This booklet traces the historical development of the Department of Health, Education, and Welfare. HEW was established April 11, 1953 by Reorganization Plan No. 1 of 1953, which abolished its predecessor organization, the Federal Security Agency (July 1 , 1939) and transferred all components and functions of FSA to the new Department.
The need for grouping such activities into a Cabinet-level Department had long been recognized. In 1923, President Harding proposed a Department of Education and Welfare, which also was to include health functions. In 1924, the Joint Committee on Reorganization recommended a new department similar to that suggested by President Harding. In 1932, one of President Hoover's reorganization proposals called for the concentration of health, education and recreational activities in a single executive department.
The President's Committee on Administrative Management in 1937 recommended the placing of health, education and social security functions in a Department of Social Welfare. This recommendation was partially implemented in 1939 with the creation of the Federal Security Agency, by which action the Congress indicated its approval of the grouping of these functions in a single agency.
A new department could not be proposed at that time because the Reorganization Act of 1939 prohibited the creation of additional executive departments. In 1949, the Commission on Organization of the Executive Branch of the Government proposed the creation of a department for social security and education.
This historical narrative begins with a brief chronology of the Federal Security Agency, followed by a longer and more detailed account of the key events of each year- in the history of the Department, including organizational changes, legislative enactments, and programmatic highlights.
As the story of the Federal Security Agency makes clear, however, the agencies which were grouped into FSA and later into the Department have origins which can be traced back well beyond 1939-to 1798 in the case of the Public Health Service, to 1867 for the Office of Education, and to 1935 for the Social Security Administration.
Other features of this booklet include a composite organizational chart illustrating how agencies of the Department have been absorbed by other agencies or have been split into new agency-level components; the budgetary development of the Department since 1953; a yearly employment table; and key officials of the Department and the years they served.
This publication has been prepared as a public service for the many persons who have expressed an interest in the historical background of the Department.
July 1, 1972 Washington, D. C.
The Federal Security Agency was established on July 1, 1939, under the Reorganization Act of 1939, P.L. 76-19. The objective was to bring together in one agency all Federal programs in the fields of health, education, and social security. The first Federal Security Administrator was Paul V. McNutt.
The new agency originally consisted of the following major components: the Office of the Administrator; the Public Health Service; the Civilian Conservation Corps; the Office of Education; and the Social Security Board.
The origins of these components, however, could be traced back to the early days of the Republic. On July 16, 1798, President John Adams signed an act creating the Marine Hospital Service to furnish treatment to sick and disabled American merchant seamen. On April 29, 1878, the first Federal Quarantine Act enlarged the Service's responsibilities to include prevention of epidemics from abroad. On August 14, 1912, the name was changed to the Public Health Service. On May 26, 1930, the Hygienic Laboratory of the Service was redesignated the National Institute of Health. The Public Health service was transferred from the Treasury Department to the Federal Security Agency in 1939.
Even though the first steps toward public education were taken in 1647 by the Massachusetts Bay Colony and land was set aside for public schools by the Congress of the Confederation in 1785, the idea of universal, free public schools did not become firmly established until the Civil War era. Even then, only half of the States had an efficient public school system. In 1867, Congress established the Department of Education to promote the cause of education and collect and disseminate facts and statistics about education. Until it was transferred to the Federal Security Agency, the Office of Education and its predecessor organization had been part of the Department of the Interior.
The Civilian Conservation Corps, which was born during the great depression to provide employment for American youth and advance conservation of the Nation's natural resources, operated from April 5, 1933, until June 30, 1942. During that time, the CCC provided work training to 3 million men and advanced conservation by more than 25 years. It was an independent agency until it came to FSA.
The Nation's social security and public assistance programs also were born during the depression with approval of the Social Security Act on August 14, 1935. The initial Act of 1935 established the Social Security Board to administer Titles I, II, III, IV, and X of the Act, and it remained an independent organization until its transfer to FSA. The Social Security Act Amendments of 1939 revised and expanded basic provisions of the program and eligibility requirements and extended protection to aged wives, dependent children and certain survivors of insured workers.
Organized in 1855 and incorporated by the Kentucky Legislature in 1858, the American Printing House for the Blind was established to produce educational materials for the blind and since 1879 has received an allocation of Federal funds to help support this activity. Federal responsibility regarding the Printing House was transferred to FSA from the Treasury Department on July 1, 1939.
Established in 1935 to provide youth with work training, the National Youth Administration later trained young people for jobs in war industries. It was supervised by the Office of the Administrator from the time FSA was created in 1939 until 1942, when it was transferred to the War Manpower Commission.
Under a Reorganization Plan which became effective on June 30, 1940, the organization of the Federal Security Agency was enlarged: The Food and Drug Administration was transferred from the Department of Agriculture; and Saint Elizabeths Hospital, Freedmen's Hospital, and Federal functions relating to Howard University and the Columbia Institution for the Deaf were transferred to FSA from the Department of the Interior.
As a result of pressure for the Federal Government to control adulterated and misbranded foods and drugs, the Food and Drugs Act was enacted on June 30, 1906. These responsibilities were entrusted to the Bureau of Chemistry in the Department of Agriculture in 1907 and were organized into a Food, Drug and Insecticide Administration in 1927, renamed the Food and Drug Administration in 1931. Transferred to FSA in 1940, FDA also was responsible for administering the Tea Importation Act (1897), the Filled Milk Act (1923), the Caustic Poison Act (1927), and the Food, Drug, and Cosmetic Act (1938).
Saint Elizabeths Hospital, created by Act of Congress in 1852 as the Government Hospital for the Insane, received its first patients on January 15, 1855. Founder of Saint Elizabeths was Dorothea Dix, the most prominent humanitarian of the era. The name was changed by Act of Congress in 1916.
Freedmen's Hospital was an outgrowth of the Bureau for the Relief of Freedmen and Refugees authorized by the Act of March 3, 1865. In 1871, the Hospital was transferred to the Department of the Interior. Howard University was established by an act of March 2, 1867, to provide higher education for Negroes. Education for the deaf was made available in the District of Columbia through the Columbia Institution for the Deaf, which was established by the Act of February 16, 1857. The name was changed to Gal laudet College in 1954.
The Vocational Rehabilitation Act Amendments of 1943 expanded functions relating to vocational rehabilitation and assigned them to the Federal Security Administrator, who established the Office of Vocational Rehabilitation on September 4, 1943, to carry out these functions. Since the original Vocational Rehabilitation Act of 1920, certain vocational rehabilitation and vocational education activities had been a responsibility of the Office of Education, first when it was part of the Department of Interior, then after it became part of FSA in 1939.
World War II had a broad impact on the social programs of FSA. Between 1941 and 1947, the Government recognized the need to maintain essential health and welfare services. The Federal Security Administrator also served as coordinator of the Office of Health, Welfare, and related Defense Activities, renamed the Office of Defense, Health, and Welfare Services in September 1941, which provided health care, education, and related services necessitated by the war effort. It was responsible for adjusting the distribution of remaining professional personnel to meet the requirements of the population. In 1943, the Office's title was again changed to the Office of Community War Services, which was abolished on June 30, 1947.
The Food and Drug Administration during the war was charged with maintaining food standards to insure delivery of properly tested foods and drugs to the military establishment. The Public Health Service was in charge of protecting both the general population and military personnel against epidemics and carrying out medical research.
When the war ended, President Truman moved to "strengthen the arm of the Federal Government for better integration of services in the fields of health, education, and welfare."
Reorganization Plan No. 2 of 1946, effective July 16, 1946, abolished the three-man Social Security Board, creating in its place, the Social Security Administration, headed by a Commissioner of Social Security. The plan transferred the Children's Bureau (created in 1912), exclusive of its Industrial Division, from the Department of Labor to FSA, where it became part of the Social Security Administration; the U. S. Employees Compensation Commission, formerly an independent organization, to the Office of the Administrator of FSA; functions of the Department of Commerce regarding vital statistics to the FSA Administrator, who delegated them to the Surgeon General of the Public Health Service.
Legislation of major importance to the Agency also was passed in 1946: the National Mental Health Act; the Vocational Education Act; the Federal Employees Health Act; the 1946 Amendments to the Social Security Act; and the Hospital Survey and Construction Act.
In 1947, the Administrator directed the establishment of a central library, consolidating the resources of three independent libraries at the Social Security Administration, the Office of Education, and the Office of Vocational Rehabilitation. This library eventually became the central library of the Department of Health, Education, and Welfare.
By 1948, the retail price of food had risen 114 percent over the 1935-39 base, yet the monthly benefits under social security had not changed since the 1939 amendments had established a base level. On October 1 , 1948, increases in social security benefits were authorized.
Other key pieces of legislation passed in 1948 included bills creating the National Heart Institute and the National Institute of Dental Research. On June 16, 1948, the name of the National Institute of Health was changed to the National Institutes of Health. On June 30, 1948, the President signed the Water Pollution Bill, delegating national water pollution responsibilities to the Public Health Service. Also in 1948, legislation authorized the transfer of the Federal Credit Union program from the Federal Deposit Insurance Corporation to the Social Security Administration.
The Federal Property and Administrative Services Act of 1949 gave the Federal Security Administrator authority to dispose of surplus Federal propel property to tax-supported or nonprofit educational institutions for health or educational purposes.
During 1949, the Federal Security Agency began the establishment of 10 FSA regional offices to replace the 11 previously operated by the Social Security Administration and consolidated those being operated by other FSA constituents into one common regional office structure. Previous to the consolidation, constituent agencies were maintaining five and, in some cases, six independent regional offices in a single city.
On May 24, 1950, Reorganization Plan No. 19 of 1950 transferred from FSA to the Department of Labor the Bureau of Employees Compensation and the Employees Compensation Appeals Board. Then, the Federal Security Administrator abolished the Office of Special Services, which had administered the two transferred units plus the Office of Vocational Rehabilitation and the Food and Drug Administration. The effect of this action was to elevate OVR and FDA to agency status.
In 1950, two important national conferences required months of staff work by FSA personnel. The Mid-century White House Conference on Children and Youth was held in Washington, D.C. in December 1950. Nearly 6,000 representatives of 100,000 local and community groups throughout the country met to discuss the "spiritual values, democractic practice, and the dignity and worth of the individual." In August of that year, a Conference on Aging was called by the FSA Administrator to study the needs and problems of the older segment of the population.
In September 1950, Congress authorized the impacted aid program-to relieve the impact on local school facilities of a heavy influx of Federal civilian and military personnel-and in FY 1951 appropriated $96.5 million for school construction under P.L. 81-815, September 23, 1950, and $23 million for school operating expenses under P.L. 81-874, September 30, 1950.
The Social Security Act Amendments of 1950 added to the social security rolls about 10 million persons who previously had been ineligible. These persons included agricultural workers and selfemployed small shop owners. Others who benefitted from the changes were the elderly and those who had job-related disabilities. This expansion of beneficiaries was made possible by revisions to the oldage and survivors insurance and long-term disability insurance sections of the original Act.
In May of 1951, a citizens committee, the National Mid-century Committee for Children and Youth, was established to provide national follow-up to the problems discussed at the White House Conference. Staff of the Children's Bureau worked closely with the Committee until it was dissolved in 1953.
The year 1952 was a period of transition for FSA. Despite the contributions made by the Agency during and before the Korean War, most of the defense-related activities in FSA were being phased out. The Food and Drug Administration continued to study chemical and bacteriological warfare agents but other FSA components were mobilized to provide disaster relief and health care assistance to a number of foreign countries. Technical assistance, under the Federal "Point IV" and Mutual Security Agency programs, provided needed help to many underdeveloped countries. The Agency also furnished guidance for foreign representatives sent to this country to study American programs and methods in the fields of health and education. Later in the year, FSA accelerated its response to the Nation's social needs.
By 1953, the Federal Security Agency's programs in health, education, and social security had grown to such importance that its annual budget exceeded the combined budgets of the Departments of Commerce, Justice, Labor and Interior and affected the lives of millions of people.
Consequently, in accordance with the Reorganization Act of 1949, President Eisenhower submitted to the Congress on March 12, 1953, Reorganization Plan No. 1 of 1953, which called for the dissolution of the Federal Security Agency and elevation of the agency to Cabinet status as the
Department of Health, Education, and Welfare. All of the responsibilities of the Federal Security Administrator would be transferred to the Secretary of Health, Education, end Welfare and the components of FSA would be transferred to the Department. A major objective of the reorganization was to improve administration of the functions of the Federal Security Agency. The plan was approved April 1, 1953, and became effective on April 11, 1953.
The Department of Health, Education, and Welfare was created on April 11, 1953, when Reorganization Plan No. 1 of 1953 became effective. HEW thus became the first new Cabinet-level department since the Department of Labor was created in 1913. The Reorganization Plan abolished the Federal Security Agency and transferred all of its functions to the Secretary of Health, Education, and Welfare and all components of the Agency to the Department. The first Secretary of HEW was Oveta Culp Hobby, a native of Texas, who had served as Commander of the Women's Army Corps in World War II and was editor and publisher of the Houston Post. Sworn in on April 11, 1953, as Secretary, she had been FSA Administrator since January 21, 1953.
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The Department of Health, Education, and Welfare was created on April 11, 1953, when Reorganization Plan No. 1 of 1953 became effective. HEW thus became the first new Cabinet-level department since the Department of Labor was created in 1913. The Reorganization Plan abolished the Federal Security Agency and transferred all of its functions to the Secretary of Health, Education, and Welfare and all components of the Agency to the Department. The first Secretary of HEW was Oveta Culp Hobby, a native of Texas, who had served as Commander of the Women's Army Corps in World War II and was editor and publisher of the Houston Post. Sworn in on April 11, 1953, as Secretary, she had been FSA Administrator since January 21, 1953.
A major objective of the Department's establishment was to improve the administration of Federal responsibilities in the fields of health, education, and social security. Creation of the Department also assured that its areas of concern were represented in the President's Cabinet.
There were six major components of the new Department: the Public Health Service; the Office of Education; the Food and Drug Administration; the Social Security Administration; the Office of Vocational Rehabilitation; and Saint Elizabeths Hospital. The Department also was responsible for three Federally Aided Corporations: Howard University; the American Printing House for the Blind; and the Columbia Institution for the Deaf.
In addition, the Office of the Secretary was responsible for overall administration and coordination of Department activities.
The Department began with 35,408 full-time employees and a budget of $7,017,302,000, including $1,936,308,000 in Federal funds (general revenue) and $6,507,960,000 in social security trust funds.
A highlight of the first year was the dedication on July 2, 1953, of the NIH Clinical Center, a 500-bed research hospital to serve physicians and patients throughout the Nation in the fields of cancer, mental illness, arthritis, heart disease, and other chronic illnesses. Its first patients were admitted 4 days later.
On July 12, 1954, President Eisenhower signed a law which provided funds, under a matching formula with the States and local organizations, to build chronic disease hospitals, diagnostic and treatment centers, nursing homes, and rehabilitation facilities.
Another new health law, enforced by the Food and Drug Administration, provided a procedure for establishing safe tolerances for pesticide chemical residues on raw agricultural products.
Legislation signed August 3, 1954, authorized programs to increase fourfold within 5 years the annual number of disabled people rehabilitated for self-support.
In the educational field, the Cooperative Research Act authorized the Office of Education to conduct cooperative research programs with educational institutions and agencies concerned with problems of education.
In one of the earliest actions of the new Department, a group of consultants thoroughly studied the social security system. The result was a legislative proposal that would extend social security to farm and domestic workers and the self-employed. It was enacted September 1, 1954, adding 10 million persons to social security rolls. The new law meant that 9 out of 10 American workers were covered by the system.
A major organizational development took place in 1954. On June 18, P.L. 83-568 transferred the Indian Health program involving 3,400 personnel from the Department of the Interior to PHS.
Development by Dr. Jonas Salk of a vaccine against paralytic poliomyelitis was one of the most dramatic medical accomplishments of the decade. On April 12, 1955, upon recommendation of the Public Health Service, the Secretary of HEW licensed six manufacturers to produce the vaccine. Later that year, through its Communicable Disease Center, PHS helped the States distribute the vaccine, continually studying vaccine performance and evaluating its effectiveness.
In 1955, Saint Elizabeths Hospital observed its centennial by marking a century of progress in treatment of the mentally ill.
On July 1, 1955, civil defense responsibilities were delegated to the Department, including control of hazards to health and training.
The second Secretary of Health, Education, and Welfare, Marion B. Folsom, was sworn in August 1, 1955. A native of Georgia, he had served as Under Secretary of the Treasury from 1953-55 and previously as a top executive with Eastman Kodak Co, in Rochester, New York.
The White House Conference on Education was held in the fall of 1955, resulting in 72 specific recommendations for improvement of elementary and secondary schools. The Department responded with a number of proposals over the next 18 months designed to greatly expand Federal assistance to education.
Ten years of operating the Hill-Burton hospital construction program was marked in 1956. By June 30, more than 2,000 federally aided hospitals and health centers were in operation, including 550 new general hospitals. More than 136,000 beds and 750 health units for outpatient care had been added to the Nation's health system.
The poliomyelitis vaccine program was accelerated to the point where, by July 1, 1956, protection had been provided to virtually all children under 20 and all expectant mothers.
In June 1956, the President signed a bill authorizing the Public Health Service to conduct a continuing national health survey, the first in 20 years. Legislation also was enacted to combat the nursing shortage and improve nursing service.
By June 30, 1956, more than 5 million Americans were receiving public assistance and 8.4 million were receiving social security benefits--three fourths of the retired age population.
The Armed Forces Medical Library was transferred August 3, 1956, to the Public Health Service and was renamed the National Library of Medicine.
During fiscal year 1956, 66,273 handicapped persons were returned to useful lives, a new record under the 35-year-old program. The Department also reported that from 1946 to 1956 maternal death rates fell 76 percent and infant death rates dropped 23 percent.
By the fall of 1956, 40 million children were overcrowding the Nation's schools. About 2 1/4 million were enrolled in excess of normal capacity and 80,000 new classrooms were needed to meet the overflow. In fiscal year 1956, the Administration had requested an unprecedented 100 percent increase in funds for the Office of Education to help meet this need-from $3 1/4 million to $6 million. Congress approved more than $5 1/4 million for fiscal year 1957, a 65-percent increase.
Significant advances were made by researchers at the National Institutes of Health in fiscal year 1957, especially in the treatment of cancer with drugs and the treatment of burns with gamma globulin. In the previous ten years, NIH research programs had increased from $8 million to $183 million and NIH support of promising scientists increased from $2 million in 1953 to $5 million in 1957.
The Nation was free from smallpox for the fourth straight year in 1957, which was attributable to the work of PHS's Quarantine Service. Rapid and thorough work by PHS in 1957 helped the Nation survive the most widespread influenza epidemic in 40 years. More than 80 million doses of influenza vaccine were produced and distributed by the end of the year. At its peak in mid-October, an estimated 12 million people were in bed with the virus.
In 1957, the Social Security Administration reported that social security beneficiaries had passed the 10 million mark. Monthly benefits in June 1957, totaled $554.6 million.
In 1958, PHS intensified research in air and water pollution and created a Division of Radiological Health to deal with problems of radiation exposure.
Aided by an increase in staff from 806 to 1,215, the Food and Drug Administration increased its inspection, evaluation and research activities considerably in 1958. The Agency estimated that during the year $56.4 billion worth of food products, $3.9 billion worth of drugs and medical devices, and $1.4 billion in cosmetics moved through some 83,692 factories and warehouses, subject to Federal inspection.
The 85th Congress passed the food additives amendment to the Food, Drug and Cosmetic Act. Effective March 5, 1959, it required the manufacturer or promoter of a new food additive to submit to FDA evidence that its safety has been tested and established before marketing.
The third Secretary of Health, Education, and Welfare, Arthur S. Flemming, was sworn in August 1, 1958. A native of New York, he had been president of Ohio Wesleyan University.
Stimulated in part by the launching of the first earth satellite by the U.S.S.R., interest in American education increased dramatically in 1958. The President's Committee on Education Beyond the High School reported that by 1969 from 180,000 to 270,000 new college teachers must be recruited. The shortage of qualified teachers in elementary and secondary schools had grown to 130,000. The classroom shortage stood at 142,000. A survey by the Office of Education showed that of the 2,776,000 students enrolled in 11th and 12th grades of public high schools in 1956, only 830,000 were studying science and 659,000 were studying mathematics. About 100,000 seniors were in schools where no advanced mathematics of any kind were taught. In addition, the United States was found to be weaker in the teaching of foreign languages than any other major country in the world.
In partial response to this educational gap, Congress passed and the President signed on September 2, 1958, the National Defense Education Act, which set up a program of about $900 million in Federal aid to education. The Act provided support to guidance, counseling and testing, support for expanded and improved teaching of science, mathematics, and foreign languages, area vocational training, the training of more college teachers and language specialists, for research in use of television and other modern media, and it made loans available for deserving college students.
Amendments to the Social Security Act, effective October 1, 1958, increased the amount of Federal funds available to the States for public assistance and greatly increased appropriations for three grant programs of the Children's Bureau: maternal and child health services; crippled children's services; and child welfare services.
On June 26, 1959, SSA marked the 25th anniversary of the Federal Credit Union Act. Total assets of federally chartered credit unions had passed the $2 billion level and active membership exceeded 5 million.
The Department reported that in the 5 years since the 1954 amendments to Federal vocational rehabilitation legislation, more than 350,000 persons had been rehabilitated. Among them were 17,000 entering professions, 38,000 beginning skilled trades and 30,000 entering agriculture. The total cost of the rehabilitation was estimated at $14 million. The earnings of the entire group after rehabilitation in their first full year of employment was estimated to be $156 million.
On July 31, 1959, the President approved the Indian Sanitation Facilities Act, which authorized the Public Health Service to construct domestic and community sanitation facilities for Indians.
The White House Conference on Children and Youth was held in Washington from March 27 to April 2, 1960, involving a great deal of staff work on the part of the Department. About 7,600 persons attended the meetings, including 1,400 youngsters and 500 visitors from foreign countries. A total of 670 recommendations were formulated by the conference. The Children's Bureau made an intensive study of the recommendations and how they could be implemented through its various programs. The findings were expected to influence child life for years to come.
The 1960 Amendments to the Social Security Act authorized research and demonstration projects in the field of child welfare. The amendments also increased Federal participation in health care assistance for the aged, liberalized the retirement test, increased benefits for children of deceased workers, and removed the age 50 limitation for disability benefits.
Social Security celebrated its 25th anniversary in 1960. SSA reported that in June 1960, almost 14.3 million persons were receiving benefits. Of these beneficiaries, 11.5 million were age 62 or over, 2.4 million were young survivors and dependents and 371 ,000 were disabled workers age 50-64. Annual benefit payments had reached $10.8 billion. The 1960 amendments were expected to add 1,075,000 persons to social security rolls.
The public assistance programs also marked a quarter century of service in 1960. SSA, which was administering them, reported that nearly 5.8 million persons were receiving public assistance payments of more than $3.3 billion. The Federal share was 58.6 percent, the State share was 33.7 percent, and the local share was 7.7 percent.
By FY 1961, 10 years after the impacted aid program began, school assistance to federally affected areas had grown from $119.5 million to $266.9 million, of which $59.2 million represented construction aid and $207.7 million represented aid for school operating expenses.
In May 1960, the PHS Hospital at Lexington, Kentucky celebrated its 25th anniversary of service in the treatment of narcotic addiction. Also, the first Public Health Service Hospital for Indians was dedicated on May 21, 1960, at Shiprock, New Mexico.
The international health research programs of PHS were expanded by the International Health Research Act, July 12, 1960.
The Office of Education reported that after three years of operating under the Library Services Act of 1956-designed to extend library services to rural areas-30 million rural people were enjoying new or improved library services and 5 million books and other information materials had been added to resources of rural communities.
The National Center for Health Statistics was established in August 1960, to bring together major elements of the Public Health Service which measure the status of the Nation's health.
On September 1, 1960, the Division of Air Pollution was established in PHS to accelerate research in this vital area.
Later that month, a new program of Medical Assistance for the Aged (MAA) was established with the passage of Public Law 86-778.
A landmark meeting, the White House Conference on Aging, was held in Washington, D. C. during the closing days of the Eisenhower Administration, January 9-12, 1961, and was attended by 2,565 official delegates. The recommendations of the conference were to have a profound impact on the national policy for older citizens for years to come.
Later that month, the Social Security Administration began recording on magnetic tape payment histories for all beneficiaries and updating these records daily, one of the earliest steps toward computerization of social security records.
On January 21, 1961, the day after President John F. Kennedy was inaugurated, Abraham Ribicoff was sworn in as Secretary of Health, Education, and Welfare. A native of Connecticut, Mr. Ribicoff was governor of that State from 1954 to 1961.
Shortly after assuming office, the President assigned responsibility to the Department to coordinate, itensify and expedite assistance to Cuban refugees who had fled the communist regime of Fidel Castro. First payments to refugees were made on February 27 and a week later some 2,800 adults and 840 children were receiving financial aid.
In 1961, the Office of Education began a long-term program of assistance to Cuban refugees consisting of aid to the Dade County (Florida) School System to help ease the impact of Cuban refugees residing there; funds to the University of Miami to train Cuban doctors and lawyers in United States practices; and a special program of loans to needy Cubans studying in American universities.
On February 1, 1961, the Division of Chronic Diseases was established in PHS to bring new focus and direction to such health problems as heart disease, arthritis, diabetes, cancer control, and vision and hearing defects.
In March, a milestone was marked in Federal credit history when Secretary Ribicoff presented the 10,000th active Federal credit union charter to employees of the Inter-American Development Bank.
On July 20, 1961, the President signed amendments to the Water Pollution Control Act, which strengthened the Federal role in this field and provided additional aid to State and local governments for control programs and waste treatment facilities.
Freedmen's Hospital was transferred September 21, 1961, by P.L. 87-262 from the Public Health Service to Howard University, where it continued to serve as a teaching hospital for medical students.
Public Law 87-273, signed by the President on September 22, provided for a 5-year program of grants for demonstration, evaluationtraining, and prevention and control of juvenile delinquency. Public Law 87-276, signed on the same date, was enacted to encourage and facilitate the training of teachers of the deaf.
In the wake of the 1961 White House Conference on Aging, efforts were accelerated to make the Department more responsive to the needs of the Nation's 17.5 million senior citizens. The Special Staff on Aging, an element of the Office of the Secretary, was doubled in size and given an increased budget so it could better coordinate HEW programs on aging and provide special services to State, community, and voluntary organizations in this field. A 29-member panel of nationally known specialists was appointed to advise the Secretary on problems of the aging and, upon recommendation of the Department, a President's Council on Aging was established in May 1962, to coordinate all Federal programs for older people.
An increase in the inspection staff of the Food and Drug Administration during fiscal year 1962 enabled wider enforcement of food and drug laws covering the amount of toxic residues that may safely remain on raw foods. FDA also began a concerted effort to alert the public to frauds connected with medical and nutritional quackery, which it estimated cost the public $1 billion a year. On February 1, 1962, enforcement of the Federal Hazardous Substances Labeling Act began. Also, FDA responsibilities were significantly enlarged by passage of the Kefauver-Harris Drug Amendments of 1962.
The Manpower Development and Training Act was signed into law March 15, 1962, and, even though no funds were appropriated during fiscal year 1962, the Office of Education made extensive preparations to administer their responsibility for institutional training under the Act.
During the Centennial Celebration of the first Morrill Act of 1862, which established the system of federally aided land-grant colleges, the Office of Education published a historical and statistical review of the impact of this historic program and reported that aid to landgrant colleges from the Office of Education in fiscal year 1962 totaled $10,744,000. These funds supplemented the original land-grant endowments of 1862, the income from which totaled more than S3.5 million in FY 1962.
In examining other higher education programs, the Office reported that since the inception of the student loan program under the National Defense Education Act, about 350,000 students had received more than $225 million in National Defense Student Loans.
On July 31, 1962, Anthony J. Celebrezze, who had served as mayor of Cleveland, Ohio from 1953 to 1962, was sworn in as Secretary of Health, Education, and Welfare replacing Abraham Ribicoff.
The Public Welfare Amendments of 1962 enabled sweeping changes in the delivery of public assistance including a family-centered approach to welfare problems.
A major milestone was reached in the Department's vocational rehabilitation program in FY 1962, the first year that more than 100,000 disabled persons-actually 102,377-were rehabilitated successfully to productive employment.
Additional organizational changes in the Public Health Service during 1962 broadened and strengthened the Agency's mission to enhance the health status of the Nation. A new Division of Community Health Services was established to help local communities in their planning and coordination of vital public and private health and medical services. On October 17, P.L. 87-838 established the National Institute of Child Health and Human Development within NIH to provide a central facility for research on unsolved problems relating to child health, prenatal development, and aging. At the same time, the Division of General Medical Sciences was elevated to Institute status, giving added recognition to a Federal program which supports research in sciences basic to medicine and biology. These changes took effect January 30, 1963.
On January 25, the Secretary ordered a reorganization of the Department to emphasize changing priorities and better align related functions. The Office of Vocational Rehabilitation was renamed the Vocational Rehabilitation Administration. The Welfare Administration was established to administer the Department's public assistance programs. Accordingly, three units were transferred to the Welfare Administration from the Social Security Administrationthe Cuban Refugee Program, the Bureau of Family Services, and the Children's Bureau-and two units, the Office of Aging and the Office of Juvenile Delinquency and Youth Development, were transferred from the Office of the Secretary.
On April 11, 1963, the Department marked its 10th anniversary. During that period, the Department's budget had nearly tripled, from $7 billion, including $1.9 billion in general funds, to $20.1 billion, of which $5.1 billion represented general funds. Paid employees had increased from 35,408 to 81,062.
On June 9, 1963, the Secretary announced appointment of a 13-member advisory council to review the status of social security trust funds and equity of benefits. Payments under OASDI during FY 1963 totaled $15 billion. At the end of June 1963, 18.6 million persons were receiving benefits, 14.4 of whom were aged 62 and over. The average retired worker was receiving $73 a month, while the average retired couple was receiving $128.70.
At the end of fiscal year 1963, about 6.8 million needy men, women, and children, or about 3.6 percent of the Nation's population, were being helped by the five federally supported public assistance programs. Benefits totaled $4.2 billion.
Major health legislation passed during 1963 included: the Health Professions Education Assistance Act, an important step toward meeting the Nation's critical shortage of health manpower; the Mental Retardation Facilities and Community Mental Health Centers Construction Act; and the Clean Air Act, which provided increased assistance to State and local governments to meet the problems of air pollution.
In the educational field, the Higher Educational Facilities Act of 1963 authorized Federal grants and loans to assist eligible public and other nonprofit institutions of higher education in financing construction, rehabilitation, or improvement of certain academic and related facilities. Assistance was to be principally for the construction of classrooms and laboratories which would result in a substantial expansion of needed student enrollment capacity. Assistance also was authorized to improve or establish graduate schools and cooperative graduate centers to increase the nation's supply of critically needed professional personnel. The Vocational Education Act of 1963 increased and extended existing vocational education programs, teacher training, and curriculum development.
Also in 1963, the Maternal and Child Health and Mental Retardation Planning Amendments to the Social Security Act expanded substantially the Welfare Administration's services in behalf of children.
In December 1963, the National Library of Medicine activated its Medical Literature Analysis and Retrieval System (MEDLARS), including its Index Medicus, a monthly listing of articles from the world's biomedical literature.
Early in 1964, the Surgeon General of the Public Health Service released his first report on smoking and health, which concluded that "cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action".
Several important health measures were enacted in 1964. The Nurse Training Act provided for the construction of new schools of nursing and expansion of existing schools, loans for nursing students, and funds for curriculum development. The Hill-Burton hospital construction program was extended under P.L. 88-443 for 5 years and the professional public health traineeship program was extended by P.L. 88-497 .
The Library Services and Construction Act of 1964, P.L. 88-269, February 11, 1964, amended the Library Services Act of 1956 to improve and develop public library services and facilities in areas without such services or with inadequate services. It extended services to urban areas and provided Federal assistances to the States for the construction of public library buildings.
During fiscal year 1964, Section 102(b)(6), of the Mutual Educational and Cultural Exchange Act of 1961, P.L. 87-256, known as the Fulbright-Hays Act, went into effect. It provided for modern foreign language training and area studies in United States schools, colleges and universities, visits and study in foreign countries by teachers and prospective teachers to improve their language and area culture knowledge, including summer seminars abroad, and for visits by foreign specialists to the United States.
Under Title IV of the Civil Rights Act of 1964, signed on July 2, 1964, the Commissioner of Education was directed to survey and report to the President and the Congress on the extent to which discrimination because of race, color, religion, or national origin limited equal educational opportunities in public educational institutions in the United States. The Act also authorized grants, training institutes, and technical assistance to overcome problems of desegregation.
Title VI of the Act stated: "No person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance".
Within a week after enactment of the law, teams of HEW officials were touring the South and meeting with superintendents of schools to discuss voluntary compliance with the new law. Thus began the Department's civil rights compliance program that was to embrace school districts, hospitals, nursing homes and welfare agencies. Civil rights enforcement eventually was moved to the Office of the Secretary so that the law could be more effectively enforced.
The Economic Opportunity Act, approved August 20, 1964, created a host of new resources for helping families escape the cycle of poverty, including several new programs for the Department. Title V of the Act created the Work Experience and Training Program for jobless needy people which became the responsibility of the Welfare Administration. Title I-C created a Work-Study program for needy college students and Title II-B authorized Federal grants for adult basic education. Both programs were delegated to the Office of Education. Joint planning by OEO and OE was required to implement the Head Start and Upward Bound programs.
The Food and Drug Administration in 1964 accelerated its efforts to crack down on health food rackets, which it conservatively estimated cost 10 million Americans more than $500 million a year.
Two major organizational changes took place in 1965. The Older Americans Act, signed by the President July 14, 1965, established the Administration on Aging, elevating the Welfare Administration's Office of Aging to agency status, beginning in fiscal year 1966. The Water Quality Act, October 2, 1965, established the Federal Water Pollution Control Administration, elevating a Public Health Service division to agency level. Also during 1965, the Secretary ordered internal reorganizations of the Social Security Administration and the Office of Education to improve their administration of programs.
The White House Conference on Education met in Washington July 20-21, 1965, with 600 leaders in education, industry, labor, and government attending.
On August 18, 1965, John W. Gardner, a Californian who had served as president of the Carnegie Corporation in New York from 1955 to 1965, was sworn in as the sixth Secretary of Health, Education, and Welfare. Only a month before, he had chaired the White House Conference on Education.
In September 1965, the Public Health Service established the National Clearinghouse for Smoking and Health. In its first year it awarded nearly $2 million in grants and contracts for research and education projects.
In 1965, the first session of the 89th Congress passed 25 major pieces of legislation affecting the Department:
Social and Economic Opportunity
The flood of legislation and the resulting manpower effort required to implement the newly authorized programs had a profound impact on the Department during late 1965 and early 1966.
The preparatory work of implementing Medicare has been described as one of the largestscale civilian management efforts in history. The program became effective July 1, 1966. About 19 million Americans 65 or older were eligible for hospital insurance benefits. Of these persons, 17.7 million enrolled in the voluntary medical insurance program which pays doctor bills and other health services not covered by hospital insurance. The Social Security Administration was required to develop a wide range of partnerships with intermediaries-74 Blue Cross Plans, 33 Blue Shield Plans, 15 commercial insurance companies, and 12 other insuring organizations-who act as agents for processing claims.
The Welfare Administration's medical assistance program (Medicaid) became effective January 1, 1966.
The huge new programs authorized by the Elementary and Secondary Education Act, the Higher Education Act, and other key legislation greatly enlarged responsibilities of the Office of Education. From 1965 to 1966, Office of Education employment grew from 2,113 to 3,198. During the one-year period, the Office of Education budget more than doubled, from $1.5 billion to $3.4 billion.
Correspondingly, the budget of the Department grew from $6.9 billion to over $10 billion (general funds) or from $24.6 billion to over $30 billion when trust funds are included. Employment rose in one year from 87,316 to 99,810. The Department was administering 200 separate programs. In contrast, in 1960, the Department's budget was $15.2 billion, including S3.4 billion in general funds, employment was 61,641, and programs totaled 100.
The sheer size and scale of the increased responsibilities required new top management positions and new talent. Of the top 23 posts in the Department, 15 were filled with new people in fiscal year 1966.
To help coordinate the new program structure and 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. The Office of Field Administration was reorganized and redesignated the Office of Field Coordination. Budget functions were lifted out of the Office of Administration and placed under the newly created post of Comptroller, which in late June was elevated to an Assistant Secretaryship.
Civil rights activities of the Department, involving compliance with title VI of the Civil Rights Act of 1964, were reorganized and the post of Special Assistant to the Secretary for Civil Rights was created to coordinate activities of the equal opportunity offices of the agencies. Consequently, 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.
Two additional organizational changes took place during the year. On May 10, 1966, Reorganization Plan No. 2 of 1966 transferred the Federal Water Pollution Control Administration to the Department of the Interior. On June 24, 1966, Reorganization Plan No. 3 reorganized the Public Health Service, effective January 1, 1967.
The three-bureau structure of PHS was enlarged to include five bureaus: Health Services; Health Manpower; Disease Prevention and Environmental Control; the National Institutes of Health; and the National Institute of Mental Health. In addition, the structure was headed by the Office of the Surgeon General; directly related to this office but with independent status were the National Library of Medicine and the National Center for Health Statistics.
In August 1966, the Hill-Burton program of health facilities construction celebrated its 20th anniversary. During that period, the program had been responsible for 9,000 construction and modernization projects and provided $2.9 billion in federal funds.
A Division of Environmental Health Sciences was established on November 1, 1966, within the National Institutes of Health to provide a scientific base for surveillance, standard-setting, control, and enforcement in environmental health programs.
In 1966, nine major pieces of legislation were passed which expanded or added to the program responsibilities of the Department:
In January 1967, the Department established a Center for Community Planning in the Office of the Secretary to coordinate and focus resources of HEW programs on urban problems and integrate them into Model Cities projects.
In March 1967, the Office of Education celebrated its centennial with commemorative ceremonies in front of the headquarters building.
The Department had created early in 1966 an Office for Civil Rights headed by a Special Assistant to the Secretary for Civil Rights and, in June 1967, all civil rights compliance activities were transferred to it from other components of the Department. During the period from 1963 to 1967, the percentage of Negro students attending school with whites in Southern States rose from 1.1 7 to 18 percent. I n the six Border States, the percentage of Negro students in schools with whites rose from 58 percent in 1963 to an estimated 70 percent in 1967.
The Department also took steps to deal with the problems of other minority groups. In May 1967, the Office of Education appointed an Advisory Committee on Mexican-American Education and brought in a distinguished Mexican-American educator to serve as staff director. At the Departmental level, the Deputy Assistant Secretary of Education assumed special responsibility for coordinating the efforts of all agencies to assist in solving the problems of Mexican-Americans.
In order to bring all the resources of the Department to bear on the very difficult problems facing American Indians, a Special Assistant for Indian Affairs was appointed in November 1967 to advise the Assistant Secretary for Education and to head a new Office of Indian Affairs.
On August 9, 1967, the Secretary's Reorganization Order transferred Saint Elizabeth's Hospital to the National Institute of Mental Health, effective August 13, 1967. Major objectives of the transfer were to further reduce the resident patient load, enabling the institution to close several pre-Civil War facilities, intensively develop its capability to treat mental patients on an out-patient basis, and gradually transform the hospital into a communityoriented mental health treatment facility for the District of Columbia.
During 1967, the National Institute of Mental Health launched new research programs in suicide prevention, alcoholism and drug abuse. Also, that year, administration of the PHS hospitals for drug addiction at Lexington, Ky. and Fort Worth, Texas became the responsibility of NIMH
On August 15, 1967, the Secretary abolished the Vocational Rehabilitation Administration and the Welfare Administration and transferred those programs as well as those of the Administration on Aging and the Division of Mental Retardation of the Public Health Service to the newly created Social and Rehabilitation Service (SRS). The Social and Rehabilitation Service thus consisted of the following sub-agencies: Rehabilitation Services Administration; Children's Bureau; Administration on Aging; Medical Services Administration; and Assistance Payments Administration.
Fifteen new laws were passed in fiscal year 1968 which broadened responsibilities of the Department. Major amendments strengthened and expanded the Elementary and Secondary Education Act, the Library Services and Construction Act, the College Work-Study program, the Partnership for Health programs, mental health and mental retardation programs, the Older Americans Act, vocational rehabilitation programs, juvenile delinquency prevention and control, and the Federal Credit Union program.
On July 4, 1967, the Public Information Act of 1966, known as the "Freedom of Information Act", became effective. Its purpose was to provide freer access to information about Federal programs and policies. To implement this legislation, the Secretary established the post of Associate Director of Information for Public Services to administer the Act and to head the Visitors-Information Center, which opened in temporary quarters July 1, 1967, and moved into a new permanent center in the HEW building in October, 1968.
Reorganization Plan No. 1 of 1968, February 7, 1968, transferred the Bureau of Drug Abuse Control from the Food and Drug Administration to the Department of Justice.
On March 1, 1968, Under Secretary Wilbur Cohen became Acting Secretary and was sworn in as Secretary May 16, 1968.
The Secretary's Reorganization Order, effective March 13, 1968, transferred all functions of the Public Health Service and the Food and Drug Administration to the supervision of the Assistant Secretary for Health and Scientific Affairs. The Department's top health official also was given overall health policy direction and coordination of other health programs, including Medicare, Medicaid, and the health activities of the Children's Bureau. The Surgeon General of the Public Health Service, as the senior career health official of the Department, would serve as the principal deputy to the Assistant Secretary.
A second major step in the organization and strengthening of the health activities of the Department came on April 1, when a reorganization order realigned functions of PHS to include the following new operating agencies: The National Institutes of Health, which would include the previous NIH structure, the Bureau of Health Manpower, and the National Library of Medicine; and the Health Services and Mental Health Administration (HSMHA), which would be responsible for all other functions previously assigned to the Public Health Service. In addition, the Division of Regional Medical Programs was transferred from NIH to HSMHA.
A major purpose of the reorganization was to place under unified direction related responsibilities for health research and health education. Passage of the Health Manpower Act of 1968, P.L. 90-490, August 16, 1968, extended educational assistance and health research facilities programs.
A second major purpose of the reorganization was to centralize in the Health Services and Mental Health Administration direction of the planning and delivery of health services. It began with nine operating components, consisting of the National Institute of Mental Health; the Community Health Service, combining the Office of Comprehensive Health Planning with components of the Division of Medical Care Administration; the Regional Medical Programs Service, including elements of the National center for Chronic Diseases; the National Communicable Disease Center; the Health Facilities Planning and Construction Service, formerly the Division of Hospital and Medical Facilities; the National Center for Health Statistics; the Indian Health Service; the Federal Health Programs Service, including the former Division of Direct Health Services, the Division of Federal Employee Health and the former Division of Health Mobilization. Another major HSMHA component, the new National Center for Health Services Research and Development, was established on May 1, 1968.
On July 1, 1968, the Public Health Service was further reorganized to include, in addition to NIH and HSMHA, a third major agency, the Consumer Protection and Environmental Health Service (CPEHS). The principal components of CPEHS were the Food and Drug Administration; the Environmental Control Administration; and the National Air Pollution Control Administration. This new organization was to focus within a single agency the responsibility for identifying health hazards in man's environment, including the environment of the products which man must consume; for developing and promulgating criteria and standards for the control of these hazards; and for mounting appropriate compliance programs.
Four pieces of significant legislation were enacted in 1968:
During fiscal year 1968, the long-sought goal of 200,000 disabled persons rehabilitated into employment was achieved. The number of rehabilitants actually totaled 207,918.
In December of 1968, the Department released a statistical report of trends and progress in the Department's 250 programs during the period 1963 to 1968. A total of 102 laws, 62 of which were considered landmark bills, were enacted during the period. Among the more significant of the trends were:
On January 21, 1969, the day after President Richard M. Nixon was inaugurated, Robert H. Finch was sworn in as the eighth Secretary of Health, Education, and Welfare. Born in Arizona, Mr. Finch had spent most of his life in California and had served as Lieutenant Governor of that State.
Shortly after assuming office, Secretary Finch emphasized that he would scrutinize Departmental operations and make efficient and effective management of existing programs one of his primary goals.
The Secretary released the final report of the Department's Task Force on Prescription Drugs on March 16. The principal recommendation of the Task Force called for coverage of out-of-hospital prescription drugs under Medicare.
On May 16, 1969, the Secretary and Dr. Leonard M. Elstad, President of Gallaudet College, signed an agreement authorizing Gallaudet to construct, equip, and operate a model secondary school for the deaf. The school would open with a class of 50 students in temporary quarters in December.
On June 5, the Secretary issued Federal regulations establishing standards for the production of German measles (rubella) vaccine. On June 10, he announced that he had approved the first license in the U.S. to produce a live attenuated German measles vaccine, bringing to fruition a 7-year Government-industry effort to develop and make available to physicians such a vaccine.
The Secretary announced on June 30 that he was issuing a new regulation limiting fees paid to physicians, dentists, and other individual providers of medical services under Medicaid, effective July 1, 1969.
The Office of Child Development was established July 1, 1969, to carry out the President's commitment to improving the first five years of life. On the same date, Head Start, the program for preschool children launched in 1965 by the Office of Economic Opportunity, was transferred from OEO and delegated to OCD.
In August the Secretary established under the general direction of Deputy Under Secretary Frederic Malek the Federal Assistance Streamlining (FAST) Task Force to review grant programs, streamline procedures and simplify the application process.
The Social and Rehabilitation Service announced on August 20, that a record total of 241,390 disabled persons were rehabilitated to gainful employment in fiscal year 1969, an increase of 16 percent over the 207,918 of FY 1968.
Organizational changes designed to strengthen the Department's programs affecting children were announced by the Secretary September 17. The Children's Bureau was moved from the Social and Rehabilitation Service to the Office of Child Development in the Office of the Secretary. A Community Services Administration was established in SRS to consolidate administration of social service programs for children and adults. Health programs formerly administered by the Children's Bureau were moved to the Health Services and Mental Health Administration.
A dramatic reform of the current welfare structure, the Family Assistance Program, which would place a floor of uniform Federal welfare payments under the existing Federal-State-local payments and, for the first time, help the working poor, was proposed and sent to the Congress on October 2, 1969.
The Secretary ordered cyclamates removed from the list of substances generally recognized as safe (GRAS) on October 18 and on November 20, he banned the sale of beverages containing cyclamates after January 1, 1970.
The Department also acted in November to ban the chemical pesticide D.D.T. for all but essential use within the next two years. Laboratory tests had shown that both D.D.T. and cyclamates had caused cancer in mice. The actions were taken to protect the public health.
On October 23, three months after the President delivered his Message on Population, the Department established within the National Institutes of Health the National Center for Family Planning with a 5-year goal of reaching the estimated 5 million low-income women of child-bearing age who desire family planning services but cannot afford them.
The following day, the Secretary announced a major organizational change designed to strengthen HEW operations in consumer protection and environmental health. Effective February 1, 1970, the Consumer Protection and Environmental Health Service would be abolished and the Food and Drug Administration, one of its components, would be elevated to agency status. The two remaining elements of CPEHS would comprise a new Environmental Health Service. The action increased the Department's agencies from six to seven.
Seven new Medicaid programs-in Alabama, Arkansas, Florida, Indiana, Mississippi, New Jersey, and North Carolina-began operation on January 1, 1970, which meant that Medicaid was operational in 48 of the 50 States plus the District of Columbia, Guam, Puerto Rico and the Virgin Islands.
The Social Security Administration reported on January 4 that more than 25 million persons-one of every eight Americans-were receiving social security monthly payments, including 16.6 million older workers and their dependents, 6.2 million survivors of deceased workers, and 2.5 million disabled workers and their dependents. Cash benefits totaled nearly $27 billion in calendar year 1969, $2 billion higher than in 1968.
Secretary Finch and Transportation Secretary Volpe announced jointly January 20 that representatives of virtually all of the Nation's airlines agreed to a program of sharply reduced smoke emissions from aircraft jet engines by 1972.
Federal regulations became effective January 22 regarding corrective action to be taken by manufacturers when such electronic products as color television receivers and microwave ovens are found to have a radiation safety defect or fail to comply with a Federal radiation control standard.
The Department joined with the Department of Defense on March 18, to launch MEDIHC, a program designed to encourage the more than 30,000 medically trained servicemen and women discharged from the Armed Forces annually to enter civilian careers in some 200 health occupations.
On April 5, the National Air Pollution Control Administration named an additional 34 interstate air quality control regions to be designated by the end of the summer, which would bring the total of such regions to 91.
Contracts totalling $5 million were awarded by the Department May 11 to two manufacturers to furnish 6,850,000 doses of rubella (German measles) vaccine between May and September of 1970. The Department estimated that 12 million children would be immunized against the disease by June and that by September half of the target population of 40 million children would be reached.
The Federal Assistance Streamlining Task Force reported in May on its efforts to simplify and overhaul the Department's grants-in-aid procedures. Of the first 50 programs reviewed, the task force:
In a related move, the Department restructured boundaries of the regional offices to conform with those of other major domestic agencies so that headquarters cities are the same. In addition, the Department moved to strengthen its 60,000-man regional organization and shifted line authority to the regional directors and regional agency heads, which reduced lines of reporting from 38 to 9.
In another management effort, to consolidate and strengthen the Department's architecturalengineering activities for HEW construction programs, the Facilities Engineering and Construction Agency (FECA) was established in the Office of the Secretary on May 26, 1970. Through regional and district offices, FECA would support architectural and engineering activities involving more than $1 billion annually.
SRS reported in June that the number of Americans receiving public assistance rose to a record 12.2 million-an increase of 2 million or 20 percent, over the previous year. The money payments, in the same period rose $2.1 billion to $12.8 billion-also a 20 percent increase.
On June 24, 1970, President Nixon moved to create the Environmental Protection Agency, a new independent Federal agency reporting directly to the President, to deal with the urgent problem of environmental pollution. To be established in December of 1970, EPA would bring under one organizational roof all Federal programs for controlling air and water pollution, solid wastes, pesticides, and radiation. The action would transfer most of the programs of the Department's Environmental Health Service to the new agency and abolish the Service as an HEW agency, reducing the number of such agencies in the Department from seven to six.
Also on June 24, 1970, Elliot L. Richardson was sworn in as the ninth Secretary of Health, Education, and Welfare. He had served as Assistant Secretary for Legislation from 1957 to 1959 in the Eisenhower Administration and as Acting Secretary from April to July 1958. In 1964 he was elected Lieutenant Governor of Massachusetts and in 1966 was elected Attorney General of that State. A native of Boston and a graduate of Harvard College and Harvard Law School, he had practiced law in Boston between periods of public service. He had served as Under Secretary of State from January 1969 until he was sworn in as HEW Secretary.
In his first speech as HEW Secretary, delivered July 8, 1970, before the Indiana University Bicentennial Convocation in Bloomington, Secretary Richardson struck a theme which he was to enunciate in subsequent speeches: The more effective delivery of the Department's services.
He attributed many of the failures of governmental assistance to meet the needs of people to the continued reliance on categorical grants programs, characterizing them as responsible for the "virtual strangulation of Federal efforts as more resources are continually forced into narrow, constricting funnels long since inadequate to the task."
The Secretary made it clear early in his tenure that more effective management of the Department's resources to meet human needs would be the cornerstone of his stewardship. He also developed two themes that would be emphasized throughout his tenure to make the Department more responsive to the people it serves: The prevention of dependency and the accomplishment of institutional reform.
On July 25, the Department announced that it was mailing to all HEW grantees a two-volume publication, "A Program for Improving the Quality of Grantee Management." For the first time in the history of HEW grants administration, policy requirements for individual grantee organizations would vary according to the quality of their business management systems. The new policy would enable the Department to distinguish, through review, evaluation, and classification procedures, three major categories of business management systems: those warranting relaxed policy requirements; those needing special requirements; and those continuing under normal requirements. It supported the efforts of the Federal Assistance Streamlining Task Force.
Secretary Richardson announced on July 31 appointment of the initial members of a National Reading Council to focus and coordinate the National Right to Read Effort. Endorsed by President Nixon in his 1970 Education Message, the effort seeks to eradicate the high rate of reading failure and deficiency encountered among students of all ages and background through a partnership of public and private interests.
As part of the effort, the Office of Education launched a new research program on reading, designed to provide the scientific foundation for developing improved reading instruction programs. The goal of this research effort is to enable every child in a national sample to achieve sufficient reading skill by age 10 to become a competent adult reader.
A Federal Clean Car Incentive Program to spur development of a low-pollution automobile was announced by the Secretary on August 7. To be administered by the National Air Pollution Control Administration, the program was designed to stimulate private efforts to market a passenger car by the 1980's that will match performance and convenience of present cars but which will be fundamentally pollution free.
On August 5, the Office of Education announced the award of $3 million in grants to train teachers and other school and community personnel in drug education. This action was the second step in an accelerated effort by the Department to combat drug abuse among the Nation's youth. In March 1970, President Nixon had announced that $2.8 million in supplemental funds were being made available to the National Institute of Mental Health for a variety of activities, including: acceleration of the marihuana research program; establishment of a National Clearinghouse for Drug Abuse Information; intensified professional training in prevention and treatment of drug abuse, including the production of materials for use by teachers and others in the educational field; and expansion of the NIMN mass media information/ education campaign.
The Office of Education reported September 6, 1970, that over 62 million people-more than 30 percent of the population-would be involved in the U.S. education process during the 1970-71 school year and that the Nation would commit an estimated $73.6 billion to education, compared with $69.5 billion in 1969-70. Of the total participants, 2.8 million were teachers and administrators and 59.2 million represented the fall enrollment, including 36.8 million at elementary level, 14.8 million at secondary level, and 7.6 million degreecredit students in higher education.
Surplus Federal property made available to the States by the Department during the first six months of 1970, totaled $169,481,130 according to an announcement September 14. Real property accounted for $19,609,910 and personal property totaled $149,871,220.
On September 15, the Office for Civil Rights reported that since January 1969, the number of black pupils attending schools that were at least 5 percent white had increased from 18.4 percent to 28.9 percent. In the 11 southern and border states, 1,977 school districts had desegregated-346 of them in the 1969-70 school year. More than 600 districts were committed to total desegregation in the fall of 1970, 200 of which had submitted voluntary plans to OCR. There were still 80 school districts not committed to desegregation being sued by the Federal Government.
Secretary Richardson announced in late October that of the approximately 2,700 school districts in the 11 southern States, more than 97 percent had desegregated under voluntary plans and court orders. Of the 3.1 million black children in these States, 27.4 percent were living in districts that had desegregated prior to 1970; an additional 63 percent were living in the more than 600 districts desegregating by voluntary plan and court order in the fall of 1970; 9.6 percent were living in the 76 districts still not listed in compliance. Of the white students in these 11 southern States, 48.3 percent were living in districts that desegregated prior to the fall of 1970; 42.2 percent were living in the districts desegregating in the fall of 1970 and 9.5 percent were living in districts not in compliance.
A study of Medicare released in November showed that nearly 17 million hospital admissions had been made under the program during the first three years and that the number of admissions is rising each year.
The Office of Education made two major announcements in November:
The Social and Rehabilitation Service reported in November that about 6 percent of the population in the United States was receiving public assistance money payments under the Aid to Families with Dependent Children (AFDC) program. Ten years earlier, less than 2 percent of the U.S. population was receiving AFDC payments.
On December 2, the Department transferred to the newly created independent Environmental Protection Agency its air pollution control program, its solid waste management program, efforts concerned with radiation in the general environment, and the Bureau of Water Hygiene. The action brought under one roof all Federal programs for controlling air and water pollution, solid wastes, pesticides, and radiation.
Early in December, the Food and Drug Administration banned certain toys with mechanical hazards and proposed repurchase or adjustment plans for consumers affected by such actions. The ban was the first such action to be taken under the 1969 Child Protection and Toy Safety Act.
Secretary Richardson announced on December 13 that loans under the Guaranteed Loan Program, authorized by the Higher Education Act of 1965, were approaching the $3 billion mark. The program, which became operational in the fall of 1966, had made more than three million separate loan transactions, with an estimated 2.5 million students having continued or completed their college and vocational training during five years of the program operation.
There were a number of organizational changes in the Department during 1970.
On March 19, the Bureau of Federal Credit Unions was removed from the Social Security Administration and made an independent Federal agency, the National Credit Union Administration.
The Youth Development and Delinquency Prevention Administration was created in the Social and Rehabilitation Service on June 1, 1970, elevating to sub-agency level the Office of Juvenile Delinquency and Youth Development in the Office of the Administrator. The new unit was to provide a sharper Federal focus in this field.
The Food and Drug Administration was gradually reorganized along product lines during 1970 and 1971 : The Bureau of Drugs was reorganized on August 20, 1970. On October 23, the Bureau of Product Safety was established and new units were created in the Bureau of Veterinary Medicine. On February 10, 1971 , the Bureau of Foods was established.
In the National Institutes of Health, the Bureau of Health Professions Education and Manpower Training was renamed the Bureau of Health Manpower Education on September 18, 1970.
The Office of the Assistant Secretary for Education was retired on October 21, 1970 and its functional responsibilities were transferred to the Office of Education.
Other units reorganized during the year were the Bureau of Health Insurance in SSA (December 10) and the Rehabilitation Services Administration in SRS (December 19).
During fiscal year 1970, 37 pieces of legislation were enacted, the most important of which were:
A new report by the Surgeon General on the health consequences of smoking which confirmed and strengthened conclusions of four previous such reports was published by HEW in January. It revealed stronger evidence of the adverse effect of smoking by pregnant women on the unborn child; it also cited additional evidence concerning cigarette smoking as a risk factor in the development of coronary heart disease and peripheral vascular disease. In addition, it confirmed earlier findings that cigarette smoking is the main cause of lung cancer in men.
In February, the Office of the Secretary announced the creation of two new offices:
In the health area, four significant actions were taken during February:
Early in March, a task force on higher education called for substantial overhaul of the American system of higher education. The "Newman Report" challenged the concept of continuing growth of the existing system of higher education without major reforms. The Report asserted that nearly all 2,500 institutions of higher learning have adopted the same mode of teaching and learning, and that it is no longer true that most students have real choices among differing institutions of higher education. Major recommendations of the report included eliminating locksteps; expanding non-college opportunities; vigorous efforts to achieve equality for women; strengthening institutional missions through elimination of non-educational activities; refocusing on high priority academic programs, and creation of new special-purpose institutions.
The White House Conference on Youth was held in Estes Park, Colo. April 18-22 in an effort to determine the needs of America's youth and develop a program of governmental response. Top officials of the Department were among the more than 1,500 delegates who attended, 1 ,000 of whom were 14-24 years of age. Ten task forces explored issues of special concern to youth.
Also in April, initial administrative steps were taken in the conversion of the Army's Pine Bluff Arsenal (Arkansas) to a unique facility for improving consumer protection. President Nixon had announced January 27, 1971 that FDA will establish and administer a new activity-the National Center for Toxological Research-at the Pine Bluff biological plant. The facility will occupy 504 acres of former Arsenal property and will include 33 buildings with 1.7 million square feet of floor space.
On May 11, the National Institute on Alcohol Abuse and Alcoholism was established within the National Institute of Mental Health, to develop and conduct comprehensive programs of research, training, development of community services and public education to help prevent and treat alcohol abuse and alcoholism.
An Office of Special Concerns was established in May in the Office of the Secretary to insure special priority for women employees of the Department, American Indians, Spanish-Surnamed Americans, migrant workers and the HEW Fellows.
The Food and Drug Administration warned the nation in May not to eat swordfish since FDA's testing program had revealed an excessive level of mercury contamination. To prevent health hazards to the public, FDA seized 832,000 pounds of swordfish and fish brokers withheld 4 million pounds from commercial markets.
In June, the Department established within the Office of Child Development, a National Center for Child Advocacy, a recommendation of the 1970 White House Conference on Children. A major mission of the new center was to follow up on other conference recommendations and work with State, local and private organizations. A children's concern center, which accepts inquiries and statements of concern from any parent or citizen about matters affecting children, was established within the national center.
In the first annual report by SSA on the operation of the black lung benefit program, it was announced that over 200,000 disabled miners, widows and dependents were receiving monthly black lung benefits under the Federal Coal Mine Health and Safety Act of 1969. Total benefits paid since the law was signed on December 30, 1969, exceeded $300 million. The law authorized payment of monthly benefits to coal miners totally disabled due to pneumonoconiosis arising out of the disease.
By the end of June, the Department announced that 66 grants and contracts totalling $6.5 million had been awarded for health maintenance organizations (HMO's). HMO's are organized systems of health care, providing comprehensive health services to voluntarily enrolled members for a fixed, prepaid annual fee. The groups receiving awards included group practices, medical care foundations, hospitals, consumer groups, medical schools and neighborhood health centers.
The Food and Drug Administration on July 2 sounded an urgent warning to consumers not to eat cans of Bon Vivant Vichyssoise soup because of potential botulism contamination. On July 7, it ordered a recall of all soups, sauces, and other canned products by Bon Vivant Soups, Inc., as a precautionary measure to protect public health and safety.
In August, a National Advisory Committee was created to begin immediate planning on the President's accelerated program of research and treatment against sickle cell anemia, the painful and lifeshortening disease which afflicts an estimated 50,000 black Americans each year. Six contracts totaling more than half a million dollars were awarded by the National Institutes of Health for clinical studies.
The Office of Education reported in August that some 1,072,581 degrees were awarded by institutions of higher education during the 12 months ending June 30, 1971, a 50 per cent increase over 1966. There was a sharp percentage increase in the number of women earning degrees. During the 5-year period, the number of women receiving doctorates increased by 88 per cent, the number receiving master's degrees went up by 75 per cent, and the number receiving bachelors degrees increased by 54 per cent.
The Social and Rehabilitation Service announced in August the investment of $4.1 million toward the development of a national program of comprehensive social services for the elderly. The extensive efforts were aimed at helping aged citizens who suffer from isolation, nutritional problems and other unmet social needs. The program was expected to be a major breakthrough in the development of comprehensive social services for the elderly.
On August 23, Secretary Richardson announced the opportunity for employees to take college credit courses free of charge. The Upward Mobility College Program operated by D.C.'s Federal City College, would enable nearly 1,600 HEW employees who have graduated from high school or its equivalent, to work toward a college degree, with HEW paying for tuition and books, and releasing the employee from work for half the time spent in class. The program began in April of 1970 as a pilot demonstration in the Office of Education.
The Social and Rehabilitation Service announced that nearly three-quarters of a billion dollars was added to the Nation's economy as a result of rehabilitating a record number of disabled Americans to productive employment during FY 1971. Annual earnings of the 291,272 persons rehabilitated during the year increased by an estimated $770 million over what they earned the year before entering the State-Federal vocational rehabilitation program.
A Deputy Under Secretary for Welfare Reform Planning was appointed in September, to plan and organize welfare reform implementation, which has been described as the most complex management undertaking in the history of the Federal government.
Early in September the National Right to Read program developed a master plan for the next ten years aimed at eradicating illiteracy by 1980; 38 States submitted Right to Read plans, and a reading resources network of 80 information centers was established.
Also in September, the Food and Drug Administration completed inspections of 122 toy manufacturing firms. The action was one of a number of initiatives undertaken by FDA to improve toy safety. Since December of 1970, about 150 individual toy products had been banned, and some 60 types of toys had been voluntarily corrected by toy firms on the basis of FDA identification of potential mechanical hazards. The Agency's Bureau of Product Safety also had set up a Toy Review Committee, and had examined approximately 600 toys for mechanical hazards.
The Commissioner of Education announced October 1 the award of $2 million to the Children's Television Workshop to support the continuing development of educational programs for children. The amount awarded the producers of Sesame Street represented partial payment on a total commitment of $5 million during FY 1972, and would be used to support both Sesame Street and the Workshop's new reading series, The Electric Company, designed to supplement in-school reading instruction for 7- 10-year olds.
President Nixon formally announced on October 18 that the laboratory facilities of Fort Detrick, Md. would be converted from germ warfare research to an intensive program of cancer research. The laboratories were the U.S. Army's principal facility for chemical and biological research until the United States stopped production of such weapons in November of 1969. Cancer research at the laboratories will be conducted by private firms under contract with the National Institutes of Health and will be part of the accelerated Cancer Cure Program.
By October 31, a total of 24.4 million doses of a vaccine against rubella (German measles) had been administered under public programs and about 5 million by private physicians in the national campaign to vaccinate 60 million children which began in June 1969. It was the first time in the Nation's history that so many children received a vaccine so soon after its licensure.
In response to a Presidential mandate in August to upgrade the quality of nursing home care for some 1 million elderly persons confined to nursing homes, HEW expanded nursing home inspection efforts and announced a program to train 2,000 additional State inspectors over the next two years.
In an address to the 3,400 White House Conference on Aging delegates in late November, the Secretary announced that 38 States had "substantial deficiencies" in their nursing home certification process under Medicaid. The States were notified that unless improvements were made by February 1, 1972, all Federal Medicaid funds would be withheld.
Secretary Richardson announced on November 16 a ban on Federal government use of lead-based paint in residual structures. Leadbased paint is defined as paint containing more than one percent of lead by weight. The prohibition was required by the Lead-Based Paint Poisoning Prevention Act (P.L. 91-695, Section 401).
The Secretary also announced in November plans to eventually merge the Public Health Service Commissioned Corps and the civil service system into a single, unified civilian personnel system. The action was based upon recommendations of a Secretary's Committee to Study the PHS Commissioned Corps.
Secretary Richardson issued on November 29, 1971, a memorandum, "Policy Development and Implementation in the Department of Health, Education, and Welfare," establishing a policy management system.
The system provided for two principal policy development and implementation procedures: The Baton-Passing Model, in which the responsibility is passed from office to office as policy alternatives are developed, decisions made and implemented, and programs executed and evaluated; and the Project Management Model for those special policies and issues of such complexity and overriding importance that a full-time project manager is needed to facilitate their development and implementation. Policy coordination was assigned to the ASPE and the monitoring of the process to the Executive Secretariat.
On December 23, 1971, the Secretary issued a memorandum establishing, as a further step in the new management system, the Master Planning Calendar. This concept was to fit policy development and implementation into a workable schedule of activities based on an annual framework. The planning cycle would begin every year in August and carry a policy initiative through a series of key milestones for 24 months. The Calendar would schedule all planning functions, establish sequences of centralized direction of activities, and relate decisionmaking in planning, budget, legislation and other key functions.
The Office of Education announced on December 31 that more than one million postsecondary students borrowed more than $1 billion through the Guaranteed Student Loan Program in 1971. It was the first time in the 6-year history of the program that the number of borrowers exceeded one million and the number of dollars borrowed exceeded one billion. The amount loaned during 1971 was greater than the total loaned in the first three years of the program's operation.
In December, Secretary Richardson made a talk before several groups of HEW employees in which he discussed the responsibilities of the Department and what he felt must be done to make HEW "a more responsible and responsive instrument for serving the American people."
The Secretary summarized his views as follows: "We in HEW are charged with a fourfold task-to identify the problems of the people and of the institutions with which we are concerned; to eliminate the gaps between promise and performance by setting and meeting attainable goals; to make the best possible use of the resources we have; and to fight for the additional resources we know how to use well."
Organizational changes in 1971 included the following:
The Office of State Merit Systems was transferred on January 5, 1971 from the Office of the Secretary to the U.S. Civil Service Commission under authority of P.L. 91-648.
In March, the first Assistant Secretary for Public Affairs in the 18-year history of the Department was appointed to assure a more integrated and effective Department-wide communications program. In mid-June, Deputy Assistant Secretaries for Communications and Operations were named.
The remaining elements of the Environmental Health Service which did not become part of the new Environmental Protection Agency were transferred May 25 to HEW agencies as follows: The Bureau of Occupational Safety and Health to the National Institute of Occupational Safety and Health, HSMHA; the Bureau of Community and Environmental Management to HSMHA; and the Bureau of Radiological Health to FDA.
The Office of Education was completely reorganized on October 13, 1971. Six Deputy Commissioners were appointed to achieve more effective management of the agency. The Executive Deputy Commissioner was designated as the principal deputy to the Commissioner of Education. In addition:
The Deputy Commissioner for Management was given responsibility for the Office of Administration, the Office of Regional Office Coordination, and the Office of Program Planning and Evaluation.
The Deputy Commissioner for School Systems assumed responsibility for the Bureau of Elementary and Secondary Education, the Bureau of Education for the Handicapped, and the Bureau of Adult, Vocational, and Technical Education.
The Deputy Commissioner for Development would direct activities of the National Center for Educational Research, the National Center for Educational Communication, the Experimental Schools Program Staff, the National Center for Educational Statistics, and the Bureau of Educational Personnel Development.
The Deputy Commissioner for Higher Education was given responsibility for the Bureau of Higher Education, the Institute of International Studies, and the Bureau of Libraries and Educational Technology.
While the Office of Education reorganization was the most sweeping organizational change during the year, a number of bureaus and subagencies were reorganized as follows: SRS's Community Services Administration, February 10; The Office of Child Development, OS, February 11 ; SSA's Bureau of Health Insurance, February 17; HSMHA's Indian Health Service, March 10, the Community Health Service, HSMHA, May 10; Regional Medical Program Service, HSMHA, June 12; SSA's Bureau of Disability Insurance, September 1; and SSA 's Bureau of Retirement and Survivors Insurance, November 26.
In addition, the Health Maintenance Organization Service (October 12) and the Comprehensive Health Planning Service (November 12) were established in HSMHA.
Public Law 92-5, signed March 17, 1971, provided for: (1) a 10 percent across-the-board increase in Social Security cash benefits (with a 5 per cent increase in the special payments for certain people over age 72); (2) an increase in the contribution and benefit base ($7800 under prior law) to $9000, effective for 1971; and (3) an increase in the previously scheduled social security contribution rates for years after 1975.
Public Law 92-31, signed on June 30, 1971, amended and extended the Juvenile Delinquency Prevention and Control Act for one year. The original act authorized the Department to make grants to a state agency for planning, training and the development of improved practices and techniques in dealing with delinquents. The amendments raised the Federal matching share from 60 percent to 75 percent, and created the Interdepartmental Council on Juvenile Delinquency to coordinate all Federal juvenile delinquency programs.
Public Law 92-54, signed on July 12, 1971, was designed to provide jobs in needed public services during times of high unemployment, and specifically includes health workers in its provisions. It has speeded the identification of personnel needs in the health care field that could be met under its provisions.
The Comprehensive Health Manpower Training Act, P.L. 92-158, signed on November 18, 1971, was aimed at eliminating, by 1980 the shortage of doctors and other trained medical personnel in the Nation by providing substantial new Federal support to medical education. The measure gave programs of aid to schools of medicine, dentistry, osteopathy, veterinary medicine, optometry, podiatry, pharmacy, and their students, totalling $2.9 billion over a 3-year period.
The Nurse Training Act, P. L. 92-158, signed on November 18, authorized grants and loans with interest subsidies for the construction of facilities for schools of nursing; provided special project grants to schools of nursing and other non-profit agencies including assistance to nursing schools in financial distress; start-up grants for new nurse training programs; and scholarship grants and contracts to encourage full utilization of education talent for the nursing profession.
The National Cancer Act, P.L. 91-218, signed on December 23, 1971, authorized mounting a concerted national campaign against cancer. It authorized the spending of $1.6 billion over the next three years for research and related activities. The cancer fight will be kept within NIH's National Cancer Institute, but NCI will be able to send its budget directly to the White House, bypassing both the head of NIH and HEW. The directors of both NIH and NCI will be Presidential appointees and the President will monitor the fight through a three member watchdog panel reporting directly to him.
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Assistant Secretary for Planning and Evaluation (ASPE)
U.S. Department of Health and Human Services (HHS)