March 8, 1963
PAGE 3795
SIMPLIFICATION OF FEDERAL GRANTS-IN-AID TO STATES FOR PUBLIC HEALTH SERVICES
Mr. MUSKIE. Mr. President, for myself and Senators BARTLETT, ERVIN, McCARTHY, MCGEE, MOSS, MUNDT, NELSON, PEARSON, PROUTY, RANDOLPH, TOWER, and WILLIAMS of New Jersey, I introduce, for appropriate reference, a bill which would simplify Federal grants-in-aid to States for public health services and provide greater flexibility in the allocation of certain categorical public health service funds in the States. Similar legislation has been introduced in the House of Representatives.
This proposed legislation was drafted as the result of the second report to the President by the Advisory Commission on Intergovernmental Relations, of which I am a member.
Last year, on August 1, 1962, 1 introduced S. 3592, legislation designed to simplify grants-in-aid to the States for public health services to permit greater State flexibility in the use of public health allotments. I plan to reintroduce that measure now.
The proposed legislation originated under the title S. 1467, a bill I introduced on March 29, 1961. S. 3592 included technical changes in the bill. It reflects both the judgment of the Advisory Commission on Intergovernmental Relations, of State health officers, and other experts in the field. Formal resolutions urging enactment of the measure have been adopted by the Governors' conference, the executive committee of the National Conference of State Legislative Leaders, the National Association of State Budget Officers, Midwestern Regional Conference of the Council of State Governments, the National Association of County Officials, the American Municipal Association, and the National Legislation Conference of the Council of State Governments.
The bill which I have introduced today would amend the Public Health Service Act of 1944, to permit States, at the discretion of the Governor in each case, to transfer up to one-third of the Federal funds granted in any one of five health categories to one or more of the other four such categories. The following five categorical grants are involved: General health assistance, cancer control, heart disease control, tuberculosis control, and venereal disease control. The bill would not affect the remaining categories of mental health, maternal and child health, and crippled children's services.
In addition, the bill would establish a uniform allotment and matching formula for Federal grants to States in the special categories listed above. A number of different formulas now apply to these five categories.
Under the bill, funds would be allocated to the States on the basis of population, with matching requirements established according to per capita income in the individual States. Matching requirements would range from one-third State funds to two-thirds Federal funds -for the lowest income States, to two-thirds State funds to one-third Federal funds for the highest income States. This formula follows the general principle established under the Hill-Burton program.
This proposal, Mr. President, is designed to improve the flexibility of federally supported public health service programs administered by the States, without removing the present overall direction of these programs in accordance with the priorities set by Congress. Initially, several of these categories were established to allow the Federal Government to stimulate State activity. Today the major cost is borne by the States, with the Federal Government playing an important supporting role.
By allowing the States to transfer up to one-third of the funds in the five categories listed, we would provide sufficient flexibility for State administrators in meeting peculiar and changing local needs, without endangering the integrity of the overall program. It should be noted that the proposed allowance for transfers would not be applied to the categories of mental health, maternal and child health, and crippled children’s services, since functional lines of responsibility between the Federal Government and the States do not coincide in these categories.
This bill, Mr. President, represents the considered opinion of members of the Advisory Commission on Intergovernmental Relations, State and Territorial health and budget officers, and other experts in this field. It offers a sensible -improvement in an important facet of intergovernmental relations.
The VICE PRESIDENT. The bill will be received and appropriately referred.
The bill (S. 1051) to amend section 314 of the Public Health Service Act, by providing greater flexibility to States in the use of certain public health grants-in-aid, and for other purposes; introduced by Mr. MUSKIE (for himself and other Senators), was received, read twice by its title, and referred to the Committee on Labor and Public Welfare.