led the Office's applied research unit—Public Health Methods—from July 1958 through 1961. With some form of national health insurance widely anticipated to be imminent, Stewart became an inhouse expert for PHS on issues related to health services delivery and third-party reimbursement. In November 1961 he returned to BSS to head a new Division of Community Health Services devoted to these issues, then from January 1963 through August 1965 worked closely with Medicare architect Wilbur Cohen (the Department of Health, Education, and Welfare (DHEW) Assistant Secretary for Legislation), as an Assistant to Dr. Boisfeuillet Jones, the Special Assistant for Health and Medical Affairs (subsequently renamed the Assistant Secretary for Health). Stewart’s nomination to be Surgeon General on September 24, 1965 came as a complete surprise. Only weeks earlier, then-Surgeon General Luther Leonidas Terry had appointed him to succeed James Watt as Director of NIH. Surgeon General Stewart found himself at the helm of PHS under pressure both to expand his agency because of Medicare and Medicaid and to cut back because of the war in Vietnam and a slowing of the phenomenal growth of NIH. His response was to weave PHS into the Johnson Administration’s creative approaches to federalism, using the highly successful Hill-Burton hospital construction program as a starting point for efforts to improve access to services through government planning. Soon after Stewart became Surgeon General, for example, PHS took on the high-profile and critical task of certifying the nation’s hospitals for compliance with Title 6 of the Civil Rights Act of 1964, prior to the July 1966 implementation of Medicare reimbursement for health services. Public concern that NIH research become the basis for improved care and greater access to care moved DHEW to convene the DeBakey Commission, whose 1964 Report Stewart used as the basis for PHS’s Regional Medical Program (the Heart Disease, Cancer, and Stroke Amendments of 1965). States relations programs, including categorical grants-in-aid to state health departments, were revamped along the lines of urban planning, as the Comprehensive Health Planning Act (also known as the Partnership For Health Act of 1966 and its 1967 Amendments) bypassed state health departments to award grants directly to local government and community not-for-profits, coordinated through state (so-called "section 314a") and nongovernmental ("section 314b") planning agencies. Cycles of administrative upheaval accompanied these dramatic changes at PHS. The first of two major reorganizations reflected nearly a decade’s worth of planning, articulated in terms