Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
352356376
label
Aging (2)
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
352356376
contentType
document
title
Aging (2)
citationUrl
collections
Spencer C. Johnson Files (Ford Administration)
Spencer Johnson's Subject Files
subjects
Legislation
Old age
Medicare
thumbnailUrl
largeImageUrl
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
352356376
coverageEndDate
logicalDate
1976-10-31
month
10
year
1976
coverageStartDate
logicalDate
1975-02-01
month
2
year
1975
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
5559c69ee44c79f2
ocrText
The original documents are located in Box 1, folder "Aging (2)" of the Spencer C. Johnson
Files at the Gerald R. Ford Presidential Library.
Copyright Notice
The copyright law of the United States (Title 17, United States Code) governs the making of
photocopies or other reproductions of copyrighted material. Gerald R. Ford donated to the
United States of America her copyrights in all of her husband's unpublished writings in National
Archives collections. Works prepared by U.S. Government employees as part of their official
duties are in the public domain. The copyrights to materials written by other individuals or
organizations are presumed to remain with them. If you think any of the information displayed
in the PDF is subject to a valid copyright claim, please contact the Gerald R. Ford Presidential
Library.
Some items in this folder were not digitized because it contains copyrighted
materials. Please contact the Gerald R. Ford Presidential Library for access to
these materials.
BLUE SHIELD'S POSITION ON FEDERAL DE-REGULATION
Blue Shield Plans are subject to federal regulation principally as Medicare
Part B carriers. In that capacity 32 of our member Plans process and pay
claims for physicians' services to nearly 12 million program beneficiaries,
and perform related technical and administrative duties in accordance with
P.L.89-97.
P.L.89-97, it should be noted, explicitly provides for the use of private
carriers "in order to provide for the administration of (Medicare benefits)
with maximum efficiency and convenience for individuals entitled to benefits
and providers of services
to such individuals
11 (Section 1842a)
At the same time, of course, P.L.89-97 vests ultimate responsibility for the
Medicare program in the Secretary of Health, Education and Welfare, who in
turn delegates regulatory responsibilities to the Social Security Administra-
tion's Bureau of Health Insurance.
On the whole, Blue Shield carriers have enjoyed excellent relations with SSA
and BHI. Together, the public and private sectors have demonstrated a basic-
ally successful "partnership" approach to an enormously difficult task.
Following inception of the Medicare program, however, questions and issues
arose with respect to appropriate carrier management latitude within the
federal regulatory framework. These concerns culminated, in 1973, in the
appointment of a prestigious HEW Advisory Committee to "advise the Secretary
and the Commissioner of Social Security concerning broad organizational and
operational matters, contract formulation and reimbursement principles applic-
able to Medicare contracts and subcontracts."
GERALD FORD LIBRARY
-2-
The central thesis of the Advisory Committee's June 1974 Report was that
"the pluralistic system created by Congress in 1965 for the administration
of Medicare has continuing advantages" and that "SSA should reduce its role
in carrier decision-making and rely on its capacity to test carrier perform-
ance by results."
In reaching these important conclusions, the Advisory Committee articulated
quite remarkably the same basis and impetus for federal de-regulation which
is so prevalent in America today. Indeed, we are struck by the similarity
between certain features and recommendations in the Advisory Committee's 1974
Report, on the one hand, and the more recent findings of the Domestic Council's
Public Forums, on the other.
We believe BHI, for its part, has responded positively to the bulk of the
Advisory Committee's many recommendations. Some differences exist between
BHI and our Plans with respect to carrier electronic data subcontracting pre-
rogatives.
In this specific context, the Advisory Committee urged "that BHI adopt the
philosophy that unwise carrier decisions as to data processing subcontracts
will show up in the results of carrier performance, and that BHI will put its
faith in the capacity to measure results rather than in attempting to guide
carrier decisions."
Nevertheless, Medicare carriers seeking to improve their performance through
major data processing management decisions must first obtain prior approval
GERALD R. LIBRARY FORD
from BHI if any contemplated changes will exceed a certain dollar threshold.
-3-
In some instances, BHI's delay and indecisiveness in approving such Plan
requests has resulted in higher administrative costs and poorer beneficiary
services, rather than the economies and improved performance sought by the
carrier. As the Advisory Committee observed: "Unreasonable delay is one of
the worst features of Government procurement. 11
Thus, bonafide de-regulation of the carrier EDP subcontracting function, with
a concomitant emphasis on measuring carrier performance by results, will go
a long way toward fulfilling contemporary economic and Congressional health
care objectives.
March 1, 1976
FORD is LIBRARY GERALD
U.S. Department of Health, Education, and Welfare
Office of Public Affairs
- 10
fele
Daily News
April 1, 1976 p.69
Catastrophic illness: For the sick and old,
the financial burden is crushing
By KEN McKENNA
For most Americans, & prolonged
a typical situation when the wife is
First of two articles
illness in the family imposes an impos-
crippled or chronically ill. "The children
sible financial burden. Most private
have to fill in where possible and the
Benjamin R., 65 and weakened
insurance plans have limits. Some com-
husband has to be there almost always.
by a severe respiratory illness, en-
panies have introduced plans that boost
Everything in the household. centers
the allowable benefits to $250,000 and
around the wife. There's little left for
tered the Bronx's St. Barnabas
beyond, but the price tag is high and the
the rest of the family."
Hospital in the spring of 1973, not
elderly, the most likely victims, mostly
Cancer Care is paying a portion of
worrying about medical expenses.
are ineligible. Medicare runs out after
the medical bills for a mechanic, 39, who
He qualified for Medicare and had
90 days while Medicaid requires an
was operated on for cancer three years
a fat bank account and other
individual to be at the poverty level in
ago. The cancer spread from the lung
assets worth more than $80,000.
order to qualify.
to other parts of his body and he is now
At Montefiore Hospital in the Bronx,
disoriented and almost in a coma. The
By the time of his discharge last
Myra Eisen, who works in social services,
family has seven children, the oldest 13.
November, he was a virtual pauper.
told of a woman, a retired city employe,
Mrs. Weissman observed, "His wife
After his Medicare benefits expired, he
who had just learned that her husband
on a conscious level wants him to live
paid the medical bills himself for a year.
must enter a nursing home. The woman's
but on an unconscious level, she wants
839
U.S. Department of Health, Education, and Welfare
Office of Public Affairs
- 9
Wash. Star
April 2, 1976 p.B1
Retarded Lack Supplies That Sit
in Forest Haven Warehouse
By Diane Brockett
ways he measured the hu-
automatically processed.
supplies such as toothpaste
At one point, the employe
We've had trouble but
and deodorant for the resi-
maneness of an institution
said, there were enough
Washington Star Stall Writer
Some of the mentally retarded
was whether the institution
things have never been so
dents monthly, with sup-
toothbrushes to go around
was careful to provide each
tow we can't get tooth-
plies received in 10 to 20
but as they have worn out,
residents of Forest Haven had, until
patient with his own tooth-
brushes. I think it just goes
days.-
no replacements have been
this morning, been using communal,
back to institutionaliza-
One employe at Curley
brush.
provided.
toothbrushes. Lacking toothpaste,
tion," Queene said.
said that she cares for 19
Yesterday Queene said
The employe used to buy
their mouths had been treated to a
there was no excuse for the
"Sometimes employes
persons each day but has such items as toothpaste for
daily scrubbing with the same soap
situation. "An employe just
just don't treat the resi-
only 10 toothbrushes and no the residents, he said, but
used for their showers.
needs to requisition it
dents like human beings."
toothpaste. "But that's bet- "you just get tired of it."
Abundant supplies of both are
Queene said the cottages
ter than when Infirst came
through his or her supervi-
three years age the em.
THE WHITE HOUSE
WASHINGTON
DATE 3/8/76
TO: Spence
FROM: SARAH MASSENGALE
Please throw away
the last copy l
sent you.
Thanks.
FORD & LIBRARY 076835
THE PRESIDENT'S COUNCIL ON PHYSICAL FITNESS
AND SPORTS
Attached is the revised version
of the aging testimony.
FORD & LIBRARY GERALD
PRESIDENT'S COUN COUNCIL
THE PRESIDENT'S COUNCIL ON PHYSICAL FITNESS AND SPORTS
MANISCAL FITNESS
WASHINGTON, D.C. 20201
April 9, 1976
MEMORANDUM FOR
Spencer Johnson
Associate Director
Domestic Council
The White House
Attached is a copy of my testimony, on the subject of
"The Role of Physical Fitness in Reducing Health and
Long-Term Care of the Elderly," to be delivered be-
fore the joint Subcommittees on Health and Long-Term
Care, and Federal, State, and Community Relations.
The hearing will be held on April 14, 1976, at 9:30 am,
in room H-139, the Capitol.
I think you will find these remarks well illustrative
of the role physical fitness can play in a disease
prevention public health strategy.
If you have any questions regarding my remarks, please
give me a call.
Attachment
Dext
Richard O. Keelor, Ph.D.
Director
Program Development
FORD i LIBRARY GERALD
TESTIMONY TO THE JOINT HEARING
HELD BY SUBCOMMITTEES ON:
HEALTH AND LONG-TERM CARE
FEDERAL, STATE, AND COMMUNITY RELATIONS
SELECT COMMITTEE ON AGING
The Role of Physical Fitness in Reducing
Health and Long-Term Care of the Elderly
By
Richard O. Keelor, Ph.D.
Director of Program Development
President's Council on Physical
Fitness and Sports
April 14, 1976
Honorable Claude Pepper
Honorable Spark M. Matsunaga
Chairmen
FORD is LIBRARY GERALD
Regular exercise has emerged as one of the key factors
in reducing chronic physical degeneration associated
with living in our highly sedentary society.
In testimony before the Senate Subcommittee on Aging
one year ago, Frederick C. Swartz, MD, Chairman of the Ameri-
can Medical Association's Committee on Aging, called the lack
of physical fitness our nation's greatest health problem. He
went on to say that, "Here the answer is the simplest and
the cheapest, and has the greatest application, and its reflec-
tion on the reduction of morbidity and mortality rates would
be immediate and tremendous." In reference to exercise for
older Americans, this authority on aging for the AMA said,
"We are convinced that participation in regular exercise
programs increases the confidence and a feeling of well-being
of the individual and helps him stay off dependency by pre-
venting or softening the shaky hand and tottering gait syn-
drome."
While there are still a few misinformed individuals who
view regular exercise as some kind of fad or passing fancy,
and "fitness freak" can still be heard to describe a person
who is intelligently managing his life style with regular ex-
ercise, we believe that by and large, Americans are slowly
waking up to the physiological need of the human body for
regular physical activity.
An even more dramatic demonstration of what we call the
FORD & LIBRAR
-2
"physical fitness renaissiance" in America can be found in
business and industry, and in the government. Facing the
growing human and financial cost of health care and the effects
of chronic physical degeneration on employees, these groups
are clearly moving towards a preventive strategy. Within
this strategy physical fitness has emerged as one of the
cheapest and most immediate remedies in preventing the
severe and predictable consequences of sedentary living.
Now, how does all this apply to our older population?
We believe that many of the health problems and the dis-
ability, dependency, and deterioration now associated with
aging are "acquired changes" resulting from poor personal
health practices rather than simply the result of the
passage of time. A social attitude has evolved in this
country which suggests because of a person's age he is ex-
pected to have these changes. Therefore, we should sit back
and wait until they appear and then take the necessary steps
as a humanitarian society to care for them when they develop.
We further believe that many of the problems noted in
older prople which we attribute to aging are the direct
result of disuse, and are not just the normal ravages of time.
There is clear evidence of loss of muscle cells if they are
not used, just as there is evidence that the amount of muscle
mass can be increased with appropriate exercise. Disuse of
bodily systems not only affects skeletal muscles but can
FORD & LIBRARY GERALD
-3
affect the heart muscle, decreasing the heart's capacity. It
can affect the lungs' capacity and almost every bodily system.
Nature seems to follow a simple principle: "If you don't use
it, you lose it."
As an example of this, let us consider atherosclerosis.
Atherosclerosis is the accumulation of fatty deposits in the
arteries. This can occur anywhere in the body. If it
affects the arteries to the heart muscle, it causes heart
disease; to the brain, it causes strokes; to the legs, it
interferes with walking; to the kidneys, it can alter their
normal function. Because atherosclerosis leads to blockage
of the arteries, it interferes with circulation. Cells will
then be deficient in oxygen and nutrients and accumulate
end products of metabolism like carbon dioxide. These
adverse effects on the cells limit their capacity to reg-
enerate and hinder their growth and response to use, there-
by contributing to the disuse problem. In their extreme
form they can result in cell death.
Through causing heart attacks, strokes, and kidney
disease and its multiple problems, atherosclerosis accounts
for approximately one half of the deaths in the United States.
It occasions untold numbers of cases of senility because of
brain damage and a host of other medical problems. The
amount of fatty deposits in the arteries clearly increases
with age, and it was therefore once assumed that atheroscle-
rosis was an aging phenomenon. This is obviously a false
FORD & LIBRARY GERALD
-4
assumption, since atherosclerosis also occurs in young people
particularly in the arteries to the heart in men as young as
22 years of age and in sufficient amounts to cause heart
attacks in these individuals. Nevertheless, because it in-
creases with age, the changes it brings about are often
considered as aging. They are, of course, acquired changes.
There is no argument about the application of this
principle to muscle tissue. The commonly observed decrease
in the size of muscles with increasing age is not all time
related. The muscle mass can be influenced by the amount
and type of physical activity. A person with relatively
small muscles can develop large muscles with a properly carried
out weight training program. Exercise which causes the muscles
to have to contract firmly or against force will gradually in-
crease the size of the muscles. Older individuals who have
continued forms of physical activity that constantly work the
muscles often have retained a larger muscle mass than much
younger individuals who follow no physical fitness program.
The range of possibility of development of muscle mass is so
great that there is a very obvious overlap between the physically
active older person and the inactive young person. Not that
the very old person by physical activity alone can retain the max-
imum amount of muscular development that the human body is able
to achieve. But physical activity is a major factor in main-
taining muscle mass, and its absence is a major factor in
FORD & LIBRARY GERALD
-5
failure to develop or maintain muscle mass.
Because physical activity progressively declines in in-
dividuals with increasing years, or sometimes with material
success, there is a tendency toward a gradual change in body
composition so that a large portion of the muscle mass is re-
placed with fat tissue. This is a main reason for the change
in body configuration attributed to aging. It is often
said that as a person gets older his chest falls. The largest
dimension is no longer around the chest but around the waist
and buttocks.
The commonly observed loss of muscle mass in advancing
years affects some muscle groups more than others. Muscle
tissue is typically lost between the bones in the hand, lead-
ing to the development of the "bony hand" of older individuals.
By appropriate hand exercises these muscles can be at least
partially maintained. Similarly, the muscle fibers in the
arms and legs tend to shrink, so that the size of the muscles
in the extremities is decreased. The loss in size and strength
of the abdominal muscle results in the relaxed abdomen which
is a major factor in the familiar "bay window."
The muscles along the entire spine are likely to weaken,
as are those between the shoulders. These and other changes
are responsible for the posture and physical appearance of
the bodies of older people. There is a constant battle against
gravity to maintain upright posture. As the muscles weaken,
the battle is lost and the body begins to sag. Just as an
old tree gradually bends to the earth, the human body bends
DERALD FORD LIBRARY
-6
more and more; its muscles can no longer keep the skeleton
in its optimal, upright position.
We commonly think of youth as being associated with
supple bodies with good muscles and strong bones capable
of a wide range of physical activity and endurance. We
think of age, by contrast, as being associated with loss
of muscles, weak and brittle bones, and loss of body supple-
ness. Certainly within our framework of living patterns
these concepts are true. Yet in many parts of the world
older individuals continue to be physically vigorous with strong
muscles, strong bones, and supple bodies.
It is interesting to note that much of the deconditioning
accepted as a normal by-product of aging can be induced in
young, well-conditioned men by the simple expedient of en-
forced bed rest in as little as three weeks.
The Foundation for Optimal Health and Longevity in
California has done international research in exercise,
diet, and longevity to determine why some individuals and
population groups are able to maintain vigor of mind and
body with advancing age, whereas the majority follow the
course of progressive deterioration cited above. These
studies were done in Ecuador, the Caucausus of Southern USSR,
Hunzaland in Kashmir, and California over a five year period.
These studies revealed that diet and prolonged physical
activity as a part of an individual's life style are a major
factor in the maintenance of physical and mental vigor many
FORD is LIBRAR 07V839
-7
years beyond the usual retirement age. Furthermore,
regular endurance activity at appropriate levels of stress,
in properly supervised programs, can allow older individuals
to maintain physical and mental vigor, lower the incident
rate of hypertension and cardiovascular disease, reduce blood
cholestrol and triglyceride levels, and help them maintain
slender, well muscled bodies. They concluded by observing
that mental and physical deterioration so commonly seen in
older individuals in the USA is not a part of the normal
process of aging, and therefore not inevitable. It is due
to specific diseases or is a consequence of many years of in-
sufficient use of mental and physical faculties. Further-
more, they concluded that properly designed and supervised
exercise programs based on endurance activities appear to be
a practical substitute for the physical activities which
are a part of the life style of long-lived individuals in more
physically active cultures than our own.
A variety of other research, too extensive to cite here,
has demonstrated a number of health benefits that accrue as
the result of physical conditioning of the older individual,
including improved muscle strength and increased joint flex-
ibility, increased total blood volume, and a regression in
EKG abnormalities.
A rather well-known study conducted in California by
Dr. Herbert DeVries of the University of Southern California's
School of Gerontology, which was supported by Federal funds,
clearly demonstrated the trainability of older persons with
regard to physical fitness.
FORD & 976839 LIBRAR
-8
I can personally testify, having traveled throughout the
country extensively as a clinician and lecturer on the subject
of physical fitness, that the elderly are as responsive and
interested in improving their overall physical capacities
as any single group in our population. After all, they
realize as well as anyone the frightful price their bodies
have paid for years of sedentary living and, most of all,
they desire to regain all vigor and function possible in
order to maintain their independence and enjoy their remain-
ing years. I would invite anyone of you to join me in
observing first-hand the several exercise programs for the
elderly in the greater Maryland Area, many of which have
been a direct result of the demonstration project conducted
by the National Association of Human Development in cooperation
with the President's Council on Physical Fitness and Sports.
Observe the movements of these vigorous, upright and enthusiastic
people, many of whom have built themselves up to a point
where they are into jogging and vigorous calisthenics.
It is a moot question whether they are active because
of their enthusiasm, or enthusiastic and interested because
of their activity. The two characteristics unquestionably
go hand in hand. It may be significant that if one of these
healthy older individuals is compelled to remain inactive
for a prolonged period, by accident or illness, deterioration
will set in and a steady downhill course will ensue unless
the individual can be stimulated to return to the greatest
degree of activity possible.
FORD is LIBRARY GERALD
-9
The major issue confronting individuals and agencies
interested in reducing degeneration and dependence through
improved levels of physical fitness of older Americans is:
where do we find the leadership to conduct the programs
and how can we afford to conduct them? In the demonstration
program we believe it was clearly shown that laymen can be
trained to conduct mild, low stress exercise programs in
already existing social service centers. Furthermore, with
very low comparative cost, volunteer leaders can be organized
to assist and develop these programs throughout the country.
Central to any effort in improving the physical fitness
of older people is a total approach of health education
which recruits, educates, and motivates a basic life style
from physical dependence to physical self-management.
In summary, the President's Council on Physical Fitness
and Sports is of the opinion that it would be both productive
and economical in reducing the human and financial costs associ-
ated with the health and intensive care of the elderly to en-
courage the development of both immediate and long-range pro-
grams to assist older Americans to attain and maintain im-
proved physical fitness. This opinion is based upon the following
beliefs:
1. Regular exercise at appropriate levels of stress can im-
prove the function of the heart and circulatory system, in-
crease flexibility and range of motion, and increase muscular
strength in otherwise deconditioned older people.
FORD is GERALD LIBRARY
-10
2. Appropriate levels of physical activity can reduce the
effects of physical degeneration and dependence normally
associated with older persons.
3. A state of improved physical fitness enhances the quality
of life for the elderly by increasing independence. The
ability to "go places and do things" without being dependent
on others, provides a strong psychological lift which is
conducive to good mental health.
4. The benefits of regular physical activity are not
exclusive to already active older people. The frail, feeble,
and even bed-ridden individuals can profit to some degree
from appropriate levels of exercise conducted by competent
persons;
5. All levels of Government and concerned individuals should
encourage activities of health education and leadership
training to develop specialists capable of conducting and
supervising fitness activities for the elderly;
6. It is only when adequate recognition is given to the im-
portant role of physical fitness in changing the destructive
life style of our people that we can fully expect to reduce
the cost of health and intensive care of the elderly.
It would seem that we may have no alternatives. Aren't
we already spending one of every eight dollars we make on
health care? Isn't this cost continuing to go up at an
astronomical rate? We can't accommodate ourselves to a
situation like that. We have to prevent its development.
GERALD
-11
That is the humane course, it's the practical course, and
it's probably the only course we can afford.
When adequate programs are developed and applied we
believe that we will be able to document financial savings
to the American people above the costs of such programs, not
to speak of the psychological and physiological benefits
that will be derived by individuals and society through having
more healthy, happy, and independent older Americans.
The American people spend billions on health care and
the search for answers to medical riddles. Why not spend
a million or so to put into effect the answers we have in
a preventative approach?
I will be glad to answer any questions, and I thank
you for the privilege of appearing before you.
Washington Post 4/3/76 nutrition Agrs for
HEW to Free
Nutrition Funds
For Elderly
Associated Press
The Department of
Health, Education and Wel-
FORD is LIBRARY GERALD
THE WHITE HOUSE
WASHINGTON
file in Medicare
Cuba stophie
proposal to
State of Oni-
FORD & LIBRARY GERALD
DEPART EDUCATION
HEALTH.
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
U.S.A.
WASHINGTON, D.C. 20201
2.4
MAR 1976
NOTE TO SPENCER JOHNSON
Subject: Congressional Reaction to the Administration's
Medicare Proposal (Per your Request)
Sufficient experience has now been gained to permit us to gage
preliminary Congressional reaction to the Administration's Medicare
catastrophic proposal. Essentially this proposal consists of
three parts: 1) a 7 percent and 4 percent cap on inflationary
hospital and practitioner charges, respectively; 2) a dynamic
deductible and 10 percent coinsurance charge to beneficiaries;
and 3) a $500 and $250 annual "catastrophic" cap on hospital
and practitioner charges to beneficiaries.
Shortly before the bill's introduction, three days of hearings were
held before Congressman Rostenkowski's Subcommittee on Health (Ways
and Means) during which every witness, except for the Secretary of
DHEW, opposed the measure on one or more grounds (see attached
summaries). The 7 percent and 4 percent caps were attacked
as unrealistic and unattainable. Increased costs, it is
claimed, would merely be shifted to non-Medicare patients.
Although the catastrophic benefit was thought to be of value
for a few, the cost sharing imposed on all 25 million Medicare
beneficiaries was regarded as a greatly disproportionate burden.
Individually, each Medicare beneficiary would pay a substantially
increased cost in exchange for coverage of a relatively remote
risk. The beneficiary population as a whole would be paying
approximately $.4 billion more in costs than the value of the
new benefit received.
Following the hearing, statements were issued to the press which
indicated interest in the expanded benefit, exclusive of the
7 percent and 4 percent cap and cost sharing features. The
Subcommittee subsequently notified the Congressional Budget Committee
of its desire to ear mark $200 million for the "start-up" of a
possible Medicare catastrophic benefit.
Obtaining introduction of the Administration's proposal has proven
difficult. Congressman Duncan (ranking minority member on the
Rostenkowski Subcommittee) was asked and agreed to do so, but
unexpectedly reversed himself and introduced it by request.
Congressman Martin (R-N.C.) also declined to introduce the
measure. Senators Curtis, Roth and Fannin were each approached
and declined to introduce it, except by request.
FORD & LIBRARY GERALD
Page 2 - - Mr. Spencer Johnson
Subsequently, further meetings were arranged with Congressman
Martin and his staff; Congressman Cotter (D-Conn.) and Harvey Pies,
Minority Counsel for the Subcommittee. The information derived
from the multiplicity of these contacts and communications may be
summarized as follows:
1) There is some bi-partisan interest in the House
for consideration of a hospital and practitioner
cap, though at a percentage level higher than
recommended by the Administration.
2) There is a bi-partisan consensus in the House, and
in the Senate, that the cost sharing features proposed
by the Administration are either unacceptable or too
high.
3) There is bi-partisan interest in the House for
enactment of the catastrophic benefit proposed by the
Administration.
In view of the above information, it is now necessary to determine
whether the Administration's posture is sufficiently flexible to
encourage House action on the bill and to permit negotiation as
to its contents. If enactment of the measure is to be actively
sought, then appropriate discussions should be organized as
soon as possible.
Gene
Gene R. Haislip
Deputy Assistant Secretary
for Legislation (Health)
Attachment
BERALD FORD VIBRARY
NINETY-FOURTH CONGRESS
AL ULLMAN, OREG., CHAIRMAN
WILDUR D. MILLS, ARK.
HERMAN T. SCHNEEBELI, PA.
JAMES A. BURKE, MASS.
BARBER B. CONABLE, JR., N.Y.
DAN ROSTENKOWSKI, ILL
JOHN J. DUNCAN, TENN.
PHIL M. LANDRUM, GA.
DONALD D. CLANCY, OHIO
CHARLES A. VANIK, OHIO
BILL ARCHER, TEX.
COMMITTEE ON WAYS AND MEANS
OMAR BURLESON, TEX.
GUY VANDER JAGT, MICH.
JAMES c. CORMAN, CALIF.
WILLIAM A. STEIGER, WIS.
WILLIAM J. GREEN, PA.
PHILIP M. CRANE, ILL
U.S. HOUSE OF REPRESENTATIVES
SAM M. GIBBONS, FLA.
BILL FRENZEL, MINN.
JOE D. WAGGONNER, JR., LA.
JAMES G. MARTIN, N.C.
JOSEPH E. KARTH, MINN.
L. A. (SKIP) BAFALIS, FLA.
WASHINGTON, D.C. 20515
OTIS G. PIKE, N.Y.
WILLIAM M. KETCHUM, CALIF.
RICHARD F. VANDER VEEN, MICH.
J.J. PICKLE, TEX.
HENRY HELSTOSKI, N.J.
TELEPHONE (202) 225-3625
CHARLES B. RANGEL, N.Y.
WILLIAM R. COTTER. CONN.
FORTNEY H. (PETE) STARK, CALIF.
JAMES R. JONES, OKLA.
ANDY JACOBS, JR., IND.
ABNER J. MIKVA, ILL.
April 6, 1976
MARTHA KEYS, KANS.
JOSEPH L. FISHER, VA.
HAROLD FORD, TENN.
JOHN M. MARTIN, JR., CHIEF COUNSEL
3. P. BAKER, ASSISTANT CHIEF COUNSEL
JOHN K. MEAGHER, MINORITY COUNSEL
MEMORANDUM
To:
Members of the Subcommittee on Health
From:
Dan Rostenkowski, Chairman
W.R.
On January 21, 1976, the Subcommittee on Health
met to discuss an agenda for the second session of the
94th Congress. At that time, we decided to defer further
discussion of specific medicare legislation until after
hearings on the President's medicare proposals.
As a result of those February hearings, other
testimony that was taken on medicare amendments last fall,
and certain work in the medicare area by the Oversight
Subcommittee, I have developed an outline of a proposal
responsive to some of the more pressing problems in the
medicare area. This outline is enclosed for your consid-
eration. I would request that all members submit to the
Subcommittee staff by April 16, 1976, comments on this
outline, including alternatives or additional amendments
that they might want to propose.
It is my intention to have the staff develop
from this outline and comments received from individual
Subcommittee members a working document that would become
the basis for and define the scope of a Subcommittee
markup beginning in the early part of May. In addition
to the enclosed outline and alternatives that may be
proposed, the document will include background material
in much the same manner as was done for full Committee
consideration of the first phase of tax reform.
In either endorsing aspects of this proposal
or in developing alternatives to it, I would only like to
caution the members that whatever legislation is eventually
FORD & LIBRARY GERALD
-2-
developed must be fashioned in such a balanced manner as
to show a strong awareness of the fiscal year 1977 budgetary
targets that will soon be established for the medicare
program. At present, the House Budget Committee has agreed
to our recommendation for medicare spending at a level of
$200 million over present law.
Members of the Subcommittee staff will of course
be available not only to assist individual members in the
analysis of the tentative proposals, but also to assist
in the preparation of any supplemental or alternative
proposals related to the agenda that members feel should
be included in the Committee Print for markup.
DR/sm
FORD : GERALD LIBRARY
4/6/76
OUTLINE OF POSSIBLE MEDICARE PROPOSALS
1. Catastrophic Insurance Protection for Medicare Beneficiaries
(a) Hospital Insurance Provisions--Under present law, an
individual pays a deductible (presently $104) toward the cost
of his first hospitalization in a benefit period. After
payment of this $104 inpatient hospital deductible, medicare
covers all other hospital costs for the first sixty days of
hospitalization in that benefit period. From the 61st day
through the 90th day, an individual pays a coinsurance amount
equal to one-fourth of the inpatient hospital deductible
(presently $26) for each day he is hospitalized. If an
individual requires hospitalization after the 90th day of
hospitalization in a benefit period, he may elect to utilize
part of his lifetime reserve of sixty additional days of
hospital coverage for which he must pay a coinsurance amount
(presently $52) per day. Unlike the first 90 days of coverage
which become available again at the outset of a new benefit
period, lifetime reserve days cannot be replaced. An
individual can begin a new benefit period each time when
for a period of sixty consecutive days he is neither an
inpatient in a hospital or in a skilled nursing facility.
The proposal would eliminate the present restriction on
use of hospital days in a benefit period and set an annual
maximum amount that an individual would be required to pay
in any calendar year for covered hospital services. This
annual limit would equal $500 for 1977 and would be adjusted
upward in the future years to keep pace with increases in
social security cash benefits. An individual under the
proposal would pay the inpatient hospital deductible no more
than once in a year. He would also pay the coinsurance
amounts for hospital days after day 60 in that year until
he has paid a maximum of $500 in deductibles and coinsurance.
After that, all covered hospital services would be covered in
full for the remainder of the calendar year. In addition to
the deductible and coinsurance amounts for hospital care,
the deductible and coinsurance amounts for a revised skilled
nursing facility benefit would be applied toward the same
$500 annual maximum. (See section 2 (a) for revised skilled
nursing benefit.)
GERALD FORD LIBRART
-2-
(b) Medical Insurance Provisions--Under present law,
medicare part B currently pays (after an annual deductible)
80 percent of the reasonable charge for physician services.
Beneficiaries only pay a 20 percent coinsurance after the
annual deductible amount has been met.
The proposal would set an annual maximum amount that
an individual would have to pay in deductible and coinsurance
payments for physician services under part B. This limit would
equal $250 for 1977 and would be adjusted upward in future
years to keep pace with increases in social security cash
benefits. As in the Administration's catastrophic proposal,
charges made by physicians in excess of the reasonable charge
(which are presently not covered by medicare) would not be
included in this ceiling.
2. Improvements in the Skilled Nursing Facility and Home
Health Benefits
The proposed provision would eliminate the present
requirement that a covered stay in a skilled nursing facility,
or use of the home health benefit, must be related to and follow
an inpatient hospital stay of at least three days. Elimination
of this requirement would mean that the existence of any
condition which requires care in a skilled nursing facility
or use of the skilled services of the home health benefit
would be the basis of eligibility for these services.
Since the skilled nursing facility benefit would no
longer be subject to the prior hospitalization requirement,
a deductible equal to one-half the hospital deductible would
be imposed at the beginning of each new benefit period
(see Item #1 for explanation of benefit period). The total
amount paid for deductibles (hospital and skilled nursing
facility) which an individual would have to pay in a single
calendar year, however, would not exceed the amount of the
hospital deductible for that year ($104 in 1976).
In addition, the skilled nursing facility deductible
and any skilled nursing facility coinsurance incurred would
be applied to the annual part A maximum amount a beneficiary
would have to pay ($500 in 1977). The present skilled
nursing facility coinsurance requirements (one-eighth of
the hospital deductible amount per day for the 21st through
100th day) and the present limitation of 100 days of skilled
nursing facility care per spell of illness would remain.
FORD & GERALD LIBRARY
-3-
The proposal would also liberalize the home health
benefit by moving the 100 visits available under part B
to part A so that these 100 visits are no longer subject
to the annual part B deductible. Thus, 200 home health
visits would be available under part A with no requirements
for prior hospitalization or cost-sharing.
3. Limitation on Increases in Hospital Costs
The rising cost of hospital care continues to be the
major factor driving up medicare expenditures. Between
FY 1971 and FY 1977, total medicare expenditures increased
from $7.8 billion to an estimated $21.7 billion. Hospital
care expenditures under medicare (part A) for FY 1977 will
exceed $15 billion, an increase of almost $3 billion over
FY 1976 expenditures. Only about 18 percent of this
increase is attributable to growth in the number of
beneficiaries; about 80 percent of this increase is the
result of higher costs per patient day.
Moreover, it is expected that in the absence of any
restraints hospital costs will increase next year by about
15 percent. (If hospital wages were held to the same rate
of increase as general wage levels and if prices paid by
hospitals for goods and services increased at the same rate
expected for the economy generally, hospital costs would
only go up by about eight percent.) Although the drastic
limitation proposed by the Administration (limiting increases
in hospital costs to seven percent) would probably adversely
affect services to beneficiaries, it seems clear that some
reasonable restraints are necessary to assure the stability
of the medicare program.
The proposal would deal with this cost problem by
providing for a limitation in the range of 9-1/2 to
10 percent on increases in hospital costs recognized as
reasonable by medicare and by initiating steps designed
to lead to the implementation over time of a prospective
reimbursement system. The proposed limitation would allow
for reasonable increases in hospital wage levels and for
necessary improvements in services. The limitation would
be applied on a national basis, with provision for adjustments
on a local basis where appropriate, and provision for an
exception procedure to take account of unique individual
circumstances. The Secretary would be required to issue
guidelines for exceptions that would, for example, recognize
new construction or renovation approved by planning agencies,
large wage agreements negotiated prior to enactment, and
documented changes in patient mix.
GERALD FORD LIBRARY
-4-
The proposal would also direct the Secretary to
develop a plan for implementing a prospective reim-
bursement system that includes: (1) a uniform hospital
accounting, reporting and cost allocation system; (2) a
hospital classification system with reimbursement
limits set prospectively for each class of institution
and offering financial incentives for efficient performance;
and (3) appropriate provisions for an appeals process, for
adjustment of prospective rates to take account of
contingencies beyond the hospital's control, for parti-
cipation of planning agencies in the evaluation of proposed
capital expenditures and for periodic congressional review
of operating experience. The proposed prospective reim-
bursement system when approved by the Congress would be
implemented over a three-to-four-year period and when
fully implemented, would supersede the transitional
limitation described above.
4. Incentives to Encourage Physicians' Use of Assignment
Under present law, physicians may agree to accept assignment
of a medicare claim and thereby agree to accept, as payment in
full, whatever medicare determines is the reasonable charge
for the service provided. When the physician accepts
assignment, he may bill the beneficiary only for the coinsurance
(20 percent of the medicare-determined reasonable charge) plus
any portion of the annual deductible the beneficiary has not
yet met.
It is in the interest of the beneficiary for the physician
to accept assignment, otherwise the physician bills the patient
directly for the actual charge. The actual charge is often
greater than the medicare reasonable charge for the service
and the beneficiary must then make up the difference out-of-
pocket. Under the present system, beneficiaries generally do
not know whether a physician will accept assignment on any
particular claim until the service is provided.
The proposed provision would create incentives for
physicians to become "participating physicians" who would,
by formal arrangement, agree to accept assignment of
medicare claims in all cases. This would allow beneficiaries
to "shop around" for a physician they could be sure would
accept assignment of their claims. The incentives to become
a participating physician could include such things as
streamlining the billing process through use of multiple
billing forms on which physicians could claim reimbursement
for services furnished to many beneficiaries (instead of
submitted a separate claim for each patient), and more
expeditious payment of claims that would improve cash flow
for the physician.
LISAARY GERALD R. FORD
-5-
Any participating physician who decided to terminate
his participating physician agreement could do so by
giving notice to his medicare carrier. Those physicians
who do not choose to become participating physicians would
continue to accept assignment on the present "all, some,
or none" basis.
5. Improvements in Renal Dialysis Provisions
Under present law, medicare coverage is provided for
individuals with chronic renal disease without regard to
age. Entitlement to benefits for such individuals, which
includes coverage of costly services related to kidney
transplantation and dialysis, generally begins after a
three-month waiting period and ends 12 months after
transplantation or termination of dialysis.
The proposal would deal with several problem areas
disclosed in the course of extensive Oversight Subcommittee
hearings. Certain inequitable effects of the entitlement
requirements would be overcome by extending post-transplant
coverage and by reducing the waiting period in cases of
early hospitalization for transplantation. Incentives would
be provided to undertake less costly and generally more
effective home dialysis (as opposed to facility dialysis)
by expanding coverage of supplies necessary to perform
dialysis at home, authorizing earlier entitlement
to benefits for patients who undergo home dialysis training
and assuring the availability of home dialysis training
programs. The proposal would clarify congressional intent
to reimburse dialysis facilities on a cost-related basis
and provide for a study of reimbursement for physician
services to renal patients. Additionally, the proposal
would correct certain technical deficiencies in the
present provisions relating to determinations of eligibility,
costs incurred by kidney donors and reports to Congress on
developments in the program.
FORD & LIBRARY GERALD
-6-
6. Revision of Durable Medical Equipment
Two recurring problems have been encountered in
connection with the durable medical equipment provisions
of the medicare law. One concerns the uneconomical use of
durable medical equipment arising from extended periods of
rental of such equipment even where less costly pur-
chase would have been justified by the period of need
estimated by the patient's physician. (Under present
law, beneficiaries make their own arrangements to acquire
such equipment and may either rent or purchase it.) The
difficulty is the lack of incentives in present law,
for both beneficiaries and suppliers, to choose purchase
rather than rental. In 1972, Congress authorized the
Secretary to experiment with alternative approaches but
little progress has been made to date.
The second problem concerns the present prohibition
on coverage of durable medical equipment rented or pur-
chased by a beneficiary residing or confined in a
facility which meets part of the basic statutory defini-
tion of a skilled nursing facility, even if that fa-
cility does not meet all the statutory and regulatory
requirements for medicare participation and is, in
fact, not a skilled nursing facility by medicare
standards.
The proposal would address the prolonged rental
problem by authorizing (and encouraging) lump sum reim-
bursement procedures for the purchase of durable medical
equipment where long-term need has been certified by
the patient's physician and where cumulative rental
charges would exceed the allowable purchase price,
including the use of financial incentives where used
equipment is available and where suppliers are willing
to enter into rental purchase-conversion arrangements.
The proposal would deal with the second problem by
modifying the durable medical equipment coverage
limitation with respect to facilities that are not
designed to meet medicare requirements for skilled
nursing facilities and are, in fact, established with
the primary purpose of serving as custodial or resi-
dential facilities.
FORD & LIBRARY GERALD
-7-
7. Elimination of Waiting Period for Reentitled Dis-
ability Insurance Beneficiaries
Under present law, medicare protection is provided
for individuals after they have been receiving social
security cash benefits on the basis of disability for
24 consecutive months. Should the individual recover
sufficiently to engage in gainful employment, he loses
his social security benefits and his medicare coverage.
If the individual becomes disabled a second time within
five years, he automatically regains his cash social
security benefits, but he must once again satisfy the
24-month waiting period requirement before he can return
to the medicare rolls.
There is a widespread concern that this provision
works an undue hardship on the individual who has tried
but failed to return to work. Also, in some cases, it
could serve as a disincentive to trying full-time employ-
ment.
The proposal would eliminate the 24-month waiting
period for reentitlement. Medicare coverage would be
provided for disabled individuals from the first month
of their reentitlement to disability benefits in cases
where the individual becomes reentitled within 5 years
of his previous coverage period, thus conforming medicare
to the cash social security program in this respect.
8. Revisions To Assure Cost-Effectiveness and Adminis-
trative Efficiency
(a) Relating Part B Deductible to Increases in
Social Security Cash Benefits--The proposal would increase
the annual part B medicare deductible in the same manner
that cash social security benefits increase. The de-
ductible would increase from $60 to $65 in 1977 and
automatically increase in future years to keep pace with
increases in social security cash benefits. This proposal
would help to reduce the program cost of the $250 ceiling
on beneficiary cost-sharing liability for part B that is
proposed in section 1 (b). For beneficiaries as a group,
the modest increase in the deductible would be more than
offset by the value to them of the $250 annual ceiling
on deductible and coinsurance.
FORD & LIBRARY GERALD
-8-
(b) Use of State Planning Agency Determinations
for Medicare Approval of Participating Health Facilities--
The enactment of the National Health Planning and Resources
Development Act of 1974 reflected congressional concern
about the need to assure the orderly growth of health
facilities and to deter the proliferation of duplica-
tive or unnecessary services. Present medicare law also
supports this concept in that it includes provision for
withholding a portion of a health facility's reimburse-
ment under medicare for capital expenditures determined
by the state planning agency to be inconsistent with
area wide or state plans. However, some services, such
as home health services, are not covered by these pro-
visions of law and concern has been expressed about the
possibility of uncontrolled proliferation of such agencies
with concomitant adverse cost and manpower effects. To
meet this potential problem, the proposal would provide
authority, with respect to medicare, for the Secretary
to require planning agency approval of the need for
additional or expanded services and agencies.
(c) Improvement in the Detection of Fraud and Abuse
in the Medicare Program--The proposal would direct the
Secretary of Health, Education, and Welfare to designate
an organizational unit devoted solely to the detection
and prevention of fraud and abuse in the medicare program.
This unit would be charged with the following responsi-
bilities:
(1) the operation of an expanded program to detect
and combat patterns of fraud and abuse;
(2) the preparation of materials to assist the
Department of Justice and, as appropriate, State agencies,
in the development and prosecution of cases arising out
of criminal violations involving the operation of the
medicare program; and
(3) the preparation of an annual report of this
organizational unit to the Committee on Ways and Means
and the Committee on Finance detailing:
FORD & LIBRARY GERALD
-9-
(A) the activities of the office during the
previous 12-month period;
(B) the disposition of recommendations for
prosecution submitted to the Department of Justice
through the various United States Attorneys;
(C) recommended changes in statutory medicare
provisions to better promote the integrity of the
program; and
(D) recommended changes in existing adminis-
trative practices, including the levels of funding
and personnel resources devoted to audit activities,
which would better facilitate the discovery of
potential fraud and abuse problems.
In developing this statutory unit, the Secretary shall
make appropriate use of the existing manpower and other
resources presently assigned to similar. functions within
the Bureau of Health Insurance and assign such additional
personnel to such unit as would be appropriate considering
the monies and the unique administrative complexities
involved in a health insurance program of this scope.
The activities of this new medicare unit will be
coordinated with the General Office of Investigations
which has recently been established on a department-wide
basis within HEW.
(d) Clarification of PSRO Provisions--Controversy
about the acceptability of the PSRO program has given
way in considerable degree to concern about delays in
implementation, the cost-effectiveness of the program
(and its effects on the quality and delivery of care),
and the collection of necessary data. The medicare
bill passed last year addressed the major part of the
implementation problem by assuring the funding needed
for prompt nationwide implementation. Still to be con-
fronted is the data collection issue which involves
both the acquisition and confidentiality of medical
data, and the accumulation of PSRO cost and operational
data needed by Congress to assess the overall effective-
ness of the program.
FORD & LIBRARY GERALD
-10-
The proposal would require the Secretary to begin
reporting regularly to the Congress on the total program
costs incurred in implementing the PSRO provisions, the
effects of PSRO activities on the utilization, quality
and cost of services furnished to beneficiaries, and the
operational experience acquired in administering the
program. The proposal would also clarify the congres-
sional intent to make use of the most efficient and
reliable data collection system so as to assure (1) the
collection, analysis and use of comparative data in
bringing about improvements in the quality and utiliza-
tion of services furnished to medicare beneficiaries,
and (2) the maintenance of appropriate safeguards against
improper disclosure.
(e) Reasonableness of Provider Costs Related to
Overhead Costs--Overhead costs incurred by medicare
providers rendering similar services, such as home health
agencies, vary significantly. To assure that such
variations are attributable to necessary operating costs,
the proposal would explicitly direct the Secretary to
include consideration of the relationship between over-
head costs and the direct costs of the provision of
services in the determination of a medicare provider's
overall reasonable cost.
(f) Study of Reimbursement Methods for Physician
Services Under Medicare- There is a present and growing
concern that the method of determining the medicare
reasonable charge for a service rendered by a physician
often results in payments which are neither rational
nor equitable.
The medicare prevailing charge (the ceiling on what
medicare will recognize as a reasonable charge) varies
regionally to a much greater degree than can be easily
justified and tends to vary inversely with distribution
of physicians- doing nothing to improve the distribution
of physicians and perhaps aggravating current problems.
Urban-rural differentials are especially difficult to
justify. Questions may also be raised about the varia-
tions in prevailing charges for the same procedure between
general practitioners and specialists.
FORD & BERALD LIBRARY
-11-
There is, however, a general lack of knowledge
about factors which are needed to determine the best
way to reimburse for physician services. The proposal
is to mandate a study aimed at providing the informa-
tion necessary to allow equitable reimbursement for the
physician; prevent rapid inflation in fees recognized
by the program; provide the maximum protection for
beneficiaries; and have a more positive effect on the
health care delivery system.
9. Coverage Provisions and Other Technical Changes
Involving Negligible Cost
(a) Coverage of Pap Smears Under Part B--Coverage
of services under part B of medicare (medical insurance)
is restricted to those services which are reasonable
and medically necessary for diagnosis and treatment of
an illness, injury, or malformed body member. Services
which are routine in nature (including routine diagnos-
tic tests) are specifically excluded. Accordingly,
coverage of Pap smears is currently restricted to
instances where they are taken for the diagnosis of
a suspected condition.
There is considerable evidence, however, that Pap
smears as a routine diagnostic test are effective in
early detection of uterine and cervical cancer. This
early detection cannot only possibly save a life but
can minimize the scope of services necessary to treat
the illness. The proposed provision would, therefore,
cover Pap smears, under regulations to be prescribed
by the Secretary.
FORD & LIBRARY GERALD
-12-
(b) Revised payment Method for Physician services When
Patient Has Died--Under present law, a beneficiary who has
received physician services which are reimbursable under
medicare part B can either (1) send medicare an itemized,
unpaid bill and be reimbursed directly, or (2) assign the
right to receive payment to the physician who provided the
service.
In the case where a beneficiary dies and has not executed
an assignment of the bill, payment may be made directly to the
physician if he agrees to accept the medicare reasonable charge
as payment in full. The physician can then bill the survivor
or the estate only for the coinsurance and deductible amounts
which medicare is not obligated to pay.
However, if the physician does not agree to this procedure,
present law authorizes medicare reimbursement only if the bill
has already been paid rather than on the basis of an unpaid
bill. This often results in a large financial burden for
survivors of the deceased beneficiary.
The proposed provision would eliminate the potential hard-
ship by allowing medicare to pay, in the case of a deceased
beneficiary, on the basis of an itemized, unpaid bill.
(c) Eliminate 5-year Residency Requirement for Voluntary
Enrollment in Medicare by Aliens--Individuals over age 65 who
have not become eligible for coverage under medicare part A
(hospital insurance) through entitlement to social security
cash benefits can obtain medicare coverage by enrolling on a
voluntary basis and paying a monthly premium. Also, individuals
who wish protection under part B (voluntary medical insurance),
regardless of whether they are automatically entitled to part A,
may enroll and a pay a monthly premium.
However, for aliens, one of the requirements for enrollment
in either of these plans is that the person must have been law-
fully admitted for permanent residence and have resided in the
United States continuously for at least five years prior to
enrollment. The equity of the five-year requirement has been
questioned generally, and declared unconstitutional by a three-
judge District Court panel (Diaz VS. Weinberger, 361 F. Supp. 1
(S.D. Fla. 1973)). An appeal from that decision has been made
to the U.S. Supreme Court but no decision on the case has yet
been handed down.
The proposed provision would eliminate the five-year
residency requirement.
GERALD FORD LIBRARY
T/D
THE WHITE HOUSE
SCHEDULE BD.
DATE RECEIVED
WASHINGTON
MAY 5 1976
MESS. GE
April 28, 1976
SPEAKERS BUREAU
OTHER
MEMORANDUM FOR:
BILL NICHOLSON
APPOINTMENT OFFICE
FROM:
SPENCE JOHNSON sey
SUBJECT:
Memorandum regarding Greater
Grand Rapids Hospital Council
A letter dated April 13, 1976, from the Greater
Grand Rapids Hospital Council to the President
indicated a desire to discuss the impact of Medicare/
Medicaid programs on hospitals.
Such an issue would fall within my area and I would
be glad to talk with them as you think appropriate.
filed under "M" Marshall
GERALD FORD LIBRARY
W.B. MARSHALL Executive Director
THE PRESIDENT'S COUNCIL ON PHYSICAL FITNESS
AND SPORTS
SPENCE For your INF
Xx GERALD R. FORD LIBRARY
ABSTRACTS
arabinoside and of thioguanine.
50 and 59 at the time of diagno-
Statistical measures were 'used
Most patients in this age range
sis appeared to have slightly
to avoid misinterpreting a possi-
should have a course of intensive
longer survival times than those
ble "practice effect."
chemotherapy.
in later decades, but there were
Patients in the exercise group
Differences in survival do not
too few patients in each age
took brisk walks at the begin-
appear to be related to improved
group for statistical comparison.
ning and end of each session of
treatment (antibiotics, transfu-
Remission rates and survival
calisthenics and rhythmic body
sions, and platelet concentrates)
did not differ significantly for
movements. To control the possi-
or to the type of hospital offer-
patients treated in a community
ble psychologic effects of atten-
ing treatment. When appropri-
hospital, cancer center, or uni-
tion and changes in routine, a
ately trained physicians and re-
versity hospital.
second treatment group was giv-
it
and
&
GERALD
RARY
AR,
GERIATRICS, June 1974
155
FOR IMMEDIATE RELEASE
MAY 23, 1976
OFFICE OF THE WHITE HOUSE PRESS SECRETARY
(Laguna Hills, California)
THE WHITE HOUSE
REMARKS OF THE PRESIDENT
AT
ROSSMOOR LEISURE WORLD
7:30 P.M. PDT
And I add, as many of you I am sure know, I
recommended in my budget for the next fiscal year the full
cost of living increase in Social Security benefits. I
think this is the proper thing, the move that is required
if we are to keep faith with those in our society who
have earned and retired.
And let me say, I have also proposed major
improvements in the Medicare program to make it serve you
better. One of the most important improvements would
provide for the full payment of all but a very small
fraction of the cost of catastrophic illness and extended
care,
There is no reason whatsoever that older
Americans should have to go broke just to get well or
to stay well in the United States of America.
MORE
Under my proposals. the individual contribution to
Medicare would go up slightly. But consider what the
increase would provide. Nobody eligible for Medicare would
have to pay more than $500 a year for hospital or nursing
home care or more than $250 a year for physician service.
Medicare would pay the rest.
Whether it was $1,000, $10.000 or $50,000, I
think it is a good program, and I would appreciate your
support.
Our problem is the Congress. The ruinous economic
burden of catastrophic illness is one thing, if this
passes, you will never have to worry about again. You
deserve it, and the country ought to enact it, and it
GERALD LIBRARY GERALD R. FORD
ought to be on the statute books.
FOR IMMEDIATE RELEASE
MAY 26, 1976
OFFICE OF THE WHITE HOUSE PRESS SECRETARY
(Columbus, Ohio)
THE WHITE HOUSE
REMARKS OF THE PRESIDENT
AT THE
OHIO GOVERNORS' CONFERENCE ON AGING
THE STATE FAIRGROUNDS
4:24 P.M. EDT
Jim, distinguished members of the Ohio delegation--
and let me personally introduce each and every one of them
to you because they are old and very dear friends of mine.
They are strong supporters of what all of you are interested
in. Would you please stand up and remain standing while I
introduce the others, Andy Devine, Bill Harsha, Chuck Mosher,
Bud Brown, Chalmers Wiley, Tennyson Guyer, and Tom Kindness.
They are great people, they have been invaluable
in their aid and assistance to me, and I thank each and
every one of them. Of course, we have on the platform here
a man who spoke from the heart to you just a few moments
ago and who has been a tremendous asset to me as a member
of my Cabinet, Earl Butz. Earl, come on, get up again.
Then it is great to be in the City of Columbus
and Tom Moody, it is nice to see you, your great, great
Mayor here in the City of Columbus. May I also thank the
Walnut Ridge Band -- great music. You play that Victors
very well.
In 1952, Winston Churchill, then a mere 77
years old, had been called into the service of his country
for a second term as Prime Minister of Great Britain, and
smiling somewhat impishly he told the British Commons,
and I quote, "Everyone has his day, and some days last
longer than others."
Today, I welcome this great opportunity to be
a part of your annual Governors' Conference, and I congratulate
Jim Rhodes for undertaking it back in 1968, a conference
concerned with the many, many Americans whose days have
lasted longer than others.
MORE
LIBRARY GERALD FORD
Page 2
The careers of Winston Churchill, as well as
others who rose to prominence in later years, reminds
all of us -- if we need to be reminded -- that advancing
years need not mean a retreat from active, even future
enjoyable life, nor should advancing years be the certain
barrier of poor health, meager income or social isolation.
The ancient philosophers taught us that the measure
of a civilization's advancement and greatness can be found
in its proper treatment of the elderly.
Let me say that here in Ohio you have demon-
strated your concern in a very solid and a very practical
way.
This conference is but just one example of your
ongoing commitment. I congratulate Jim and all those
associated with him for initiating it in 1968 and continuing
it in his term at the present time.
You all know, and so do those of us from outside
of Ohio, that this State has pioneered in providing senior
citizens' centers that offer a very broad range of
services to the elderly.
The two golden age villages constructed by
your State provide a model alternative to institutional
care at a very reasonable cost.
Now let me thank and commend Jim Rhodes for my
participation in the Golden Buckeye program, which was
begun some three months ago.
I am told that in the very short span of 90
days 178,000 Ohioans have signed up and now it is 178,001.
(Laughter)
Obviously, I am very proud of the fact that the
Federal Government was able to make a contribution to
the Golden Buckeye program, making it a reality by providing
to the Governor's office for use as he saw fit -- through
the comprehensive education and training legislaton --
and I have been so impressed with the program as a whole.
MORE
GERALD FORD LIBRARY
Page 3
When I get back to Washington, we are going to
take a real good look to see if we can't, on a national
scale, implement something comparable to this. We have
to, of course, see what the law says, what the money is,
but the concept is good and we are going to do our best
to expand it beyond the borders of the State of Ohio.
For more than 40 years, through the vehicle of
Social Security and other programs, the Federal Government
has made a firm commitment of support for older citizens
of our society. I pledge to you that I will continue without
hesitation, reservation, to uphold that commitment.
In recent years there has been some very dramatic
progress to meet the needs of America's older generation. I
want to do better and, with your help and with the help
of a responsible Congress, I will, and we will. And this
is something that all of us owe to this great generation of
Americans, those at the present and those that are to follow.
And as President of the United States, I will do everything
possible in my power to help our Nation demonstrate its deep,
deep concern for the dignity, for the well-being of our older
generations.
The Social Security program, the largest of its
kind in the world, will pay almost $83 billion to more than
32 million Americans in this next fiscal year. This is
more -- and I emphasize more -- than a $10 billion increase
over the current year. And, of course, I suspect many of
you know -- but I want to reemphasize it to show my commit-
ment -- in my budget for the next fiscal year, which begins
October 1, 1976, I am recommending that the full cost of
living increase in Social Security benefits be paid in
that year.
As you also know, however, there are problems
facing our Social Security system. Next year, unless my
reforms are adopted, the Social Security Trust Fund will run
a deficit of nearly $3-1/2 billion, and the next 12 months
after that, if we don't follow a responsible course as I
have proposed, the deficit will be $4 billion in a 12-month
period.
But let me assure you very emphatically, my
Administration intends to preserve the integrity and the
solvency of the Social Security for your benefit and that of
all working Americans now as well as in the future. As long
as I am President, we are going to keep our Social Security
protection and every other retirement program strong, sound
and certain.
In addition to the Social Security program, we are
continuing our commitment to benefit programs for more than
3 million railroad, military and Federal Government employees.
MORE
BERALD FORD LIBRARY
Page 4
After many, many years of sacrifice and hard work,
these Americans have contributed much to our great Nation.
They have earned our respect as well as our admiration.
They have earned more than the prospect of poverty in their
retirement years.
In my budget, the Supplemental Security Income
program, or SSI, will pay almost $6 billion in Federal benefits
to more than 5 million disabled and disadvantaged older
Americans in 1977, 140,000 of them right here in the great
State of Ohio.
In the field of health care, the Federal Medicare
program, in 1976, will provide more than $17 billion for the
health care of 24 million older and disabled Americans,
1,200,000 again right here in the great State of Ohio.
Now, there are some flaws in this program, which
actually help raise the cost of your medical care and which
fail, unfortunately, to provide or to protect you adequately
against the economic burdens of a prolonged illness. I have
proposed major improvements in the Medicare program to make
it serve you better. One of the most important improvements
would provide for the payment of all but a very small fraction
of the catastrophic costs of complex or extended care as
well as treatment.
I don't have to tell you that medical treatment is
very, very expensive these days. If you have to stay in a
hospital or in a nursing home or under a doctor's care for
a very long, long time, it puts an incredible strain on your
lifetime savings or on your peace of mind, and that strain is
felt by your loved ones just as well as yourself. All of us
know cases -- a friend, a neighbor, a part of your family --
in which someone has been stricken with an illness that lingers
on and on and on. We know of the pain, we know of the heartache
associated with a prolonged and expensive illness. We know
that being sick and bedridden for an extended period of time
is bad enough without having a person's income and life savings
dwindling as the medical bills keep piling up.
This must not continue and I, as President, will
not permit it to continue and, therefore, I recommended what
I think is a good program to solve the problem. There is no
reason that older Americans should have to go broke just
to get well or stay well in the United States of America.
Under my proposal, the individual's contribution to Medicare
would go up very slightly, but consider what the increase would
provide to you and to the other 24 million who would be covered.
Nobody eligible for Medicare would have to pay more than $500
per year for hospital or nursing home care or more than $250
a year for a physician's services. Medicare would pay the
rest, whether it is $1,000, $10,000 or $50,000.
MORE
BERALD FORD LIBRARY
Page 5
That is good protection, and I think it is a
good program, and I hope you will support it. This proposal
provides the full protection so vitally needed by older
Americans and, if the Congress passes it, the ruinous
economic burden of catastrophic illness is one thing
America's older citizens will never have to worry about
again.
Another of my programs would consolidate 16
Federal health programs, including Medicare, into a single
$10 billion block grant program to the States. If we
can consolidate these programs, we can make them far
more humane and far more effective.
We can improve the services that they provide
to you and millions like you, and we can get those services
to more people who really need them. Programs of this
kind, despite some abuses, do a tremendous amount of good.
They provide food services and health care for many of
our older citizens. For some of our elderly neighbors,
they provide the means for life itself.
MORE
FORD & LIBRARY GERALD
Page 6
I know it is all too easy to say that the
Federal Government is too big, that this program and that
program ought to be cut out of the Federal budget, tossed
back to the States to cope with it if their taxpayers
will permit it.
Jim Rhodes knows and I think most of you know
it .is not that simple. I know it and anyone who has
thought it out knows it very, very well. The programs --
if I can put it this way -- the problems and the challenges
discussed at this conference will center on the needs of
Ohio's older citizens. They are often very, very special
needs.
But, the elderly of our nation are also vitally
affected by the problems and concerns that face all of the
215 million Americans. Perhaps the greatest of these are
the problems of inflation. During 1974, August 9 to be
precise, when I became President, inflation was ranging
at an annual rate of 12 percent or higher, eating away at
everybody's buying power, but absolutely devouring the
livelihood of people on fixed incomes.
Americans living on fixed incomes could see
their purchasing power eroding with each visit to the
supermarket. I knew that something had to be done
to bring the situation under control as quickly and as
effectively as possible. I knew that deficit spending
by the Federal Government was a major contributor to
inflation, that slowing the growth of Federal spending was
essential to solve the problem. In short, I believe our
Government should spend less and our Government should tax
less.
I am proud to say to each and every one of you,
I am proud of the sound and steady policies of my Admin-
istration that have succeeded. In the last four months --
from January through the month of April -- the rate of
inflation on an annual basis is less than 3 percent, and
that is a 75 percent reduction from what it was when I
became President.
It is a victory for all Americans because
inflation is no respecter of age. The old as well as
the young suffer. What I want -- and I think all of us
want, young or old, black or white, rich or poor -- is
to live in dignity, to live in security and to live in
peace.
If we continue making the progress America has
made in the last 12 months, we will see that goal achieved.
If I had to sum up the record of my Administration in
just a very few words, it would be peace, prosperity and
trust.
MORE
FORD & LIBRARY GERALD
Page 7
Today, America is at peace. There are no
American boys fighting anywhere on the face of the earth,
and I intend to keep it that way. I will continue my
policies of cutting your taxes, expanding the private
economy, reducing bureaucracy and useless regulation and
restraining Federal spending.
My policies have brought us from the depths of
a recession to a sustained recovery, and will insure
that runaway inflation never again robs us or our
loved ones of the rewards of honest work and lifetime
savings.
Finally, I want to finish the most important
job -- the restoration of trust in the Presidency itself.
As your President, I will promise no more than I can
deliver and I will deliver everything that I promise.
I need your support to insure peace, prosperity
and trust for the future, the good, secure, fulfilling
future that we owe to our children and to our grandchildren.
Americans have always wanted a life to be better for our
children than what it was for us because life for us
has been better than it was for our parents.
Now, what do I see for this great country of
ours in the future? I see a strong and confident America,
secure in a strength. that cannot alone be counted in
megatons, a nation rejoicing in riches or blessings that
cannot be eroded by inflation or by taxation.
I see an America where life is valued for its
quality as well as for its comfort, where the
individual is inviolate in his constitutional right,
where the Government serves and the people rule.
Thank you very, very much.
END
(AT 4:44 P.M. EDT)
BERALD FORD LIBRAR,
Medicare
904
CONGRESSIONAL RECORD DAILY DIGEST
June 25, 1976
of intangibles, deferral on foreign income, DISC,
FOOD MARKETING COMMISSION
and tax cut extension.
Pages S10632-$10635, 510696
Committee on Agriculture and Forestry: Subcommittee
Presidential Message: Senate received a message from
on Agricultural Production, Marketing, and Stabiliza-
the President transmitting annual reports on adminis-
tion of Prices continued hearings on S. 3004 and S. 3045,
tration of the Highway Safety and National Traffic
to create a temporary national commission to study the
and Motor Vehicle Safety Acts of 1966-referred to
broad area of food marketing, receiving testimony from
Committee on Appropriations.
Page 510662
Dr. Kenneth R. Farrell, Deputy Administrator for Food
Presidential Communications: Senate received com-
and Fiber Economics, Economic Research Service,
munications from the President as follows:
Department of Agriculture; Robert Lewis, National
Farmers Union, Washington, D.C.; Kenneth D. Naden,
Transmitting amendment to the fiscal year 1977
National Council of Farmer Cooperatives, Washing-
budget in the amount of $381,000 for the Department
ton, D.C.; and Charles J. Carey, National Canners Asso-
of Justice-referred to Committee on Appropriations
ciation, accompanied by H. Edmund Dunkelberger,
and ordered printed as S. Doc. 94-223; and
Counsel, Washington, D.C.
Transmitting amendment to the fiscal year 1977
Hearings were adjourned subject to call.
budget in the amount of $23,430,000 for the Depart-
NOMINATIONS
ment of the Interior-referred to Committee on Appro-
priations and ordered printed as S. Doc. 94-224.
Committee on Commerce: Committee concluded hear-
Page S10663
ings on the nominations of Edward O. Vetter, of Texas,
to be Under Secretary of Commerce, and Leonard S.
Time Limitation Agreement: By unanimous consent
it was agreed that when Senate considers on Saturday,
Matthews, of Illinois, to be an Assistant Secretary of
Commerce, after the nominees testified and answered
June 26, H.R. 14233, making appropriations for De-
questions on their own behalf.
partment of Housing and Urban Development, debate
thereon be limited to one hour, with 30 minutes on
COMMITTEE BUSINESS
amendments.
Pages $10632, 510696
Committee on Finance: Committee ordered favorably
Committee Authority to Sit: Committee on Govern-
reported the following business items:
ment Operations was authorized to sit during the
H.R. 9401, to continue until June 30, 1978, suspension
session of the Senate on July I, and Committee on
of the import duty on certain horses;
Commerce was authorized to sit during the session
H.R. 12033, to continue until June 30, 1979, suspen-
of the Senate on June 30, 1976.
sion of duty on manganese ore (including ferruginous
Page $10632
ore) and related products;
Confirmations: Senate confirmed the nominations of
H.R. 14114, increasing to $700 billion through Sep-
Alan M. Lovelace, of Maryland, to be Deputy Adminis-
tember 30, 1977, the temporary limit on the public debt,
trator of the National Aeronautics and Space Adminis-
(with an amendment providing that to the extent that
tration; and
the Tax Reform Act of 1976 involves a revenue loss
Kay Bailey, of Texas, to be a member of the National
exceeding $15.3 billion-the target figure in the first
Transportation Safety Board.
Page 510696
budget resolution-spending in fiscal year 1977 will be
Record Votes: Five record votes were taken today
reduced by an equivalent amount); and
(total-345).
H.R. 13501 (amended) to extend or remove certain
time limitations and to make other administrative im-
Pages $10569, $10575, S10581, $10607, ST0613-S10614
provements in the conduct of the medicare program.
Recess: Senate met at 9 a.m. and recessed at 7:39 p.m.,
(Committee amendment would give the Secretary of
until 9 a.m. on Saturday, June 26. (For program for
HEW discretion to increase reimbursement for care in
Saturday, see last page of today's Record.) Page $10696
nursing homes in Alaska which previously cared for or
currently care for Medicare patients).
Committee Meetings
Prior to these actions, Committee held hearings on
the nomination of Jules G. Korner III, of Maryland,
(Committees not listed did not meet)
to be a Judge of the United States Tax Court, where the
NOMINATION
nominee testified and answered questions on his own
behalf.
Committee on Aeronautical and Space Sciences: Com-
mittee ordered favorably reported the nomination of
COMMITTEE BUSINESS
Alan M. Lovelace, of Maryland, to be Deputy Admin-
Committee on Interior and Insular Affairs: Committee
istrator of the National Aeronautics and Space Admin-
ordered favorably reported the following business items:
istration, after the nominee testified and answered
H.R. 9460, to provide for the establishment of a con-
questions on his own behalf.
stitution for the Virgin Islands (amended);
GERALD FORD LIBRARY
June 30, 1976
CONGRESSIONAL RECORD-SENATE
S11139
the functional targets is strictly your pre-
The result was announced-yeas 75,
The PRESIDING OFFICER. Without
rogative and I trust you will cover the rea-
nays 17, as follows:
objection, it is so ordered.
sonable needs of CSA.
Sincerely,
[Rollcall Vote No. 368 Leg.]
PETE V. DOMENICI,
YEAS-75
ORDER FOR CONSIDERATION OF
U.S. Senator.
Abourezk
Hartke
Moss
CERTAIN MEASURES
Bayh
Hatfield
Muskie
COMMITTEE ON APPROPRIATIONS,
Beall
Hathaway
Nelson
Mr. MANSFIELD. Mr. President, I ask
Washington, D.C., June 16, 1976.
Bellmon
Hollings
Nunn
unanimous consent that instead of the
Hon. PETE V. DOMENICI,
Bentsen
Hruska
Packwood
military procurement bill coming up this
Biden
Huddleston
Pastore
U.S. Senate,
Brooke
Humphrey
Pearson
afternoon, because the House is still con-
Washington, D.C.
Bumpers
Inouye
Pell
sidering it, that it will follow the medical
DEAR SENATOR DOMENICI: Thank you for
Burdick
Jackson
Percy
your letter indicating that a $534 million ap-
Byrd, Robert C.
Javits
Randolph
manpower bill tomorrow morning and,
propriation is needed for the Community
Cannon
Johnston
Ribicoff
in turn, that we can work with a rea-
Services Administration in fiscal year 1977,
Case
Kennedy
Schweiker
sonable time limitation, that will be fol-
if this agency is to continue to function.
Chiles
Leahy
Scott, Hugh
lowed by nominations on the Calendar.
Church
Sparkman
The Senate Labor-HEW Appropriations
Long
Clark
Magnuson
Stafford
The PRESIDING OFFICER. Without,
Subcommittee has recommended an appro-
Culver
Mansfield
Stennis
objection, it is so ordered.
priation of $558.5 million for the Community
Dole
Mathias
Stevens
Mr. MANSFIELD. Mr. President, I ask
Services Administration for fiscal 1977. This
Domenici
McClure
Stevenson
is an increase of $62.5 million over the $496
Durkin
McGee
Stone
unanimous consent that in place of the
million House Appropriations Committee al-
Eagleton
McGovern
Symington
military procurement bill, the Senate
lowance. After passage by the full Senate and
Fong
McIntyre
Taft
this afternoon turn to the consideration
Ford
Metcalf
Talmadge
House, a conference will be necessary to set-
Glenn
Mondale
Weicker
of the foreign aid bill, which had been
tle the differences between the two versions
Hart, Gary
Montoya
Williams
scheduled for tomorrow, to be followed
of this bill. The final conference agreement
Hart, Philip A.
Morgan
Young
by the debt ceiling bill, to be followed
will probably be much closer to the $534 mil-
NAYS-17
then by the tax bill.
lion appropriation you recommend.
I appreciate receiving your views on the
Allen
Fannin
Roth
Mr. STENNIS. Mr. President, reserv-
proper funding levels for Federal anti-pov-
Baker
Garn
Scott,
ing the right to object
Bartlett
Griffin
William L.
erty programs, particularly in view of your
Brock
Hansen
Thurmond
Mr. ALLEN. Reserving the right to
active participation in determining the budg-
Byrd,
Helms
Tower
object
et ceiling in this area.
Harry F., Jr.
Laxalt
Mr. MANSFIELD. Mr. President, I sug-
Best regards.
Curtis
Proxmire
gest the absence of a quorum,
Sincerely,
NOT VOTING-8
The PRESIDING OFFICER. The clerk
WARREN G. MAGNUSON,
Buckley
Goldwater
McClellan
will call the roll.
Chairman, Subcommittee on Labor-
Cranston
Gravel
Tunney
Health, Education, and Welfare.
The assistant legislative clerk pro-
Eastland
Haskell
ceeded to call the roll.
Mr. MAGNUSON. Mr. President, I do
So the bill (H.R. 14232), as amended,
Mr. MANSFIELD. Mr. President, I ask
not see any further amendments on the
was passed.
unanimous consent that the order for
horizon.
Mr. MAGNUSON. Mr. President, I
the quorum call be rescinded.
The PRESIDING OFFICER. Are there
move that the Senate insist on its
The PRESIDING OFFICER. Without
any further amendments pending? The
amendments and request a conference
objection, it is so ordered.
bill is open to further amendment. If
with the House on the disagreeing votes
there be no further amendment to be
thereon and that the Chair be author-
proposed, the question is on the engross-
ORDER TO POSTPONE
ized to appoint conferees on the part of
ment of the amendments and the third
INDEFINITELY S. 3622
the Senate.
reading of the bill.
The amendments were ordered to be
The motion was agreed to, and the
Mr. MANSFIELD. Mr. President, I ask
presiding officer (Mr. PHILIP A. HART)
unanimous consent that Calendar No.
engrossed and the bill to be read a third
appointed Mr. MAGNUSON, Mr. STENNIS,
934, S. 3622, a bill to amend the Solid
time.
Mr. ROBERT C. BYRD, Mr. PROXMIRE, Mr.
Waste Disposal Act to authorize State
The bill was read the third time.
The PRESIDING OFFICER. All time
MONTOYA, Mr. HOLLLINGS, Mr. EAGLETON,
program and implementation grants, to
has been yielded back.
Mr. BAYH, Mr. CHILES, Mr. McCLELLAN,
provide incentives for the recovery of re-
Mr. BROOKE, Mr. CASE, Mr. FONG, Mr.
sources from solid wastes to control the
The bill having been read the third
time, the question is, Shall it pass? On
STEVENS, Mr. SCHWEIKER, and Mr.
disposal of hazardous wastes, and for
YOUNG, conferees on the part of the
other purposes, be indefinitely postponed.
this question, the yeas and nays have
been ordered, and the clerk will call the
Senate.
The PRESIDING OFFICER. Without
objection it is so ordered.
roll.
The second assistant legislative clerk
APPOINTMENT BY THE VICE
called the roll.
PRESIDENT
CONSIDERATION OF CERTAIN
Mr. ROBERT C. BYRD. I announce
MEASURES ON THE CALENDAR
The PRESIDING OFFICER (Mr.
that the Senator from Mississippi (Mr.
WILLIAMS). The Chair, on behalf of the
Mr. MANSFIELD. Mr. President, I ask
EASTLAND), the Senator from Alaska (Mr.
Vice President, appoints the Senator
unanimous consent that the Senate turn
GRAVEL), the Senator from Arkansas
from Rhode Island (Mr. PASTORE) and
to the consideration of Calendar Nos.
(Mr. McCLELLAN), the Senator from Cali-
the Senator from Tennessee (Mr. BAKER)
939, 948, and 951.
fornia (Mr. CRANSTON), the Senator from
to attent the 20th session of the general
The PRESIDING OFFICER. Without
Colorado (Mr. HASKELL), and the Sena-
conference of the International Atomic
objection, it is so ordered.
tor from California (Mr. TUNNEY) are
Energy Agency, to be held in Rio de
necessarily absent.
Janiero, Brazil, September 21-28, 1976.
I further announce that, if present and
MEDICARE EXTENSION
voting, the Senator from California (Mr.
AMENDMENTS
TUNNEY) would vote "yea."
PRIVILEGE OF THE FLOOR-H.R.
The Senate proceeded to consider the
Mr. GRIFFIN. I announce that the
14114 AND H.R. 10612
bill (H.R. 13501) to extend or remove
Senator from Arizona (Mr. GOLDWATER)
certain time limitations and make other
is necessarily absent.
Mr. BELLMON. Mr. President, I ask
administrative improvements in the
I further announce that the Senator
unanimous consent that Mr. Jim Ver-
medicare program under title XVIII of
from New York (Mr. BUCKLEY) is absent
dier of the Congressional Budget Office
the Social Security Act, which had been
due to illness.
be granted privilege of the floor during
reported from the Committee on Finance
I further announce that, if present and
Senate consideration of H.R. 14114, the
with an amendment on page 3, begin-
voting, the Senator from Arizona (Mr.
debt ceiling bill, and H.R. 10612, the Tax
ning with line 6, insert the following
GOLDWATER) would vote "nay."
Reform Act of 1976.
new section:
FOR IMEDIATE RELEASE
fyi
July 19, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
STATEMENT BY THE PRESIDENT
- = have signed H.R. 13501, the "Medicare Extension
Amendments. " Although this bill would, for the most part,
simply extend certain technical provisions of the Medicare
law, other portions of the bill will increase Medicare
payments for physicians' services above the level recommended
in my budget without meeting the urgent needs of Medicare
beneficiaries and taxpayers. These deficiencies in Medicare
benefits can be corrected if the Congress will promptly con-
sider and enact the needed reforms proposed in my "Medicare
Improvements of 1976" which was submitted in February.
My proposal would provide catastrophic protection
against large medical bills for all of the 25 million aged
and disabled who are insured by the Medicare program. These
beneficiaries would be entitled to unlimited hospital and
nursing home care and would not have to pay any costs above
$500 per year for hospital and nursing home care and $250
per year for doctors' fees. This catastrophic protection
would reduce payments for hospital or physician services for
3 million persons in 1977. The comprehensive reforms in
the "Medicare Improvements of 1976" also include moderate
cost-sharing to encourage economical use of services, and
a limit on Federal reimbursements for hospital and physician
services in order to help control health cost inflation.
In total, my proposal would improve insurance against really
large medical bills while also saving the taxpayers $1.5
billion in fiscal year 1977.
The Congress has also recognized the high priority that
must be given to economies in the Medicare program. The
congressional concurrent budget resolution for fiscal year
1977 calls for $300 million of net savings in Medicare.
I am keenly sensitive to the burdens borne by some of
our elderly and disabled in meeting their medical expenses.
I believe we should take positive steps to provide better
protection against catastrophic health costs and inflation
in health costs.
Once again, therefore, I urge the Congress to turn its
attention to meeting the real needs of the aged and of the
taxpayer and enact the "Medicare Improvements of 1976" before
it adjourns this year.
# # # #
BERALD FORD LIBRARY
July 23, 1976
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Johnson
94th Congress - 2nd Session
HEARINGS
COMMITTEE
SUBJECT
DATE
WITNESS
Subcommittee on Health & Environment
Swine Flu
7/23/76
Drs. Cooper,
(Rogers)
Sencer, Krause
House Interstate & Foreign Commerce Committee
& Meyer
Mr. Taft
Subcommittee on Health (Talmadge)
S. 3205, Medicare -
7/26/76
Secretary
Senate Finance Committee
Medicaid Reform
Dr. Cooper
Messrs. Morrill
& Cardwell
Select Committee on Nutrition & Human Needs
Nutrition (Oversight)
7/27/76
Drs, Cooper, Burton,
(McGovern)
Lowe Mr. Haislip
Subcommittee on Consumer Protection
H.R. 882, H.R. 884, Prescription
7/28/76
Drs. Dickson
& Finance (Murphy)
Drug Labeling
& Levanthal
House Interstate & Foreign Commerce Committee
Messrs. Merrill
& Haislip
Subcommittee on Legislative Oversight
Publicity for Earned
7/28/76
Mr. Simmons
(Vanik)
Income Tax Credit Provision
House Ways & Means Committee
Subcommittee on Energy Research, Development
Health & Coal Mine Safety
7/28/76
Messrs. Baier
& Demonstration (Heckler)
(Oversight)
& Merchant
House Science & Technology Committee
GERALD FORD LIBRARY
D/HEW - 94th Congress - 2nd Session
July 23, 1976
Page 2
HEARINGS (Continued)
COMMITTEE
SUBJECT
DATE
WITNESS
Subcommittee on Legislative Oversight
Administrative Costs & Charges
8/2/76
Mr. Tierney Invited
(Stark)
by Medicare Intermediaries
Mr. Stepnik
House Ways & Means Committee
(Oversight)
Subcommittee on Health (Rostenkowski)
Revision of Medicare Hospital
8/3/76
No Formal Request
House Ways & Means Committee
Reimbursement
Subcommittee on Retirement & Employees
Preventative Health Services
8/3, 8/10,
Dr. Cooper Invited
Benefits (White)
for Federal Employees
8/24 or
House Post Office & Civil Service Committee
8/31/76
Subcommittee on Communications (Van Deerlin)
Equal Employment in Public
8/9/76
Mr. Gerry
House Interstate & Foreign Commerce Committee
Broadcasting (Oversight)
Mr. Cameron
Subcommittee on Legislative Oversight
End Stage Renal Dialysis
8/23/76
Mr. Tierney Invited
(Vanik)
Regulations (Oversight)
House Ways & Means Committee
FORD is LIBRARY GERALD
D/HEW. - 94th Congress - 2nd Session
July 23, 1976
Page 3
POSSIBLE HEARINGS
COMMITTEE
SUBJECT
DATE
WITNESS
Senate Special Committee on Aging
Legal Services for the Elderly
Possible
Dr. Flemming
(Church)
August
House Agriculture Committee (Foley)
Labeling of Fats & Oils
Possible
No Formal Request
Subcommittee on Health
S. 2696, S. 2697, FDA
Possible
Drs. Cooper
(Kennedy)
Reorganization
& Schmidt
Senate Labor & Public Welfare Committee
Subcommittee on Health (Kennedy)
Swine Flu: Indemnification
Possible
No Formal Request
Senate Labor & Public Welfare Committee
Subcommittee on Oversight & Investigation
Utilization Review
Possible
No Formal Request
(Moss)
House Interstate & Foreign Commerce Committee
Senate Finance Committee (Long)
SSI
Possible
No Formal Request
Subcommittee on Health (Rostenkowski)
Home Health Services
Possible
No Formal Request
Subcommittee on Legislative Oversight (Vanik)
Under Medicare
House Ways & Means Committee
Subcommittee on Health (Talmadge)
EPSDT Program
Possible
No Formal Request
Senate Finance Committee
Subcommittee on Health & Environment
S. 2515, Protection of Human
Possible
No Formal Request
(Rogers)
Subjects (Senate Passed 5/25/76)
House Interstate & Foreign Commerce Committee
Subcommittee on Intergovernmental
National Cancer Institute
Possible
No Formal Request
Relations & Human Resources (Fountain)
House Government Operations Committee
Permanent Subcommittee on Investigations
Medicaid Fraud
(Jackson)
FORD is LIBRARY GERALD
Possible
Secretary
Requested
Senate Government Operations Committee
"
"
Hearing Aids
Possible
No Formal Request
D/HEW - 94th Congress - 2nd Session
July 23, 1976
Page 4
POSSIBLE HEARINGS (Continued)
COMMITTEE
SUBJECT
DATE
WITNESS
Subcommittee on Constitutional Rights
Privacy of Drug Treatment
Possible
No Formal Request
(Tunney)
Senate Judiciary Committee
"
"
Rights of Prisoners
Possible
No Formal Request
Subcommittee on Alcoholism & Narcotics
Domestic Council Report
Possible
No Formal Request
(Hathaway)
on Drug Abuse
Senate Labor & Public Welfare Committee
Subcommittee on Consumer Protection &
Generic Drugs
Possible
No Formal Request
Finance (Van Deerlin)
House Interstate & Foreign Commerce Committee
Subcommittee on Legislative Oversight
SSI Outreach & Services
Possible
Mr. Kelly
(Vanik)
(NYC) (Oversight)
September
House Ways & Means Committee
Subcommittee on Select Education (Brademas)
Rehabilitation Research
GERALD FORD LIBRARY
Possible
No Formal Request
House Education & Labor Committee
Subcommittee on Health & Environment (Rogers)
S. 1191, Lister Hill Scholarships
Possible
No Formal Request
House Interstate & Foreign Commerce Committee
(Senate Passed 6/12/75)
"
"
NIH (Oversight)
Possible
No Formal Request
Subcommittee on Administrative Practices
Freedom of Information: Agencies'
Possible
No Formal Request
& Procedures (Kennedy)
Inability to Cover Costs for
Senate Judicial Committee
Pharmaceutical Requests
House Select Committee on Aging (Randall)
Education & Training for the Aged
Possible
Dr. Flemming
Subcommittee on Legislative Oversight
Implementation of SSI Study
Possible
No Formal Request
(Vanik)
Group Regulations
September
House Ways & Means Committee
D/HEW - 94th Congress - 2nd Session
July 23, 1976
Page 5
EXECUTIVE SESSIONS
COMMITTEE
SUBJECT
DATE
Public Assistance Subcommittee (Corman)
SSI: Keys Amendment
7/26/76
House Ways & Means Committee
Title IVD Child Support Amendments
Subcommittee on Intergovernmental
H.R. 14761, Office of Inspector General
7/27/76
& Human Resources (Fountain)
House Government Operations Committee
Subcommittee on Labor (Williams)
S. 3183, H.R. 10760, Black Lung
Week of 7/26/76
Senate Labor & Public Welfare Committee
House Rules Committee (Madden)
H.R. 12048, Congressional Veto
Unknown
of Regulations (Judiciary Filed
Report 4/8/76)
Senate Labor & Public Welfare Committee
S. 1325, Drug Compendium
Unknown
(Williams)
Senate Labor & Public Welfare Committee
S. 1282, National Center for Clinical
Unknown
(Williams)
Pharmacology
House Interstate & Foreign Commerce Committee
H.R. 14319, Clinical Laboratories
Unknown
(Staggers)
(Senate Passed S. 1737 on 4/29/76)
Subcommittee on Health (Kennedy)
S. 2910, Diabetes
Unknown
Senate Lavor and Public Welfare Committee
Senate Finance Committee (Long)
H.R. 13272, AFDC-UI (House Passed 5/19/76)
Unknown
Subcommittee on Health (Rogers)
H.R. 14437, H.R. 14569, Swine Flu
Unknown
House Ways & Means Committee
Indemnification
Senate Government Operations Committee
S. 2812, Federal Regulatory Reform
(Ribicoff)
FORD & LIBRARY GERALD
Unknown
(OMB Lead Agency)
D/HEW. - 94th Congress - 2nd Session
July 23, 1976
Page 6
EXECUTIVE SESSIONS (Continued)
COMMITTEE
SUBJECT
DATE
Subcommittee on Health (Rostenkowski)
H.R. 12082, Medicare
Unknown
House Ways & Means Committee
Catastrophic Health Insurance
Subcommittee on Reports, Accounting &
S. 2947, Federal Advisory Committee
Unknown
Management (Metcalf)
Amendments (OMB Lead Agency)
Senate Government Operations Committee
Subcommittee on Administrative Practice
S. 1210, Freedom of Information
Unknown
& Procedure (Kennedy)
Amendments (CSC Lead Agency)
Senate Judiciary Committee
"
"
S. 3297, Congressional Veto of
Unknown
Regulations
Subcommittee on Health (Talmadge)
H.R. 12961, S. 3292, Consent to Suit
Unknown
Senate Finance Committee
Under Medicaid (House Passed H.R. 12961, 5/12/76)
Subcommittee on Health (Kennedy)
S. 118, S. 215, S. 482, Medical Malpractice
Unknown
Senate Labor & Public Welfare Committee
Insurance
Subcommittee on Indian Affairs (Abourezk)
S. 2801, Siletz Restoration
Unknown
Senate Interior & Insular Affairs Committee
(Interior Lead Agency)
Senate Government Operations Committee
S. 2925, Zero-based Budget
Possible Week of
(Ribicoff)
(OMB Lead Agency)
7/26/76
Senate Judiciary Committee (Eastland)
S. 1289, Open Communications Act
Unknown
(OMB Lead Agency)
FORD & GERALD LIBRARY
D/HEW - 94th Congress - 2nd Session
July 23, 1976
Page 7
EXECUTIVE SESSIONS (Continued)
COMMITTEE
SUBJECT
DATE
Subcommittee on Health & Environment
H.R.13794,H.R.13020,H.R.13265,
Unknown
(Rogers)
H.R.14255, PHS Personnel
House Interstate & Foréign Commerce Committee
Subcommittee on Health (Kennedy)
S. 2902, National Health Research
Unknown
Senate Labor & Public Welfare Committee
& Development (Cigarette Tax)
Subcommittee on Health & Environment (Rogers)
S. 963, Prohibition of DES
Unknown
House Interstate & Foreign Commerce Committee
"
"
H.R. 559, Radiological Health
Unknown
H.R. 14289 FDA Amendments
Unknown
H.R. 12082, Medicare Catastrophic
Unknown
Health Insurance
Subcommittee on Immigration & Naturalization
S. 3074, Illegal Aliens
Unknown
(Eastland)
(Justice Lead Agency)
Senate Judiciary Committee
Subcommittee on Dairy & Poultry (Jones)
H.R. 397, H.R. 1321, H.R. 1342, H.R. 2722,
Unknown
House Agriculture Committee
H.R. 4692, H.R. 10742, Inspection & Labeling
of Imported Dairy Products
Subcommittee on Public Assistance (Corman)
H.R. 12175, Social Service Block Grant
Unknown
House Ways & Means Committee
Subcommittee on Higher Education (O'Hara)
S. 972, Scholarships to Dependents
Unknown
House Education & Labor Committee
of Public Safety Officers
(Senate Passed 7/20/76)
FORD & GERALD LIBRARY
D/HEW - 94th Congress - 2nd Session
July 23, 1976
Page 8
BILLS ORDERED REPORTED
COMMITTEE
SUBJECT
DATE
Senate Labor & Public Welfare Committee (Williams)
S. 1681, Cosmetic Safety
2/26/76
FLOOR ACTION
HOUSE
DATE
Conference Report on S. 2145, Vietnamese Refugees Education Assistance
Week of 7/26/76
H.R. 8911, SSI Amendments
Unknown
H.R. 13502, AFDC Formula (Medicaid)
Unknown
H.R. 5970, Emergency Health Insurance (S. 625)
Unknown
H.R. 8713, Illegal Aliens (Justice Lead Agency)
Unknown
H.R. 12664, EMS & Burns Centers (S. 2548, Passed by Senate 6/10/76)
Unknown
H.R. 2525, Indian Health (Senate Passed S. 522, 5/16/75)
7/29/76
H.R. 11656, Government in the Sunshine-FOI Amendments (OMB Lead Agency)
7/28/76
H.R. 14070, GSL Amendments
8/3/76
H.R.
14514 SSI-Food Stamp Cash Out (S. 3656, Passed by Senate 7/2/76)
7/27/76
H.R. 14032, Toxic Substances (EPA Lead Agency)
Unknown
H.R. 5465, Indian Health Service Employees (Senate Amended 7/20/76)
Unknown
SENATE
S. 422, Youth Camp Safety (House Passed H.R. 46, 4/17/75)
Unknown
S. 625, Health Insurance for Unemployed
Unknown
S. 2657, Education Amendments of 1976 (House Passed H.R. 12835, H.R. 12851, 5/11/76, 5/12/76)
8/3/76
S. 2715, Attorneys' Fees for Citizens Participating in Agency Hearings (Justice Lead Agency)
Unknown
Conference Report on H.R. 12455, Title XX Eligibility/Day Care (House Agreed 7/1/76)
Unknown
LEBRARY GERALD R. FORD
D/HEW - - 94th Congress - 2nd Session
July 23, 1976
Page 9
BILLS IN CONFERENCE
SUBJECT
DATE
H.R. 7575 (S. 200), Consumer Advocacy (Not Yet Requested) (OMB Lead Agency)
Unknown
H.R. 12838, Arts & Humanities (Senate Acts First) (NEH/A Lead Agency)
7/29/76
H.R. 9019, HMO Amendments (Senate Acts First)
Current
H.R. 14232, Labor-HEW Appropriations (House Acts First)
Current
H.R. 5546, Health Manpower (Not Yet Requested)
Unknown
ENROLLED BILLS
SUBJECT
DATE
S. 586, Coastal Zone Management (Shellfish)
7/26/76
S. 3184, Alcoholism Extension
7/26/76
H.R. 14231, Interior Approprations (IHS)
8/3/76
NOMINATIONS
COMMITTEE
Senate Labor & Public Welfare Committee (Williams)
Bertha Adkins, Mrs. John William Devereau,
John Martin, Harry Holland, & Nat T. Winston, Jr.
were nominated on 1/26/76 to be Members of the
Federal Council on Aging.
Senate Finance Committee
Thomas Lias was nominated on 6/17/76
to be Assistant Secretary for Legislation
FORD & GERALD LIBRARY
MEMORANDUM
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
TO
:
The Honorable Max Friedersdorf
DATE:
July 23, 1976
Assistant to the President for
Legislative Affairs
FROM :
Assistant Secretary for Legislation
SUBJECT:
Department of Health, Education, and Welfare
Weekly Activity Report
WELFARE
Black Lung
Staff from the Office of Legislation and the Social
Security Administration met this week with Senate
minority staff members to discuss the Senate's committee
print of the black lung bill. In its current form, the
bill entitles anyone with 25 years of coal mine work to
receive benefits. A number of amendments, both liberal-
izing and de-liberalizing, are expected to be offered
during mark-up by the Subcommittee on Labor. Although
the schedule is uncertain, mark-up sessions could begin
during the week of July 26.
Decoupling Briefing
On Wednesday, July 21, the Office of Welfare Legislation
provided a briefing for the legislative assistants and
staff of the Ways and Means Committee members. Don Hirsch
of the Office of General Counsel Legislation Division
explained H.R. 14430, The Social Security Benefit Indexing
Act (Decoupling), and its effect on the long-range financing
of the Social Security.
HEARING HELD
Decoupling
On Friday, July 23, the Social Security Subcommittee, chaired
by Congressman Burke, heard testimony on Decoupling from
four interest groups. The speakers were Preston C. Bassett
of the Chamber of Commerce for the United States, Nelson H.
Cruikshank of the National Council of Senior Citizens, Issac
Fine of the National Retired Teachers Association and the
American Association of Retired Persons, and Walter E. Klint
FORD LIBRARY & GERALD
of the National Association of Manufacturers. All of the
speakers supported the principle of decoupling; however, they
each recommended specific changes to the pending legislation
-2-
which would alleviate the short-term financial problem.
Chairman Burke commented that the inflexibility of these
groups with regard to their specific recommendations to
and/or reservations about the decoupling bill makes it
impossible for the subcommittee to draft legislation that
will "fly in Congress," and he cautioned them to reconsider
their individual positions with that in mind. Chairman
Burke also said that something should be done this year in
relation to the short-term problem, but he added, "I would
rather have something go through than nothing.' The
Subcommittee will continue its hearings on Monday, July 26,
at 10 o'clock.
HEALTH
HEARINGS HELD
FDA Investigation
The Senate Subcommittees' in Health and in Administrative
Practice and Procedure continued hearings this week on
procedures used by the Food and Drug Administration for
testing new drugs. Commissioner Alexander Schmidt, the
lead witness, gave an update of the Agency's scientific
investigations of private and commercial laboratories.
He told the members that while the Agency's inspections of
animal toxicity laboratories are continuing, a number of
major deficiencies in testing procedures have been revealed.
The Commissioner further stated that FDA has documented the
validity of the Committee's concerns and the need to do
something about it. As a result of these occurrences, Dr.
Schmidt stated that the FDA will have additional resources
to support a comprehensive Bio-research Monitoring Program.
Subsequently, Secretary David Mathews, testified before the
joint session focussing on the work of the Review Panel on
New Drug Regulation. Other witnesses prepared to testify
included the Chairman, former Chairman and representatives
of the Panel. Senator Kennedy and Senator Javits worked
out a general agreement with the witnesses to extend the
termination date of the Panel in order for the Panel to
complete its investigation of FDA employee allegations and
to report on their examination of specific issues and policies
of new drug regulation.
FORD & GERALD LIBRARY
-3-
National Influenza Immunization Program
The House Subcommittee on Health and the Environment resumed
hearings on July 20 on the National Influenza Immunization
Program. The Assistant Secretary for Health, Dr. Theodore
Cooper, testified before the Committee, giving a status
report on the program. He stated that the scientific work
for the vaccine is on schedule and even though there has been
no outbreak of "swine flu " since last February, the
Administration is still committed to the program. In addi-
tion, Dr. Cooper told the members that the manufacturers
of the vaccine have not been able to obtain liability
insurance and the Administration is now proposing to set
a precise, insurable limit of funds for baseless suits,
using the indemnification powers in the Department's pro-
posed legislation (H.R. 14409) to pay for legal costs of
suits. The members were not receptive of this proposal and
Congressman Rogers stated that he will request all parties
involved in the program to appear before the Committee later
on in the week.
Subsequently, the Subcommittee met with representatives from
HEW and the insurance and drug industries in an effort to
find a solution to the current dilemma involving the insurance
industry's unwillingness to provide insurance coverage for
swine flu. The following determinations were made: 1) A
meeting of insurance companies and HEW representatives will
take place on Monday, July 26 for the purpose of discussing
ways in which the companies might pool risk in order to pro-
vide necessary protection. 2) Drug manufacturers agreed to
continue to produce the vaccine for another five days in hopes
that at the end of that time, the issue will be resolved.
HOURS OF TESTIMONY
Hours of testimony for the reported period are:
Principal Witnesses
5
Support Witnesses
25
TOTAL
30
Mary Jane Fiske
Attachments
FORD is LIBRARY GERALD
July 23, 1976
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
94TH CONGRESS, 1ST AND 2ND SESSION
Pending Bills:
Page
A. SOCIAL SECURITY AND WELFARE
Black Lung
1
Allied Services
2
Social Security Cost Control
3
Social Service Consolidation
4
Social Security Amendments of 1976
5
Day Care Penalities
6
Title XX Means Test - Day Care Suspension
7
Child Support Amendments
8
AFDC Amendments
9
Rehabilitation Service Delivery
10
Child Abuse Prevention Treatment
11
Food Stamps - SSI
12
SSA Totalization (International Social Security Agreement)
Act
13
Social Security Decoupling
14
B.
EDUCATION
Career Education
15
Repeal of 2nd Morrill Act
16
Impact Aid
17
Higher Education Act Extension
18, 18a
Vocational Education
19, 19a,19b
Repeal of Sec. 411 (b) (4) of Higher Education Act of
1965
20
Extension of NIE
21
Student Loan Amendments of 1975
22
Technical and Perfecting Amendments to P.L. 93-380
23
Educational Assistance for Indochinese Refugees
24
Minor Amendments to the Education Amendments of
25
Indian Post-Secondary Education
26
Extension of the Library Services and Construction Act
27
Career Education Act of 1976
28
Education Block Grant
29
Museum Services Act
30
C. HEALTH
Clinical Laboratories
31
Health Insurance for Unemployed
32
Health Manpower
33
BERALD FORD LIBRARY
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
94th CONGRESS, 1ST AND 2ND SESSION
Pending Bills:
Page
C. HEALTH (Continued)
Maternal and Child Health Crippled Children and Medicaid
Cost control
34
Youth Camp Safety
35
Health Block Grant
36
Emergency Medical Services
37
Indian Health
38, 38a
HMO Amendments
39
Medicare Improvement Act
40
Medicaid Reimbursement Amendments
41
PHS Hospitals
42
Swine Flu Indemnification
43
Utilization Control
44
FDA Amendments
45
FORD is LIBRARY GERALD
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
94TH CONGRESS, 1ST AND 2ND SESSION
FIRST SESSION
P. L. 94-7 (signed 3/14/75)
Continuing Appropriations for FY '75
P. L. 94-12 (signed 3/29/75)
Tax Reduction Act
P. L. 94-23 (signed 5/23/75)
Vietnamese Refugee Assistance Act
P. L. 94-24 (signed 5/23/75)
Vietnamese Refugee Appropriations
P. L. 94-32 (signed 6/12/75)
Supplemental Appropriations for FY '75
P. L. 94-41 (signed 6/27/75)
Continuing Appropriation for FY '76
P. L. 94-43 (signed 6/28/75)
College Work Study
P. L. 94-44 (signed 6/28/75)
Assistance for Repatriated Americans
P. L. 94-45 (signed 6/30/75)
Unemployment Compensation
P. L. 94-46 (signed 6/30/75)
Tariff on Istle (Title IV-D delay)
P. L. 94-48 (signed 7/1/75)
Medicaid Amendments
P. L. 94-63 (enacted 7/29/75)
Nurse Training and Health Services
P. L. 94-88 (signed 8/9/75)
Tariff on Watches; Child Support
P. L. 94-94 (enacted 9/10/75)
Education Appropriations for FY 76
P. L. 94-103 (signed 10/4/75)
Developmental Disabilities
P. L. 94-120 (signed 10/21/75)
Duty on Graphite - Day Care
Staffing Requirement Delay
P. L. 94-122 (signed 10/21/75)
Agriculture Appropriations (FDA)
P. L. 94-135 (signed 11/28/75)
Older Americans
P. L. 94-142 (signed 11/29/75)
Education for the Handicapped
P. L. 94-157 (signed 12/18/75)
Supplemental Appropriations for FY '76
GERALD FORD LIBRARY
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
PUBLIC LAWS OF THE 94TH CONGRESS (Continued)
FIRST SESSION
P. L. 94-159 (signed 12/20/75)
Continuing Appropriations for FY '76
P. L. 94-182 (signed 12/31/75)
Medicare Amendments
P. L. 94-194 (signed 12/13/75)
Reading Improvements Amendments
P. L. 94-203 (signed 1/2/76)
Hearings and Appeals
SECOND SESSION
P. L. 94-206 (enacted 1/28/76)
Labor-HEW Appropriations for FY '76
P. L. 94-224 (signed 2/27/76)
White House Conference on the
Handicapped
P. L. 94-230 (signed 3/15/76)
Vocational Rehabilitation Amendments
P. L. 94-230 (signed 3/19/76)
SAODAP Extension
P. L. 94-266 (signed 4/15/76)
Emergency Appropriations for Swine
Flu Prevention
P.. L. 94-273 (signed 4/21/76)
Fiscal Year Adjustment (Title I, ESEA
Amendment)
P. L. 94-277 (signed 4/21/76)
Allen J. Ellender Fellowships
P. L. 94-278 (signed 4/22/76)
Heart and Lung, Research Award
P. L. 94-279 (signed 4/22/76)
Animal Welfare Act (USDA Lead Agency)
P. L. 94-287 (signed 5/21/76)
Designation of Helen Keller Deaf-Blind
Centers
P. L. 94-295 (signed 5/28/76)
Medical Devices
P. L. 94-303 (signed 6/1/76)
Second Supplemental Appropriation
for FY 76
P. L. 94-308 (signed 6/4/76)
D.C. Health Manpower
P. L. 94-313 (signed 6/21/76)
Indochinese Refugees Assistance
(Laotions)
P. L. 94-317 (signed 6/25/76)
Health Education & Communicable
Diseases
FORD is LIBRARY GERALD
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
PUBLIC LAWS OF THE 94TH CONGRESS (Continued)
SECOND SESSION (Continued)
P. L. 94-328 (signed 6/30/76)
Emergency Guaranteed Student
Loan Amendments
P. L. 94-345 (signed 7/8/76)
Canal Zone Alcohol Regulation
P. L. 94-351 (signed 7/12/76)
USDA Appropriations (FDA)
P. L. 94-361 (signed 7/14/76)
Military Procurement
(Variable Incentive Pay)
P. L. 94-365 (signed 7/14/76)
SSI-June 30 Extension
P. L. 94-368 (signed 7/16/76)
Medicare Amendments
FORD & LIBRARY GERALD
Page 1
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Black Lung
SENATE BILLS : S. 1302, introduced by Senator Williams on 3/21/75.
S. 3183, introduced by Senator Haskell on 3/18/75.
HOUSE BILLS : H.R. 7, introduced by Mr. Perkins on 1/14/75. (E&L)
H.R. 8, introduced by Mr. Dent on 1/14/75. (E&L)
H.R. 3333, introduced by Mr. Perkins on 2/19/75. (E&L)
H.R. 10760, introduced by Mr. Dent on 11/14/75 (E&L)
PROVISIONS :
SENATE STATUS: 3/26/76 - Stephen Kurzman, Assistant Secretary for
Legislation, testified before the Sub-
committee on Labor, Labor and Public Welfare
Committee on H.R. 10760.
6/25/76 - Subcommittee on Labor held an executive session
on S. 3183.
HOUSE STATUS : 3/13/75 - Bruce Cardwell, Commissioner for Social
Security Administration, and Stephen Kurzman,
Assistant Secretary for Legislation, testified
before the Subcommittee on Labor Standards on
H.R. 7, H.R. 8 and H.R. 3333.
11/12/75 - Subcommittee on Labor Standards ordered H.R. 8
reported, with amendment.
12/9/75
- Committee on Education and Labor ordered
H.R. 10760 reported (for H.R. 8).
12/31/75 - Committee on Education and Labor filed
H.R. 10760 (Rept. 94-770).
2/25/76 - Committee on rules granted a two hour debate,
open rule.
3/2/76 - House passed H.R. 10760 by a vote of 210-183
GERALD FORD LIBRARY
Page 2
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT:
: Allied Services
SENATE BILLS : S. 2489, introduced by Senators Curtis and Javits on
10/7/75. (Finance, LPW)
HOUSE BILLS : H.R. 9981, introduced by Mr. Quie, Mr. Perkins, Mr. Brademas
and Mr. Bell on 10/2/75. (Administration Bill)
PROVISIONS : To encourage and assist States and localities to
develop, demonstrate, and evaluate means of imposing
the utilization and effectiveness of human services
through integrated planning, management and delivery.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 3
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Social Security Cost Control
SENATE BILLS : S. 1720, introduced by Senator Curtis on 5/13/75.
(Administration Bill) (Finance)
HOUSE BILLS : H.R. 4820, introduced by Mr. Staggers and Mr. Devine on
3/12/75. (Administration Bill) (IFC)
PROVISIONS : To improve and control the cost of the program of old-age
survivors and disability insurance, AFDC and Medicare.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 4
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Social Service Block Grant
SENATE BILLS : S. 3061, introduced by Senators Curtis, Fannin, Hansen
and Roth on 3/2/76. (Administration Bill) (Finance)
HOUSE BILLS : H.R. 12175, introduced by Messrs. Vander Jagt, Schneebeli,
Bafalis on 2/26/76. (Administration Bill) (W&M)
PROVISIONS : To amend Title XX of the Social Security Act and to
strengthen the ability of States to support social services.
SENATE STATUS:
HOUSE STATUS : 5/21/76 - Secretary Mathews, testified before the Sub-
committee on Public Assistance of Ways and
Means Committee on H.R. 12175. He was
accompanied by Stephen Kurzman, Assistant
Secretary for Legislation and William Morrill,
Assistant Secretary for Planning and Evaluation.
GERALD FORD VIBRARY
Page 5
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Social Security Amendments of 1976
SENATE BILLS: S. 3092, introduced by Senator Curtis on 3/9/76
(Administration Bill) (Finance)
HOUSE BILLS : H.R. 13770, introduced by Mr. Steiger (Wisc.) by request
on May 13, 1976. (Administration Bill) (W&M)
PROVISIONS : To amend the Social Security Act to increase FICA and self-
employment taxes; to revise retroactive payment and
retirement provisions and to phase out student benefits
under OASDI.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY CERALD
Page 6
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Day Care Penalties
SENATE BILLS : S. 2466, introduced by Senator Fannin by request on
10/2/75. (Finance) (Administration Bill)
HOUSE BILLS : H.R. 10386, introduced by Mr. Litton on 10/28/75. (W&M)
(Administration Bill)
PROVISIONS : To amend Title XX of the Social Security Act to require
that state social service plans comply with Federal
Interagency day care requirements, subject to existing
penalities in cases on non-compliance.
SENATE STATUS:
HOUSE STATUS ;
FORD & LIBRARY GERALD
Page 7
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Title XX Means Test-Day Care Suspension
SENATE BILLS :
HOUSE BILLS : H.R. 12014, introduced by Mr. Corman et. al., on 2/23/76.
(W&M)
H.R. 12455, introduced by Mr. Corman, et. al., on 3/11/76.
(Administration position) (W&M)
PROVISIONS
: To extend until October 1, 1976 the maximum period during
which those Title XX recipients who were eligible on
9/30/75 may receive benefits without individual
determination (H.R. 12014 provided for greater flexibility
by the States with regard to the means test.)
SENATE STATUS: 5/11/76 - Committee on Finance ordered H.R. 12455 reported
with amendments, including to suspend day
care staffing requlations until October 1, 1977.
5/13/76 - H.R. 12455 was filed (Rept. 94-857).
5/20/76 - H.R. 12455 was passed by a vote of 48-16.
6/10/76 - Senate agreed to conference.
HOUSE STATUS : 3/4/76 - Stephen Kurzman, Assistant Secretary for
Legislation, testified before the Subcommittee on
Public Assistance on the Administration's
position on the means test and its position on
H.R. 12014.
3/15/76 - Ways and Means Committee filed H.R. 12455 (Rept.
94-903). H.R. 12455 reflected the
Administration's position.
3/16/76 - House passed H.R. 12455 by a vote of 383-0.
5/26/76 - House disagreed with Senate amendment and
requested conference.
6/30/76 - Conference Report was filed. Representative FORD
Vander Jagt refused to sign the conference
later he testified before the House Rules
Committee.
LIBRARY GERALD
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (Continued)
HOUSE STATUS : 7/1/76 - House adopted conference report by a vote
of 281-71.
FORD & LIBRARY GERALD
Page 8
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Child Support Amendments
Bill Transmitted 6/26/75.
SENATE BILLS :
HOUSE BILLS :
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD + LIBRARY GERALD
Page 9
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: AFDC Amendments
Bill Transmitted 4/12/76.
SENATE BILLS :
HOUSE BILLS : H.R. 13472, introduced by Mr. Vandee Jagt on April 29, 1976.
(Administration Bill) (W&M)
PROVISIONS :
SENATE STATUS:
HOUSE STATUS ;
FORD i LIBRARY GERALD
Page 10
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Rehabilitation Service Delivery
SENATE BILLS : S. 3034, introduced by Senator Stafford by request
on 2/25/76. (Administration Bill)
HOUSE BILLS :
PROVISIONS : To provide for demonstration of alternative organization
plans for delivery of rehabilitation services.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 11
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Child Abuse Prevention and Treatment
Bill Transmitted 5/19/76.
SENATE BILLS :
HOUSE BILLS : H.R. 14727, introduced by Mr. Quie on 7/19/76 by request.
(Administration Bill)
PROVISIONS : To amend and extend the programs authorized by the
Child Abuse Prevention and Treatment Act.
SENATE STATUS:
HOUSE STATUS :
FORD is LIBRARY GERALD
Page 11
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Child Abuse Prevention and Treatment
Bill Transmitted 5/19/76.
SENATE BILLS :
HOUSE BILLS :
PROVISIONS :
SENATE STATUS:
FORD & LIBRARY GERALD
Page 12
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Food Stamps - SSI
Bill T nsmitted 6/11/76.
SENATE BILLS : S. 3656, introduced by Senator Mansfield for Senator Long.
HOUSE BILLS : H.R. 14514, introduced by Mr. Corman on 6/23/76.
(Administration Bill)
PROVISIONS : To amend P.L. 92-233 to extend certain temporary
provisions of law affecting food stamp eligibility of
supplemental security income recipients and to amend
Title XVI of the Social Security Act to make permanent
the temporary program of reimbursement to States for
interim assistance payments.
SENATE STATUS: 7/21/76 - Senate took from the desk and passed S. 3656
by voice vote.
HOUSE STATUS : 6/23/76 - Ways and Means Committee ordered H.R. 14514
reported.
6/28/76 - H.R. 14514 was filed (Rept. 94-1310).
FORD & LIBRARY GERALD
Page 13
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: SSA Totalization (International Social Security Agreement
Act).
SENATE BILLS : S. 3598 introduced by Senator Curtis on 6/21/76.
(Finance) (Administration Bill)
HOUSE BILLS : H.R. 14429, introduced by request by Mr. Burke and
Mr. Archer on 6/17/76. (W&M) (Administration Bill)
H.R. 14440, introduced by Mr. Archer et. al on
6/17/76 (W&M)
PROVISIONS :
SENATE STATUS:
HOUSE STATUS:
FORD & LIBRARY GERALD
Page 14
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Social Security Decoupling
SENATE BILLS :
HOUSE BILLS : H.R. 14430, introduced by Mr. Burke and Mr. Archer
on 6/17/76. (W&M) (Administration Bill)
PROVISIONS :
SENATE STATUS:
HOUSE STATUS : 6/18/76 - Secretary David Mathews, accompanied by James
Cardwell, Commissioner of Social Security
testified before the Subcommittee on Public
Assistance, Ways and Means Committee on the
Administration proposal.
FORD & LIBRARY GERALD
Page 15
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Career Education School Health and Nutrition Program
Environmental Education Act Alcohol and Drug Abuse
Education Act
Bill Transmitted 6/9/76.
SENATE BILLS :
HOUSE BILLS :
Provisions
: Extends authority for State Career Education planning
grants one year (through FY '78) and repeals the
Alcohol and Drug Abuse Education Act, the
Environmental Education, and the School Health and
Nutrition Program.
SENATE STATUS:
HOUSE STATUS :
FORD i LIBRARY GERALD
Page 16
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Repeal of 2nd Morrill Act
Bill Transmitted 3/3/75.
SENATE BILLS :
HOUSE BILLS :
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page S 173
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Impact Aid
Bill Transmitted on 3/2/76.
SENATE BILLS :
HOUSE BILLS :
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 18
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Higher Education Act Extension
SENATE BILLS: S. 2657, introduced by Senator Pell on 11/21/75. (LPW)
(Omnibus Education Amendments).
S. 2497, introduced by Senator Mondale (relating to
LifeTime Learning). (LPW)
S. 972, introduced by Senator Moss on 3/4/75 (Scholarships
to children of public service officers killed on
duty) (LPW)
S. 3190, introduced by Senator Beall on 3/22/76.
(Administrative Bill) (LPW)
HOUSE BILLS : H.R. 3470, H.R. 3471, introduced by Mr. O"Hara on 2/20/75.
(E&L) (H.R. 3470 deals with non-student aid provisions,
H.R. 3471 deals with student aid provisions).
H.R. 11939, introduced by Mr. Erlenborn on 2/18/76.
(Administration Bill) (E&L)
H.R. 10965, introduced by Mr. Fraser on 12/3/75. (E&L)
(relating to LifeTime Learning).
H.R. 12851, introduced by Mr. O'Hara on 3/29/76.
PROVISIONS
: To amend and extend the Higher Education Act of 1965.
SENATE STATUS: 7/23/75 - Dr. Virginia Trotter, Assistant Secretary for
Education testified before the Subcommittee on
Education on student assistance. She was
accompanied by John Philips, Acting Deputy
Commissioner for Postsecondary Education.
12/2/75 - Subcommittee on Education discussed provisions
12/10/75 - of S. 2657 in absence of a quorum.
1/22, 2/2/76 - Subcommittee on Education met in Executive
Session on S. 2657.
2/3/76 - Subcommittee on Education ordered S. 2657
reported to full committee.
3/23/76 - Labor and Public Welfare Committee held executive
session and adopted S. 972 by 9-4.
3/30, 3/31/76 - Labor and Public Welfare Committee held executive
sessions on S. 2657.
4/6/76 - Labor and Public Welfare Committee ordered S. 2657
reported by unaminous vote.
5/12/76 - S. 972 was filed (Rept. 94-822).
7/20/76 - senate passed S. 972 by voice vote.
HOUSE STATUS : 4/8/75 - Virginia Trotter, Assistant Secretary for
Education, testified before the Subcommittee
on Postsecondary Education, Education and Labor
Committee, on the Administration's position on FORD
student assistance. Commissioner of Education
Bell, testified to the specification of
H.R. 3471.
GERALD
LIBRARY
Page 18a
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (Continued)
11/13/76 - Executive session on H.R. 3471 began. Sub-
committees failed to obtain a quorum during
December. One Executive session held in
January.
2/4/76 - Dr. Bell, et. al., testified before the Sub-
committee on Postsecondary Education on the
shortfall in BEOG funding, increase in GSL
interest rate, and impact of various proposals
to increase BEOG benefits.
2/24/76- Dr. Virginia Trotter, et. al., testified before
the Subcommittee on Postsecondary Education on
the Administration's Higher Education Amend-
ments of 1976.
3/24/76 - Subcommittee on Postsecondary Education
unanimously ordered reported a clean bill for
H.R. 3470, with amendments, to full committee.
4/13/76 - Education and Labor Committee ordered H.R. 12851
reported.
5/4/76 - H.R. 12851 was filed (Rept. 94-1086).
5/12/76 - H.R. 12851 was passed by the House by a vote
of 388-7 with eight floor amendments.
FORD & LIBRARY GERALD
Page 19
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Vocational Education
SENATE BILLS : S. 939, S. 940, S. 941, S. 942, and S. 945, introduced by
Senator Pell and Senator Beall on 3/4/75. (L&PW)
S. 1863, introduced by Senator Beall and Senator Pell
on 6/4/75. (Administration Bill) (L&PW)
S. 2657, introduced by Senator Pell on 11/12/75 (LPW)
S. 2603, introduced by Senator Mondale on 11/3/75. (LPW)
S. 1338, introduced by Senator Percy on 3/26/75. (LPW)
(N.B. Latter two relate only to sex sterotyping)
HOUSE BILLS : H.R. 19 and H.R. 20, introduced by Mr. Perkins on 1/14/75.
H.R. 3036, introduced by Mr. Perkins and 19 others on
2/6/75. (identical bill H.R. 329, introduced by
Mr. Perkins and Mr. Quie on 3/19/75.
H.R. 3037, introduced by Mr. Perkins and 19 others on
2/6/75. (identical bill H.R. 3271, introduced by Mr. Perkins
and Mr. Quie on 3/19/75.
H.R. 3270, introduced by Mr. Perkins and Mr. Quie on 2/19/75.
H.R. 3990 (substitute for H.R. 19 and H.R. 20) introduced
by Mr. Perkins and Mr. Patman on 2/27/75.
H.R. 3991 (substitute for H.R. 3036) introduced by
Mr. Perkins and ten others on 2/27/75.
H.R. 3992 (substitute for H.R. 3037) introduced by
Mr. Perkins and ten others on 2/27/75.
H.R. 3993 (substitute for H.R. 3270) introduced by
Mr. Perkins and 18 others on 2/27/75.
H.R. 4797, introduced by Mr. Perkins and Mr. Quie on
3/12/75.
H.R. 6251 (Administration Bill) introduced by Mr. Quie
(by request) on 4/22/75.
H.R. 12835, introduced by Mr. Perkins, et. al. on 3/29/76.
PROVISIONS : S. 2657, to extend the Vocational Educational Act of 1963,
through FY '82 and to make numerous revisions. Major
changes are (1) to mandate broad-based planning
commissions at the State level (2) to increase authoriza-
tions by FY '82 90% over FY '76 levels (3) to add three
new categories to program.
SENATE STATUS: 3/3/75 - Subcommittee on Education, Labor and Public
Welfare Committee, held hearings on GAO report on
Vocational Education. Testimony was heard from
Commissioner of Education Bell, accompanied by
William Pierce and Charles Cooke.
GERALD FORD LIBRARY
Page 19a
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (Continued)
SENATE STATUS: 5/8/75 - Subcommittee on Education, Labor and Public
Welfare Committee, held hearings on the
Administration bill. Testimony was heard from
Commissioner of Education Bell, accompanied by
William Pierce and Charles Cooke.
12/2/75 - Subcommittee on Education met in Executive session
12/10/75 - in absence of a quorum.
1/22/76 - Subcommittee on Education met in Executive session
2/2,2/3 - on S. 2657. Major decisions on Vocational
Education deferred to full committee.
2/3/76 - Subcommittee on Education ordered S. 2657 reported
to full committee.
3/23/76 - Labor and Public Welfare Committee held an
executive session on S. 2657.
4/6/76 - Labor and Public Welfare Committee ordered
S. 2657 reported.
HOUSE STATUS : 2/19/76 - Subcommittee on Elementary, Secondary, and
Vocational Education held hearings on the GAO
report on Vocational Education, testimony was
heard from Dr. T. H. Bell, Commissioner of
Education, accompanied by Dr. William Pierce
Deputy Commissioner for Occupational and Adult
Education, OE, Dr. Charles Buzzell, Acting
Associate Commissioner, BOAE, OE and
Charles M. Cooke, Jr.
4/8/76 - Subcommittee on Elementary, Secondary, and
Vocational Education held hearings on research
and development efforts in vocational education.
Testomony was heard from William Pierce, Deputy
Commissioner for Occupational and Adult Education
and Emerson Elliott, Acting Director of NIE,
accompanied by Susan Hause.
4/28/76 - Subcommittee on Elementary, Secondary and Vocati-
onal Education held hearings on sex sterotyping in
vocational education. Testimony was heard from
Peter Holmes, Director, Office of Civil Rights,
William Pierce, Deputy Commissioner for Occupati-
onal and Adult Education, Corinne Rieder,
Director of Career Education, NIE, accompanied
by Susan Hause.
6/25/75 - Subcommittee on Elementary, Secondary, and
Vocational Education held hearings on positive
accomplishments of the vocational education
program. Testimony was heard from Dr. William
Pierce, Deputy Commissioner for Occupational and
Adult Education, OE, accompanied by Mr. Richard
A. Hastings.
BERALD FORD LIBRART
Page 19b
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (Continued)
HOUSE STATUS : 5/14/75 - Subcommittee on Elementary, Secondary, and
Vocational Education held hearings on the
Administration vocational education proposal.
Testimony was heard from Commissioner or
Education of Education, T. H. Bell,
Dr. William Pierce, Deputy Commissioner for
Occupational and Adult Education, Dr. Charles
Buzzell, Acting Associate Commissioner, OE,
and Charles Cooke, Jr.
3/23/76 - Subcommittee on Elementary, Secondary, and
Vocational Education held executive sessions
on H.R. 19.
4/1/76 - Subcommittee on Elementary, Secondary, and
Vocational Education ordered clean bill
H.R. 12835 reported to full committee.
4/8/76 - Education and Labor ordered H.R. 12835 reported.
4/13/76 - Education and Labor reconsidered H.R. 12835
and ordered it reported, incorporating
provisions of H.R. 5988 NIE reauthorization and
H.R. 3801 technical amendments.
5/4/76 - H.R. 12835 was filed (Rept. 94-1085).
5/11/76 - H.R. 12835 was passed by a vote of 390-3, with
12 floor amendments.
GERALD FORD LIBRART
Page 20
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Repeal of Sec. 411 (b) (4) of Higher Education Act of 1965
SENATE BILLS :
HOUSE BILLS : H.R. 6025, introduced by Mr. Eshleman on 4/16/75.
(Administration Bill) (E&L)
PROVISIONS
: Repeals section prohibiting payments of BEOG's unless
appropriations for certain other programs are at least
equal to specified level.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 21
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Extension of NIE
SENATE BILLS: S. 1498, introduced by Senator Beall, by request, on
4/22/75. (Administration Bill) (L&PW)
S. 2657, introduced by Senator Pell on 11/12/75. (LPW)
HOUSE BILLS : H.R. 5988, introduced by Mr. Brademas and Mr. Quie with
24 co-sponsors, on 4/15/75. (Administration Bill) (E&L)
PROVISIONS : To extend and amend section 405 of the General Education
Provisions Act. S. 2657 contains provisions relating
to reorganization but not extension.
SENATE STATUS: 7/22/75 - Dr. Virginia Trotter, Assistant Secretary for
Education and Dr. Harold Hodgkinson, Director
of NIE, testified before the Subcommittee
on Education.
Sec. S. 2657, Higher Education Act.
HOUSE STATUS : 7/30/75 - Dr. Virginia Trotter and Dr. Harold Hodgkinson,
Director of NIE testified before the Select
Committee on Education regarding reauthorization
of the Institute.
11/6/75 - Dr. Trotter and Dr. Hodkinson returned to
testify further on NIE.
12/16/75 - Subcommittee on Select Education ordered H.R. 5988
reported to full committee.
1/27/76 - Education and Labor ordered H.R. 5988 reported.
4/13/76 - Education and Labor Committee reconsidered
H.R. 12835, incorporated H.R. 5988 and
ordered H.R. 12835 reported.
See H.R. 12835, Vocational Education
FORD is LIBRARY GERALD
Page 22
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Student Loan Amendments of 1975 (Reduce Default Rate Under
GSL Program)
SENATE BILLS : S. 1229, introduced by Senator Beall on 3/18/75.
(Administration Bill) (LPW)
HOUSE BILLS : H.R. 4376, introduced by Mr. Eshleman, Mr. Erlenborn and
Mr. Quie on 3/6/75. (Administration Bill) (E&L)
H.R. 31 and H.R. 32, introduced by Mr. Edwards and Wiggings
on 1/14/75. (Judiciary Committee) (These bills are omnibus
amendments to the Bankruptcy Act and contain provisions
on discharge of GSL debts in bankruptcy.
H.R. 14070, introduced by Mr. O'Hara on 5/27/76. (E&L)
PROVISIONS :
SENATE STATUS: 3/5/75 - Subcommittee on Education, Labor and Public
Welfare Committee held hearings on Adminis-
tration's bill. Commissioner of Education
T. H. Bell testified; accompanied by
Edward York, Kenneth Kohl, and Charles Cooke.
1/22/76 - Major portions of S. 1229 incorporated into
S. 2657.
2/3/76 - S. 2657 ordered reported by the Subcommittee on
Education to the full committee.
SEE ACTION ON S. 2657, under higher education amendments.
HOUSE STATUS : 1/29/76 - Mr. Edward T. York, Deputy Commissioner for
Management, OE, testified before Edwards
Subcommittee on Civil and Constitutional Rights,
Judiciary Committee, on H.R. 31 and H.R. 32 to
exclude discharge in bankruptcy of GSL for
five years after a student leaves school.
5/27/76 - Subcommittee on Postsecondary Education ordered
clean bill reported to full committee.
6/2/76 - Education and Labor ordered H.R. 14070 reported.
6/8/76 - H.R.14070 was filed. (Rept. 94-1232)
GERALD LIBRARY GERALDR. FORD
Page 23
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Technical and Perfecting Amendments to P.L. 93-380
SENATE BILLS :
HOUSE BILLS : H.R. 3801, introduced by Mr. Quie on 2/26/75.
(Administration Bill) (E&L)
H.R. 7121, introduced by Mr. Benitez on 5/20/75. (E&L)
H.R. 8273, introduced by Mr. Matsunaga on 6/26/75 (E&L)
H.R. 9228, introduced by Mr. Jeffords on 8/1/75. (E&L)
PROVISIONS
: To clarify and correct certain provisions of P.L. 93-380,
Education Amendments of 1974, and to change deadlines for
nandated studies and make other technical changes.
SENATE STATUS: 12/31/75 - The portions of the bill relating to reading
was incorporated into P.L. 94-194, Reading
Improvement Amendments.
HOUSE STATUS : 6/4/75 - Subcommittee on Elementary, Secondary and
Vocational Education, Education and Labor
Committee held hearings on H.R. 3801. Other pro-
posed amendments to P. L. 93-380 was heard from
Dr. Duane Mattheis, Executive Deputy Commissioner,
Office of Education.
7/28/75 - A letter was sent by Dr. Bell requesting
expeditions or consideration.
12/31/75 - The portions of the bill relating to reading was
incorporated in P. L. 94-194, Reading Improvement
Amendments.
4/13/76 - Education and Labor Committee adopted amended
version of the Administration bill and
incorporated it as Title III of H.R. 12835.
See H.R. 12835 - Vocational-NIE Amendments.
GERALD FORD LIBRARY
Page 24
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Educational Assistance for Indochinese Refugees
SENATE BILLS : S. 2145, introduced by Senator Cranston on 7/21/75. (LPW)
HOUSE BILLS : H.R. 7897, introduced by Mr. Roybal, et. al.; on 6/13/75.
(E&L)
PROVISIONS : To assist State and local school systems for providing
educational Indochinese refugees.
SENATE STATUS: 10/22/75 - Labor and Public Welfare filed S. 2145,
10/29/75 - Senate passed S. 2145 by voice vote.
4/1/76 - Senate disagreed with House amendments and
requested conference with the House.
6/17/76 - Conferees met and reached agreement.
HOUSE STATUS : 11/5/75 - Dr. Terrell H. Bell, Commissioner of Education
testified before the Subcommittee on
Elementary, Secondary and Vocational Education
on H.R. 7897.
11/12/75 - Subcommittee on Elementary, Secondary, and
Vocational Education ordered H.R. 7897 reported
to full committee.
12/9/75 - Committee on Education and Labor ordered
H.R. 7897 reported.
12/12/75 - H.R. 7897 was filed (Rept. 94-719).
12/17/75 - H.R. 7897 granted an open rule for consideration
and one hour of general debate.
1/19/76 - House passed H.R. 7897 by a vote of 311-75;
subsequently vacated passage and passed Senate
companion measure S. 2145, substituting language
GERALD R. LIBRARY FORD
of H.R. 7897. This bill contained an amendment
that disallowed administrative costs.
Page 25
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Minor Admendments to the Education Amendments of 1974
SENATE BILLS :
HOUSE BILLS :
PROVISIONS : Makes six minor amendments to P. L. 93-380, includes
repeal of provisions requiring Secretary to fill vacancies
on advisory councils if President fails to act in timely
fashion.
SENATE STATUS: No committee action yet.
HOUSE STATUS : 6/4/75 - Subcommittee on Elementary, Secondary, and
Vocational Education, Education and Labor Committee
held hearings on minor amendments to P. L. 93-380,
Dr. Duane Mattheis, Deputy Commissioner, OE
testified on Department's behalf.
4/13/76 - Education and Labor Committee adopted amended
version of the Administration bill and
incorporated it as Title III of H.R. 12835.
See H.R. 12835-Vocational and NIE amendments.
GERALD FORD LIBRARY
Page 262
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Indian Post-Secondary Education (Community Colleges)
SENATE BILLS : S. 2634, introduced by Senator Abourezk and Senator
McGovern on 11/6/75. (Interior)
Amendment to be proposed by Senator Gravel to S. 2634.
HOUSE BILLS : H.R. 11220, introduced by Mr. Abnor on 12/17/75. (E&L)
PROVISIONS : Authorizes $75 million through FY '81 for grants to ten
specified Indian controlled community colleges to
support their operating and other expenses.
SENATE STATUS: 3/15/76 - Duane Mattheis, Deputy Commissioner of Education
testified before the Subcommittee on Indian
Affairs, Interior and Insular Affairs Committee
in opposition to S. 2634.
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 27
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Extension of the Library Services and Construction Act
SENATE BILLS :
HOUSE BILLS : H.R. 11233, introduced by Mr. Brademas on 12/18/75.
PROVISIONS : Extension of all titles of LSCA.
SENATE STATUS:
HOUSE STATUS : 12/16/76 - Subcommittee on Select Education ordered
reported H.R. 11233 to full committee with
amendments.
1/27/76 - Education and Labor ordered H.R. 11233 reported.
2/10/76 - H.R. 11233, was filed (Rept. 94-817).
2/17/76 - House suspended the rules and passed H.R. 11233
by a vote of 342-48.
FORD is LIBRARY GERALD
Page 28
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Career Education Act of 1976
SENATE BILLS : S. 2657, introduced by Senator Pell on 11/21/75. (Title V
Career Development Guidance Counseling Programs)
HOUSE BILLS : H.R. 11023, introduced by Mr. Perkins on 12/4/75. (E&L)
PROVISIONS : Authorizes for FY '77 $5 million for the development of
State plans to infuse career education into education
programs. Authorizes for FY '78-81 $250 million for
grants to LEAs, through the States, to implement career
education programs.
SENATE STATUS: See S. 2657
HOUSE STATUS : 2/2/76 - Subcommittee on Elementary, Secondary, and
Vocational Education held a hearing with public
witnesses.
FORD i LIBRARY GERALD
Page 29
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Education Block Grant
SENATE BILLS : S. 3166, introduced by Senator Beall on 3/17/76.
(Administration Bill) (LPW)
HOUSE BILLS : H.R. 12196, introduced by Mr. Quie on 3/1/76.
(Administration Bill) (E&L)
PROVISIONS : To consolidate the administration of certain programs of
financial assistance to States for educationl services.
SENATE STATUS:
HOUSE STATUS : 6/9/76 - The Secretary, accompanied by Dr. Virginia
Trotter, Assistant Secretary for Education,
Stephen Kurzman, Assistant Secretary for
Legislation, and Dr. Terrel Bell, Commissioner
of Education, testified before the Subcommittee
on Elementary, Secondary, and Vocational
Education of the Education and Labor Committee
on H.R. 12196.
FORD is LIBRARY GERALD
Page 30
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Museum Services Act
SENATE BILLS : S. 1800 (Title II, part A), introduced by Senators Pell
and Javits on 5/21/75. (LPW)
S. 3440, introduced by Senator Pellon on 5/17/76.
HOUSE BILLS : H.R. 12838 (Title II), introduced by Brademas, et. al.,
on 3/29/76.
PROVISIONS : Creates an Institute of Museum Services within HEW to
administer a program of general institutional assistance
to museums.
SENATE STATUS: 4/28/76 - Subcommittee on Arts and Humanities ordered
reported a clean bill on arts and humanities
to full committee.
5/12/76 - Labor and Public Welfare Committee ordered
a clean bill reported. This version placed
the Institute of Museum Service in NEH/NEA.
5/20/76 - Senate passed H.R. 12838 after inserting
provisions of S. 3440 as amended by voice vote.
6/30/76 - Senate agrees to conference.
HOUSE STATUS : 4/6/76 - Education and Labor Committee ordered H.R. 12838
reported by a unaminous vote.
4/9/76 - H.R. 12838 was filed (Rept. 94-1024).
4/26/76 - H.R. 12838 was passed 279-59.
6/18/76 - House requested conference with the Senate.
FORD & LIBRARY GERALD
Page 31
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Clinical Laboratories
SENATE BILLS : S. 1737, introduced by Senator Javits on 5/14/76.
HOUSE BILLS : H.R. 11341, introduced by Mr. Rogers on 12/19/75.
H.R. 12611, introduced by Mr. Scheuer on 3/17/76.
PROVISIONS : To amend Public Health Service Act to encourage uniform
standards for nursing and regulation of clinical
laboratories. H.R. 12611 deals with clinical laboratory
services for Medicaid.
SENATE STATUS: 9/8/75 - Dr. Theodore Cooper, Assistant Secretary for
Health, testified before the Subcommittee
on Health in opposition to S. 1737.
2/17/76 - Subcommittee on Health ordered S. 1737 reported
to full committee.
2/26/76 - Labor and Public Welfare Committee ordered
S. 1737 reported to Senate.
4/26/76 - S. 1737 was filed (Rept. 94-764).
4/29/76 - Senate passed S. 1737, amended, by a vote of
64-11.
HOUSE STATUS : 3/23/76 - Subcommittee on Health and Environment on
H.R. 11341 and H.R. 12611 Dr. James Dickson,
Deputy Assistant Secretary for Health,
testified in opposition to H.R. 11341.
5/27/76 - Subcommittee on Health and Environment began
series of executive sessions on H.R. 11341
and H.R. 12611.
6/8/76 - Subcommittee on Health and Environment ordered
a clean bill reported to full committee.
GERALD FORD LIBRARY
Pace 32
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Health Insurance for Unemployed
SENATE BILLS : S. 625, introduced by Senator Mondale on 2/7/75. (L&PW)
S. 496, introduced by Senator Bentsen on 1/30/75. (Finance)
S. 970, introduced by Senator Hartke on 3/5/75. (Finance)
HOUSE BILLS : H.R. 3208, introduced by Mr. Corman on 2/19/75. (W&M)
H.R. 4004, introduced by Mr. Rogers on 2/27/75. (IFC)
H.R. 5000, introduced by Mr. Rostenkowski on 3/17/75. (W&M)
H.R. 5970, introduced by Mr. Rogers on 4/15/75 (W&M)
PROVISIONS : To revise and extend the programs of assistance under
Titles VII and VIII of PHS Act.
SENATE STATUS: 9/16/75 - Dr. Theodore Cooper, Assistant Secretary for
Health testified on Administration's position.
Hearing with non-government witnesses were
held through December.
HOUSE STATUS : 3/10/75 - Subcommittee on Health and Environment, Interstate
and Foreign Commerce Committee heard testimony
from the Secretary on H.R. 4004.
3/10/75 - Subcommittees on Health of House Ways and Means
Committee heard testimony from the Secretary
on H.R. 3208.
3/19/75 - Subcommittee on Health approved H.R. 5000 for
full committee action (W&M).
4/22/75 - Ways and Means filed clean bill, H.R. 5970,
which was then referred to the Interstate and
Foreign Commerce Committee. (Rept. 94-171 - Part I)
4/29/75 - Interstate and Foreign Commerce Committee
ordered H.R. 5970 adversely reported and
approved a Committee amendment (an amended
version of H.R. 4004) which will be offered in
nature of a substitute when H.R. 5970 is
considered by the House.
5/7/75 - H.R. 5970 was filed (Rept. 94-171 Part II).
GERALD FORD LIBRARI
Page 33
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Health Manpower
SENATE BILLS : S. 966, introduced by Senator Schweiker, by request, on
3/6/75. (Administration Bill) (L&PW)
S. 990, and S. 992, introduced by Senator Kennedy on
3/6/75. (L&PW)
S. 2748, introduced by Senators Kennedy, Javits and
Schweiker on 12/5/75. (Administration Bill) (L&PW)
S. 3239, introduced by Senator Kennedy on 4/1/76.
HOUSE BILLS : H.R. 2956, introduced by Mr. Rogers on 2/6/75. (IFC)
H.R. 4717, introduced by Mr. Staggers, and Mr. Devine,
by request, on 3/12/75. (Administration Bill) (IFC)
H.R. 5546, introduced by Mr. Rogers on 3/7/75.
H.R. 11119, introduced by Mr. Staggers and Mr. Devine
on 12/11/75. (Administration Bill) (IFC)
PROVISIONS
: To revise and extend the programs of assistance under
Titles VII and VIII of PHS Act.
SENATE STATUS: 9/16/75 - Dr. Theodore Cooper, Assistant Secretary for
Health testified on Administration's position.
Hearing with non-government witnesses were
held through December.
3/31/76 - Subcommittee on Health approved H.R. 5546
with amendments.
4/7/76 - Labor and Public Welfare ordered H.R. 5546 reported.
5/14/76 - H.R. 5546 was filed (Rept. 94-886).
7/1/76 - Senate passed H.R. 5546, substituting pervisions
of S. 3239 by vote of 88-0.
HOUSE
STATUS
:
2/20/76 - Secretary testified on the issue before the
Subcommittee on Health and Environment Interstate
and Foreign Commerce Committee.
3/7/75 - Subcommittee on Health & Environment approved a
clean bill in lieu of H.R. 2956 for full
committee action (H.R. 5546).
5/15/75 - Committee on Interstate and Foreign Commerce
ordered H.R. 5546 reported.
6/7/75 - H.R. 5546 was filed, Rept. 94-266.
7/11/75 - House passed H.R. 5546, 296-58, after adopting
amendments, including Broyhill amendment
deleting residency control provisions.
GERALD FORD LIBRARY
Page 34
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Maternal and Child Health Crippled Children and Medicaid
Cost Control
SENATE BILLS : S. 1721, introduced by Senator Curtis on 5/13/75. (Finance)
(Administration Bill)
HOUSE BILLS : H.R. 4821, introduced by Mr. Staggers and Mr. Devine on
3/12/75. (IFC) (Administration Bill)
PROVISIONS : To amend Title X and Title XIX of Social Security Act, to
improve and control the cost of these programs.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 35
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Youth Camp Safety
SENATE BILLS : S. 298, introduced by Senator Taft on 1/21/75. (L&PW)
S. 422, introduced by Senator Mondale on 1/27/75. (L&PW)
HOUSE BILLS : H.R. 46, introduced by Mr. Daniels on 1/15/75. (E&L)
PROVISIONS : To provide for development and implementation of programs
for Youth Camp Safety.
SENATE STATUS: 9/10/75 - Subcommittee on Children and Youth ordered
S. 422 reported.
10/7/75 - Labor and Public Welfare Committee ordered
S. 422 reported.
11/20/75 - S. 422 was filed (Rept. 94-486).
HOUSE STATUS : 3/20/75 - H.R. 46 was filed (Rept. 94-27).
4/17/75 - House passed H.R. 46 by a vote of 197-174.
FORD & LIBRARY GERALD
Page 36
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Health Block Grant
SENATE BILLS : S. 3137 introduced by Senator Curtis on 3/15/76.
(Administration Bill) (Finance/LPW)
HOUSE BILLS : H.R. 12233, introduced by Mr. Staggers and Mr. Devine
by request on 3/2/76. (Administration Bill) (IFC)
PROVISIONS : To consolidate Federal financial assistance to the States
for programs in field of health, to focus on the needy,
and to eliminate unnecessary restrictions on the
expense of States responsiblity for program administration.
This bill covers Medicaid 12 categorical health service
programs, health planning, medical facilities, construction
and developmental disabilities.
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 37
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Emergency Medical Services
SENATE BILLS : S. 2011, introduced by Senators Schweiker, and Javits
(by request) on 6/25/75. (Administration Bill) (LPW)
S. 2548, introduced by Senator Cranston on 10/22/75.
S. 2673, introduced by Senator Randolph on 11/14/75.
HOUSE BILLS : H.R. 1480, introduced by Mr. Staggers and Mr. Devine on
5/22. (Administration Bill) (IFC)
H.R. 11327, introduced by Mr. Florio, Mr. Rogers, and
Mr. Mollohan on 12/19/76.
H.R. 12664, introduced by Mr. Florio, et. al., on 3/18/76.
PROVISIONS :
SENATE STATUS: 11/23/76 - Subcommittee on Health heard testimony from
Dr. Theodore Cooper, Assistant Secretary for
Health on S. 2011, S. 2548 and S. 2673.
5/6/76 - Subcommittee on Health ordered S. 2548
5/12/76 - Labor and Public Welfare Committee ordered
S. 2548 reported.
5/14/76 - S. 2548 was filed (Rept. 94-889).
6/10/76 - S. 2548 was passed by voice vote.
HOUSE STATUS : 1/27/76 - Subcommittee on Health and Environment heard
testimony from Dr. Theodore Cooper, Assistant
Secretary for Health on H.R. 11327.
3/17/76 - Subcommittee on Health ordered a clean bill for
H.R. 11327 reported to full committee.
3/24/76 - Interstate and Foreign Commerce ordered
H.R. 12664 reported.
5/5/76 - H.R. 12664 was filed (Rept. 94-109).
FORD & LIBRARY GERALD
Page 38.
DEPARTMENT OF HEALTH, EDUCATION AND WELFARE
SUBJECT
: Indian Health
SENATE BILLS : S. 522, introduced by Senator Jackson, et. al., on 2/3/76.
(IIA)
HOUSE BILLS : H.R. 2525, introduced by Mr. Meeds on 1/31/75. (IIA)
PROVISIONS : To extend and amend the Indian Health Act.
SENATE STATUS: 4/13/75 - Interior and Insular Affairs Committee filed
S. 522 (Rept. 94-133).
4/16/75 - Senate passed S. 522.
HOUSE STATUS : 9/25/75 - Dr. James Dickson, Deputy Assistant Secretary
for Health, Dr. Robert Van Hoek, Acting
Administrator of HSA and Emery Johnson,
Director of Indian Health Service testified
before Subcommittee on Indian Affairs on H.R. 2525.
12/9/75 - Subcommittee on Indian Affairs ordered H.R. 2525
reported to full committee.
3/3/76 - Interior and Insular Affairs Committee ordered
H.R. 2525 reported.
4/9/76 - Interior and Insular Affairs filed H.R. 2525
(Rept. 94-1026, Part I) and referred bill
to Ways and Means Committee and Interstate and
Foreign Commerce Committee.
5/4/76 - Ways and Means ordered an amendment on
Medicare reported.
5/6/76 - Subcommittee on Health and Environment ordered
H.R. 2525 reported to full committee. Then
InterState and Foreign Commerce Committee ordered
H.R. 2525 reported to the House.
GERALD
LIBRARY
Page 38a
Page 35a
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
HOUSE STATUS: (Continued)
5/10/76 - Ways and Means Committee filed
H.R. 2525 (Rept. 94-1026 Part II).
5/12/76 - Interstate and Foreign Commerce
Committee filed H.R. 2525
(Rept. 94-1026 Part III).
FORD & LIBRARY GERALD
Page 39
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: HMO Amendments
SENATE BILLS : S. 1926, introduced by Senators Schweiker, Mondale, and
Javits on 6/12/75.
HOUSE BILLS : H.R. 7847, introduced by Mr. Rogers on 6/12/75.
H.R. 9019, introduced by Mr. Rogers on 9/4/75. (IFC)
PROVISIONS : To revise and extend the Health Maintenance Organization
Act.
SENATE STATUS: 11/21/75 - Dr. Theodore Cooper, Assistant Secretary for
Health, testified before the Subcommittee on
Health S. 1926.
1/29/76 - Subcommittee on Health began a series of
executive sessions.
2/26/76 - Labor and Public Welfare ordered S. 1926
reported.
5/14/76 - S. 1926 was filed (Rept. 94-844).
6/14/76 - Senate passed H.R. 9019, after substituting
provisions of S. 1926 by a vote of 80-8.
6/21/76 - Senate agreed to conference.
HOUSE STATUS : 7/14/75 - Dr. Theodore Cooper, Assistant Secretary for
Health, testified before the Subcommittee on
Health and Environment on H.R. 7847.
9/4/75 - Committee on Interstate and Foreign Commerce
ordered clean bill H.R. 9019 reported.
9/26/75 - H.R. 9019 was filed, Rept. 94-518.
11/7/75 - House passed H.R. 9019, 345-1.
6/18/76 - House disagreed to Senate amendments and
requested conference.
7/22/76 - Conference agenda.
FORD & LIBRARY GERALD
Page 40
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Medicare Improvement Act
SENATE BILLS :
HOUSE BILLS : H.R. 12082, introduced by Mr. Duncan by request on
2/25/76. (Administration Bill) (W&M, IFC)
PROVISIONS : To extend Medicare to include catastrophic coverage, to
reform hospital insurance and supplementary
medical insurance coinsurance to make the SMI deductible.
dynamic, to place a ceiling on reasonable charges and
costs and to eliminate trust fund financing for State
capital expenditure review activities.
SENATE STATUS:
HOUSE STATUS: 2/11/76 - Secretary David Mathews testified before
Subcommittee on Health, Ways and Means
Committee on the Administration's proposal.
FORD & LIBRARY GERALD
Page 41
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Medicaid Reimbursement Amendments
SENATE BILLS : Transmitted 5/19/76.
HOUSE BILLS :
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY
Page 42
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Transfer & Closing of PHS Hospitals
SENATE BILLS :
HOUSE BILLS : H.R. 14499, introduced by request by Mr. Staggers and
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD & LIBRARY GERALD
Page 43
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Swine Flu Indemnification
SENATE BILLS :
HOUSE BILLS : H.R. 14409, introduced by Dr. Carter and Mr. Madigan on
6/16/75.
H.R. 14437, introduced by Mr. Staggers and Mr. Devine
by request on 6/17/76.
(Administration Bill) (IFC)
H.R. 14569, introduced by Dr. Carter on 6/25/76, by request.
(IFC).
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD is LIBRARY GERALD
Page 44
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: Utilization Control Amendments (Medicaid)
SENATE BILLS :
HOUSE BILLS : H.R. 14438, introduced by request by Mr. Staggers and
Mr. Devine on 6/17/76. (Administration Bill)
(IFC)
PROVISIONS :
SENATE STATUS:
HOUSE STATUS :
FORD is LIBRARY GERALD
Page 45
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SUBJECT
: FDA Amendments
SENATE BILLS :
HOUSE BILLS : H.R. 14289, introduced by Mr. Rogers on 6/9/76.
(Certain Administration Provisions) (IFC)
PROVISIONS :
SENATE STATUS:
HOUSE STATUS : 6/22/76 - Dr. Theodore Cooper, Assistant Secretary
for Health, testified before the Subcommittee
on Health on H.R. 14289.
FORD & LIBRARY GERALD
THE WASHINGTON WHITE HOUSE SSR
Sile aged in 19/96
To: : mr. Johnson
From Pill Hisferder
FORD & LIBRARY GERALD
EMBARGOED FOR RELEASE
Office of the White House Press Secretary
THE WHITE HOUSE
FACT SHEET
H.R. 10210 amends in a significant way the Unemployment
Compensation program and makes changes in the Supplemental
Security Income (SSI) program.
The Unemployment Provisions of H.R. 10210:
Stabilizes Financing of the Unemployment Program:
- By permanently increasing the wage base on which
employers pay Federal Unemployment Insurance tax
from $4,200 to $6,000 beginning with wages paid
in calendar year 1978.
- By temporarily increasing effective in calendar
year 1977 the net Federal tax rate from 0.5 percent
to 0.7 percent until all advances from general
revenues to the extended Unemployment Compensation
account, to the Federal unemployment account, and
loans to State accounts have been repaid at which
time the tax rate will revert to 0.5 percent.
Outstanding advances from general revenues to the Unemploy-
ment Compensation program total $10 billion. These amend-
ments will help repay those advances and restore the fiscal
integrity of the Unemployment Compensation system.
Extends Coverage
- To agricultural workers on any farm employing 10 or
more persons in each of 20 weeks during a calendar
year or paying $20,000 or more in wages during a
calendar quarter.
- To domestics working for an employer who paid $1,000
or more for such services in any calendar quarter.
- To all State and local government employees except
major non-tenured policymakers and advisers, elected
officers, judges, legislators, National Guardsmen, and
emergency disaster relief workers.
GERALD
FORD LIBRARI
2
The Special Unemployment Assistance (SUA) Program Provisions
of H.R. 10210:
- Extend SUA, which provides Unemployment Compensation
for workers who were not eligible for benefits
under any other law, for 1 year, to December 31, 1977,
providing a transitional step during the implementa-
tion of extended coverage described above.
In Addition H.R. 10210:
- Establishes a 13-member National Commission on Unem-
ployment Compensation to study the long-range needs
of the Unemployment Insurance system. The Commission
will issue an interim report on March 31, 1978 and a
final report on January 1, 1979.
- Brings the Virgin Islands within the Federal-State
Unemployment Insurance system.
Other Major Unemployment Provisions in H.R. 10210:
- Amend the trigger provisions for Federal-State extended
benefits.
- Require States to assume the full cost of extended
benefits for State and local workers, but the Federal
Government will continue to pay the administrative
costs involved in covering these workers.
- Deny Unemployment Compensation benefits to illegal
aliens.
Also deny benefits to professional athletes,
teachers and other professional school employees between
sports seasons and academic terms.
- Repeal the "finality" clause which provided that findings
of fact by a Federal agency in Unemployment Compensation
cases respecting employees leaving the Federal service
were final, thereby subjecting the compensation claims
of Federal employees to the same administrative proce-
dures that apply to other workers.
FORD & LIBRARY GERALD
3
- Amend the Social Security Act to require (subject
to denial of benefits) that an applicant under the
Aid to Families with Dependent Children-Unemployed
Fathers (AFDC-UF) program apply for and accept any
Unemployment Compensation benefits to which he would
be entitled, but those benefits would be reduced
by the amount of the Unemployment Compensation benefits
which he receives. It will reduce AFDC-UF expenditures
by approximately $47 million, which will be absorbed
by the Unemployment Insurance Trust fund, and thus
financed by an employer tax rather than general
revenues.
- Require State employment offices, at the request of
a State or local AFDC or child support agency, to
furnish certain information including whether an
individual is receiving, has received, or has applied
for Unemployment Compensation, whether the individual
has refused an offer of employment, and his home address.
The Supplemental Security Income (SSI) Provisions of H.R. 10210:
- Amend SSI eligibility criteria to permit full SSI
benefits to be paid to individuals in public non-
Medicaid institutionsserving 16 or less residents.
- Require, effective October 1, 1977, that State or
local authorities ensure the enforcement of mandated
standards at institutions where a significant number
(determined by the State) of SSI recipients are living.
- Require that the Federal Government pay twice, in
effect, for cost-of-living increases in the Federal
SSI benefit in the three remaining "hold harmless"
States (Massachusetts, Wisconsin and Hawaii).
- Provide that no recipient of Federal SSI benefits or
State SSI supplementary payments will lose "categorical
eligibility" for Medicaid solely as the result of a
cost-of-living increase under Title II of the Social
Security Act.
- Provide new procedures and funding for State services
to disabled children under the age of 16 who are
receiving SSI benefits through a new formula grant program.
- Provide that, for any full month during which a spouse
is in an institution, the couple involved would be
treated as individuals for purposes of computing their
eligibility and SSI benefit amount.
FORD & LIBRARY GERALD
NADMEC
of
National Affiliation of Durable
Medical Equipment Companies
5023 Ventura Canyon Avenue
Sherman Oaks, California 91403
Phone (213) 981-0234
EXECUTIVE DIRECTOR
Edward E. Roseman
PRESIDENT
Martin Frank
Martin Rents
Los Angeles, Ca.
VICE-PRESIDENTS
October 8, 1976
Richard Karlson
Abbey Rents
Los Angeles, Ca.
Paul Kraemer
Medicare Products
Dania, FI.
Mr. Spencer C. Johnson
John McGuarn
Delcrest Medical Products
Associate Director Domestic Council
Pennsauken, N.J.
Executive Office Building - White House
SECRETARY-TREASURER
Alfred A. Smith
Washington, D.C.
Guardian Products
Los Angeles, Ca.
BOARD OF DIRECTORS
Peter Barile
Shelby-Williams-Goodman
Philadelphia, Pa.
Gerald Bell
Good morning, Mr. Johnson!
Lumex, Inc.
Bayshore, N.Y.
Chester Black
It was a great pleasure to have the opportunity to
P.D.C., Inc.
spend a few minutes with you when I was in Washington
(Medi-Shack)
Boston, Ma.
last week.
C. Nagle Bridwell
Accurate Medical Service
Philadelphia, Pa.
I feel I must thank you again for taking time out of
Barry Eigen
a busy day to listen to Shelly Herman and me review
Sickroom Service
Milwaukee, Wisc.
some of the problems of the Durable Medical Equipment
Louis Fitzsimmons
providers.
Fitzsimmons Surgical
Chicago, 11.
Mae Garnett
If I can be of any service to you related to the
Smith-Davis Mfg. Co.
St. Louis, Mo.
Durable Medical Equipment sections of the Medicare
Arnold Gross
Program, please do not hesitate to call upon me.
Aaron Rents
Atlanta, Ga.
Myron Jaffee
Cordially,
Admiral Chair
St. Louis, Mo.
Edward E.Roseman
Fred King
Union Carbide, Linde Div.
Edward E. Roseman
St. Petersburg, FI.
Executive Director
Dewey Kuhn
Southern Medical Assoc.
NADMEC
Atlanta, Ga.
Bill Landow
Decoro-Pedic
Cherry Hill, N.J.
ER/sc
Leon Miller
Pacific Rents
Los Angeles, Ca.
C.C. Sheldon Herman
Margaret Phillips
A.Y.S. Medical, Inc.
Youngstown, Oh.
Milton Sandberg
General Counsul, N.Y. Surgical
Dealer's Assoc., N.Y., N.Y.
Ken Sandler
lowa Sickroom Service
Des Moines, la.
Edw. C. Smith
Everest & Jennings, Inc.
Los Angeles, Ca.
Warren Venable
Invacare, Corp.
Elyria, Oh.
Tom Walls
A. American Surgical
FORD is LIBRARY GERALD
Hialeah, FI.
Seldon V. Whitaker
A NON-PROFIT ORGANIZATION
Grant Airmass Corp.
Stamford, Ct.
THE WHITE HOUSE
WASHINGTON
DATE
10/14/76
TO: JIM CANNON
FROM: SARAH MASSENGALE
There is an event tentatively scheduled
for Thursday, October 21 that I feel we
should encourage -- that is the swearing-
in of six new members of the Federal
Council on Aging. (Baroody has submitted
a schedule proposal). The President
has not addressed the "aging" population
at all; this provides him an opportunity
to make some remarks.
I recommend that you encourage the
President's participation.
Thank you.
CC: Art Quern
Allen Moore
Spence Johnson
FORD & LIBRARY GERALD