Dr. GRANING. Yes, sir. Mr. FARNUM. What is the authorization? Dr. GRANING. It is the new legislation passed by Congress. Dr. GRANING. $160 million is authorized by the Congress. Mr. FARNUM. $160 million even? Dr. GRANING. Yes, sir. Mr. FARNUM. The request here is over the authorization? Mr. HAMBLETON. There is $25 million additional authorized for the nursing construction. There are two different laws, one for nursing construction and one for medical, dental and other health personnel. Mr. FARNUM. How much have you obligated so far? Dr. GRANING. We have obligated all but $6.5 million of the money that has been made available to us to date. This is $168,500,000 obligated out of $175 million appropriated. Mr. FARNUM. How much would it take to fund all the applications. that you have on hand? Dr. GRANING. All applications, just applications? Mr. FARNUM. Yes. Dr. GRANING. $182 million. Mr. FARNUM. In other words, the applications on hand exceeds the amount? Dr. GRANING. If we were to include letters of intent, it would be a much larger figure. ELIGIBILITY REQUIREMENTS Mr. FARNUM. What are the eligibility requirements for a school to receive a grant under this program? Dr. GRANING. To be eligible, applicants are required to be public or nonprofit institutions. They must be accredited by the body or bodies approved for such purposes by the Commissioner of Education, U.S. Department of Health, Education, and Welfare. Also, while teaching hospitals may participate, the participation is limited to that portion of the project which the Surgeon General determines necessary for medical school teaching purposes. In addition, there must be reasonable assurance of matching construction money in evidence as well as operating money for the school. Title to land must be secure. Further, the facility must be in compliance with title VI of the Civil Rights Act. Mr. FARNUM. How are applications processed? Dr. GRANING. The potential applicant is contacted and urged to arrange a visit to discuss his project. Such a meeting allows the Public Health Service staff to provide detailed information on the program and consultation on the preparation of the application. Major projects may require several visits by the applicant, his consultants, and architects before final details can be completed for the submission of an application. The application is then reviewed by the Public Health Service for completeness and to verify that all legal requirements are met. Arrangements are then made for a site visit by a team of non-Federal consultants in the discipline for which the application is made who will review in detail the proposed project. The report of the site visitors, as well as all other material, is then presented to the appropriate review committee composed of peers. There are six advisory committees representing the disciplines of medicine and osteopathy, pharmacy, optometry, public health, podiatry, and dentistry. The committee recommendations are considered by the National Advisory Council on Education for Health Professions which, in turn, makes recommendations of approval, provisional approval, deferral, or disapproval to the Surgeon General for final decision. Applicants are advised as soon as possible of the action taken by the National Advisory Council. Grant recipients are referred to the appropriate regional office of the U.S. Department of Health, Education, and Welfare which works with the school through the completion of construction. DIVISION OF COSTS Mr. FARNUM. What percent of total costs are borne by Federal funds? Dr. GRANING. As in most Federal aid programs, the applicant must provide the necessary matching funds. The level of Federal participation varies with the type of construction. For example, we may participate up to 75 percent of the cost of construction in a school of public health. For other disciplines eligible under the act, new schools can receive up to two-thirds of the total construction cost and schools planning major expansion can receive up to 66% of the eligible costs attributable to the expansion. All other projects may receive up to 50 percent of the eligible cost. AUTHORIZATION, MATCHING, AND ELIGIBILITY FOR OTHER PARTS OF PROGRAM Mr. FARNUM. For teaching facilities for nurses you have $15 million this fiscal year and are requesting $25 million for 1967? Dr. GRANING. That is correct, sir. Mr. FARNUM. What is the amount of authorization? Dr. GRANING. For 1966 the authorization is $10 million for the collegiate program. For 1967 the authorization is $15 million for the associate and diploma programs. Mr. FARNUM. How much has been obligated so far? Dr. GRANING. Out of the $5 million appropriated for collegiate schools we have obligated $4,200,000. Out of the $10 million appropriated for associate degree and diploma schools we have obligated no funds to date. I would like to add, however, that we now have on hand applications requesting $11,600,000 Federal funds from the associate and diploma category and we plan to obligate the entire $10 million before June 30, 1966. Mr. FARNUM. How much would it take to fund all the applications that are now on hand? Dr. GRANING. For collegiate programs $15 million. For diploma and associate programs we anticipate a backlog of $1,600,000 by June 30, 1966. Mr. FARNUM. What are the eligibility requirements? Dr. GRANING. The eligibility requirements, sir, are the same as for the health professions Public Law 88-129 program. Mr. FARNUM. How are applications processed? Dr. GRANING. Again, sir, the processing of applications in the two programs is done in the same manner. Mr. FARNUM. What percentage of total costs are borne by Federal funds? Dr. GRANING. The level of Federal participation varies here, also, with the type of construction. New schools can receive up to twothirds of the total construction cost and schools planning major expansion can receive up to two-thirds of the eligible costs attributable to expansion. All other nursing-school projects may receive up to 50 percent of the eligible cost. Mr. FARNUM. Thank you, Dr. Graning. We will adjourn until 10 o'clock tomorrow morning. 1 Includes funds carried over for obligational purposes from prior years. Summary of changes 1966 enacted appropriation_-_ 1967 estimated obligations--- Total change.. INCREASES Mandatory: Increased pay costs-- Annualization of 13 positions and other objects new in 1966–– Subtotal, mandatory increase__ Program: 1. Increase in grants for construction of teaching facilities for 2. Increase in grants for construction of teaching facilities 3. Increase in operations and technical services related to con- 4. Increase in operations and technical services related to con- Subtotal, program increases__. Gross increases_ DECREASES 60, 000, 000 10, 000, 000 34,000 34,000 6,000 70, 074, 000 70, 203, 000 -8,000 Nonrecurring equipment costs--- Total net change requested---- EXPLANATION OF CHANGES +70, 195, 000 Grants for construction of teaching facilities for medical, dental, and other health personnel The increase of $60 million requested for this purpose will provide a total of $135 million in Federal funds for the construction of teaching facilities for medical, dental, and other health personnel. As of January 18, 1966, a total of 128 applications have been received requesting Federal funds in excess of $337 million. Grants for construction of teaching facilities for nurses The additional amount of $10 million requested will provide a total of $25 million for the construction of teaching facilities for nurses. This amount will provide $10 million for construction, expansion, replacement, and rehabilitation of facilities for collegiate schools of nursing, and $15 million for construction, expansion, replacement, and rehabilitation of facilities for associate degree or diploma schools of nursing. Operations and technical services To carry out the increased responsibilities in the expanded programs, an increase of $34,000 is requested to provide four additional positions related to the construction of teaching facilities for medical, dental, and other health personnel and $34,000 for four positions related to construction of teaching facilities for nurses. These additional positions are needed to issue regulations, procedures, and guide material, provide technical assistance and consultation to professional health schools, arrange for site visits, develop guide material pertaining to the design, construction, and equipping of professional health schools. Funds are requested for project grants to assist public or other nonprofit schools of medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, nursing, and public health in the construction of teaching facilities. These funds will increase the opportunities for training of professional health personnel by providing additional teaching facilities, and will prevent the curtailment of enrollment or deterioration in the quality of training provided in existing schools by rehabilitating or replacing them. A request in the amount of $160,794,000 is submitted for 1967. This amount provides $135 million for grants under the Health Professions Educational Assistance Amendments of 1965 to assist in the construction and rehabilitation of teaching facilities for schools of medicine, osteopathy, dentistry, pharmacy, optometry, podiatry, or public health; $25 million for construction of teaching facilities for training professional nursing personnel under the provisions of the Nurse Training Act of 1964; and $794,000 for operations and technical services required in the administration of the programs. Grants for construction and rehabilitation of teaching facilities for medical, dental, and other health personnel (except nursing) The construction grant funds requested for these teaching facilities in the amount of $135 million will provide for the construction, expansion, and rehabilitation of schools of medicine, dentistry, osteopathy, pharmacy, optometry, podiatry, and public health. The $135 million requested represents an important step in increasing the supply of physicians, dentists, and other health profession personnel. To maintain the present levels of supply of physicians and dentists in relation to population, the admissions during the next 10 years to medical schools must be increased by almost 50 percent and admissions to dental schools must be doubled. In order to meet this goal, new medical schools and new dental schools must be constructed and a substantial number of existing schools must be expanded. In addition, a large-scale remodeling and replacement program must be undertaken, if some schools are to avoid the curtailment of enrollment or deterioration in the quality of training in existing schools. Health profession schools of other types must be constructed or expanded to increase enrollment and prevent curtailment of enrollment or deterioration of the quality of training. As of January 18, 1965, a total of 128 applications have been received requesting Federal funds in excess of $337 million. Of these 68 have been approved and funded requiring over $150 million in Federal funds. Applications already approved will provide 2,442 additional first-year places as follows: medicine 885, optometry 36, pharmacy 137, public health 226, dentistry 372, and nursing |