Treatment and retraining of handi- Director: Michael J. Shortley. capped persons. Over-all administration. Administrator: Oscar Ross Ewing; 1 Anticipated benefit payments from OASI trust fund. While the Children's Bureau has important health functions, it is now part of the Social Security Administration and thus included here in the security group. The "security" group of the constituent units of the Federal Security Agency, with about one-third of the total personnel, will have control over more than 92 percent of the total PUBLIC ASSISTANCE AND THE FEDERAL GOVERNMENT At the present time there is no Federal participation in general assistance, or direct public relief, other than for the categorical aid programs (old-age assistance, aid to the blind, and aid to dependent children). Both total costs and the Federal share for these programs have steadily increased, despite high prosperity and employment. There is a movement to obtain regular Federal aid for general assistance as well as categorical programs, and its is general assistance which fluctuates most directly with the level of economic activity. If such proposals are adopted, they would greatly increase Federal expenditures and administrative scope even under full employment. IN THE EVENT OF A DEPRESSION It is to be hoped that the Nation will not again face an economic crisis such as that of the thirties, with widespread unemployment and acute distress. Nevertheless, the possibility must be faced. During that period, the Federal administration obtained congressional approval for unprecedented welfare measures. A large group of powerful independent agencies were established for direct and work relief, including the Civil Works Administration, the Federal Emergency Relief Administration, the Public Works Administration, Civilian Conservation Corps, National Youth Administration and Works Progress Administration. These agencies accounted for a major share of Federal expenditures in the thirties. While some of them continued in existence for several years after the economic emergency had subsided, nevertheless, as temporary agencies, they were eventually disbanded. With a Cabinet Department of Health, Education and Security, the logical place for the expansion of relief measures would be within that Department. Functions that in the thirties were assigned to temporary agencies would probably go to the Department; indeed, the Department would likely have sufficient political strength to play a major part in initiating legislation to this effect. There is dan ger that a single Cabinet department, combining extensive regular functions with a new FERA, WPA, NYA, and CCC, might obtain such power and control over public funds as to constitute a real threat to democratic government and freedom of enterprise. Then, too, incorporation of emergency functions in a permanent department may tend to have the effect of perpetuating such functions long after the reason for their establishment has disappeared. These possibilities may seem remote at present, but they merit careful consideration from both Congress and the public in weighing the cabinet proposal. TABLE 3.-Provisions of S. 140 Introduced by: Fulbright, Democrat, Arkansas; Taft, Republican, Ohio. Date: January 10, 1947. Disposition: Reported with amendment by Aiken, Republican, Vermont, by Committee on Expenditures in the Executive Departments, on June 6, 1947. Title: "Health, Education, and Security Department Act of 1947": A bill to create an executive department of the Government to be known as the Department of Health, Education, and Security. Administrative heads: Under direction of the Secretary of Health, Education, and Security at $15,000 a year. (The secretary is to appoint advisory committees to consult on matters of policies and procedures.) Under Secretary for Health at $12,000 a year. (One of these to act as Secretary in case of absence or vacancy in the Secretary's office). Purpose of department: "To promote the general welfare of the people of the United States by aiding and fostering progress * * * in the fields of health, education, public welfare, and related services. Duties of Department: * * * 1. Promote, foster, and encourage the development 2. Collect and analyze statistics and make studies, investigations, and reports on conditions in those fields in the United States and other countries, and disseminate and make available information in those fields. 3. Make reports and recommendations with respect to the most effective policies and methods for the promotion of health, education, public welfare, and related services, including recommendations with respect to legislation and matters of administrative policy. 4. Advise and cooperate with international organizations functioning in those fields. 5. Administer such Federal programs, including grants-in-aid, and such powers, functions, and duties in those fields as are assigned to it or provided through this or subsequent legislative enactment. Administrative system: Creates the following bureaus, with designated transfers. Divisions of the department are to be, in order of descending ranking, bureaus, divisions, branches, sections, and units. Bureau of Health: United States Public Health Service, Food and Drug Bureau of Education: United States Office of Education plus Howard Uni- Bureau of Public Welfare: Social Security Administration. Transfers existing personnel, equipment, appropriations, etc., of the foregoing agencies. In addition, the Secretary is authorized to appoint a general counsel and to create such additional divisions, branches, etc., as he deems necessary. Grants-in-aid: The Secretary is directed to establish uniform standards and procedures relating to fiscal, personnel, and other requirements for grants, and standards and procedures to enable State agencies receiving more than one grant to submit a single plan of operation and to be subject to a single fiscal and administrative review of its operation. Reports to Congress: The Secretary is required to prepare a report to Congress at the close of each fiscal year, giving an account of expenditures, describing the work done by the Department, and making such recommendations as he deems necessary. Effective date: 90 days after date of enactment. Transfers of other agencies: Director of the Bureau of the Budget is authorized and directed to study activities of other departments and agencies in the Federal Government and report to Congress on whether any of them should be transferred to the new department in the interest of economy and simplicity of administration. WHAT ABOUT THE FURTHER DEVELOPMENT OF FEDERAL AND STATE RELATIONSHIPS? Of more immediate interest is the need for a clear definition of the division between Federal, State, and local responsibility for matters of health, education, and public welfare. Expansion of social activities at all levels of government has been piece-meal, in response to specific needs and demands. The line of demarcation between areas of responsibilities grows ever hazier. There are those who believe that these matters are and should be the responsibility only of States, individuals and communities. In contrast, others believe that local groups cannot be relied on to handle them, and that the Federal Government alone should take over the task of providing health and social services. By way of compromise between these two extreme views, the grants-in-aid principle has been the means of extending Federal participation (chart 4). * The effect of a Cabinet department may be to hasten Federal encroachment. The bill would not prevent such a development. Its only safeguard of local and voluntary interests is the following sentence in the bill: "* * Nothing in this act shall be construed as conferring on any Federal officer or employee the right to exercise any supervision or control over the administration, personnel or operation of any State or local agencies, public or voluntary, in the fields of health, education, public welfare or related services * This sentence, added by the Senate Committee on Expenditures in Executive Departments, replaced the original wording in the bill as introduced by Senators Fulbright and Taft: * * "" 67* * * The Department shall promote the general welfare of the people of the United States by aiding and fostering progress throughout the Nation in the fields of health, education, security, and related services contributing to individual, family, and community well-being; and these objectives shall be carried out to the fullest possible extent through State and local agencies, public and voluntary, and in such manner as to preserve and protect to the highest possible degree the independence and autonomy of State and local agencies, public and voluntary, in education, health, security, and related fields * * * Chart 2.-Public expenditures for health and medical care services. Total public expenditures for health and medical care services increased 58.5 percent from 1941 to 1945, while the Federal share increased 167 percent. Not included are health services incidental to other functions, such as public assistance, the Army, the Navy, and education. Source: Social Security Yearbooks. Chart 3.-Total costs for categorical aid programs of public assistance (old-age assistance, aid to the blind and aid to dependent children). Total costs for these programs have risen 68 percent in 7 years, while the Federal share has nearly doubled. Source: Social Security Administration. Includes benefits and administration. Column marked (1) excludes administrative costs paid from State sources; not yet available. |