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SUGGESTED LANGUAGE FOR AMENDMENT OF H. R. 6874

Amend section 8 by inserting designation "(a)" before the first word, and add the following subsection:

"(b) The following subsection '(d)' is inserted after subsection (c) of said section 706:

“‘(d) (1) All laborers and mechanics employed by contractors or subcontractors in the performance of construction work financed with the assistance of any grant of Federal funds under the provisions of this title shall 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 DavisBacon Act, as amended (40 U. S. C. 276a–276a−5), and every such employee shall receive compensation at a rate not less than one and one-half times his basic rate of pay for all hours worked in any workweek in excess of eight hours in any workday or forty hours in the workweek, as the case may be. The Surgeon General shall not approve such grant of Federal funds without first obtaining adequate assurance that these labor standards will be maintained upon the construction work.

"(2) The Secretary of Labor shall have, with respect to the labor standards specified in subsection (1) of this section, the authority and functions set forth in Reorganization Plan Numbered 14 of 1950 (15 F. R. 3176, 64 Stat. 1267, 5 U. S. C. 133Z-15), and section 2 of the Act of June 13, 1934, as amended (48 Stat. 948, as amended, 40 U. S. C. 276c)'."

Hon. OREN HARRIS,

DEPARTMENT OF HEALTH, EDUCATION, And Welfare,
Washington, May 13, 1957.

Chairman, Committee on Interstate and Foreign Commerce,

House of Representatives, Washington, D. C.

DEAR MR. CHAIRMAN: This is in response to your request of April 25, 1957, for a report on H. R. 6874, a bill to amend the provisions of the Public Health Service Act relating to grants for construction of research facilities so as to increase their duration from 3 to 5 years and to authorize grants for medical and dental teaching facilities.

H. R. 6874, and the identical bill H. R. 6875, embody this Department's proposals for legislation to carry out the President's recommendation, made in his January 16, 1957, budget message, that the temporary program of Federal grants for construction of medical and dental research facilities be amended to include also grants for construction of medical and dental teaching facilities. This proposal was transmitted to the Congress on April 10, 1957, with a covering letter of explanation, and a statement of cost estimates and personnel requirements which would be entailed by its enactment, as required by Public Law 801, 84th Congress, 2d session. Copies of my April 10 letter to the Speaker of the House of Representatives and the accompanying statement of costs and personnel requirements are enclosed for the convenience of your committee.

For the reasons indicated in the enclosed letter, this Department believes that enactment of this proposed legislation would provide substantial assistance to existing schools, and to the sponsors of new schools, in their efforts to expand and improve the Nation's training capacity in these important fields.

Sincerely yours,

JOHN A. PERKINS, Acting Secretary.

THE SECRETARY OF HEALTH, EDUCATION, AND WELFARE,
Washington, April 10, 1957.

Hon. SAM RAYBURN,
Speaker of the House of Representatives,
DEAR MR. SPEAKER: I am enclosing for your consideration a draft of a bill to
carry out the President's recommendation, made in his January 16, 1957, budget
message, that the temporary program of Federal grants for construction of
medical and dental research facilities be amended to include also grants for
construction of medical and dental teaching facilities.

The enclosed draft bill would amend title VII of the Public Health Service Act, which was added in the last session of the 84th Congress. That title now authorizes grants to public and private institutions to assist in the construction of facilities for research in the sciences related to health. The amendment

would add authorization for grants to accredited public and private nonprofit medical and dental schools to assist in the construction of teaching facilities. Under the amendment, funds would be made available on a project-grant basis, generally under the procedures now in effect for the research facility construction grants. Schools of medicine (including schools of osteopathy and public health) and dentistry could use such grant funds for the construction of new facilities or for the improvement or expansion of existing facilities for either research or teaching, or for both. Grants to other institutions could be used only for facilities for research purposes.

Grant funds could not be used for costs of land acquisition or off-site improvements, or for projects eligible for assistance under the Hospital Survey and Construction Act. As under the existing program, grants could not exceed 50 percent of the necessary costs of construction. The duration of the continued program of construction grants for both research and teaching facilities would be five years as contrasted with the 3-year duration of the existing program. Annual appropriations for the combined program would be authorized up to an aggregate, for the 5-year period beginning July 1, 1956, and ending June 30, 1961, of $225 million-$195 million for medical research and teaching facilities and $30 million for dental research and teaching facilities.

The present National Advisory Council on Health Research facilities would be enlarged by the addition of the Commissioner of Education, as an ex officio member, and 4 more appointed members-2 public and 2 specialized-and would be redesignated the "National Advisory Council on Health Research and Teaching Facilities." The duties of the new Council would be similar to those of the present Council but would embrace the review of applications for teaching, or teaching and research construction grants as well as applications for grants for the construction of facilities for research purposes only.

While the draft bill is in the form of an amendment to title VII of the Public Health Service Act, which title was added by the Health Research Facilities Act of 1956 (Public Law 835), it is in substance a resubmission of the measure recommended by the administration to the last Congress. The only major change made is the reduction by $25 million of the aggregate amounts that would be authorized for the 5-year period.

This proposal is directed toward two primary needs which are basic to continuing progress in realizing our national health objectives. Medical and dental research and the skills necessary for the application of new knowledge resulting from that research are prerequisites to further progress in reducing the human suffering and economic losses caused by disease and disability. The medical and dental schools of the country do a large share of this research and they are the source of supply for all of our physicians and dentists, and for most of our graduate students in the basic medical sciences. We know that the effective demand for medical scientists, physicians, dentists, and other skilled personnel in the health fields is increasing faster than our supplies. There is accumulating evidence that augmented research and training in these critical fields will not be possible without improvement and expansion of the present physical plant of the research and training institutions. It is clear also that the financial situation of these public and nonprofit research and training institutions is such that in all too many cases they cannot, with their present resources, undertake the rehabilitation of laboratory and teaching facilities necessary for the maintenance of present levels of quality.

We are convinced, therefore, that the national interest requires a temporary grant program to assist these institutions in meeting their essential needs for physical plant adequate to their multiple responsibilities-for teaching as well as for research. The assistance authorized by the last Congress reaches only one area of their construction needs.

The proposed program is a flexible one. It is designed to assist the schools in their efforts to achieve a desirable balance between research and teaching programs-the two basic functions which support and strengthen each otherand to continue their contributions to the preparation of specialized research personnel, to the training of many allied health personnel, and to the postgraduate training of physicians and dentists which plays such an important part in the maintenance of the quality of care. Achievement of a wider geographic distribution of research and teaching facilities would continue to be a factor to be taken into consideration in the making of grants.

Assistance for construction of teaching as well as research facilities will make it possible for the medical and dental research and training institutions to

maintain and improve the quality of the programs they now carry and to expand their capacity to the limits of wise institutional planning. In addition, the availability of funds for construction can be expected to stimulate construction of new medical and dental schools, especially in those States in which there has been active consideration of the organization of new schools or the expansion of 2-year basic science schools to 4-year medical schools.

We shall appreciate it if you will refer the enclosed draft proposal to the appropriate committee for consideration.

In compliance with Public Law 801, 84th Congress 2d session, there is enclosed a statement of cost estimates and personnel requirements which would be entailed by enactment of the proposed legislation.

The Bureau of the Budget advises that enactment of this proposed legislation would be in accord with the program of the President.

Sincerely yours,

Secretary.

Construction grants to medical and dental schools for research and teaching facilities, estimate of cost, 1958–62, in addition to expenditures authorized by Public Law 835, 84th Congress

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Hon. OREN HARRIS,

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE,
Washington, April 18, 1958.

Chairman, Committee on Interstate and Foreign Commerce,
House of Representatives, Washington, D. C.

DEAR MR. CHAIRMAN: This is in response to your request of June 11, 1957, for a report on H. R. 7841, a bill to authorize a 5-year program of grants for construction of medical, dental, and public-health educational and research facilities, and for other purposes.

For the convenience of the committee this report also includes brief comparative comment on H. R. 6874 and H. R. 6875, identical bills which embody this Department's proposals for legislation to carry out the President's recommendation, made in his January 16, 1957, budget message, that the temporary program of Federal grants for construction of medical and dental research facilities be amended to include also grants for construction of medical and dental teaching facilities. H. R. 7841 would amend the Public Health Service Act to add a new title VIII authorizing appropriations for a 5-year period, beginning with the fiscal year ending June 30, 1958, for construction grants for teaching and research facilities for public and private nonprofit schools of medicine (including osteopathy), dentistry, and public health, as follows: $45 million each fiscal year for schools

of medicine and osteopathy, $8 million a year for dental schools, and $7 million a year for schools of public health. Amounts appropriated annually would be available also for the 2 succeeding fiscal years.

There would be a ceiling of $3 million for any one medical school for the 5-year period, and a similar ceiling of $1 million for any one school of dentistry or of public health. Individual construction grants could not exceed 50 percent of construction costs for existing schools, except that in the case of a school which gave satisfactory assurance of a 5-percent increase in freshman enrollment (over that for the academic year 1956-57) the grant is directed to be made in an amount equal to 66% percent of the cost of construction. Also, in the case of new schools, a grant could be made up to a ceiling of 66% percent of construction costs. An additional grant of $25,000 could be made for planning. In the case of any grant for new construction the school would have the option of allocating up to 20 percent of the amount of the grant to permanent endowment for the cost of maintenance of the new facility.

These proposals must be considered in relation to our going program of research construction grants. Present title VII of the Public Health Service Act, added in the last session of the 84th Congress (Public Law 835), authorizes grants, for a 3-year period ending June 30, 1959, to public and private institutions to assist in the construction of facilities for research in the sciences related to health. These grants are made only after recommendation by the National Advisory Council on Health Research Facilities. H. R. 7841 proposes the authorization of a parallel, but separate, 5-year program of construction grants to assist in the expansion and improvement of teaching facilities, with a new Federal Council on Health Educational Facilities to screen the applications filed by the schools and recommend the making of grants to assist in the construction of facilities which could be used for teaching or research or both. The institutions which participate in the present program of construction grants for research facilities are in the majority of cases the same training institutions which would be eligible to participate in any program of construction grants in aid of teaching facilities. This Department believes that research and training are closely and vitally interrelated-not only in respect to objectives, but in daily operation and accomplishments. The research mission of medical and dental schools is combined with and supported by their training mission. This interrelationship is illustrated and accentuated by the fact that a single facility is commonly used for both purposes. The Department's recommendations for legislation to carry out these objectives (introduced as H. R. 6874 and H. R. 6875) have therefore taken the form of an expansion of the existing program—to cover an aggregate period of 5 years, and to include teaching as well as research facilities-enlarging the existing Council and extending its functions to include review of applications for teaching or teaching and research construction grants, as well as applications for grants for the construction of facilities for research purposes only. Grants under the combined program would be made under the same general procedures now in effect for research construction grants.

In our opinion, Federal construction grants are necessary and appropriate for assisting both training and research functions, but the realities of the situation and the practical problems of the training institutions will be better met by an integrated program of grants to assist in the construction of essential facilities for either or both purposes. Such an integrated program would also avoid needless duplication of administrative procedures and the otherwise inevitable overlap in functions of the two advisory Councils.

Thus, while we are in agreement with the objectives of H. R. 7841, we believe that the identical bills H. R. 6874 and H. R. 6875 represent a more generally sound approach to these important problems. We also question the necessity and desirability of several of the specific provisions of H. R. 7841; e. g., the additional grant for planning, the provision for optional allocation of 20 percent of the grant money to permanent endowment for maintenance in the case of new construction, and the mandatory grant in the amount of 66% percent of costs in the case of schools giving assurances of a 5-percent increase in freshman enrollment.

It seems undesirable, also, to earmark construction grant funds for a category of schools so few in number and for which the estimated volume of needed construction is so small as in the case of schools of public health. H. R. 7841 would authorize the appropriation of $35 million for the 5-year period to aid construction for research and teaching purposes in schools of public health. Even at the proposed maximum matching rate of 66% percent of Federal funds, this sum would be considerably in excess of the Federal share of the estimated construc

tion needs of these schools. Information supplied by the schools of public health for purposes of your committee's March 1957 staff report (medical-school inquiry) indicated a total construction need of $24.6 million for both teaching and research purposes. Of this, some $9 million was attributed to research requirements, a part of which will be met by construction grants under the existing program of research construction authorized by the 84th Congress.

For the reasons outlined, we recommend enactment of legislation along the lines of H. R. 6874 and H. R. 6875 in preference to H. R. 7841. Copies of my April 10, 1957, letter transmitting to the Speaker of the House the proposal contained in the administration-sponsored bills, and the accompanying statement of costs and personnel requirements which would be entailed by its enactment, are enclosed for the convenience of your committee.

The Bureau of the Budget advises that it perceives no objection to the submission of this report to your committee.

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Chairman, Committee on Interstate and Foreign Commerce, House of
Representatives, House Office Building, Washington, D. C.

MY DEAR MR. CHAIRMAN: This is in reply to your request of June 11, 1957, for the views of the Bureau of the Budget on H. R. 7841, a bill to authorize a 5-year program of grants for construction of medical, dental, and public health educational and research facilities, and for other purposes.

H. R. 7841 would add a new title VIII to the Public Health Service Act establishing a program of grants to public and nonprofit medical, dental, and public health schools for the construction of educational facilities. The bill would create a Council on Health Educational Facilities to advise the Surgeon General on the administration of grants and would authorize an annual appropriation of $45 million for medical schools, $8 million for dental schools, and $7 million for schools of public health. Grants could be made to eligible institutions on the basis of not to exceed 50 percent of the cost of construction except that for new schools or where the school gives assurance that the freshman enrollment will be increased by 5 percent over the 1956-57 level, the maximum grant may be increased to 66% percent. The bill would also permit grants up to $25,000 for preliminary planning and would allow the recipient of a construction grant to set aside 20 percent of the total grant for the establishment of a permanent endowment to provide for the cost of maintaining the new facility.

The purpose of this bill is based on the recognition that the continued progress in reducing disease and disability depends upon the assured supply of competent, well-trained physicians, dentists, and scientific investigators. There is accumulating evidence that the existing facilities for both teaching and research are not adequate to meet the demands for an ever-increasing number of people skilled in medical science. The President, in his messages transmitting both the 1958 and 1959 budgets to the Congress, recognized the need for expansion of the program of assisting the Nation's medical and dental schools to build research facilities to include teaching facilities.

While this Bureau endorses the objectives of this bill, we believe that these objectives could be better accomplished through the extension of the existing program of grants for the construction of health research facilities, rather than through the creation of a new and parallel program for the administration of grants for the construction of educational facilities alone. Such a dual program arrangement would, in our opinion, cause substantial administrative difficulties. We would also concur with the Department of Health, Education, and Welfare's report on this bill that it contains various provisions of questionable necessity or desirability.

Therefore, for these reasons the Bureau of the Budget recommends against the enactment of H. R. 7841, but urges the committee to give favorable consideration to the enactment of H. R. 6874 or H. R. 6875. These bills, sponsored by

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