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Special scientific projects

The bill would add a new section 395 to the Public Health Service Act which would authorize not to exceed $500,000 a year for a 5-year period beginning with fiscal year 1966, to be used by the Surgeon General to assist, through awards to physicians and scientists, in the compilation of existing, or the writing of original, contributions relating to scientific, social, and cultural advancements in the sciences related to health which will facilitate the distribution and utilization of such knowledge and information. The Surgeon General would be authorized to make appropriate arrangements whereby the facilities of the National Library of Medicine and of other institutions would be made available in connection with the projects for which the awards are made.

With the tremendous increase in the volume and complexity of the literature in the biomedical sciences there is an urgent need for preparation of critical reviews, articles, abstracts, and other compilations or original contributions of a high degree of excellence and reliability to make more readily available to the medical community knowledge of advancements in the medical sciences. Such reviews, by physicians and scientists of stature, can serve as one of the most important keys to the literature, by providing practitioners, teachers, scientists, students, and others with access to, and appropriate perspectives on, significant aspects of scientific developments.

Research and development in medical library science and related fields

The bill would add a new section 396 to the Public Health Service Act which would authorize appropriations of not to exceed $3 million a year for a 5-year period beginning with fiscal year 1966, for grants or contracts for research or investigations in the field of medical library science and related activities, and for the development of new techniques, systems, and equipment for processing, storing, retrieving, and distributing information pertaining to sciences related to health.

The magnitude and diversity of the requirements of the Nation's corps of healthworkers for the information in the medical literature is tremendous. The information resources of the Nation's biomedical libraries must be made available to its corps of health practitioners, to researchers in the health fields, and to students being trained in the health professions, in ways which are commensurate with their urgency, variety, and volume.

The volume and character of the published biomedical literature are such as to pose peculiar problems of storage, retrieval, and transmission of the information contained therein. The uses to which the information is put are of such vital importance in terms of the health needs of the Nation that the urgency of improving these aspects of its handling cannot be too strongly emphasized. Nearly all aspects of current medical library science need to be reassessed to develop more efficient skills and technologies. In addition, research is needed in related areas such as the uses of information by scientists. teachers, and practitioners and their searching techniques and attitudes; medical terminology and classification; machine indexing; graphic image storage and retrieval, and the like. Such research will not only provide answers to many immediate problems of medical information handling, it will also provide important guidelines for the future. Support of biomedical publications

The bill would add a new section 399 to the Public Health Service Act which would authorize appropriations of not to exceed $1.5 million a year for a 5-year period beginning with fiscal year 1966 for grants or contracts with nonprofit institutions of higher education or individual scientists for support of nonprofit biomedical scientific publications and to procure the compilation, writing, editing. and publication of reviews, abstracts, indices, handbooks, bibliographies, and related matter pertaining to scientific works and scientific developments. No grant for support of any periodical publication could be made for more than 3 years.

Effective access to the medical literature requires a variety of secondary publications, including abstracts, indices, handbooks, critical reviews, and the like. This is particularly true as the volume, magnitude, and complexity of the literature increases. The support authorized by this section would be limited in duration and could serve as a stimulus to the initiation and successful maintenance of a few carefully selected publications which have potential for making a special contribution to the biomedical community.

National Medical Libraries Assistance Board

The bill would provide that the Board of Regents of the National Library of Medicine shall constitute and serve as the National Medical Libraries Assist

ance Board to advise and assist the Surgeon General in the preparation of regulations and with respect to policy matters relating to the administration of the programs which the bill would authorize. The Board would also review a construction applications, and would advise the Surgeon General on support of biomedical scientific publications and on establishment of regional medical libraries. (Note that, in its capacity as Board of Regents of the National Library of Medicine, the Board would also advise the Surgeon General on the establishment of branches of the National Library of Medicine to serve as regional medical libraries.)

We strongly endorse the use of the Board of Regents of the National Library of Medicine as the advisory council for the programs authorized under this bill. This would assure maximum coordination and continuity between the new programs and the ongoing activities and responsibilities of the National Library of Medicine. We would suggest however, that, in line with the advisory role of the Board in the construction program, the introductory phrase in the proposed section 393(b) (p. 6, lines 5-7) be changed to read: "A grant under this section may be made only if the application therefor is reviewed by the Board and is approved by the Surgeon General."

Section 4 of the bill would provide for an increase in the authorized ceiling for per diem pay of members of the Board of Regents of the National Library of Medicine from $50 to $75. This would bring the authorized ceiling for the per diem of members of the Board of Regents to the same level as that authorized last year for the Federal Hospital Council and the National Advisory Council on Nurse Training.

In summary: the medical library is an essential instrument in the training of medical personnel, the conduct of medical research, and the practice of medicine. Yet in recent years the Nation's medical libraries have been seriously neglected and today are in critical condition. The difficulties of medical libraries and the effect of their weaknesses on medical training, research, and practice must now be recognized as a problem of national proportions, and one which ultimately could pose a threat to the health of the American people. The needs are extensive and urgent. An intensive, comprehensive program directly related to meeting these needs should be initiated without further delay. H.R. 3142 would provide the

basis for such effort.

We would therefore strongly recommend enactment of H.R. 3142. (We suggest, however, that a clarifying amendment, along the lines enclosed herewith, be included in the bill to make clear that nothing in the bill is intended to limit any authority existing under present law. It should also be noted that favorable action on this bill will make unnecessary the references in the proposed Higher Education Act of 1965 to the "biomedical" field. (See S. 600, p. 20, lines 13-14; p. 23, lines 10-11.)

We are advised by the Bureau of the Budget that there is no objection to the presentation of this report from the standpoint of the administration's program. Sincerely,

WILBUR J. COHEN,
Assistant Secretary.

DRAFT LANGUAGE TO CARRY OUT SUGGESTION IN DEPARTMENT'S REPORT ON H.R. 3142

On page 23, after line 3, insert the following new section:

"OTHER AUTHORITY NOT AFFECTED

"SEC. 5. Nothing in this Act shall be construed as limiting the authorities and responsibilities, under any other provision of the Public Health Service Act or any other law, of the Surgeon General, the Public Health Service, or the Secretary of Health, Education, and Welfare."

Hon. OREN HARRIS,

DEPARTMENT OF THE NAVY,

OFFICE OF THE SECRETARY, Washington, D.C., September 13, 1965.

Chairman, Committee on Interstate and Foreign Commerce,
House of Representatives, Washington, D.C.

MY DEAR MR. CHAIRMAN: Your request for comment on H.R. 3142, a bill to amend the Public Health Service Act to provide for a program of grants to assist

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in meeting the need for adequate medical library services and facilities, has been assigned to this Department by the Secretary of Defense for the preparation of a report thereon expressing the views of the Department of Defense.

This bill would amend the Public Health Service Act to permit assistance to medical libraries. This assistance would include renovation and construction, training of medical librarians, assistance to medical and other scientific authors and assistance in investigation and research. The bill includes a section authorizing regional branches of the National Library of Medicine. The Surgeon General of the Public Health Service would manage the program with the advice and assistance of the Board of Regents of the National Library of Medicine.

The proposal is considered desirable, not only for the National Library of Medicine, but for medical practice and medical libraries in the Department of Defense. Accordingly, the Department of the Navy, on behalf of the Department of Defense, recommends enactment of legislation to accomplish the purpose of H.R. 3142 but defers to the Department of Health, Education, and Welfare as to the specific provisions of the legislation.

This report has been coordinated within the Department of Defense in accordance with procedures prescribed by the Secretary of Defense.

The Bureau of the Budget advises that, from the standpoint of the administration's program, there is no objection to the presentation of this report on H.R. 3142 for the consideration of the committee. For the Secretary of the Navy. Sincerely yours,

M. K. DISNEY,

Captain, U.S. Navy, Director, Legislative Division.

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U.S. DEPARTMENT OF LABOR,

OFFICE OF THE SECRETARY,
Washington, September 15, 1965.

Hon. OREN HARRIS,

Chairman, Committee on Interstate and Foreign Commerce,
House of Representatives, Washington, D.C.

DEAR MR. CHAIRMAN: This is in further response to your request for our views on H.R. 3142, the Medical Library Assistance Act of 1965.

Since the Department of Labor has no direct responsibility in this area, we prefer to leave comments on the substantive provisions of this bill to the Department of Health, Education, and Welfare, the agency with special competence in this field and most directly concerned with the administration of the program. From the standpoint of our particular responsibilities, we note with approval that the bill contains provisions to protect the labor standards of laborers and mechanics employed on projects authorized by this legislation. However, since the bill defines "construction" to include "equipping new buildings and existing buildings", we recommend that section 393(b)(3) of the bill be amended to limit the application of the labor standards to the type of construction normally covered by the Davis-Bacon Act, as amended. Suggested draft language is enclosed.

The Bureau of the Budget advises that there is no objection to the submission of this report from the standpoint of the administration's program. Sincerely,

W. WILLARD WIRTZ,
Secretary of Labor.

PROPOSED LANGUAGE FOR SECTION 393(b)(3) or H.R. 3142

"No grant for a project of construction under this Act shall be made unless the Secretary finds that the application contains or is supported by reasonable assurance that all laborers and mechanics enployed by contractors or subcontractors on projects of the type covered by the Davis-Bacon Act, as amended (40 U.S.C. 276a-276a-5), will be paid wages at rates not less than those prevailing on similar work in the locality as determined by the Secretary of Labor in accordance with that Act; and the Secretary of Labor shall have with respect to the labor standards specified in this paragraph the authority and functions setforth in Reorganization Plan No. 14 of 1950 (15 F.R. 3176; 5 U.S.C. 133z-15) and section 2 of the Act of June 13, 1934, as amended (40 U.S.C. 276c)."

COMPTROLLER GENERAL OF THE UNITED STATES,
Washington, D.C., March 8, 1965.

B-74254.

Hon. OREN HARRIS,

Chairman, Committee on Interstate and Foreign Commerce,
House of Representatives.

DEAR MR. CHAIRMAN: By letter dated February 15, 1965, you requested our comments on H.R. 3142. The stated purpose of this measure is to amend the Public Health Service Act to provide for a program of grants to assist in meeting the need for adequate medical library services and facilities.

While we have no special information that would assist the committee in its consideration of the merits of H.R. 3142, we would like to offer the following comments regarding this measure. No provision is made in H.R. 3142 nor in legislation applicable to other grant programs now authorized by the Public Health Service Act, as amended, 42 U.S.C. 201 et seq.-with the exception of the hospital programs under title VI thereof—to require a grantee to keep adequate cost records of the projects to which the Federal Government makes financial contributions, or specifically authorizing the Secretary of Health, Education, and Welfare or the Comptroller General to have access to the grantee's records for purposes of audit and examination. In view of the increase in grant programs over the last several years, we feel that in order to determine whether grant funds have been expended for the purpose for which the grant was made, the grantee should be required by law to keep records which fully disclose the disposition of such funds. We also feel that the agency as well as the General Accounting Office should be permitted to have access to the grantee's records for the purpose of audit and examination. We therefore suggest that consideration be given to amending the bill to include such requirements with respect to the proposed new grant program, or preferably to an amendment of the Public Health Service Act to cover all grant programs therein authorized. The latter could be accomplished by the following language:

"RECORDS AND AUDIT

"(a) Each recipient of assistance under this Act shall keep such records as the Surgeon General shall prescribe, including records which fully disclose the amount and disposition by such recipient of the proceeds of such grants, the total cost of the project or undertaking in connection with which such funds are given or used, and the amount of that portion of the cost of the project or undertaking supplied by other sources, and such other records as will facilitate an effective audit.

"(b) The Secretary of Health, Education, and Welfare and the Comptroller General of the United States, or any of their duly authorized representatives, shall have access for the purpose of audit and examination to any books, documents, papers, and records of the recipients that are pertinent to the grants received under this Act."

Language similar to that suggested above is contained in section 11 of the Clean Air Act, approved December 17, 1963, Public Law 88-206, 77 Stat. 401, the act of May 31, 1962, Public Law 87-460, 76 Stat. 83, and in section 25 of the Area Redevelopment Act, approved May 1, 1961, Public Law 87-27, 75 Stat. 63, 42 U.S.C. 2522 (supp. V).

Sincerely yours,

JOSEPH CAMPBELL, Comptroller General of the United States.

Mr. STAGGERS. Again, I would like to say that any witness who is here who would like to present his testimony for the record will be considered as giving it and it will be inserted in the record.

At this time we will hear from our colleague, Mr. Fogarty of Rhode Island, who is one of the sponsors of the legislation under consideration. STATEMENT OF HON. JOHN E. FOGARTY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF RHODE ISLAND

Mr. FOGARTY. Mr. Chairman, early in June I appeared before this committee to urge passage of another vital health measure-the Health Professions Educational Assistance Amendments of 1965. Under your skillful handling on the floor of the House that bill passed

the House and is going to become law. Earlier this month this committee reported out the regional medical plan which has already passed the Senate and which, when it comes before the House, is sure to pass and become law. Today we are considering a related health measure, the Medical Library Assistance Act of 1965, and it— like the other bills-deserves to become a part of the law of this land. In January I introduced on the House floor three separate measures-H.R. 5999, H.R. 6000, and H.R. 6001-which embodied proposals now incorporated in the health professions educational assistance amendments, the regional medical plan, and the Medical Library Assistance Act we are considering today. Unlike some of the other health bills to come before this Congress, the medical library assistance bill has a striking unanimity of support and I have no doubt that it will pass this Congress and become law. Without a dissenting voice, the health professions and librarians alike are agreed that the need to strengthen the country's medical library system is urgent.

For the medical libraries of this Nation are indeed in shocking state. There are 6,000 libraries in this country, but only 3,000 librarians one-half a librarian for each library. The needs for additional space to allow libraries to expand to a size sufficient to meet minimum standards runs to millions of additional square feet. The requirements for books and journals to support medical research are massive. And as for training, only 40 additional professional librarians are being added to the field of medicine every year-while the national attrition of medical librarians is 150 every year.

A weak and inefficient medical library system results in a wastage of our medical research effort that is both unnecessary and of such proportions that it can no longer be overlooked. Unplanned and unnecessary duplication of research costs time and money. And research results that are reported but cannot be retrieved might as well never have been reported. Someone else will have to duplicate them and report them again before they can help one other scientist or be used by one practitioner to alleviate the sufferings of patients. The irony of this is that our success in creating and sustaining a national effort in biomedical research over the past two decades has resulted in a flow of new medical information the like of which has never been seen before in human history. But this flow of information has turned into a flood and swamped the reservoirs--the Nation's medical libraries are the inevitable reservoirs of this new knowledge. The flooding the information that has seeped away or has been lost down the spillways-is a tragic thing to watch.

I think that it is this spectacle that has brought about the general recognition that we must act quickly to meet this desperate situation. Everyone seems to have suddenly recognized what such organizations as the Association of American Medical Colleges have been saying for a number of years about the worsening plight of this Nation's medical libraries. The President's Commission on Heart Disease, Cancer, and Stroke, as well as the American Medical Association have pointed to the need to improve our Nation's medical libraries.

Everyone seems to be saying with one voice that a large-scale national effort has to be made now to rehabilitate medical school libraries. It is clear to all that no temporary solution is possible, and

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