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Total, Program Decreases......

-1,287, nnn

Net change in obligation of prior year and subsequent year appropriations..

-59,760, non

Total Decreases.

61,047, nnn

Net Increase.

1,669,476,000

Explanation of Changes

Program Increases:
1. Maintenance Assistance:

The requirements for maintenance payments for 1972, including administration, are $6,655,321,000, an increase of $1,038,132,000 over the 1971 requirements including the proposed supplemental. Of the total increase in requirements 70% is for the increase in Aid to Families with Dependent Children; 15% for increases in old Age Assistance and 13% for increases in Aid to the Permanently and Totally Disabled. The increase for State and local administration is limited by the application of the 110% limitation (Section 208). States estimated a 13% increase in this activity without the limitation.

2. Medical Assistance:

Increase of $611,447,000 is primarily associated with increased member of recipients, increases in unit prices of medical goods and services and increased utilization of covered medical services. The Federal share of Medical vendor payments will be about 19 percent higher. Sixty-three percent of this increase is associated with the recipient increase and 37 percent is relatable to the rise in prices and increased utilization.

The number of persons in whose behalf medical vendor payments will be made in 1972 is expected to be about 19,000,000 and is 2,000,000 and 12 percent higher than in 1971. Ninty-five percent of the increase is in services for families with dependent children and is consistent with the continued increase in recipients under the maintenance assistance program. The dollar distribution of total medical vendor payments by types of services, made in behalf of recipients, has not altered materially since utilization of services by these families is similar.

3. Social Services:

The requested increase of $80,914,000 would provide for the Federal share of the cost of the expected increase in assistance caseload and the increase in the member of adults and children receiving social services. This increase would also be utilized in helping the State provide services to target groups such as migrant families and socially handicapped children 1.6. addicted youth, teenage unmarried mothers, homeless youth, school drop outs, etc. This increase is limited by the application of the 110% limitation (Section 208). States estimated a 20% increase in this activity without the limitation.

Program Decreases:

1. Assistance to repatriated U.S. nationals

The decrease of $83,000 is based on a reduction in the estimated number of persons to be repatriated partially offset by an increase in the costs of hospitalization for the mentally ill.

2. State and local training

The decrease in State and local training results from the pro rata distribution among social services, maintenance administration and State and local training of the estimated total savings of $110,625,000 for all three which accrues from the application of the 110% limitation (Section 208), States estimated a 6% increase in this activity without the limitation.

Authorizing Legislation

1972

Appropriation requested

Legislation

Authorization

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Social Security Act

Section 1--01d Age Assistance..
Section 401--Aid to Families with Dependent

Children..
Section 420--Child Welfare Services....
Section 1001--Aid to the Blind......
Section 1113--Assistance for United States 2/

Citizens Returned from Foreign countries.
Section 1401--Aid to the Permanently and

Totally Disabled...
section 1601--Aid to the Aged, Blind, or

Disabled..
section 1901--Medical Assistance Program.
Public Law 86-571
Section 2--Assistance for Certain Nationals of

the United States Adjudged Insane or
Otherwise Found Mentally Ill in Foreign
Countries..

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Authorized in Various Titles of the Social
Security Act
Social Services, Maintenance Administration

and Training...

Indefinite

1,280,676,000

1 Included under titles I, X, and XIV.
2/ Section 1113 of the Social Security Act will expire on June 30, 1971.

Proposed legislation is pending which would make this section permanent.

SOCIAL SECURITY ACT

Title I--Grants to States for old-Age Assistance and

Medical Assistance for the Aged

Appropriation

Section 1. For the purpose (a) of enabling each State, as far as practicable under the conditions in such State, to furnish financial assistance to aged needy individuals, (b) of enabling each State, as far as practicable under the conditions in such State, to furnish medical assistance on behalf of aged individuals who are not recipients of old-age assistance but whose income and resources are insufficient to meet the costs of necessary medical services, and (c) of encourage ing each State, as far as practicable under the conditions in such State, to furnish rehabilitation and other services to help individuals referred to in clause (a) or (b) to attain or retain capability for self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purpose of this title.

Title IV--Grants to States for Aid and Services to Needy

Families with Children and for Child Welfare Services

Part A. Aid to Families with Dependent Children

Appropriation

Section 401. For the purpose of encouraging the care of dependent children in their own homes or in the homes of relatives by enabling each State to furnish financial assistance and rehabilitation and other services, as far as practicable under the conditions in such State, to needy dependent children and the parents and to help such parents or relatives to attain or retain capability for the maximum self-support and personal independence consistent with the maintenance of continuing parental care and protection, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this part.

Title IV, Part B. --Child Welfare Services

Appropriation

Section 420. For the purpose of enabling the United States, through the Secretary, to cooperate with state public welfare agencies in establishing, extending, and strengthening child welfare services, the following sums are hereby authorized to be appropriated: $55,000,000 for the fiscal year ending June 30, 1968, $100,000,000 for the fiscal year ending June 30, 1969, and $110,000,000 for each fiscal year thereafter.

Title X--Grants to States for Aid to the Blind

Appropriation

Section 1001. For the purpose of enabling each State to furnish financial assistance, as far as practicable under the conditions in such state, to needy individuals who are blind, and of encouraging each State, as far as practicable under such conditions, to furnish rehabilitation and other services to help such individuals attain or retain capability for self-support or self-care, there is hereby authorized to be appropriated to each fiscal year a sum sufficient to carry out the purposes of this title.

Title XI--General Provisions

Section 1113 (a) (1). The Secretary is authorized to provide temporary assistance to citizens of the United States and to dependents of citizens of the United States, if they (A) are identified by the Department of State as having returned, or been brought, from a foreign country to the United States because of the destitution of the citizen of the United States or the illness of such citizen or any of his dependents, or because of war, threat of war, invasion, or similar crisis, and (B) are without available resources.

Title XIV--Grants to States for Aid to the Permanently

and Totally Disabled

Appropriation

Section 1401. For the purpose of enabling each State to furnish financial assistance, as far as practicable under the conditions in such State, to needy individuals eighteen years of age and older who are permanently and totally disabled, and of encouraging each State, as far as practicable under such

conditions, to furnish rehabilitation and other services to help such individuals attain or retain capability for self-support or self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this title.

Title XIV-Grants to States for Aid to the Aged, Blind, or Disabled,

or for Such Aid and Medical Assistance for the Aged

Appropriation

Section 1601. For the purpose (a) of enabling each state, as far as practicable under the conditions in such State, to furnish financial assistance to needy individuals who are 65 years of age or over, are blind, or are 18 years or over and permanently and totally disabled; (b) of enabling each State, as far as practicable under the conditions in such State, to furnish medical assistance on behalf of individuals who are 65 years of age or over and who are not recipients of aid to the aged, blind, or disabled but whose income and resources are insufficient to meet the costs of necessary medical services; and (c) of encouraging each State, as far as practicable under the conditions in such State, to furnish rehabilitation and other services to help individuals referred to in clause (a) or (b) to attain or retain capability for self-support or self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this title.

Note: States way elect to provide assistance to the needy aged, blind, and permanently and totally disabled under this title in lieu of titles I, X, and XIV.

Title XIX--Grants to States for Medical Assistance Programs

Appropriation

Section 1901. For the purpose of enabling each State, as far as practicable under the conditions of such State, to furnish (1) medical assistance on behalf of families with dependent children and of aged, blind, or permanently and totally disabled individuals, whose income and resources are insufficient to meet the costs of necessary medical services; and (2) rehabilitation and other services to help such families and individuals attain or retain capability for independence or self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this title.

PUBLIC LAW 86-571
Section 2--Assistance for Certain Nationals of the
United States Ad judged Insane or otherwise

Found Mentally Ill in Foreign countries

Section 2(a). Upon request of the Secretary of State, the Secretary of Health, Education, and Welfare is authorized (directly or through arrangements under this sub section) to receive any eligible person at any port of entry or debarkation upon arrival from a foreign country and, to the extent he finds it necessary, to temporarily care for and treat at suitable facilities (including a hospital), and otherwise render assistance to such person pending his transfer or hospitalization pursuant to other sections of this Act. for the purpose of providing such care and treatment and assistance, the Secretary is authorized to enter into suitable arrangements with appropriate State or other public or nonprofit agencies. Such arrangements shall be made without regard to section 3709 of the Revised Statutes, as amended (41 0.9.c. 5), and may provide for payment by the Secretary either in advance or by way of reimbursement.

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