and participate in the health and medical assistance benefits made available as a matter of national policy by the Social Security Amendments of 1965, Public Law 89-97. We hold that to hesitate or defer enactment of HR 3972 constitutes prolonging the hardship not only to individual taxpayers of the District of Columbia but denial to those in need of that health and Medical assistance which is rightfully theirs to receive. The trials and burdens of poverty further compounded by poor health so thoroughly deprives the spirit that there is little meaning or opportunity left to life. In our service responsibility as a health agency we see ample evidence of the consequences illustrated every day as people ignore social and legal restrictions of the community to indulge in the only self expression they see open to them. The high incidence of venereal disease and illegitimacy, owes its existence, in part, to the misguided effort to loose the bonds. We anticipate that passage of HR 3972 will open the way to subsequent changes in the District policies giving these people new hope and enthusiasm for wholesome living. The Social Hygiene Society of Metropolitan Washington urges your support of early enactment of HR 3972. Sincerely yours, WILLIAM F. BENEDICT (For the Board of Directors). JEWISH FOUNDATION FOR RETARDED CHILDREN, INC., CONGRESSMAN JOHN DOWDY, Chairman, House District Committee 3, DEAR CONGRESSMAN DOWDY: The Jewish Foundation for Retarded Children would like to urge you to enhance the passing of Bill HR 3972 which was introduced on January 26, 1967, in the 90th Congress. This Bill will authorize the Commissioners of the District of Columbia to take the necessary action in amending rules and regulations to permit the District to qualify for Federal reimbursement for costs of medical assistance made available under Title XIX of Public Law 89-97. This legislation is indeed of utmost importance for the afflicted residing in the District of Columbia and it will become even more crucial when Title 18 of the same Bill will become operative. A great number of afflicted children are awaiting this new legislation and we hope that your Committee will deem it urgent and necessary to recommend it for passage by Congress. We are fully aware of the tremendous burden the 90th Congress carries in the area of social legislation but in the name of the many afflicted individuals in the District of Columbia we hope that Congress will find effort and time to pass this legislation in their behalf. Wishing you luck in all of your endeavors. Attention: Mr. James Clark. ERWIN FRIEDMAN, PH. D., Director. WASHINGTON HEARING SOCIETY, HON. JOHN DOWDY, Chairman, District of Columbia Subcommittee, Washington, D.C. DEAR CONGRESSMAN DOWDY: The Washington Hearing Society wishes to express its support of legislation Medicaid, Title 19, Medical Assistance Bill H.R. 3972. We believe this bill is most necessary for the many less privileged in the District of Columbia and is of universal concern to all those interested in their welfare. Thanking you in advance for your support of this measure, RUTH A. HUDNUT, Executive Director. HOMEMAKER SERVICE Hon. JOHN DOWDY, OF THE NATIONAL CAPITAL AREA, INC. Chairman, Subcommittee No. 3, House District Committee, House of Representatives, Washington, D.C. DEAR MR. DOWDY: The Board of Directors of the Homemaker Service of the National Capital Area, Inc. has earlier expressed its support for Medicaid for the District of Columbia in a letter under date March 14, 1967 to the Honorable John L. McMillan, Chairman of the District of Columbia Committee. We urge now that Subcommittee 3 be given an opportunity to vote and send H.R. 3972 and H.R. 6818 to the full District Committee for its consideration. Homemaker Service is an independent voluntary social agency which provides trained and supervised women to care for children during the illness or absence of their mother and to help with the care of elderly, disabled and ill persons in their own homes. This past year 774 such families and individuals were served by this agency and as many could not be served because of our limited resources. Although our service to people in their own homes is available to everyone who needs it and can benefit from it, everyone is expected to pay what he is able toward the cost. For many families with minor children and for many elderly people living on small fixed incomes, even token payments are not possible. This is equally true of their ability to pay for needed medical care. Our interest in Medicaid for the District stems from our experience with and knowledge about the lack of adequate medical and health services for many residents of this community. A heavy burden falls upon voluntary agencies and hospitals to subsidize care from private contributions which more suitably should be subsidized from the broader base of tax funds. The fact that Medicaid provisions permit and encourage the utilization of existing public and voluntary agency services by realistic vendor payments contributes toward a healthy partnership and greatly improved services to those who need them. Although our agency is not and cannot be a certified provider of home health services, the positive implications for a better community prompt us to write to you. Sincerely yours, Re H.R. 3972. Mrs. C. WORTH SPRUNT, President. GREATER WASHINGTON CENTRAL LABOR COUNCIL, AFL-CIO, Congressman JOHN DOWDY, Chairman, House District Subcommittee No. 4, DEAR CONGRESSMAN DOWDY: The Greater Washington Central Labor Council AFL-CIO takes this opportunity to express strong support for the enactment of H.R. 3972, "to enable the District of Columbia to participate in the health and medical assistance benefits made available by the Social Security Amendments of 1965, Public Law 89-97." The adoption of H.R. 3972 would delegate to the District of Columbia Commissioners the authority to make it possible for medically indigent District of Columbia citizens to receive medical assistance under Title 19 of the Social Security Act. Again, we urge your early and favorable action on H.R. 3972. Sincerely, J. C. TURNER, President. Mr. DOWDY. As I was saying, the record will be open until next Tuesday, or through next Tuesday for filing of any statements in connection with this bill. The hearings are now adjourned. (Whereupon, at 11 a.m. the subcommittee was adjourned.) APPENDIX SUMMARY OF MEDICAL ASSISTANCE PLANS APPROVED BY VARIOUS STATES TO IMPLEMENT TITLE XIX OF SOCIAL SECURITY ACT TITLE XIX FACT SHEETS CALIFORNIA 1. Name of State agency responsible for administering title XIX: California State Health and Welfare Agency. 2. Date program began operation: March 1, 1966. 3. What groups became eligible when the program began? (a) All persons who receive all or part of their incomes from the federally aided public assistance programs: Old-age assistance, aid to the blind, aid to families with dependent children, aid to the permanently and totally disabled. (b) Children between 18 and 21 in whose behalf an aid to families with dependent children payment would be made, except that these individuals are neither disabled nor attending school or a course of vocational or technical training. (c) All individuals in the above groups who would be entitled to financial assistance except that they do not meet the durational residence requirement of any of the public assistance programs. (d) All persons who, except for having enough income for their daily needs (under State assistance standards), could qualify for public assistance under the Federal eligibility requirements. 4. What are the maintenance levels for persons eligible for coverage? The amount of income and liquid assets they have, as well as the cost of the care they need, will be taken into consideration in determining what people are eligible. In general, however, income and liquid assets at or below the following amounts are considered to be sufficient only for maintenance, and not available for medical care: (a) For a single person: $2,000. (b) For a family of four: $3,800. 5. What are some of the major features of the (State) medical assistance program? Provides institutional care for all who are eligible: unlimited hospital care, and nursing home care (for persons 21 years and older). Also provides noninstitutional care: outpatient diagnostic services, and prescribed medical services for 90 days after hospitalization to continue the treatment begun in a hospital. A wide scope of services is available to persons defined under 3 (a), (b), and (c), above. These include: physicians' and dental services, remedial care by other qualified vendors, laboratory and radiological services, prescription drugs and medical supplies, and blood bank services. 6. What are the terms of financing the new program? California is entitled to receive from the Federal Government approximately 50 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in California during fiscal year 1967 (July 1966-June 1967) will be $333,408,000. Actual cost to the Federal Government during fiscal year 1966, in which the program was in operation for 4 months (March 1966-June 1966), was $82,507,458. 95 7. How many persons are served by the new program? The State of California estimated approximately 2,500,000 persons, or 13 percent of its forecasted 1967 population of 19 million, are potentially eligible for benefits under this program. 8. Financial eligibility to determine persons who are medically needy: Amount protected for maintenance needs: (a) Income scale beginning with $1,998 for single person and $3,324 for two persons plus $240 for each additional person. (b) Assets-Real property: May have home. Other real property and personal property: Up to $1,500 for 1 adult and $3,000 for two persons or a family may be held as reserves. CONNECTICUT 1. Name of State agency responsible for administering title XIX: State welfare department. 2. Date program began operation: July 1, 1966. 3. What groups became eligible when the program began? (a) All persons who receive all or part of their incomes from the federally aided public assistance programs: Old-age assistance, aid to the blind, aid to families with dependent children, aid to the permanently and totally disabled. (b) All persons who, except for having enough income for their daily needs (under State assistance standards), could qualify for public assistance under the Federal eligibility requirements. (c) All children (under 21) who could not qualify for public assistance but whose families cannot afford to pay for all or part of the cost of the medical care they need. 4. What are the maintenance levels for persons eligible for coverage? The amount of income and liquid assets they have, as well as the cost of the care they need, will be taken into consideration determining what people are eligible. In general, however, income and liquid assets at or below the following amounts are considered to be sufficient only for maintenance, and not available for medical care: (a) For a single person: $2,100. (b) For a family of four: $3,800. 5. What are some of the major features of the (State) medical assistance program? Medical care services provided by the State include the five basic services required under Federal law plus the following: (1) Dental care. (2) Clinic services. (3) Prescribed drugs. (4) Prosthetic, surgical, and orthopedic appliances and sickroom supplies. (5) Eyeglasses. (6) Hearing aids. (7) Ambulance and common carrier transportation. (8) Public health nurses in the home under the direction of a medical doctor. (9) Physical, occupational, and speech therapy. (10) Private duty registered nursing service in hospitals. (11) Maternity care centers. (12) Treatment centers licensed as medical institutions, except for psychiatric care, in or out of Connecticut. 6. What are the terms of financing the new program? Connecticut is entitled to receive from the Federal Government approximately 50 percent of the costs of operating its medical assistance program. It is estimated that the Federal share of the cost of operating the program in Connecticut during fiscal year 1967 (July 1966-June 1967) will be $15,300,000. 7. How many persons are served by the new program? The State agency estimated that approximately 10 percent of the State's population of 2.8 million persons would be eligible for the new title XIX program. Eventually this program will serve approximately 297.000 persons. |