Additional information submitted for the record by-Continued American Optometric Association, statement of Dr. V. Eugene American Public Health Association, statement of Atwell, Dr. Robert J., director, School of Allied Medical Services, Dobranske, Veronica C., telegram from.. Page 126 127 129 94 131 Elliott, Dorothy, telegram from 130 Health, Education, and Welfare Department: Cost estimates for proposed Moss amendments to H.R. 13196.. 112 proposed legislation, table... 23 List of allied health professions... State scholarship-loan programs for medical students, as an Huntting, Inez, telegram from............ 24 30 130 Latimer, Ruth M., director, physical therapy educational program, 127 Phillips, Grace, president of the council of physical therapy school directors, letter from.. 119 Schmidt, Edna, letter from.. 135 Schnebly, Martha, telegram from.... 130 Temple University, letter from Millard E. Gladfelter, president... 134 Willard, Helen, telegram from...-- 130 Zlatolovek, Harriet, telegram from... 130 ALLIED HEALTH PROFESSIONS PERSONNEL TRAINING ACT OF 1966 TUESDAY, MARCH 29, 1966 HOUSE OF REPRESENTATIVES, COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE, Washington, D.C. The committee met at 10 a.m., pursuant to call, in room 2123, Rayburn House Office Building, Hon. Harley O. Staggers (chairman) presiding. The CHAIRMAN. The committee will come to order. The hearings today are on H.R. 13196, which I introduced at the request of the administration to carry out recommendations of the President made in his message on domestic health and education. This bill is designed to increase the opportunities for training of medical technologists and personnel in other allied health professions, and to improve the educational quality of the schools training such personnel. The bill also proposes fairly substantial modifications in the student loan programs established under the Health Professions Educational Assistance Act of 1963, as amended, and the Nurse Training Act of 1964. The bill provides for grants for construction of teaching facilities for allied health professions personnel, provides grants to improve the quality of training centers, authorizes traineeships for training of teachers, supervisors, and specialists, and provides grants for projects to develop, demonstrate, or evaluate curriculums for the training of new types of health technologists. The provisions relating to student loans in general would authorize the transfer of the funding of these loans to the private sector. Recent action taken by a subcommittee of the Committee on Education and Labor during its consideration of proposed amendments to the National Defense Education Act raises some questions in my mind as to whether this change would be desirable if a similar change is not made in the National Defense Education Act. I hope that this point will be developed in the hearings. At this point there will be included the text of the bill, H.R. 13196, and agency reports thereon. (The documents referred to follow :) [H.R. 13196, 89th Cong., 1st sess.] A BILL To amend the Public Health Service Act to increase the opportunities for training of medical technologists and personnel in other allied health professions, to improve the educational quality of the schools training such allied health professions personnel, and to strengthen and improve the existing student loan programs for medical, osteopathic, dental, podiatry, pharmacy, optometric, and nursing students, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Allied Health Professions Personnel Training Act of 1966". ADDITION OF PART G TO TITLE VII OF THE PUBLIC HEALTH SERVICE ACT SEC. 2. Title VII of the Public Health Service Act is amended by adding at the end thereof the following new part: "PART G-TRAINING IN THE ALLIED HEALTH PROFESSIONS "GRANTS FOR CONSTRUCTION OF TEACHING FACILITIES FOR ALLIED HEALTH PROFESSIONS PERSONNEL "Authorization of Appropriations "SEC. 791. (a) (1) There are authorized to be appropriated for grants to assist in the construction of new facilities for training centers for allied health professions, or replacement or rehabilitation of existing facilities for such centers, such sums as may be necessary for the fiscal year ending June 30, 1967, and each of the next two fiscal years. "(2) Sums appropriated pursuant to paragraph (1) for a fiscal year shall remain available for grants under this section until the close of the next fiscal year. "Approval of Applications for Construction Grants "(b)(1) No application for a grant under this section may be approved unless it is submitted to the Surgeon General prior to July 1, 1968. The Surgeon General may from time to time set dates (not earlier than the fiscal year preceding the year for which a grant is sought) by which applications for grants under this section for any fiscal year must be filed. "(2) A grant under this section may be made only if the application therefor is approved by the Surgeon General upon his determination that "(A) the applicant is a public or nonprofit private training center for allied health professions; "(B) the application contains or is supported by reasonable assurances that (i) for not less than ten years after completion of construction, the facility will be used for the purposes of the training for which it is to be constructed, and will not be used for sectarian instruction or as a place for religious worship, (ii) sufficient funds will be available to meet the non-Federal share of the cost of constructing the facility, (iii) sufficient funds will be available, when construction is completed, for effective use of the facility for the training for which it is being constructed, and (iv) in the case of an application for a grant for construction to expand the training capacity of a training center for allied health professions, for the first full school year after the completion of the construction and for each of the nine years thereafter, the enrollment of full-time students at such center will exceed the highest enrollment of such students at such school for any of the five full school years preceding the year in which the application is made by at least 5 per centum of such highest enrollment, and the requirements of this clause (iv) shall be in addition to the requirements of section 792(b) (2), where applicable; "(C)(i) in the case of an application for a grant for construction of a new facility, such application is for aid in the construction of a new training center for allied health professions, or construction which will expand the training capacity of an existing center, or (ii) in the case of an application for a grant for replacement or rehabilitation of existing facilities, such application is for aid in construction which will replace or rehabilitate facilities of an existing training center for allied health professions which are so obsolete as to require the center to curtail substantially either its enrollment or the quality of the training provided; "(D) the plans and specifications are in accordance with regulations relating to minimum standards of construction and equipment; and "(E) the application contains or is supported by adequate assurance that any laborer or mechanic employed by any contractor or subcontractor in the performance of work on the construction of the facility will be paid wages at rates not less than those prevailing on similar construction in the locality as determined by the Secretary of Labor in accordance with the Davis-Bacon Act, as amended (40 U.S.C. 276a-276a5). The Secretary of Labor shall have, with respect to the labor standards specified in this subparagraph (E), the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 F.R. 3176; 64 Stat. 1267), and section 2 of the Act of June 13, 1934, as amended (40 U.S.C. 276c). "(3) Notwithstanding paragraph (2), in the case of an affiliated hospital (as defined in paragraph (3) of section 724), an application which is approved by the training center for allied health professions with which the hospital is affiliated and which otherwise complies with the requirements of this section, may be filed byłany public or other nonprofit agency qualified to file an application under section 605. "(4) In the case of any application, whether filed by a training center or, in the case of an affiliated hospital, by any other public or other nonprofit agency, for a grant under this section to assist in the construction of a facility which is a hospital or part of a hospital, as defined in section 625, only that portion of the project which the Surgeon General determines to be reasonably attributable to the need of such training center for the project for teaching purposes or in order to expand its training capacities or in order to prevent curtailment of enrollment or quality of training, as the case may be, shall be regarded as the project with respect to which payments may be made under this section. (5) In considering applications for grants, the Council and the Surgeon General shall take into account "(A) the extent to which the project for which the grant is sought will aid in increasing the number of training centers for allied health professions providing training in three or more of the curriculums which are specified in or pursuant to paragraph (1)(A) of section 795 and are related to each other to the extent prescribed in regulations; "(B) (i) in the case of a project for a new training center for allied health professions or for expansion of the facilities of an existing center, the relative effectiveness of the proposed facilities in expanding the capacity for the training of students in the allied health professions involved and in promoting an equitable geographical distribution of opportunities for such training (giving due consideration to population, relative unavailability of allied health professions personnel of the kinds to be trained by such center, and available resources in various areas of the Nation for training such personnel); or "(ii) in the case of a project for replacement or rehabilitation of existing facilities of a training center for allied health professions, the relative need for such replacement or rehabilitation to prevent curtailment of the center's enrollment or deterioration of the quality of the training provided by the center, and the relative size of any such curtailment and its effect on the geographical distribution of opportunities for training in the allied health professions involved (giving consideration to the factors mentioned above in subparagraph (i)); and "(C) in the case of an applicant in a State which has in existence a State or local area agency involved in planning for facilities for the training of allied health professions personnel, or which participates in a regional or other interstate agency involved in planning for such facilities, the relationship of the application to the construction or training program which is being developed by such agency or agencies and, if such agency or agencies have reviewed such application, any comment thereon submitted by them. "Amount of Construction Grant; Payments "(c) (1) The amount of any grant for a construction project under this section shall be such amount as the Surgeon General determines to be appropriate; except that (A) in the case of a grant for a project for a new training center for allied health professions, and in the case of a grant for a project for new facilities for an existing center where such facilities are of particular importance in providing a major expansion of the training capacity of such center, as determined in accordance with regulations, such amount may not exceed 66% per centum of the necessary cost of construction, as determined by the Surgeon General, of such project; and (B) in the case of any other grant, such amount may not exceed 50 per centum of the necessary cost of construction, as so determined, of the project with respect to which the grant is made. "(2) Upon approval of any application for a grant under this section, the Surgeon General shall reserve, from any appropriation available therefor, the amount of such grant as determined under paragraph (1); the amount so reserved may be paid in advance or by way of reimbursement, and in such installments consistent with construction progress, as the Surgeon General may determine. The Surgeon General's reservation of any amount under this subsection may be amended by him, either upon approval of an amendment of the application or upon revision of the estimated cost of construction of the facility. "(3) In determining the amount of any grant under this section, there shall be excluded from the cost of construction an amount equal to the sum of (A) the amount of any other Federal grant which the applicant has obtained, or is assured of obtaining, with respect to the construction which is to be financed in part by the grant under this section, and (B) the amount of any non-Federal funds required to be expended as a condition of such other Federal grant. "Capture of Payments "(d) If, within ten years after completion of any construction for which funds have been paid under this section "(1) the applicant or other owner of the facility shall cease to be a public or nonprofit private training center for allied health professions, or "(2) the facility shall cease to be used for the training purposes for which it was constructed (unless the Surgeon General determines, in accordance with regulations, that there is good cause for releasing the applicant or other owner from the obligation to do so), or "(3) the facility is used for sectarian instruction or as a place for religious worship, the United States shall be entitled to recover from the applicant or other owner of the facility the amount bearing the same ratio to the then value (as determined by agreement of the parties or by action brought in the United States district court for the district in which such facility is situated) of the facility, as the amount of the Federal participation bore to the cost of construction of such facility. "GRANTS TO IMPROVE THE QUALITY OF TRAINING CENTERS FOR ALLIED HEALTH PROFESSIONS "Authorization of Appropriations "SEC. 792. (a) There are authorized to be appropriated for the fiscal year ending June 30, 1967, and each of the next two fiscal years such sums as may be necessary for grants under this section to assist training centers for allied health professions to develop new or improved curriculums for training allied health professions personnel and otherwise improve the quality of their educational programs. "Basic Improvement Grants "(b) (1) Subject to the provisions of paragraph (2), the Surgeon General may, for each fiscal year in the period beginning July 1, 1967, and ending June 30, 1969, make to each training center for allied health professions whose application for a basic improvement grant has been approved by him a grant equal to the product obtained by multiplying $5,000 by the number of curriculums specified in or pursuant to paragraph (1)(B) of section 795 in which such center provides training during such year, plus the product obtained by multiplying $500 by the number of full-time students in such center receiving training in such curriculums. "(2) The Surgeon General shall not make a grant under this subsection to any center unless the application for such grant contains or is supported by reasonable assurances that for the first school year beginning after the fiscal year for which such grant is made and each school year thereafter during which such a grant is made the enrollment of full-time students at such center will exceed the highest enrollment of such students in such center for any of the five school years during the period July 1, 1961, through July 1, 1966, by at least 21⁄2 per centum of such highest enrollment, or by three students, whichever is greater. The requirements of this paragraph shall be in addition to the requirements of section 791(b) (2) (B) (iv) of this Act, where applicable. The Surgeon General is authorized to waive (in whole or in part) the provisions of this paragraph if he determines, after consultation with the Council, that the required increase in enrollment of fulltime students in a center cannot, because of limitations of physical facilities available to the center for training, be accomplished without lowering the quality of training for such students. "Special Improvement Grants "(c) (1) From the sums appropriated under subsection (a) for any fiscal year and not required for making grants under subsection (b), the Surgeon General may make an additional grant for such year to any training center for allied health professions which has an approved application therefor and for which an application has been approved under subsection (b), if he determines that the requirements of paragraph (2) are satisfied in the case of such applicant. "(2) No special improvement grant shall be made under this section unless (A) the Surgeon General determines that such grant will be utilized by the recipient |