HEALTH RESOURCES AND SERVICES ADMINISTRATION MATERNAL AND CHILD HEALTH BUREAU Social Work in MCHB: Some Historical Social Work in MCHB: Some Historical Highlights Highlights Presentation to LEND Social Workers MCHB, DRTE by Isadora Hare, M.S.W., L.C.S.W. Perinatal Health Specialist MCHB, DHSPS Crystal Gateway Marriott Crystal City, VA 4 March, 2006
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HEALTH RESOURCES AND SERVICES ADMINISTRATION
MATERNAL AND CHILD HEALTH BUREAU
Social Work in MCHB: Some Historical Social Work in MCHB: Some Historical HighlightsHighlights
Presentation to LEND Social WorkersMCHB, DRTE
byIsadora Hare, M.S.W., L.C.S.W.
Perinatal Health SpecialistMCHB, DHSPS
Crystal Gateway MarriottCrystal City, VA4 March, 2006
Trends and Events Prior to Social Security Act of 1935
> Dismal conditions for mothers, infants and children; high mortality rates
> Post-Civil War, a few states established State health departments (14 by 1877)
> 1907 – New York City established Division of Child Hygiene under Dr. S. Josephine Baker
> 1911 – Nine states had mandatory school health inspection laws
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The Children’s Bureau, 1912 - 1969
> 1909 First White House Conference on the Care of Dependent Children
> April 9th, 1912 : Children’s Bureau (CB) established in Department of Labor and Commerce
> Broad mission “……. All matters pertaining to the welfare of children ……. infant mortality, birth rates, orphanages juvenile courts, employment, desertion, dangerous occupants, accidents and diseases ……..
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Julia Lathrop 1858 - 1932
> 12 years as Director of Children’s Bureau> Vassar College, 1880; Hull House> Well-known advocate for children and mentally ill
Edith Abbott - Dean of S5 SA, University of Chicago, 1924 – 1942
Milton Wittman, NIMH 1947 - 1979, NIMH
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Leaders in MCH Social work programs:
Edith Baker, first Chief of Medical Social Work, Children’s Bureau, post 1935 - 1955
Virginia Insley 1955 - 1980
Juanita Evans 1980 - 2000
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History of Public Health Service and
Commissioned Corps.
1798- President John Adams establishes Marine Hospital Fund for relief of seamen
1870- Hospitals reorganized after Civil War Surgeon General appointed Military model adopted: ranks similar to U.S. Navy
1889- Commissioned Corps formally established: social workers enter Corps in 1950
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History of Public Health Service and
Commissioned Corps.
1891- Assigned responsibility for medical inspection of immigrants
1912- Name of Service changed to Public Health Service: provides wide range of services
1929- Establishes formal unit for mental health issues
1935- Social Security Act
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History of Public Health Service and
Commissioned Corps.
1944- Public Health Service Act codifies authorities of the PHS
1946- National Mental Health Act: Social Work Training
1953- President Eisenhower- DHEW
1970- National Health Service Corps- few slots for social workers
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MCH Policy Developments before 1935
1918- Children’s Year
1920- 19th Amendment: Votes for Women
1921- Sheppard-Towner Act: Maternity and Infancy Act, PL 67-97. First Federal formula grant program in health
1927- 47 States + Hawaii provided matching funds for MCH activities
1929- S-T Act expires
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MCH Policy Developments before 1935
1930- President Hoover convenes White House Conference on Child Health and Protection
1930- Great Depression begins
1933- Frances Perkins: Secretary of Labor
1934- President Roosevelt creates Committee on Economic Security: chaired by Perkins
1934- Consultants included Grace and Edith Abbott; Katherine Lenroot; Dr. Martha May Eliot
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Frances Perkins: 1882-1965
• Secretary of Labor appointed by President Roosevelt, 1933-1945; First woman member of a U.S. cabinet
• Hull House- Masters from Columbia 1910
• Became authority on industrial conditions and hazards
• Advocacy for minimum wages, maximum hours, child labor legislation, unemployment compensation, social security
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The Social Security Act, P.L. 74-271, 1935
• Title V provides for Federal-State partnershipsto promote MCHto promote care for “crippled children”(1985- COBRA- “children with special health care needs”)to strengthen public child welfare services
• By June 1937, all States and Territories have MCH divisions
• Before 1935, only one State (MA) and one County (LA) had public health social workers
• Social Security Act brought social workers into public health programs nationally
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Edith Baker
• Lobbied for social work in implementation of Social Security Act through American Association of Medical Social Workers
• Worked with Dr. Martha May Eliot, social worker and pediatrician---Chief of C.B. (1951-1957)
• Became first Chief of Medical Social Work for MCH and CCS, 1936-1955
• Federal policy required States to have social workers in CCS, and later in various MCH programs
• Strong recognition of training needs
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Virginia Insley
• 2nd Chief of Social Work in C.B.- 1955-1980. Formerly Regional Medical Social Consultant, C.B.’s San Francisco Regional Office
• 1953- Pres. Eisenhower establishes DHEW; C.B. placed there within Social Security Administration
• 1963-1969- C.B. transferred to various administrative units in reorganizations of DHEW
• 1969- C.B. dismantled: MCH and CCS programs (Title V) transferred to US Public Health Service; moves to Rockville
• 1977- Disciplinary Sections abolished
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Virginia Insley
• 1977- Disciplinary Sections abolished: Insley’s title remains “Chief Social Worker”
• Succeeded by Juanita Evans, 1980-2000
• 1990- Maternal and Child Health Bureau established within HRSA
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Juanita Evans“Chief Social Work Officer”
1980-2000
• Though Disciplinary Sections abolished in 1977, Insley retains title “Chief Social Worker”
• Juanita Evans succeeds Insley in 1980• Continues social work activities through grants:
e.g. 1985, Working Conference of the Public Health Social Work Advisory Committee“Public Health Social Work in Maternal and Child Health: A Forward Plan”
• Sponsored by Columbia University School of Social Work, Alex Gitterman
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Services for “Crippled” Children
• 1897- Minnesota- first state to serve crippled children-followed by MA and NY
• 1850-1900- Volunteer organizations working for improved services; educating blind and deaf
• Until 1935, very few State dollars spent on services for handicapped children
• Citizen groups e.g. National Society for Crippled Children and Adults, grew active in advocacy efforts
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“Mental Retardation” (MR) in Children
• Parents kept children hidden or sent them to “asylums”
• By 1898, 24 public institutions for “feebleminded” children existed in 19 states, by 1918, all but four states provided institutions
• 1915- Children’s Bureau conducted study of “Mental Defectives in the District of Columbia”
• 1923- Children’s Bureau study of work potential of children who had been in special classes for “mental defectives”
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“Mental Retardation” cont’d: The 1950’s
• A new approach developed through parent activism
1950- Foundation of National Association for Retarded Children (later Citizens) directed by Gunnar Dybwad, a social worker
1954- Dr. Martha May Eliot designated “mentally retarded”as a group needing special emphasis
1955- C.B. makes 4 grants for special demonstrations of clinical services for the M.R.- social workers included in multidisciplinary teams
1958- Congressional earmarks: $2 million of Title V to develop MR clinical services; new diagnostic and education (D and E) clinics established
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“Mental Retardation” cont’d: The 1960’s and 1970’s
• Increasing influence of NARC and leadership of Pres. John F. Kennedy
• Presidential Panel appointed
• President deliver message relative to Mental Illness and Mental Retardation
• Congress enacts recommendations from President’s Panel; Legislation establishes UAF’s (later UAP’s) and LEND program
• 1970- Developmental Disabilities Act: new terminology
• 1975- Education for All Handicapped Children Act,