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Mr. Flood. On page 4, at the top, you speak about your Educational Assistance Act, and the Nurses Training Act, and all the things you have done. What are your results in numbers? In the Appropriations Committee, this is like the payoff window at Bowie, we are interested in figures. What is the payoff? What about the figures on nurses' training? If you don't have that available, can you prepare some sort of a statistical presentation as to just what the payoff is in numbers?

Dr. STEWART. Certainly.

Mr. Flood. How many nurses, how much assistance, where was it, what part of the country, how many men, women, technicians, nurses, the whole area of these laws. What did we buy? What did we get?

Dr. STEWART. Certainly.
(The information to be supplied follows:)

Estimated number of trainees under the Health Professions Educational Assist.

ance Act of 1963, Public Law 88-129, amended by Public Law 88-654, and the Nurses Training Act of 1964, Public Law 88-581

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1. Student loans:

Health professions.

Nursing. 2. Projects for improvement of nurse training: Estimated number of students

who will benefit by awards in these programs.. 3. Traineeships:

Short-term traineeships: Estimated number of trainees.
Long-terin traineeships: Estiinated number of trainees.

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i Not available.

TABLE 1.—Projects for improvement of nurse training

Fiscal year


Fiscal year

1966 (as of Feb. 15, 1966)

Total amount of grants awarded.
Number of States
Number of programs receiving project grant awards.
Number of project grants..
Estimated number of students who will benefit by awards in these programs

during the period funded

$1, 989, 564


$573, 913

12 2 12

2 12

3 10,000

1% 3, 655

1 District of Columbia and Puerto Rico. 2 Evanston Hospital Association, Illinois, submitted and was awarded 1 project grant in behalf of a council of 18 participating schools which will benefit from and participate in this i project.

* Estimated.

TABLE 2.Payments to diploma schools

Fiscal year


Fiscal year

1966 (as of Feb. 15, 1966)




Total amount of grants awarded.
Number of States.
Number of programs eligible to apply.
Number of programs applying...
Number of programs receiving awards.
Number of students enrolled in programs with payments to diploma schools.
Total number of students on which awards are based.
Increases in enrollment over 1962-64 average.
Federally sponsored students..

$788, 150

2 39

569 4 229

190 26, 379 3, 123 2, 102 1, 021


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! Estimated. : It is estimated that 5,140 trainees will participate in short-term traineeships by the end of 1966. 3 District of Columbia and Puerto Rico.

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Mr. Flood. Now you say you are going to create a national system of medical libraries. I have a medical library in my county that has been running for years, and a very good one, under the auspices of my county medical association. What do you do forget about me again and set up a lot of new ones? What about the existing medical libraries set up by medical societies all through the country?

Dr. STEWART. At the present time, Mr. Flood, the medical libraries, some of which are at medical schools and most of which are not but are located with medical societies or large hospitals or academies of medicine, do have ties in with the National Library of Medicine. Any doctor who walks in your library and wants something and that library does not have it, they can get it from the national library right away. Mr. Flood. Do they know that!

Dr. STEWART. Yes, they do. We are now beginning to develop regional libraries, which will tie in, and be able to get our medlars tape world literature closer to the man if he wishes.


Mr. FLOOD. I have one more question. On page 14 you refer to: A genetic screening test now permits physicians to identify 75 percent of women who, though showing no symptoms themselves, are carriers of progressive muscular distrophy and transmit this disease to half of all of their sons.

Dr. STEWART. That is right.
Mr. FLOOD. Say something about that. What is this carrier?

Dr. STEWART. A recessive gene. And this is a genetic pattern that would occur, and what we have got now is a way of genotyping the person, screening the women, to find out if they are carrying this recessive gene. If they are, you can figure it transmits the disease to half of all of their sons. This is the standard genetic pattern. The new thing is they know how to do this genetic screening test.

Mr. Flood. You have done it, and you now have identified a carrier. What do you do about it?

Dr. STEWART. I can't go beyond what is said there. This was just developed with the last year or so.

Mr. FLOOD. It sounds of great importance if you have the next step. Of course, even this step impresses me very much.

Dr. STEWART. I am sure Dr. Masland can tell you more in detail.

Mr. Flood. The nature of muscular dystrophy, being what it is, being identified is quite something.

Mr. Flood. What you do next is something else.


Mr. FOGARTY. Before we adjourned at noontime I had one more question. What are your current regulations regarding cost sharing by research grant recipients? You can put the regulations in the record.

(The information supplied follows:)


Washington, D.C., February 11, 1 To: The heads of institutions conducting research with Public Health S

research grants. From: Chief, Division of Research Grants. Subject: Cost 'sharing in research grants.

In appropriating funds for the Department of Health, Education, and fare for fiscal year 1966, the Congress removed the previous limitation percent for indirect cost and inserted in its stead a provision that "none funds provided herein shall be used to pay any recipient of a grant for tl duct of a research project an amount equal to as much as the entire cost project.” The attached Bureau of the Budget Circular A-74 establishes i and guidelines for the Federal Government to use in connection with cos ing for research grants.

The provisions of Circular A-74 will be applied to Public Health Servi and renewal (competing) research grants for which the Notice of R Grant Awarded carries a date of March 1, 1966, or later as the “date i At the same time, full indirect cost may be allowed on these grants p an indirect cost rate has been satisfactorily negotiated in accordance w reau of the Budget Circular A-21. In the absence of a negotiated rat direct costs will be awarded.

The provisions of Circular A-74 will not be applied to continuation (noncompeting) nor to supplements to grants awarded prior to the date of this policy. For the remainedr of fiscal year 1966 and througho year 1967, the PHS interim policy on cost sharing will continue to be to continuation or supplemental awards for ongoing projects. The policy requires that the Public Health Service limit the indirect cost al to 90 percent of actual indirect cost or 20 percent of the total direct cos on the Notice of Grant Awarded, whichever is the lesser.

It should be noted that the provisions of Circular A-74 are not int reduce the current level of cost participation by the grantee institutio as a result of increased indirect cost allowances. The circular does that where there has been no requirement for cost participation in the grantee institution must now share in the research costs on more thar basis. Where the applicatnt proposes a "lower” contribution as des section 4.c. of the circular, explanation and justification must be provi the cost-sharing data.

There are four additional provisions in connection with cost shari should be called to your attention at this time: (1) each grantee instit be required to maintain records to demonstrate the total actual contri the grantee; (2) time or effort reports will be required for personi salaries, in whole or in part, are charged to the PÁS grant or claim grantee contribution to the research supported by the grant; (3) th of grantee contribution will be subject to audit; and (4) the requirer viously governing expenditure of Public Health Service funds, inclus approval for certain uses, will now apply to the total costs of the pro, will include both PHS funds and the grantee contribution.

The PHS has on hand many new and renewal applications which reviewed. In addition, many more will be received within the next f before application forms and instructions can be developed to provid tion on proposed cost sharing. Institution officials responsible for a ing specific grants will receive instructions from PHS awarding In Divisions concerning additional information that will be needed for ing application before an award can be made.

The cost-sharing policy'applies only to research project grants. apply, for example, to general research support grants, training gra services grants, construction grants, conference grants, grants to Fe cies, of foreign grants where the indirect cost is provided by t institution.


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