HEALTH RESEARCH FACILITIES

TUESDAY, APRIL 22, 1958

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON HEALTH AND SCIENCE OF THE

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D. C. The subcommittee met at 10 a. m. in room 1334, New House Office Building, the Honorable John Bell Williams (chairman of the subcommittee) presiding.

Mr. WILLIAMS. This morning the Subcommittee on Health and Science commences 2 days of hearings on 4 bills providing for Federal matching grants for the construction of health research and teaching facilities.

The first of the four bills, H. R. 6874, introduced by our chairman, Mr. Harris, and H. R. 6875, introduced by our ranking minority member, Mr. Wolverton, were introduced at the request of the administration. The other two bills are H. R. 7841, introduced by Mr. Fogarty, who is chairman of the Subcommittee on Health and Welfare of the Appropriations Committee, and H. R. 11913, introduced by Mr. Roberts of Alabama, our colleague on the Committee on Interstate and Foreign Commerce.

The time allotted for these hearings is quite limited. If the legislation is to be considered seriously during the present Congress, time is of the essence. Furthermore, I might add that the Committee on Interstate and Foreign Commerce is quite familiar with the premises on which this legislation is based.

During the 84th Congress the committee considered and reported favorably legislation providing for matching grants for the construction of health research facilities. The committee considered extension of that legislation to include the construction of teaching facilities as well. However, as all of you know, Public Law 835 of the 84th Congress as finally enacted was limited to Federal grants for the construction of health research facilities as distinguished from teaching facilities.

The Health Research Facilities Act, which authorized a total of $90 million for the construction of health research facilities will expire next year, and all of the authorized funds have already been spent or committed. The report of the Surgeon General states that the Surgeon General has on hand additional approvable applications amounting to $61 million. This legislation has contributed substantially to the expansion of health research facilities.

The committee is aware that medical schools, including dental schools, public health schools, and osteopathic colleges, are in urgent need of funds for teaching facilities as well as research facilities. The

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staff report made at the direction of the committee, which was submitted to this committee at the beginning of the 85th Congress, contains a complete survey of medical school needs.

The question arises in my mind and, I am quite certain, in the minds of others on this committee, as to whether or not this is a Federal rather than a local responsibility.

Having this report before us, the committee is in possession of most of the relevant facts with regard to this legislation, and the hearings today and tomorrow are more in the nature of a refresher course designed to touch only the highlights of the legislation.

In order to save time, the hearings for the most part will be in the nature of informal panel discussions in which representatives of medical schools, dental schools, and the Department of Health, Education, and Welfare will participate. However, a few other witnesses have expressed a desire to testify, and the subcommittee will do its best to hear as many of them as possible at the end of the panel dis

cussion.

Before we proceed with the hearing, let copies of the bills under consideration be inserted in the record at this point, together with reports of the Department of Health, Education, and Welfare, the Department of Labor, and the Executive Office of the President, Bureau of the Budget.

(The material referred to is as follows:)

[H. R. 6874, 85th Cong., 1st sess.]

A BILL To amend the provisions of the Public Health Service Act relating to grants for construction of research facilities so as to increase their duration from three to five years and to authorize grants for medical and dental teaching facilities

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Medical and Dental Teaching Facilities Act of 1957".

SEC. 2. The heading of title VII of the Public Health Service Act is amended to read "HEALTH RESEARCH AND TEACHING FACILITIES”.

SEC. 3. Section 701 of the Public Health Service Act (setting forth the declaration of policy) is amended to read as follows:

"SEC. 701. (a) The Congress hereby finds and declares that (1) the Nation's economy, welfare, and security are adversely affected by many crippling and killing diseases the prevention and control of which require adequate numbers of physicians, dentists, and professional public health personnel and a substantial increase, in all areas of the Nation, of research activities in the sciences related to health, and (2) funds for the construction of new and improved non-Federal facilities in which teaching of such personnel may be provided or to house such research activities are inadequate.

"(b) It is therefore the purpose of this title to assist in the construction of medical and dental teaching facilities and facilities for the conduct of research in the sciences related to health by providing grants on a matching basis to public and nonprofit institutions for such purposes."

SEC. 4. (a) Paragraph (1) of section 702 of the Public Health Service Act (relating to the definitions) is amended by striking out "Research Facilities" and inserting in lieu thereof "Research and Teaching Facilities".

(b) Such section 702 is further amended by striking out "and" at the end of paragraph (3), by striking out the period at the end of paragraph (4) and inserting in lieu thereof a semicolon, and by inserting at the end of such section the following new paragraphs:

"(5) the term 'medical school' means a school which provides training leading to a degree of doctor of medicine or osteopathy, or a graduate degree in public health; and

"(6) the term 'dental school' means a school which provides training leading to a degree of doctor of dental surgery, or an equivalent degree." SEC. 5. (a) The heading of section 703 of the Public Health Service Act (re

lating to the National Advisory Council on Health Research Facilities) is amended by striking out "RESEARCH FACILITIES" and inserting in lieu thereof "RESEARCH AND TEACHING FACILITIES".

(b) (1) The first sentence of subsection (a) of such section is amended by striking out "Research Facilities" and inserting in lieu thereof "Research and Teaching Facilities", by striking out "the Surgeon General of the Public Health Service who shall be Chairman, and" and inserting in lieu thereof "the Surgeon General, who shall be Chairman, the Commissioner of Education, and”, and by striking out "twelve” and inserting in lieu thereof "sixteen".

(2) The second sentence of such subsection is amended by striking out "Four" and inserting in lieu thereof "Six" and by striking out "eight" and inserting in lieu thereof "ten".

(3) Clause (1) of the third sentence of such subsection is amended by inserting "medical or dental schools or" before "institutions". Clause (2) of such sentence is amended by striking out "research" and inserting in lieu thereof "research or teaching".

SEC. 6. Section 704 of the Public Health Service Act (relating to authorization of appropriations) is amended to read as follows:

"SEC. 704. There are hereby authorized to be appropriated for each fiscal year in the period beginning July 1, 1956, and ending June 30, 1961, such sums as the Congress may determine for making grants, as provided in this title, to assist in the construction of facilities for research in the sciences related to health or for medical or dental teaching; except that the aggregate appropriations during such period for such grants for facilities for research in dentistry and the fundamental and applied sciences related thereto, and for dental teaching facilities, may not exceed $30,000,000, and the aggregate appropriations during such period for such grants for other facilities may not exceed $195,000,000. Sums appropriated pursuant to this section shall remain available until expended."

SEC. 7. (a) Subsection (a) of section 705 of the Public Health Service Act (relating to approval of applications) is amended by striking out "1958” and inserting in lieu thereof "1960".

(b) Subsection (b) of such section is amended to read as follows:

"(b) (1) To be eligible to apply for a grant to assist in the construction of any facility under this title, the applicant must be a public or nonprofit school or other institution and must be approved as provided in paragraph (2) or (3). "(2) To be approved for purposes of eligibility for a grant to assist in the construction of a facility for teaching or a facility for both teaching and research, an institution must be a medical or dental school accredited by a recognized body or bodies approved for such purpose by the Commissioner of E lucation, except that a new school which (by reason of no, or an insufficient, period of operation) is not, at the time of application for a grant to construct a facility under this title, eligible for accreditation by such a recognized body or bodies, shall be deemed accredited for purposes of this title if the Commissioner of Education finds, after consultation with the appropriate accreditation body or bodies, that there is reasonable assurance that the school will, upon completion of such facility, meet the accreditation standards of such body or bodies.

"(3) To be approved for purposes of eligibility for a grant to assist in the construction of a facility for research in the sciences related to health, an institution must be determined by the Surgeon General, after consultation with the Council, to be competent to engage in the type of research for which the facility is to be constructed."

(c) Such section 705 is further amended by redesignating subsections "(c)", "(d)", and "(e)" as subsections "(d)", "(e)", and "(f)", respectively, and by inserting after subsection (b) the following new subsection:

"(c) No medical or dental school shall be eligible for a grant under this title to assist in the construction of a facility, for teaching or for teaching and research, which is a hospital, diagnostic or treatment center, rehabilitation facility, or nursing home (as defined in subsections (e), (1), (n), and (0), respectively, of section 631)."

(d) The subsection and such section 705 herein redesignated as subsection (d) is amended by striking out "subsection (b)" in paragraph (1) and inserting in lieu thereof "subsections (b) and (c)", by inserting "or, in the case of a medical or dental school, the facility will be used by the school for teaching or for research in the sciences related to health" before the comma at the end of clause (A) of paragraph (2), by striking out "research" in clause (C) of such para

graph and inserting in lieu thereof "research or teaching", and by striking out paragraph (3) and inserting in lieu thereof:

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(3) the proposed construction will expand the applicant's capacity for research in the sciences related to health or, in the case of facilities for any medical or dental school, capacity for such research or for teaching medicine, dentistry, osteopathy, or public health, or is necessary to improve or maintain the quality of such research or teaching by the applicant." (e) The subsection of such section 705 herein redesignated as subsection (f) is amended by inserting "or, in the case of facilities for any medical or dental school, capacity for such research or for teaching medicine, dentistry, osteopathy, or public health" after "research in the sciences related to health", by striking out "such research" each time it appears therein and inserting in lieu thereof "such research or teaching", by inserting "or prospective student applicants" after "scientific research workers", and by striking out "available research resources" and inserting in lieu thereof "available research or teaching resources".

SEC. 8. Subsection (a) of section 706 of the Public Health Service Act (relating to amount of grant and payments) is amended by inserting “(1)” after "proportionate" and by inserting before the period at the end of the subsection ", or (2) when a medical or dental school is the applicant, to the contemplated use of the facility by the school for such research or for teaching".

SEC. 9. Section 707 (b) of the Public Health Service Act (relating to recapture of payments) is amended to read as follows:

"(b) unless the Surgeon General determines, in accordance with regulations, that there is good cause for releasing the applicant or other owner from the obligation to use the facility for such purposes, the facility shall cease to be used for the research purposes for which it was constructed or, in the case of a medical or dental school facility, shall cease to be used by the school for teaching or for research in the sciences related to health,". SEC. 10. Section 708 of the Public Health Service Act (relating to noninterference with administration of institutions) is amended by striking out "the research conducted by, and the personnel or administration of, any institution" and inserting in lieu thereof "the personnel, curriculum, methods of instruction, research, or administration of any institution".

SEC. 11. The second sentence of section 710 of the Public Health Service Act is amended to read: "The fourth such report (to be submitted on or before January 15, 1960) shall include an appraisal of the current program under this title in the light of its adequacy to meet the needs for funds for the construction of non-Federal facilities for medical or dental teaching or for research in the sciences related to health."

SEC. 12. The amendments made by this Act shall become effective July 1, 1957, except that such amendments shall not have any effect upon the entitlement of any applicant to payments under title VII of the Public Health Service Act with respect to any project approved by the Surgeon General of the Public Health Service under such title prior to the enactment of this Act.

SEC. 13. Within six months after the enactment of this Act, the Surgeon General of the Public Health Service, after consultation with the National Advisory Council on Health Research and Teaching Facilities (established by section 703 of the Public Health Service Act) and with the approval of the Secretary of Health, Education, and Welfare, shall, to the extent necessary to carry out the amendments made by this Act, amend the regulations prescribed pursuant to section 709 (a) of the Public Health Service Act.

SEC. 14. As soon as convenient after June 30, 1957, the Secretary of Health, Education, and Welfare shall appoint the additional members, authorized by the amendments made by this Act, of the National Advisory Council on Health Research and Teaching Facilities.

SEC. 15. As used in the provisions of the Public Health Service Act set forth in this Act, the term "Secretary" means the Secretary of Health, Education, and Welfare.

(NOTE.-H. R. 6875, introduced by Mr. Wolverton of New Jersey, is identical with H. R. 6874 and is not printed herewith.)