are.

If the corrections are made which I have indicated, I would be very glad to see the last bill on this subject introduced by Mr. Cooper passed. I do not know what the chances are at this session as S. 255, which will continue the old maternity and infancy program, has passed the Senate. That is the program for which I am responsible and in which I am most interested.

Mr. HUDDLESTON. Ignoring the parliamentary situation, you are willing to see this bill, H. R. 12995, passed?

Miss ABBOTT. Provided the amendments that I have suggested are incorporated; yes.

Mr. HUDDLESTON. You have suggested to whom?

Miss ABBOTT. I have just been talking about them. I can put them quite concretely if you would like to have them.

Provided the time limit in section 3b is removed so that the maternity and infancy work is put on the same basis as the county health work, and this clause about the approval of the board found in lines 7 and 8 on page 5 of the bill is changed to approval by the Secretary of Labor.

There is one provision which is confusing in the last Cooper bill as to the submission of plans and there are a few minor changesI should say typographical changes-that need to be made.

Mr. HUDDLESTON. I would be glad if you would specify those amendments pretty clearly in your remarks.

Miss ABBOTT. I shall be very glad to give them. I have a memorandum of them, but I can not put my hand on it just now. Mr. CROSSER. You would be altogether satisfied with S. 255, would you not?

Miss ABBOTT. So far as the maternity and infancy program is concerned, I am entirely satisfied. I am, however, very glad to lend any help that I can to the county unit program, and I want to make that clear.

Mr. CROSSER. But if you had your personal choice, would you not rather have S. 255?

Miss ABBOTT. Not if the provisions of S. 255 are in the other. I do not have any feeling that confusion will result in the administration of the maternity and infancy work. That is, if the provisions with reference to maternity and infancy were the same in the two, I should have no embarrassment at all about it. Or if the suggestions that I make also about the amendment of the last Cooper bill were adopted, I should be very happy to say that I was for that and really preferred it, provided it has the same chance of passage at this session.

Mr. NELSON. Has there been any suggestion in any of these discussions you have had with various people that if you did not get H. R. 12995 you might not get any legislation?

Miss ABBOTT. Yes; I have heard that statement and I have also been told that H. R. 12995 has no chance of passage at this session. Mr. NELSON. Has that influenced your discussion or your judg ment in this matter at all?

Miss ABBOTT. It could influence it only in this sense, that I am primarily concerned with the special work for promoting maternal and infant health. That is my responsibility under the act creating the bureau, and I should like to see that work continued at this session.

Mr. NELSON. You would rather have bill H. R. 12995 enacted than none at all?

Miss ABBOTT. No; I would rather have it with the promotion of the county units, providing the bill takes care of the maternity and infancy work as it should. But now some one says to me that we can not get H. R. 12995 this session because it has to go back to the Senate; that as S. 255 has already passed the Senate, it has the best change of passage. I agree that so far as the legislative situation is concerned, there is some embarrassment, but I have no embarrassment in saying that if the provisions with reference to maternity and infancy are cleared up a little bit in the Cooper bill, I should rather see that passed, giving to the States the cooperation that is made possible in the county-unit program, to be administered by the Public Health Service and the maternal and infant health program administered by the Children's Bureau, rather than to have only the maternity and infancy program go through.

Mr. NELSON. Now, there has been something of a dispute as to whether this work should be continued under the Public Health Service or under the Children's Bureau. Under this bill H. R. 12995, as disclosed by the previous witness, you proceed to set up these health units, which include all people, and the promotion of health, which would include practically every disease, including hygiene of maternity and infancy.

Miss ABBOTT. Well, Mr. Nelson, that is perfectly easy to make clear. There are general health measures that promote the health of the mothers and babies; for instance, the proper collection of garbage, disposal of sewage, pollution of streams, provision of a pure milk and pure water supply-a great many sanitary measures. And then, in addition, in order to promote the health of mothers and babies, there needs to be a special organization and a special program for promoting the education of mothers in the care of their children. In other words, we find that babies die because they contract communicable diseases to which they are exposed. That is, there may be an epidemic of flu which attacks mothers and babies as well as others; there is impure water or, because the sanitation generally is not good, their health may be affected. But babies also die, and more frequently because their mothers do not know how to give them the benefits of scientific care. Now, to give them the benefits of scientific care you need a special organization. Mr. NELSON. Is it not true that in the first place you set up a health unit which has the supervision of the health of all people and of all diseases, including that of hygiene of maternity and infancy? Is that not true?

Miss ABBOTT. Well, pregnancy is not a disease. [Laughter.]

Mr. NELSON. In the first place, you set up the general bureau which includes everything, and then

Miss ABBOTT (interposing). It may include everything, and it may include almost nothing. Now, you can set up a general organization for health promotion and not have any maternity and infancy health work there. That is what we had mostly over the country until the maternity and infancy act became a law and promoted special services for mothers and children. There appears to be some duplication in the way it is set up. That is, we need general

services for all ages, the general sanitation program, for example, and then we need a special service for the mother and child. Because this is an educational program this service should be given by another type of expert-not a sanitarian or specialist in epidemiology, but a specialist in maternal and infant hygiene. In the States this special service is provided in a child hygiene division or bureau. Of course, if you get down to the smallest unit, it may be that you get none of the specialization that you need, and one nurse going out with no one else with her undertakes to carry more or less the whole program and do the whole job. In such a situation in the past under the maternity and infancy act a contribution was made for a part of her program, because she was doing a part of the maternity and infancy program.

I don't know whether I have answered your questions. I have tried to answer them all.

Mr. NELSON. Now go a little further. It seems to me that in the first part of the bill you set up a general agency which includes all people and all health matters, and then out of the whole a part is selected, and over that part you take charge. Now, do you feel, as. the one who would have charge of that matter, that you could get along with those several agencies, the one a small part of the whole,. without difficulty?

Miss ABBOTT. I know, because we have had seven years experience in doing it.

Mr. NELSON. That is what I wanted to get.

Mr. COOPER. May I ask you to submit for the record your suggestion?

Miss ABBOTT. I will be glad to do so.

Suggested changes in H. R. 12995 submitted by Miss Abbott:

1. Put the maternity and infancy work on the same basis as to the time for which the appropriation is authorized as the time for the general rural health: work by eliminating the time restriction. To do that it is necessary to make the following changes in section 3b, page 4:

Line 8, omit ",for five years,".

Line 10, omit the words "for the fiscal year ending June 30, 1931," and insert the words "for the fiscal year ending June 30, 1931, and annually thereafter," Lines 11, 12, 13, and 14 to be omitted entirely.

Line 15, omit the words "fiscal year ending June 30, 1935,".

2. Place the Secretary of Labor in the same relation to the supervision of the work of the Children's Bureau as the Secretary of the Treasury is to the work of the Public Health Service. As proposed, supervision of the bureau is lodged with the Federal Health Coordinating Board, of which the Surgeon General of the Public Health Service, the Chief of the Children's Bureau, and. the Commissioner of Education are members. This provision is administratively impossible. The board has no fiscal or personnel officers, it is not in continuous session, etc. To correct this the words " with the approval of the board" in section 3c, page 5, lines 7 and 8 should be omitted and the words "with the approval of the Secretary of Labor" substituted.

3. In order to make the conditions with reference to plans contained in section 5, page 6, apply to all the States, in line 23 after the word "act" the word "and should be omitted and a period and the word "Each State" should be inserted. As it now reads only States which did not accept or which repealed their acceptance of the act of 1921 and have accepted this act are required to submit plans in conformity to the provisions specified.

4. Substitute for the word "board" the words "chief of the Children's Bureau" in section 5, page 8, lines 3 and 6

5. On page 4, line 24, substitute the word "health" for the word "welfare "..

6. On page 8, line 13, omit the words "board or of any organization represented thereon " and substitute the words "Children's Bureau, the Public Health Service or any State or local department of health."

Mr. COOPER. Have you anyone else, Miss Sherwin?

Miss SHERWIN. I should like to ask to have the statement of the organizations filed, since the hour is growing short and Miss Abbott has answered the questions so fully.

I should like to say that I have been told, although I have not seen the statement of those organizations, that all of the organizations favor the provision in S. 255 for an unrestricted period of appropriation, and therefore of operation of the benefits of the maternity and infancy work, and I know that is true of my own organization, which desires to see the 5-year limitation in H. R. 12995 removed, rather than to remain embodied in that bill.

Now, if I may, I should like to file the statements of the 12 organizations. I do not know that you need to have their names read. Do you wish to have the names read?

Mr. COOPER. I think you might file them in the record now, and later on you will have another opportunity to speak.

Mr. MAPES. Would it not be well to give the committee the benefit of the names of the organizations?

Miss SHERWIN. I regret they are not arranged alphabetically. I will read them.

American Association of University Women, National Consumers League, National Council of Jewish Women, The Service Star Legion, National Board of Young Women's Christian Association, the President of the Council of Women's Home Missions, The Women's Trade Union League, the American Nurses' Association, The American Medical Federation, The Teachers' National Congress, Parents and Teachers, National League of Women Voters, American Home Economics Association, the General Federation of Women's Clubs, The American Farm Bureau Federation, and the American Federation of Labor.

Mr. MAPES. Are all those organizations supporting H. R. 12995? Miss SHERWIN. As I say, I do not know, because I have not seen their statements. They are supporting materinity and infancy provisions in legislation which they wish to see enacted in the present session of Congress. I believe that the emphasis of the friends of the measure, with which I should like to leave this hour of the hearing, is on the need for this type of legislation, which is very obvious under present conditions, when there is great need among children, with less resources in communities to provide for them.

Mr. MAPES. You seem to be more hesitant in your indorsement of H. R. 12995 than Miss Abbott is.

Miss SHERWIN. No, not hesitant. My statement, for my own organization is that we have supported maternity and infancy provisions in both; and we prefer the unrestricted term of operation. That is the reason we would seem to give the benefit of our support, if it be such, to S. 255. We would be perfectly happy to see maternity and infancy legislation enacted in this Congress in either one of these measures, only hoping that there might be no difference between the periods of appropriation as outlined for the two purposes in H. R. 12995.

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Mr. MAPES. I understood you to say that you were in favor of the maternity and infancy part of H. R. 12995, but do you go the next step and say that you are in favor of the rest of the bill? Miss SHERWIN. Perhaps you were not here when I said— Mr. MAPES (Interposing). Yes, I have been here all the time. Miss SHERWIN (Continuing). When I said I was speaking for an organization which could not take action on anything which it had not studied previously, and on which its convention had not voted. Mr. MAPES. I understood you to say that, but I also understood you to say, when I said that you were more hesitant about indorsing this bill than Miss Abbott, that you took exception to that.

Miss SHERWIN. Not to the maternity and infancy provisions. And, of course, speaking as a human being, I would welcome a broad general health program in the country.

Mr. MAPES. So that you too think that H. R. 12995 is preferable to S. 255 if the amendments are made as Miss Abbott suggested? Miss SHERWIN. I could not say that it would be preferable. I should say that it would have the same support in respect to the maternity and infancy provisions.

Mr. MAPES. Would it not be preferable in that it is broader, it takes in a broad, general public health program?

Miss SHERWIN. If you ask me to speak as an individual, I would say that in the future I think it will be; as a representative of the organization I could not say that. That is all.

Mr. MAPES. Would you as an individual say that it is preferable to S. 255?

Miss SHERWIN. With the changes suggested, as an individual I should say, yes, that it was preferable because the future health work was promising under it. I can not say anything about the method nor the detail of the bill.

Mr. MAPES. I understood that the State organizations of the League of Women Voters had indorsed H. R. 12995.

Miss SHERWIN. I do not know that they have.

Mr. COOPER. Thank you very much, Miss Sherwin. We will now hear your next witness, Doctor McCormack.

Doctor McCORMACK. I would like to present Dr. John A. Ferrell, director for the United States of the International Health Board of the Rockefeller Foundation. Doctor Ferrell was formerly assistant State health commissioner of North Carolina and has had a vast experience in the organization of county health work, and has been in practically every county now organized in the United States. He can answer the questions of the committee in any detail in regard to that work.

STATEMENT OF DR. JOHN A. FERRELL, REPRESENTING THE INTERNATIONAL HEALTH DIVISION OF THE ROCKEFELLER FOUNDATION

Doctor FERRELL. Mr. Chairman and gentlemen, I would like to square myself at the start by saying that it is not the policy of the organization with which I am connected to meddle in the affairs of Congress or the legislatures of States, and as a staff member I invariably refrain from attempting to lobby or to influence legislation, National or State. I came here to-day only by invitation of