Department of Maternal and Child Health

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MCH/Public HealthMilestonesPart VIII
1965-1969
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Greg R. Alexander, MPH, ScDCathy Chadwick, MPH
Donna J. Petersen, MHS, ScDMaryAnn Pass, MD,
MPH Martha Slay, MPHNicole Shumpert, BS

• Department of Maternal and Child Health
• The MCH Leadership Skills Training Institute
• University of Alabama at Birmingham

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Acknowledgement

• Supported by funding from the Maternal and Child
  Health Bureau

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1965
Medicaid and Medicare enacted
Title V Amended
Children and Youth Project
Neighborhood and Migrant Health Centers
Child Nutrition Act
Highway Safety Act
Reorganization of HEW
Title V authorizes infant care, family planning,
and dental
EPSDT
School Lunch and Child Nutrition Act expanded
Childrens Bureau transferred to Office of Child
Development
Rubella vaccine licensed
1969
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The 1960s and 70s

• Tremendous expansion of federally funded
  programs for the poor and for children
• Growth in public sector programs at the state
  and local levels, many providing direct services
• Growth in disillusionment with government

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War on Poverty

• In his first State of the Union address, on
  January 8, 1964, President Johnson announced that
  his administration "today, here and now, declares
  unconditional war on poverty in America, and I
  urge this Congress and all Americans to join with
  me in that effort.
• His program called for a systematic effort in
  "chronically distressed areas" of the country, a
  youth employment ("job corps") plan, expansion of
  the food stamp and unemployment relief systems,
  and special aid to schools, libraries, hospitals,
  and nursing homes.

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War on PovertyPresident Johnson and Mrs.
Johnson in Kentucky
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1965 Title XVIII and XIX of the Social Security
Act

• Medicare (Title XVIII) established to provide
  health insurance coverage to persons over age 65
• Medicaid (Title XIX) established to provide
  health insurance coverage to low income women and
  children (also, aged, blind and disabled)

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1965 Title V Amended, P.L. 89-97

• The 1965 amendments (P.L. Law 89-97) amended
  Title V of the Social Security Act by providing
  comprehensive health care for children and youth,
  the so-called CY Projects.

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C Y Projects

• There was a growing realization that
  comprehensive care was needed for children and
  youth, particularly in low-income areas.
• Legislation passed in 1965 (P.L 89-97),
  provided this care through Children and Youth (C
  Y) projects.
• A primary directive was to make these services
  accessible, available and appropriate to the
  identified low-income neighborhoods
• The intent was to provide comprehensive health
  care to children and youth including health
  supervision, screening, medical care, nutrition,
  and social services.

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Comprehensive Neighborhood Health Centers

• Comprehensive Neighborhood Health Centers were
  created as part of the Partnership for Health Act
  and under the Office of Economic Opportunity.
• The intent of these centers was to provide
  family-focused community health care.
• In 1971, the program was transferred to the
  Public Health Service and was renamed the
  Community Health Centers Program

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Migrant Health Program

• The Migrant Health Program was established in
  1965 to provide prenatal and infant care services
  to migrants, seasonal farm workers and their
  families

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Migrant Health
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1966 Child Nutrition Act

• The intent of the Child Nutrition Act of 1966
  was to ensure that children were provided with
  adequate food in order to promote better
  development and learning

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1966 Highway Safety Act and the National Traffic
and Motor Vehicle Safety Act

• Authorized the federal government to set and
  regulate standards for motor vehicles and
  highways
• Vehicles were built with new safety features,
  including head rests, energy-absorbing steering
  wheels, shatter-resistant windshields, and safety
  belts
• By 1970, motor-vehicle-related death rates were
  decreasing

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1967 Department of HEW Reorganized

• A reorganization of the Department of Health,
  Education and Welfare (HEW) was instituted by
  administrative order.
• The health and welfare components of the
  Childrens Bureau were separated, with some of
  the responsibilities of the Childrens Bureau
  distributed among other agencies

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1967 Title V Authorizes Infant Care, Family
Planning and Dental Care

• The Title V authorization of 1967 created three
  new medical project grants
• infant care (neonatal intensive care)
• family planning
• dental care

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Title XIX Amendments EPSDT

• The Medicaid statute (Title XIX) was amended in
  1967 to create the Early and Periodic Screening,
  Diagnosis and Treatment (EPSDT) program for needy
  children.
• The purpose of EPSDT was to identify and
  diagnose health problems of indigent children
  though the provision of periodic physical and
  developmental examinations.
• The program also provided funds for the
  treatment of illnesses and other health conditions

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Child receiving oral polio vaccine
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1968 School Lunch and Child Nutrition Act
Expanded

• In 1968, Congress expanded the School Lunch and
  Child Nutrition Act.
• A program was created to provide food for
  school-age children during the summer.
• Additionally, a year-round program was initiated
  to provide food to low-income children, as well
  as children in day-care centers and Head Start
  programs.

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1969 White House Conference on Food, Nutrition,
and Health

• In 1969, President Nixon convened a White House
  Conference on Food, Nutrition, and Health.
• After this Conference, the Secretary of
  Agriculture established the Food and Nutrition
  Service in order to administer the federal food
  assistance programs.

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President Richard M. Nixon
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Childrens Bureau Transferred to Office of Child
Development

• The Childrens Bureau was disbanded in 1969.
• Duties that had remained with the Childrens
  Bureau after the HEW reorganization, were
  transferred to the newly created Office of Child
  Development.
• When this occurred, the health programs of the
  Childrens Bureau were transferred to the U.S.
  Public Health Services, in an agency now known as
  the Maternal and Child Health Bureau.

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Rubella Vaccine Licensed

• The rubella vaccine was licensed in June, 1969.

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Child with Rubella
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• Maternal and Child Health/Public Health
  Milestones 1965-1969
• Photo Acknowledgements
• Slide 6 During the 1960s, hundred of thousands
  of people took part in several different protest
  movements, including the civil rights movement,
  the anti-Vietnam War movement, the women's rights
  movement, the gay rights movement, and the
  environmental movement. These activists were
  attempting to change American society through
  demonstrations, marches, sit-ins, and teach-ins.
  Jason Laure/Woodfin Camp and Associates, Inc.
  www.encarta.com
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• Slide 8 On April 24, 1964, Lyndon and Lady Bird
  Johnson visited Inez, KY, and the property of
  Tommy Fletcher, a father of eight whose living
  conditions epitomized the squalor that
  characterized Appalachia for decades. On
  Fletchers porch, Johnson declared the War on
  Poverty. (AP photo) www.post-gazette.com
• Slide 10 Physician and nurse examining elderly
  patient in home. 1963. CDC/Charles Farmer.
  www.cdc.gov
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• Slide 12 Courtesy of WHO and National Library of
  Medicine. www.nlm.nih.gov
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• Slide 14 Courtesy of National Library of
  Medicine. www.nlm.nih.gov
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• Slide 16 Courtesy of National Library of
  Medicine. www.nlm.nih.gov

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• Maternal and Child Health/Public Health
  Milestones 1965-1969
• Photo Acknowledgements
• Slide 18 Public Health Service photo.
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• Slide 20 Courtesy of National Library of
  Medicine. www.nlm.nih.gov
• Slide 24 Nursery school. Courtesy of the
  National Library of Medicine. www.nlm.nih.gov
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• Slide 26 Building a Better Life Family
  Planning. Courtesy of the National Library of
  Medicine. www.nlm.nih.gov
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• Slide 28 www.cdc.gov . Health workers
  administering oral polio vaccine to child. 1963.
  CDC.
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• Slide 30 Courtesy of the National Library of
  Medicine. www.nlm.nih.gov
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• Slide 32 Richard M. Nixon. www.encarta.com .
  Richard M. Nixon, the twice-elected 37th
  president of the United States, was the only
  chief executive to resign from office. Shortly
  after becoming General Dwight D. Eisenhower's
  vice-presidential running mate in 1952, Nixon was
  suspected of misusing a fund. He is heard here
  giving his famous "Checkers" speech concerning
  this incident.
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• Slide 34 Mother and child in consultation with
  a physician. Courtesy of National Library of
  Medicine. www.nlm.nih.gov
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• Slide 36 Rash of rubella on childs back. 1978.
  CDC

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CREDITS

• This work builds upon the earlier efforts of
  Dr. Allan C. Oglesby, Cindy Camberg, EdD, and
  Cathy Chadwick of the Maternal and Child Health
  Institute to Increase Leadership Skills Project,
  San Diego State University, and draws upon their
  Manual of the History and Philosophy of Maternal
  and Child Health as a foundation for this
  multi-volume series.