32. U.S. Department of Labor. Manpower Report of the President and a Report on Manpower Requirements, Resources, Utilization, and Training, p. 187. Washington, D.C.: U.S. Government Printing Office, 1967. 33. U.S. Department of Labor and U.S. Department of Health, Education, and Welfare. Training Health Service Workers: The Critical Challenge, p. 11. Washington, D.C.: U.S. Government Printing Office, 1966. STATEMENT OF HON. JACOB K. JAVITS, A U.S. SENATOR FROM THE STATE OF NEW YORK Senator JAVITS. I am pleased that we have today commenced hearings on various legislative proposals including two bills I sponsored. the Veterans in Allied Health Professions and Occupations Act of 1969 (S. 2753), which I authored and introduced with Senator Prouty last July; and the administration's Allied Health Professions Training Amendments of 1970 (S. 3718) which I introduced on behalf of myself and Senators Prouty, Murphy, Dominick, and Saxbe-all the Republican members of the health subcommittee-and Senator Scott to extend and improve programs of assistance for training in the allied health professions. I am particularly gratified that the administration bill and the chairman's allied health professions legislative proposal, S. 3586, all incorporate features in my own bill, S. 2753, relating to the utilization of the medical corpsmen who leave the military service and to broadening the scope of eligible institutions which can participate in training and retraining programs for allied health profession personnel. As we aspire to bring the full potential of modern medicine to every American-whatever his economic status-we must overcome the grave deficiencies in health manpower. Although the full range of health manpower shortages plaguing the public are all too well known to us to require repetition-particularly in the more clearly recognized and longer established health professions of medicine, dentistry, and nurs ing I would like to share with the subcommittee the documented sad statistics of allied health profession personnel shortages. The April 1969 report to the President and the Congress, by the Department of Health, Education, and Welfare on the Allied Health Professions Personnel Training Act of 1966, as amended, reveals the magnitude of the allied health manpower deficits in 1967 as follows: Shortage of medical allied manpower__ Shortage of environmental health allied manpower_. 110,000 28, 700 60,000 To help overcome these critical manpower shortages, I believe we must increase the Nation's supply of manpower in the allied health fields by taking an important first step forward and utilizing in our civilian-health industry the more than 30,000 medical corpsmen who leave the military service each year. What better way to help many of the thousands of returning Vietnam veterans find meaningful employment? Surely, a medical corpsman who is qualified to treat the wounded on the battlefield should be quickly qualified to assist in the treatment of patients in our hospitals' wards and emergency rooms. My bill S. 2753 was not intended to replace existing legislation which now provides resources to educational and training institutions that presently support allied health training, but to supplement such legislation. It was designed to bring veterans and others with background and interest into the civilian medical service where they are desperately needed and to explore the possibility of finding new sources of manpower capable of performing many of the functions now carried out by highly skilled and scarce professional personnel. In reviewing the pending legislation I might note that one of our greatest concerns in helping overcome the critical manpower shortages is the need for conducting a comprehensive study of existing laws, regulations, customs, and practices governing the licensing, certification, or other means by which individuals are determined to be qualified to practice in the allied health professions. On the basis of the information obtained from the study, and with the advice and assistance of appropriate State and local agencies, professional groups, and other appropriate groups and organizations we should recommend to States and professional groups model codes relating to the classification of the various occupations and specialties within the allied health professions, the standards which must be met by personnel qualified to engage in such occupations or specialties and the licensing, certification, or other procedures to be employed in determining whether individuals meet such standards. This feature is provided for by my bill and I would request that each of the witnesses be asked to comment on the need for such a provision in allied health professions legislation. I have long been concerned with the pressing problems of meeting the needs for health manpower in the allied health professions and the critical problems of the education of allied health manpower and the utilization and development of new kinds of workers. Therefore, I ask unanimous consent that an article appearing in the Journal of the American Medical Association, November 24, 1969, relating to the role of the AMA in meeting the responsibilities to allied health education be made a part of the hearing record. Also, I ask unanimous consent that a report published by the National Academy of Sciences on Allied Health Personnel and their use in the military services as a model for use in nonmilitary health care programs be made a part of the hearing record. The CHAIRMAN. One of the cosponsors of S. 3586, the first cosponsor with me on this bill, is the very able Senator from California who has been in the Senate less than 2 years and has already earned the title distinguished. It isn't applied to him merely because he was elected, but because, among other reasons, his outstanding examination of our veterans' hospitals detailed partly in this week's issue of Life magazine, which has won him recognition already as one of the Senators with concern for the people and with the ability to carry that concern into action. Senator Cranston, I have just made a brief opening statement. Would you care to make any remarks? Senator CRANSTON. First, I want to thank you for those very generous remarks. I am extremely interested in the particular topic that we have before the committee today. And we have some particularly fine witnesses. Roger Egeberg is a man I respect greatly. I am delighted to have an opportunity to hear his testimony here. I regret I will not be able to stay the whole time. But I want to say that on the Veterans' Affairs subcommittee we hope to be able to bring about the establishment of certain new procedures that will provide new opportunities for the use of paramedical and allied health personnel in ways that will demonstrate to the medical community as a whole how effective that approach can be. I hope we can do this quite soon through existing doors that are open to us in the veterans' hospitals and create an atmosphere that will speed the ability to do the same thing in the rendering of medical service generally in the United States. For that reason, I am particularly interested in this hearing on S. 3586, which I am privileged to cosponsor, and the leadership that Ralph Yarborough in his very effective way is providing in this field as he has in so many others. The CHAIRMAN. Thank you, Senator Cranston. The first witness on the list today is the Assistant Secretary for Health and Scientific Affairs, Department of Health, Education, and Welfare; and Dr. Roger Egeberg, I believe you have some associates and members of your staff with Will you. you introduce them, please? STATEMENT OF DR. ROGER EGEBERG, ASSISTANT SECRETARY FOR HEALTH AND SCIENTIFIC AFFAIRS, ACCOMPANIED BY DR. KENNETH ENDICOTT, DIRECTOR, BUREAU OF HEALTH PROFESSIONS EDUCATION AND MANPOWER TRAINING, NATIONAL INSTITUTES OF HEALTH; DR. JOHN ZAPP, ACTING DEPUTY ASSISTANT SECRETARY FOR HEALTH MANPOWER; THOMAS HATCH, ACTING DIRECTOR, DIVISION OF ALLIED HEALTH, BUREAU OF HEALTH PROFESSIONS EDUCATION AND MANPOWER TRAINING, AND DAVE BAYER, DIVISION OF STUDENT FINANCIAL AID, OFFICE OF EDUCATION, DEPARTMENT OF HEALTH, EDUCATION AND WELFARE Dr. EGEBERG. Thank you, sir. I will. On my extreme right is Mr. Dave Bayer, who is from the Office of Education, where he is in the Division of Student Financial Aid. Next to me on my right is Dr. Kenneth Endicott, who is the head of the Health Manpower Bureau, now in the National Institutes of Health. You may remember him formerly as head of the National Cancer Institute. On my immediate left is Mr. Thomas Hatch, who is Acting Director of the Division of Allied Health Manpower in the Bureau of Health Manpower with Dr. Endicott. On my extreme left is Dr. John Zapp, Acting Deputy Assistant Secretary for Health Manpower in our office. Senator Cranston, I am personally very grateful for the relationships that you helped to bring about between the Veterans' Administration and our Department. As you know, I have long been deeply interested and involved with the VA. I think we are in the process of working out some cooperative efforts toward the development of health manpower, which, I think, the Veterans' Administration is more admirably suited for than virtually any other Government agency at the present time. Mr. Chairman, I am grateful for the quality of your statement, the feeling in it, and the vehemence with which you delivered it. I agree with everything that you have said. Now, I would like to read a prepared statement. The CHAIRMAN. I want to thank you for those kind words, Dr. Egeberg. Dr. EGEBERG. I hope you realize how I feel about you, sir. The CHAIRMAN. We are grateful for the effort you are putting forth. We know you work under extreme difficulties because of budget restrictions. We are not unsympathetic to this extreme difficulty, but we are determined to try to get better health for the American people. Dr. EGEBERG. I think we are trying to accomplish the same thing. If we fight in here, we will understand. I am told, if I can read this in less than 15 minutes, it would be a good idea. It is a pleasure to be here this morning to testify on S. 2753, S. 3586, and S. 3718, bills which would significantly broaden and strengthen the Allied Health Professions Personnel Training Act authorities of part G of title VII of the Public Health Service Act. These authorities are due to expire June 30, 1970. These bills evidence a serious concern for the health of the American people and a commitment to prepare the manpower necessary to provide needed health services. There are now major unmet needs for health manpower. Indeed, as you have said, sir, the lack of allied health manpower is a most. serious problem as we aspire to bring the full potential of modern medicine to all members of our society. Efforts to increase medical, dental, and nursing manpower have received major attention for a number of years. Relatively little attention, however, has been given until recently to the essential contributions of allied health personnel to the provision of modern health services. Their effectiveness is already clearly demonstrated in many settings where health care is provided. Improvement in the utilization of health manpower can be effected through greater use of capable supportive personnel in the delivery of vitally needed health services. This is now done to only a very limited extent in the American healthcare system. More general use of allied health manpower in this country requires effective utilization of our present training capacities and experimentation and development of new and improved ways of training and increasing the effective use of allied health personnel. The Allied Health Professions Personnel Training Act of 1966 (Public Law 89-751) was approved November 3, 1966. This law was enacted in recognition of the increasing importance of personnel in the allied health professions and technical occupations as essential elements in the provision of health services. It authorized four types of grants-in-aid to "training centers of allied health professions": grants for the construction of teaching facilities; basic and special improvement grants (formula and special project grants) for the expansion and improvement of allied health curriculums; traineeships for advanced training of allied health personnel to become teachers, administrators, supervisors, or specialists; and grants for the development of new methods for the training of new types of health technologists. Only modest appropriations ($3.7 million) were available for these programs in the first year of operation, which was fiscal year 1967, and at the time of the Health Manpower Act of 1968 there had been only very limited experience on which to base recommendations for modifications of the legislation. That act extended the legislative |