3 1 subsection (a) is amended by striking out "and to those 2 schools of nursing or engineering which provide graduate 3 or specialized training in public health for nurses or engi4 neers, for the purpose of strengthening or expanding gradu5 ate public health training in such schools" and inserting in 6 lieu thereof "and to other public or nonprofit private institu7 tions providing graduate or specialized training in public 8 health, for the purpose of strengthening or expanding gradu9 ate or specialized public health training in such institutions". (c) Subsection (b) of such section is amended by strik11 ing out "schools" wherever it appears therein and inserting 12 in lieu thereof "institutions". 10 Passed the House of Representatives July 21, 1964. Attest: RALPH R. ROBERTS, Clerk. EXECUTIVE OFFICE OF THE PRESIDENT, on. LISTER HILL, BUREAU OF THE BUDGET, Washington, D.C., August 6, 1964. hairman, Committee on Labor and Public Welfare, .S. Senate, Washington, D.C. DEAR MR. CHAIRMAN: This is in reply to your letter of July 23, 1964, requesting ne views of the Bureau of the Budget on H.R. 11083, a bill to amend the Public Tealth Service Act to extend the authorization for assistance in the provision of raduate or specialized public health training, and for other purposes. This bill would enable the Public Health Service to expand its efforts in attractng and training qualified persons for service in public health. In addition, it would serve to strengthen the programs of those institutions which provide the acilities and faculties for such training. The enactment of the Health Professions Educational Assistance Act of 1963 necessitates the supplementation of the medical practitioner with more public health officials and professional nurses. H.R. 11083 would help meet the need for public health manpower as outlined by the President in his health message. Enactment of this legislation would be in accord with the program of the President. Sincerely yours, PHILLIP S. HUGHES, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, - Hon. LISTER HILL, DEAR MR. CHAIRMAN: This is in response to your request of July 23, 1964, for a report on H.R. 11083, as passed by the House, an act to amend the Public Health Service Act to extend the authorization for assistance in the provision of graduate or specialized public health training, and for other purposes. The bill would extend for 5 years the authorization for public health traineeships contained in section 306 of the Public Health Service Act, and for 4 years the authorization contained in section 309 of that act for project grants to schools of public health, schools of nursing, and schools of engineering for public health training. These complementary programs would then carry identical expiration dates of June 30, 1969. The bill would also strengthen and improve the program of project grants for public health training by amending the provisions of section 309 of the Public Health Service Act to (a) Broaden the eligibility for project grants to include other types of institutions and agencies which provide graduate or specialized public health training, in addition to schools of public health, schools of nursing, and schools of engineering; (b) Broaden the purpose of the project grants to include the strengthening and expansion of specialized training in public health, in addition to the presently authorized graduate training in public health; and (c) Increase the annual appropriation authorization from its present level of $2 million to a maximum of $9 million for fiscal year 1969. The bill would carry out recommendations of the President contained in his health message, and is the same as the legislative proposal submitted to the Congress by this Department, except for the appropriation ceilings for the traineeship program which were added in the House. Extension and expansion of these training activities along the lines provided for in this legislation would significantly contribute to alleviation of the critical shortage of adequately trained professional public health manpower. We therefore urge enactment of this bill. The Bureau of the Budget advises that enactment of this legislation would be in accord with the program of the President. Sincerely, WILBUR J. COHEN, The CHAIRMAN. In the Senate, I have introduced companion bills, S. 2529 to expand our capacity for training nurses and S. 2530 to extend the traineeship program in public health. The Nurse Training Act would carry out the recommendations of the Surgeon General's Consultant Group on Nursing, a committee of consultants that studied the supply and demand for nurses over the period of a year and issued a final report, "Toward Quality in Nursing," in February 1963. H.R. 11241 would authorize Federal assistance in the construction of hospital and collegiate schools of nursing; a program of grants to assist schools of nursing meet the additional costs of strengthening and expanding their training programs; the extension and expansion of the existing program of traineeships for the advanced training of professional nurses; and a student loan program in nursing education at collegiate, associate degree, and diploma schools of nursing. H.R. 11083 as passed by the House would extend the existing program of public health traineeships for 5 additional years and the existing program of project grants to schools of public health and other institutions for public health training for 4 additional years. Both of these programs have been most helpful in supplying well-trained public health personnel to the 50 States for their State and local public health departments. The provisions of H.R. 11083 would carry out the recommendations of the Second National Conference on Public Health Training. Dr. Price, will you come around, please, sir? STATEMENT OF DR. DAVID PRICE, DEPUTY SURGEON GENERAL, Dr. PRICE. Thank you, sir. The CHAIRMAN. Mr. Kimble, Dr. Peterson, and Miss Scott. All right, Doctor, we will be glad to have you and your associates here with us and you may proceed now in your own way, sir. Dr. PRICE. Mr. Chairman, as you and your committee know, the problem of manpower in the health field is one of the most important problems that we face, and we are, therefore, very greatly interested in the two pieces of legislation you have before your committee today. I do not have prepared testimony, but with your permission I should like to read the report of our Department on the nurse training bill, H.R. 11241. The CHAIRMAN. All right. We will be glad to have you do that, sir. Dr. PRICE. The purpose of this bill is to increase the supply of nurses in the United States through a variety of approaches. The major provisions of this bill would (1) Authorize a 4-year program of construction grants for teaching facilities to expand the training capacity of nursing schools. (2) Authorize a 5-year program of project grants to assist collegiate and associate degree schools of nursing to meet the additional costs of strengthening, improving, or expanding their training programs; and a 5-year program of formula grants to diploma schools of nursing for partial reimbursement of costs of training students of nursing whose attendance may be attributable to this legislation. (3) Extend for 5 years and expand the existing program of traineeships for advanced training of professional nurses. (4) Authorize a 5-year student loan program for students of nursing at collegiate, associate degree, and diploma schools of nursing. To help meet the urgent need for facilities to expand the Nation's capacity to train nurses, the bill would authorize a 4-year program of construction grants to accredited public or nonprofit private schools of nursing to assist in the construction of teaching facilities. This authorization would parallel the provisions of Public Law 88-129, the recently enacted Health Professions Educational Assistance Act of 1963. Eligible for grants would be schools providing collegiate, diploma, or associate degree programs. Grants would aid construction of new schools, or construction which would expand the training capacity of an existing school, or replacement or rehabilitation of facilities which are so obsolete as to require the school to curtail substantially either its enrollment or the quality of training provided. In considering grant applications, the Surgeon General would take into account effectiveness in expanding and maintaining enrollment, and in promoting an equitable geographic distribution of opportunities for such training. Appropriations for construction would be authorized beginning with fiscal year 1966. The appropriations The CHAIRMAN. There would be none for this present year, would there? Dr. PRICE. There would be none under this bill for the current year. The CHAIRMAN. 1965. Dr. PRICE. Yes, sir. Our report deals with this particular issue at a later point, sir. The CHAIRMAN. All right, sir. Go ahead. Dr. PRICE. The appropriations authorized for construction of collegiate schools would be $5 million the first year and $10 million in each of the following 3 years. The appropriations authorized for construction of hospital and associate degree schools would be $10 million the first year, and $15 million in each of the 3 succeeding years. Grants for the costs of construction of new schools or for major expansion of existing schools could equal up to 66% percent of such costs. Other grants under this authorization could not exceed 50 percent of construction costs. Under section 3 of the bill, collegiate schools of nursing would not be eligible for construction funds under Public Law 88-129 after June However, funds for construction of these facilities under H.R. 11241 would not be authorized until fiscal year 1966. The CHAIRMAN. In other words, you would have a lapse there of a year, would you not? Dr. PRICE. A hiatus of 1 year; yes, sir. The CHAIRMAN. Yes. Dr. PRICE. Since, several applications have been received under Public Law 88-129 from nursing schools which could begin constru tion in fiscal year 1965, and we anticipate that funds would be available for these projects under that law, we recommend that section 3 of the bill be amended to strike "1964" wherever it appears and insert in lieu thereof "1965", in order that these projects which were submitted in good faith under the existing law will not have to be delayed until fiscal year 1966 when funds would first become available under H.R. 11241. The CHAIRMAN. Doctor, do you suppose the House in typing up this bill was conscious of that lapse? Do you suppose they realized it? Dr. PRICE. I am not certain, sir, that this was clear. The CHAIRMAN. I see. There is nothing in the discussion on the bill or the report to indicate they were, is there? Dr. PRICE. I am not aware of any. The CHAIRMAN. All right. Thank you, sir. Dr. PRICE. The last clause of section 3(b) of H.R. 11241 also provides for nonduplication between this bill and certain hospital construction provisions of title VI of the Public Health Service Act. This provision would, in order to avoid such duplication, exclude from title VI of the act authority for construction of hospital facilities for nurse training since these facilities would be eligible for aid under H.R. 11241. However, this provision of the bill was addressed to title VI of the act prior to its amendment by the recently passed Hospital and Medical Facilities Amendments of 1964. It is necessary to address this provision of the bill to title VI as changed by those amendments. To do this, section 3(b) of H.R. 11241 must be changed so that its amendment of the Hill-Burton program (striking out "nurses' home and training facilities" and inserting instead "nurses' home facilities") is addressed to the new section 625 (c) of the Public Health Service Act instead of the old section 631 (e). The enactment of H.R. 11241 authorizing grants for construction of nurses training facilities and eliminating grants for such facilities from the Hill-Burton program also makes it necessary that we delete from the newly revised title VI of the Public Health Service Act the provision for giving special consideration, in determining priority of construction projects, to hospital facilities which would include new or expanded nurse training facilities. This would be accomplished by adding, before the period at the end of section 3(b) of H.R. 11241 ", and section 603 (a) of such Act is amended by striking out clause (4), by striking out 'and' following the semicolon at the end of clause (3), and by inserting 'and' after the semicolon at the end of clause (2)". Now, as to the improvement in nurse training, H.R. 11241 would authorize a new program of project grants totaling $17 million over a 5-year period to enable public and nonprofit private collegiate and associate degree schools of nursing to strengthen, improve, and expand programs to teach and train nurses. |