summer workshops on captioning films, preparing study guides, and developing curriculums for the deaf in consumer education, health, and social relationships. Funds also were provided for teachers of adult education programs in the Los Angeles area to aid them in making more effective use of new media in teaching the deaf. Supported research and related activities included projects on new media development in programed instruction, study of visual perception among deaf children, and field testing of multisensory visual materials for classroom instruction. In addition, projects covered 21 films on vocational guidance and attitudes. Production of weekly filmstrips was extended to cover second- and third-grade reading. These filmstrips reached 485 classes over a 32-week span. Condensed versions of 10 selected productions, along with 186 Department of Health, Education, and Welfare, 1966 My Weekly Reader, were mailed to the homes of 11,000 deaf children during the summer. Acquisitions of new films included 48 general interest titles, 79 educational titles, and 51 free or sponsored subjects having both educational and recreational uses. These loan service acquisitions raised the total of available films over the 200,000 mark. Some 2,000 projectors and screens also were purchased for loans to schools for the deaf. By the end of the 1966 fiscal year, 1,400 groups were registered to use the loan service. The total audience reached was estimated at more than 900,000. Number of distribution centers for educational materials for the deaf increased from 48 to 60, while recreational films continued to be distributed from 3 depositories—in Colorado, Indiana, and New York. Educational Materials Center The Educational Materials Center contributes to dissemination activities of the Office with particular emphasis on new Office programs, developing activities in regional and local communities, and liaison with educational publishing interests in the Nation. The Center’s collection has grown to 15,000 volumes, representing the latest texts for students and teachers and children’s literature (trade books) used in schools and in public libraries. This nonlending collection is used by domestic and foreign educators interested in comparison study and research into newly published instructional materials. At the suggestion of the American Textbook Publishers Institute, a number of the regional educational laboratories established under the Cooperative Research Act are working with the Educational Materials Center to develop similar centers throughout the Nation. The Center in the Office of Education continued its bibliographic services in fiscal year 1966. It collaborated with ERIC in documentation of programs for the disadvantaged. It prepared a major bibliography for the National Conference on the Disadvantaged in Washington, D.C., July 18-20, 1966. In addition, the Center collaborated with the Library of Congress in compiling its yearly publication on children’s books. Demonstration Center The Demonstration Center in the Office of Education is staffed to service seminars, workshops, exhibits, and presentations of equipment and materials adopted for use in education. The Center also maintains and assists in project evaluations where media components are integral aspects of an activity. During fiscal year 1966, the Demonstration Center was host to some 295 presentations, conferences, and demonstrations in support of Office of Education 187 Office program activities. Audiences totaling 14,750 persons were accommodated. The Center held inservice workshops on audiovisual materials and their use. It also reviewed and evaluated films for 32 projects and proposals in the area of dissemination. American Education American Education was a year and a half old on June 30, I960. Published 10 times a year, this magazine is designed as a link between the Office and the public—both general and professional. It provides the lay reader with background on the kaleidoscopic world of education and furnishes the professional educator with fresh ideas on Government programs relating to education. American Education looks like what it is intended to be—a popular magazine. It covers the span of learning—from preschool to postdoctoral, from educational research and development to desegregation, from schools on the Canadian border to universities in the Southwest. It recognizes that education is complex, interrelated with other facets of contemporary life, and of proper concern to the entire citizenry. National Center for Educational Statistics The survey of educational opportunities called for by section 402 of the Civil Rights Act of 1964 was completed and published at the end of fiscal year 1966 so that the Commissioner could meet the July 2, 1966, deadline established by the law for reporting to the President and the Congress. More than 4,000 elementary and secondary schools, 60,000 teachers, and 645,000 pupils and students were involved in the survey carried out under the direction of the National Center for Educational Statistics with the assistance of outside consultants. Entitled Equality of Educational Opportunity, the survey examined in depth the variations in educational opportunities available to minority and majority groups throughout the Nation. It focused on the relationship between student achievement and kinds of schools attended in metropolitan and nonmetropolitan areas of various parts of the country. Never before were data on student achievement, instructional staff, physical facilities, and other variables for the major ethnic and racial groups gathered on so large a scale. The Center also developed the Higher Educational General Information Survey. It combines in one form the content of the previous survey forms in a way that standardizes definitions, reduces duplication of requests for data, and provides respondents in institutions of higher learning with advance instructions as to kind of information needed. This survey is the first of seven general information 188 Department of Health, Education, and Welfare, 1966 packages for gathering data on a more timely basis while reducing the burden on respondents. A beginning was made in the development of analytic models of educational operations in the Nation. They give promise for evaluating existing programs and providing information on probable effects of program changes. A manual on Principles of School Accounting was prepared. It provides an operational guide to financial accounting for school districts. Also completed was a dictionary of terms used in the manual and in five other publications comprising the handbook series on “State Educational Records and Reports.” An information retrieval language was designed for use with the interim automatic data-processing system to provide rapid access to major data bases through remote stations. Eventually, the data base is to encompass all Office programs, including grants and research projects as well as financial, program, student, personnel, and facilities information for educational institutions and systems in the country. The 18 statistical publications prepared and issued during fiscal year 1966 contain data on such subjects as residence and migration of college students, earned degrees conferred, engineering degrees and enrollments, and land-grant college statistics. Most popular are the annual Digest of Educational Statistics and its companion Projections of Educational Statistics. State Education Agency Statistical Services Grants to help State education agencies strengthen their statistical services are authorized under section 1009 of the National Defense Education Act of 1958, as amended. During fiscal year 1966, Center staff members provided direct consultation and assistance in modernizing data-handling procedures at the various levels of education and in State education agencies. All but 2 percent of the $2.5 million appropriated for grants under the program was allocated in fiscal year 1966. Thirty States received the maximum of $50,000. Of these, 17 States overmatched the Federal funds provided. Administration of the Office The organizational pattern of the Office of Education was restructured effective July 1,1965, in preparation for new and expanded responsibilities as a result of extensive new legislation in the field of education. Operating programs were grouped by level of education served or specific function performed such as research, equal educational opportunities, and administration. The chart which follows, depicts the general pattern in fiscal year 1966. Office of Education 189 CHART 1.—OFFICE OF EDUCATION ORGANIZATION ASSOC. COMM'R FOR COMMISSIONER OF EDUCATION ASSOC. COMM'R FOR INTERNATIONAL - -------------------- —— FEDERAL-STATE EDUCATION_ DEPUTY COMMISSIONER ___RELATIONS__ ______I , , I , , I — I . . I T3__________________________________________________________________ OFFICE OF OFFICE OF OFFICE OF OFFICE OF OFFICE OF OFFICE OF PROGRAM PLANNING EQUAL EDUCATIONAL DISADVANTAGED AND ADMINISTRATION INFORMATION LEGISLATION ( _______ AND EVALUATION OPPORTUNITIES HANDICAPPED ______EZZ“ ~□_________________ CONTRACTS AND NATIONAL CENTER CONSTRUCTION FOR EDUCATIONAL SERVICE STATISTICS , . I , , BUREAU OF BUREAU OF ASSOC. COMM'R FOR BUREAU OF BUREAU OF ELEMENTARY AND SECONDARY ADULT AND VOCATIONAL FIELD SERVICES HIGHER EDUCATION RESEARCH EDUCATION EDUCATION Division of Division of ... e Division of Division or _ , — Plans and — Vocational and — — Elementary-Secondary _ , . . . Student Financial Aid ROcParrh Supplementary Centers) Technical Education _______ ________ _______________Research__ Division of _. . c Division of — Division of — Library Services and — ivision o — Adult aj)d Vo