HYGIENE OF MATERNITY AND INFANCY. COMMITTEE ON LABOR, HOUSE OF REPRESENTATIVES, Washington, D. C., January 15, 1919. The committee met at 10.30 o'clock a. m., Hon. James P. Maher (chairman), presiding. The CHAIRMAN. The committee will, hear Miss Rankin in connection with H. R. 12634, which is as follows: [H. R. 12634, Sixty-fifth Congress, Second Session.] A BILL To encourage instruction in the hygiene of maternity and infancy, and to extend proper care for maternity and infancy; to provide for cooperation with the States in the promotion of such instruction and care in rural districts; to appropriate money and regulate its expenditure, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled That there is hereby annually appropriated, out of any money in the Treasury not otherwise appropriated, the sums provided in section two of this act. to be paid to the several States for the purpose of cooperating with the States in promoting the care of maternity and infancy in rural districts; to provide instruction in the hygiene of maternity and infancy, and the sum provided in section five for the use of the Chief of the Children's Bureau Department of Labor, for the administration of this act and for the purpose of making such studies, investigations, and reports as will further the efficient administration of this act. SEC. 2. That for the purpose of paying the expenses of said cooperative work in providing the services and facilities specified in this act, and the necessary printing and distribution of information in connection with the same, there is permanently appropriated. out of any money in the Treasury not otherwise appropriated, the sum of $480,000 for each year $10 000 of which shall be paid annually to each State, in the manner hereinafter provided: Provided, That there is also appropriated for the use of the States, subject to the provisions of this act, for the fiscal year ending June thirtieth, nineteen hundred and nineteen, an additional sum of $1.000.000; for the fiscal year ending June thirtieth. nineteen hundred and twenty. the sum of $1,200,000; for the fiscal year ending June thirtieth. nineteen hundred and twenty-one, the sum of $1,400.000; for the fiscal year ending June thirtieth, nineteen hundred and twentytwo, the sum of $1,600,000; for the fiscal year ending June thirtieth. nineteen hundred and twenty-three, the sum of $1,800 000; for the fiscal year ending June thirtieth, nineteen hundred and twenty-four, the sum of $2 000,000; and annually thereafter the sum of $2,000,000: Provided further. That no payment out of the additional appropriations herein provided shall be made in any year to any State until an equal sum has been appropriated for that year by the legislature of such State for the maintenance of the services and facilities provided for in this act. So much of the appropriation apportioned to any State for any fiscal year as remains unexpended at the close thereof shall be avialable for expenditures in that State until the close of the succeeding fiscal year. Any amount apportioned under the provisions of this act unexpended at the end of the period during which it is available for expenditure under the terms of this section shall be reapportioned, within sixty days thereafter, to all the States in the same manner and on the same basis, and certified to the Secretary of the Treasury and to the State boards of maternity and infant hygiene in the same way as if it were being apportioned under this act for the first time. SEC. 3. That in order to secure the benefits of the appropriations provided for in section two of this act, any State shall, through the legislative authority thereof, accept the provisions of this act and designate or authorize the creation of a State board of maternity aid and infant hygiene, which shall have all necessary power to cooperate as herein provided, with the Chief of the Children's Bureau, Department of Labor, in the administration of the provisions of this act; the members of the State board shall 3 be appointed by the governor and shall consist of the following persons: The governor, ex officio, who shall be chairman of the board; a representative of the State board of health, who shall be a physician; a representative of the nursing profession, who shall be a graduate nurse, and in States where registration obtains shall be duly registered; a representative of the teaching profession, who shall be selected from the State university or the State college of agriculture. The first meeting of said board shall be called by the governor, at such time and place as he may direct; the board shall elect a vice chairman and a secretary, and shall notify the chief of the Children's Bureau, Department of Labor, of the assent of the State to the provisions of this act and shall state the name and address of the officer authorized to conduct the correspondence of the board. In any State the legislature of which does not meet in nineteen hundred and nineteen the governor of that State, so far as he is authorized to do so, shall accept the provisions of this act and designate or create a State board of not less than three members to act in cooperation with the Chief of the Children's Bureau, Department of Labor. The Chief of the Children's Bureau shall recognize such local board for the purposes of this act until the legislature of such State meets in due course and has been in session sixty days. SEC. 4. That the Chief of the Children's Bureau, under the direction and control of the Secretary of Labor, shall have charge of all matters concerning the administration of this Act, and shall have power to cooperate with State boards in carrying out the provisions of this act. It shall be the duty of the Chief of the Children's Bureau, under the direction or with the approval of the Secretary of Labor, to make or cause to have made, such studies, investigations, and reports as will further the efficient administration of this act. SEC. 5. That so much, not to exceed five per centum of the appropriation for any fiscal year made by or under this act, as the Chief of the Children's Bureau, with the approval of the Secretary of Labor, may estimate to be necessary for administering the provisions of this act, shall be deducted for that purpose, available until expended. Within sixty days after the close of each fiscal year the Chief of the Children's Bureau, under the direction or with the approval of the Secretary of Labor, shall determine what part, if any, of the sums theretofore deducted for administering the provisions of this act will not be needed for that purpose and apportion such part, if any, for the fiscal year then current in the same manner and on the same basis, and certify it to the Secretary of the Treasury and to the State boards of maternity aid and infant hygiene, in the same way as other amounts authorized by this act to be apportioned among all the States for such current fiscal year. The Secretary of Labor, after making the deduction authorized by this section, shall apportion the remainder of the appropriation for each fiscal year among the several States in the proportion which the rural population of each State bears to the total rural population of all the States as determined by the next preceding Federal census. SEC. 6. That out of the appropriations made by or under this act, the Secretary of Labor, upon the recommendation of the Chief of the Children's Bureau, is authorized to employ such assistants, clerks, and other persons in the city of Washington and elsewhere, to rent buildings outside of the city of Washington, to purchase such supplies, material, equipment, office fixtures, and apparatus, and to incur such travel and other expense as he may deem necessary for carrying out the purposes of this act. SEC. 7. That within sixty days after the approval of this act the Secretary of Labor shall certify to the Secretary of the Treasury and to each State board of maternity aid and infant hygiene the sum which he has estimated to be deducted for administering the provisions of this act, and the sum which he has apportioned to each State for the fiscal year ending June thirtieth, nineteen hundred and nineteen, and on or before January twentieth next preceding the commencement of each succeeding fiscal year shall make like certificates for such fiscal year. SEC. 8. That any State desiring to avail itself of the benefits of this act shall, by its board of maternity aid and infant hygiene, submit to the Secretary of Labor detailed plans for carrying out the provisions of this act. These plans shall include the provisions made in the State for the administration of the act: the provision of instruction in the hygiene of maternity and infancy through public-health nursing, consultation centers, and other suitable methods; and the provision of medical and nursing care for mothers and infants at home or at a hospital when necessary, especially in remote areas. If the Chief of the Children's Bureau finds the same to be in conformity with the provisions and purposes of this act, the same shall be approved under the direction of the Secretary of Labor. SEC. 9. That in order to provide popular, nontechnical instruction to the residents of the various States, particularly to those to whom such facilities are not accessible, on |