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other libraries which cooperate in the program; and it would delete an ambiguous criterion for award contained in the current act. This bill would also permit the selective use of the contract mechanism, as well as grants-in-aid, to support specific regional services.

For the program to support biomedical scientific publications projects, this bill would authorize $1 million per year during the 3 years of the extension, the present level.

Factors considered by the committee

The committee weighed carefully the administration's request, reflected in S. 2239, that the current program be extended for 1 year only. The witnesses who testified before this committee on July 31, 1969, as well as action of the House of Representatives and the report of the House Committee on Interstate and Foreign Commerce with respect to H.R. 11702, clearly support the position of this committee that a longer period of extension is entirely justified.

H.R. 11702, as reported, would add "health communications" to the title under which these programs are gathered. Eligibility for participation in the programs authorized by the Medical Library Assistance Act has always been intended to include all appropriate public and private institutions and individuals active in the provision of health services or in health related teaching and research, within the provisions of the law, and the terms used in this act are defined accordingly. While the intent of the act was broad, and its programs have been implemented accordingly, the committee accepted the value of added emphasis to this concept. The term "health communications" in the title of H.R. 11702 is an appropriate indicator of the broad intent of the program. The committee expects these programs to extend eligibility for participation to all clinical fields including medicine, dentistry, optometry, pharmacy, osteopathy, veterinary medicine where relevant to human health, nursing, public health, other health-related fields, and fundamental and applied sciences when related thereto.

The committee preferred the program-by-program authorizations for Federal support proposed in S. 2549 and H.R. 11702 to the single, nonspecific appropriation authority contained in S. 2239, for two reasons. First, the committee feels that it is useful to designate the level of the Federal contribution which would be desirable for these programs, as guidance for their implementation, at the same time allowing some program flexibility through limited authorization for transfer of funds among programs. Secondly, the committee endorses the original concept of the act, to provide coordinated assistance for all areas of need through balanced support for each of the seven programs. H.R. 11702, as amended by the committee, increases the authorization for Federal support for four of the seven programs. In the opinion of the committee, those programs which contribute to improved facilities and resources and manpower and which help to provide better access to existing centers for health information services should be supported at substantially higher levels than heretofore. During the initial years, policies and procedures have been developed and tested, and expansion of the Federal contribution is now justified.

The level of support wasn't increased for scientific and technical publications which help expand the production of aids to information searching, such as indexing, abstracting, and other reference aids. No

increase in funding was provided for the special projects and research programs; such support should be highly selective, with emphasis on contemporary health problems, such as drug abuse and alcoholism.

In summary, S. 2549 would authorize a moderate increase in funding. The committee judges that the level of support is commensurate with the demonstrated needs which must be met. The committee based its acceptance of the funding levels on the following considerations: Health library construction.-The Medical Library Assistance Act authorized $40 million for the 4-year period-fiscal 1967-70-for grants to public or private nonprofit agencies or institutions towards the cost of construction of any medical (health) library facility. The Federal contribution under this law may not exceed 75 percent of the necessary cost of construction. Section 393 of this act authorizes the construction of health library facilities per se, without reference to educational, teaching, or research functions. It is the only Federal construction program which can provide for medical library and information facilities needed for nonteaching, nonresearch institutions such as hospitals, clinics, community health service programs. Through fiscal 1970 the National Library of Medicine will have provided 11 construction grants for health school library construction, totaling $11.25 millon. While the 330,000 net square feet of new library space provided by this small number of projects will have a considerable value to the Nation, the contribution from this and other Federal programs does not begin to meet the need identified in 1965 and since reaffirmed. For this reason the committee endorsed provisions to increase the yearly funding authorization from $10 million to $11.5 million in fiscal 1971, $14 million in fiscal 1972, and $16.5 million in fiscal 1973; to provide $42 million for construction, renovation, and expansion of health library facilities for the period July 1, 1970, to June 30, 1973.

Training in medical library sciences.-The Medical Library Assistance Act of 1965 authorized $1 million per year to support training grants and fellowships to train medical librarians and other muchneeded information specialists. With the $4.5 million which has been appropriated the National Library of Medicine has established approximately 20 training programs. Some of these provide training opportunities for medical librarians; others explore new ways of training individuals to organize and utilize the new informationprocessing technology to apply it to health fields. Still others support training for research careers in information fields. During the initial years of this program some 300 individuals will have completed training. While this is an encouraging beginning it does not begin to meet the identified need. In 1965 there were approximately 6,000 medical libraries in the United States with fewer than 3,000 trained librarians or other appropriate persons to staff them. The committee endorsed provisions to increase the authorization ceiling to $1 million per year to $2 million in fiscal year 1971, $2.5 million in fiscal year 1972, and $3 million in fiscal year 1973, with the expectation that this program, now that it is well established, can expand to provide larger numbers of the skilled library and information personnel needed.

Special scientific projects and research and development. The authorities for these programs under the Medical Library Assistance Act have permitted support and encouragement of useful projects to explore the needs and preferences of health workers for information serv

ices and to encourage and support the development of new systems and techniques. The committee believes that a research program at the current level authorized, $500,000 per year for special projects and $3 million per year for research, development, and demonstration projects will permit an adequate level of activity, provided the funds are appropriated. The committee took note of the fact that, while $12 million was authorized for research and development during fiscal years 1966-69, only about $5.3 million was appropriated. It is the opinion of the committee that appropriated funds be used for contemporary health problems such as alcoholism, drug abuse, population control, and environmental health.

Grants for library resources.-The Medical Library Assistance Act authorizes $3 million a year for this program, which has received enthusiastic endorsement from witnesses testifying in behalf of H.R. 11702 and related bills. In its initial years of development, this mechanism has been shown to be an effective one for encouraging medical and other health libraries to acquire the documents, materials, staff, equipment, and systems to permit them to provide better services. However, the $9.7 million which has been appropriated and expended for such grants does not begin to approach the need, reported in 1965 as in excess of $100 million for medical library collections at that time. This program should be expanded. H.R. 11702 would provide for such expansion, authorizing $15 million during the 3-year period of the extension. At the same time the committee wishes to emphasize that expanded support through this program of grants for library resources should not replace local support for health libraries. H.R. 11702 retains the $200.000 ceiling on individual grants specified in the current act, and requires assurance of adequate continuing financial support for such libraries or instrumentalities during and after the period of Federal assistance. Related to this expansion, the bill would also provide authority to permit the establishment of new collections. With increasing emphasis upon continuing education of local health service personnel, such new information centers can contribute significantly to the information resources available for this crucial function.

Grants for regional medical libraries.-H.R. 11702 would increase the authorization for support for regional library service programs from $2.5 million to $3, $4, and $5 million per year, providing a total of $12 million for the 3-year period of the extension. The current authorization would have provided a maximum of $12.5 million for fiscal 1966-70. During fiscal 1966-69, $3.2 million was appropriated for regional library programs. The committee recognized that efforts to encourage and support the development of cooperative, coordinated programs to share information resources within large geographic regions of the United States is a complex task which would necessarily proceed slowly. Progress under the current legislative authority has been very encouraging; the response of the health library community in its voluntary efforts to work with this program has been enthusiastic. Eight of 10 planned grant-supported regional library programs have received their initial awards. This program has shown that it is possible by sharing library resources to improve the quality and speed of health information services to users of health information who are geographically remote from centers for such services. Such a system can also avoid the costly duplication of specialized or unusually com

plete collections of health literature. Regional library programs can not only provide conventional library services but can also serve as catalysts to encourage and develop needed innovations and improvements to the kinds of services available to health practitioners.

With the expectation that the transition must soon occur to the provision of full regional library services, and that preparation for special efforts to reach geographically isolated health workers and their institutions will soon begin, it is evident that this program requires substantially greater support than that which has been available under the present law. Continuity of support is essential for this program. Extension of this authority for less than 3 years would, in the opinion of the committee, be detrimental to its effectiveness.

Other amendments provided by H.R. 11702 for this program would help to assure effective administration and improve the responsiveness of this program to the ultimate user of information services. Support of planning activities is particularly important since an accurate knowledge of the health information resources and needs of the region is the only sound base upon which to plan a realistic program which will meet local needs. H.R. 11702 would also permit the selective use of the contract mechanism for certain specific activities which require direct guidance by the National Library of Medicine, such as MEDLARS and other computer-based services.

Support of biomedical scientific publications. The committee noted that one of the problems which led to passage of the Medical Library Assistance Act was the rapid, accelerating growth of the volume of health documents and information which had to be processed. The Congress recognized that simply to make primary health literature available as it is published is not enough to assure the efficient flow of vital information from its point of generation to the ultimate user. It is also necessary to categorize and analyze this literature and provide locating devices to make it possible for each health worker to find the information which meets his individual needs. Such locating devices include universal and selective abstracting and indexing services, and annual, updated, and critical reviews of the literature for specific subject areas. To encourage the support of such worthwhile activities, H.R. 11702 maintains the authorization for the selective support of health-related publications at $1 million per year or $3 million during the 3-year period of the extension.

SECTION-BY-SECTION ANALYSIS

Section 1.-This section provides that the act may be cited as the "Medical Library and Health Communications Assistance Amendments of 1969."

Section 2. Clarifying and technical amendments and declaration of policy and statement of purpose.-Amends clause (3) of subsection (b) of section 390 to authorize grants to public or nonprofit private institutions; amends clause (4) of such subsection to authorize demonstrations in the field of medical library science; amends clause (5) of such subsection to authorize establishment of regional collections under the resource grants program.

Assistance for construction of facilities.-Section 2(b) (1) amends section 393 of the Medical Library Assistance Act (42 U.S.C. 280b–3).

deletes reference from this section to award in the absence of matching funds. Section 2(b) (2) deletes authority for approval of applications for medical library construction when matching funds are not available. Assistance to special scientific projects. Section 2(c) (1) amends the heading of section 395 of such act (42 U.S.C. 280b-5) to reflect the combination of such sections with section 396, the new title to read "Assistance for Special Scientific Projects, and for Research and Development in Medical Library Science and Related Fields." Section 2(c) (2) substitutes "Secretary" for "Surgeon General" and changes the reference from "fellowships" to "grants"; and authorizes and adds authorization for such grants to be made to public or nonprofit private institutions on behalf of qualified individuals.

Research and development in medical library science and related fields.Subsection 2(d) adds authority for the support of demonstration projects under the research and development program.

Grants for improving and expanding the basic resources of the medical libraries and related instrumentalities.-Subsection 2(e) (1) amends the heading of section 397 of such act (42 U.S.C. 280b-7) to read "Grants for Establishing, Improving, and Expanding the Basic Resources of Medical Libraries and Related Instrumentalities."

Subsection 2(e) (2) adds authority to establish new collections for this program.

Subsection 2(e) (3) deletes reference to levels of award on the basis of the library's annual budget and deletes the requirement for grants subsequent to the first year being in decreasing amounts; and requires assurance of adequate continuing financial support for such libraries or instrumentalities from other sources during and after the period for which Federal assistance is provided.

Grants for establishment of regional medical libraries.-Subsection 2(f) (1) provides authority under this program to support planning for services and activities.

Subsection 2(f) (2) provides authority for the grantee library to supplement the resources of cooperating libraries in the region.

Subsection 2(f) (3) deletes the requirement, under section 393 (c) (2) (A) of such act, that in making a grant, priority must be based on need of the library.

Subsection 2(f) (4) adds authority to this section for use of the contract mechanism as well as grants. Subject to the same limitations as are provided in this section for grants.

Authorization of appropriation-Extension of duration.-Section 3(a) provides that funds appropriated for grants for construction shall remain available until extended.

Assistance for construction of facilities. Subsection 3(b) provides an authorization of $11.5 million in fiscal 1971, $14 million in fiscal 1972, and $16.5 million in fiscal 1973.

Grants for training in medical library sciences.-Section 3(c) authorizes the appropriation of $2 million in fiscal 1971, $2.5 million in fiscal 1972, and $3 million in fiscal 1973.

Assistance for special scientific projects. Subsection 3 (d) (1) authorizes appropriations not to exceed $500,000 for any fiscal year during the period of the extension.

Subsection 3(d) (2) substitutes "Secretary" for "Surgeon General”. Research and development in medical library science and related

S. Rept. 91-480- -2

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