Reports & Studies

The Committee on Economic Security (CES)

"Social Security In America"

Part III

SECURITY FOR CHILDREN

Chapter XVI

A PROGRAM OF SPECIAL SECURITY MEASURES FOR CHILDREN

THE PROPOSALS incorporated in the program which is outlined in this chapter were prepared in the light of the reports presented to the medical and public-health advisory committees and were developed in consultation with the child-welfare advisory committee.{l} The reports and discussions of these groups emphasized the necessity of developing coordinated public-health and social-welfare programs covering all types of need, with definite provision for participation of the Federal Government, the States, and local communities.

The recommendations of the Committee on Economic Security for legislation to promote the security of children were largely incorporated in the Social Security Act, as may be seen from a comparison of the proposed program with the provisions of the Social Security Act, which are described in the final section of this chapter:

THE PROGRAM PROPOSED

It was considered that Federal, State, and local participation would be necessary for the development of more adequate and more generally available public-welfare services for children. The term "child-welfare services" covers a wide range of activities receiving support from State and local governments and to a very considerable extent from voluntary contributions. It was felt that three forms of public service needed strengthening through a cooperative Federal, State, and local program, namely, (1) care of dependent children in their own homes (aid to dependent children); (2) welfare services for children needing special care, such as homeless and neglected children and children whose surroundings are such as gravely to impair their physical and social development; (3) services for maternal and child health, including services for crippled children. These three groups of measures are closely related, one to the other, for child health is dependent upon adequate home care, and conversely, family life and child development are profoundly affected by

{1} See appendix III for a list of members of these committees.

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the health of mothers and children. Briefly, the proposals were as follows:

(1) Strengthening and expansion of the system giving aid to dependent children, which provides home care for children deprived of parental support. It was estimated that approximately $25,000,000 a year from Federal funds would be required for aid to dependent children for the first 2 years, rising to a possible maximum of $50,000,000 as the program developed. The Federal Government has been spending much more than $25,000,000 on relief families that would probably be eligible for aid to dependent children.

(2) Strengthening of State and local services for the protection and care of homeless and neglected children and children in danger of becoming delinquent, through a joint program of service supported by State and local funds with the assistance of Federal grants-in-aid. An appropriation of $1,500,000 a year was proposed for assistance to State welfare departments in promoting more adequate care and protection of children and strengthening local public services.

(3) A maternal and child-health program involving Federal assistance to the States, and through the States to local communities, in the extension of maternal and child-health services, especially in rural areas, including (a) education of parents and professional groups in maternal and child care and supervision of the health of expectant mothers, infants, preschool and school children, and children leaving school for work; (b) provision for rural maternal-nursing service; (c) demonstration and research in child and maternal care, with special emphasis on the problems of rural mothers; and (d) provision for medical and other care for crippled children in counties predominantly rural. It was recommended that the program be developed under the leadership of public-health authorities in close cooperation with medical and public-welfare agencies and groups and other agencies, public and private, concerned with these problems. It was estimated that approximately $7,000,000 a year would be required for this program, to be increased as the program develops.

Aid to Dependent Children.-Local administration of aid to dependent children, now vested in various local agencies, should be brought as soon as possible into a unified public-welfare administration. State administration should be vested in a State welfare department, and Federal administration should be brought into close relationship with other forms of Federal relief and welfare service. In the absence of a permanent Federal department of public welfare it was proposed that Federal administration be placed in the Children's Bureau of the United States Department of Labor.

The plan proposed was based upon a gradual expansion of the program giving aid to dependent children as State laws, State and local appropriations, and administrative facilities were broadened and developed to take care of the increased load. It was recognized that this method would not immediately release emergency relief administrations, Federal, State, and local, from responsibility for the care of children deprived of parental support. Administration of the new plan would have to be developed in the light of general relief policies and coordinated with the services of relief administrations, or of welfare administrations taking over responsibilities for general relief. The extent to which States would be induced to increase State appropriations for aid to dependent children on a basis of a Federal contribution of one-half of the combined State and local expenditures would depend upon the general policies developed as part of a comprehensive program of Federal, State, and local responsibility for relief and welfare services. It is obvious that States receiving a very high proportion of their total relief expenditures from the Federal Government would be reluctant to transfer relief cases to the system for aid to dependent children. Moreover, many States would receive comparatively little benefit from Federal assistance in a program for aid to dependent children until they were in a position to increase substantially their State appropriations for this purpose. In order to stimulate the extension of aid to dependent children to States and areas in which this service was neglected or inadequately provided, it was, proposed that a portion of the Federal appropriation be set aside at the beginning of each year as a reserve and discretionary fund, to be available for States not able immediately to contribute two-thirds of the total expenditures through State and local funds.

Welfare Services for Children Needing Special Care.-Federal administration should be coordinated with other features of a unified public-welfare program. The Children's Bureau of the United States Department of Labor has had many years of experience in cooperating with State and local welfare agencies and has been designated as the Federal administrative agency, cooperating with the State departments of public welfare in the development of the services provided.

The proposed plan of Federal participation with the States in the development of child-welfare services included the following recommendations:

That the Federal aid for this purpose in the social security program be designed to enable the Federal Government to cooperate with the States and Territories, and through them with local gov-

ernments, in the protection and care of homeless, dependent, and neglected children, and children in danger of becoming delinquent, through encouraging and assisting in the development of adequate methods of community organization for child welfare, and giving financial assistance to local public-welfare services for children, especially in rural areas and other areas of special need.

Maternal and Child-Health Program.-In order to promote Nation-wide interest in and facilities for adequate State programs for the protection of the lives and health of mothers and children, it was recommended that the Federal Government participate through the Children's Bureau with States and through States with local communities in programs for maternal and child health. That the ability of local communities and States to finance such programs varies greatly according to their resources is common knowledge. Many States have never been able to carry on adequate programs and within States many communities are without resources or have very limited resources for such work with mothers and children. To provide more equitable distribution of the opportunities for education and for service to mothers and children in the various States and local communities and to promote improved methods of administration and care, Federal funds were made available to States in the past and should again be provided.

The function of the Federal administrative bureau would be primarily consultative, educational, and promotional, with the power of approval of plans made by State departments of health receiving Federal funds for cooperative Federal-State programs. The consultative and promotional functions would be exercised through a field Staff medical, nursing, and other; the educational function through demonstrations of special maternal and child-health services in cooperation with State health departments and through the provision of opportunities for certain types of professional education, such as institutes and "refresher" courses. On the administrative side the Federal Government would assist States in building up well-staffed divisions of maternal and child health and through such divisions improve services to mothers and children in local communities. The general program to be developed in States receiving Federal aid or in local communities receiving combined State and Federal aid, and the standards for personnel and procedure, should be in accordance with generally accepted public-health practice, as determined by the Children's Bureau previous to the making of grants.

In addition, the Federal Government, through the Children's Bureau, should undertake further research and conduct investigations or demonstrations that have to do with the health or mortality

of mothers and children or with improvement in methods of care that cannot be conducted by individual States or communities. As part of its program of demonstration and investigation the Children's Bureau, through its various divisions, would promote joint activities among groups interested in various phases of child welfare, as, for instance, further community demonstrations in the field of delinquency and its relation to mental health and recreation, and studies of health of children entering employment.

Under the provisions for Federal aid to States, funds would be made available for four general purposes:

First, a general program to stimulate the development of more adequate State divisions of maternal and child health and through them to build up improved health services to mothers and children in local communities, especially those in rural areas and in areas in economic need. The development of this general program of maternal and child care would be considered a prerequisite to participation in the second program.

Second, a program of maternity nursing for delivery and postpartum care of mothers in rural areas. The need to develop this special aspect of the general maternal-care program is very great. Few mothers have this service in the smaller cities or towns or in rural areas, yet it is of great importance in the program for the reduction of maternal deaths.

Third, a program of demonstration and research in child and maternal care, with special emphasis on the problems of rural mothers.

Fourth, a program of aid to States for medical care and other services for crippled children in counties predominantly rural.

PROVISIONS OF THE SOCIAL SECURITY ACT {2}

In addition to the indirect benefits to children provided by other titles of the Social Security Act, grants-in-aid to the States for promoting the health and welfare of children are provided specifically in title IV,{3} Grants to States for Aid to Dependent Children, and title V,{4} Grants to States for Maternal and Child Welfare. These grants must be considered in relation to the grants for health and welfare services authorized in other portions of the act, especially title I, Grants to States for Old-Age Assistance, title X, Grants to States for Aid to the Blind, and title VI, Public Health Work.

{2}Ch. 531, 49 Stat. 620; U. S. C. (1935 Supp.). Secs. 301-1305.

{3}49 Stat. 627 ; 42 U. S. C. (1935 Supp. ) , Secs. 601-606.

{3} 49 Stat. 629 ; 42 U. S. C. (1935 Supp.), Secs.701-731.

Aid to Dependent Children.-The Social Security Act in title IV establishes a system of Federal-State cooperation under the administration of the Social Security Board "for the purpose of enabling each State to furnish financial assistance, as far as practicable under the conditions in such State, to needy dependent children." A sum of $24,750,000 {5} was authorized for appropriation for the fiscal year ending June 30, 1936, and for each fiscal year thereafter a sum sufficient to carry out the purposes of the title was authorized for appropriation. The Federal funds authorized are to be used for making payments to States which have submitted and had approved by the Board State plans for aid to dependent children.

The requirements for approval are summarized with other provisions of title IV in table 64. To receive Federal approval a State plan for aid to dependent children must be effective in all political subdivisions of the State, and, if administered by them, must be mandatory upon them; it must provide for financial participation by the State; it must provide either for the establishment or designation of a single State agency to administer or supervise the administration of the plan; it must provide an opportunity for a fair hearing before the State agency to any individual whose claim with respect to aid to a dependent child is denied; it must provide such methods of administration (other than those relating to selection, tenure of office, and compensation of personnel) as are found by the Board to be necessary for the efficient operation of the plan; and it must provide that the State agency will make such reports, in such form and containing such information as the Board may from time to time require, and comply with such provisions as the Board may from time to time find necessary to . assure the correctness and verification of such reports.

In addition to these requirements established as a condition for the receipt of Federal grants, the Board is not permitted to approve any State plan which imposes as a condition for eligibility for aid to dependent children a residence requirement which denies aid with respect to any child residing in the State who has resided in the State for 1 year immediately preceding the application for aid, or who was born within the State within 1 year immediately preceding the application, if its mother has resided in the State for 1 year immediately preceding the birth.

{5}The Social Security Act was not approved until Aug. 14, 1935, and the supplemental appropriation bill, fiscal year 1936 [H. R. 9215], failed of passage in the first session of the Seventy-fourth Congress. The Supplemental Appropriation Act, fiscal year 1936, Public, No. 440, 74th Cong., 2d sess. [H.R. 10464], approved Feb. 11, 1936, included an appropriation of $5,000,000 for the remainder of the fiscal year ending June 30, 1936.

Aid to dependent children is defined as money payments with respect to a child or children under the age of 16 who have been deprived of parental support or care by reason of the death, continued absence from home, or physical or mental incapacity of a parent, and who is living with his father, mother, grandfather, grandmother, brother, sister, stepfather, stepmother, stepbrother, stepsister, uncle, or aunt, in a place of residence maintained by one or more of such relatives as his or their own home.

The amount of Federal aid to the States will be determined from State estimates of their quarterly expenditures for aid to dependent children, together with records of the number of dependent children in the State. The Federal Government will pay for each quarter an amount, which shall be used exclusively for carrying out the State plan, equal to one-third of the total of the sums expended during such quarter under such plan, not counting so much of such expenditure with respect to any dependent child for any month as exceeds $18, or, if there is more than one child in the same home, as exceeds $18 for any month with respect to one such dependent child and $12 for such month with respect to each of the other dependent children.

Prior to the beginning of' each quarter the Board will estimate, the amount to be paid to each State with an approved plan for aid to dependent children for each quarter. These estimates will be based upon (1) reports filed by the State agency containing its estimates of the sums to be expended in the quarter under the plan, (2) records showing the number of dependent children in the State, and (3) such other investigation as the Board may find necessary. The amount to be appropriated or made available by the State and its political subdivisions must be shown in the report of estimated quarterly expenditures. If this amount is less than two-thirds of the total sum of the estimated expenditures, the source or sources from which the difference is expected to be derived must be reported to the Social Security Board.

The Board will then certify to the Secretary of the Treasury the amount of Federal grant to the State, reduced or increased, as the case may be, by any sum by which it finds that its estimate for any prior quarter was greater or less than the amount which should have been paid to the State for such quarter, except to the extent that such sum has been applied to make the amount certified for any prior quarter greater or less than the amount estimated by the Board for such prior quarter. The Secretary of the Treasury, through the Division of Disbursement of the Treasury Department and prior to audit or settlement by the General Accounting Office, will pay to the State, at the time or times fixed by the Board, the amount certified as the Federal grant to the State for aid to dependent children.

If the Social Security Board finds after a State plan for aid to dependent children has been approved that it has been changed so as to impose a prohibited requirement or that in its operation there is failure to comply with required conditions for approval, the Board must notify the State agency that further Federal payments will not be made. Such suspension of Federal grants will be preceded by reasonable notice and opportunity for hearing to the State agency, and Federal grants will be resumed when the Board is satisfied that the prohibited requirement is no longer imposed and that there is no longer any failure to comply.

Maternal and Child-Health Services: The annual appropriation authorized under title V, part 1, of the act {6} is $3,800,000 {7} "for the purpose of enabling each State to extend and improve, as far as practicable under the conditions in such State, services for promoting the health of mothers and children, especially in rural, areas and in areas suffering from severe economic distress." The act provides that "the sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Chief of the Children's Bureau, State plans for such services." To be approved by the Chief of the Children's Bureau, a State plan for maternal and child-health services must provide for financial participation by the State; provide for administration or the supervision of administration by the State health agency; provide such methods of administration (other than those relating to selection, tenure of office, and compensation of personnel) as are necessary for the efficient operation of the plan; provide that the State health agency will make such reports, in such form and containing such information, as the Secretary of Labor may from time to time require, and comply with such provisions as the Secretary of Labor may from time to time find necessary to assure the correctness and verification of such reports; provide for the extension and improvement of local maternal and child-health services administered by local child-health units; provide for cooperation with medical, nursing, and welfare groups and organizations; and provide for the development of demonstration services in needy areas and among groups in special need.

The conditions under which a State may receive Federal funds for maternal and child-health services are summarized in appendix XII, together with other provisions of the act relating to Federal grants.

{6} 49 Stat. 629, Sec. 501; 42 U.S.C. (1935 Supp.), § 701.

{7} The Social Security Act was not approved until Aug. 14, 1935, and the supplemental appropriation bill, fiscal year 1936 [H. R. 9215], failed of passage in the first session of the Seventy-fourth Congress. The Supplemental Appropriation Act, fiscal year 1936, Public, No. 440, 74th Cong., 2d sess. [H. R. 10464], approved Feb. 11, 1936, included an appropriation of $1,580,000 for the remainder of the fiscal year ending June 30, 1936.

Allotments to the States from this appropriation are directed by section 502 {8} of the act to be made by the Secretary of Labor on the following basis: An initial uniform allotment of $20,000 {9} to each State, (Hawaii, Alaska, and the District of Columbia are considered as States for the purposes of the act), an additional allotment based on the ratio of live births in the State to the total number of live births in the United States, and an allotment of $980,000 {9} based upon the need of the State for financial assistance in carrying out its State plan, the number of live births in the State being taken into consideration. Funds allotted under this latter provision need not be matched. Other allotments are to be matched equally by State or State and local funds.

Services for Crippled Children.-The annual appropriation authorized under title V, part 2, of the act {10} is $2,500,000 {11}"for the purpose of enabling each State to extend and improve (especially in rural areas and in areas suffering from severe economic distress), as far as practicable under the conditions in such State, services for locating crippled children and for providing medical, surgical, corrective, and other services and care, and facilities for diagnosis, hospitalization, and aftercare, for children who are crippled or who are suffering from conditions which lead to crippling." Plans for such services are to be submitted to the Chief of the Children's bureau for approved.

The Social Security Act specifies the conditions which a State plan for services for crippled children must meet in order to receive the approval of the Chief of the Children's Bureau. The State plan must provide for financial participation by the State; provide for the administration of the plan by a State agency; provide such methods of administration (other than those relating to selection, tenure of office, and compensation of personnel) as are necessary for the efficient operation of the plan; provide that the State agency will make such reports, in such form and containing such information as the Secretary of Labor may from time to time require, and comply with such provisions as the Secretary of Labor may from time to time find necessary to assure the correctness and verification of such reports; provide for carrying out the purposes of section 511, quoted in the paragraph above; and provide for cooperation with medical, health,

{8} 49 Stat. 629, 42 U. S. C. (1935 Supp.); 702.

{9}The Supplemental Appropriation Act, fiscal year 1936, Public, No. 440, 74th Cong., 2d sess. [H. R. 10464], approved Feb. 11, 1936, cut the allotment to five-twelfths of the amount specifically authorized in the Social Security Act. (see also footnote 7.)

{10} 49 Stat. 631, Sec. 511; 42 U. S. C. (1935 Supp. ), Sec. 711.

{11} The Social Security Act was not approved until Aug. 14, 1935, and the supplemental appropriation bill, fiscal year 1936 [H. R. 9215], failed of passage in the first session of the Seventy-fourth Congress. The Supplemental Appropriation Act, fiscal year 1936, Public, No. 440, 74th Cong., 2d sess. [H. R. 10464], approved Feb. 11, 1936, included an appropriation of $1,187,000 for the remainder of the fiscal year ending June 30, 1936.

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nursing, and welfare groups and organizations and with any agency in such State charged with administering State laws providing for vocational rehabilitation of physically handicapped children. (See appendix XII for a summary of the provisions of the Social Security Act relating to Federal grants for services for crippled children as well as those relating to the other grant features of the act.)

Allotments for services for crippled children {12} are on the following basis: A uniform grant of $20,000 {13}available to each State and the balance available according to the need of each State as determined by the Secretary of Labor after taking into consideration the number of crippled children in such State in need of the services referred to in section 511 and the cost of furnishing such services to them. These grants are to be matched dollar for dollar by State or State and local funds.

Child-Welfare Services.-The annual appropriation authorized by this part of the act {14} is $1,500,000 {15} "for the purpose of enabling the United States, through the Children's Bureau, to cooperate with State public-welfare agencies in establishing, extending, and strengthening, especially in predominantly rural areas, public-welfare services (hereinafter in this section referred to as `child-welfare services') for the protection and care of homeless, dependent, and neglected children and children in danger of becoming delinquent." The Federal funds are to be allotted by the Secretary of Labor for use by cooperating State public-welfare agencies on the basis of plans developed jointly by the State agency and the Children's Bureau. Unlike funds allotted for maternal and child-health services and services for crippled children, these funds do not have to be matched by the States. A uniform allotment of $10,000{16} is available to each State and the remainder is allotted on the basis of the ratio of the rural population of the State to the total rural population of the United States. Although there is no provision for matching funds, the act indicates that there must be financial participation by the State or by local communities, since the act iequires that "the amount so allotted shall be expended for payment of part

{12} 49 Stat. 631, § 512 ; 42 U. S. C. (1935 Supp. ), § 712.

{13}The Supplemental Appropriation Act, fiscal year 1936, Public, No. 440, 74th Cong., 2d sess. [H. R. 10464], approved Feb. 11, 1936, cut the allotment to five-twelfths of the amount specifically authorized in the Social Security Act. (See also footnote 11.)

{14} 49 Stat. 633, § 521; 42 U. S. C. (1935 Supp.), § 721.

{15} The Social Security Act was not approved until Aug. 14, 1935, and the supplemental appropriation bill, fiscal year 1936 [H. R. 9215], failed of passage in the first session of the Seventy-fourth Congress. The Supplemental Appropriation Act, fiscal year 1936, Public, No, 440, 74th Cong., 2d sess. [H. R. 10464], approved Feb. 11, 1936, included an appropriation of $625,000 for the remainder of the fiscal year ending June 30, 1936.

{16} The Supplemental Appropriation Act, fiscal year 1936, Public, No. 440, 74th Cong., 2d sess. [H, R. 10464], approved Feb. 11, 1936, cut the allotment to five-twelfths of the amount specifically authorized in the Social Security Act. (See also footnote 15.)

of the cost of district, county, or other local child-welfare services in areas predominantly rural, and for developing State services for the encouragement and assistance of adequate methods of community child-welfare organization in areas predominantly rural and other areas of special need." Another difference between part 3 (childwelfare services) and parts 1 and 2 (maternal and child-health services and services for crippled children) lies in the provisions relating to approval of State plans. No conditions are prescribed for approval of State plans for child-welfare services other than that they are to be "developed jointly" by the State agency and the Children's Bureau. Appendix XII gives in tabular form a comparative analysis of all the provisions of the Social Security Act relating to Federal grants to States.