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assistance for those persons who do not qualify under OASDI, but we are fully convinced that the social insurance mechanism is the soundest approach to meeting medical need for the great bulk of aged persons.
The association, as a result of its studies, has included in its Federal legislative objectives, which are reviewed each year by the association's board of directors, the following statement:
"Health costs of old-age, survivors, and disability insurance beneficiaries should be financed through the OASDI program. Arrangements for achieving this objective should take into account the priority needs of the groups to be served; availability of facilities, personnel, and services; and protection and encouragement of high quality of care, including the organization of health and related services to effect appropriate utilization of services and facilities."
As this policy statement indicates, we are in full accord with the principle of amending the OASDI program to include the financing of certain health benefits for social security beneficiaries. We believe that it is not the wish of the American people that substantial numbers of our aged citizens be required to turn to public assistance for help with their medical needs. Whereas cash benefits under the OASDI program in many instances may be sufficient for the individual's average maintenance requirements, it is rare that medical costs of an unpredictable or large character can be met unless the aged or disabled person has considerable other income and resources. It has been established that only a small proportion of aged and disabled people fall into this fortunate group. We strongly urge, therefore, the establishment of a program of health benefits for social security beneficiaries as part of OASDI. This program, together with the expansion of OAA to provide better for the medical needs of persons not eligible under social insurance or whose needs cannot be fully met in that way, would give to all aged persons the assurance that they will not have to go without essential medical care when their working years are over. We subscribe to the principle of financing the costs of any health insurance benefits to OASDI beneficiaries through the contributory social insurance program so widely accepted by the American people. We believe that it is both proper and desirable for all employers, employees, and the self-employed to finance the costs so that individuals during their working years will build for themselves health insurance coverage which will meet their needs after retirement. It appears that voluntary insurance cannot accomplish this for any large number of persons within the reasonably near future.
SUPPORT FOR OTHER PROVISIONS IN THE BILL
We should like to comment briefly on some of the social insurance provisions in H.R. 12580. It appears to us that the recommendations for change, both major and minor, are in the right direction. We are particularly pleased with the removal of the age 50 limitation for disability insurance benefits. We support strongly, too, the measure which would strengthen the rehabilitation aspects of the disability program by providing a 12-month period of trial work during which benefits would be continued for all disabled workers who attempt any planned rehabilitation rather than limiting this trial work period to those receiving services under the official Federal-State vocational rehabilitation program, as at present.
We support the change in the insured status requirement for retired workers, the new benefit protection provisions for widows and children, and the extension of coverage to self-employed physicians and to a number of other groups.
We are pleased to note that the authorization for appropriation for the maternal and child health services program would be increased to $25 million and the services for crippled children authorization to $25 million. We are disappointed that the bill proposes that the authorization for appropriation for the child welfare program be increased only to $20 million. Our studies of needs in this program indicate that this authorization, too, should be increased to $25 million and we have previously recommended this to the Congress. The new authorization for research and demonstration projects in the child welfare services program, which would permit grants to public and other nonprofit institutions and agencies for this purpose, would meet an existing need for further study in the child welfare field.
FEDERAL LEGISLATIVE OBJECTIVES, 1960
(Prepared by Committee on Welfare Policy, American Public
The American Public Welfare Association believes that the States and their political subdivisions have the primary responsibility for developing and administering effective public welfare services in the United States. The Federal Government has the obligation to develop nationwide goals and to use its constitutional taxing power to equalize the financing of public welfare so that public welfare services may be available on a reasonably equitable basis throughout the country. The States, their political subdivisions, and the Federal Government, in cooperation, must provide the leadership and the professional and technical personnel to carry out these obligations. The association's legislative objectives are based on these premises and on the recognition of the importance of preserving and strengthening family life, encouraging selfresponsibility, and assuring humanitarian concern for individuals and families. To accomplish these purposes the association believes that:
Contributory social insurance is a preferable governmental method of protecting individuals and their families against loss of income due to unemployment, sickness, disability, death of the family breadwinner, and retirement in old age;
Public welfare programs should provide effective services to all who require them including financial assistance and preventive, protective, and rehabilitative services, and these services should be available to all persons without regard to residence, settlement, or citizenship requirements; The benefits of modern medical science should be available to all; and to the extent that individuals cannot secure them for themselves governmental or other social measures should assure their availability;
Democracy has a special obligation to assure to all the Nation's children full and equitable opportunity for family life, healthy growth, and maximum utilization of their potentialities.
These general principles are amplified in other policy statements approved by the board of directors of the association. The welfare policy committee of the association has reviewed all of these statements in the light of current needs and has developed specific legislative objectives for 1960. While the following list does not include all of the association's policy positions, it presents in condensed form those immediate and longer range legislative objectives which are most likely to be of current significance in improving public welfare services.
Scope of program
PUBLIC WELFARE PROGRAMS
1. The comprehensive nature of public welfare responsibility should be recognized through Federal grants-in-aid which will enable the States to provide not only financial assistance (including medical care) and other services for the aged, the blind, the disabled, and dependent children, but also general assistance and services for all other needy persons.
2. Federal financial aid should be available to assist States in carrying out public welfare responsibility for preventive, protective, and rehabilitative services to all who require them, irrespective of financial need.
The Federal Government should participate financially in State and local projects which would encourage, extend, or establish programs for self-support, self-care, or the rehabilitation of persons receiving or likely to need public assistance.
3. The Federal Government should participate financially only in those assistance and other welfare programs which are available to all persons within the State who are otherwise eligible without regard to residence, settlement, or citizenship requirements.
4. In order to strengthen family life, the aid to dependent children program should provide Federal aid to the States for any needy child living in the home of any relative.
5. Specific provisions should be made for Federal financial participation in the maintenance of children in foster care.
6. Child welfare services in the Social Security Act should be broadened in scope, should specifically include child welfare srevices for the delinquent child, and the funds authorized and appropriated should be increased in all States sufficiently to extend and improve their programs compatible with the
growing child population and the continuing advances in knowledge which make more effective services attainable.
Specific provision should be made for Federal financial assistance to States to stimulate and support programs for the prevention and control of juvenile delinquency. This should include research and the training of personnel.
7. The category of aid to the permanently and totally disabled should be modified by eliminating the Federal restriction requiring a disability to be permanent and total and by eliminating the age requirement so that all needy disabled persons may be aided under the program.
8. The Federal Government should participate financially in the development of specialized services for the aged, irrespective of financial need.
9. The Federal Government, in cooperation with the States, should study the restriction on Federal financial participation in assistance payments to adults living in public nonmedical institutions.
Methods of financing programs
10. The continuation of the Federal open-end appropriation is essential to a sound State-Federal fiscal partnership in all aspects of public assistance. Since it is not possible to predict accurately the incidence and areas of need, flexibility, and comprehensiveness are necessary in financing public assistance programs.
11. Federal financial participation should be on an equalization grant basis provided by law and applicable to financial assistance (including medical care) for all needy persons, welfare services (including child welfare), and administration.
12. Any maximums on Federal participation in public assistance (including medical care) should continue to be related to the average payment per recipient and should be increased sufficiently to assure reasonable standards of maintenance, comprehensive medical care of high quality and appropriate quantity, and the preservation and strengthening of family life.
Federal participation in aid to dependent children should be increased to a level which will assure treatment of children equitable with that accorded. other public assistance recipients.
13. There should be no reduction in the overall Federal proportion of assistance and service expenditures unless and until changes in the scope and adequacy of Federal legislation affecting public assistance and social insurance enable the States to meet needs more effectively.
14. No change should be made in the Federal matching formulas which would result in a reduction in the Federal share of State and local administrative costs.
15. Federal aid for public assistance should be on the same basis for Puerto Rico, the Virgin Islands, and Guam as for other jurisdictions. In particular, the annual dollar limitations on Federal participation should be removed.
16. The Federal Government should participate financially in the costs of any State and local civil defense welfare services.
17. Federal legislation should provide funds for American nationals in need of assistance and other services who are repatriated from abroad.
18. States should have the option to administer Federal funds for assistance and services by categories or by a single comprehensive program covering all needy persons.
19. Adequate and qualified personnel is essential in the administration of public welfare programs. Federal financial participation in administrative costs of State welfare programs should be sufficient to enable States to provide for the adequate administration of all welfare programs.
20. Adequate Federal funds should be authorized on a permanent basis to assist States in training staff for State and local public welfare programs and moneys should be appropriated for this purpose.
21. All public welfare programs in which the Federal Government participates financially should be administered by a single agency at the local, State, and Federal level.
22. Federal, State, and local public welfare agencies should participate in and assist in the administrative coordination of all related programs in which there is Federal financial participation.
23. The administration of the Children's Bureau should be maintained within the Social Security Administration.
SOCIAL INSURANCE PROGRAMS
24. The contributory old-age, survivors, and disability insurance program, as a preferable means of meeting the income-maintenance needs of people and as a means of keeping the need for public assistance to a minimum, should be strengthened. Among the needed improvements are: making benefit payments more adequate, increasing the amount of earnings creditable for contribution and benefit purposes in line with current conditions, providing benefits for disabled insured persons of any age and for their dependents, extending coverage to earners still excluded.
25. Health costs of old-age, survivors, and disability insurance beneficiaries should be financed through the OASDI program. Arrangements for achieving this objective should take into account the priority needs of the groups to be served; availability of facilities, personnel, and services; and protection and encouragement of high quality of care, including the organization of health and related services to effect appropriate utilization of services and facilities.
26. The funds of the insurance program should be available to help restore persons on the OASDI disability rolls to gainful employment since such expenditures would result in a net saving to the fund and increase the number of persons rehabilitated.
27. To the extent that changes to improve the OASDI program increase the cost of the program, contributions should be increased to insure the financial stability of the program.
28. The membership of the Advisory Council on Social Security Financing, established by the 1956 amendments, should include representation from public welfare and its functions should be broadened to include responsibility for recommending improvements in all aspects of old-age, survivors, and disability insurance, with particular emphasis on methods of keeping the program in line with current economic conditions and with changes in levels of living, and as a means of keeping the need for public assistance to a minimum.
29. Adequate and qualified personnel are essential in the administration of the old-age, survivors, and disability insurance program. Federal funds should be utilized for the professional training of staff in institutions of higher learning. Unemployment insurance
30. The unemployment insurance program, as a preferable means of meeting the income-maintenance needs of unemployed people and as a means of keeping the need for public assistance to a minimum, should be strengthened. Among the needed improvements are establishing Federal standards which would assure more adequate benefit payments including benefits for dependents; extension of coverage to earners still excluded; provision for a minimum duration of benefits and appropriate extension of the duration during any period of extended unemployment; provision for more equitable eligibility conditions; provisions for less restrictive disqualification requirements; and an increase in the amount of earnings creditable for contribution and benefit purposes in line with current conditions.
Other social insurance
31. Study should be given to ways of improving and extending, on a sound social insurance basis, temporary disability insurance benefits and workmen's compensation programs, with emphasis on planning for effective medical care and vocational rehabilitation.
RESEARCH AND DEMONSTRATION PROJECTS
32. Federal funds should be authorized and appropriated for research and demonstration projects in all aspects of social security and public welfare.
33. The Federal Government should provide leadership, funds, and research for the promotion of health and the prevention of sickness and disability contributing to dependency. Federal health programs should encourage and enable State and local health departments to make a more effective contribution to broad programs of physical restoration. In view of the increasing number of children and the increasing cost of medical service, the amounts authorized and appropriated for maternal and child health and crippled children's services in the Social Security Act should be increased.
34. Public welfare has a responsibility to assure that comprehensive rehabilitative services are made available to persons who require them. In carrying out this objective, public welfare programs have the responsibility to restore individuals to self-care and independent living and to strengthen family life. As part of this responsibility, public welfare agencies are concerned with the availability of adequate vocational rehabilitation services for individuals who can benefit from them.
Since many eligible individuals in the United States still are deprived of vocational rehabilitation services, such services should be strengthened so that all vocationally handicapped persons who present reasonable possibilities of attaining a vocational objective would be served. The vocational rehabilitation program also should be strengthened by permitting States to designate the State agency which can most effectively administer this program.
35. Federal programs should provide more effective aid to help meet the needs of mentally retarded and other handicapped children.
36. The nonquota entry of foreign-born orphans should be limited to children who are placed for adoption in the United States with the approval of authorized social agencies, and to children who are adopted abroad by U.S. citizens residing in the country where the adoption takes place.
37. The Federal Fair Labor Standards Act should be amended to extend coverage and to increase the minimum wage in line with current conditions.
38. Federal programs should provide more effective aid to help meet the needs of migratory workers and their families.
JUNE 27, 1960.
Hon. HARRY F. BYRD,
Chairman, Senate Committee on Finance,
DEAR MR. CHAIRMAN: I am informed that on Tuesday, June 28, your committee will meet in executive session to consider H.R. 12580 and related proposals amending the Social Security Act.
In this connection I would appreciate your consideration of a bill which I filed on Wednesday, June 23, which would amend title II of the Social Security Act and the Internal Revenue Code so as to increase the minimum insurance benefits payable under such title, to increase the amount of earnings upon which such benefits are based, to increase the amount of such benefits payable to widows, widowers, and parents, to increase the amount of earnings permitted without loss of benefits, and for other purposes. I believe this is a modest, constructive and self-sufficient package making needed changes in our social security system. Enclosed is a copy of the bill, S. 3725, and my remarks in its regard as they appeared in the Congressional Record.
Thank you for your consideration.