A Common Thread of Service . Secretary Cohen


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:

  • Federal Credit Union Act Amendments of 1968, P.L. 90-375, July 5, 1968, increased maturity of secured loans, increased limit on unsecured loans, continued Project Moneywise for residents of low income areas, and updated procedures of Federal two-thirds credit unions.
  • Vocational Rehabilitation Amendments of 1968, P.L. 90-391, July 7, 1968, extended appropriations through 1971 for grants to States for vocational rehabilitation services and innovation projects and renewed authority for projects grants in research, demonstrations, expansion, and training of rehabilitation personnel.
  • Juvenile Delinquency Prevention and Control Act of 1968, P.L. 90-448, authorized funds to support research and training efforts and to provide assistance for the diagnosis, treatment, and rehabilitation of youths who are delinquent or in danger of becoming delinquent.
  • Elimination of Architectural Barriers to Physically Handicapped Act, P.L. 90-480, August 12, 1968, required that every building which the Federal Government constructs, alters, leases, or finances shall be subject to standards for design and construction suitable for full and free access by handicapped persons.

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:

  • In 1963, the Nation spent $100 billion for health, education, and welfare, of which the Federal share was $32.6 billion; by 1968, the total expenditure had risen to $168 billion, of which the Federal share was $61 billion.
  • Federal funds for health had more more than tripled and Federal funds for education had quadrupled during the 5 years.
  • Medical research funds had increased two-thirds.
  • Infant mortality had declined 12 percent and maternal mortality had declined 19 percent.
  • Hill-Burton hospital construction program had provided the Nation with 413,800 beds from 1948 to 1968.
  • 9 million children were benefiting from special improvement programs in poverty areas under Title I of the Elementary and Secondary Education Act (ESEA).
  • 10 million children had benefited from innovative projects under Title II I of ESEA.
  • About 70 million books and other instructional materials had been purchased under Title II of ESEA and were available to 45 million children - 88 percent of U.S. pupils.
  • 1,550,000 college and university students in 1968-69 received Federal financial help for educational expenses versus 350,000 in 1964-65.
  • Enrollment in Federally supported vocational and technical education programs had doubled to 9.2 million since 1963.
  • 450,000 adult basic education enrollees in 1968 represented an 1,100 percent increase since 196 5.
  • 85 million people were being served by Federally assisted public libraries, compared to 40 million in 196
  • The high school dropout rate had declined 27 percent.
  • The number of handicapped persons rehabilitated annually had doubled in 6 years.
  • Poverty had declined 38 percent in 5 years.
  • Savings in Federal credit unions had grown from $3.45 billion to $6 billion.
  • Social security beneficiaries had grown from 18.6 million to 24.1 million; average benefits had increased from $77 to $98 for a retired worker, from $90 to $112 for a disabled worker, and from $192 to $254 for a widow with two children; annual cash benefit payments had increased from $15.6 billion to $25.3 billion; social security and railroad retirement survivors insurance face value had increased from $603 billion to $950 billion. In August of 1968, social security celebrated a third of a century of service.
  • After two years of Medicare, 19.7 million aged were protected with hospital insurance and 18.6 million with medical insurance and the program had paid $5.7 billion for inpatient hospital care (10.6 million bills), $2.1 billion for physicians' care and other medical services (45 million bills), and $420 million for extended care (1.3 million bills).
  • HEW had distributed $2.2 billion in surplus real and personal property from 1963 to 1968.
  • Public assistance expenditures had risen from $4.6 billion in 1963 to $10.4 billion in 1969.