It

In 1966, the share of the total vocational education funds going to the health occupations has increased, as has the share to junior college health programs. is anticipated that in 1967 the funds expended for junior college health programs will at least double with an attendant doubling of enrollments.

Under Public Law 88-210 authority for construction of area schools providing training in at least 5 occupational fields, 208 facilities were under construction at the close of fiscal year 1965. Of this number 43 were junior or community colleges. Opportunities for an additional 4,500 students in health occupations will be provided in the 208 facilities. (The figures for junior colleges alone are not yet available.)

Projections for fiscal year 1966 show that an additional 200 new area school facilities will be constructed, with increased emphasis on postsecondary and junior college facilities for vocational and technical education and increased emphasis on health occupations.

The CHAIRMAN. Is that all?

Mr. PICKLE. That is all, Mr. Chairman.

The CHAIRMAN. Mr. Devine?

Mr. DEVINE. Mr. Chairman, I have no questions other than to compliment Mr. Kinsinger for his testimony. We don't have many junior colleges in our State but I have a daughter attending a junior college and I have one that graduated from a junior college.

Mr. KINSINGER. You are starting some, sir. You have some new

ones.

The CHAIRMAN. Mr. Kornegay?

Mr. KORNEGAY. I want to compliment Mr. Kinsinger for a fine statement and to assure him of my interest in the junior colleges and the wonderful role that they do play in the educational system. The CHAIRMAN. Mr. Mackay?

Mr. MACKAY. Thank you, Mr. Chairman.

I would like to compliment him on his statement. The community colleges of Georgia are becoming a tremendous resource. I hope that your group will keep pressing for the use of this resource. Someone said that educational orthodoxy is much more acute and rigid than religious orthodoxy, and I believe it.

I think that if we fail to use this new educational resource in training these people we are not going to do what the intent of this bill clearly is. So I just want to say thank you for what you have done. That is all, Mr. Chairman.

The CHAIRMAN. Mr. Gilligan?

Mr. GILLIGAN. Thank you, Mr. Chairman.

Mr. Kinsinger, some of the questions I have in mind have already been asked. You anticipated one by picking up in your letter to Mr. Rogers a question concerning the statement of the Secretary about the training of health-related technicians under the Vocational Education Act.

I note that on page 3 of that statement you say that in a given fiscal year about $434 million Federal funds were made available for the training of 67,000 students, most of whom were not carrying a full curriculum course.

In the Secretary's statement the other day he proposed expenditures under this bill of approximately $8 million for 1967, $18 million for 1968 and $26 million for 1969. Aimed at solving a relatively narrow problem. Presumably then to include this vast new field at the community college level, junior college level, it would require a substantial increase in these appropriations.

Would you say that if the appropriation did not match the scope of the bill, amending it as you would have amended, that it would

be a mistake to attempt the program when it would be obviously inadequate to begin with?

Mr. KINSINGER. Yes. I will have to speak for myself and not for the American Association of Junior Colleges. I would feel this way. If this bill is going to be restricted in funds, the important aspect which has been proposed for this bill, which is to provide the base of baccalaureate level personnel, which in turn can provide our basis for a teaching staff and this is fundamental to an expansion of the associate degree program-should have priority. If that were all that could be done I would say that ought to be done first.

Now the answer to my plea is not necessarily in this bill. If it can be envisioned in this bill, if it is possible that funds can be made available and that this bill can enable this, that would be ideal. If the whole field of health services technicians on the junior college level could be funded through this bill, we would be very fortunate.

If there are limited funds the solution might lie in strengthening the Vocational Education Act so that it has meaning for the junior college health field.

In other words, I know what I think ought to be done. The legislators know how it can be done.

Mr. GILLIGAN. You recognize, Mr. Kinsinger, that this is authorizing legislation and that we are not actually appropriating money. At the same time all of us have listened to lengthy debates on the floor of the House in the last few weeks about what is suggested as an imperative necessity to cut back Federal spending now in domestic programs.

It occurs to me that if this committee were to broaden the scope of the bill and not at the same time express its willingness to properly fund a much broader program, that by adding the community colleges within the scope of the bill, its operation, the result might be to impair the entire program so that we would not be doing either part of the program very well.

I do not ask you to agree or disagree but this is a point that occurred Thank you, sir.

to me.

The CHAIRMAN. Mr. Farnsley.

Mr. FARNSLEY. Thank you, Mr. Chairman. Thank you, Mr. Witness. I am for any aid to education by the Federal Government or any other government because I know that any money which we spend on education is invested and will come back to the Government many times over in the extra income tax we get from the people who have been through the institutions.

The CHAIRMAN. Thank you very much.

Mr. Moss. Mr. Chairman, I have a couple more questions that I feel I must ask.

Your dialogue with Mr. Gilligan I think needs to be clarified because you definitely limited your remarks as an expression of personal opinion and not of the association for which you speak.

Now in my questions to you I think that I tried to make clear that we are talking about two things. One, your statement deals with expanding the scope of the proposed program.

We both agree that that was desirable.

Mr. KINSINGER. That's right.

Mr. Moss. And that is where we might have a substantial increase in the number of dollars required. We also discussed another

important matter and that was the expanding of the number of qualified institutions through a change in the definition, in recognition of the fact that many of the junior colleges currently provide parallel

courses.

Now you would not want to see anything happen that would prevent that change or that modification in the bill.

Mr. KINSINGER. That is correct, sir. That would not increase the cost substantially. It would just be saying that you are not restricting your support to those institutions that take them all 4 years but rather that they could start at the junior college and be financed there and then go on.

I wholeheartedly support this.

Mr. Moss. We might call that the fairness doctrine in this field of education. Thank you.

Mr. YOUNGER. Will the gentleman yield?

Mr. Moss. Yes, I will be happy to yield.

Mr. YOUNGER. Is it not also true that it is not necessary to increase the amount but to allow them to participate in whatever amount is allocated for that purpose?

Mr. Moss. Just put one more plate on the table.

Mr. YOUNGER. That is right.

Mr. Moss. Thank you.

The CHAIRMAN. Mr. Rogers.

Mr. ROGERS of Florida. I would share that feeling too that our facilities, the junior colleges, which actually are a great reservoir of manpower, should be used. We pointed out, and had pointed out time and time again, the critical shortage in this country. For us to overlook the use of this vital reservoir is, I think, absurd. I share the feelings that have been expressed by my two colleagues. Junior colleges should be used under this program.

I hope that we can do something about it.

Thank you.

The CHAIRMAN. Thank you, Mr. Kinsinger.
Mr. MURPHY. Mr. Chairman.

The CHAIRMAN. Excuse me.

Mr. Murphy has come in so we will call on him for some questions. Mr. MURPHY. I am sorry I was not here to hear your full statement, Mr. Kinsinger.

I was in a hearing on maritime personnel which is in critical shortage because of the Vietnam crisis. In line with Congressman Rogers' questions, we do have a 2-year college program in New York State and these colleges certainly contribute a great deal to the medical technicians and just technical, let us call it, reservoir of personnel in our State.

We certainly think they should be included for consideration under this act.

Thank you, Mr. Chairman.

The CHAIRMAN. Thank you very kindly.

Mr. KINSINGER. Thank you, Mr. Chairman.

The CHAIRMAN. Our next witness is Miss Lucy Blair, the executive director of the American Physical Therapy Association.

STATEMENT OF MISS LUCY BLAIR, EXECUTIVE DIRECTOR, THE AMERICAN PHYSICAL THERAPY ASSOCIATION

Miss BLAIR. Good morning.

The CHAIRMAN. Any statement you may have you may insert in the record and summarize if you wish or read it in its entirety.

Miss BLAIR. Thank you. Members of the committee, as the chairman indicated, I am the executive director of the American Physical Therapy Association and this morning I am speaking for that organization.

Over 10,000 members are distributed in 50 States, the District of Columbia, Commonwealth of Puerto Rico, Panama, and the Virgin Islands; also some of our members are out of the country on military assignments, in the Peace Corps, and one recently was sent to Honduras through the Organization of American States to give guidance in a restorative program after a recent polio epidemic which is quite foreign to us in this country these days.

Although the bill, H.R. 13196, does not name physical therapy or physical therapists as such it is my understanding that the profession of physical therapy is included among the health professions covered by the proposed legislation.

Physical therapists participate in the evaluation of disabilities of patients resulting from illness or injury and administers treatments for the alleviation of pain and for correction or improvement of their conditions.

They instruct the patient, his family, and other personnel. Physical therapists receive referrals from licensed physicians and maintain contact with physicians regarding progressive care of patients.

They work with physicians and other health personnel such as nurses, speech and occupational therapists in contributing to the comprehensive care of patients through direct service to them as well as through participation in community and regional planning.

There are over 5,000 facilities in this country including hospitals, rehabilitation centers and public health agencies with organized physical therapy services. With the advent of medicare these facilities will be required to extend their services to more people and more over a greater geographic area. The qualified manpower services must be doubled in the foreseeable future to meet patient care needs and to train supervisors and teachers.

For effective implementation of such responsibilities, preparation of physical therapists is provided in universities at the bachelor or postbachelor level. A strong foundation in general education followed by basic professional courses and professional experience is provided in the educational program.

The association has supported the establishment of educational programs in physical therapy in universities which also have a medical school and the opportunity of using primary teaching and affiliated clinical facilities.

At the present time there are 42 programs in physical therapy accredited by the Council on Medical Education of the American Medical Association in collaboration with the American Physical

Therapy Association. Six additional programs are being developed in colleges and universities.

Approximately 900 students in physical therapy graduate from these programs each year but twice the number should be graduated to meet the health service needs of people in relation to the increasing population of the United States. This is not to say that we have been unmindful of these needs nor that Federal and voluntary assistance in the form of grants, loans, and scholarships has not been forthcoming. But other kinds of support are needed as well as financial assistance for students. For years physical therapists have been carrying on their fight in the area of rehabilitation with then all the indications of maintaining or assisting in restoring functional ability so that the man or woman could return to work or the child could have his handicap alleviated and that he could grow up to be a contributing member of society. The Vocational Rehabilitation Administration has given increasing financial support through grants to the American Physical Therapy Association, and in 1955 an institute for teachers and clinical instructors was initiated through the VRA grant fund.

At present they are supporting a study of physical therapy education which will be completed by 1968. This study will have a significant effect in the education for physical therapy in the future. Since 1958 grant funds from the VRA have been made available for physical therapists to pursue graduate education in a variety of fields, and anatomy, physiology, psychology, education, and public health.

The grant funds are administered through the American Physical Therapy Association and the traineeship awards are made with the advice and counsel of the National Committee on Graduate Study. Approximately 125 physical therapists have had such assistance in pursuing master's or doctor's programs. In 1962 the VRA instituted assistance to students in physical therapy to ease the rising cost of tuition.

This has continued to expand each succeeding year and indeed we have been most grateful. I should like to make clear to the committee that of the several needs in expanding high quality physical therapy service in this country the major one is for assistance in construction and to expand the training resources of physical therapy schools.

The present training grant programs of VRA are filling great need for help to undergraduate students and for preparing more teachers and administrators. But these could be further expanded through additional Federal funds.

The acute problems in expanding the physical therapy plants in the university and for related teaching call for prompt action such as that proposed in H.R. 13196. The directors of schools of physical therapy are reporting that requests for admission to some of the presently approved programs in physical therapy have had to be denied because of limitations in classrooms, laboratory facilities, and the delay in obtaining qualified faculty.

A year ago a representative of a Midwest State university which had one of the approved programs in physical therapy made an urgent plea for resources for building funds to assist in relocating several of the educational programs for the health professions in one structurally sound building on the campus of the university medical center. To many this was imperative to facilitate classroom and laboratory quarters and to permit the sharing of instructional staff.