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contributions to student loan funds, scholarship programs for disadvantaged minority health students and grants for community

based scholarship programs.

AMHPS institutions rely heavily on Disadvantaged Assistance grants and contracts in order to identify, recruit, retain and place minority and disadvantaged students. The President's

budget proposal does not adequately increase funding for Disadvantaged Assistance or Exceptional Financial Need Scholarships.

Research Centers at Minority Institutions, Minority Biomedical Research Support, and Minority Access to Research Centers

The 0.875% of the total NIH budget spent on major minority targeted programs is insufficient to meet the training and funding needs of a segment of the population which is expected to reach one-third of the total population in the year 2000. effort to make further progress in studying disorders that disproportionately impact Blacks and other minorities, AMHPS supports the establishment of a goal of providing 3% of total NIH funding to minority related research within 5 years and 5% in 10 years.

In an

Budgets for the MBRS and the MARC programs have not increased enough over the last three years to keep pace with inflation. The MBRS grant programs are an important tool in supporting the participation of minority undergraduates, graduates, and faculty in biomedical research at minority The MARC program provides special research training opportunities and incentives in the biomedical sciences to attract and retain minority students for research These two excellent programs must be appropriately funded.



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The RCMI program is critical to our institutions ability to develop research infrastructures, train minority professionals in research capacities, compete for research dollars and most importantly research health programs common to blacks and other minorities. The President's HHS budget did not provide a significant increase for these three landmark programs. It is imperative that Congress increase the funding for these programs. For example, the Morehouse School of Medicine will be using their RCMI core grant and their RCMI AIDS infrastructure supplemental grant to support the institutional infrastructure of research support services and to further develop the core AIDS research laboratories as well as to develop an international AIDS symposia, while the Tuskegee University School of Veterinary medicine continues to use the funding for their Center for Biomedical Research through the application of computerized research support services.

AMHPS strongly supports the President's funding initiative for the construction or expansion of biomedical and behavioral research facilities for institutions of emerging excellence. Institutions of emerging excellence have been described as RCMI recipients in the report accompanying last years NIH authorization bill that passed the Senate. Unfortunately, last year the NIH bill fell short in the last days of Congress.

The collective missions of our institutions to train disadvantaged individuals to serve in underserved areas is a challenge to institutional financial stability. Because of that mission our institutions fall behind in the entire realm of research infrastructure from our research faculty, to

instrumentation, to facilities. However, based on our past accomplishments with meager resources, we feel confident that we are making a significant contribution, but could make even greater strides if these improved facilities were supported


particularly in studying


disproportionately affect blacks and other minorities.

Education Initiatives, Title III


of paramount importance to Our III, Part B, Section 326 programs postgraduate professional


health conditions that

institutions is the Title

for historically black

The purpose of this

development offices,

funding is to assist graduate HBCUS in establishing and strengthening their physical plants, endowments, academic resources and student services. Currently funding is provided for five independent HBCU professional programs, four of which are members of AMHPS (Morehouse, Meharry, Tuskegee, and Charles R. Drew). Congress should be very proud of this program. It has been a tremendous success. For example, as a direct result of support from this section, Morehouse has been able to make great strides. With the assistance provided to Morehouse under Section 326, Morehouse has been able to strengthen and expand development as related to the clinical sequence of the medical education program. With Title III funds, Morehouse has been able to significantly expand development of faculty and programs in the basic medical sciences, expand their medical curriculum and academic support system and enhance research capability.

It is essential that funding be provided to add five new qualified eligible graduate and professional schools to the Title III, Part B, Section 326 program. For example, the Texas Southern University (TSU) College of Pharmacy currently does not receive Title III funds. One of the limiting factors in expanding the pharmacy program at TSU is the lack of resources. Title III will allow the College the opportunity to establish its own development office. This will facilitate the development of

the infrastructure that will be vital to raising and maintaining permanent endowment support for the program. The resources of Title III will also provide significant assistance in encouraging other extramural organizations to support the biomedical research equipment and student support needed in a competitive health sciences programs. For TSU to continue its quest for academic and research excellence, Title III funding would serve as a springboard to future financial stability. Finally, Title III

There is a

funding will allow TSU to increase its enrollment. documented need for more pharmacists in the State of Texas.

It is important to note that AMHPS believes that the addition of new institutions to the program should not jeopardize the funding that exists for currently participating schools. In this way, no institution would be forced to reduce its budget or cancel obligations already incurred.

Black Hospitals

Historically black hospitals have traditionally played a major role in serving the health care needs of underserved Blacks and other minorities in this country. of the 200 black hospitals in existence at the turn of the century only 11 remain in existence and their survival is in question. All of these hospitals are experiencing severe financial problems and may have to close. Federal funding is desperately needed for these hospitals in order to provide improved facilities, medical equipment, and improved patient care.

Mr. Chairman, thank you for the opportunity to discuss the views of the Association of Minority Health Professions Schools. And again, thank you for your outstanding support.


Senator BUMPERS. Mr. Gemmell.

Mr. GEMMELL. Yes, Mr. Chairman.

Mr. Chairman, with your permission, let the record show that the Association of Schools of Public Health of Dr. Satcher's testimony.

Mr. Chairman, I am grateful for the opportunity to testify on the contributions of academic public health toward promoting health, preventing disease, and cutting medical costs, and to present the association's position on the Federal role in public health professional education assistance and prevention.

As an aside, Mr. Chairman, we would like to applaud your ef forts, sir, on behalf of immunizations and your championing that cause in Congress.

Every study and report dating back to 1979 has warned of the shortages of public health professionals. With your permission, I will let Dr. Sullivan state our case for Federal support. Secretary Sullivan, in his March 1990 report to Congress and to the President on the status of health personnel states that:

Shortages of public and community health personnel currently exist in the following specialties: epidemiologists, biostatisticians, several environmental health and occupational health specialties, public health nutritionists, public health nurses, physicians trained in public health and preventive medicine.

Mr. Chairman, they are trained in schools of public health.

Compounding the problem of shortages of public health personnel is that a declining number of physicians, scientists, and engineers are obtaining education in public health.

These professionals are needed to attain the year 2000 national health objectives.

An HHS advisory committee has projected a shortage of some 1,500 public health and preventive medicine physicians needed in the 1990's.

According to the Institute of Medicine in its study entitled "The Future of Public Health," the IOM reported that the public health activities in the United States have been taken for granted and that there is a need for well-trained public health professionals.

State health officers are particularly alarmed about the low number of nurses trained at the graduate level in public health.

The limited but vital Federal support for public health training has been declining slowly since the 1980's. Ever since 1958, the Congress has recognized that specialized training of public health professionals is a Federal responsibility to be shared with the universities with accredited schools of public health. The 11 schools of public health then and the 24 schools of public health now are essentially national schools since students come from the 50 States, Puerto Rico, and from the U.S. related territories. Graduates of these schools then and now serve primarily in the public, nonprofit sector. Over 80 percent of the graduates work in Government agencies, universities, or for nonprofit health organizations. Mr. Chairman, there is no other source of comprehensive training and organization, policy development and management of health services, prevention programs, and promotion of health for whole population groups.

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