Wilbur J. Cohen and Mental Retardation Legislation

By Edward Berkowitz, Ph.D., George Washington University, Washington, D.C.

On mental retardation legislation, the second major sustained effort of the Kennedy years, Cohen operated as the servant of others. Cohen worked hard on this matter, and that was because Eunice Kennedy Shriver, who was an extraordinarily driven and dedicated woman, wanted him to do so. More than any other individual, Mrs. Shriver urged that the Department of Health, Education, and Welfare pay attention to mental retardation. In this manner, Mrs. Shriver helped to make a personal concern of the Kennedy family into a national cause that was supported by federal funds.

It fell to Cohen to coordinate the Department’s efforts. As early as May, 1961, Cohen began meeting with the Shrivers, Dr. Cooke (the Hopkins pediatrician), and Myer Feldman of the White House staff to fashion an administration program in mental retardation. As Cohen envisioned a basic package of proposals, it would include the establishment of the National Institute of Child Health and Human Services, the authorization of the Children’s Bureau to make research grants in the fields of maternal and child health and crippled children’s services, and increases in grants for basic maternal health and child welfare services. Cohen also urged an expansion of the vocational rehabilitation program, so that it would work more closely with people who were mentally retarded. In addition, Cohen envisioned special survey, planning, and construction grants, similar to the existing grants for hospital construction, that could be used to build residential care facilities for mentally retarded children. Finally, Cohen wanted Congress to enact a program of grants that could be used to train teachers who worked with mentally retarded children.

The details, as always in these types of proposals, were exceedingly complex. In essence, however, Cohen wanted to tie Mrs. Shriver’s interest in mental retardation with the ongoing activities of the Department of Health, Education, and Welfare. He also wanted, as always, to assuage powerful interests within the Department such as the Children’s Bureau and the Office of Vocational Rehabilitation. He knew that Mary Switzer, the head of the vocational rehabilitation program, would make her own approach to Mrs. Shriver. Switzer, a bureaucrat whose competence matched Cohen’s own, had a remarkable ability, as Cohen put it, to “romance” people who were important to her and her program.

It took some time for the administration to decide on its approach to mental retardation legislation. Instead of simply sending up legislation, the President and Mrs. Shriver appointed a special panel to formulate a “comprehensive and concentrated attack on mental retardation.” This panel deliberated through the winter, spring and summer of 1962 and did not release its report until the fall of 1962. Meanwhile, the National Institute of Child Health and Human Development bill made its way through Congress.

As the Panel engaged in acrimonious debates over such subjects as whether environment or heredity held the key to understanding mental retardation, Cohen tried to anticipate the direction its report would take. He began to see the possibility for a more ambitious legislative program than he had originally envisioned. In particular, he contemplated legislation that could be introduced in 1963 that would provide funds for the construction of facilities devoted to mental retardation research.

Early in 1963, Cohen completed much of the staff work for the introduction of a complete legislative program devoted to mental retardation, one that would be introduced by a special presidential message concerned exclusively with mental retardation and mental health policy. If all of the legislation passed Congress and if Congress authorized the administration’s requests for increased funds to existing programs, the Department would spend more than two hundred million dollars on activities related to mental retardation in fiscal 1964. The new legislative proposals included a plethora of grants: project grants to the states for comprehensive planning on mental retardation, grants for the construction of mental retardation research centers, grants for the construction of mental retardation treatment centers, and grants for improving the education of “exceptional children.”

Beginning in February, 1963, Wilbur Cohen personally oversaw the preparation of weekly progress reports on mental retardation that went to Mrs. Shriver and to others in the government with a special interest in the subject. The reports detailed the progress of the mental retardation legislation through Congress and described departmental efforts to publicize its efforts in the field. The first report followed closely upon the President’s message to Congress in which Kennedy spoke of the nation’s obligation “to prevent mental retardation, whenever possible, and to ameliorate it when possible.”

As Kennedy conducted his high-profile publicity for a mental retardation program, Cohen began an endless series of meetings to get the legislation enacted. He talked with Wilbur Mills and convinced him to introduce a bill that combined the mental retardation planning grants and various proposed changes in the programs run by the Children’s Bureau, all of which took the form of amendments to the Social Security Act. Mills told Cohen that he could not begin hearings on the bill before he completed action on the administration’s tax bill. Still, he agreed to sponsor the legislation. Cohen then sent copies of a second mental retardation bill, one that contained the various grants to the states for the construction of facilities related to mental retardation, to Senator Hill and Congressman Oren Harris. Hill and Harris agreed to introduce this second bill.

Even as Cohen sent the bills to Congress, he continued to meet with Myer Feldman, Dr. Cooke, and HEW officials in an effort to perfect the language in the bills. Dr. Cooke, for example, wanted to make sure that there was money to staff the research and clinical centers, rather than simply to construct them. Cohen worried, however, that there were not enough trained workers in the field that “would enable us to recommend at this time a sound, well thought out, proposal for initial staffing grants for mental retardation facilities.”

Cohen’s most important discussions were with Senator Hill, Congressman Oren Harris, and Congressman Wilbur Mills. Hill decided to consolidate portions of an education bill, a mental health bill, and the mental retardation legislation. The result was a large legislative package that contained three different facility grants for mental retardation and three types of education grants. The package also contained a full series of provisions that related to mental health.

Hill could accomplish this consolidation because his Senate Committee on Labor and Public Welfare handled both health and education. In the House, authority over health and education legislation lay scattered across two different committees and a score of subcommittees. Cohen knew, for example, that Congressman Edith Green of Oregon would object if the House Interstate and Foreign Commerce handled the mental retardation bill without closely consulting her.

Cohen negotiated with the major players in Washington and, at the same time, travelled around the country making speeches in support of the mental retardation program. In these speeches, he appealed for the support of the professionals who would largely be responsible for implementing the new legislation. In 1963, people understood mental retardation as a medical problem that should be handled by professionals. Despite the emphasis on integrating people with mental retardation into the community, few people thought of citizens with mental retardation as an active constituency in their own right. Hence, Cohen spoke to professional groups whose members differed substantially from later groups of advocates for disability rights. The speeches themselves tended to be dull and dutiful recitals of legislative details.

The amount of aid that Arkansas would receive explained in part Congressmen Mills and Harris’s desires to facilitate passage of the President’s mental retardation program. Here was another sort of political interest that needed Cohen’s attention. The record showed that Arkansas did well in the receipt of federal funds for social welfare activities. The state, which ranked dead last in per capita income, spent the most per capita on vocational rehabilitation. It boasted impressive rehabilitation facilities, such as the Hot Springs Rehabilitation Center. Each of these facilities owed its existence to federal grants that its influential Congressional delegation helped to secure.

The mental retardation legislation represented just the sort of small-scale, well-targeted legislation of which Congressmen like Harris and Mills approved. Medicare and aid to education remained highly contested items. Mills, in particular, refused to support Medicare and did as much as anyone to block its passage. More limited aid to medicine, in the form of planning and facility construction grants, and more limited aid to education, in the form of grants for the training of teachers in special education, met with much less resistance. Mills decided not even to hold hearings on his end of the legislation. Instead, he simply solicited written comments, and these comments proved sufficiently encouraging, as Cohen put it, “to permit the Committee to move expeditiously.”

Mills did hold closed, executive sessions on the “Maternal and Child Health and Mental Retardation Planning Amendments of 1963” in July. As was customary, Mills invited Cohen to attend and answer questions about the legislation. The sessions resulted only in minor changes to the bill. Making these minor changes, Mills placed his distinctive stamp on a bill of which he largely approved and from which he stood to gain tangible political benefits in his home district. Mrs. Shriver and other administration officials relied on Cohen’s judgment as to whether to accept Mills’s changes in the bill.

The facility construction and education bill, the second of the mental retardation bills, posed more of a political challenge for Cohen. Here a significant dispute developed between the House and the Senate over the amount of money authorized for the three type of mental retardation facilities specified in the legislation. The House wanted to authorize three years of spending, and the Senate preferred to authorize five years. The dispute had nothing to do with mental retardation policy. Instead, it concerned the desire of Oren Harris to protect the power of his Interstate and Foreign Commerce Committee–an authorizing committee–and not to cede more power to Representative Fogarty and his Appropriations Committee. Hence, Harris wanted the mental retardation advocates to return within a few years for the reauthorization of the bill rather than to let the policy action shift to winning already authorized funds from the appropriations committee. It was the sort of byzantine, internal politics that people like Cohen understood but that could be comprehended only within its immediate context.

Cohen resolved the matter by simply compromising the difference. He asked that four years of funding be included in the bill and the conferees accepted his suggestion.

In the end, the Kennedy administration won approval of both mental retardation bills. As it became clear that the bills would pass, Cohen turned his attention toward the politics of implementation. He helped to resolve questions to which even uncontroversial legislation gave rise. Which agency would take the lead in administering the various parts of the legislation? How much of an increase in appropriations to the Children’s Bureau would be earmarked specifically for mental retardation activities? Just which Republicans would be invited to the signing ceremonies?

Soon after passage of the mental retardation bills, Cohen went off on a speaking engagement in Oklahoma at the specific request of his old friend and patron Lloyd Rader. In his speech, Cohen highlighted the good job of implementing the mental retardation legislation that Oklahoma was doing. Cohen’s trip to Oklahoma also provided him with an opportunity to gather some political intelligence. Senator Kerr had died on January 1, 1963. Cohen met with State Senator Fred Harris, who hoped to take over Kerr’s seat. He also ate breakfast with Governor Bellmon and tried to convince the Governor to support Medicare on the grounds that it would reduce the state’s public assistance costs.

As the contents of Cohen’s political discussions revealed, Medicare and aid to education animated Wilbur Cohen far more than did mental retardation legislation. At the same time, Cohen’s work on this subject showed his competence in undertaking a project that involved composing, passing, and implementing legislation. He managed to satisfy a very demanding Eunice Shriver that the Department was giving sufficient attention to her area of special interest, to gain departmental support for a coherent program, and to respond to the demands of Congressional leaders. It was a particularly adroit performance, particularly given Cohen’s relative lack of knowledge about the topic and the fact that almost always other projects took precedence over mental retardation.

Cohen’s work on the mental retardation legislation also demonstrated the inner workings of the legislative process. Even as Congress refused to pass big ticket items like federal aid to education or national health insurance, it routinely handled less controversial measures. On these measures, Congressional leaders, particularly in the House of Representatives, made sure that the legislation contained tangible benefits for them. It was a mark of Cohen’s ability that he could simultaneously handle the routine legislation and the controversial legislation, even though the same set of people were involved in both.

Camelot

In this manner, Cohen spent the Kennedy years. The nature of his achievement illustrated why historians would have such difficulty assessing Kennedy’s accomplishments. Simply put, Kennedy enjoyed legislative successes but not on many of the issues that he chose to highlight. The passage of a welfare reform bill or mental retardation legislation went relatively unheralded; the continued failure to pass Medicare and aid to education attracted a great deal of attention.

In addition, Congress played a major role in the Kennedy legislation, and Congress often transformed the legislation that Kennedy proposed into something different. That made it more difficult for Kennedy to proclaim a legislative victory. It also meant that the legislation of the Kennedy years bore many similarities to the laws that Congress had passed in the Eisenhower years. Since Congress seldom boldly announced its belief in “big” government, the laws always had a protective rhetorical coating: they were often measures to cure people or invest in their future. More often than not, they amended or modified existing laws and maintained the power of existing agencies. Hence, it would be difficult to characterize them in later years as conservative or liberal, as incremental expansions or bold new initiatives. Further, many of the key Kennedy measures, the controversial ones that involved the expansion of federal power into new areas, were eventually passed into law after Kennedy’s death, causing understandable confusion about how much credit he should receive for them.

For his part, Cohen remained devoted to Kennedy and his memory. It was Kennedy, not Johnson who brought him into a position of executive leadership, and it was Kennedy, not Johnson whom Cohen supported in 1960. For the rest of Cohen’s life, he wore a PT 109 tie clasp, the way others wore an old school tie. He delighted in his personal association with Kennedy. He later noted that he saw Kennedy more times than he did Johnson, even though he was only an Assistant Secretary in the Kennedy administration. In general, Cohen found the Kennedy White House easier to work with than the Johnson White House, in part because Sorensen enjoyed more of Kennedy’s confidence than Joseph Califano did Johnson’s.

Wilbur Cohen treasured the occasions on which he got to see President Kennedy and even compiled a scrapbook of his memories. On November 9, 1961, Wilbur Cohen sat next to Arthur Goldberg, only a few feet from Robert Kennedy and Dean Rusk, at a Cabinet Meeting. He watched the President stride into the room, clutching the New York Herald Tribune and joking about the Republicans’ poor showing in the 1961 elections. The President asked Robert McNamara about sending additional military equipment to Southeast Asia. As Dean Rusk talked about his trip to Japan, the President exhibited his famous impatience. He talked to Ted Sorensen and with Pierre Salinger. He doodled. He pulled his chair aside and chatted with his brother. Then Sorensen led a discussion of the 1962 legislative program, and suddenly Cohen became involved, commenting on the administration’s failure to pass an education bill. After the meeting, Cohen walked out by the West entrance, chatting with Arthur Goldberg and Robert Kennedy about how much the administration should request in education appropriations. It was heady stuff for Cohen, the sort of moment that frames a lifetime.

In the summer of 1962, Cohen returned to the cabinet room, but this time he sat with other staff members, with his back to the wall. Ribicoff occupied the HEW position between Commerce Secretary Luther Hodges and Labor Secretary Arthur Goldberg at the cabinet table. At this meeting, Cohen noted that the President was very serious and used little of his famous sense of humor. Then again, Cohen felt slightly uncomfortable, because he was the only Assistant Secretary in attendance. Sorensen told him that he had asked Ribicoff to bring Cohen because so much of the administration’s legislative program involved HEW. Indeed, of the top ten priority items, three involved the Department.

Occasionally, Cohen had the pleasure of putting the words in Kennedy’s mouth. In 1963, attending a conference on mental retardation, he received a call from Eunice Shriver to help write a message for the President. He and Lois Perry Jones, a department staff member with responsibility for mental retardation, hammered out a message. Cohen dictated, and Jones typed. The President then recited the speech over the telephone to the people attending the conference.

As it turned out, the mental retardation legislation proved to be the last law of Cohen’s that Kennedy signed. Cohen attended the signing ceremony.

Then came the assassination. Cohen’s world collapsed like everyone else’s. On November 23, 1963, Wilbur and Eloise went to the White House to view the President’s bier. Since neither felt they could go alone, they arranged to meet Jim Quigley and his wife. After viewing the casket, they drove to Georgetown and ate lunch. Cohen spent the next day watching television. “I just couldn’t get out to go to the Capitol or elsewhere. It was too terrible, too unreal, too preposterous,” he wrote. On November 25, 1963, Cohen watched the funeral on television.

Then he got a call from Henry Wilson who asked if he could bring a memo on Medicare down to the White House for President Johnson to see. He and Eloise drove to the HEW Building on Independence Avenue. Eloise retyped the memo, and they brought it to the White House at six in the evening. They walked into the West Wing and up to the second floor where Lawrence O’Brien’s office was located. There Cohen encountered Richard Donahue and other close JFK aides, many of whom were drinking. Cohen noticed that Donahue was very drunk and quickly got out of his way. He walked down to the first floor and stopped at Sorensen’s office. “He was there alone,” Cohen recalled, “a white numbed pallor on his face…When we remarked what a great loss had occurred, he said that President Johnson needed all of us.”

How to Cite this Article (APA Format): Berkowitz, E. (2011). Wilbur J. Cohen and mental retardation legislation. Social Welfare History Project. Retrieved from https://socialwelfare.library.vcu.edu/issues/wilbur-j-cohen-and-mental-retardation-legislation/