The CHAIRMAN. Relatively 900,000; all but 18 percent of those are in college; so, close to 800,000, would you say?

Mr. BAYER. Yes; I have heard the figure of 18 percent used for the proprietary schools. Therefore, the balance I would assume would be colleges and universities.

The CHAIRMAN. If you talked to the students, of course, these figures are tremendously impressive and encouraging. I came to these committees 12 years ago and we didn't have any NDEA loans. They came with the National Defense Education Act of 1958. It later became the work study opportunity grants guaranteed loans, and then in 1966 the GI bill. All of these together adds up to something close to 3 million college students.

But what would you estimate the overlap to be over that 22 million? Mr. BAYER. I have no basis for estimating the overlap on those programs.

The CHAIRMAN. When we passed the NDEA act in 1958 it was our hope that by beginning that program we could double the number of college students in 10 years. There were then 234 million in college. Now we have what, about 8 million in college in America, senior and junior?

Mr. BAYER. Full and part time, yes.

The CHAIRMAN. Around 8 million. So, the Federal Government is roughly assisting almost as many students now through grants or work study or loans or guaranteed loans or the GI bill, almost as many as we had in college in 1958. I think this is one of the most notable accomplishments of the American Government for the past 12 years in any field-in all fields of government. I think it is one of the greatest things our Government is doing.

We are not doing that much in medicine. This bill on allied health professions is a good bill. It ought to be twice as much. I am hopeful we can get help from the administration for this very modest bill. Do any of you gentlemen have any supplemental statements you desire to add to Dr. Egeberg's statement?

Dr. Egeberg, your statement, as you said, is comprehensive covering the three different bills.

It is 11:32. We have a number of other witnesses. In the interest of time, if I have other questions to submit, I will submit them in writing.

Dr. EGEBERG. Thank you, sir.

The CHAIRMAN. Senator Javits would like to submit some questions in writing, too. One of these bills is his bill and one is the administration bill.

Dr. EGEBERG. Thank you very much.

The CHAIRMAN. Thank you for your contribution.

Our next witness is Dr. Joseph Hamburg, dean of the College of Allied Health Professions, University of Kentucky, Lexington, Ky., and president of the Association of Schools of Allied Health Professions.

If you have staff or assistants or officers of your national association with you, would you identify them, please.

STATEMENT OF DR. JOSEPH HAMBURG, DEAN, COLLEGE OF ALLIED HEALTH PROFESSIONS, UNIVERSITY OF KENTUCKY, LEXINGTON, KY., AND PRESIDENT, ASSOCIATION OF SCHOOLS OF ALLIED HEALTH PROFESSIONS; ACCOMPANIED BY ROBERT GERTZ, EXECUTIVE DIRECTOR, ASSOCIATION OF SCHOOLS OF ALLIED HEALTH PROFESSIONS, AND TONY ESSAYE, COUNSEL

Dr. HAMBURG. I will be happy to, Senator.

With me today to join in this testimony are on my immediate right, Mr. Robert Gertz, who is our executive director of the Association of Schools of Allied Health Professions and on my left, Mr. Anthony Essaye, Association Counselor.

Mr. Chairman, I am pleased to have been invited to testify before this subcommittee with respect to Senate bill 3586 and the subject of allied health education.

What I would like to concentrate on in my brief remarks are the main elements that emerge from the responses to this questionnaire and their relationship to S. 3586.

The main point identified in this information is the need for educational facilities and faculty to prepare allied health personnel. It is the view of our members that although qualified students are available in sufficient numbers, they simply do not have the facilities in which to prepare them.

In making the above point, I do not wish to imply that programs directed toward identifying sources of students and assisting students while they receive education and training in allied health are not also of value. We would support the provisions of S. 3586 directed to that end, such as the work study, scholarship, and loan programs for students. We also support and agree with the provision in S. 3586 which would delineate special project grants as a separately funded program and which would broaden the purposes for which these funds could be used.

As you know, the funding level under the Allied Health Professions Personnel Training Act for construction of teaching facilities and for basic improvement grants, under which faculty salaries can be provided, has been minimal.

The provision in S. 3586 to continue and to expand these programs is heartily supported by the association. We must emphasize, however, that full funding as proposed in this bill is essential if our country is to come anywhere near meeting its potential need for well-trained, allied health personnel.

Our member institutions have reported to us that expansion of enrollment in all of their curriculums is dependent on an availability of Federal funds to provide facilities to enable this. Our members have attempted to seek funds from sources other than Federal agencies, with very limited success.

Inadequate funding of these programs under the Allied Health Professions Personnel Training Act has postponed full-fledged recruitment in many areas. Moreover, a number of our members have actually had to cut back on existing programs over the last few years,

in light of the cost increases that are inherent today in our educational institutions and their inability to secure Federal funds to offset these costs.

Some statistics in this regard may be helpful. The 23 universities and colleges, providing the funding information, summarized in the addendum to my statement, reported that since 1966 when the Allied Health Professions Personnel Training Act was enacted they has sought Federal grants totaling $21 million. Of the amounts actually sought, as of this date only $8.9 million (42 percent of the funding applied for) has been funded.

Moreover, these institutions-which represent only a relatively small number of the total allied health related programs existing throughout the country-report that their basic funding needs for allied health training for fiscal year 1971 total approximately $29 million.

Of this amount, $19 million would be for construction of new facilities, $4.5 million for educational improvement, $2 million for traineeships, and $3.5 million for developmental grants. These institutions believe that approximately 30 percent of these needs can be satisfied from State and local funding sources, however, the remaining 70 percent-$20.5 million-would have to come from the Federal Government.

I think it seems clear that the level of funding which these institutions have received thus far-and I am sure it is representative of the experience of all allied health training institutions over the past few years-is totally inadequate.

At the same time, the need for health personnel continues to grow enormously. In 1900, there was approximately one supportive health person for every physician. It is estimated that today that ratio is 13 to 1. Similarly, if this Nation is to come anywhere near fulfilling its commitment to provide comprehensive health care for all citizens, it is expected that this ratio will rise to 20-25 to 1 by 1975.

Today, our association is very concerned that the allied health movement will lose its momentum and consequently its potential for providing comprehensive health care if adequate funding is not soon made available in support of these educational endeavors. The hopes and aspirations of allied health educational institutions were raised by the enactment of the allied health legislation in 1966. Obviously, there has been great disappointment since that time in the minimal funding that this legislation has actually received. S. 3586 offers us renewed hope that adequate funding will be available.

The only area of concern with respect to S. 3586 voiced by our membership was with the broadening of the definition of eligible institutions to read "public or nonprofit agencies, institutions and organizations" rather than "public or nonprofit training centers for allied health professions."

It was their hope that this broadened eligibility should not be allowed to dilute the quality of allied health education. In this regard, they urged that provision be made in the bill that to be eligible for funding, an agency, institution or organization must meet generally recognized educational standards.

Before concluding my remarks, I would like to respond to the request of Senator Cranston who asked us to comment on the need of health professionals to have a bit more understanding and empathy for and toward the sick. I think we can categorically state we are in complete agreement. Many of us both in health practice and education deplore this lack of empathy on the part of our health care personnel. I believe that there are things, however, that we can do to make certain or to correct the attitudinal effects and to make these students a little more socially sensitive to their patient's needs.

I think that, first of all, we can be more careful in our selection of applicants to help insure that the potential student for the health care profession has the qualities we seek. Second, I believe that we can teach both by lecture in the classroom and directly by example in the areas of patient care these very attitudes which we seek from our students.

I have a definition, I suppose my own, of professionalism as it relates to the health professions. Professionalism demands not only a skilled performance on the part of the health professional, but also that one's own personal needs, ambitions and problems are held subordinate to the health care needs of the patient.

In summary, Senator, our association is strongly supportive of S. 3586 and we wish to commend you, Senator Yarborough, for your continued attention to the vital need in America for a steady growth in allied health personnel.

The CHAIRMAN. Thank you, Dr. Hamburg, for coming to the session and presenting the facts in a few pages. I order printed at this point in the record your addendum that you filed supplementing and showing your questionnaire to the member schools and the institutional members and council chairmen and so forth concerning these needs. (The information referred to follows:)

ASSOCIATION OF SCHOOLS OF ALLIED HEALTH PROFESSIONS

One Dupont Circle, N.W., Washington, DC. 20036 Telephone: (202) 293-3422

ADDENDUM

Addendum to Statement of Joseph Hamburg, M.D., President of the Association of Schools of Allied Health Professions, before the Subcommittee on Health of the Senate Committee on Labor and Public Welfare, May 19, 1970.

In order to provide the Subcommittee with some first-hand information, the

Association prepared a questionnaire concerning the experience of its Institutional and Provisional Institutional membership schools and a small group of other individuals: Total Questionnaires

Institutional Member Schools

Provisional Institutional Member Schools

Council Chairmen

31

25

2
4

Of the 31 questionnaires which were distributed, 25 were returned and the

results which are reported here are based on these responses. However, the fiscal exhibits are based on 23 responses because the others could not be clarified in time for this presentation. Although this sample cannot be considered to represent the

entire allied health field, it does represent a group of institutions whose primary focus of attention is the education of allied health personnel in four-year colleges

and universities.

EXPERIENCE WITH PRESENT GRANTS

(a) some

The first question on the questionnaire was directed to the experience of the respondents with grants since the enactment of the Allied Health Professions Training Act of 1966. The following data represents 23 replies which were received. The total applications are accounted for in the following three categories: applications were still pending when the questionnaire was completed; (b) some applications were approved by the U.S. Department of Health, Education, and Welfare (DHEW), but because of shortage of federal funds some of these could only be partially