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Health (6)
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16988008
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Health (6)
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collections
James M. Cannon Files (Ford Administration)
James Cannon's Issues Files
subjects
Drugs
Federal aid
Genetics
Health
Insurance
Legislation
Medicaid
Medicare
National health insurance
Presidential campaign, 1976
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1976
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1975
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The original documents are located in Box 16, folder "Health (6)" of the James M. Cannon
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 Ford donated to the United
States of America his copyrights in all of his unpublished writings in National Archives collections.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.
Digitized from Box 16 of the James M. Cannon Files at the Gerald R. Ford Presidential Library
July 14, 1976
Dear Tom:
Many thanks for your letter of
July 7 restating your telegram to the
President on S. 3184. It's great to
hear from you, and I'll make sure your
views on S. 3184 are carefully considered.
With deep appreciation to you for
writing directly to me, and warm regard,
Sincerely,
Nelson A. Rocktfeller
Mr. Thomas P. Pike
Chairman
FORD LIBRARY i GERALD
National Council on
Alcoholism
707 Wilshire Boulevard
Suite 3157
Los Angeles, California 90017
MAR/GRA/dlb
bcc: Jim Cannon with copy of incoming
are nr la bw e is
THOMAS P. PIKE
707 WILSHIRE BOULEVARD
SUITE 3157
LOS ANGELES, CALIFORNIA 90017
July 7, 1976
The Honorable Nelson A. Rockefeller
Vice President of the United States
Washington, D.C. 20540
Dear Nelson:
Following is the telegram I have just sent to the President on S. 3184:
"Strongly urge you sign into law S. 3184 passed unanimously by the
Senate and with only three dissenting votes in the House. Having worked
on this vital comprehensive alcoholism legislation since 1969, I was
instrumental in prevailing on former President Nixon to sign it as P.L.
91-616 on December 31, 1970, over the veto recommendation of OMB
and HEW. Although HEW's NIAAA has made tremendous progress in
combatting alcoholism since then, several more years of Federal funding
and leadership are desperately needed to consolidate gains and complete
the foundations. Katherine and I know this first hand through our contin-
uous involvement as members of HEW's National Advisory Council on
Alcoholism since 1970. Mr. President, Katherine and I earnestly be-
speak your signature on S. 3184 on behalf of ten million American
alcoholics and the forty million members of their families. Warm
personal regards."
I'm deeply convinced the country desperately needs a continuance of
this alcoholism legislation and a veto seems certain to be overridden
by Congress.
I hope that you will make the President aware of my views before he
makes his decision and that you will urge him to sign S. 3184.
Sincerely,
Thomas Jan
GREATS FORD CIBRARY
Chairman
National Council on Alcoholism
TPP:md
DEPARTMENT OF HEALTH, EDUCATION AND WELFARE
Health
OFFICE OF THE SECRETARY
WASHINGTON DC 20201
JUL 16 1976
MEMORANDUM FOR THE HONORABLE JAMES M. CANNON
I am writing in response to your memorandum of June 24 in
which you request further information concerning my memorandum
of June 18 to the President. As you know, the National
Institutes of Health (NIH) released guidelines on June 23
for recombinant deoxyribonucleic acid (DNA) research supported
or conducted by NIH. The purpose of the committee I proposed
to the President in my memorandum would be to review and
coordinate Federal agency policies and actions in this re-
search area in light of the NIH guidelines.
In response to your questions concerning the proposed committee,
it is my intent that this committee shall be composed solely
of Federal officers and employees representing all departments
and agencies which conduct, support, or have possible regulatory
authority over the conduct of recombinant DNA research. Such
a committee is specifically excluded from the provisions of the
Federal Advisory Committee Act. The relevant section of that
Act is as follows:
Sec. 3. For the purpose of this Act-
(2) The term "advisory committee" means any
committee, board, commission, council,
conference, panel, task force, or other similar
group, or any subcommittee or other subgroup
thereof (hereafter in this paragraph referred to
as "committee"), which is--
(A) established by statute or reorganization
plan, or
(B) established or utilized by the President,
or
(C) established or utilized by one or more
agencies,
in the interest of obtaining advice or recommendations
for the President or one or more agencies or officers
of the Federal Government, except that such term
excludes (i) the Advisory Commission on Intergovernmental
Relations, (ii) the Commission on Government Procurement,
and (iii) any committee which is composed wholly of
full-time officers or employees of the Federal Government.
(Emphasis added.)
The Honorable James M. Cannon
2
Thus, the proposed committee, inasmuch as it would be composed
solely of Federal officers and employees, would not need to be
chartered under this Act.
You also ask how this proposed committee relates to S. 2515,
which would modify the present National Commission for the
Protection of Human Subjects of Biomedical and Behavioral
Research. In the bill, which recently passed the Senate, there
is a provision concerning recombinant DNA research. The
Commission is authorized to conduct a study of the ethical,
social, legal, and safety implications of recombinant DNA
research and devise guidelines, if appropriate. I am enclosing
a copy of a letter that I am planning to send to Congressman
Harley O. Staggers, Chairman of the Committee on Interstate
and Foreign Commerce of the House of Representatives, commenting
on the bill. In the letter is outlined the Department's
stated opposition to S. 2515, including comments that the study
of recombinant DNA research proposed for the Commission would
duplicate the efforts of NIH.
In my view, it is most important that we be able to proceed
as expeditiously as possible to organize an intergovernmental
committee to review the experience of NIH and, where appropriate,
make recommendations for the other Federal departments and
agencies and possibly for the private sector. Legislative
prospects for S. 2515 are uncertain at best. Further, even if
the Congress were to pass legislation to create such a
Presidential Commission, over the Administration's objections,
and it were to become law, there would be certain administrative
delays in reorganizing and reconstituting such an entity. And
even if the Commission were to undertake such a study, it would
still not meet the stated needs of the committee that I am
proposing. The committee would have a far broader mandate
and a broader representation of interested parties.
I have received a considerable amount of correspondence on
this research activity in the past several months. In these
letters there has been special emphasis by public commentators
on the need for uniformity in the conduct of recombinant DNA
research. The committee I propose would be most responsive
to this public concern. I strongly urge you to recommend to
the President that I be allowed to proceed in this matter
without undue delay.
/s/Marjorie Lynch
Acting Secretary
Enclosure
HEALTH
DUT
NOTAL
DRAFT
SECURITY
DEPARTMENT OF HEALTH, EDUCATION. AND WELFARE
USA
The Honorable Harley 0. Staggers
Chairman, Committee on Interstate
and Foreign Commerce
House of Representatives
Washington, D.C. 20515
Dear Mr. Chairman:
This is in response to your request for a report on S. 2515, a bill "To
amend the Public Health Service Act to establish the President's Commis-
sion for the protection of human subjects involved in biomedical and
behavioral research, and for other purposes."
In summary, we oppose S. 2515 as passed by the Senate because the existing
statutorily established National Commission for the Protection of Human
Subjects of Biomedical and Behavioral Research has yet to complete its
recommendations. These are to include the development of an effective
Federal administrative mechanism for applying its ethical guidelines to
research programs conducted or supported by Government departments or
agencies, including its definition of the function and authority of the
proposed National Advisory Council for the Protection of Subjects of
Biomedical and Behavioral Research.
We feel that the recommendations of the present National Commission will
make an invaluable contribution toward the development of a consistent
Government-wide plan for the protection of human subjects of biomedical
and behavioral research. Assuming that such an administrative framework
will be based on the guidelines currently being recommended to the
Department of Health, Education, and Welfare, we favor an Executive
Order to extend Departmental regulations on the protection of human
subjects uniformly to all other Federal agencies and departments rather
than legislative creation of a new Presidential Commission.
S. 2515, as amended, would in effect replace the Commission created in
Title II of the National Research Act. The new President's Commission
would be permanent and would contain eleven members plus ex officio
advisors from the Department of Health, Education, and Welfare, the
Department of Defense, the Central Intelligence Agency, the Science
Advisor to the President, and the Veterans Administration. The President's
Commission would assume the functions, powers, and duties of the current
National Commission and expand its jurisdiction to encompass all Federal
departments and agencies conducting research involving human subjects.
Page 2 - The Honorable Harley 0. Staggers
In addition to the duties prescribed for the National Commission, the
President's Commission would be responsible for continually reviewing
and analyzing the ethical, social, and legal implications of all research
on human subjects supported by the Federal Government, and for making
appropriate recommendations concerning the protection of human subjects
to the supporting agency. These recommendations would be published in
the Federal Register and, if the responsible agency chooses not to
follow them, the negative determination and the reasons for it would be
published in the Federal Register.
The President's Commission would also be required to study the ethical,
social, legal, and safety implications of recombinant DNA research on
research personnel, human subjects of the research, and the public at
large.
We strongly endorse efforts to protect human subjects of biomedical and
behavioral research. However, in addition to establishing a mechanism
which we do not believe is necessary, the structure of the proposed
commission contains some administrative shortcomings.
First, the President's Commission would be independently advisory to the
several Federal agencies and departments, rather than to the Government
as a whole. Thus, there would be an opportunity not only for uncoordi-
nated advice but for disparate, inconsistent, and possibly conflicting
responses on the part of agencies conducting similar research. Second,
the proposed ex officio membership would not represent the extent of
biomedical research carried out by other Federal agencies, such as the
Energy Research and Development Administration, National Aeronautics and
Space Administration, Department of Transportation, or Department of
Agriculture. Third, there are no positions or funds authorized to
support the activities of the proposed Commission.
One of the recommendations already made by the National Commission for
the Protection of Human Subjects is that there be established a national
review body to consider ethical problems raised by research proposals
whenever the application of recommended standards proves difficult. The
Department of Health, Education, and Welfare is establishing an Ethical
Advisory Board to provide advice to the Public Health Service and other
components of the Department on ethical issues and on classes of applica-
tions or proposals which (1) must be submitted to the Board or (2) need
not be submitted to the Board (45 CFR 46.204). Creation of the Ethical
Advisory Board will create a more flexible instrument for dealing with
ethical dilemmas concerning human research subjects than the proposed
Presidential Commission.
Page 3 - The Honorable Harley 0. Staggers
Finally, we are very aware of the controversy over recombinant DNA
research and have recently released guidelines according to which support
may be given for research conducted by grantees, contractors, and intra-
mural scientists. The National Institutes of Health, Public Health
Service, has gone to great lengths to involve the Congress, the public,
and the press in the decisionmaking process which has addressed the
social, legal, ethical, and safety implications of such research. It
has sought and received advice from many sectors--scientists, ethicists,
lawyers, and consumer representatives--and has taken all comments into
account in preparing the guidelines for this activity. While we do not
oppose having the guidelines reviewed by another advisory body, we feel
this is already being done under present authority.
We therefore recommend that S. 2515 not be favorably considered at this
time, and that any legislative initiatives concerning Federal regulation
of research involving human subjects be delayed until the existing
National Commission for the Protection of Human Subjects has made its
final report and recommendations to the President and the Congress as
required by the National Research Act.
We are advised by the Office of Management and Budget that there is no
objection to the presentation of this report from the standpoint of the
Administration's program.
Sincerely,
Secretary
OFFICE OF THE COVERNOR
Health
STATE OF OHIO
OFFICE OF THE GOVERNOR
THIS
OF
OHIO
COLUMBUS 43215
JAMES A. RHODES
GOVERNOR
July 20, 1976
The Honorable David F. Mathews
Secretary of Health, Education, and Welfare
Washington, D. C.
20201
GERALD FORD LIBRARY
Dear Secretary Mathews:
Ohio faces a severe financial crisis in its Medicaid program.
The severity of this crisis is apparent when you compare the
appropriation of $471 million (state funds plus projected federal
earnings) which is available for fiscal year 1977 with the pro-
jected expenditures of $597 million required to support the
FY 77 Medicaid program in its present form.
This situation is further compounded by the fact that Ohio is
under court order not to reduce the scope of the current program
until pre-reduction hearings are provided to eligible recipients.
The projected deficit of $126 million in the Medicaid program has
been the subject of much publicity, legislative committees have
examined the program and many medical provider associations have
provided suggestions and recommendations. Since the projected
deficit includes both state funds and federal earnings, Ohio needs
your recommendations as to how this situation might best be re-
solved. I understand that the federal funds required to support
the program are indeed available to Ohio but only if the state
certifies that it can provide the necessary state matching funds.
Your verification of this requirement would be most helpful,
Without an increase in state matching funds, Ohio cannot continue
the existing Medicaid program, The problem becomes critical on
November 15, 1976, when the federal estimates for the January-
March 1977 quarter are due, Without an increase in state funds
prior to this date, Ohio will not be able to certify the avail-
ability of sufficient state funds to maintain the Medicaid program
for FY 77. It is anticipated that the current appropriation will
be exhausted in February 1977 and Ohio will be forced to discontinue
the Medicaid program for lack of funds.
I plan to propose a reallocation of state funds that will insure
the continuation of Ohio's Medicaid program through fiscal year
1977. Immediate action is necessary if Ohio is to avoid a repeat
of the FY 76 crisis when Medicaid funds were exhausted on May 11,
1976. I need your support to reinforce the necessity for a speedy
but effective solution to the Medicaid crisis, Attached is a
suggested letter for your signature which would accomplish that
purpose.
Secretary David F. Mathews
July 20, 1976
Page 2
Also attached is a letter from Clyde V. Downing of the Chicago
Regional Office showing that this estimate of the total funds to
continue Ohio's Medicaid program for FY 77 is $540 million. To
this estimate must be added the backlog of unpaid FY 76 bills
amounting to over $68 million, This letter will provide assurance
that the fund requirements for Ohio's Medicaid program have not
been overstated and that additional funds are truly required if
the Medicaid program is to continue.
There is also attached a copy of a memo from my Office of Budget
and Management attesting to the appropriation of both state funds
and federal earnings that is currently available to support Ohio's
FY 77 Medicaid program.
Lam Governor Sincerely AMES A. RHODES
JAR:em
Attachments
CERALO FORD
Draft of a letter from Secretary Mathews to Governor Rhodes:
Dear Governor Rhodes:
Responding to your recent inquiry concerning the requirement
for state matching funds in the Medicaid program, I must advise
you that the availability of federal funds is dependent upon
the assurance from the state that state matching funds are
available to support the total program expenditures. Without
such assurance there is no legal basis for the provision of
federal funds.
I should also point out that Ohio's state plan for the Medicaid
program has been accepted and approved as a plan for a con-
tinuing program that would operate only for a limited time
during a fiscal period dependent upon the availability of
funds. The state-federal partnership in the funding of the
Medicaid program is based upon the premise that each of the
partners will commit the necessary resources to insure con-
tinuing operation of the program, Failure of either party to
provide such assurance can only serve to negate the concept
upon which the federal-state partnership is based.
I would encourage you to do everything within your power to
insure that Ohio provides the necessary state matching funds
to support the continuation of Ohio's Medicaid program which
is so vital to health care needs of Ohio's citizens.
Sincerely,
DAVID F. MATHEWS
Secretary
ETORO
LIBRARY
State of Ohio Office of Budget and Management
30 East Broad Street
Columbus, Ohio 43215
(614) 466-3085
July 20, 1976
MEMORANDUM TO:
Governor James A. Rhodes
FROM:
William W. Wilkins, Director
William
W.Wilkins
Office of Budget and Management
SUBJECT:
FY 77 Medicaid Appropriation
This will certify the amounts appropriated to support Ohio's Medicaid
program. These appropriations include projected Federal matching funds.
From Amended Substitute HB 155 - $ 410,631,513
From Amended Substitute HB 1508-
60,000,000
*
Total Appropriation
$ 470,631,513
* Subject to release by the State Controlling Board
WWW:cb
HEALTH
DEPARTMENT
IDUC
ARTMENT
DEPARTMENT OF HEALTH. EDUCATION. AND WELFARE
REGION V
... 50018 BACKER with
CHICAGO. ILLINOIS 6060£
SOCIAL a REHABILITATION
SERVICE
June 30, 1976
EXECUTIVE
2- 700 92.
Mr. Kwegyir Aggrey, Director
RECEIVED
Ohio Department of Public Welfare
State Office Tower, 32nd Floor
30 E. Broad Street
Columbus, Ohio 43215
Dear Mr. Aggrey:
The Regional Office estimate of total expenditures for the Medicaid
Program in Ohio, as requested in your letter of June 17, is $539,872,000
for the period July 1, 1976 through June 30, 1977, compared to your
May 3 estimate of $536,662,000 for the same period.
This estimate was derived for Federal Budget purposes from historic
medical expenditure trends as provided by the State, through its normal
statistical and monetary reporting system. It is based on the program
continuing in its present form and providing the identical service
classifications.
Sincerely,
alyli
Clyde V. Downing
Regional Commissioner, ? SRS
Region V
HEALTH.
to
PRICATION
INTERNATIONAL SECURITY AND
THE UNDER SECRETARY OF HEALTH, EDUCATION, AND WELFARE
WASHINGTON, D.C. 20201
U.S.K.
July 21, 1976
MEMORANDUM TO THE HONORABLE JAMES CANNON
Enclosed are the Department's Reports
on Major Initiatives which you requested.
hearing Marjorie Lynch hyrch
Under Secretary
Enclosures
CC: Mr. David Lissy
FORD LIBRARY
Dr. James Cavanaugh
Miss Sarah Massengale
OVERVIEW OF TITLE XX
Title XX of the Social Security Act was a far-
reaching reform of public social services. The title
provided for goal oriented services, allowed the States
to determine which services they would provide, and
required that States develop an open planning process
with citizen participation, The clear intent of the
law was to allow States greater flexibility in the
planning and delivery of social services.
After the first year of Title XX operation, HEW
in connection with States, counties, State legislatures
and cities undertook a comprehensive review of Title XX
regulations. The purpose of this review was to remove
those aspects of the regulations which reduced State
flexibility or caused serious administrative problems
These regulations are being revised to the extent possible
within the statute to remove these barriers. The President
introduced the Community Services Block Grant which would
further remove the statutory barriers to State flexibility
for public social service programs. A more detailed des-
cription of Title XX is attached.
MEMORANDUM
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
TO
:
Michael Licata
DATE: July 20, 1976
ES
FROM : ORR Glenn Kamber GK.
SUBJECT: Major Initiatives Report for the Domestic Council
The Secretary has made regulatory reform one of his highest
priorities in the Department. In order to coordinate the
efforts of the Department in regulatory reform, the Secretary
established the Office of Regulatory Review on February 3,
1976. The Secretary announced a two-fold objective for
regulatory reform in the Department:
1. Improve the process by which new regulations,
either proposed or final, are developed, cleared
and reviewed; and,
2. Review existing regulations to recommend which
ones can and should be modified, simplified, or
eliminated.
To accomplish these two major objectives and to incorporate
the Secretary's initiative to open the processes of HEW to
more public involvement the following six major activities
have been initiated:
Meetings about the regulations development process
to solicit ideas for changes needed in that process
have been held with over 150 HEW-related interest groups
as well as with all key Department personnel.
A high-level Departmental Task Force composed of
representatives from each agency within the Department
was formed to review the regulations development process
and presented recommendations for change to the Secre-
tary on April 8, 1976. Included in these recommendations
are methods to open the system to more meaningful public
involvement, to provide for earlier decision-making
by the Secretary and Under Secretary, to assure more
timely development of regulations and to formalize the
"periodic review" of regulations to evaluate their im-
pact and effectiveness.
A Task Force composed of personnel from the Federal
Register, SRS, SSA and H, was established in June to
recodify the Medicaid regulations (which will include
a review of all regulations, guidelines, memoranda and
policy letters).
A Task Force composed of personnel from the Office of
Education will be formed in August to develop regulations
for the Higher Education and Vocational Education Acts.
The two-fold objective of this OE Task Force is to pro-
vide a model for implementing regulations as mandated
by the new legislation and to recodify the existing
pertinent regulations to produce a unified, consistent
and clearly written set of final regulations.
Training sessions in the regulations process and clear
writing of regulations are being conducted within each
agency. The goal of these pilot training sessions is
to develop a training program which can be applied
throughout the Department so that regulations will be
written in clear, simple and easily understood manner.
Current regulations are often written in legal and program
jargon which often cannot be understood by the ordinary
citizen. These courses are being developed with the
cooperation of Federal Register personnel.
A study is underway to investigate how computer
technology can be applied to the regulations development
process. Included in the study will be the possible uses
of computer systems for internal monitoring for the
entire development process and for cataloging existing
regulations.
Excluding the Food and Drug regulations, HEW regulations
currently cover 3,167 pages of the Code of Federal Regulations.
Approximately 500 items that must be signed by the Secretary
will be sent to the Federal Register this year.
We believe that these activities to reform the regulation
process and review existing regulations are positive and
constructive responses by the Department to the public as it
is affected in the vital areas of service delivery in the
numerous areas that are touched upon by policies and programs
emanating from the Department of Health, Education and Welfare.
MEMORANDUM
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SOCIAL AND REHABILITATION SERVICE
Office of the Administrator
TO
:
DATE:
Michael J. Licata
July 21, 1976
Executive Secretary
to the Department
FROM
Administrator
:
Social & Rehabilitation Service
SUBJECT:
Major Initiatives Report
Attached is material pertinent to the Title XX proposals to be used
as part of a summary of major initiatives undertaken or completed
during the last two years.
Dallot Robert Fulton
Attachment
1
Title XX of the Social Security Act
1. Then and now facts
The title XX social services program is the result of a collaborative
effort on the part of the Congress, the Department, the State adminis-
trators, the National Governors Conference, and numerous organizations
concerned with services for children, the aged, the handicapped and
other groups. By creating title XX (Public Law 93-647) this coalition
resolved an impasse of some 20 months when no one could agree on new
regulations for titles IV-A and VI and what direction public social
services should take.
Effective October 1, 1975 in the 50 States and the District of Columbia,
the title XX program began, providing services for needy families and
children (formerly served under title IV-A of the Social Security Act),
needy aged, blind and handicapped (previously served under title VI of
the Act), and, at State option, intact families, childless couples, and
single (not old, not handicapped) persons with incomes net exceeding
115% of the State or national median income as adjusted for family size.
Under title IV-A, fees could be charged for child care. Under title XX,
fees were mandatory for persons with a gross monthly family income above
80% of the median income and up to 115% of it. But while the universe of
population under title XX seemed broader than for the predecessor titles,
the focus was still on the poor as shown by the legislation which required
that an amount equal to 50% of the Federal contribution be used for
service expenditures for recipients of AFDC (title IV-A), SSI (the Supplemental
Security Income program under title XVI), and Medicaid.
Gone were the "former" and "potential" recipients of title IV-A and VI
and the determination of eligibility on a group basis.
Title XX introduced a new concept of "universal" services - that is
two services which a State might provide to anyone without regard to
their incomes: information and referral services and services to prevent
or remedy abuse, neglect or exploitation of children or adults.
The requirement for providing services on a Statewide basis remained; but
under title XX, a State could divide itself into geographic areas (encompassing
the whole State) and vary services by geographic areas according to the needs
of the eligibile persons there and availability of resources.
The same ceiling remained on social services, $2.5 billion, and the
allocation formula was still on the basis of population. However, if States
did not certify complete usage of their allocations under title XX, $15
million of the remainder could be allocated to Puerto Rico and $500,000
each to the Virgin Islands and Guam for services under title I, IV-A, X,
XIV or XVI (AABD). There was no change in the Federal match: 75% for
services and administration; 90% for family planning services. States
could still receive donations from public or private agencies under the
same circumstances to use as the State match, and services could be provided
by title XX staff, by referral, or by purchase. As under the previous
titles, States with title XX programs may be found out of compliants and
be subject to withholding of Federal funds. However, under title XX the
Then and now - continued
2
HEW Secretary has the option of withholding 3% of funds otherwise
payable to the State for each requirement out of compliance, as well
as withholding all funds.
State
The same/organizational unit which operated title IV-A had to operate
the program under title IV-B (child welfare services). Likewise, the
tifle XX State agency must operate the IV-B program (except in Illinois
where there is a separate child welfare services unit).
There were numerous mandatory services under the "old" titles. This
concept is vestigial under title XX: three SSI services in each
geographic area, family planning services for all AFDC recipients who
request them, and at least one service in each geographic area to
carry out each of title XX's national goals. These goals are: self-
support, self-sufficiency; services to prevent or remedy abuse, neglect
or exploitation of children or adults; reuniting families; deinstitu-
tionalization when appropriate; institutionalization or services
within some institutions when necessary. Title XX is completely goal-
oriented both in assessing the needs of an applicant and reporting on
services given.
Title XX departs radically from the two former programs in that it
decentralizes planning out of Washington and places it in the States
where the leadership and people are closer together and can presumably
better articulate needs and allocate resources. The vehicle for this
thrust is the open planning process conducted on a yearly basis. The
statute spells out how the State must develop, publish and make generally
available a proposed services plan 90 days before the program year
begins. Minimally, the State must publish a display advertisement in
newspapers covering each geographic area detailed in the plan and provide
copies of the plan or a summary of it. A comment period of 45 days
follows publication of the ad. States also use public hearings, radio
and TV to solicit public input. What the public is commenting on is
the contents of the plan: who is eligible for what services in what
geographic area; criteria for eligibility; description of each service
offered; fee schedule if any; the Federal allotment and how much the
State will spend of it, the State contribution (also local and donated);
the needs assessment; how evaluation and reporting will be conducted;
projected estimates of numbers of persons to be served with what
services where; how it will coordinate with other human services programs;
how the title XX agency is organized. (Priorntothe start of the program,
SRS issued a Citizens Handbook to explain the program to the public.
Many thousands were put into circulation.) When the 45 days are up and
comments are analyzed, a final services plan is published (minimally in
a display ad in the same newspapers as before) explaining the differences,
if any, between the proposed and final plans.
final
There is a procedure for amending the/services plan which is like that
for a proposed services plan but has a 30-day comment period.
This kind of open planning permits great flexibility, affords an opportunity
for initiative at the grassroots, and is expected to result in programs
more nearly meeting the needs of the State's residents.
Then and now - continued
3
The title XX agency must also prepare a second plan covering adminis-
trative aspects of the program - such as fair hearings, use of
Merit System for agency personnel, safeguarding information, standards,
etc. This plan must be submitted for approval to SRS. The services
plans are reviewed by SRS to see that they montain all the items
required by the legislation and regulation, but SRS does not have
approval authority.
The Federal role under title XX is to provide technical assistance,
monitor and evaluate the program and report to Congresson it.
2. Highlights and key numbers
- Almost $3 billion was expended for title XX in FY 1976, of
which $2.2 billion, or 75%, was the Federal share.
- Expenditures increased 40% from $1.6 billion in FY 1974. to
$2.2 billion in FY 1976. Expenditures are projected at
$2.35 billion in FY 1977.
- In FY 1974, expenditures represented 63% of the States'
entitlements, increasing to 88% in FY 1976, and estimated at
94% in FY 1977.
- In FY 1974 only 7 States used their full entitlements com-
pared to 21 in FY 1976 and estimated at 34 States in FY 1977.
- Child day care, the largest single service provided accounted
for $546 million, or 25% of the Federal expenditures in
FY 1976.
- Expenditures for training and retraining of persons engaged
in the delivery of title XX services increased from $43
million in FY 1974 to $54 million in FY 1976.
4
3. Concerns or problems encountered in the title XX program in the
last two years (major areas):
a. Making the transition from the two preceding services programs
Setting up and implementing a new planning process on a yearly
cycle, educating the public to the new concept and developing
methods to obtain public input into the planning;
Converting contracts under the "old" titles to conform to the
requirements for purchase of services under title XX;
Setting up information systems for reporting title XX services
and expenditures.
b. Determining eligibility
Methods of performing initial detammination of eligibility and
redetenmination, including time periods and availability of
FFP; pressure for determining eligibility on a group basis (as
had been possible under titles IV-A and VI), especially for
senior citizens (legislation constantly being introduced); pres-
sure for considering as one-person families various groups
such as youth for certain services (family planning, drug abuse),
handicapped youth and adults living with family members; children
in foster care. The regulations were amended three times to
deal with matters of eligibility.
C. Child Care
Although the Federal Interagency Day Care Requiremen (SI(FIDCR)
had been required under title IV-A, the title XX legislation
specified their use and the regulations made it a matter of FFP
if States did not adhere to these requirements and additional
ones on staffing for children under six years of age in day
care outside their homes, required by the regulations. Some
States could not meet these standards and legislation was always
being introducedito afford some relief to theStates. One sus-
pension of the new staffing standards was in effect to the end
of January 1976 and another bill has passed the House to continue
this suspension and otherwise assist the States in child care
matters.
d. Confidentiality
With heavy emphasis on confidentiality of records throughout
the nation and a growing fear of the citizenry of centralized
government "data banks," much concern has been expressed by
services consumers about providing information necessary for
acountability of expenditures and demographic knowledge about
the program. Service providers are also reluctant to supply
such information about the title XX eligibiles they serve with
title XX funding. Several suits were brought against the Depart-
ment and others threatened.
e. Rigidity of the statute
The statute is very specific about details of planning and preparing
5
Concerns (continued)
and publicizing the proposed and final services plans and
specifying time frames in which certain tasks must be
accomplished. This lack of flexibility often has jeopardized
FFP to the States when a specific procedure or required content
of the plan has been inadvertently overlooked. Since the
regulations must implement the law, they are often criticized for
being "too tight."
In an effort to accommoda te to the realities S of operation of the
program, the Department has amended the regulations four times already
and is now embarked on a fifth, major, comprehensive amending - all
within the first year of the program. The purpose is to simplify the
administrative requirements as much as possible and remove to the
greatest extent the potential for having to penalize the States financially.
4. Key quotes
a. Senator Walter F. Mondale (D., Minn.) who introduced the "Social
Services Amendments of 1974 on behalf of himself and Senators
Javitz, Packwood and Bentzen, in the Senate, September 20, 1974:
"This program provides special help for the elderly and disabled,
alcoholism and drug rehabilitation, and a host of other services
directed toward preventing welfare dependency, avoiding unnecessary
institutionalization, and strengthening family life."
b. Former Secretary of HEW, Caspar W. Weinberger, announcing his
support for the bill, October 3, 1974:
"The proposed amendments make theState social services program
answerable primarily to the State's citizens, within broad
Federal guidelines. I am convinced that this new approach can
FORD
free us all to concentrate on getting services to people.
c. President Ford on signing the bill, January 4, 1975:
LIBRARY
"The provisions concerning the Federal-State partnership program
for social services successfully concludes many long months cf
negotiations among the Congress; the Department of Health, Education,
and Welfare; governors; State administrators; and spokesmen for
producers and consumers. Ending a long impasse, the efforts of
all exemplify my call for communication, cooperation, conciliation
and compromise when I assumed the office of President
"
"I am particularly pleased that this legislation follows a
desireable trend in Federal-State relations. It will improve the
results of programs previously hampered by unrealistic assumptions
of Federal review and control. These decisions related to local
conditions and needs will be made at the State level, while Federal
responsibilities are clearly delineated. Indeed, the interests of
not only the Federal andState governments, but also producers and
consumers are recognized and protected. I also believe that this
new legislation significantly improves program accountability and
Quotes (continued)
6
focuses on those most in need of services.
"In summary, I regard the social services provisions as a
major piece of domestic legislation and a significant step
forward in Federal-State relations."
5. Referernce to or contact with outside groups
The collaborative effort which resulted in development and
enactment of theSocial Services Amendments of 1974 (Title XX)
has continued. There is constant consultation between the
Department (principally through the Social and Rehabilitation
Service and its Public Services Administration) on policy
development with State administrators, relevant members of
Congress, national voluntary advocacy groups, the National
Governors Council, NERO, NACO, other parts of HEW and other
Federal agencies. The Department meets with these groups,
communicates by telephone and mail and solicits input into
regulations in the developmental stage and when regulations
are issued in proposed form. One of the major coalitions
which serves in an advisory capacity is the Human Resources
Forum.
MEMORANDUM
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
SOCIAL SECURITY ADMINISTRATION
TO
: Executive Secretary to the Department
DATE:
July 20, 1976
REFER TO: IPE-4
FROM : Harris Factor, Director
Executive Secretariat, SSA
SUBJECT: Major Initiatives in Medicare Legislation (Your memorandum of 7/20)--ACTION
Attached for your use in responding to the request from the Domestic
Council for a summary of major initiatives in Medicare legislation
is a brief discussion paper on the Administration's proposed Medicare
Improvements of 1976.
off
Harris Factor
Attachment
Report from the Commissioner of Social Security Concerning
Major Initiatives in Medicare Legislation
Over the course of the last 2 years the Social Security Administration's
major legislative initiatives concerning the Medicare program have
been proposals which would: provide protection against catastrophic
illness; restructure beneficiary cost sharing; and introduce other
features into the Medicare program to help reduce the rate of
inflation in medical care costs generally and the corresponding growth
in Medicare program expenditures.
The Administration's most recent legislative proposal was submitted
to the Congress on February 11, 1976, as the "Medicare Improvements
of 1976.' The proposal would modify Medicare's cost-sharing structure
to provide: (1) unlimited days of covered hospital (except psychiatric
hospital) and skilled nursing facility care; (2) a coinsurance equal
to 10 percent of all charges above the inpatient hospital deductible
amount (currently $104) for all services covered under Medicare's hospital
insurance (part A) program; (3) an increase in the annual deductible
amount under Medicare's supplementary medical insurance (part B) program
from $60 to $77 in 1977; (4) a coinsurance equal to 10 percent of charges
above the deductible amount for all hospital-based physicians and part B
home health services; and (5) under part A, a maximum cost-sharing
liability limit of $500 per year in 1976 and 1977, and under part B,
a maximum cost-sharing liability limit of $250 in 1977. The part B
deductible amount and the cost-sharing liability limits under part A and
part B would be increased after 1977 in proportion to increases in
social security cash benefits.
The Medicare Improvements of 1976 also contains cost-control provisions
under which Medicare would not recognize for reimbursement purposes
increases in hospital, skilled nursing facility, or other provider costs
of more than 7 percent, or increases in charges for physician's and
other part B covered services of more than 4 percent.
In his message transmitting to the Congress several Administration
proposals for improvements in programs serving the elderly, the
President outlined the purposes of the Medicare proposal as follows:
"There are weaknesses in the Medicare program which must be
corrected. Three particular aspects of the current program
concern me: 1) its failure to provide our elderly with
protection against catastrophic illness costs, 2) the serious
effects that health care cost inflation is having on the Medicare
program, and 3) lack of incentives to encourage efficient and
1 of 3
economical use of hospital and medical services. My proposal
addresses each of these problems.
"In my State of the Union Message I proposed protection against
catastrophic health expenditures for Medicare beneficiaries. This
will be accomplished in two ways. First, I propose extending
Medicare benefits by providing coverage for unlimited days of
hospital and skilled nursing facility care for beneficiaries.
Second, I propose to limit the out-of-pocket expenses of beneficiaries,
for covered services, to $500 per year for hospital and skilled
nursing services and $250 per year for physician and other non-
institutional medical services.
"This will mean that each year over a billion dollars of benefit
payments will be targeted for handling the financial burden of
prolonged illness. Millions of older persons live in fear of
being stricken by an illness that will call for expensive hospital
and medical care over a long period of time. Most often they
do not have the resources to pay the bills. The members of their
families share their fears because they also do not have the
resources to pay such large bills. We have been talking about
this problem for many years. We have it within our power to
act now so that today's older persons will not be forced to
live under this kind of a shadow. I urge the Congress to act
promptly.
"Added steps are needed to slow down the inflation of health costs
and to help in the financing of this catastrophic protection.
Therefore, I am recommending that the Congress limit increases in
medicare payment rates in 1977 and 1978 to 7% a day for hospitals
and 4% for physician services.
"Additional cost-sharing provisions are also needed to encourage
economical use of the hospital and medical services included under
Medicare. Therefore, I am recommending that patients pay 10% of
hospital and nursing home charges after the first day and that the
existing deductible for medical services be increased from $60 to
$77 annually.
"The savings from placing a limit on increases in medicare payment
rates and some of the revenue from increased cost sharing will be
used to finance the catastrophic illness program.
"I feel that, on balance, these proposals will provide our elder
citizens with protection against catastrophic illness costs,
promote efficient utilization of services, and moderate the increase
in health care costs."
2 of 3
It is estimated that the cost-sharing modifications in the Medicare
program would reduce the costs of the program by $327 million in
fiscal year 1977. The cost-control provisions are estimated to reduce
Medicare outlays by an additional $1.2 billion. Together, these
provisions would reduce by one-third the projected 23-percent increase
in Medicare program outlays in fiscal year 1977 under the provisions of
present law.
A number of congressional committees have held hearings on the proposed
Medicare Improvements of 1976. However, no committee has acted on this
legislation or reported it for consideration by the Senate or the
House of Representatives. The Administration is currently reconsidering
this legislation with a view toward submitting its recommendations to
the 95th Congress.
3 of 3
STATE
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
UAA
WASHINGTON, D.C. 20201
OFFICE OF THE SECRETARY
July 20, 1976
NOTE TO MICHAEL LICATA
Subject: Major Initiatives Report
In response to your memorandum, attached is the major
iniative report on the Health Block Grants.
bra Goldation
Ira Goldstein
Attachments
MAJOR INITIATIVES REPORT: HEALTH BLOCK GRANT
1. Then and Now Facts
On February 25, 1976, the President proposed to improve the efficiency
and equity of health services to the poor by consolidating sixteen
federal health programs, including Medicaid, into one $10 billion
block grant to the States. Every State would receive more in fiscal
years 1977, 1978 and 1979 than was received in fiscal year 1976.
No State would ever receive less than it did in fiscal year 1976.
2. Highlights and Key Numbers
The President submitted to Congress the Financial Assistance for
Health Care Act. Its objectives are to:
o
improve access to quality health care at reasonable
costs;
achieve, over time, a more equitable distribution
of federal health dollars among States in relation-
ship to those persons most in need;
increase State and local control over health spending
to:
a. allow each State to set its own priorities
for health programs based on the particular
needs of its low-income population and its
resources;
b. allow each State to integrate its programs
into a cohesive total; and
C. increase the States' motivation to control
rising health care costs;
restrain the growth of federal spending and the federal
bureaucracy and reduce red tape.
Page 2
The proposal includes a requirement for a State-developed "State
Health Care Plan." Public participation in the development of
the plan is required to ensure that increased State responsibility
is coupled with expanded public involvement in the formation of
State health policies.
3. Problems Encountered in the Last Two Years
No congressional committee hearings have been held, or likely are
to be held, on the bill.
HEW and OMB staff have consulted extensively with representatives
of State and local governments. Major issues raised are:
Funding levels under the block grant are insufficient.
Both initial grants and subsequent inflation increments
are not adequate to maintain existing program levels or
keep pace with escalating health costs.
The allocation formula results in too drastic a
redistribution of federal dollars.
Will the Federal Government or Congress overlay elaborate
regulatory requirements on States in the future? States
are concerned that subsequent regulations and standards
implementing the consolidation would be exceedingly
costly and require large increases in State health
expenditures.
The required State Health Care Plan and the planning process
should be the responsibility of State government. Under
P.L. 93-641, the National Health Planning Act, States were
given regulatory responsibility, but no control over plan-
ning for the allocation of State, local and private health
resources. The law gave planning to private, non-profit
agencies that reported to the Secretary of HEW.
Compliance, audit and enforcement procedures should be
the responsibility of each State.
4. Key Quotes
From the President's message to Congress, February 25, 1976:
Page 3
"In the past 10 year period (1965-1975) Federal spending for
health has increased from $5 billion to $37 billion. With
greater Federal funding has come a multitude of Federal
programs, regulations and restrictions -- all motivated by
the best of intentions but each adding to the confusion
and overlap and inequity that now characterizes our efforts
at the national level.
"The Financial Assistance for Health Care proposal is being
submitted after extensive consultation with organizations
representing the publicly elected officials who will be
responsible for administering the program. I believe this
proposal represents a major step toward overcoming some of
the most serious defects in our present system of Federal
financing of health care.
"My proposal is designed to achieve a more equitable
distribution of Federal health dollars among States and
to increase State control over health spending. My
proposal also recognizes the appropriate Federal role
in providing financial assistance to State and local
governments to improve the quality and distribution of
health services.
"The enactment of this legislation will achieve a more
equitable distribution of Federal health dollars by
providing funds according to a formula giving primary
weight to a State's low-income population. The formula
also takes into account the relative tax effort made by
a State and the per capita income of that State."
5. Contact with Outside Groups
National Governors' Conference
National Association of County Officials
National Conference of Mayors
National League of Cities
National Conference of State Legislatures
HEALTH
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
U.S.A.
WASHINGTON, D.C. 20201
July 20, 1976
To:
Michael Licata
Executive Secretary
From:
Director
Office for Civil Rights
Subject: Major Initiatives Report for Domestic Council on
Section 504 of the Rehabilitation Act of 1973
I. Background and Status
On September 26, 1973, the Rehabilitation Act of
1973 became law. Section 504 of the Act broke new
legislative ground in that it was the first major
civil rights enactment to protect the rights of the
twenty-five million handicapped persons in the
United States. This section provides that no quali-
fied handicapped person shall be denied the benefits
of or be discriminated against in any federally
assisted program or activity. (See Tab A.) In 1974,
the definition of handicapped person in the Act was
amended SO that the protections of section 504
apply to any person who has a physical or mental
impairment which substantially limits one or more
of that person's major life activities, any person
who has a record of such an impairment, and any
person who is regarded as having such an impair-
ment. Section 504, however, applies only to quali-
fied handicapped persons. Thus, the Act would
allow an employer to refuse to hire a blind bus
driver but would not allow the automatic dis-
qualification of a blind teaching applicant because
of blindness.
On April 28, 1976, President Ford issued Execu-
tive Order 11914, which provides for a govermentwide
enforcement scheme under which the Secretary of Health,
Education, and Welfare is assigned responsibility to
coordinate the federal government's implementation of
section 504. (See Tab B.) The Secretary is to develop
standards for determining who are handicapped persons
and guidelines for determining what are discriminatory
practices. The executive order also delineates specific
enforcement procedures and sanctions for noncompliance,
including termination of federal financial assistance.
Page 2
Mr. Licata
Responsibility for development and implementation of a
section 504 compliance program for HEW was delegated to
the Office for Civil Rights. On May 17, 1976, the Depart-
ment published in the Federal Register a Notice of Intent
to Issue Proposed Rules under section 504. (See Tab C.)
This notice raised a number of fundamental issues con-
cerning section 504 and sought public comment on these
issues before the Department published a notice of pro-
posed rulemaking. The Department received over 400
comments as a result of this notice and, after analyzing
them, published in the Federal Register on July 16, 1976,
a Notice of Proposed Rulemaking allowing at least 60 days
for public comment. (See Tab D.)
II. Highlights and Problems
While section 504 raises a myriad of issues, several
are so basic and critical that they should be highlighted:
the definition of handicapped person, the elimination of
architectural barriers and the provision of services to
beneficiaries of federal programs. The phrase "regarded
as having such an impairment" in the statutory definition
is open-ended and presents a problem of interpretation.
This part of the definition recognizes that a person who
is not otherwise significantly handicapped may be dis-
driminated against on the basis of being perceived as
handicapped. In this category are included persons who are
grossly disfigured, dwarfs and persons who limp.
Architectural barriers exclude handicapped persons from
programs and employment opportunities by preventing access
to and use of the facilities where such programs are offered.
While the intent of section 504 is to prohibit the existence
of such barriers, the statute does not address this issue
separately and the expense involved in eliminating
architectural barriers in existing facilities is consider-
able. The Department's approach to this situation re-
quires that recipients of federal funds devise and implement
a plan which will, within three years, ensure that its
federally assisted program, when viewed in its entirety,
be accessible. This provision would not require that
every building or part of every building be made free of
architectural obstacles but encourages flexibility and
creativity in making sure that no beneficiary is denied
access to federal programs because of handicap.
The thrust of section 504 in the provision of edu-
cation, health and social services is to ensure that handi-
capped persons receive an equal opportunity to participate
in federally assisted services. Thus, providers of ser-
vices must ensure that notice and information is given to
Page 3
Mr. Licata
their beneficiaries in such a manner that it can be under-
stood by handicapped persons with impaired sensory or
speaking skills. In the area of elementary and secondary
education, the proposed regulation is consistent with
numerous recent court decisions and Public Law 94-142, the
Education for All Handicapped Children Act of 1975. It
requires that a recipient provide as suitable, adequate
and free an education to each handicapped person of school
age, regardless of the nature or severity of the person's
handicap, as it provides to nonhandicapped persons; that
the education be provided in the most normal setting feasible;
that, before placement of a student in a specialized instruc-
tion setting, the student be properly evaluated and given
certain due process rights; that no handicapped child be
excluded from the educational process on the basis of
handicap; and that nonacademic and extra-curricular
services and activities be provided in a nondiscriminatory
manner.
Several factors contributed to the Department's delay
in promulgating proposed rules for section 504. The lack of
Congressional guidance on the enactment of the statute has
been a persistent problem in formulating proposed rules.
Similarly, the amendments to the definition of handicapped
person contributed to the difficulty of drafting a regula-
tion for section 504 and added to the delay. Finally, the
need to develop an inflationary impact statement, which esti-
mated the regulator's economic costs and benefits, added
substantially to the amount of time which it took the
Department to prepare proposed rules.
III. Contact with Outside Groups
The Department has involved non-HEW people in a mean-
ingful manner at all stages of development of the proposed
rules. Before the publication of the May 17 Notice of
Intent, the Office for Civil Rights met with over sixty
national organizations, constituent groups and agencies of
federal and state governments. The Office has conducted
seminars with recipients of federal funds, service organi-
zations and consumer groups and has participated in a
number of national conferences. In addition to receiving
the comments from the May 17 notice, the Office for Civil
Rights held ten seminars across the country to solicit
public comment on the issues raised in the May 17 notice.
OCR is presently planning to hold town meetings in twenty-two
cities across the United States in August and September
to generate public interest in and knowledge of section
504 and the Department's responsibility in enforcing section 504.
That 9eng
Martin H. Gerry
LIBRARY
Page 4
Mr. Licata
Tab A: Section 504, Rehabilitation Act of 1973
Tab B: Executive Order 11914
Tab C: May 17, 1976 Notice of Intent to Publish Proposed Rules
Tab D: July 16, 1976, Notice of Proposed Rulemaking
Public Law 93-112
93rd Congress, H. R. 8070
September 26, 1973
REHABILITATION ACT OF 1973
NONDISCRIMINATION UNDER FEDERAL GRANTS
SEC. 504. No otherwise qualified handicapped individual in the
United States, as defined in section 7(6), shall, solely by reason of his
handicap, be excluded from the participation in. be denied the benefits
of, or be subjected to discrimination under any program or activity
receiving Federal financial assistance.
Sec. 7. For the purposes of this Act:
(6) The term "handicapped individual" means any individual who
(A) has a physical or mental disability which for such individual
constitutes or results in a substantial handicap to employment and (B)
can reasonably be expected to benefit in terms of employability from
vocational rehabilitation services provided pursuant to titles I and III
of this Act.
Public Law 93-516
93rd Congress, H. R. 17503
December 7, 1974
REHABILITATION ACT AMENDMENTS OF 1974
Sec. 111. (a) Section 7(6) of such Act is amended by adding at the
end thereof the following new sentence: "For the purposes of titles
IV and V of this Act, such term means any person who (A) has a
physical or mental impairment which substantially limits one or more
of such person's major life activities, (B) has a record of such an
impairment, or (C) is regarded as having such an impairment.".
Nondiscrimination With Respect
to the Handicapped in Federally
Assisted Programs
Executive Order 11914. April 28, 1976
By virtue of the authority vested in me by the Constitu-
(c) No such suspension or termination of, or refusal
tion and statutes of the United States of America, includ-
to award or continue, Federal financial assistance shall
ing section 301 of title 3 of the United States Code, and
become effective unless there has been an express finding,
as President of the United States, and in order to provide
after opportunity for a hearing, of a failure by the recipi-
for consistent implementation within the Federal Govern-
ent of, or applicant for, Federal financial assistance to
ment of section 504 of the Rehabilitation Act of 1973 (29
comply with the requirements adopted pursuant to this
U.S.C. 794), it is hereby ordered as follows:
order; however, such suspension or termination of, or
SECTION 1. The Secretary of Health, Education, and
refusal to award or continue, Federal financial assistance
Welfare shall coordinate the implementation of section
shall be limited in its effect to the particular program or
504 of the Rehabilitation Act of 1973, as amended, here-
activity or part thereof with respect to which there has
inafter referred to as section 504, by all Federal de-
been such a finding of noncompliance.
partments and agencies empowered to extend Federal
SEC. 4. Each Federal department and agency shall
financial assistance to any program or activity. The Secre-
furnish the Secretary of Health, Education, and Welfare
tary shall establish standards for determining who are
such reports and information as the Secretary requests
handicapped individuals and guidelines for determining
and shall cooperate with the Secretary in the implementa-
what are discriminatory practices, within the meaning of
tion of section 504.
section 504. The Secretary shall assist Federal departments
SEC. 5. The Secretary of Health, Education, and Wel-
and agencies to coordinate their programs and activities
fare may adopt rules and regulations and issue orders
and shall consult with such departments and agencies, as
which he deems are necessary to carry out his respon-
necessary, so that consistent policies, practices, and pro-
sibilities under this order. The Secretary shall ensure that
cedures are adopted with respect to the enforcement of
such rules, regulations, and orders are not inconsistent
section 504.
with, or duplicative of, other Federal Government policies
SEC. 2. In order to implement the provisions of section
relating to the handicapped, including those policies
504, each Federal department and agency empowered to
adopted in accordance with sections 501, 502, and 503 of
provide Federal financial assistance shall issue rules, regu-
the Rehabilitation Act of 1973, as amended, or the Archi-
lations, and directives, consistent with the standards and
tectural Barriers Act of 1968 (42 U.S.C. 4151 et seq.).
procedures established by the Secretary of Health, Educa-
GERALD R. FORD
tion, and Welfare.
The White House,
SEC. 3. (a) Whenever the appropriate department or
April 28, 1976.
agency determines, upon all the information available to
[Filed with the Office of the Federal Register, 11:07 a.m.,
it, that any recipient of, or applicant for, Federal financial
April 28, 1976]
assistance is in noncompliance with the requirements
adopted pursuant to this order, steps to secure voluntary
compliance shall be carried out in accordance with stand-
ards and procedures established pursuant to this order.
(b) If voluntary compliance cannot be secured by
informal means, compliance with section 504 may be
effected by the suspension or termination of, or refusal to
award or continue, Federal financial assistance or by other
appropriate means authorized by law, in accordance with
standards and procedures established pursuant to this
order.
MEMORANDUM
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
TO
: Mr. Michael J. Licata
DATE: July 20, 1976
Executive Secretary to the Department
THROUGH: The Under Secretary
be
FROM : Director, Office of Investigations
SUBJECT: Major Initiatives Report
Re Your Memo of July 20
1. Secretary Mathews announced the formation of an
independent Office of Investigations reporting directly
to the Under Secretary effective November 30, 1975.
This unit was to investigate all allegations of criminal
fraud and related matters. The new office has no
responsibility for physical security, personnel security
clearances, or for personnel investigations except as
they related to fraud or conflict of interest. On
December 28, 1975, the Investigations Branch of the
Office of Administrative Appraisal and Planning, Social
Security Administration, was transferred to the Office
of Investigations.
2. Congressional approval to increase the staff of the new
Office of Investigations to 74 was obtained. A career
appointment of an experienced, professional investigator
to the position of Director, Office of Investigations
was made April 19, 1976.
In a series of announcements, the Secretary and Under
Secretary affirmed their complete support and backing
for this office and their intention to see that it was
operated in an independent, professional, and non-partison
manner. The new Director was directed to open and close
investigations on his own authority and to present cases
directly to the Department of Justice for prosecution.
Since April 1976, efforts have been under way to select
experienced and competent personnel to fill the authorized
complement. Personnel are now on board in all ten of the
HEW Regional Offices. Twenty-five professional investigators
are in the field and at headquarters. Offers are pending
to three more investigators and selections are now being
processed to fill vacant slots. Cases are being investigated,
presented to the Justice Department, and prosecutions are
going forward.
Mr. Michael J. Licata -- page 2
Other moves were made to emphasize the Department's
interest in the elimination of fraud and abuse. A
close rapport was established between the HEW Audit
Agency and the Office of Investigations and steps were
taken to increase the independence of the Audit Agency.
A special Fraud and Abuse Unit for Medicaid was
established within the Social and Rehabilitation Service
to seek out program areas where potential fraud and
program abuse might exist. Teams from this unit have
initiated pilot projects in Massachusetts and Ohio to
formulate and improve techniques to detect potential
fraud and abuse.
John J. I Walsh
THE WHITE HOUSE
WASHINGTON
July 27, 1976
MEMORANDUM FOR THE HONORABLE DAVID MATHEWS
SECRETARY OF HEALTH, EDUCATION AND WELFARE
FROM:
JIM CANNON
At the Midwestern Governors Conference yesterday, Governor
Rhodes spoke to me about these two matters.
Would you ask someone on your staff to arrange to have an
appropriate response sent directly to Governor Rhodes?
Thank you.
GERALE & FORD LIBRARY
THE OHIO STATE UNIVERSITY
July 19, 1976
The Honorable James A. Rhodes
Governor, State of Ohio
Columbus, Ohio 43215
Dear Governor Rhodes:
This is in response to your request for information relating to significant
Federal--State actions pending regarding The Ohio State University Comprehen-
sive Cancer Center.
1. A Construction Grant for $3,000,000 in Federal funds to con-
struct a $4,000,000 Cancer Research Center is being resubmitted
to the National Cancer Institute on 1 October 1976, $1,000,000
of State matching funds are included in the University's 1977-83
Capital Plan submitted to the Board of Regents on July 6, 1976.
This reapplication has been discussed with Drs. Rauscher and Fox
of the National Cancer Institute.
2. On June 28, 1976 The Ohio State University submitted to the
National Cancer Institute a Grant Application for $1,806,138
for the three year April 1, 1977 to March 31, 1980 time period
to fund a Developmental Cancer Control Program, for the Ohio
Valley Region. (See Attachment 1). This application is under
consideration by the National Cancer Institute.
3. On January 28, 1975 The Ohio State University submitted to
the National Cancer Institute a Grant Application for $1,055,369
to fund a three year (September 1, 1975 to August 31, 1978)
grant entitled "Carcinogenic Mechanisms: In Vitro Studies"
(See Attachment 2). This grant application was recommended for
approval by the National Cancer Institute staff in the reduced
amount of $596,169 (See Attachment 3). This grant is still
pending and funding is dependent upon the availability of funds
and project priority.
Your support and interest in the OSU Medical Center, our Comprehensive
Cancer Center and the enhancement of our ability to provide better medical
LIBRARY
THE
GOVERNOR
STATE OF OHIO
OFFICE OF THE GOVERNOR
OHIO
COLUMBUS 43215
OF
JAMES A. RHODES
GOVERNOR
July 20, 1976
The Honorable David F. Mathews
Secretary of Health, Education, and Welfare
GERALD FORD LIBEARY
Washington, D. C.
20201
Dear Secretary Mathews:
Ohio faces a severe financial crisis in its Medicaid program,
The severity of this crisis is apparent when you compare the
appropriation of $471 million (state funds plus projected federal
earnings) which is available for fiscal year 1977 with the pro-
jected expenditures of $597 million required to support the
FY 77 Medicaid program in its present form.
This situation is further compounded by the fact that Ohio is
under court order not to reduce the scope of the current program
until pre-reduction hearings are provided to eligible recipients.
The projected deficit of $126 million in the Medicaid program has
been the subject of much publicity, legislative committees have
examined the program and many medical provider associations have
provided suggestions and recommendations. Since the projected
deficit includes both state funds and federal earnings, Ohio needs
your recommendations as to how this situation might best be re-
solved. I understand that the federal funds required to support
the program are indeed available to Ohio but only if the state
certifies that it can provide the necessary state matching funds.
Your verification of this requirement would be most helpful.
Without an increase in state matching funds, Ohio cannot continue
the existing Medicaid program, The problem becomes critical on
November 15, 1976, when the federal estimates for the January-
March 1977 quarter are due. Without an increase in state funds
prior to this date, Ohio will not be able to certify the avail-
ability of sufficient state funds to maintain the Medicaid program
for FY 77. It is anticipated that the current appropriation will
be exhausted in February 1977 and Ohio will be forced to discontinue
the Medicaid program for lack of funds.
I plan to propose a reallocation of state funds that will insure
the continuation of Ohio's Medicaid program through fiscal year
1977. Immediate action is necessary if Ohio is to avoid a repeat
of the FY 76 crisis when Medicaid funds were exhausted on May 11,
1976. I need your support to reinforce the necessity for a speedy
but effective solution to the Medicaid crisis, Attached is a
suggested letter for your signature which would accomplish that
purpose.
Health
THE WHITE HOUSE
WASHINGTON
7/27/76
TO:
SPENCE JOHNSON
FROM: JIM CANNON
What is the status on this?
FORD LIBRARY & GERALD
status
HEALTH.
CC Johnson
PATIENT
DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
OFFICE OF THE SECRETARY
USA
WASHINGTON, D.C. 20201
JUL 16 1976
MEMORANDUM FOR THE HONORABLE JAMES M. CANNON
I am writing in response to your memorandum of June 24 in
which you request further information concerning my memorandum
of June 18 to the President. As you know, the National
Institutes of Health (NIH) released guidelines on June 23
for recombinant deoxyribonucleic acid (DNA) research supported
or conducted by NIH. The purpose of the committee I proposed
to the President in my memorandum would be to review and
coordinate Federal agency policies and actions in this re-
search area in light of the NIH guidelines.
In response to your questions concerning the proposed committee,
it is my intent that this committee shall be composed solely
of Federal officers and employees representing all departments
and agencies which conduct, support, or have possible regulatory
authority over the conduct of recombinant DNA research. Such
a committee is specifically excluded from the provisions of the
Federal Advisory Committee Act. The relevant section of that
Act is as follows:
Sec. 3. For the purpose of this Act-
(2) The term "advisory committee" means any
committee, board, commission, council,
conference, panel, task force, or other similar
FORD i GERALD LIBRARY
group, or any subcommittee or other subgroup
thereof (hereafter in this paragraph referred to
as "committee"), which is--
(A) established by statute or reorganization
plan, or
(B) established or utilized by the President,
or
(C) established or utilized by one or more
agencies,
in the interest of obtaining advice or recommendations
for the President or one or more agencies or officers
of the Federal Government, except that such term
excludes (i) the Advisory Commission on Intergovernmental
Relations, (ii) the Commission on Government Procurement,
and (iii) any committee which is composed wholly of
full-time officers or employees of the Federal Government.
(Emphasis added.)
The Honorable James M. Cannon
2
Thus, the proposed committee, inasmuch as it would be composed
solely of Federal officers and employees, would not need to be
chartered under this Act.
You also ask how this proposed committee relates to S. 2515,
which would modify the present National Commission for the
Protection of Human Subjects of Biomedical and Behavioral
Research. In the bill, which recently passed the Senate, there
is a provision concerning recombinant DNA research. The
Commission is authorized to conduct a study of the ethical,
social, legal, and safety implications of recombinant DNA
research and devise guidelines, if appropriate. I am enclosing
a copy of a letter that I am planning to send to Congressman
Harley O. Staggers, Chairman of the Committee on Interstate
and Foreign Commerce of the House of Representatives, commenting
on the bill. In the letter is outlined the Department's
stated opposition to S. 2515, including comments that the study
of recombinant DNA research proposed for the Commission would
duplicate the efforts of NIH.
In my view, it is most important that we be able to proceed
as expeditiously as possible to organize an intergovernmental
committee to review the experience of NIH and, where appropriate,
make recommendations for the other Federal departments and
agencies and possibly for the private sector. Legislative
prospects for S. 2515 are uncertain at best. Further, even if
the Congress were to pass legislation to create such a
Presidential Commission, over the Administration's objections,
and it were to become law, there would be certain administrative
delays in reorganizing and reconstituting such an entity. And
even if the Commission were to undertake such a study, it would
still not meet the stated needs of the committee that I am
proposing. The committee would have a far broader mandate
and a broader representation of interested parties.
I have received a considerable amount of correspondence on
this research activity in the past several months. In these
letters there has been special emphasis by public commentators
on the need for uniformity in the conduct of recombinant DNA
research. The committee I propose would be most responsive
to this public concern. I strongly urge you to recommend to
the President that I be allowed to proceed in this matter
without undue delay.
Throjone Lynch
Acting
Secretary
Enclosure
THE
ATION
DEPARTMENT OF HEALTH, EDUCATION. AND WELFARE
USA
DRAFT
The Honorable Harley 0. Staggers
Chairman, Committee on Interstate
FORD
and Foreign Commerce
House of Representatives
Washington, D.C. 20515
Dear Mr. Chairman:
This is in response to your request for a report on S. 2515, a bill "To
amend the Public Health Service Act to establish the President's Commis-
sion for the protection of human subjects involved in biomedical and
behavioral research, and for other purposes."
In summary, we oppose S. 2515 as passed by the Senate because the existing
statutorily established National Commission for the Protection of Human
Subjects of Biomedical and Behavioral Research has yet to complete its
recommendations. These are to include the development of an effective
Federal administrative mechanism for applying its ethical guidelines to
research programs conducted or supported by Government departments or
agencies, including its definition of the function and authority of the
proposed National Advisory Council for the Protection of Subjects of
Biomedical and Behavioral Research.
We feel that the recommendations of the present National Commission will
make an invaluable contribution toward the development of a consistent
Government-wide plan for the protection of human subjects of biomedical
and behavioral research. Assuming that such an administrative framework
will be based on the guidelines currently being recommended to the
Department of Health, Education, and Welfare, we favor an Executive
Order to extend Departmental regulations on the protection of human
subjects uniformly to all other Federal agencies and departments rather
than legislative creation of a new Presidential Commission.
S. 2515, as amended, would in effect replace the Commission created in
Title II of the National Research Act. The new President's Commission
would be permanent and would contain eleven members plus ex officio
advisors from the Department of Health, Education, and Welfare, the
Department of Defense, the Central Intelligence Agency, the Science
Advisor to the President, and the Veterans Administration. The President's
Commission would assume the functions, powers, and duties of the current
National Commission and expand its jurisdiction to encompass all Federal
departments and agencies conducting research involving human subjects.
Page 2 - The Honorable Harley 0. Staggers
In addition to the duties prescribed for the National Commission, the
President's Commission would be responsible for continually reviewing
and analyzing the ethical, social, and legal implications of all research
on human subjects supported by the Federal Government, and for making
appropriate recommendations concerning the protection of human subjects
to the supporting agency. These recommendations would be published in
the Federal Register and, if the responsible agency chooses not to
follow them, the negative determination and the reasons for it would be
published in the Federal Register.
The President's Commission would also be required to study the ethical,
social, legal, and safety implications of recombinant DNA research on
research personnel, human subjects of the research, and the public at
large.
We strongly endorse efforts to protect human subjects of biomedical and
behavioral research. However, in addition to establishing a mechanism
which we do not believe is necessary, the structure of the proposed
commission contains some administrative shortcomings.
First, the President's Commission would be independently advisory to the
several Federal agencies and departments, rather than to the Government
as a whole. Thus, there would be an opportunity not only for uncoordi-
nated advice but for disparate, inconsistent, and possibly conflicting
responses on the part of agencies conducting similar research. Second,
the proposed ex officio membership would not represent the extent of
biomedical research carried out by other Federal agencies, such as the
Energy Research and Development Administration, National Aeronautics and
Space Administration, Department of Transportation, or Department of
Agriculture. Third, there are no positions or funds authorized to
support the activities of the proposed Commission.
One of the recommendations already made by the National Commission for
the Protection of Human Subjects is that there be established a national
review body to consider ethical problems raised by research proposals
whenever the application of recommended standards proves difficult. The
Department of Health, Education, and Welfare is establishing an Ethical
Advisory Board to provide advice to the Public Health Service and other
components of the Department on ethical issues and on classes of applica-
tions or proposals which (1) must be submitted to the Board or (2) need
not be submitted to the Board (45 CFR 46.204). Creation of the Ethical
Advisory Board will create a more flexible instrument for dealing with
ethical dilemmas concerning human research subjects than the proposed
Presidential Commission.
Page 3 - The Honorable Harley O. Staggers
Finally, we are very aware of the controversy over recombinant DNA
research and have recently released guidelines according to which support
may be given for research conducted by grantees, contractors, and intra-
mural scientists. The National Institutes of Health, Public Health
Service, has gone to great lengths to involve the Congress, the public,
and the press in the decisionmaking process which has addressed the
social, legal, ethical, and safety implications of such research. It
has sought and received advice from many sectors--scientists, ethicists,
lawyers, and consumer representatives--and has taken all comments into
account in preparing the guidelines for this activity. While we do not
oppose having the guidelines reviewed by another advisory body, we feel
this is already being done under present authority.
We therefore recommend that S. 2515 not be favorably considered at this
time, and that any legislative initiatives concerning Federal regulation
of research involving human subjects be delayed until the existing
National Commission for the Protection of Human Subjects has made its
final report and recommendations to the President and the Congress as
required by the National Research Act.
We are advised by the Office of Management and Budget that there is no
objection to the presentation of this report from the standpoint of the
Administration's program.
Sincerely,
Secretary
executive Health
THE WHITE HOUSE
IV/1976/ST43/PAILAS
WASHINGTON
July 30, 1976
MEMORANDUM FOR:
JIM CANNON
FROM:
SPENCE JOHNSON Sy
SUBJECT:
Invitation to the President to address
American Hospital Association convention
to be held September 20 - 23.
This would be an excellent opportunity for the President
to make a major health policy statement in the Fall. This
will be the largest health conference with nationwide
representation between Labor Day and the election. I
would strongly recommend that if the President is going
to make a major health address, this forum be used.
FORD :- LIBRARY 07V8.35
THE WHITE HOUSE
WASHINGTON
K-
close
out!
G.
RECEIVED
AUG 21976
CENTRAL FILES
THE WHITE HOUSE
WASHINGTON
July 22, 1976
MEMORANDUM FOR:
JIM CANNON
FROM:
WILLIAM NICHOLSON
WN
SUBJECT:
Invitation to the President to address
American Hospital Association convention
to be held September 20-23 in Dallas
I would appreciate your comments and recommendation on the attached
invitation to the President.
Thank you.
COMMENTS:
EXECUT
Ir/1976/5T43/Dallad
July 22, 1976
MEMORANDUM FOR:
JIM CANNON
FROM:
WILLIAM NICHOLSON
SUBJECT:
Invitation to the President to address
American Hospital Association convention
to be held September 20-23 in Dallas
I would appreciate your comments and recommendation on the attached
invitation to the President.
Thank you.
COMMENTS:
FORD 2 LIBRARY 938870
RECEIVED
JUL 23 1976
CENTRAL FILES
\
EXECUTIVE
July 19, 1976
Dear Mr. McMahon:
On behalf of the President, I wish to acknowl-
edge and to thank you for the letter you addressed
to him on June 30 in which you invited him to
appear before the American Hospital Association
convention in Dallas on Monday September 20 or
on Thursday, September 23.
We are carrying this invitation forward for
consideration as the President's calendar for
this time frame is under advisement and we will
be back in touch with you as soon as it is
possible to give you a more definite answer.
In the meantime, please be assured of the
President's appreciation for your thoughtful-
ness and his warm, good wishes.
Sincerely,
William W. Nicholson
Director
Scheduling Office
Y
Mr. J. Alexander McMahon
President
X
American Hospital Association
840 North Lake Shore Drive
Chicago, Illinois 60611
cc/w incmg to M. Widner for Sept. 20 folux follow_ up
CC: two opies to nancy Gemmell
and
jeh
9
RECEIVED
JUL201976
CENTRAL FILES
HOSPITAL
AMERICAN
MM
ASSOCIATION
American Hospital Association
FOUNDED
-2581
J. ALEXANDER McMAHON
President
June 30, 1976
My dear Mr. President
A recent Gallup Poll indicated that the American public
considers the issue of health care one of the highest
priorities that the federal government can address.
Therefore, it is appropriate and it is with pleasure
that the $40 billion hospital industry offers you a
forum before our Association convention in Dallas,
September 20-23, 1976.
The American Hospital Association represents most of
the nation's 7,000 hospitals who are providing inpatient
and outpatient care for approximately 150 million people
this year.
Other U.S. Presidents, including your predecessor, have
used this industry's rostrum to discuss health and
related issues. More than 14,000 delegates, who repre-
sent three million hospital employees, are expected at
Dallas for this annual conference which will be heavily
covered by the national media, as well as the health
care press. These delegates, and the hospital industry,
would be most anxious to hear how you perceive the issue
of health care in the next four years.
We would be pleased to have you speak either to our
plenary session on Monday, September 20, or the plenary
session on Thursday, September 23. These sessions will
be of equal length, and we are also offering Mr. Carter
the same opportunity to speak at one of these sessions.
840 North Lake Shore Drive
Chicago, Illinois 60611
312 645-9400
President Ford/2
6/30/76
So that the necessary arrangements can be made, may I
hear from you as soon as possible.
Sincerely yours
J. Alexander McMahon
cc: Mrs. Mary Louise Smith
Chairman
National Republican Party
President Gerald R. Ford
The White House
Washington, DC 20500
THE WHITE HOUSE
WASHINGTON
July 30, 1976
MEMORANDUM FOR:
JIM CANNON
FROM:
SPENCE JOHNSO
Invitation to of the President to address
SUBJECT:
American Hospital Association convention
to be held September 20 - 23.
This would be an excellent opportunity for the President
to make a major health policy statement in the Fall. This
will beathe largest health conference with nationwide
representation between Labor Day and the election. I
would strongly recommend that if the President is going
to make a major health address, this forum be used.
976 AUG 2
FORD is LIBRARY GERALD
MAssengale
July 22, 1976
MEMORANDUM FOR:
JIM CANNON
FROM:
WILLIAM NICHOLSON
SUBJECT:
Invitation to the President to address
American Hospital Association convention
to be held September 20-23 in Dallas
1 would appreciate your comments and recommendation on the attached
invitation to the President.
Thank you.
COMMENTS:
BERALD FORD LIBRAPT
CC: Art Quern
Staffed out by comp.
THE WHITE HOUSE
H.E.W.
WASHINGTON
August 5, 1976
ADMINISTRATIVELY CONFIDENTIAL
FORD i LIBRARY GERALD
MEMORANDUM FOR:
JIM CANNON
FROM:
JIM CONNORS JEE.
The attached articles were returned in the President's outbox with
the following notation:
"Good P.R."
Please follow-up with appropriate action.
CC: Dick Cheney
The Atlanta Tournal
Covers Dixie Like the Dew
Since 1883
James M. Cox, Chairman 1939-1957 - James M. Cox Jr., Chairman 1957-1974
Jeck Torver, Publisher
Jack Spalding, Editor
14-A *****
JULY 26, 1976
Worth Trying
PAGE 12
THE INDIANAPOLIS STAR
Where the Spirit of the Lord is, there is Liberty
II Corinthians 3:17
EUGENE C. PULLIAM-1889-1975
Publisher 1944-1975
EUGENE S. PULLIAM, Publisher
"Let the people know the, facts and the
country will be saved. "-Abraham Lincoln
Asking The People
THE DALLAS TIMES HERALD
EDITORIALS
2-C**** Tuesday, July 27, 1976,
Regulations reform
, illiens
Page A4-Austin, Texas
Tuesday, July 27, 1976
Jim Fain, Publisher; Ray Mariotti, Editor; Bill Meroney,
General Manager; Bob Easter, Circulation Director; Tim
Brown, Systems Director; Everett Bushell, Advertising
Director; George W. Spaulding, Classified Manager.
Public agency
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Monday, July 26, 1976
BYRON V. BOONE, Publisher
ROBERT E. LORTON, President
SID STEEN, Executive Editor
WALTER BISCUP, Editor of Editorial Page
PHIL DESSAUER, Associate Editor
ALEX ADWAN, Associate Editor
TRAVIS WALSH, Managing Editor
BIBLE THOUGHT
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10
Wednesday, July 28, 1976
Slower to Regulate
S. Fowler
The l'uscaloosa News
Tommy -7-
45-7263
EDITORIALS and COMMENTS
Stevenson
This page contains opinions and comments. Editorials in the lefthand column express The News'
News Staff Writer
viewpoints. Other Items which appear are expressions of those whose name appears and may. or may not,
reflect The News opinions. Comments on subjects of general public interest from readers are accepted
All letters must be signed, home address given, and conform to published standards limiting length to 300
words, be in good taste and reason THE EDITORS.
Monday, July 26, 1976 3
HEW to seek public's
It appears the U.S. Department of
Health, Education and Welfare has
ended up with egg on its bureaucratic
advice
face once too often and HEW Secretary
-5- -
San Francisco OF WEST Chronicle
Founded 1865 by Charles and M. H. de Young
George T. Comeron, Publisher 1925-55
Charles de Young Thieriot
Editor and Publisher
Gordon Pates
Richard Thieriot
Managing Editor
Associate Editor
Templeton Peck
Editorial Page Editor
Editorials
Public Input
To HEW Rules
-3-
22-A MORNING ADVOCATE, Baton Rouge, La., Wed., July 28, 1976
:
Editorial
Taking Bureaucracy
Out of the Vacuum
Herbert S. Fowler
The Tuscaloosa News
245-7263
-6-
EDITORIALS and COMMENTS
This page contains opinions and comments. Editorials in the lefthand column express The News'
viewpoints. Other Items which appear are expressions of those whose name appears and may, or may not,
reflect The News' opinions. Comments on subjects of general public interest from readers are accepted.
All letters must be signed, home address given, and conform to published standards limiting length to 300
Editorials
words. be in good taste and reason THE EDITORS
July 25, 1976
Reforms
HEW Secretary Mathews is to be commended
for his revamp efforts
EDITORIALS
Associate Editor
HEW Reform of Regulations
The Miami Herald
JAMES L. KNIGHT, Chaitman
LEEVILLS, Publisher ALVAH H. CHAPMAN, H., President DON SHOEMAKER, Editor BEVERLY R. CARTER, Gen. Mgr.
Is Good News for the Public
LAWS passed by Congress may not
fies a contrite Secy. Mathews, "when
GEORGE BEEBE, Associate Publisher LÀRRY JINKS, Executive Editor JOHN D. PENNEKAMP,
mean anything, as Bill Klem would say,
the need for a regulation arose, the De-
until they are interpreted in the Federal
partment consulted largely with groups
Register or other nosy places by the
having a special interest in a given pro-
federal regulatory
gram and then. proposed a regulation
RON MARTIN, Managing Editor
Sunday, July 25, 1976
sencies.
which often reflected their common
As the immortal
preconceptions. The public at large was
baseball umpire ex-
shut out of the process." For an agency
plained, "Some of
which was created 23 years ago (and is
em is strikes, and
old enough to vote: this, pray, is an
some of 'em is
election year) the confession is sensa-
balls, but they ain't
tional.
nothing until I calls
JOHN S. KNIGHT, Editor Emeritus
But we think Secy. Mathews ought
em."
to be taken at his word. The whole
Well, sir, the
subject of government regulation, as
worm is turning at
President Ford has emphasized often,
least several de-
needs the swift broom of reform.
grees. Health, Edu-
Mathews
cation and Welfare
Some businesses which otherwise are
BRO
Secretary David Mathews announces
quick to bernoan the stern eye of gov-
that HEW today is instituting "sweep-
ernment, actually like regulation and
ing reforms in the way the Department
are aghast when it is criticized as a
develops and issues its regulations.
form of governmental oppression of
2-E
"Most extreme of these," he goes on,
free enterprise competition.
is the requirement for HEW to consult
In the main, however, most regula-
ceoments of the public before it
tion is counterproductive It increases
Daily Record
Our Opinion
Morristown, N.J.
July 27, 1976
HEW Reforms
no you believe in the HE'W That is
A Good Idea
Many critics, by no means all of
service announcemer
them political conservatives, have
releases, professional a
complained of growing im-
organizations, maili
periousness on the part of some of-
Federal Register, and t
ficials within the huge
ment's 10 regional off
bureaucracy of the federal Depart-
regional office for Vir
ment of Health, Education and
Philadelphia.) Some
Velfare (HEW). A recent decree
methods of communica
Janning father-son, mother-
similar to what the fede
daughter outings at public
ment already is doing,
chools-a decree promptly
like the use of public n
Suspended by an angry President
hear the opinions prior 1
Ford-was editorially lambasted
tion of regulations, do a
as "civil rights madness" by the
innovative.
Iberal Washington Post, for ex-
Other changes call
emple.
Mathews are training s
Last week, Rep. G. William
HEW officials in how
/hitehurst, R-Va., scored a re-
regulations in clear
Cional HEW official for "bureau-
English (now there'
cratic arrogance" because
revolutionary proposal
of his alleged refusal to an-
review of regulations to
wer questions of a Norfolk news-
are doing what was ínt
Richmond Times-Dispatch
ALAN $. DONNAHOE, President and Associate Publisher
paper reporter aboût how funds
modification of regula
DAVID TENNANT BRYAN, Chairman and Publisher
JOHN E LEARD, Executive Editor ALF GOODYKOONTZ, Managing Editor
EDWARD GRIMSLEY, Editor of the Editorial Page
were spent for certain social
impose too many or to
programs. (HEW has a $128 billion
requirements on pro
udget this year.) Whitehurst said
ministrators.
has demanded a full accounting
Secretary Mathews s
Monday, July 25, 1976
expenditures for the programs
given credit for a good
question.
Examples of the problem could
all up this page and then some. But
last comes an indication that the
roblem is recognized at
HEW-by the top man, at least, if
not necessarily by all his un-
derlings.
HEW Secretary David Mathews
announced yesterday a package
of "reforms" that is meant to give
the general public more of a say in
NEW regulation-writing. The
regulatory process is HEW's most
intrusive channel into people's
Aves, said Mathews, declaring:
Perts
*For far too long HEW has gone to
Mathews
Wash. Post
July 27, 1976, EDIT.
!
HEW and Rulemania
The Washington Star
JOE L ALLERITTON, Publisher
JAMES G. BELLOWS Editor
SIDNEY EPSTEIN, Managing Editor EDWIN M. YODER JR., Associate Editor
FRIDAY, JULY 23, 1976
HEW: Regulating the regulators
Rile
HEW
THE WHITE HOUSE
WASHINGTON
August 12, 1976
MEMORANDUM FOR:
FROM:
JIM CANNON
I am writing in response to your memoranda of July 16
SECRETARY Jan DAVID MATHEWS
and June 18 in which you propose to create an interagency
committee to review and coordinate Federal agency policies
and actions in DNA research supported or conducted by NIH
in light of the recent NIH guidelines.
Since you would have the authority to establish the committee
without the President's approval, according to the General
Counsel of HEW, we have no objection and feel the decision
is best made by you.
If you decide to create such a committee and feel that a
letter from the President to the heads of departments and
agencies urging their cooperation would be useful, please
send me a draft letter.
FORD is LIBRARY GERALD
FOR IMMEDIATE RELEASE
August 6, 1976
Office of the White House Press Secretary
THE WHITE HOUSE
STATEMENT BY THE PRESIDENT
I have been following with great concern the investigations
into the cause of the tragic outbreak of illness in Pennsylvania
this past week. All Americans join me, I am sure, in their
sympathy for the families of the more than 20 people who have
died and their hope for the speedy recovery of those people
currently under treatment.
I am greatly relieved that these tragic deaths were not
the result of swine flu. But let us remember one thing:
they could have been. The threat of swine flu outbreak this
year is still very genuine. Data from the scientific
community still clearly supports the need for a full-scale
inoculation program. Clinical tests conducted to date
clearly demonstrate that the vaccine is both safe and
effective. There is no excuse to let the legislative program
that I proposed seven weeks ago a program that could safeguard
the lives of many, many Americans - be delayed any longer.
Health, Education, and Welfare Secretary Mathews and the
leaders of Congress reported to me on Wednesday that after
long hours of hearings, discussions, and negotiations, Congress
finally would act yesterday to pass legislation to provide
swine flu vaccine to all the American people. Needless to
say, I was keenly disappointed to learn last evening that the
news from the doctors in Pennsylvania has led to another
slowdown in the Congress.
I am frankly dumb founded that Congress, which took
the time and effort to enact 111-advised legislation to
exempt its own Members from State income taxes, has failed
to act to protect 215 million Americans from the threat
of swine flu. Drug manufacturers have produced over 100
million doses of swine flu vaccine in bulk form, but the
vaccine has not been prepared in suitable dosage form,
pending action by the Congress.
Because of these legislative delays, we are, at this
moment, at least six weeks away from beginning an effective
inoculation program. Had Congress acted promotly after I
submitted my proposal we would have been in a position to
dispatch shipments of vaccine today.
As President, I cannot accept any further dilly-dallying
by the Congress on this legislation that could be vital to
the health and safety of our people.
I call on the Congress to act quickly before its
next recess - so that the health of the American people
will be fully protected.
##
GERALD FORD LIBRARY
Rile - abortions
THE WHITE HOUSE
Health
WASHINGTON
August 27, 1976
MEMORANDUM FOR:
DICK CHENEY
THRU:
JACK MARSH
FROM:
MAX FRIEDERSDORF
M.
Press inquiries have been received from Nick Thimmesch
and John Lofton regarding the administration's position
on the amendment to the Labor/HEW appropriations bill
banning the use of federal funds for abortions.
As you know, the Hyde amendment passed the House and is
in disagreement with the Senate version.
The inquiries from Lofton to me came in the form of a letter
which I have merely acknowledge.
Thimmesch's questions came after I retured his fifth phone
call this afternoon with the concurrence of Jack Marsh
who anticipated what the question might be.
Thimmesch said that Carter has taken a position in support
of the Hyde amendment which, of course, if inconsistent with
other Carter statements and the Democratic platform.
At the time of the floor consideration of the Hyde amendment
Hyde requested our position and I ran the amendment through
the system here at the White House but we never took a
formal position.
I recommend this issue be analyzed by Jim Cavanaugh and Mike
Duval because I am sure we can anticipate further press
inquiries because of the strong focus on the Congressional
legislation.
CC:
Ron Nessen
Jim Cavanaugh
Mike Duval
Jim Cannon
GERALD FORD LIBRARY
File
THE WHITE HOUSE
WASHINGTON 8/27/76
Jack -
who is
handling
domestic policy
fitues now?
FORD & GERALD LIBRARY
Donester comicil?
or others ?
Jui