This report assesses the impact of federal child health policy under Titles V and XIX of the Social Security Act upon the states of Connecticut and Vermont for the years 1935 to 1975, and analyzes the reasons for the discrepancy between policy intent and state execution. Two simultaneous approaches are used for data analysis: a cross sectional perspective using data collected from one time segment across different areas, and an historical approach for analysis of the development of policy and administrative change. Specific research methods comprise a review of Congressional intent, Department of Health, Education and Welfare (HEW) regulations, state legislation, administrative performance, services with special references to urban/rural variations, and the Early Periodic Screening, Diagnosis and Treatment (EPSDT) program. Overall findings indicate that federal agencies interpret federal law diversely, and that states faced with uncertain policy, short funds, and external pressures fail to comply with even the federal EPSDT mandate. In addition, since HEW has failed to monitor its programs, states face no loss of funds or penalties. Recommendations include (1) that Congress provide sufficient funding to assure state cooperation and monitor state performance with continuous reporting systems; (2) that Congress be specific as to populations to be served and services to be provided; (3) that administrative agencies be consolidated to avoid interbureaucratic confusion; and (4) that child health advocacy groups become more involved in legislation and in monitoring programs. (Author/CM)