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/ < ,7v- > 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 r<» r^’
/ /■**«-<— /via I vi _x L™„^) j llx
-—| / /-----PbrTskT ^j‘° I_M v I \ I T^’^o"---------\ J Ch‘^1 V |°H! \ uTTVC/
A """'•“ \ t__ >L.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<40 7 9 6 — MASS 14 6.3 5 MHBI MASS. 169.8 9 BBBBBBB NJ 5 144 BHS HAWAII 12 178 BMB DC. 72 40 B^H
VT IO? 5K n"? Y4K nn CALIF 12864 IND 13 8.6 9 BMB MASS 51.01 Bm N. DAK. 107 90 MBB MD. 70.9 9 BI^B
uLs o ?o 4, i *™ NH 15 93 i W'S. 132.0 5 BBBM CONN. 4 9 76 MM OKLA. 9 9 7 2 EBSSB HAWAII 5 9.9 0
MASS '0110 MM FLA. 3 3 2 2 8 B^B WIS. 10 8.5 5 BM KANS. 122.25 i^M N.Y 4 8 48 BBS N.Y. 97.30 BBBi PA 5 5 3 5 ^BB^B
R ' 99.70 ALA 3 2 5 0 9 MB NEBR. 108 47 N.H. 119 49 BBBM WIS. 4 7.6 4 BBM1 MINN. 94 8 4 B^M M0. 54 85 BBBM
DC 9 8 2 0 ^^^B MAINE 2 9 5 7 I BB IOWA 10 8.1 8 ^MM NEBR. II 4 3 4 KBi N. H. 4 6.96 MM PA 82 86 MM UTAH 5412 MMM
'N° mi N J 2,279 46 MB PA. 106 98 MMM i IOWA 110.64 BMM MINN. 4 6.70 MM ILL. 38.02 M WASH 4 8 3 5 ^M
COLO. 9 7 36 MB VT. 2 3 4 4 6 M CONN 10 6.76 MBBi ALASKA 108 99 BMM CALIE 4 3 4 7 TCM LA 4 7 6 5
IOWA 9 6 9 3 BBM CONN. lj 2 0 9 2 5 M , Rl 106.5 7 MM I CALIF 107.98 BMM Rl 4 2 50 Bid NY 4 5 7 1 ^M
CALIF 96 86 —■ NEBR.Z/206 05 M NEV §/1 0 5 I 8 MMB I NJ 105.96 SMB IOWA 4 0 8 5 BBB ILL 38 86 MB
KANS 95 99 COLOZ'203.9 7 M OKLA 104 29 BBM MICH. 104.2 0 ^MB HAWAII 4 0 7 5 ZM NJ S,' ’ ■> 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***’ ’• <• . -4 N
O150-|- | \ <:: /■’’* L ...' ■ £
E ! X • /U 1 • ' ‘3 o
o ____i :••.•: ]• • •• 'rate:-. o
c 100 W < . 2
i i - ••:•••'.' '• ••• ; ••• :7 .. • - 2 u
50 1 t I i
o i |—t -i r !'■■■<'' I"’ :f r * —f ..............—[_ o
1937 39 41 43 45 47 49 51 53 55 57 59 61 63 65
the development of multidiscipline centers for multiply handicapped children.
By the end of the fiscal year, the Bureau was supporting service projects for the care of multiply handicapped children in 12 medical centers.
CHILD WELFARE SERVICES
About 697,300 children were receiving services from public and voluntary child welfare agencies and institutions in the United States on March 31, 1965, or 7 percent more than were being served on March 31,1964. Of this total, 483,000 (69 percent) were being served primarily by public agencies and institutions, and 213,500 (31 percent) primarily by voluntary agencies and institutions. The rate was 87 children served per 10,000 in the population, as compared with 83 per 10,000 in 1964.
Two-fifths of all children served lived with parents or relatives, or maintained living arrangements, as older teenagers, on their own; nearly one-third were in foster family homes; one-sixth were in institutions ; and one-tenth in adoptive homes.
State and local public welfare agencies spent an estimated $352 million in fiscal year 1965 for public child welfare services, a 12-percent rise over 1964. This amount included expenditures of $176 million from State funds (50 percent of the national total), $141.8 million
W elf are Administration
55
from local funds (40 percent), and $34.2 million from Federal funds (10 percent).
A total of $5 million in child welfare training grants, the full amount of the appropriation, provided for 125 field instruction units and 30 other faculty members to strengthen the school program in relation to child welfare; 727 traineeships, including 46 traineeships at the postmaster’s level; and 21 short-term training projects.
For more than 20 years, both the number and rate of children in foster family care have risen steadily, with the largest increase occurring for those under public agency auspices. These increases, along with socioeconomic factors, made it difficult for public and voluntary agencies to recruit the number and quality of foster families needed. There was, however, a growing recognition by citizens and public officials of the complexities involved in the placement of children. There was also increasing acknowledgment that a high percentage of these children need foster family care for a long period of time, many for their entire childhood.
Foster family care programs were being developed for the emotionally disturbed child. Greater use was made of foster family homes for emotionally disturbed children in lieu of residential treatment centers.
Institutions generally responded to a variety of changing community needs by developing specialized combinations of residential and community services for adolescent boys and girls; by expanding the institutions into multiple child welfare service programs; and by developing psychiatric consultation, casework, and clinical services for children in institutions.
University extension divisions and graduate schools of social work started training programs in many parts of the country for staff of child-caring institutions.
The Office of Economic Opportunity, the Administration on Aging, and the Children’s Bureau began a foster grandparents program during the summer of 1965. This program utilizes impoverished elderly men and women in a service role in the child-caring institutions. Participating child welfare agencies were enthusiastic about the program and reported that the children benefited from daily activity periods with grandparents who “really care.”
About 142,000 children were adopted in the United States in 1965, as compared with about 135,000 in 1964. Relatives adopted 54 percent of the children, and nonrelatives adopted 46 percent. The general public was becoming more aware of the advantages of adoptions made through social agencies: 83 percent of nonrelative adoptions in 1964 were made through social agencies as compared with 50 percent in 1951. Both public and voluntary agencies made greater ef-
237-319—67---5
56
Department of Health, Education, and Welfare, 1966
forts to place children who were handicapped, older, nonwhite, or had mixed racial backgrounds. The number of children needing to be adopted had increased so rapidly, however, that agencies were not able to keep pace.
Many States improved the requirements for obtaining licenses for day care homes and centers and upgraded the standards for day care services. All States and Territories (except Idaho and Guam) included day care services in their child welfare services plans, and 27
CHART 5.—CHILDREN RECEIVING CHILD WELFARE SERVICES BY LIVING ARRANGEMENTS, MARCH 31, 1965
CHILDREN SERVED (IN THOUSANDS)
States appropriated funds for day care services. As of September 1965, there were about 7,300 licensed or approved day care centers in the Nation with an aggregate capacity estimated at 252,000 children. In addition, there were about 16,400 licensed family day care homes with an aggregate capacity estimated at 58,500 children.
A concerted effort to coordinate federally aided daytime programs for children began in fiscal year 1966. A meeting of representatives of the Welfare Administration and the Office of Education in the
OWN HOMES
FOSTER FAMILY HOMES
INSTITU-
TIONS
ADOPTIVE HOMES
ELSEWHERE
< TOTAL > 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<.atlonal
Program Operations |Education.l Facilities| | F°rei8n StUdieS | Research
Division of Division of Division of Division of
— State Aeencv — Adult Education —1 _ . _ Higher Education
6 7 „ Graduate Programs
Cooperation Programs Research
Division of Division of Division of
— Educational Personnel — College Facilities — „
Training Research Development
Division of School Division of Division of
— Assist, in Federally <— Coll s t «— Research Training
Affected Areas ______j and Dlssemination
_ National Teacher
Corps
190
Department of Health, Education, and Welfare, 1966
There were 3,198 employees on Office of Education rolls by June 30, 1966, compared with 2,113 a year earlier. Training through Government facilities such as the General Service Institute and the Civil Service Commission was provided to 350 employees at a cost of $1,760 and through nongovernmental facilities to 258 employees at a cost of $21,000.
The number attending these training or developmental courses in fiscal year 1966 under the aegis of the Office nearly tripled over that of the preceding year. Other training offered during the year was part of the on-the-job training programs of the Bureaus.
In response to need for accessible data on the work force, a personnel information retrieval system was designed and initiated during the year. Full implementation is expected in fiscal year 1967.
Field Reorganization
Office of Education field structure was reorganized during fiscal year 1966. The new plan is designed to strengthen and expand services to the educational community as well as improve internal administration.
A direct line now is established from the Associate Commissioner for Field Services to the nine regional assistant commissioners who are in direct charge of Office operations and who coordinate Office programs in their respective geographic areas. The regional assistant commissioners are located in the regional offices of the U.S. Department of Health, Education, and Welfare.
These regional offices are located in Boston, New York, Charlottesville (Va.), Atlanta, Chicago, Kansas City, Dallas, Denver, and San Francisco. Goals of the Office of Education structure in these cities call for:
• Strengthening administration of field activities by vesting responsibility for coordination and leadership in the assistant commissioner for the geographic area who reports to one official in the Office of the Commissioner in Washington.
• Incorporating within the structure operating units for major program elements such as aid to educationally deprived children, support for innovative and exemplary educational projects and research, financial aid to college and university students, and support for construction of academic facilities.
• Improving and increasing technical support to public and private education agencies through use of staff services in the field.
• Effecting efficiency and economy in field operations by integrating and systematizing methods and procedures for administrative management.
Food and Drug Administration
The Food and Drug Administration is a regulatory agency whose highest purpose is the protection of human life. The premarket clearance of human and veterinary drugs and medicated feeds; the batch certification of insulin, antibiotics, and color additives; the clearance of food additives and pesticide residues in food; the control of drug abuse; the requirement that hazardous products for home use bear adequate warnings—all are directed toward the prevention of physical injury to the public. The agency also requires honesty and fair dealing in the marketing of regulated products.
In these services FDA cannot ignore risk, nor can it hinder progress in the development of products that may save lives or improve the public welfare. But it cannot assume the entire burden of protecting the public. A vast collaborative effort among Federal and State agencies, scientists of other organizations, the medical and veterinary professions, manufacturers, pharmacists, and many others is essential.
Late in 1965, Commissioner George P. Larrick, Deputy Commissioner John L. Harvey, and a number of senior staff members retired. A special HEW Department committee was appointed to identify the major organizational problems affecting FDA’s future and to advise the Secretary on the desirable professional qualifications of a new Commissioner. The report of this committee, chaired by Mr. Rufus Miles, was released by Secretary John W. Gardner in January.
Dr. James Lee Goddard, the first physician to serve as Commissioner of Food and Drugs in 45 years, took office on January 17,1966. He requested the FDA staff to prepare a full reorganization plan to meet its expanded mission and an anticipated greater workload.
Two new Bureaus, Veterinary Medicine and Drug Abuse Control, were established immediately. The two former scientific bureaus were combined into the Bureau of Science. The Bureau of Medicine was reorganized so that a specific drug is followed by the same medical
191
192
Department of Health, Education, and Welfare, 1966
specialty unit from investigational trials through approval for marketing to surveillance in actual clinical practice.
The Office of the Commissioner was reorganized to strengthen executive direction and improve line and field operations. The positions of Associate Commissioner for Compliance and Associate Commissioner for Science were established to provide top-level administrative direction and coordination of those two basic agency functions. An Office of Assistant Commissioner for Education and Information was proposed to build more effective communications between the agency, regulated industries, and the public.
A new Office of International Affairs was proposed in recognition of FDA’s growing involvement in international affairs. (FDA is now represented on 26 committees of international scientific and medical organizations working to protect human life.) The Science Information Facility began organization of an information retrieval system that will serve FDA and provide a link with similar programs in and out of Government.
The budget estimate approved by Congress for fiscal year 1967 was $60,000,000, and provides for a permanent staff of 5,080. (The appropriation for 1966 was $53,079,000, with 4,710 positions authorized.) An additional $3,130,000 was allotted to add to the buildings and facilities fund.
Despite nearly complete occupancy of the new Washington headquarters building during the year, satisfactory housing of the agency’s scientific staff is not yet in sight. Space was leased in two buildings in Arlington, Va., for many agency offices. Funds were requested in the 1967 budget for planning a second research laboratory in Beltsville, Md.
Food, Drug, and Cosmetic Act
FOOD ACTIVITIES
Natural Disasters
Hurricane Betsy, with winds up to 140 miles an hour, struck the gulf coast on September 9,1965. Serious flooding followed in Betsy’s wake.
The total value of all unfit merchandise that had to be destroyed because of Hurricane Betsy was estimated at $4 million. Damage to personal, public, and industrial property exceeded $1 billion. Almost all the 32 wharves in New Orleans were seriously damaged by wind and water. Over 381,000 pounds of flour had to be converted to animal feed, and almost 500,000 pounds of other foodstuffs on the docks had to be destroyed. In addition, after the examination of 9,700,000 pounds of coffee, 2,800,000 pounds valued at more than $1 million were
Food and Drug Administration
193
destroyed. A number of grain barges were blown aground or sunk, and an estimated 3,840,000 bushels required examination. More than 2,440,000 bushels of grain were so damaged that diversion to animal food use was required. Federal inspectors from three FDA districts (New Orleans, Dallas, and Kansas City), veterinarians from the U.S. Department of Agriculture Meat Inspection Division, and State and parish inspectors visited almost 2,000 food and drug establishments in wind- and flood-damaged areas following the disaster.
Chemicals in Foods
The coordination of Federal, State, and local inspectional, analytical, and enforcement resources has alleviated many problems raised by pesticide residues on farm crops. States are acquiring better laboratory equipment to detect the minute amount of permissible residues and are using better lab methods developed by FDA. State officials also use embargo powers not available to FDA to keep high-residue lots from being shipped.
After a review of the recommendations of a committee appointed by the National Academy of Sciences-National Research Council, the Secretaries of Agriculture and HEW issued a joint statement calling for replacement of the “zero tolerance” requirement with finite tolerances low enough to leave negligible and harmless residues. The “zero tolerance” concept had become a subject of concern as more sensitive methods for detecting trace amounts of residues were developed. These new methods have shown that the use of many pesticides produces some small residues in some foods. The new procedure provides a means to establish minute tolerances judged to be safe for these pesticide residues. Where a safe, low-level tolerance cannot be established, no residues will be permitted; that is, a “zero tolerance” will prevail.
Most “no-residue” pesticides registered by the U.S. Department of Agriculture will be discontinued for food use by December 31, 1967, unless FDA has set a new low tolerance or enough progress has been made to determine safety.
Food products seized because of excessive or nonpermitted pesticide residues during fiscal year 1966 included carrots, peanuts, celery, beet pulp, milk, and Boston lettuce.
FDA forbade the use of mercury-treated “pink wheat” for food, and advised the grain trade that conventional washing and scouring processes are not adequate to recondition mercury-treated seed wheat for food use. Shipments of mercury-treated barley, wheat, and oats were seized.
FDA published a food additives manual containing analytical methods for many additives used in foods and feeds regulated by the
194
Department of Health, Education, and Welfare, 1966
agency. Most of these methods were submitted by petitioners to support requests for regulations and were proved to be satisfactory when tried out in FDA laboratories.
Food Poisoning
Salmonella contamination occurred in a number of commodities, including dry milk, eggs, smoked fish, and poultry. FDA and the Atlanta Communicable Disease Center of the Public Health Service worked together on these outbreaks.
Smoked fish contaminated by Salmonella poisoned at least 186 people in 5 separate outbreaks on the east coast. Through FDA-CDC-New York State cooperation, all the smoked fish were traced to a single producer. The firm told its customers not to sell the suspect fish, cleaned up its plant, screened its employees to see who were carriers, and voluntarily destroyed 3% tons of the fish.
When FDA learned that 29 occurrences of salmonellosis had been traced to instant nonfat dry milk, it obtained samples from each producer. The agency collected 636 samples from 281 firms. A Minnesota firm recalled more than 1 million pounds of dry milk connected with salmonellosis; another recalled more than 350,000 pounds.
Salmonella also was implicated in 2 outbreaks affecting 185 persons who ate improperly handled poultry. Coconut pie caused an outbreak involving 30 people.
Staphylococcus food poisoning was responsible for outbreaks involving at least 404 persons. Poultry, meat, and fish products and potato salad were implicated in staphylococcus poisoning of 137 people. Insanitation and mishandling appeared to be responsible. A followup of products in interstate shipment did not show contamination of the parent lots.
Two Midwest cheese producers recalled 4 million pounds of cheese from across the Nation. FDA enjoined the producers from selling the cheese, which was contaminated with staphylococcus organisms. The recalled cheese was examined, using FDA methods; all but 60,000 pounds was released to the producers as nontoxic.
Clostridium botulinum caused 3 outbreaks, involving 10 persons. Home-canned mushrooms affected one person and home-canned beans six others. FDA suspected that precooked meats shipped in interstate commerce caused the third outbreak, involving three people, but was not able to prove this.
Clostridium perfringens in hamburger and chicken sauces caused 2 outbreaks affecting 425 persons.
More than 5,000 college students became ill with gastroenteritis after eating frozen orange juice cups at a football game in Berkeley, Calif. A Tracy, Calif., firm supplied the cups. Widespread investi-
Food and Drug Administration
195
gation, with FDA help, traced the contamination to Tracy’s water supply.
To Keep Food Clean
Food sanitation is an important concern of both the food industries and FDA. The agency constantly surveys food plant sanitation as part of its enforcement program. At the same time, industry management, through voluntary compliance with the law, spends large sums of money to improve sanitation facilities and practices. Firms reported 376 plant improvements, costing more than $44.6 million, to FDA inspectors in 1966.
During the year, the food industry voluntarily destroyed, or diverted to nonfood use, more than 8,100 tons of food in 1,554 actions, when FDA inspectors determined that the foods were unfit for human consumption.
Forty-one criminal actions terminated during the year involved unfit foods or insanitary operations that might result in food becoming unfit. In 36 cases, fines were levied ranging from $25 to $8,000. Six injunctions were granted to prevent the shipment of unfit foods.
A Louisiana rice grower was fined $4,500 for preparing rice under insanitary conditions. A Louisiana wholesale grocer was fined $7,000 for holding flour, cornmeal, and biscuit mix under insanitary conditions. A Texas candy company partner and his firm each were fined $1,000 for preparing, packing, and holding peanut candy under insanitary conditions. Convicted on a third offense, a Maryland pickle and pepper processing firm and its president were fined a total of $8,000 for shipping filthy products.
Fifty-two new criminal filth and decomposition cases were forwarded to the courts; 33 of them involved commercial storage houses. Four new injunctions were requested.
Traffic in unfit egg products—made from incubator rejects, decomposed or low-grade eggs, or eggs with broken shells—is still a regulatory problem. Most of the producers have small clandestine operations which are difficult to control. Insect- and rodent-infested grains are also a continuing problem.
Seizures were made because of insect or rodent infestation of such products as nuts, rice, pickles, catsup, and canned tomatoes, and because of bacteriological contamination of such products as eggs, breaded shrimp and other seafood, frozen onion rings, and cheese.
During the year, FDA sponsored 12 courses in food inspection techniques which were attended by 354 State and local officials. The agency also is sponsoring a research study to learn if the odor-causing elements in spoiled foods are lost in freeze-drying, a process coming into wider use. The Association of Food and Drug Officials of the
196
Department of Health, Education, and Welfare, 1966
United States has had a major program of study of bacterial contamination of frozen precooked foods.
Economic Protection
The agency initiated the seizure of 857,694 pounds of food in 81 separate actions to protect consumers from substandard, short-weight, or mislabeled products. Among the products seized because they failed to meet established standards were canned tomatoes, beans, cherries, peaches, cheddar cheese, butter, nonfat dried skim milk, breaded shrimp, preserves, and orange juice. Other violative products included “ready-to-eat” chicken that was not adequately dressed, frozen beans labeled with a misleading vignette, lemon juice in which citric acid was substituted, and foods containing color or preservatives not declared on the label as required. A firm and two of its officers were fined $4,000 for shipping adulterated and misbranded “pure vanilla extract.”
Diet Foods and Supplements
FDA ordered a major overhaul of requirements for special diet foods and diet supplements in June. Regulations were promulgated affecting both labeling and content of these products to give the public greater protection against misleading nutritional or calorie claims.
The regulations substitute “recommended dietary allowances” of recognized vitamins and minerals for “minimum daily requirements”; clarify labeling on foods promoted on the basis of lower than normal calorie values; establish classes of foods that may be fortified with vitamins and minerals; and limit the kinds and amounts of vitamins and minerals permitted in diet supplements. At the end of the fiscal year, FDA was reviewing objections and requests for a public hearing on the regulations, which were to become effective in December 1966, unless stayed to permit a hearing.
FDA denied a proposal to label edible fats, oils, and fatty foods to show the percentages of polyunsaturated, monounsaturated, and saturated fatty acid content. Experts differed on whether information concerning the composition of fatty foods in terms of fatty acid content serves any purpose to laymen.
At the end of the fiscal year, FDA was considering comments on a proposal which would reduce the amount of vitamin D that may be added to food products to prevent possible injury to infants.
FDA won several court decisions in fiscal year 1966 in its continuing battle against nutritional quackery.
In January, a landmark decision in Michigan climaxed a 5-year enforcement action against Detroit Vital Foods, Inc. The firm and two
Food and Drug Administration
197
of its officers were convicted of misbranding drugs that were sold as health foods. The products were promoted as effective treatments for liver and kidney trouble, serious circulatory and gall bladder diseases, and many other conditions. Lelord Kordel, president of the firm, was sentenced to two years in prison and fined $10,000. Company treasurer Alfred J. Feldton was required to serve 30 days and was fined $2,000. The corporation was fined $5,000 and court costs.
The Government seized quantities of foodstuffs used in Zen Macrobiotic diets because of false and misleading claims. The diets—promoted as cure-alls for conditions ranging from cancer to schizophrenia—had caused malnutrition and even death by starvation.
Five promoters of “CDC Capsules”—a worthless weight-reducing product tied to theories advanced in the best-selling book Calories Don’t Count—were fined a total of $8,000 on a misbranding conviction. (The author of the book, Herman Taller, M.D., was under indictment and awaiting trial at the end of the fiscal year.) The promoters claimed their “CDC Capsules,” which contained safflower oil, would take off weight and keep the user slender “without regard to total caloric intake.” Labeling also claimed the capsules would control several chronic diseases, promote health, and increase sexual drive.
DRUGS AND DEVICES
The Kefauver-Harris Drug Amendments of 1962 provided that new drugs must be demonstrated to be effective, as well as safe, before they are approved for general use. Efficacy data has been required in new drug applications (NDA’s) submitted since enactment of the amendments.
As an essential step in extending the efficacy requirement to new drugs marketed earlier, as authorized by the 1962 amendments, FDA contracted with the National Academy of Sciences-National Research Council in 1966 to evaluate the effectiveness of 3,000 to 4,000 new drugs which were approved on the basis of safety alone between 1938 and 1962. About four-fifths of them are prescription drugs.
The agency also moved forward in other areas, through both educational and enforcement activities, to achieve improved compliance with the Kefauver-Harris amendments and other provisions of the Food, Drug, and Cosmetic Act. Seminars were held on good manufacturing procedures, and the drug industry was urged to take the necessary steps to reduce the frequency of product recalls. The need for excellence in the testing, production, and advertising of drugs was the basic theme as broader channels of communication were opened with industry and industry groups.
The first criminal case under advertising provisions of the Kefauver-Harris amendments was concluded in August 1965. The firm in
198
Department of Health, Education, and Welfare, 1966
volved was fined $2,000 for omitting warnings which, were part of the labeling from advertisments of a prescription drug. In February 1966, the first seizure action under the advertising provisions was taken against the drug Peritrate SA (pentaerythritol tetranitrate) because of therapeutic claims the Government charged were false and misleading. A seizure action was initiated in May against Serax (oxazepam) on similar grounds.
In another court action, a drug firm was fined $40,000 for submitting false information with a supplemental new drug application for a tranquilizer. Reports of three deaths were received by the firm but not submitted to FDA, while promotional literature distributed to physicians emphasized the “remarkable” safety of the drug.
FDA reaffirmed its decision to bar Krebiozen, an alleged cancer treatment, from interstate commerce. Promoters of Krebiozen were acquitted of criminal charges after a lengthy trial in Chicago, but this did not change the status of the drug itself, which on the basis of scientific evidence was found to be worthless long before the trial.
Dr. Ernest T. Krebs, Sr., was given a 1-year suspended sentence for failing to register as a producer of drugs—specifically the so-called cancer cure Laetrile. A Florida physician was fined for bringing Laetrile into the country from Mexico.
FDA also began a nationwide seizure campaign to remove Aller-gimist from the market. Promoted by a Florida firm as a cure for hay fever, bronchial asthma, migraine headaches, and dermatitis, Allergimist was distributed in interstate commerce without clearance as a new drug.
New Drugs
ND A approvals.—One hundred and forty-seven original applications for approval of new drugs for human use were received during the year and 239 applications were resubmitted. There also were 1,430 amendments and other submissions related to pending applications. Forty new drug applications were approved.
Significant new drugs approved included an antileukemia agent (thioguanine), an antimalarial compound (amopyroquin), an oral contraceptive (ethynodiol diacetate with mestranol), a diagnostic radiopharmaceutical agent for determining rupture in pregnancy (quinaldine blue), a sedative-hypnotic for oral use (methaqualone), and a potent oral diuretic (furosemide).
Investigational new drug.—A total of 714 notices of claimed investigational exemption for a new drug were submitted during the year, along with 9,900 amendments and progress reports on the approximately 3,400 notices received during the previous 3 years. Sponsors voluntarily discontinued investigations on 572 notices and 187 were
Food and Drug Administration
199
terminated by the FDA. Among the notices withdrawn by the agency were 27 for DMSO (5 were later reinstated for limited application) and 146 for the mineral oil adjuvant preparation Daroil (28 studies subsequently were allowed to proceed on a limited basis).
New drug surveillance.—Evaluation of medical experience with approved new drugs led to the addition of significant warnings in the labeling of long-acting sulfonamides, oral contraceptives, meclizine, cyclizine, and hydroxyzine. Warning letters were sent to physicians concerning several of these drugs. Approval of eight NDA’s was withdrawn.
Among the drugs withdrawn was Madricidin (sulfadimethoxine, phenindamine tartrate, acetaminophen, and caffeine), which was marketed as a palliative treatment of the common cold and for the prevention of secondary bacterial infections. Approval was withdrawn because of reported adverse effects and the lack of effectiveness for the labeled claims.
Elipten (aminoglutethimide), distributed as an anticonvulsant for the control of epilepsy, was withdrawn from the market on the basis of reports that the drug caused sexual precocity in some children and masculinization of some young females. Rat studies showing toxic effects had not been included in data submitted with the NDA in 1959. There was also a question of the effectiveness of the drug in treating convulsions.
Librax (chlordiazepoxide hydrochloride and clidinium bromide), an antianxiety and anticholingeric medication, was withdrawn from the market (and outstanding lots recalled) pending changes in manufacturing procedures to eliminate impurities.
Approval of five new drug applications for coated potassium chloride preparations was withdrawn on the basis of evidence associating the use of such drugs with nonspecific small bowel lesions.
An investigation of clinical reports by Cass Research Associates, Cambridge, Mass., led to a proposal to withdraw the new drug application for Norgesic Tablets (orphenadrine citrate, aspirin, phenacetin, and caffeine). Clinical investigations of the drug by Cass Associates, accepted originally as evidence of efficacy, contained false data. Drug sponsors were notified that this firm was ineligible as an investigator. A hearing on Norgesic was pending at the close of the year.
FDA also acted to remove from the market nonprescription antibiotic lozenges promoted for the treatment of sore throats and throat pains associated with coughs and colds. There was no substantial medical evidence of effectiveness despite up to 15 years of experience with the preparations.
Recoils.—There were 558 drug recalls during the year, a substantial increase over the previous record high of 340 recalls in 1965. Re-
237-319—67—14
200
Department of Health, Education, and Welfare, 1966
calls are undertaken to retrieve from the market drug lots that fail to meet regulatory requirements. The manufacturer is responsible for carrying out a recall and FDA monitors its effectiveness. Of the recalls during 1966, 90 involved nonsterility, 74 adulteration, 73 subpotency, 67 cross-contamination with penicillin, and 54 misbranding. Others were ordered because of terminated investigations of new drugs, certification revocations, disintegration or decomposition, label mixups, substandard quality, excess potency, and distribution without effective new drug applications.
Veterinary Drugs and Medicated Feeds
Creation of the Bureau of Veterinary Medicine in November reflected the growing significance of veterinary products and medicated feeds. The Bureau’s functions formerly were carried out by a division within the Bureau of Medicine.
Many potent drugs are used in animal feeds to promote growth, improve feed efficiency, and to prevent, control, or treat disease. Properly used, such feeds prevent livestock and poultry losses and contribute to the efficient production of high-quality food, thus benefiting both producer and consumer.
During the fiscal year, 1,413 new drug applications for medicated feeds were received and 1,170 approved. The agency also received 1,123 supplements and approved 822. There were 72 applications for veterinary drug dosage forms submitted (31 were approved) and 222 supplements (95 were approved).
The use of potent drugs by feed mills that formerly handled straight feeds on a protein content basis presented new problems, since mills were required to develop procedures for mixing grams of the additives with tons of feed. FDA and industry associations have cooperated in providing guidance in good manufacturing practices and techniques.
More than 1,500 representatives of medicated feed-mixing firms attended 20 workshops conducted by feed trade associations to promote compliance with Federal law and FDA regulations. The programs were planned by industry leaders who attended a national FDA workshop in June 1965. FDA’s color slide series, “FDA Regulations and Inspections in the Feed Industry,” has been widely used as an effective educational tool.
Although many feed mixers employing potent drugs operate only on a local scale, Federal law requires inspection of each mill every 2 years. Since mill operators need guidance as to good manufacturing practices, a plan was developed to utilize both Federal and State resources. A joint program of inspection and analysis of finished products was intensified in 1966. States participating were Indiana, Kansas, Maine, Massachusetts, Michigan, and Oklahoma.
Food and Drug Administration
201
FDA sponsored seven training courses in this field in 1966. The courses were attended by 150 State and 2 Canadian feed control officials. Inspection techniques, the collection of samples, and the application of good manufacturing practices were stressed.
The agency also conducted 2 workshops—attended by 191 industrial veterinarians—to discuss requirements of veterinary investigational drug regulations, new drugs for investigational use in animals, and regulations on the marketing of edible products of animals treated with investigational drugs.
FDA has made arrangements to obtain adverse reaction reports on veterinary drugs through 18 veterinary schools, the American Veterinary Medical Association, the Industrial Veterinarians Association, and the Extension Service of the U.S. Department of Agriculture.
Illegal Sales of Prescription Drugs
The Drug Abuse Control Amendments to the Food, Drug, and Cosmetic Act were signed into law on July 15, 1965, and became effective on February 1, 1966. The amendments impose tighter controls on the production and distribution of stimulant, depressant, and hallucinogenic drugs and give FDA broader authority to curb illicit sales. Steps were taken shortly after enactment to establish the Bureau of Drug Abuse Control (BDAC) and to promulgate interpretative regulations.
BDAC field offices were established in Atlanta, Chicago, Kansas City, Los Angeles, and New York soon after the new legislation became effective. Four additional offices—in Baltimore, Boston, Dallas, and Denver—were to be opened early in the next fiscal year
FDA contracted with the University of California at Berkeley to train BDAC agents. By the end of the fiscal year, 90 agents had completed a special 8-week course at the university’s school of criminology and an additional 60 were in training. The course covered sociological aspects of the drug problem as well as law enforcement techniques.
The Bureau began an educational program with a general conference in Washington in March for representatives of all groups engaged in the distribution of controlled drugs. Specialized programs were planned for manufacturers and distributors of controlled drugs, practicing pharmacists, teachers of pharmacy law, leaders of pharmaceutical associations, school administrators, and law enforcement officers.
Enforcement activities of the Bureau are directed toward the discovery and apprehension of those involved in the illicit diversion and distribution of controlled and counterfeit drugs through records
202
Department of Health, Education, and Welfare, 1966
accountability and undercover investigations. Although the Bureau was in operation for only 5 months in fiscal year 1966, BDAC agents made eight arrests and seized more than 1.4 million amphetamine and barbiturate pills.
In cooperation with FDA’s Office of Federal-State Relations, BDAC established a pilot plan under which State enforcement agencies accepted major responsibility for checking compliance by retail drug outlets. Information concerning illicit distribution of controlled drugs will be referred to FDA. Florida, Georgia, Indiana, New York, Texas, and Washington are participating in the pilot program. An FDA training school was conducted on retail drugstore investigational techniques, drug stock audits, and courtroom procedures.
The first Federal seizure of drugs under the 1965 Drug Abuse Control Amendments was made in Salt Lake City, Utah, climaxing a 2%-month investigation during which an osteopath sold more than 11,000 amphetamine tablets to an FDA undercover agent.
Eighteen months of undercover work by FDA and the Philadelphia Police Narcotic Squad resulted in the arrest of 6 members of an illegal drug ring and the confiscation of more than 160,000 amphetamine tablets. The ring illegally obtained drugs from a Philadelphia drug firm through one member who was employed as a maintenance man by the company.
In California, a peddler was sentenced to 3 years in prison on charges of selling amphetamine tablets on the streets of Los Angeles. His wife was given a 2-year sentence. They had sold the “pep pills” in lots of 1,000 to an FDA inspector.
In New York, a peddler who sold the hallucinogenic drug LSD on sugar cubes at $250 for 100-cube lots was sentenced to a 9-month prison term. The cubes were intended for resale at $10 each. A part-time bellboy at a Laguna Beach, Calif., hotel was sentenced to 3 months in jail and placed on probation for 3 years for illegal sales of LSD.
During fiscal year 1966, 193 drug-prosecution cases were initiated by FDA against 319 firms and individuals charged with illegal sales of prescription drugs. Unlicensed dispensers—including employees of truckstops and drive-in restaurants and other peddlers—were involved in 107 cases. Sixty-seven cases were brought against drugstores, their pharmacists, or both, for dispensing drugs without prescriptions or refilling prescriptions without authorization. The 19 other prosecutions were brought against physicians selling prescription drugs without a physician-patient relationship and against supply houses. FDA initiated an additional 32 drug-prosecution cases for violations including transporting, counterfeiting, and possessing prescription drugs—-making a total of 225 such cases initiated during the year.
Food and Drug Administration
203
Devices
FDA initiated 70 seizures of medical devices during the year. Some were seized because of false and misleading claims, some were substandard, and some were inadequately labeled.
Forty-six recalls of medical devices were undertaken during the fiscal year. All but seven involved nonsterile products. Two nationwide warnings to hospitals and doctors followed FDA seizure of nonsterile “Jintan” disposable hypodermic needles imported from Japan. Plastic teethers for babies were seized because of high bacteria counts in the water used for filling. Some 66,000 packages of “radiation sterilized” surgeons’ gloves were seized in Riverside, N.J., on charges that they were contaminated by microscopic mold.
Insulin syringes discovered to have faulty calibrations were recalled as FDA warned diabetics and physicians that users might receive a double dose and suffer insulin shock.
An “Ionic charger” was seized because of promotional literature which suggested that drinking water charged with “Radon” gas from the device was effective in treating gout, rheumatism, insomnia, neuralgia, chronic joint swelling, chronic diarrhea, functional disease of the liver, and chronic skin diseases.
A massage device manufactured by the Niagara Therapy Manufacturing Corp, was seized in Denver on grounds that it carried “inadequate directions for use” in treating arthritis, diabetes, sinusitis, hearing trouble, and other conditions for which it was promoted by oral claims. Other Niagara devices—including vibration chairs, electrical vibrating hand units, and various thermopads—were seized because of claims that they were effective for arthritis, bursitis, falling hair, tired eyes, shot muscles, and misplaced kidneys.
COSMETICS
Approximately 25 detentions of misbranded cosmetics were ordered during the year. The products bore label claims for growing hair, bust development, or skin regeneration.
Two manufacturers recalled nail hardeners from the market after FDA received complaints of injuries from the products. Distribution of both products was terminated.
U.S. marshals seized 41 bottles of counterfeit perfume after the authentic manufacturer informed FDA that the fake perfume was being sold to dealers in Baltimore, Md., and elsewhere in the Nation.
CERTIFICATION OF COLORS AND DRUGS
Color additives.—Only those color additives listed in FDA regulations can legally be used in foods, drugs, and cosmetics. Unless
204
Department of Health, Education, and Welfare, 1966
exempted by regulation, each batch of colors manufactured must be tested and certified by FDA. In 1966, 1,736 batches representing 1,761 tons were certified; 23 batches representing 13 tons were rejected.
Insulin.—Three hundred and twenty-eight batches of insulin were tested and 325 were certified. Rejected lots contained excessive nitrogen or gave unsatisfactory pH results.
Antibiotics.—Samples of 25,194 batches of antibiotics and preparations containing antibiotics were submitted by industry for certification. Of those, 278 failed to meet standards for potency, sterility, or moisture, or were otherwise defective.
Hazardous Substances Labeling Act
The Federal Hazardous Substances Labeling Act of 1960 requires informative labeling of household products that may cause illness, injury, or death if improperly used.
The first criminal case under the act was terminated in fiscal 1966 with the defendant paying a $600 fine. The case was filed following the death of an elderly man who drank antifreeze believing it was port wine. The defendant had packaged the antifreeze in a used wine bottle. The act prohibits packaging a hazardous substance in an identifiable food, drug, or cosmetic container.
A fireworks distributor agreed to an injunction prohibiting future sales of crackerballs. Federal authorities had made more than 120 seizures of the small fireworks. Imported from Japan and Formosa, the crackerballs generally were sold in small plastic bags and closely resembled candies similarly packaged. The bags carried no warning statement, and several children were injured when crackerballs exploded in their mouths.
FDA’s campaign to remove from the market the highly flammable water repellent X-33 was concluded, and a criminal case was filed against the distributing corporation and its president.
Toy trains carried a new type of violation to FDA attention during the year—a petroleum distillate used to produce smoke from the locomotives. The product, sold with electric train sets and separately, carried no warning label. Train sets and 8,496 bottles of the “smoke” were seized.
A number of colors for glazing ceramics was seized because required warnings were omitted. Unlabeled methyl alcohol packed for use in cigarette lighters was seized and the firm recalled the fluid.
Enforcement of Other Acts
A total of 134,621,342 pounds of tea was examined under the Tea Importation Act. Imports for the year exceeded those in the previous year by approximately 3 million pounds. Eight rejections were
Food and Drug Administration
205
appealed to the U.S. Board of Tea Appeals, but the FDA examiner’s decision was upheld in each case. No actions were taken under the Filled Milk Act. Two new permits were issued in fiscal 1966 for milk shipments under the Import Milk Act.
Court Interpretations
The Toilet Goods Association won a decision on appeal holding that it had the right to sue for a declaratory judgment challenging FDA’s position that certain color-bearing cosmetics should be considered “color additives,” and therefore subject to premarket clearance. The Court of Appeals for the Second Circuit ruled that three of the issues were properly subject to review in a suit for a declaratory judgment. The Solicitor General has requested that the Supreme Court review the decision.
Also pending before the Supreme Court as the fiscal year ended was an appeal by the Pharmaceutical Manufacturers Association in the “generic name every time” case. The association is contesting FDA’s authority to require that the established name for a drug must appear each time a proprietary name is used on the label, in labeling, or in advertising for a prescription drug.
A vitamin firm lost a claim before the Court of Appeals for the Third Circuit for a number of its products seized for failing to bear “adequate directions for use.” In previous action, the trial court had found that the seized articles were drugs and the directions, which appeared in the claimant’s catalog, were suggestive of therapeutic value but contained nothing to indicate for what diseases the various preparations were to be used. The evidence of intended use consisted mainly of transcripts of a series of radio programs on nutrition, with emphasis on the therapeutic value of vitamins and foods fortified with vitamins. Neither the firm nor the trade name of any of its products was mentioned in the program, but vitamin commercials were broadcast, some of which immediately followed the program. Listeners who responded to invitations to write for nutritional literature would receive the claimant’s catalog.
An important principle was laid down by the Court of Appeals for the Tenth Circuit in a case involving an acne remedy. The court ruled that the product was no longer exempt as an “old drug” from meeting the efficacy requirement of the Kefauver-Harris amendments after it was condemned by a trial court for false and misleading claims. The product—and others in like circumstances—thus are subject to new drug approval procedures and regulations.
The Court of Appeals for the Eighth Circuit upheld the conviction of a firm for shipping adulterated prophylactics in a decision that upheld the FDA’s right to change tolerances permitted as a matter
206
Department of Health, Education, and Welfare, 1966
of administrative grace under a statute prohibiting shipment of defective products.
A Federal judge in Arkansas dismissed a libel under which an ultrasound device was seized from a chiropractor. Government experts testified that ultrasound had a legitimate use in medical practice, but only after careful medical examination and diagnosis to make certain that there were no conditions for which the use of ultrasound was contraindicated. The judge held that the chiropractor’s right to use the device in the practice of his profession would have to be determined in a State court because the practice of the healing arts is regulated by the States. An appeal to a higher court has been authorized.
Legislation and Regulation-making Activities
Section 402(d) of the Food, Drug, and Cosmetic Act was amended by Public Law 89-477 to remove a number of restrictions against nonnutritive substances in candy, if such substances are used for some practical purpose in its manufacture, packaging, or storage, and if they do not promote deception. The Secretary may issue regulations allowing or prohibiting the use of particular nonnutritive substances.
REGULATIONS
Drugs.—Thirteen drugs in addition to amphetamines and barbiturates were brought under the Drug Abuse Control Amendments. Controlled drugs are identified by a large C encircling the prescription drug symbol R set against a contrasting background. The 13 drugs were covered because of their potential for abuse because of their stimulant, depressant, or hallucinogenic effects. The addition to the controlled list of three other drugs—the tranquilizers meprobamate, diazepam (Valium), and chlordiazepoxide and its salts (Librium) — was stayed to permit public hearings.
Labeling of over-the-counter drugs containing chlorcyclizine, cyclizine, or meclizine or their salts was required to be revised to include a warning against use in pregnancy, as the drugs possibly may injure the unborn child. This requirement was adopted following FDA investigation and a recommendation from an advisory committee.
A policy statement was published limiting claims permitted for nitrates and nitrites used as coronary vasodilators in the management of angina pectoris. If represented for other uses, the drugs are misbranded unless such use is covered by an approved new drug application prior to marketing.
Following reports of eye injuries associated with use of belladonna and related preparations, FDA ordered revision of the warning statement on those nonprescription medications. Labels must warn against

Food and Drug Administration
207
use by persons having glaucoma or excessive pressure within the eye; by elderly persons where these conditions may be present and undiagnosed, and by children under six, unless directed by a physician. Labels also must warn that if eye pain occurs use should be discontinued and a physician consulted immediately because the pain may indicate undiagnosed glaucoma.
The procedure for the investigational use of new drugs was revised to permit the Commissioner to terminate an investigation without delay when it is concluded that continuation would present an imminent hazard to public health.
In recognition of the value of ipecac sirup in emergency treatment of accidental poisonings, FDA approved sale of the drug without a prescription, provided the quantity is limited to 1 fluid ounce and the label bears specific information as to use, dosage, and warnings.
Food additives.—During the fiscal year, 243 food additive petitions were received and 25 orders were published establishing new food additive regulations, in addition to the publication of 90 amendments to existing regulations. As of June 30, 1966, approximately 2,430 food additives were subject to regulations, 575 had been declared generally recognized as safe for certain uses, and prior sanctions had been listed for 115.
FDA received two petitions to permit the marketing of fish protein concentrate as a food additive. One was submitted by the Bureau of Commercial Fisheries of the U.S. Department of the Interior; the other by a private firm. Both petitions proposed a solvent extraction of hake or hake-like fish. The petitions were under study at the end of the fiscal year.
On February 17, 1966, responsibility for the promulgation of food additive regulations covering veterinary matters and feed additives was assigned to the new Bureau of Veterinary Medicine in order to coordinate these activities with veterinary drug controls.
A proposal published June 30, 1966, to revoke the tolerance for cobaltous salts in malt beverages was the first such action taken under the food additives amendments. Questions raised concerning the safety of the compounds and the discontinuance of their use by the brewing industry prompted the revocation, although no direct evidence was available linking the additive to harmful effects.
An advisory committee completed a review of the use of antibiotics to preserve food and to promote growth and feed efficiency in foodproducing animals. Its report included a recommendation that antibiotics used in human or veterinary medicine not be used in food preservation unless justified in solving serious problems. At the close of the year, steps were being taken to implement the committee’s recommendations.
208
Department of Health, Education, and Welfare, 1966
Pesticides.—During fiscal 1966, 56 pesticide petitions were received and 59 tolerances were established involving 14 pesticide chemicals. These included tolerances for herbicides, fungicides, insecticides, nematocides, plant regulators, and desiccants and defoliants. Thirty-one temporary tolerances were issued involving 13 pesticide chemicals. These temporary tolerances were established to permit the marketing of crops experimentally treated with the pesticide chemicals under permits granted by the U.S. Department of Agriculture. Since enactment of the Pesticide Chemicals Amendment in 1954, 2,730 pesticide tolerances or exemptions have been established involving 145 pesticide chemicals.
An advisory committee was requested by members of the pesticide industry to review a petition by the State of California requesting tolerances for DDT in milk and dairy products.
Food standards.—The Food Standards Branch processed 18 orders, 19 proposals, 3 withdrawals, 14 confirmations of effective date, and 4 temporary permits relating to establishment of food standards.
FDA issued a revised food standard on July 8, 1965, stipulating that peanut butter must contain at least 90 percent peanuts, but the effective date was stayed to permit a public hearing. The revised standard allows 10 percent for optional ingredients, including seasonings and hydrogenated peanut and cottonseed oils to reduce oil separation and counteract the tendency of peanut butter to stick to the roof of the mouth. Optional ingredients must be declared on the label. The peanut content of peanut butter has ranged to as low as 78 percent. The public hearing lasted intermittently for about 6 months. At the end of the fiscal year, a decision was still pending.
A standard of identity was established for soda water stipulating that “cola” or “pepper” drinks shall contain not more than 0.02 percent caffeine by weight. “Cola” drinks are made with a kola nut extract which naturally contains caffeine. Therefore, it is a mandatory ingredient in those products and does not have to be shown on the label. Other soda waters containing caffeine as an optional ingredient must carry a label stating “with caffeine added.” Caffeine in these drinks must not exceed the level allowed in “cola” drinks.
Amendments to standards for whole-egg and egg-yolk products were adopted and standards were established for egg-white products requiring pasteurization or other treatment to assure that the finished egg products are free of Salmonella.
A standard of identity for liquid margarine was established and the standard for margarine was amended to permit more latitude in the use of flavors that make the product taste more like butter.
After a court appeal on certain provisions of the orange juice regulations, hearings were held on pasteurized and canned orange juice and
Food and Drug Administration
209
orange juice concentrate. The standards set for these products were stayed pending consideration of briefs.
Hazardous substances.—Exemptions from statutory labeling requirements and regulations were granted for fireworks assortments, ethylene glycol impregnated pads, butane-type cigarette lighters, and porous tip marking devices containing ethylene glycol.
Four requests for exemption were denied because the petitioners could not demonstrate that the exemptions would be in the public interest. Two had requested permission to put “front panel” portions of the caution statement on the rear panel, another petitioner wanted to use type size smaller than that specified in FDA regulations, and the fourth sought approval of an abbreviated warning.
Scientific Investigations
Although FDA’s life-protection mission has not changed, the means of providing this protection must evolve constantly as developments occur in medicine, food technology, and consumer products. The research scientists of FDA not only devise newer and more sophisticated methods for detecting violations of the law but also investigate the effects on man of the many chemicals now in use in food additives, drugs, cosmetics, colors, pesticides, and as part of manufacturing processes.
New analytical methods were developed during the year for pharmaceuticals, including mestranol combined with other progestational agents in contraceptive tablets, phenobarbital-theophylline combinations, testosterone propionate oil injections, phenylephrine combined with a variety of drugs, and contaminants of commercial forms of adrenal cortical steroid hormones. Two types of field tests were developed for LSD, and similar tests are under study for other psychedelic drugs such as DMT, psilocybin, psilocyn, and mescaline. A chromatographic method proved successful for the quantitative analysis of thyroid constituents.
Tests of six veterinary iron preparations showed they were safe and effective, but also demonstrated that localized iron residues tended to remain near the injection site more than 30 days. A drastic cathartic tested in several animals was found to have a narrow margin of safety for equine species. Tests of an antibiotic preparation used to treat mastitis in cows revealed that neomycin entered the milk and persisted beyond the specified 96-hour withdrawal limit. A similar study is being made of phenothiazine, which is used to control internal parasites.
Antibiotic-containing drugs are being checked by improved methods for contamination by traces of penicillin. Studies are underway to improve the precision, accuracy, specificity, and speed of official microbiological assays. The rates of release and absorption of antibiotics
210
Department of Health, Education, and Welfare, 1966
in man, toxicity of antibiotics stored for long periods, and new ways of maintaining sterile test conditions are under investigation. The official bioassay for insulin potency is being compared with an immunoassay which is faster and eliminates the use of many experimental animals. The stability of insulin potency during long periods of storage is being studied.
The Bureau of Medicine awarded contracts to State health departments, several hospitals, schools of medicine, and similar institutions for clinical studies. Subjects include the possible teratogenic response of the primate embryo to commonly used drugs; the effect of nitroglycerin on effort-induced angina and the efficacy of vasodilators in affecting the blood flow of patients suffering from arterial disease; the accuracy and precision of commonly performed clinical laboratory tests, beginning with cholesterol-measuring “kits”; the usefulness of deoxyribonucleic acid analysis of bone marrow to detect cell proliferation and predict successful therapeutic agents for its depression and the possibility that toxic encephalopathy in patients is caused by ingestion of phenothiazine derivatives.
Methods have been developed to analyze components of cosmetics, including fatty compounds in lipsticks, water, and alcohol in various cosmetics, dye intermediates in hair dyes, and sunscreen compounds in suntan preparations.
Tests were continued on the effects of pesticides, drugs, dyes, and flavors on animals. When rats were fed the pesticide 2,4—D at 1,500 parts per million in the diet, the offspring of the third generation weighed less at weaning and more of them died or were killed by the mother. The pesticide Sevin impaired the reproductive capacity of dogs, reducing the number of conceptions, of offspring born alive, and of pups living until weaned. Teratogenic effects also were observed. A number of household detergents, hand cleaners, deodorants, and metal and furniture polishes were checked for their tendency to irritate eyes and skin. Improved methods of testing irritation were being developed.
Because pesticides sprayed on crops may change to related compounds, studies are underway to identify these compounds (metabolites) and to trace the course of metabolism in crops and animals. Amounts of pesticide residues that enter the edible tissue and the eggs of chickens after ingestion of feeds containing the pesticides were being measured to provide information for setting limits on permissible levels of pesticides in poultry feeds. Several types of herbicides in crops, carbamate pesticides in crops, and mixtures of pesticide residues can now be determined by new and efficient methods. Established methods for various pesticide residues have been successfully applied to different crops, and older methods for extraction of chlori
Food and Drug Administration
211
nated hydrocarbon, pesticides from crops and subsequent analysis are being improved.
New methods were developed to detect chlorohydrins (toxic compounds sometimes formed in foods fumigated with ethylene and propylene oxides) and to determine the presence in lard of certain antioxidants permitted for use in foods to retard rancidity. The long-established custom of detecting food spoilage by odor is becoming more precise through chemical analysis of the compounds that cause the odor. In codfish, 22 compounds have been identified. The official method for detecting decomposition in foods by separately measuring the lactic and succinic acids present was shortened by development of a technique for combining the two measurements. New methods were being developed to detect animal fats in vegetable oils and older methods were being adapted to prove adulteration of olive oil with peanut oil.
To detect adulteration of food, the normal composition of the food must first be known. For this purpose FDA scientists supervised the preparation and analysis of authentic packs of berries, orange juice, cocoa butter oils, and confectionery oils. Weight loss during storage of frozen glazed shrimp and of tea also was studied. Slight differences in naturally occurring flavonoids in apples and pears were determined as the basis of a method to distinguish the two fruits in canned and processed products. Similarly, a method was developed to measure Z-malic acid, the natural form of malic acid, in fruit products as a means of detecting adulteration.
Aflatoxins, highly toxic substances formed by molds that infest growing crops, remain a source of concern. Studies continued on their nature, effects, formation, and natural occurrence. Detection methods that proved successful for peanut and cottonseed products, corn, and other grains are being improved and extended to other mold toxins. The possibility that antibiotics, also derived from molds, might be infested with aflatoxins during production was checked, but tests on 11 batches of antibiotics proved negative. Pigs fed aflatoxins to determine toxic effects on blood and organs showed an increased tendency to bleed; capability of the blood to coagulate decreased. Long-range studies of carcinogenic effects of aflatoxins are being made on ducklings.
Studies continued on the physiology and growth of Escherichia Goli, the organism most commonly measured in food spoilage, and on faster and more efficient methods for its detection. Investigations of Clostridium botulinum type E, the organism responsible for botulism outbreaks several years ago, were extended to a bacteriocin produced by nontoxigenic organisms identical to type E. Other studies included methods for isolating viruses from foods, detection of filth
212
Department of Health, Education, and Welfare, 1966
in foods, and the relationship between bacterial content of frozen foods and the sanitary conditions maintained during their production.
The microfluorometric assay for vitamin C was perfected and the assay procedure for vitamin E was adapted to pharmaceuticals. A purified amino acid diet was in development to promote maximum growth of rats for studies of amino acid requirements. Studies of animal diets supplemented with different forms and sources of phosphorus showed that the nutritional value of phosphorus is affected by vitamin D and calcium in the diet. Similarly, certain nutrients, such as vitamin E, change the response of animals to toxic substances.
The 18 FDA district laboratories developed and tested methods of analysis for various products, chiefly drugs, foods, and pesticide residues. Eminent scientists from nearby universities agreed to serve as research advisers to FDA scientists at eight district laboratories. The advisory program is to be extended to other districts.
Education and Communication
New programs in consumer education were planned with special emphasis on the needs of senior citizens, low-income families, and youth. Conferences, seminars, and workshops are to be held throughout the country for professional groups and organization leaders. The safe and effective use of drugs, wise selection of health services, and basic consumer education for life protection will be stressed.
A unique consumer service was initiated in May 1966 for the 7 million Americans of Cuban, Mexican, Puerto Rican, and other Spanish-speaking descent. Informational and educational materials are now published in Spanish to serve those citizens. Distribution reaches throughout the hemisphere.
FDA’s program for promoting voluntary compliance in industry gave priority to fields in which new regulations affected manufacturing and distribution procedures. The workshop and seminar program initiated in 1965 was expanded in 1966 to reach a broader range of industries and a larger number of industry representatives.
Enforcement Statistics
Major workloads are summarized in the tabulation below:
Total_________________________________________
Foods________________________________________________
Drugs_______________________________________________
Cosmetics___________________________________________
Hazardous substances________________________________
All other___________________________________________
Inspections Samples
made collected
46, 287 81, 810
30, 075
13,487
809
1, 751
165
40, 163
40,117
451
1, 007
72
Food and Drug Administration
213
In the 232 criminal actions terminated (or terminated for some defendants) in the Federal courts during fiscal year 1966, fines assessed totaled $195,878. Seventy-three individuals were required to serve jail sentences ranging from 10 days to 8 years. Records of actions terminated in courts were published in 840 notices of judgment.
Table 1.— Number of samples on which criminal prosecutions and seizures were based and number of court actions instituted during fiscal year 1966
Item Total Criminal prosecutions instituted Seizures Injunctions requested
Violative samples, fiscal year 1966 Actions, fiscal year 1966 Violative samples, fiscal year 1966 Actions, fiscal year 1966 Violative samples, fiscal year 1966 Actions, fiscal year 1966
Total 2,758 1,362 985 291 1, 773 1,065 6
Foods 1,050 629 142 59 908 566 4
Drugs and devices 1,537 630 840 231 697 397 2
Cosmetics (colors) Hazardous household 25 14 0 0 25 14 0
substances 146 89 3 1 143 88 0
Note.—The number of samples on which the actions are based always exceeds the number of actions; in seizures a variety of articles may be contained in a single shipment, while in criminal actions each sample usually represents a single shipment which forms 1 count of action.
Table 2.—Import samples collected, examinations made, and lots detained during fiscal year 1966
Item Samples collected Examinations made Lots detained
Total 20,919 34,051 8,072
Foods _________ _ 14,127 6,166 626 28,236 5,238 577 2,981 4,824 267
Drugs and devices
Cosmetics, colors, mi seel Inn eons

Vocational Rehabilitation
Administration
The Vocational Rehabilitation Administration administers a wide variety of programs with the objective of advancing the vocational rehabilitation of disabled persons and their utilization in suitable gainful employment.
During fiscal year 1966, there were 154,279 handicapped persons rehabilitated into employment, an increase of 14 percent over the previous year.
Of this total, about 33 percent were disabled by loss of limbs, paralysis, or skeletal-muscular troubles. Approximately 23 percent had the primary disability of mental illness or retardation. Nearly 10 percent were blind or had visual impairments, 7 percent were deaf or had difficulties in speech and hearing defects, and 5 percent had cardiac troubles. The remainder had a wide variety of handicaps to employment.
They were rehabilitated into many kinds of employment. In broad categories, 8 percent went into professional or management jobs, and 24 percent found skilled or semiskilled work. About 22 percent went into service occupations, and 16 percent resumed family duties. About 15 percent went into clerical or sales work, 5 percent entered agriculture, 3 percent were placed in sheltered workshops, and 7 percent in jobs as unskilled workers.
New Legislation
Amendments to the Vocational Rehabilitation Act, enacted during the year, are having broad effects on the rehabilitation program. A revision of the fiscal relationships between the Federal and State governments provides a much greater flow of Federal money into the program. New programs have been established and older ones strengthened. A series of grant programs provides the means for orderly progress in building new workshops and facilities and strengthening those in operation. New and more comprehensive serv-
237-319—67----15
215
216
Department of Health, Education, and Welfare, 1966
ices are provided for the severely disabled. Federal support is made available to States for projecting their rehabilitation plans into the future and for expanding their services to reach more disabled people.
NEW FISCAL ARRANGEMENTS
The new legislation raises the limits of authorization for Federal appropriations for supporting the States’ basic programs of service to $300 million for 1966, $350 million for 1967, and $400 million for 1968. Allotments to States from these funds continue to be made on the basis of population and per capita income, but the rate for Federal matching of State funds for basic rehabilitation services was increased to 75 percent of each State’s expenditures. This matching ratio has the effect of giving State rehabilitation agencies about twice as much in State-Federal funds as they had under the sliding scale of participation authorized by the previous law. It also provides wide latitude to State agencies for expansion or improvement of their services to disabled people.
INNOVATION PROJECTS
Under authority of the previous legislation, grants could be made for extension and improvement of programs.
Until the signing of the new law, 43 States had used the grants for 103 projects, many of them for the introduction of specialized staff and expansion of facilities.
Under the new law, the purposes of these grants are changed. They are available to States for the introduction and development of methods or techniques new to the States, especially for the provision of services to groups having severe or catastrophic disabilities. The Federal Government bears 90 percent of the cost of these projects.
The first project approved under this provision was to Our Lady of Fatima Hospital in Providence, R.I., to provide rehabilitation services for heart disease and stroke patients under a comprehensive team approach. Eleven projects followed during the year, bringing within the range of the program the imagination and talents of many organizations and people in rehabilitation.
MATCHING LOCAL CONTRIBUTIONS
A section of the new law authorizes Federal matching of local contributions made for a community rehabilitation endeavor by adding the funds to the State’s appropriation. The consequent amounts are made available to the community for the specified purpose.
In 1966, a little more than $2.5 million in these contributions was used to match almost $5 million in State funds. These funds were used
Vocational Rehabilitation Administration
217
by 92 public and private groups in 30 States to improve, expand, or renovate existing buildings, to purchase equipment, or to provide staff.
EXPANSION GRANTS
Expansion grants under the new law encourage programs which will result in the rehabilitating of greater numbers of handicapped persons. The $3 million appropriated for this purpose in 1966 was obligated for 50 projects in 25 States, the District of Columbia, and Puerto Rico. Half of the grants were made to States and half to other public and private nonprofit voluntary agencies.
Priorities established by VRA in this grant program are for the initiation of special programs that give promise of substantially increasing the number of persons rehabilitated from such groups as welfare recipients, public offenders, alcoholics, epileptics, deaf persons, and those with spinal cord injuries.
In keeping with these priorities, five grants provide services for young disabled public offenders, two for alcoholics, one for epileptics, six for blind persons, four for deaf persons, and two are alined with the war on poverty. The remaining projects are focused on improving cooperation with other public and private agencies to reach more handicapped persons.
STATEWIDE PLANNING GRANTS
A 2-year program of grants to the States, authorized by the 1965 amendments to pay the costs of planning comprehensive rehabilitation activities over the next few years, met with an active response.
This statewide planning involves review of all current and potential resources for vocational rehabilitation in both public and private organizations. The goal is to make rehabilitation services available to all who need them by 1975.
By the end of the fiscal year, 27 applications had been received for these grants, 15 had been approved, and 5 had been funded for a total of almost $500,000.
CREATING WORKSHOPS AND FACILITIES
The sweeping provisions in the 1965 amendments that provide assistance to States and communities for creating or improving workshops and facilities for the disabled were well received.
Grants totaling $1,332,227 in Federal funds were awarded to 44 State rehabilitation agencies to plan workshops and facilities.
Grants totaling $1,305,571 were awarded to 54 workshops to enable them to improve their capabilities for providing employment and services to handicapped people. Twenty-one grants, amounting to
218
Department of Health, Education, and Welfare, 1966
$176,570, were made to various organizations for the purpose of discovering program needs for specific facilities and workshops.
A National Policy and Performance Council was established, as provided in the new amendments. The function of the 12-member Council is to advise on policies and criteria for determining eligibility for grants for workshop training services, and to make recommendations relating to workshop improvement projects.
Evaluation of the Severely Disabled
One of the deficiencies of the earlier program was the brief time allowed for State agencies to evaluate the rehabilitation potential of severely disabled persons.
Special provision is made in the new law to help States to meet the cost of services for these persons for a sufficient period to determine more accurately whether they can become engaged in remunerative employment. Services may now be provided for up to 6 months (or 18 months in special cases), during which a client’s reaction may be observed and a determination made as to whether the services should be continued.
Architectural Barriers
For many years, there has been a growing awareness of the difficulties that handicapped people have in entering public and other large buildings and using their facilities.
Awareness of these problems was crystallized in the new law, which provided for the establishment of a National Commission on Architectural Barriers to Rehabilitation of the Handicapped. The Commission was appointed and began its study of ways to encourage and assist architects and builders throughout the country to design entrances, drinking fountains, telephone booths, and other facilities that are convenient for handicapped persons.
Correctional Rehabilitation
The Correctional Rehabilitation Study Act of 1965 gave recognition to the significance of vocational rehabilitation in combating crime and delinquency. The new law amended the Vocational Rehabilitation Act to provide project grants for a 3-year nationwide study of the need for rehabilitation personnel and activities in correctional institutions and agencies.
The first year of the study is in progress, supported by a grant to a Joint Commission on Correctional Manpower and Training.
The new purposes of the expansion grant program have also been brought to bear on correctional rehabilitation. In New Jersey, North
Vocational Rehabilitation Administration
219
Carolina, South Carolina, and Virginia expansion grants are being used to establish vocational rehabilitation units in State correctional institutions. Similar efforts are underway in Federal institutions.
Research and Training Centers
In 1962, the Vocational Rehabilitation Administration instituted a series of grants to universities with medical schools and other facilities where rehabilitation research and training can be conducted under the favorable conditions that are available in such settings.
The research and training centers are in four categories:
• Several provide training in virtually every phase of rehabilitation for the disabled, with special emphasis on rehabilitation research in medicine. These centers are at Baylor, Emory, George Washington, New York, Temple, and Tufts Universities and at the Universities of Alabama, Colorado, Minnesota, Southern California, and Washington.
• Three are mental retardation centers—at the Universities of Oregon, Texas, and Wisconsin—and include courses in the behavioral and social sciences as well as biomedical research.
• Three—at the Universities of Arkansas, Pittsburgh, and West Virginia—are concerned with problems of work adjustment, motivation, and development of training methods for more effective rehabilitation.
• The fourth category—established during 1966 by a grant to New York University—is for work in the field of deafness.
Research and Demonstration
Through 1966, rehabilitation research and demonstration projects increased to a total of 1,096 since the program was established in 1954. One hundred and fifty-three of these were added in 1966. Obligations for the year were $20.6 million. Of this sum, $7.7 million was for new projects and $12.9 million was for continuation of uncompleted projects.
Among projects dealing with specific disabilities, a great many were concerned with mental retardation, mental and personality disorders, and visual handicaps. In addition, there were increases in the number of projects dealing with deafness and with the rehabilitation aspects of persons with heart disease, cancer, and stroke.
There was special emphasis on prosthetics and orthotics. A project at the University of California Medical Center has produced a below-the-knee artificial limb which is becoming a standard instrument. Projects at Case Institute and Temple University have produced methods for controlling paralyzed arms through electronic activation.
220
Department of Health, Education, and Welfare, 1966
In. the area of mental and personality disorders, more research emphasis is being placed on alcoholism, drug addiction, and rehabilitation of the disabled in correctional institutions. New halfway houses for alcoholics and drug addicts have been established. Eight projects, involving collaborative effort between State agencies and prison administrators, are devoted to the vocational rehabilitation of parolees and probationers in prison systems.
The Training Program
The VRA training program, instituted under a provision of the 1954 amendments to the Vocational Rehabilitation Act, was expanded to considerably greater proportions in 1966. Funds for the training program began with $900,000 in 1954. The appropriation for training for 1966 was $24.8 million—25 percent greater than the previous year—for support of 451 teaching projects in 152 schools and institutions.
Grants were made also for 4,546 traineeships in the several disciplines allied with rehabilitation. These included medicine, dentistry, nursing, occupational therapy, physical therapy, prosthetic-orthotic education, counseling, recreation, psychology, social work, sociology, speech pathology and audiology, and facility administration. Grants also were made for specialized training programs in rehabilitation of the deaf, blind, mentally ill, and mentally retarded persons, public offenders, and for interdisciplinary training.
By the end of 1966, 3,250 persons had graduated from VRA-sup-ported long-term training programs. During the year there were 41 programs in operation for postgraduate studies, with 16 more in the planning stage. In addition, training programs for counselors in psychiatric rehabilitation were established in four universities.
Short-term projects conducted during the year provided training for 8,500 people.
Social Security Disability Applicants
State rehabilitation agencies may now be reimbursed from the social security trust funds for their costs in providing rehabilitation services for social security disability beneficiaries.
An amendment to the Social Security Act in 1965 which made this possible has stimulated activity by the State agencies in this regard. Approximately 13,000 of the people rehabilitated in 1966 were from this source. Some State agencies have appointed special coordinators to supervise those activities and have assigned counselors to work exclusively with these disabled people.
Vocational Rehabilitation Administration
221
Rehabilitating Armed Forces Rejectees
In joint responsibility with the Public Health Service, VBA is administering a program of screening young men rejected by the Armed Forces for medical reasons. During the year, approximately 40,000 rejectees who had disabilities that might be benefited by medical treatment or other rehabilitation services accepted referral to private physicians or to their State rehabilitation agencies. The number is expected to reach about 70,000 in the next year.
Heart Disease, Cancer, and Stroke
The national focus on heart disease, cancer, and stroke engendered by the report of the President’s Commission on these killing diseases led to increased activities in the public rehabilitation program.
VRA sponsored conferences of specialists and leaders in each of the three fields—a cardiac group at Tufts University, a cancer group at the New York University Medical Center, and a stroke group at Baylor University.
The conferences were designed to stimulate specialists and researchers to sponsor research in their fields. The result has been a notable increase in project applications, presaging acquisition of new knowledge and techniques for serving people disabled by these handicaps.
Services for the Blind
The year was notable for the largest increase in the number of blind persons rehabilitated into employment in the past decade. More important was the wide range of occupations they entered, such as education, law, engineering, and social work.
Two graduate training programs in mobility of the blind produced 31 instructors during the year who were employed by public and private agencies to extend their mobility training programs.
The vending stand program, administered under the Randolph-Sheppard Act, and under the general supervision of State rehabilitation agencies, continued its growth. In 1966, 2,661 vending stands provided employment for 2,915 operators. The total gross income of these stands was $65,309,084, which provided annual earnings of $4,932 per operator.
The Mentally III
In 1966, there was a notable increase in the proportion of mentally ill persons rehabilitated through the public program. The proportion rose to 15 percent of the total number rehabilitated, as compared to 13 percent the previous year.
Several factors are responsible for this increase. Many States have emphasized their work with the mentally ill and are employing more
222
Department of Health, Education, and Welfare, 1966
trained staff. Practically every State assigns full-time rehabilitation counselors to its mental hospitals, who serve as an integral part of the total therapeutic community. A growing trend is the establishment of rehabilitation units within hospitals which offer vocational and prevocational training by highly qualified personnel representative of several disciplines. More and more States are operating halfway houses, many of which have been initiated under VRA research and demonstration grants.
Alcoholism
During the last half of the year, State rehabilitation agencies were preparing programs to combat alcoholism with grant support provided by the 1965 amendments. Iowa’s Division of Vocational Rehabilitation was awarded an expansion grant to help establish halfway houses for alcoholics, and had set aside $75,000 of its basic support funds to provide direct services to alcoholics and to encourage them to participate in rehabilitation programs.
Another collaborative project, supported by an extension and improvement grant, is active at Danville State Hospital in Pennsylvania, where the State Bureau of Vocational Rehabilitation is providing comprehensive rehabilitation services in the hospital’s alcoholics rehabilitation unit. Other States have similar programs in the planning stage.
International Research
The international rehabilitation research carried on in other countries, with the support of VRA, continued to produce tangible results.
More than 100 projects have been approved since Congress authorized VRA to use local currencies owned by the United States in eight foreign countries for support of rehabilitation research. The currencies accumulate from purchases of U.S. commodities—in Burma, India, Israel, Pakistan, Poland, Syria, the United Arab Republic, and Yugoslavia. Researchers in these countries are seeking methods of coping with a variety of disabilities. Many of their projects parallel those in the United States, and researchers from these countries and from the United States exchange visits under provisions of the International Health Act. About 85 foreign scientists and research experts in the field of rehabilitation have visited the United States since 1960. More than 100 U.S. experts have been sent abroad to work in the VRA-supported projects.
Since 1947, VRA has planned and supervised itineraries and programs for some 1,800 foreign visitors to observe or be trained in U.S. rehabilitation methods and practices.
Vocational Rehabilitation Administration
223
Table 1.—Number of referrals and active cases, by agency, fiscal year 1966
Agency 1 Referrals Active cases
During fiscal year Remaining at end of year3 During fiscal year Remaining at end of year 6
Total Accepted for services Not accepted for services 2 Total active load (receiving services) Closed from active load
Rehabilitated After rehabilitation plan initiated 4 Before rehabilitation plan initiated 5
United States, total 670,290 236,925 243, 243 190,122 499.283 154,279 21,726 27,208 296, 070
Alabama 15,428 6,463 4,205 4, 760 13,317 3,988 436 760 8,133
Alaska 7 416 142 170 104 368 82 28 62 196
Arizona: General 3,348 1,250 1,225 873 2, 450 804 135 53 1,458
Blind 180 34 65 81 161 37 16 6 102
Arkansas: General 11,615 5,419 3,804 2,392 9, 581 3, 563 430 208 5,380
Blind 488 269 57 162 269 100 4 1 164
California 53, 549 12,906 27, 529 13,114 26, 520 4,522 1,801 3,540 16,657
Colorado 7,091 3,167 2, 017 1,907 6, 064 1,955 468 304 3,337
Connecticut: General 5,121 2,782 1,144 1,195 5,073 1,250 275 339 3,209
Blind 243 89 56 98 244 75 24 2 143
Delaware: General 1,650 938 510 202 1,818 640 51 103 1,024
Blind 45 35 9 1 92 28 6 0 58
District of Columbia 7,624 3, 010 3,356 1,258 5,301 1,742 410 457 2,692
Florida: General 38, 756 11,694 16,226 10,836 21, 341 6,742 1, 685 1,177 11,737
Blind 3,148 485 1,047 1,616 1,333 325 62 41 905
Georgia 34, 052 10,811 10,383 12,858 20,107 8, 009 575 653 10,870
Guam 114 38 25 51 92 27 7 3 55
Hawaii: General7 1,854 654 550 650 1,586 395 130 50 1,011
Blind 245 152 71 22 152 25 6 13 108
Idaho: General 2,022 693 835 494 1,457 515 42 7 893
Blind 38 15 18 5 45 10 1 1 33
Illinois 26,127 11,897 9,190 5,040 24,476 8,302 509 2,258 13,407
Indiana: General 6,391 3,002 2,093 1,296 6,814 1.830 97 243 4,644
Blind 204 73 47 84 210 44 7 14 145
Iowa: General 8,101 2,483 2,498 3,120 5,403 1,462 138 206 3,597
Blind 273 121 30 122 332 68 6 7 251
Kansas: General 3,339 1,527 1,228 584 2,873 991 182 158 1,542
Blind 446 116 174 156 302 72 15 5 210
Kentucky 16,581 5, 569 7,320 3,692 10,176 4,365 496 301 5, 014
Louisiana: General 7,445 4,163 1,650 1,632 10,530 2,656 427 372 7,075
Blind 679 138 281 260 776 108 18 18 632
Maine: General 2,007 480 452 1,075 1,195 382 48 59 706
Blind 394 148 120 126 328 80 20 8 220
Maryland 11,655 5,513 3,374 2,768 9,640 3,361 382 680 5,217
Massachusetts: General 12,487 4,031 5,478 2,978 8,631 2,903 241 595 4,892
Blind 307 156 43 108 534 109 32 17 376
Michigan: General 18,698 7, 551 4,222 6,925 15,350 4,967 468 278 9, 637
Blind 526 291 85 150 653 142 29 28 454
Minnesota: General 10, 779 3,499 2,781 4,499 7,042 2, 054 274 208 4, 506
Blind 1,088 233 543 312 781 156 31 48 546
Mississippi: General 6, 464 2, 031 2,077 2, 356 4,383 1,529 153 178 2, 523
Blind 1,415 438 605 372 1,027 332 34 15 646
Missouri: General 15,386 5,138 6,116 4,132 9, 062 3,653 368 112 4,929
Blind 667 189 232 246 491 167 15 15 294
Montana: General 2, 088 820 793 475 2, 404 538 60 242 1,564
Blind 107 47 20 40 93 26 2 1 64
Nebraska: General 2, 503 1,334 384 785 3, 283 822 107 95 2,259
Blind 603 180 226 197 341 97 16 6 222
See footnotes at end of table.
224
Department of Health, Education, and Welfare, 1966
Table 1.—Number of referrals and active cases, by agency, fiscal year 1966— Continued
Agency 1 Referrals Active cases
During fiscal year Remaining at end of year3 During fiscal year Remaining at end of year8
Total Accepted for services Not accepted for services i 2 Total active load (receiving services) Closed from active load
Rehabilitated After rehabilitation plan initiated 4 Before rehabilitation plan initiated 5 * *
Nevada: General 1,253 412 592 249 655 176 106 44 329
Blind 168 30 51 87 73 20 2 0 51
New Hampshire: General 907 249 253 405 664 193 33 43 395
Blind 120 48 18 54 139 27 3 2 107
New Jersey: General 14,396 5,368 4, 054 4,974 11,121 3,915 327 502 6,377
Blind 990 265 338 387 637 195 20 34 388
New Mexico: General 2,321 657 1,168 496 1,299 434 86 56 723
Blind— 190 59 61 70 151 42 12 6 91
New York: General 2 33, 897 13, 016 10,305 10, 576 29, 902 8, 881 1,256 1, 764 18, 001
Blind _ 2, 990 819 728 1,443 2,196 631 70 109 1,386
North Carolina: General . 18,893 9,563 6, 594 2,736 19, 997 8, 728 832 731 9, 706
Blind 1,625 615 701 309 1,419 456 37 115 811
North Dakota 3, 013 698 988 1,327 1,861 376 53 135 1,297
Ohio: General _ 11, 965 4, 839 3, 879 3,247 9,742 3,172 314 495 5, 761
Blind 935 357 246 332 1,121 263 43 68 747
Oklahoma _ _ 10, 246 4,347 2,932 2,967 11, 946 2, 700 480 542 8,224
Oregon: General 7,140 2,127 2,878 2,135 4,368 1,039 323 291 2,715
Blind 202 51 56 95 198 56 6 3 133
Pennsylvania: General... 51,517 17, 680 17,579 16,258 41,334 11, 679 2, 819 1,927 24,909
Blind 4,447 866 1,635 1,946 2, 073 659 82 104 1,228
Puerto Rico 14, 704 3,953 4,572 6,179 9,409 2,136 201 652 6,420
Rhode Island: General 5, 662 2,320 980 2,362 5,123 1,472 174 77 3,400
Blind 156 101 21 34 263 73 0 18 172
South Carolina: General 19, 522 6, 974 7,530 5, 018 14, 294 4,155 515 894 8, 730
Blind . — 326 112 111 103 420 130 10 23 257
South Dakota: General . _ 1,980 543 700 737 1,317 341 40 21 915
Blind 723 80 272 371 192 48 5 3 136
Tennessee: General— 12,218 4, 944 3, 808 3,466 10,309 3, 652 341 411 5,905
Blind 1,213 431 528 254 825 318 23 37 447
Texas: General 24, 717 8, 657 11, 803 4,257 17, 774 5, 652 931 658 10, 533
Blind— 2,344 860 535 949 1,434 452 18 24 940
Utah 2,370 1,213 574 583 3,194 822 105 41 2,226
Vermont: General 1,641 423 559 659 1,044 240 65 84 655
Blind 71 18 14 39 55 15 4 2 34
Virginia: General __ 18,473 5, 559 9,390 3,524 11,922 4,572 487 1,021 5, 842
Blind— . _ _ 1,046 281 310 455 581 234 23 9 315
Virgin Islands 2 258 76 15 167 161 58 0 0 103
Washington: General 8,135 1,928 3,366 2,841 4,640 1,209 267 191 2,973
Blind— — 476 164 152 160 416 121 18 18 259
West Virginia 20,709 6,614 7,271 6, 824 15, 606 4,029 214 1, 641 9,722
Wisconsin: General __ 20, 982 6, 822 9,792 4,368 13, 577 4,550 505 397 8,125
Blind 244 103 87 54 263 58 24 6 175
Wyoming 1,318 469 433 416 1,067 250 85 62 670
i In States with 2 agencies, the State division of vocational rehabilitation is designated as “general,” and the agency under the State commission or other agency for the blind is designated as “blind.”
2 Services declined, services not needed, individual not eligible, individual needing services other than vocational rehabilitation, referred to other agencies, migratory shifting of the individual, etc.
3 Eligibility for rehabilitation not yet determined.
4 Closed after rehabilitation plan was initiated; received rehabilitation service but never reached the point of employment because of personal factors, illness, aggravated disability, etc.
5 Closed prior to initiation of rehabilitation plan because of indifference of individual, increase in degree
of disability, loss of contact, etc.
8 In process of rehabilitation on June 30, 1966.
2 Partially estimated.
Vocational Rehabilitation Administration
225
Table 2.—Vocational rehabilitation grants, fiscal year 1966, to State divisions of vocational rehabilitation
State or territory
Total________
Alabama____________
Alaska_____________
Arizona____________
Arkansas___________
California_________
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-----------
Virginia__________
Virgin Islands____
Washington -------
West Virginia_____
Wisconsin_________
Wyoming___________
Support grants Extension, improvement, and innovation grants Total
$141,120, 041 $1,842,848 $142,962,889
5,472,415 50,773 5,523,188
257, 293 257, 293
1,904', 888 18,865 1,923', 753
4, 567,114 28,807 4, 595,921
9,780, 232 269, 500 10,049,732
2,295,182 2,295,182
1, 357,390 32,977 1,390,367
270,686 270,686
538,688 15, 000 553,688
5,084,999 41, 068 5,126, 067
9,142, 077 63,992 9,206, 069
125,326 125,326
784,638 784,638
380; 000 380^ 000
5,772,710 148,411 5,92i; 121
1,242, 219 1,242, 219
L485^ 208 1', 485^ 208
' 912^ 577 ' 912' 577
2,162,734 47, 078 2,209,812
4, 073,996 34,650 4,108,646
412,165 6,714 418,582
2,419,952 19,251 2,439,203
2,363,252 28,286 2,391,538
3,574, 047 3,574, 047
1,732, 021 17,212 1,749,233
1,682,735 8,580 1, 691, 315
2,420,348 46,671 2,467, 019
477,498 15, 000 492,498
625,937 14,704 640,641
230,403 15, 000 245,403
186,145 9,563 195,708
2,806,911 73,154 2,880,065
442, 275 7,582 449,857
9, 022,186 242,815 9,265, 001
5, 009, 816 5, 009,816
' 707i 448 7,125 ' 714', 573
2,967,101 119,285 3, 086,386
2,676,990 36,735 2,713,725
1,524,180 1,524,180
12i 593,374 63,559 12, 656; 933
2,488, 021 27,750 2,515,771
907, 000 15, 000 922,000
3,272,207 35,095 3,307,302
651,894 12, 000 663,894
3, 058, 045 45,280 3,103,325
4,709,480 116, 207 4,825,687
647,327 647,327
429, 058 429,058
3,510,669 3,510,669
82i 903 1,500 84,403
1,806, 578 29, 587 1,836,165
4, 025, 429 26,780 4, 052,209
3,640, 094 41,239 3, 681,333
406,180 10,350 416,530
226
Department of Health, Education, and Welfare, 1966
Table 3.—Vocational rehabilitation grants, fiscal year 1966, to State commissions or agencies for the blind
State or territory Support grants Extension, improvement, and innovation grants Total
Total $12,445,985 $155,320 $12,601,305
Arizona 169,167 4,696 173,863
Arkansas 339, 000 8,244 339, 000
Connecticut 170,500 178,744
Delaware 55,172 12, 038 6Z, 210
Florida 858,624 858, 624
Hawaii 96,109 — 96,109
Idaho 35,320 9,123 35,320
Indiana 84,550 93,673
Iowa 559,815 559,815
Kansas 197, 000 197,000
Louisiana 305,599 305,599 153,648
Maine 153,648 —
Massachusetts 372,448 13,189 372,448
Michigan 229,399 242,588
Minnesota 410,531 11, 032 421,563
Mississippi 633,766 4,965 638, 731
Missouri 335,900 8,430 344,330
Montana 77,907 — 77,907
Nebraska 134,710 7,352 142, 062
Nevada 57,601 57,601
New Hampshire 61,060 3,900 61, 060
New Jersey 390,000 110,111 393,900
New Mexico 110, 111
New York 995,354 — 995, 354
North Carolina 809, 050 14,235 809, 050
Ohio 893,296 907,531
Oregon 139, 060 31, 064 139, 060
Pennsylvania 937,315 968,379
Rhode Island 113, 040 113, 04U
South Carolina 108,166 — 108,166
South Dakota 136,511 3,000 139,511
Tennessee 972,444 7,744 972,444
Texas 715,455 723,199
Vermont 63, 079 63,0/9
Virginia 286, 000 7,562 286, 000
Washington 237,331 244,893
Wisconsin 201,947 8,746 210,693
Administration on Aging
Introduction
The creation of the new Administration on Aging, under the provisions of the Older Americans Act of 1965, marks a major step forward in the Nation’s awareness of the need for the full participation of older citizens in our social and economic life. At the signing ceremonies on July 14, 1965, President Johnson stated, “The Older Americans Act clearly affirms our Nation’s high sense of responsibility toward the wel-being of older citizens. . . . Under this program, every State and every community can move toward a coordinated program of both services and opportunities for older citizens.”
The Act established the Administration on Aging as one of the major operating agencies within the Department. The Administration became operational on October 1,1965. It is headed by a Commissioner on Aging, appointed by the President and directly responsible to the Secretary. William D. Bechill of California was sworn in as the first Commissioner on November 2,1965.
The Administration on Aging serves as the central focus within the Federal Government in all matters of concern to older people, including adequate income, housing, health, job opportunities, and the need for meaningful participation in the life of the community. It is the traffic center of ideas for older Americans, and the central clearing;-house for information pertaining to aging.
It has the responsibility for stimulating the effective use of existing resources and programs in developing services and opportunities for older people.
Much of the activity during fiscal year 1966 was devoted to setting up, organizing, and staffing the new Administration, and to defining goals and objectives on behalf of older Americans. To carry out its responsibility, the new Administration was organized into five offices:
227
228
Department of Health, Education, and Welfare, 1966
the Office of the Commissioner; the Office of State and Community Services; the Office of Program Policy and Information; the Office of Research, Demonstration, and Training; and the Office of Administration. State operations are facilitated through regional representatives in the nine regions of the Department.
In addition to authorizing the establishment of the Administration on Aging, the Older Americans Act also provides for increased services to the aged by authorizing three grant programs.
Grants for Community Planning, Services, and Training
Title III of the act authorizes a program of grants to the States to help them establish and strengthen State and local agencies on aging and to assist in the development of services and opportunities for the elderly in their home communities. To receive these funds, the State must designate a single agency which has primary responsibility for developing and coordinating programs in aging and has legal authority to conduct a project grant program. This agency, in turn, submits a plan for administering the program. When the plan is approved, the agency becomes eligible to receive title III funds.
During fiscal 1966, 51 of the 55 jurisdictions designated an agency to administer the program in their State. By the end of the year, the plans of 35 States had been approved, representing approximately $3.5 million of the $5 million appropriated for allotment to the States. At the end of the year, approval was pending on three additional State plans.
Each State plan was developed in accord with State needs.
The plans contain a wide variety of interests and services to carry out the four basic purposes of these grants:
• Community planning and coordination of services for the elderly.
• Training people to work in the field of aging.
• Demonstration of new techniques to serve older people and to use their skills.
• Establishment of new services and expansion of proven programs.
The State agencies approved during this period some 83 grants for community projects in aging, and a number of projects were in the final stages of development prior to funding. The approved projects included homemaker and handyman services; transportation, shopping, and library services; foster home care; meals-on-wheels delivered to the homebound; employment guidance; friendly visiting; retirement preparation; financial and legal assistance and counseling; consumer advisory service; health services; and one-stop guidance and referral centers. New multipurpose centers were established and serv
Administration on Aging
229
ices in existing ones were expanded. Community planning projects involved housing, nursing home services, social services for the homebound, and recreational and educational opportunities for older people. Developing employment opportunities and combating age discrimination in employment were also part of some projects. Others called for volunteer community-service work by older people as well as programs to facilitate independent living at home.
Grants for Research and Demonstration
Research and demonstration grants, authorized by title IV of the Act, hold great promise in helping to discover new techniques and methods for meeting present and future needs of older people. These grants are made directly to, or through contract with, a public or nonprofit private agency, organization, or institution, or an individual. Projects to develop new and more effective services to help older people share more fully in the opportunities available to others in their community are encouraged.
Twenty-seven projects were funded during the year. They involve development of a pilot multipurpose senior center, reduction of social isolation, improvement of nutrition, meaningful and rewarding use of free time, rehabilitation of retired persons, training and redevelopment of skills, part-time and special employment, and education for retirement. Among the grants for studies of the personal and social adjustment of older persons were:
• A study of how a community center can serve as an institution for developing services and opportunities for the elderly.
• A program to test whether home teaching is a feasible way to meet the needs of newly blind older people.
• Demonstration institutes to offer retired people and those about to retire opportunity to continue or begin to pursue educational and cultural interests.
Emphasis was placed on the support of research that is not being-carried out by other agencies. It is hoped that the results of these research and demonstration projects will encourage leaders in organizations throughout the country to apply their energies more knowledgeably and imaginatively in solving the problems of older people.
Grants for Training
The interest shown during the year in the training grant program, authorized by title V of the Act, reflected the great need for trained personnel in every kind of service for older people. The aim of the program is to provide the trained professional and subprofessional
230
Department of Health, Education, and Welfare, 1966
people that are needed in senior centers, in housing for the elderly, in nursing homes, and in colleges and universities. The new grant money is helping to stimulate university interest in education and training related to the aged. It provides support for the education of persons who will make a career of service to older people and for short-term training of personnel of housing projects, senior centers, and community service organizations. The program is also encouraging the training of older adults themselves and community leaders for participation in programs for older persons.
The 12 projects funded during the year were addressed to providing: Knowledge and skills in the field of aging for trained administrators and program planners; university faculty with competencies in the field of aging; housing managers, senior center directors, and adult education leaders with increased knowledge and skills in the field of aging; curriculum materials for short-term and long-term training; lay leaders (older people where possible) for community projects and services; and university graduates with an exposure to older people and their special needs.
Activities With Voluntary and Religious Organizations
Since the Older Americans Act made Federal assistance available for the expansion and coordination of services for the elderly in local communities, the interest and support of national voluntary organizations and their State and local affiliates have greatly increased. The Administration has given assistance and consultation to many organizations during the year and has taken part in national meetings of the American Psychiatric Association, the National Council on the Aging, the National Council of Senior Citizens, and the National Association of State Units on Aging. It has worked with the American Association of Retired Persons, the National Farmers Union, the National Association of Housing and Redevelopment Officials, the American Red Cross, the American Optometric Association, the American Library Association, the National Recreation and Park Association, the National Association of Counties, the National Council of Jewish Women, B’nai B’rith Women, various service clubs, and major labor unions.
The conception of the role of the church in the field of aging has moved, during the past few years, beyond the traditional homes for the aged and nursing homes to broader programs related to the basic needs of all the elderly. A publication called Brighter Vistas was issued by the Administration on Aging to describe four pioneer church programs for older adults.
A series of meetings was held with State agencies on the application of the Civil Rights Act of 1964 to grants under the Older Americans
Administration on Aging
231
Act. In addition, the Administration on Aging sponsored a meeting of national voluntary organizations to solicit cooperation in developing a climate for voluntary hospital compliance with the Civil Rights Act in advance of medicare.
The Foster Grandparent Program
One of the most vital and promising programs advanced by the Administration on Aging is the foster grandparent program. Under this program, low-income persons over age 60 are employed to provide a meaningful personal relationship to deprived, institutionalized children. Each foster grandparent gives special, individual attention to a dependent, neglected, sick or otherwise handicapped child living in an institution. Thirty-three projects were authorized to employ 2,000 foster grandparents to serve approximately 4,000 children. The Administration on Aging, under contract from the Office of Economic Opportunity, is responsible for the management of the program.
The response to this program throughout the country has been excellent. Numerous reports were received indicating great improvement in the health, behavior, and abilities of the children, and a new meaning to life for the foster grandparents. Ways to expand the program to its full potential are now being examined.
Senior Citizens Month
The President proclaimed May as Senior Citizens Month, with the theme “A New Day for the Older American,” and called upon every State and community to move toward a coordinated program of services and opportunities for all older citizens.
The Administration on Aging spearheaded observance of the month in cooperation with 15 other departments and agencies of the Federal Government. State and local units on aging and voluntary and religious organizations throughout the country participated.
Relationship With Other Federal Agencies and Clearinghouse for Information
To stimulate cooperation among Federal agencies for the most effective use of existing programs, and to carry out the role of clearinghouse for information on aging, the Commissioner on Aging has been designated chairman of the executive committee of the President’s Council on Aging. This interdepartmental council, created by an Executive Order of the President, serves as a means for keeping Federal departments and agencies mutually informed about developments in the field of aging, for discussing proposed program operations, and
237-319—67----16
232
Department of Health, Education, and Welfare, 1966
for focusing particularly on identification of specific areas of joint agency concern and action. The HEW Departmental Committee on Aging serves a similar purpose within the Department. Some cooperative activities during the year were:
• The Surgeon General and the Commissioner on Aging signed an agreement under which the Administration on Aging will provide technical services to the Public Health Service for its home health aide program under a contract with the Office of Economic Opportunity. Similarly, the possibility of some type of joint program in the development of home health services was explored with the Public Health Service. This would involve joint Federal planning to bring together State commissions on aging and State public health agencies and others in a working relationship to help communities organize and develop home health services.
• Extensive coordination was undertaken, not only with the Department of Housing and Urban Development but with national organizations and individuals interested in housing for the aged.
• The Administration on Aging and six other Government agencies jointly financed a survey on susceptibility to health fallacies and misrepresentation, which will identify reasons why the elderly accept the blandishments of the quack.
New publications ranged from basic fact sheets on the organization to general interest booklets on a variety of subjects important to older people. One publication was Are You Planning on Living the Rest of Your Life?, a booklet on retirement preparation. The first National Directory of Senior Centers was published. Aging, the monthly news magazine, reached a record high in distribution.
The Advisory Committee on Older Americans
As provided by the Older Americans Act, 15 prominent citizens and leaders in the field of aging were appointed to the Advisory Committee on Older Americans, created by the Act. The committee, charged with advising the Secretary of Health, Education, and Welfare on “matters relating to his responsibilities under the Act and related activities of his Department,” held two meetings to review the objectives set forth in the Act and to develop recommendations for the Secretary. The committee has agreed upon the following overall goals as basic to planning present and future programs for the aged:
• Provision of a favorable social, economic, and political environment to enable the older American to participate fully in American life and society.
• Development of realistic programs for older people in health, housing, recreation, community services, employment, income maintenance, education, and rehabilitation.
Administration on Aging
233
• Creation of opportunities for older people to live more meaningful lives in retirement: to express themselves, to serve others, to travel, and to maintain their independence.
The Nature of the Challenge
In this century, the U.S. population aged 65 and over has increased sixfold, to about 19 million people. Persons 65 and over now constitute 9.4 percent of the Nation’s population, as compared with 4.1 percent at the beginning of the century. During the next 20 years, the older population is expected to reach 25 million.
Older people have special needs. These needs multiply as the number of persons in the older age group increases, and as industrialization and urbanization make for greater anonymity and interdependence of people. Recent Government action has created the machinery to plan and provide more vital opportunities for older people than ever before possible in our history. The legislation recognizes, however, that the ultimate success of the programs will depend as much upon the informed leadership and initiative of local communities as on the support of the Federal Government.
Saint Elizabeths Hospital
Saint Elizabeths Hospital, the largest federally operated hospital for the mentally ill, fulfills its statutory mission by means of three major activities:
• Treatment—therapeutic, rehabilitative, and protective programs for patients.
• Training and Education—multidisciplinary clinical training programs for professional and other personnel engaged or interested in mental health activities.
• Research—coordinated research programs and projects to obtain a better understanding of the causes of mental disorders, and of the factors bearing upon their development, treatment, and possible prevention.
Patient Population Trends
In spite of the new postwar high in the number of admissions (2,162), the average number of patients in the hospital continued to decline in 1966, reaching a new postwar low of 5,929 compared with 6,131 in 1965. The average number of patients on the rolls (7,569), however, remained fairly constant (7,585 in the preceding fiscal year). About 20 percent (1,432 patients) of the on-rolls population was on convalescent leave at the end of the fiscal year. Discharges increased to 1,685, a new postwar high. The figures indicate more frequent use of the hospital and more successful treatment. Especially effective has been treatment which has moved patients to an outpatient setting.
The following table reflects a continuing generally favorable trend:
June 30, 1965 June 30,1966 Changes since June 1965
Patients on rolls 7,549 7,516 -33
Resident patients. . 6,131 5,924 -207
On limited leave.. 71 82 +11
On convalescent leave _ _ 1,271 1,432 +151
On unauthorized leave 76 78 +2
235
236
Department of Health, Education, and Welfare, 1966
Accreditation and Medicare
The hospital’s accreditation was renewed for a 3-year period by the Joint Commission on Accreditation of Hospitals. The Commission, in granting accreditation, made a number of recommendations. It also stated that “the plan to replace many old buildings now housing patients with entirely new construction is highly commended.” This statement undoubtedly was based largely on the assumption that the proposed 450-bed Psychiatric Rehabilitation Center, for which funds were and are available, would be constructed in the near future. Detailed plans and specifications for this structure were completed in 1964, but approval has not been forthcoming to proceed with construction. The hundreds of patients affected are thus forced to continue living in what can only be termed primitive facilities.
Accreditation by the Joint Commission and the development of an accepted utilization review plan resulted in the approval of the hospital as a “provider of service” under medicare. Approximately 2,400 patients were enrolled for basic benefits and, of these, about 25 percent were enrolled for supplemental benefits.
Treatment Program
With shorter average hospitalization and the staff’s success in moving out long-term patients there is renewed enthusiasm and vigor. The previously cited increase in admissions included an expansion in the number of more treatable cases who voluntarily sought hospitalization early in their illness. Emergency admissions also increased. Some progress was made in decentralization. A new unit, established to receive and treat women under criminal charges, helped improve continuity of patient treatment.
Outplacement of more patients resulted from many factors in addition to successful treatment. Some of these include better organization of industrial therapy, more counselors in vocational rehabilitation, intensification of foster care placement (a special boon to the elderly and long-hospitalized) and followup; camping trips for patients; and emphasis on outpatient clinics and day hospital facilities.
Improved public interest in the mentally ill has been furthered at the hospital through employer seminars, hospital tours (3,228 visitors were conducted through the hospital during the year), ceremonies to recognize the contributions of volunteers, and television and radio productions. Increased public interest has helped in turn to bring earlier, more treatable, admissions to the hospital.
Saint Elizabeths Hospital
237
The Youth Center
Although the adolescent and younger patients constitute only a small percentage of the total patient population, they present unusual challenges. They demand more effort and more work than a similar number of adult patients, but, by and large, because of their age, they present a greater prospect of favorable response to treatment than a similar group of adult patients. These patients are an extremely heterogeneous group. They include a wide range of IQ’s—from those of mentally retarded level to above average intelligence—and a wide range of family backgrounds from foundlings to middle-class children from intact homes.
The establishment of the Youth Center in fiscal year 1964 was a significant step in developing programs oriented toward children. The Center has not only greatly helped its young patients to establish more appropriate values and aided them in securing some education but, almost as important, the training of the teachers of the Youth Center staff has produced an important cadre of people expert in working with emotionally disturbed children. Many other steps necessary in establishing a long-range youth treatment program for the hospital remain to be accomplished.
Devising ways to house the children in one building has made it possible to provide a more consistent total treatment and living program for the children. Also, liaison has been established with the District of Columbia General Hospital, a major source of referrals, so that children transferred to Saint Elizabeths have a program and plan ready for them when they are admitted.
The progress made does not lessen the hospital’s great need for a separate residential treatment center for adolescents. The necessarily specialized nature of the facility required can be met only by new construction.
Professional Training and Education
Fiscal year 1966 was marked by further consolidation and modest expansion of training programs in which a total of more than 700 trainees were enrolled. Most training programs showed further healthy development and quality improvement. Of special importance has been the marked increase in medical student teaching, which places a growing demand on teaching staff time. A closer relationship was developed with the Clinical Neuropharmacology Research Center, National Institute of Mental Health, and the Saint Elizabeths research staff made a greater commitment than in preceding years to teaching
238
Department of Health, Education, and Welfare, 1966
research, techniques in the training program. The psychiatric residency program was surveyed by the American Medical Association Council on Medical Education. The hospital’s 3-year training program was approved for another training period.
The hospital joined the National Psychiatric Residency Matching Plan, which is an arrangement for assigning residents to the hospital of their choice, and which now includes the great majority of psychiatric training centers in the United States. It operates in a manner similar to the Intern Matching Plan. All applicants must register with the NPRMP and results of the matching procedure are announced annually in December for the following July.
During recent years the hospital has accepted responsibility for teaching more medical students more intensively, particularly in the field of psychiatry. The primary affiliation is with the George Washington University School of Medicine, although students also come from Howard University and, increasingly, from other schools of medicine. During the year, all senior hospital research staff and psychiatric training staff were appointed to the faculty of the Department of Psychiatry of George Washington University.
The nonmedical training programs of the hospital continued to function effectively during the year. Most programs had a full complement of trainees, and they experienced further strengthening of curricula. These programs have a considerable advantage over the medical programs in that the training requirements of the discipline may more easily be made congruent with the hospital’s service needs.
Research
A major realignment of total research activities took place during the year, bringing the hospital’s Behavioral and Clinical Studies Research Center (BCSRC) into closer operational relationship with the Clinical Neuropharmacology Research Center (CNRC) of the National Institute of Mental Health. These administrative changes reflect a basic policy reorientation for the joint hospital-NIMH research activity at Saint Elizabeths.
Henceforward, the CNRC plans to give increasing emphasis to research in neurophysiology, neurochemistry, psychopharmacology, neuropharmacology, basic neuroanatomical sciences, electrophysiology of behavior, and model systems design. Complementing these areas of research, the hospital’s Behavioral and Clinical Studies Research Center will continue development of existing programs in experimental psychiatry, operant conditioning and psychophysics, psychophysiology, communications behavior, personality assessment, and criminal
Saint Elizabeths Hospital
239
behavior, with an increasing emphasis on clinical investigations by staff from both CNBC and the hospital.
Administrative restructuring of the joint Saint Elizabeths-NIMH research activity permitted a sharper definition of program missions and promoted the internal organization coherence designed to enhance, not restrict, responsible scientific freedom for the investigator.
Special attention has been given, and will continue to be given, to cooperative efforts with research colleagues of the intramural and extramural divisions of NIMH who require access to the hospital’s clinical population for their work.
Staffing
Employment at the end of the year, exclusive of trainees and certain other groups, was 3,640, the same as at the end of the preceding year. Although the employee-patient ratio improved, this was due entirely to the decrease in patient population. Serious staffing shortages continue in almost all employment categories but particularly in those dealing directly with patients, such as nurses and nursing assistants.
Buildings and Facilities
Funds were appropriated and a contract entered into for the development of a proposal leading to the construction of additional facilities for the treatment of patients admitted as a result of criminal proceedings and for those civil patients requiring treatment in a security setting. A total of $1,952,000 was also appropriated for a number of other projects, principally the continuation of major electrical and plumbing improvements, and the air conditioning of Nichols Building which houses several hundred geriatric patients. Work continued on projects for which funds had been appropriated in previous years.
Table 1.—Patients, admissions, discharges and deaths, fiscal years 1956-1966
Fiscal year Average number of patients Admissions 1 Discharges 1 Discharges as percent of admissions Deaths 1
On rolls In hospital
1956 7,438 7,120 1,327 884 67 600
1957 7,413 6, 994 1,615 1,014 63 507
1958 7,466 6, 965 1,605 1,076 67 532
1959 7,512 6, 900 1,607 1,034 64 479
1960 _ - 7, 691 6,983 1,894 1,101 58 504
1961 7,933 6,976 1 1,981 i 1,395 70 440
1962 7,942 6,838 2,024 1,641 81 484
1963 _ 7,799 6,668 1,930 1,546 80 513
1964 . 7,672 6,412 1,692 1,446 85 444
1965 7,585 6,148 1,965 1,557 79 423
1966 7,569 5,929 2,162 1,685 78 510
i Figures for 1061 and earlier years differ slightly from those for later years in that the earlier figures include “paper” discharges and readmissions made in order to change legal categories.
240
Department of Health, Education, and Welfare, 1966
Table 2.—Patients on the rolls, by status and by sex, time since admission, ethnic group, and age, June 30, 1966
Sex, time since admission, ethnic group and age Patients on rolls, total Resident patients 1 On limited leave On convalescent leave On unauthorized leave
Total In hospital On temporary-visit
Total 7, 516 5,924 5,877 47 82 1,432 78
Males. . ... 3, 622 2,977 2 957 20 42 547 56
Females 3; 894 2,947 2,920 27 40 885 22
Time since admission:
Less than 6 months.. 668 584 580 4 3 92 9
6 to 11 months 443 316 311 5 1 120 6
1 year 731 450 442 8 18 255 8
2 years. 451 292 288 4 10 142 7
3 to 4 years 435 287 282 5 1 141 0
5 to 9 years 1, 550 1,132 1,122 10 31 352 35
10 to 19 years L287 R056 i; 047 9 10 215 0
20 years and over. _ L931 1,807 1,805 2 8 115 1
Median time since admission
(years).. 8. 3 9. 6 9 6 3.9 6.3 4.5 5.4
Ethnicgroup:
White 3, 725 3, 034 3,013 21 44 611 36
Non white . 3; 791 2,890 2,864 26 38 821 42
Age (years):
Less than 15. . 19 17 17 0 0 2
15-17 33 24 24 0 0 8 1
18-24. 267 193 188 5 2 66 0
25-34 808 551 544 7 9 220 28
35-44.. 1,126 768 756 12 17 321 20
45-54 L405 1,024 1, 015 9 21 343 17
55-64 i; 507 L 191 1,184 7 9 302 5
6.5-74 1,245 L HO i; 103 7 15 120 0
75-84. '815 '764 764 0 9 41 1
85 and over 291 282 282 0 0 9 0
Median age 56 58 58 45 52 48 37
1 Resident patient status should not be confused with the District of Columbia resident legal category. The former is defined as patients in the hospital plus those on temporary visit.
Saint Elizabeths Hospital
241
Table 3.—Movement of patients on the rolls, by sex, time since admission, ethnic group, and age, fiscal year 1966
Sex, time since admission, ethnic group, and age Patients on rolls June 30, 1965 Admissions Discharges Deaths Patients on rolls June 30, 1966 Change during year
Total 7,549 2,162 1,685 510 7,516 -33
Males _ .. - _ 3,661 1,301 1,083 257 3,622 -39
Females 3,888 861 602 253 3,894 +6
Time from admission to June 30,1966: i Less than 6 months. 701 1,058 341 28 688 -13
6-11 months ... — 461 1,104 606 54 443 -18
1 year - 603 364 68 731 +128
2 years _ ___ 540 109 43 451 -89
3-4 years .. _ - 819 43 39 435 -384
5-9 years _ 1,110 1,324 1,991 3,857 153 121 1, 550 +440
10-19 years __ _ 49 61 1,287 -37
20 years and over _ _ - 20 96 1,931 -60
Ethnic’ group: White 994 838 288 3,725 -132
Non white 3,692 1,168 847 222 3, 791 +99
Age (years): Less than 15 .. . . 12 21 7 0 19 +7
15-17 29 24 13 0 33 +4
18-24 269 277 225 1 267 —2
25-34 808 464 430 8 808 0
35-44 1,148 458 435 9 1,126 -22
45-54 1,404 353 304 25 1,405 +1
55-64 1, 506 216 169 75 1,507 +1
65-74 1, 225 168 70 127 1,245 +20
75-84 886 115 24 162 815 -71
85 and over 262 66 8 103 291 +29
56 41 39 76 56

i Data for patients on rolls June 30,1965, represent time from admission to June 30, 1965.
Note.—Ordinarily the number of patients on the rolls at the beginning of the year plus admissions minus discharges and deaths equal the number of patients at the end of the year. However, this is not true for characteristics which change during the year, such as age or time since admission.
242
Department of Health, Education, and Welfare, 1966
Table 4.—Patients on the rolls, by status and the legal category, June 30, 1966
Legal category Patients on rolls total Resident patients 1 On limited leave On convalescent leave On unauthorized leave
Total In hospital On temp-porary visit
Total 7,516 5,924 5,877 47 82 1,432 78
Reimbursable 6,696 5,228 5,181 47 71 1,329 68
Residents of D.C 5,576 4,295 4,255 40 68 1,189 24
D.C. resident (civil ju-
dicial order) 4,817 3 891 3 861 30 57 849 20
Voluntary resident '637 297 289 8 10 326 4
Nonprotesting resident. 76 63 62 1 1 12 0
Emergency resident 46 44 43 1 0 2 0
D.C. jury trial. 91 83 83 o o 8 o
D.C. Training School 5 4 4 0 0 1 0
D.C. criminal proceedings._ 648 526 520 6 0 78 44
For examination 44 44 44 0 o o o
Mentally incompetent.. 121 116 116 0 0 0 5
Not guilty, insanity 379 283 277 6 0 65 31
Under sentence 58 57 57 o o o 1
Sex psychopath 46 26 26 0 0 13 7
U.S. criminal proceedings.. 20 20 20 0 0 0 0
Veterans Administration.. 278 232 231 1 1 45 0
U.S. nationals from abroad. 53 50 50 0 0 3 0
U.S. Soldiers’ Home.. . . 21 14 14 0 2 5 o
Indians (PUS) 4 4 4 0 0 0 0
N onreimbur sable 820 696 696 0 11 103 10
Nonresidents of D.C 435 337 337 0 8 82 8
D.C. nonresident (civil
judicial order) 305 255 255 0 7 36 7
Voluntary nonresident. 99 54 54 0 0 44 1
Nonprotesting nonresi-
dent 12 9 9 0 1 2 o
Emergency nonresi-
dent 19 19 19 0 0 0 0
Military and Coast Guard.. 209 197 197 0 0 11 1
Virgin Islands ... 117 111 111 0 o 5 1
Federal reservation 17 17 0 3 4 o
Public Health Service 12 12 12 0 0 0 0
Canal Zone 13 13 13 o o o o
Other 10 9 9 0 0 1 0
1 Resident patient status should not be confused with D.C. resident legal category. The former is defined as patients in the hospital plus those on temporary visit.
Saint Elizabeths Hospital
243
Table 5.—Movement of patients on the rolls, by legal category, fiscal year 1966
Legal category Patients on rolls June 30, 1965 Additions Removals Patients on rolls June 30, 1966 Change during year
Admissions From other legal category i Discharges Deaths To other legal category i
Total 7,459 2,162 590 1,685 510 590 7, 516 -33
Reimbursable 6,749 1,879 24 1,235 471 250 6,696 -53
Residents of D.C 5,564 1,381 61 766 424 240 5,576 +12
D.C. resident (civil judicial order) 4,955 571 117 316 364 146 4,817 -138
Voluntary resident 542 435 89 347 28 54 637 +95
Nonprotesting resident.... 51 73 4 18 25 9 76 +25
Emergency resident 16 302 5 85 7 185 46 +30
D.C. jury trial 95 0 1 2 2 1 91 -4
D.C. Training School 0 5 0 0 0 0 5 +5
D.C. criminal proceedings 625 426 10 350 10 53 648 +23
For examination 33 227 3 193 0 26 44 +11
Mentally incompetent 93 102 28 50 3 49 121 +28
Not guilty, insanity 389 40 11 52 6 3 379 -10
Under sentence 67 51 1 52 1 8 58 -9
Sex psychopath 43 6 0 3 0 0 46 +3
U.S. criminal proceedings 28 42 0 46 0 4 20 -8
Veterans administation 352 6 0 52 28 0 278 -74
U.S. nationals from abroad 52 6 1 5 1 0 53 +1
U.S. Soldiers’ home 26 12 0 11 6 0 21 -5
Indians (PHS) 5 0 0 1 0 0 4 -1
Other 2 1 0 2 0 1 0 -2
N onreimbursable 800 283 250 450 39 24 820 +20
Nonresidents of D.C 383 247 260 417 16 22 435 +52
D.C. nonresident (civil judicial order) 303 0 240 219 11 8 305 +2
Voluntary nonresident 67 99 75 128 3 11 99 +32
Nonprotesting nonresident 6 12 7 7 1 5 12 +6
Emergency nonresident 7 136 8 63 1 68 19 +12
Military and Coast Guard 227 0 0 0 16 2 209 -18
Virgin Islands 121 2 0 3 3 0 117 -4
Federal reservation 33 33 0 29 3 10 24 -9
Public Health Service 13 0 0 0 1 0 12 -1
Canal Zone 13 1 0 1 0 0 13 0
Other 10 0 0 0 0 0 10 0
1 Subtotal lines exclude legal category changes within the respective groups (e.g., the 10 changes to the total District of Columbia Criminal Proceedings exclude changes from one District of Columbia Criminal Proceedings category to another).
244
Department of Health, Education, and Welfare, 1966
Table 6.—Discharges, by status from which discharged and by condition, environment, and employment, fiscal year 1966
Condition or type, environment, and employment Total Resident patient status i Limited leave Convalescent leave Unauthorized leave
Total Direct from hospital Temporary visit
Total 1,685 1,135 1,091 44 23 417 110
CONDITION OR TYPE Medical discharges 661 251 235 16 20 368 22
Condition on discharge: Recovered 55 26 26 0 2 26 1
Socially recovered 382 85 81 4 7 277 13
Improved 208 128 116 12 10 64 6
Unimproved 16 12 12 0 1 1 2
Administrative discharges 1,024 884 856 28 3 49 88
Type of discharge: To legal or police authorities 296 292 290 2 1 1 2
To home State or country 123 119 117 2 1 2 1
Against medical advice 249 203 192 11 0 5 41
Court order 153 129 126 3 0 21 3
To VA hospital 75 72 70 2 0 3 0
Expiration of limited stay, for admission to private hospital, etc 128 69 61 8 1 17 41
ENVIRONMENT Alone 215 128 123 5 0 74 13
With spouse 280 154 141 13 5 112 9
With relatives (not spouse) 444 262 249 13 10 147 25
With others 98 56 54 2 2 32 8
In foster care home 24 0 0 0 0 24 0
In D.C. Village 4 0 0 0 0 4 0
In other home for aged, nursing or convalescent home 23 11 11 0 2 10 0
In inpatient psychiatric institution 181 169 165 4 1 4 7
In penal institution 312 307 304 3 2 1 2
In other institution 13 12 12 0 0 1 0
Unknown 91 36 32 4 1 8 46
EMPLOYMENT Fail time 299 140 133 7 4 145 10
Part time or intermittent 38 11 11 0 2 23 2
Seeking work 358 268 253 15 2 62 26
Housewife, student, retired, etc 191 100 93 7 3 86 2
Not employable: In institution 470 452 446 6 3 7 8
Other, too ill mentally or physically 132 69 66 3 7 51 5
Unknown 197 95 89 “1 2 43 57
i Resident patient status should not be confused with D. C. resident legal category. The former is defined as patients in the hospital plus those on temporary visit.
Surplus Property
Utilization1
Fiscal year 1966 was one of the most active and successful years in the history of the surplus property utilization program—with more than $535 million in Government surplus land, buildings, and a variety of equipment donated or conveyed to health, educational, and civil defense organizations. Surplus personal property with a Federal acquisition cost of more than $464 million was allocated for distribution to health, educational, and civil defense institutions, and surplus real property with an acquisition cost of more than $71 million was transferred for health, including research, and educational utilization.
As a result of the closing of more military bases, many new colleges, technical institutes, and vocational schools were established on properties conveyed through the program; in some areas the colleges would not have been established for many years. These newly established educational facilities also provided a firm basis for communities to encourage industries to move into the areas, thereby assisting in the relief of economic pressures caused by the base closings. The program also rendered needed assistance in disaster areas on the west coast and in the Midwest by providing properties needed and used by civil defense units in providing disaster relief.
Vietnam activities substantially reduced the availability of certain types of surplus personal property during the year. As a result the program accelerated the development of ways of broadening the utilization of property which was available. In addition, accelerated programs were developed to dispose of sophisticated electronic and other gear associated with obsolete missile programs, including the Atlas and Titan I missile systems and a number of the radar tracking and control stations associated with the Sage systems. A similar program was developed for the donation of electronic data-processing equipment. For example, major computing units, consisting of 20 Athena Univac computers with a Government acquisition cost in excess of $54 million, were donated to 19 universities, and donations of 17 additional computer systems of other designs were shared by 19 other universities and
1 This activity is administered by the Office of the Assistant Secretary for Administration.
245
246
Department of Health, Education, and Welfare, 1966
technical schools. Universities, colleges, and technical and vocational schools received surplus personal property which had cost more than $50 million from obsolete Atlas and Titan missile sites located in California, Colorado, Idaho, Kansas, Nebraska, New Mexico, New York, Oklahoma, South Dakota, Washington, and Wyoming.
In the surplus real property program, a number of Atlas and Titan missile sites have been conveyed to institutions for educational purposes. Two Atlas E missile sites were conveyed to two institutions in Colorado. One, conveyed to the Colorado State University, will be used in relocating hazardous research activities—in cryogenics and radiation acceleration—currently being conducted on the campus.
The second, to the Colorado Engineering Experimental Station, Inc-—organization of University of Colorado professors, representatives of the aerospace industry, and of State and Federal organizations—will be used to conduct research projects pertinent to gas flow measurements and calibration of equipment in support of aerospace activities. Postgraduate students from the University of Colorado and Colorado State University will use the site as laboratory facilities for advanced research projects.
Three missile sites are being transferred to Kansas State University. Two of them contain 175-foot-deep silos. One will be used for seismographic research; the other as a drop tower to study and test impact forces on metals. The third, an Atlas E (coffin-type) site, will be used for research in hydraulics, high energy acoustics, gas dynamics, etc.
In the conveyance of many surplus real properties, the buildings are fully equipped for immediate utilization of proposed programs. In other instances, within a short time of conveyance, buildings are substantially equipped with personal properties secured through the personal property donation program.
The following tabulation illustrates the diversified purposes for which real properties, including on-site and off-site cases, were conveyed during fiscal year 1966:
College campus sites and facilities__________________________________________ 37
College and high school agricultural, teaching, experimental, and vocational training------------------------------------------------------------- 15
Elementary and secondary educational programs________________________________ 90
Central administrative and service facilities for schools and school systems 8
Housing for school or hospital staffs______________________________________ 12
Hospital or clinic programs___________________________________________________ 8
Treatment, rehabilitation, and training centers for the mentally retarded and physically handicapped___________________________________________________ 4
Public libraries______________________________________________________________ 10
Water and sewer production treatment and service facilities___________________ 9
Land fill refuse disposal programs____________________________________________ 1
Research______________________________________________________________________ 1
Total ----------------------------------------------------------- 195
American Printing House for the Blind
As the official schoolbook printery for the blind in the United States, one of the principal functions of the American Printing House for the Blind, in Louisville, Ky., is the provision of special educational books and supplies for the blind schoolchildren throughout the country. The Federal act “To Promote the Education of the Blind,” originally passed in 1879, authorizes an annual appropriation to the Printing House for this purpose. Allocations of books and materials are made on a per capita basis. Only those pupils may be registered whose vision comes within the accepted definition of blindness: “Central visual acuity of 20/200 or less in the better eye with correcting glasses, or a peripheral field so contracted that the widest diameter of such field subtends an angular distance no greater than 20 degrees.”
The Printing House maintains large catalogs of Braille books, talking books, recorded tapes, Braille music publications, large-type texts and tangible apparatus. A rich collection of educational material is thereby provided for pupils from kindergarten through the high school grades. A total of 8,246 blind pupils was enrolled through public educational institutions for the blind and 10,381 through State departments of education—a total of 18,627 blind pupils being served by the Printing House—for the fiscal year ending June 30, 1966.
During the year, Braille books, educational periodicals, and music made up approximately 41.0 percent of the materials required by the schools; Braille slates, Braillewriters, maps, and other mechanical devices, 21.0 percent; talking books, 2.5 percent; recorded educational tapes, 0.2 percent; large-type books, 33.0 percent; and miscellaneous items, 2.3 percent.
247
237-319—67——17
Gallaudet College
Program Emphasis
Gallaudet College’s principal activity is a 4-year undergraduate course of studies leading to the B.A. and B.S. degrees. In addition, a 1-year college preparatory course is offered. Deaf children of nursery ages receive training in the Hearing and Speech Center. Elementary and secondary education for deaf children of the District of Columbia and adjacent States is provided by the Kendall School, a laboratory school serving the college’s graduate school.
During fiscal year 1966, the curriculum of the graduate school was expanded to include: Audiology, speech pathology, and nursery education. In addition, an accredited master’s degree program was initiated to prepare teachers for the education of deaf children at both the elementary and secondary levels.
Research
As the college has grown in size and stature it has attracted increasing support, largely from Federal agencies, for research into many of the aspects of deafness. Research into the precise nature of auditory stimuli as they are perceived by deaf persons received great impetus with the appointment of Dr. James M. Pickett as research professor of hearing and speech. Professor Jerome Schein’s study of the deaf population of the Washington metropolitan area has provided the first detailed analysis of the conditions under which a largely submerged minority group makes its way in the world. Professor William C. Stokoe’s long research into the nature and structure of the American sign language is completed and A Dictionary of American Sign Language on Linguistic Principles was published in January 1966.
Enrollment
Regular session enrollment during the 1965-66 academic year rose to 823, an increase of 55 over the previous year. Enrollment in the
249
250 Department of Health, Education, and Welfare, 1966
nursery school rose from 27 to 30, and in the elementary school from 145 to 157. At its June commencement, the college awarded 98 bachelor’s degrees and 14 master’s degrees.
Summer session enrollment in 1966 totaled 253, divided into 2 principal categories: (1) Teachers of the deaf who were candidates for the master’s degree or who were attending institutes in mathematics, science, reading, and librarianship; and (2) newly admitted deaf students who came to remove certain deficiencies in English and mathematics.
Howard University
Howard University, located in the District of Columbia, was chartered by an act of Congress, dated March 2,1867. The university consists of 10 schools and colleges, offering programs of higher education on the undergraduate, graduate, and professional levels. Undergraduate students are registered in the college of liberal arts; graduate students seeking the master’s and doctor of philosophy degrees are registered in the graduate school; professional students are registered in the colleges of medicine, dentistry, pharmacy, fine arts (including the school of music and the department of art and drama), and the schools of engineering and architecture, social work, law, and religion. (The school of religion receives no support from Federal funds.)
The educational program of the university is conducted in keeping with the democratic purposes of land-grant colleges and State universities, with the low tuition fees and living costs which characterize these institutions, and with an educational program resting upon and permeated by the content and spirit of a general or liberal education. The university admits students of both sexes, from every race, creed, and national origin, but it accepts and undertakes to discharge a special responsibility for the admission and training of Negro students.
Enrollment of Students
During the school year 1965-66, the university served a total of 12,-427 students as follows: 8,748 during the regular academic year and 3,679 in the summer session of 1965. The total net enrollment, excluding all duplicates, was 10,455 distributed as follows: liberal arts, 5,737; graduate school, 1,414; engineering and architecture, 731; fine arts, 640; social work, 222; medicine, 375; dentistry, 670; pharmacy, 236; law, 318; and religion, 92.
Geographical Distribution of Students
The enrollment of foreign students continues to be significant. During the second semester of the 1965-66 school year, there were 1,522 foreign students, constituting 14.8 percent of the enrollment. These students came from 77 countries, including Canada, 3 countries in Central America, 6 countries in South America, 9 islands of the West Indies, 25 countries in Africa, 20 countries in Asia and the Pacific Is-
251
252
Department of Health, Education, and Welfare, 1966
lands, and 13 countries in Europe. In addition, there were students from Puerto Rico and the Virgin Islands.
During the course of the school year, there were 8,903 degree-seek- z ing students from the United States. These students were distributed as follows: New England States, 178; Mideastern States, 5,050; Great Lakes States, 495; Plains States, 110; Southeastern States, 2,674; Southwestern States, 214; Rocky Mountain States, 20; Far Western States, 111; Alaska, 2; Hawaii, 2; Puerto Rico, 10; and the Virgin Islands, 37.
Veterans
The total enrollment of veterans and dependents of deceased veterans was 41. Four of these students were graduated. Of the total, 9 were disabled veterans and 32 were dependents of deceased veterans.
Army and Air Force ROTC
Army ROTC.—There were 571 students enrolled in Army ROTC during the 1965-66 school year. Of this number, 318 were in the first-year course, 181 in the second year, 49 in the third year, and 23 in the fourth year. There were 23 students commissioned as reserve officers in the Army during the year.
Air Force ROTC.—A total of 675 students was enrolled in Air Force ROTC. Of this number, 345 were in the first-year course, 243 in the second year, 47 in the third year, and 40 in the fourth year. During the year, 20 students were commissioned as reserve officers in the Air Force.
The Faculty
There were 974 teachers serving the university during the school year, including 560 full time and 414 part time. The full-time equivalent of the teaching staff was 660.64. Of this full-time equivalent, 553.02 were teaching at the rank of instructor or above.
The university continues, as always, to seek for its faculty the most able persons, selected on the basis of their competence and character, without regard to race, sex, color, creed, or national origin. It is to be noted, however, that the Howard University faculty has always included the largest group of Negro teachers and scholars at the university level found anywhere in the United States. Many of the most outstanding Negroes in public life have served at Howard at some time during the course of their careers. Among them were the Ambassador to Senegal, the founder and operator of the first blood plasma bank, a Governor of an American possession, an under secretary of the United Nations, two judges of the U.S. courts of appeals, the Solicitor General of the United States, the U.S. Ambassador to Luxembourg, and many others.
Howard University
253
Varied Activities of the Faculty and Staff
Numerous members of the faculty and staff were engaged in a variety of useful activities both in the United States and abroad. The president of the university, who is currently on leave, is serving as U.S. Deputy Representative to the United Nations. Several members of the staff, including the president, represented the United States in various foreign countries.
Graduates
During the 1965-66 school year, there were 1,024 graduates from the 10 schools and colleges. These graduates came from 35 States, the District of Columbia, Puerto Rico, the Virgin Islands, 31 foreign countries, and 9 island possessions of the British, French, and Dutch West Indies.
The 1,024 graduates were distributed among the 10 schools and colleges as follows: Liberal arts, 484; engineering and architecture, 92; fine arts, 44; the graduate school, 118; social work, 77; medicine, 84; dentistry, 40; dental hygiene, 23; pharmacy, 20; law, 32; and religion, 10. In addition, honorary degrees were conferred upon four persons.
From the date of its establishment in 1867, Howard has graduated 25,279 persons. The great majority of these graduates have been Negroes. Throughout its 99-year history, Howard has been a pioneer in providing Negroes with educational opportunities which were either not available or offered in only limited amount elsewhere. Among institutions in which Negro students are in a majority, the university still stands as the only one affording a complex system of undergraduate, graduate, and professional training.
The largest number of graduates has entered the field of teaching, especially in the Southern States. In the field of medicine, there have been 3,641 graduates; 2,141 have gone into dentistry and dental hygiene; 1,846 have entered the field of law; 457 have entered the ministry; 1,363 have gone into the fields of engineering and architecture ; and 842 have gone into social work. Numerous graduates of the university have engaged in government service not only in the United States but also in many countries abroad.
Significant Program Developments
Among the significant developments which took place during the year 1965-66 are the following:
• Substantial increase in the number of research and teaching grants.
• Expansion of the African studies program.
254
Department of Health, Education, and Welfare, 1966
• Conferring of the first graduate degree in law (master of comparative jurisprudence).
• Increased participation in programs devoted to community, national, and world service (Upward Bound, Head Start, Juvenile Delinquency, Peace Corps, etc.).
• Establishment of a computer and data-processing center.
• Completion by the former dean of the graduate school of the self-study project, involving all educational and administrative units of the university, to determine future lines of endeavor.
The Building Program
The program for improvement of physical facilities moved forward with these developments: Preliminary plans for a new university hospital were completed; plans for a social work building were completed; programs and preliminary plans for a men’s dormitory, women’s dormitory, university center, physical education building for women, and classroom building were brought to various stages of completion; a project for the fabrication and installation of two new steam boilers at the powerplant was started and progressed almost to completion; and several minor improvement projects—including campus lighting, parking areas, approaches to the campus, and new walkways—were developed to varying stages of planning.
All work on the women’s dormitory building, which was in the early stages of construction, was halted as a result of a dispute between the contractor and the Public Building Service of the General Services Administration and remained inactive throughout the year.
Detailed Contents
Page
THE SECRETARY’S REPORT___________________________________ i
SOCIAL SECURITY ADMINISTRATION
INTRODUCTION___________________________________________________________ 5
Developments in Social Security________________________________________ 5
WHAT THE PROGRAM DID IN FISCAL YEAR 1966_______________________________ 6
Beneficiaries and Benefit Amounts______________________________________ 6
Disability Provisions__________________________________________________ 9
Protection Provided____________________________________________________ 8
Income Maintenance_________________________________________________ 9
Health Insurance__________________________________________________ 10
Income and Disbursements__________________________________________ 10
LEGISLATIVE DEVELOPMENTS DURING THE YEAR______________________________ 11
Legislation Enacted___________________________________________________ 11
Legislation Considered._______________________________________________ 12
FUTURE PROGRAM IMPROVEMENTS___________________________________________ 14
Cash Benefit Levels___________________________________________________ 14
Disability Protection_________________________________________________ 15
Health Insurance______________________________________________________ 15
ADMINISTERING THE SOCIAL SECURITY PROGRAM________________ 16
Reorganization of the Administration__________________________________ 16
Workloads and Administrative Expenses_________________________________ 17
Implementation of the 1965 Amendments_________________________________ 17
Manpower and Resources________________________________________________ 18
Improvements in Data Processing and Telecommunications________________ 19
Progress in Cost Reduction and Productivity___________________________ 20
Service to the Public_________________________________________________ 20
Administration of the Social Security Program Abroad__________________ 22
Employee Relations____________________________________________________ 22
FINANCING THE PROGRAM_________________________________________________ 22
Retirement and Survivors Insurance Benefits___________________________ 23
Disability Insurance Benefits_________________________________________ 23
Health Insurance Benefits for the Aged________________________________ 23
Hospital Insurance Benefits___________________________________________ 24
Supplementary Medical Insurance Benefits______________________________ 24
Improvements in Hearings and Appeals Activities_______________________ 24
Administering the Federal Credit Union Program________________________ 25
Research Activities___________________________________________________ 27
Special Projects______________________________________________________ 28
Research Publications in Fiscal Year 1966_____________________________ 29
International Activities______________________________________________ 29
SUMMARY AND CONCLUSIONS_______________________________________________ 30
Table 1.—Federal credit unions: Assets, liabilities and capital, 1965_ 31
Table 2.—Federal credit unions: Selected data on operations, by State, Dec. 31, 1965____________________________________________ 32
255
256
Department of Health, Education, and Welfare, 1966
WELFARE ADMINISTRATION
Page
BUREAU OF FAMILY SERVICES___________________________________________ 35
New Legislation_____________________________________________________ 35
Medical Assistance—Title XIX________________________________________ 35
Increased Payments__________________________________________________ 36
Increases in Earnings Exemptions____________________________________ 36
Patients in Institutions____________________________________________ 36
Trends in Caseloads and Expenditures________________________________ 36
Caseloads___________________________________________________________ 37
Expenditures________________________________________________________ 37
Relation to Social Insurance________________________________________ 39
Program Developments________________________________________________ 39
Medical Care________________________________________________________ 39
Work Experience and Training Program________________________________ 40
Civil Rights Compliance_____________________________________________ 41
Social Services_____________________________________________________ 41
Demonstration Projects______________________________________________ 41
Repatriation Program________________________________________________ 42
Emergency Welfare Services__________________________________________ 42
Administrative Developments. _______________________________________ 43
Staff Development___________________________________________________ 43
New Policies________________________________________________________ 43
Organization and Management_________________________________________ 44
Review of State Operations__________________________________________ 44
Research____________________________________________________________ 45
Public Information__________________________________________________ 45
CHILDREN’S BUREAU___________________________________________________ 45
1966 Appropriations_________________________________________________ 46
Interdepartmental Committee on Children and Youth___________________ 46
State Committees for Children and Youth_____________________________ 46
Health Hazards of Smoking___________________________________________ 47
Youth Services______________________________________________________ 47
Physically Abused Children__________________________________________ 47
Programs of the Bureau______________________________________________ 47
Research in Child Life______________________________________________ 47
Some Facts and Figures__________________________________________ 48
Maternal and Child Health and Crippled Children’s Research Grants. 49
Child Welfare Research and Demonstration Grants_________________ 49
Maternal and Child Health and Crippled Children’s Services__________ 50
Mental Retardation Services_________________________________________ 51
Maternity and Infant Care Project___________________________________ 51
Family Planning_____________________________________________________ 51
Health of School and Preschool Children Projects____________________ 53
Services for the Multiply Handicapped_______________________________ 53
Child Welfare Services______________________________________________ 54
Juvenile Delinquency Service________________________________________ 57
International Cooperation___________________________________________ 60
United Nations International Children’s Fund (UNICEF)___________ 60
Training________________________________________________________ 60
Research Grants_________________________________________________ 61
International Conference on Inborn Errors of Metabolism_________ 61
Table 1.—Maternal and child health and welfare services_____________ 62
Detailed Contents
257
Page
OFFICE OF JUVENILE DELINQUENCY AND YOUTH DEVELOP-
MENT________________________________________________________ 63
Demonstration Projects________________________________________ 63
Training Projects_____________________________________________ 63
Technical Assistance__________________________________________ 64
CUBAN REFUGEE PROGRAM_________________________________________ 64
Children Reunited With Parents________________________________ 64
Voluntary Agencies Respond to Refugee Need____________________ 64
Program Appropriations________________________________________ 65
Financial Assistance__________________________________________ 65
Training of Professionals Continues___________________________ 65
Resettlement Continues as Major Objective_____________________ 66
OPERATIONAL PROGRAMS IN THE OFFICE OF THE COM-
MISSIONER___________________________________________________ 66
Welfare Research______________________________________________ 66
International Office__________________________________________ 67
Conferences___________________________________________________ 67
Cooperative Research__________________________________________ 68
Training______________________________________________________ 69
Vietnam_______________________________________________________ 70
Recruitment___________________________________________________ 70
PUBLIC HEALTH SERVICE
Health Record_________________________________________________ 74
BIRTHS, MARRIAGES, AND DIVORCES_______________________________ 75
Organization__________________________________________________ 75
Funds_________________________________________________________ 76
OFFICE OF THE SURGEON GENERAL_________________________________ 76
Health Planning_______________________________________________ 76
Guarding Individual Rights____________________________________ 77
Management Progress___________________________________________ 77
Public Information____________________________________________ 78
Health Statistics_____________________________________________ 78
International Health Activities_______________________________ 80
Emergency Health Preparedness_________________________________ 81
NATIONAL LIBRARY OF MEDICINE__________________________________ 82
BUREAU OF MEDICAL SERVICES____________________________________ 83
Division of Hospitals_________________________________________ 83
Division of Foreign Quarantine________________________________ 85
Division of Indian Health.,___________________________________ 86
Medical Facilities____________________________________________ 86
Hospitalization and Clinic Services___________________________ 87
Health Services_____________________________________________ 87
Program Planning and Evaluation_______________________________ 88
Environmental Health__________________________________________ 88
Maternal and Child Health_____________________________________ 89
Training Activities___________________________________________ 89
Construction of New Facilities________________________________ 89
Medical Services for Federal Agencies_________________________ 90
U.S. Coast Guard, Treasury Department____________________ __ 90
258
Department of Health, Education, and Welfare, 1966
Page
Bureau of Prisons, Department of Justice____________________ 90
Bureau of Employees’ Compensation, Department of Labor______ 91
Maritime Administration, Department of Commerce_____________ 92
BUREAU OF STATE SERVICES____________________________________ 92
Community Health____________________________________________ 92
Division of Accident Prevention_____________________________ 93
Division of Chronic Diseases________________________________ 94
Communicable Disease Center_________________________________ 96
Division of Community Health Services_______________________ 97
Division of Dental Health___________________________________ 98
Division of Hospital and Medical Facilities_________________ 99
Division of Medical Care Administration_____________________ 99
Division of Nursing_________________________________________ 100
Environmental Health—Office of the Bureau Chief____________ 100
Division of Air Pollution__________________________________ 101
Abatement__________________________________________________ 102
Motor Vehicles__________________________________________ 102
Interstate Polluiton___________________________________ 102
Federal Installations__________________________________ 102
Criteria___________________________________________________ 102
Program Grants and Air Pollution Trainees__________________ 102
New Interstate “Effects Network”___________________________ 103
Sulfur Compounds, Lead, Beryllium__________________________ 103
Division of Radiological Health____________________________ 103
Division of Occupational Health____________________________ 104
Division of Environmental Engineering and Food Protection_ 105
NATIONAL INSTITUTES OF HEALTH______________________________ 106
Basic Research_____________________________________________ 107
Molecular Biology__________________________________________ 107
Biomedical Engineering______________________________________ 108
Automation_________________________________________________ 108
Cardiovascular Research____________________________________ 109
Cancer Research___________________________________________ 110
Behavioral Science__________________________________________ 112
Kidney Disease_____________________________________________ 113
Rheumatic and Arthritic Diseases____________________________ 114
Disorders of Metabolism____________________________________ 114
Respiratory and Infectious Illnesses________________________ 115
Diseases of the Nervous System_____________________________ 116
Dental Research_____________________________________________ 117
Regional Medical Programs__________________________________ 118
Biologics Standards________________________________________ 119
International Research_____________________________________ 120
OFFICE OF EDUCATION
INTRODUCTION________________________________________________ 129
Planning for Assistance to Education_______________________ 131
EQUAL EDUCATIONAL OPPORTUNITIES____________________________ 132
STAFF WORK IN BEHALF OF THE DISADVANTAGED AND
HANDICAPPED_______________________________________________ 133
OPPORTUNITY FOR EDUCATIONALLY DEPRIVED CHILDREN. 135
SUPPLEMENTARY EDUCATIONAL CENTERS AND SERVICES.. 138
GUIDANCE, COUNSELING, AND TESTING___________________________ 139
Detailed Contents
259
Page
INSTRUCTIONAL MATERIALS AND EQUIPMENT__________________________ 140
School Library Resources, Textbooks, and Other Materials_______ 140
Strengthening Instruction in Critical Areas____________________ 141
Strengthening Instruction in the Arts and the Humanities_______ 142
Strengthening Undergraduate Instruction________________________ 142
IMPROVING QUALIFICATIONS OF SCHOOL PERSONNEL___________________ 144
National Teacher Corps_________________________________________ 144
Experienced and Prospective Teacher Fellowships________________ 144
Institutes for Advanced Study in 12 Areas______________________ 145
Institutes in the Arts and the Humanities______________________ 146
Counseling and Guidance Institutes_____________________________ 147
Training for Education of the Handicapped______________________ 147
ASSISTANCE TO FEDERALLY AFFECTED AND TO DISASTER
AREAS________________________________________________________ 151
School Construction____________________________________________ 151
School Maintenance and Operation_______________________________ 151
STRENGTHENING STATE DEPARTMENTS OF EDUCATION-_ 152
FINANCIAL AID FOR STUDENTS_____________________________________ 153
Educational Opportunity Grants_________________________________ 153
College Work-Study_____________________________________________ 154
Guaranteed Loans for Higher Education__________________________ 154
Guaranteed Loans for Vocational Education______________________ 155
National Defense Education Loan Funds__________________________ 155
Encouraging Utilization of Educational Talent__________________ 156
HIGHER EDUCATION FACILITIES____________________________________ 156
PAYMENTS TO LAND-GRANT INSTITUTIONS____________________________ 160
AID FOR DEVELOPING INSTITUTIONS________________________________ 160
NATIONAL DEFENSE FELLOWSHIPS___________________________________ 161
COLLEGE AND RESEARCH LIBRARY RESOURCES_________________________ 161
LIBRARIANSHIP TRAINING_________________________________________ 162
COMMUNITY SERVICE AND CONTINUING EDUCATION_____________________ 162
ADULT BASIC EDUCATION__________________________________________ 163
CIVIL DEFENSE ADULT EDUCATION__________________________________ 163
VOCATIONAL AND TECHNICAL EDUCATION_____________________________ 164
Programs Under Matched Funds----------------------------------- 164
Programs for Those in High School------------------------------ 165
Programs for Those Out of High School Preparing for Employment_ 165
Programs for Employed Adults----------------------------------- 165
Programs for Those With Handicaps______________________________ 166
Construction of Area Vocational Schools------------------------ 166
Ancillary Services and Activities------------------------------ 166
Work-Study_____________________________________________________ 167
Construction of Facilities in Appalachia_______________________ 167
Manpower Development and Training______________________________ 167
LIBRARY SERVICES AND CONSTRUCTION______________________________ 168
EDUCATIONAL TELEVISION FACILITIES______________________________ 169
ASSISTANCE FOR CUBAN REFUGEES__________________________________ 169
U.S. Loan Program for Cuban Refugee Students___________________ 169
Projects for Professional Personnel____________________________ 170
Aid to Dade County Public Schools______________________________ 170
SCIENCE CLUBS__________________________________________________ 170
INTERNATIONAL ORGANIZATIONS AND CONFERENCES____________________ 171
FOREIGN CREDENTIALS INTERPRETATION_____________________________ 173
LANGUAGE AND AREA CENTERS AND STUDIES__________________________ 173
260
Department of Health, Education, and Welfare, 1966
Page
National Defense Education Language and Area Centers_________ 173
National Defense Education Modern Foreign Language Awards.. 174
Language and Area Training for Mutual Understanding__________ 174
Summer Seminars and Travel Abroad____________________________ 175
Individual Study and Research Abroad_________________________ 175
Language and Curriculum Specialists From Abroad______________ 176
Foreign Studies Extension____________________________________ 176
TEACHER DEVELOPMENT AND EXCHANGE_____________________________ 176
Teacher Development__________________________________________ 177
Teacher Exchange_____________________________________________ 177
BILATERAL TECHNICAL COOPERATION______________________________ 178
SECONDARY AND NONGRANT VISITOR PROGRAM_______________________ 179
RESEARCH AND RELATED ACTIVITIES______________________________ 179
Cooperative Research Program_________________________________ 179
Research and Development Centers____________________________ 179
Regional Educational Laboratories____________________________ 180
Educational Research Information Center (ERIC)_______________ 182
Educational Research Training________________________________ 182
Project Research_____________________________________________ 182
Vocational Education Research and Training___________________ 183
Media for Educational Purposes_______________________________ 183
Language Development Research and Studies____________________ 184
Foreign Currency Financed Projects___________________________ 184
The Arts and the Humanities__________________________________ 184
Education of the Handicapped--------------------------------- 185
Captioned Films for the Deaf_________________________________ 185
Educational Materials Center_________________________________ 186
Demonstration Center----------------------------------------- 186
American Education___________________________________________ 187
NATIONAL CENTER FOR EDUCATIONAL STATISTICS__________________ 187
State Education Agency Statistical Services__________________ 188
ADMINISTRATION OF THE OFFICE_________________________________ 188
Field Reorganization_________________________________________ 190
FOOD AND DRUG ADMINISTRATION
Food, Drug, and Cosmetic Act_________________________________ 192
Food Activities______________________________________________ 192
Natural Disasters________________________________________ 192
Chemicals in Foods_______________________________________ 193
Food Poisoning___________________________________________ 194
To Keep Food Clean_______________________________________ 195
Economic Protection______________________________________ 196
Diet Foods and Supplements------------------------------- 196
Drugs and Devices____________________________________________ 197
New Drugs________________________________________________ 198
Veterinary Drugs and Medicated Feeds_____________________ 200
Illegal Sales of Prescription Drugs---------------------- 201
Devices__________________________________________________ 203
Cosmetics____________________________________________________ 203
Certification of Colors and Drugs---------------------------- 203
Hazardous Substances Labeling Act--------------------------- 204
Detailed Contents
261
Page
Enforcement of Other Acts____________.____________________ 204
Court Interpretations______________________________________ 205
Legislation and Regulation-Making Activities_______________ 206
Regulations________________________________________________ 206
Scientific Investigations__________________________________ 209
Education and Communication________________________________ 212
Enforcement Statistics____________________________________ 212
VOCATIONAL REHABILITATION ADMINISTRATION
New Legislation____________________________________________ 215
New Fiscal Arrangements________________________________ 216
Innovation Projects___________________________________ 216
Matching Local Contributions___________________________ 216
Expansion Grants_______________________________________ 217
Statewide Planning Grants______________________________ 217
Creating Workshops and Facilities______________________ 217
Evaluation of the Severely Disabled________________________ 218
Architectural Barriers_____________________________________ 218
Correctional Rehabilitation________________________________ 218
Research and Training Centers______________________________ 219
Research and Demonstration_________________________________ 219
The Training Program_______________________________________ 220
Social Security Disability Applicants______________________ 220
Rehabilitating Armed Forces Rejectees______________________ 221
Heart Disease, Cancer, and Stroke__________________________ 221
Services for the Blind_____________________________________ 221
The Mentally III___________________________________________ 221
Alcoholism_________________________________________________ 222
International Research_____________________________________ 222
ADMINISTRATION ON AGING
Introduction_______________________________________________ 227
Grants for Community Planning, Services, and Training------ 228
Grants for Research and Demonstration---------------------- 229
Grants for Training________________________________________ 229
Activities With Voluntary and Religious Organizations_____ 230
The Foster Grandparent Program_____________________________ 231
Senior Citizens Month______________________________________ 231
Relationship With Other Federal Agencies and Clearinghouse of
Information______________________________________________ 231
The Advisory Committee on Older Americans------------------ 232
The Nature of the Challenge________________________________ 233
SAINT ELIZABETHS HOSPITAL
Patient Population Trends---------------------------------- 235
Accreditation and Medicare_________________________________ 236
Treatment Program------------------------------------------ 236
262
Department of Health, Education, and Welfare, 1966
Page
The Youth Center____________________________________ 237
Professional Training and Education_________________ 237
Research____________________________________________ 238
Staffing____________________________________________ 239
Buildings and Facilities____________________________ 239
SURPLUS PROPERTY UTILIZATION
Program Activities__________________________________ 245
AMERICAN PRINTING HOUSE FOR THE BLIND
Services to Schools and classes for the Blind_______ 247
GALLAUDET COLLEGE
Program Emphasis____________________________________ 249
Research____________________________________________ 249
Enrollment__________________________________________ 249
HOWARD UNIVERSITY
Enrollment of Students______________________________ 251
Geographical Distribution of students_______________ 251
Veterans____________________________________________ 252
Army and Air Force ROTC_____________________________ 252
The Faculty_________________________________________ 252
Varied Activities of the Faculty and Staff__________ 253
. Graduates_________________________________________ 253
Significant Program Developments____________________ 253
The Building Program________________________________ 254
U.S GOVERNMENT PRINTING OFFICE: 1967
U005 00430350 7
HV
85 . A3812 1965/66
University of Louisville Libraries