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under HEAL and many students use the maximum amount every year. Full funding of HEAL is of critical importance to them, as is unimpeded and unrestricted borrowing under this program.

The current $260 million credit ceiling that the FY 1991 appropriations law places on HEAL borrowing will cause major problems for all health professions students within the next two months because there will be no funds left. AACOM urges an immediate lifting of the ceiling so as not to limit access to this essential program. AACOM shares this Subcommittee's concern over the problem of defaults in HEAL, and is committed to devising solutions to stem the current default situation. But the education of current and future osteopathic medical students should not be threatened as Congress, health professions educators and the financial community work on solutions to these widely recognized


What is particularly troubling is that some of the lowest cost HEAL loans may not be able to grow due to this limit. Two programs --the HEAL "NOW Loan Program offered to all osteopathic medical students through the Kirksville (MO) College of Osteopathic Medicine, and the Knight Tuition Plans/Key Bank of Maine "HEAL DEAL program for M.D., D.O. and D.D.S. students that have just negotiated improved terms could have positive benefits in terms of future debt management. The credit ceiling may prevent these programs from proceeding. AACOM urges the Subcommittee to lift the credit ceiling as soon as possible. It penalizes disciplines, such as osteopathic medicine, that have very good repayment and default profiles.


AACOM is strongly opposed to the Administration's proposal to phase out the HEAL program and to prevent new borrowers from entering it. This would have a devastating impact on our students, particularly at the private colleges of osteopathic medicine. AACOM does not understand this policy which seems to run counter to the aims of the Administration to encourage primary care training. AACOM urges this Subcommittee to reiterate its commitment to maintaining a strong HEAL program and to reject the Administration's proposal.

AACOM supports the recapitalization of the Health Professions Student Loan Program (HPSL) at the authorized level of $15 million. AACOM does not consider HPSL an adequate substitute for the HEAL program, as has been suggested by the Administration. Osteopathic medical students need to have access to both programs if they are to put together an affordable financial package.

Last year Congress reauthorized the National Health Service Corps (NHSC) and significantly increased funding for the scholarship and loan repayment programs. This program is critical to assuring that the most underserved areas of the country have primary medical care services available. AACOM encourages the Subcommittee to provide $60,000,000 for the scholarship and loan repayment programs. This will allow NHSC to continue to respond to critical health problems, such as high rates of infant mortality, so prevalent in underserved areas.

Several programs help meet the financial needs of disadvantaged and underrepresented minority students in health professions schools. The Disadvantaged Health Improvement Act of 1990 established a number of beneficial programs designed to encourage the participation of minority and disadvantaged students in the health professions. For example, the Scholarships for Disadvantaged Students (SDS) program, the Minority Faculty Loan Repayment Program and the Grants to Communities-Health Professions Scholarship Program are all excellent initiatives. These programs can benefit students at osteopathic medical colleges which have achieved a 100% increase in first year enrollment of underrepresented minorities over the last four years. AACOM urges that the SDS program receive $18 million in appropriations; the Minority Faculty Loan Repayment should be funded at $2 million; and AACOM recommends funding of $2.5 million for the Grants to Communities program.

In addition to the programs under the Department of Health and Human Services, our students make extensive use of Department of Education loans and loan guarantees under the authority of the Higher Education

Act. AACOM urges the Subcommittee's continued support for Stafford Student Loans, Supplemental Loans for Students (SLS) and the Perkins Loan Program. These programs round out the base of financial assistance so necessary to osteopathic students. For example, 85% of the students were recipients of Stafford Loans during the 1988-89 academic year. Fifty-five percent (55%) use SLS. AACOM asks the Subcommittee to recommend funding at the authorized levels.

AACOM understands the limits that the new budget law places on Congress. Within these constraints, AACOM urges the Subcommittee to maintain the availability of federal student assistance. This is a critical issue for osteopathic medical students this year. AACOM deeply appreciates the Subcommittee's continuing commitment to health professions education.



I very much appreciate this opportunity to provide a written statement to the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencles. As a rehabilitation educator at the School of Industrial and Labor Relations at Cornell University, and the current president of the Division of Rehabilitation Psychology (22) of the Amer Ican Psychological Association (APA), I would like to address the Issue of funding for the National Institute on Disability and Rehabilitation Research In the Department of Education.

The Division of Rehabilitation Psychology was established in 1956 as an organization of psychologists concerned with the psychological and social consequences of disability and with ways to prevent and resolve problems stemming from disability. The Division currently has over one thousand members, and is part of the American Psychological Association, which is an International association of over 108,000 members and affillates around the world, working to advance psychology as a science, a profession, and a means to promote human welfare.

The National Institute on Disability and Rehabilitation Research (NIDRR) has played an Important role in addressing the need for research on psychosocial Issues In rehabilitation. The report of the Task Force on Medical Rehabilitation Research (1990) emphasizes the fact that In the United Stated today, disability has become a major problem because of an unbalanced approach to medical research and practice. As a society, we spare no expense on research and technology to save lives, but are reluctant to provide the necessary resources to address the physical, emotional, and socioeconomic problems that accompany the survival of persons with disabilities. NIDRR plays an important role in addressing this Imbalance, particularly through its commitment to funding applled research. With the creation of the new Center for Medical Rehabilitation Research within the National Institutes of Health (NIH) meeting the need for medically oriented, clinical rehabilitation research, NIDRR can continue to give priority to research that addresses the psychosocial and vocational needs of persons with disabilities, and the Identification of the types of systems and services that will best meet those needs.

While NIDRR has a record of supporting research on the psychosocial aspects of disability and rehabilitation, we believe that full Implementation of the Americans with Disabilities Act will require an even better understanding of the attitudinal and environmental barriers that Impede the full Integration of persons with disabilities in our society, particularly in employment settings. NIDRR currently does have a role to play in assisting in the implementation of the ADA, through the administration of funds allocated for Technical Assistance Centers and the development of Information for persons with rights and responsibilities under the Act. However, we believe that NIDRR could make an even larger contribution In assuring the Implementation of the ADA If It was given additional resources for research and technical assistance. If the ADA is to be effectively implemented without undue costly litigation, it is

essential that timely and appropriate Information be available to both covered entitles and those with rights under the law. An area in which we anticipate particular need and which would greatly benefit from additional resources for Information and technical advice is the employment of persons with mental disabilities.

We therefore recommend that the appropriations for NIDRA be Increased to facilitate a needed expansion of psychosocial research, particularly as is relates to the successful Integration of persons with disabilities into employment settings. Additionally, we would like to see the current five million dollars allocated to ADA Implementation activities Increased to 10 million dollars to enhance NIDRA's capacity to respond to the anticipated need for technical assistance in the implementation of the Americans with Disabilities Act.

Effective Implementation of the ADA will depend on the extent and quality of technical assistance that is provided to both the disability community and the business community. A large proportion of the funds currently allocated are for the establishment of regional technical assistance centers. The establishment of these centers will take time and they will not be ready to meet the Immediate needs of the business community and persons with disabilities by early 1992. Thus, there is an urgent need to have additional funding to develop materials and training programs which will quickly and efficiently be made available to all affected parties.

It is highly preferable that potential conflicts that may arise in the course of the Implementation of the ADA be resolved through Information sharing and the provision of technical assistance, rather than through court litigation. NIDRR can serve a critical role in assuring that this educational and technical assistance process is put into place. adequate funding is necessary to assure that this can occur.


I extend my sincere thanks to the Subcommittee for your consideration of this testimony on behalf of the National Institute on Disability and Rehabilitation Research.


The Associated General Contractors of America (AGC) is a national trade association of more than 33,000 firms, including 8,000 of America's leading general contracting firms. They are engaged in the construction of the nation's commercial buildings, shopping centers, factories, warehouses, highways, bridges, tunnels, airports, water works facilities, waste treatment facilities, dams, water conservation projects, defense facilities, multi-family housing projects and site preparation/utilities installation for housing development.

AGC welcomes the opportunity to provide this statement on Fiscal Year 1992 appropriations to the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. AGC respectfully requests that this statement be made a part of the record of the Subcommittee's proceedings. AGC's statement is limited to the consequences of legislative initiatives to Fiscal Year 1992 appropriations bills that impact the implementation of final helper regulations under the Davis-Bacon Act, and proposed regulations governing construction apprenticeship programs.

In March 1991, an amendment was added to the "Dire Emergency Supplemental Domestic Appropriations" bill (H.R. 1281). This rider prohibited the Department of Labor from spending any funds to implement final regulations permitting the employment of semi-skilled helpers on construction projects subject to the Davis-Bacon and Related Acts. The helper regulations were finalized in December 1990, and implemented on February 4, 1991. They were originally proposed in 1982. After nine years of extensive examination and protracted Department of Labor rulemaking and litigation, the federal courts determined that the final helper regulations are fully consistent with the intent of the Davis-Bacon Act, which is to ensure that the wages and labor practices used on federal construction projects parallel those used in the private construction market at the local level.

Implementation of the helper regulations will reduce the economic burden that the Davis-Bacon Act imposes on the federal budget and taxpayers. The purchase of

construction services by the federal government should not dictate additional costs which do not exist in the private sector. Just as the free market system has met the needs of the nation's private sector, so too should the free market system function in the public


The same rider to H.R. 1281 that prohibited expenditures to implement the helper regulations, also prohibits the Department of Labor from spending any funds to finalize or implement proposed revisions to construction apprenticeship regulations. The objective of these regulations is the development of a competitive training system to ensure we meet our skilled workforce needs, and the extension of this system to new and existing industries. Our nation's critical need for a well trained, productive workforce, the decrease in the number of new entrants into the nation's workforce, and a continuing decline in the ability of our schools to prepare students for the school-to-work transition is exposing the United States to a workforce crisis of epic proportions. In the construction industry alone, it is estimated that over 200,000 new workers will be required

each year.

Efficient and effective apprenticeship training programs, tailored to the needs of employers, employees and market conditions, are essential to maintain the competitiveness of the American construction industry. The amendment to H.R. 1281 singles out construction training programs and prevents Department of Labor implementation of progressive regulations as they relate to the construction industry. Such discriminatory treatment is shortsighted and, if allowed to stand, will have a negative impact on the nation's economy as a whole, as well as construction.

In conclusion, AGC urges the Subcommittee to reject any legislative initiatives offered in the 1992 Fiscal Year appropriations process that would continue to prohibit or impede the Department of Labor from implementing the final Davis-Bacon helper regulations, or the proposed regulations governing construction apprenticeship programs.

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