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:
- Drug Abuse Control Amendments of 1965, P.L. 89-74, July 15, 1965, authorized Federal controls to prevent widespread nonmedical abuse and illegal traffic in depressant, stimulant, and hallucinogenic and counterfeit drugs.
- Federal Cigarette Labeling and Advertising Act, P.L. 89-92, July 27, 1965, required that after January 1, 1966, all cigarette packages bear the notice: "Caution: Cigarette smoking may be hazardous to your health".
- Mental Retardation Facilities and Community Mental Health Centers Construction Act Amendments of 1965, P.L. 89-105, August 4, 1965.
- Community Health Services Extension Amendments of 1965, P.L. 89-109, August 5, 1965.
- Health Research Facilities Amendments of 1965, P.L. 89-115, August 9, 1965.
- Water Quality Act of 1965, P.L. 89-234, October 2, 1965, established a new 4-year program of grants and contracts to develop better methods of coping with water pollution and authorized establishment of water quality standards for interstate waters.
- Heart Disease, Cancer, and Stroke Amendments of 1965, P.L. 89-239, October 6, 1965, established regional medical programs-cooperative arrangements among medical schools, research institutions, and hospitals for making available to patients the latest advances in diagnosis and treatment of major diseases.
- Clean Air Act Amendments and Solid Waste Disposal Act of 1965, P.L. 89-272, October 20, 1965, authorized the Secretary to control air pollution from motor vehicles; to abate U.S. air pollution endangering neighboring countries; to prevent new sources of air pollution; and established research, development, demonstration, and planning grants and technical assistance in solid waste disposal.
- Medical Library Assistance Act of 1965, P.L. 89-291, October 22, 1965, authorized a 5-year program of construction, training, research, development, and publications support for medical libraries, including establishment of regional branches of the National Library of Medicine.
- Elementary and Secondary Education Act of 1965, P.L. 89-10, April 11, 1965, a landmark bill authorizing $1.33 billion in FY 1966 to improve elementary and secondary education, including $1 billion to local school districts to aid educationally deprived children, and funds for library resources and textbooks, supplementary educational centers, educational research, the strengthening of State educational agencies, and the establishment of regional educational research laboratories.
- Manpower Act of 1965, P.L. 89-15, April 26, 1965, delegated to HEW responsibility for instructional training components of experimental, demonstration, and pilot projects for professional employees.
- National Technical Institute for the Deaf Act, P.L. 89-36, June 8, 1965.
- National Foundation on the Arts and Humanities Act of 1965, P.L. 89-209, September 29, 1965.
- Captioned Films for the Deaf Act, P.L. 89-258, October 19, 1965.
- National Vocational Student Loan Insurance Act of 1965, P.L. 89-287, October 22, 1965, established a system of loan insurance to assist needy students desiring vocational training.
- Health Professions Educational Assistance Amendments of 1965, P.L. 89-290, October 22, 1965, authorized basic and special improvement grants and scholarships for schools of medicine, dentistry, osteopathy, optometry, and podiatry.
- Assistance to Public Schools Affected by Major Disasters and Base Closings, P.L. 89-313, November 1, 1965.
- Higher Education Act of 1965, P. L. 89-329, November 8, 1965, authorized:
- Grants to strengthen resources of colleges and universities to aid them in providing community service programs, such as continuing education, consultations, seminars and research, designed to assist in the solution of community problems.
- Aid to college and university libraries through grants for books and supplies, training of personnel, and research and demonstration projects.
- Grants to upgrade academic standards of developing colleges through faculty and student exchanges, visiting scholars, joint use of facilities, as well as a National Teaching fellowship program.
- Student assistance programs, including scholarships, a subsidized low-interest insured loan program, expanding of the work-study program, and improvements in the NDEA loan program.
- Improved teacher preparation programs: a National Teacher Corps, graduate fellowships to train elementary and secondary teachers, and grants to improve college undergraduate and graduate teacher training programs.
- Funds for teaching equipment, including closed circuit television, and for minor remodeling of facilities to improve undergraduate instruction.
- Expansion of the Higher Education Facilities Act of 1963, with a doubling of funds authorized for 1966 for construction grants.
Social and Economic Opportunity
- Appalachian Regional Development Act of 1965, P.L. 89-4, March 9, 1965.
- Juvenile Delinquency and Youth Offenses Control Act Amendments of 1965, P.L. 89-69, July 8, 1965.
- - Older Americans Act, P.L. 89-73, July 4, 1965, authorized a 5-year program of grants to the States for community planning services and training in the field of aging and for research and demonstration projects, and created an Administration on Aging within HEW to advise the Secretary and coordinate information on problems of the aging, administer grants programs, and provide consultation and technical assistance to the States.
- Social Security Amendments of 1965, P.L.89-97, July 30, 1965, increased OASDI cash benefits, liberalized eligibility, authorized benefits to eligible children 18-21 attending school; established two national health insurance programs (Medicare) for the aged, hospital insurance and supplementary medical insurance; medical assistance (Medicaid) for medically needy; authorized grants for comprehensive health projects for needy and preschool children and grants for training professional personnel to work with crippled children; expanded maternal and child health and crippled children's services; and increased Federal participation in public assistance payments.
- Correctional Rehabilitation Study Act of 1965, P.L. 89-178, September 10, 1965.
- Economic Opportunity Amendments of 1965, P.L. 89-253, October 9, 1965.
- Vocational Rehabilitation Act Amendments of 1965, P.L. 89-333, November 8,1965, established new 5-year programs of grants for the construction of rehabilitation facilities and workshops, staffing of rehabilitation facilities, and workshop improvement and created a National Commission on Architectural Barriers to Rehabilitation of the Handicapped.
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:
- Library Services and Construction Act Amendments of 1965, P.L. 89-511, July 19, 1966, provided assistance for the States in extending specialized library services for State institutions and services for the physically handicapped.
- Clean Air Act Amendments of 1966, P.L. 89-675, October 15, 1966, authorized grants to air pollution control agencies and made use of appropriations under the Act more flexible.
- International Education Act of 1966, P.L. 89-698, October 29, 1966, provided for the strengthening of American education resources for international studies and research.
- Veterinary Medical Education Act of 1966, P.L. 89-709, November 2, 1966, authorized a program for the construction of facilities for the teaching of veterinary medicine and a program of loans for students of veterinary medicine.
- Comprehensive Health Planning and Public Health Service Amendments of 1966, P.L, 89-749, November 3, 1966, assisted in the extension and improvement of comprehensive health planning and public health services and provided for more effective use of Federal funds for such planning and services.
- Elementary and Secondary Education Amendments of 1966, P.L. 89-750, November 3, 1966, strengthened and improved programs of assistance for elementary and secondary schools.
- Allied Health Professions Personnel Training Act of 1966, P.L. 89-751, November 3, 1966, increased opportunities for training of personnel in allied health professions, improved the educational quality of the schools training such allied health professions personnel, and strengthened and improved existing student loan programs for health professions students.
- Higher Education Amendments of 1966, P.L. 89-752, November 3, 1966, amended the Higher Education Facilities Act of 1963, the Higher Education Act of 1965, and the National Defense Education Act of 1958.
- Child Protection Act of 1966, P.L. 89-756, November 3, 1966, amended the Federal Hazardous Substances Labeling Act to ban hazardous toys and other articles so hazardous as to be dangerous in the household and to apply that Act to unpackaged articles intended for household use.
- Adult Education Act of 1966, P.L. 89-750, November 3,1966, transferred authority for the adult basic education program from the Office of Economic Opportunity to the Office of Education.
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.
- Education Professions Development Act, P.L. 90-35, June 29, 1967, strengthened programs for the training and improvement of the qualifications of education professionals.
- Public Broadcasting Act of 1967, P.L. 90-129, November 7, 1967, authorized grants to assist educational radio and television broadcasting and established a nonprofit, nongovernmental corporation to channel private financial aid to educational radio and TV.
- Air Quality Act of 1967, P.L. 90-148, November 21, 1967, expanded and improved research and development programs in air pollution control, provided for planning and control programs on a regional basis, required standardsetting and enforcement by the States, and permitted strong Federal action if the States do not act.
- Vocational Rehabilitation Amendments of 1967, P.L. 90-99, October 3, 1967, set up a National Center for Deaf-Blind Youth and Adults and authorized a system of project grants to handicapped migratory workers.
- Clinical Laboratories Improvement Act of 1967, P.L. 90-174, (Partnership for Health Amendments of 1967), December 5, 1967, authorized the Secretary to establish minimum performance standards for all clinical laboratories engaged in interstate commerce and permitted him to bring court action against any licensed laboratory presenting an imminent danger to public health.
- Social Security Amendments of 1967, P.L' 90-248, January 2, 1968, provided a 13-percent, across-the-board increase in benefits, with a minimum monthly benefit of $44, and increased the special benefits for those aged 72 and over to $40 a month. The amount of permissable outside earnings was increased for disabled widows. The Act also provided for work incentives for public welfare recipients, increased authorizations for child welfare programs, demonstration projects, and support of social work manpower and training, and provided for expansion and improvement of child health programs.
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.