rehabilitation services; and (3) to develop an increased awareness of rehabilitation philosophy and methods on the part of personnel in all fields contributing to the total rehabilitation process. These purposes are related to the objective of a progressive increase in the numbers of disabled persons rehabilitated vocationally each year.

The major fields in which long-term training grants are awarded include dentistry, medicine, nursing, occupational therapy, physical therapy, prosthetics and orthotics, rehabilitation counseling, social work, and speech pathology and audiology. The total amounts obligated for training and traineeships under the Vocational Rehabilitation Act beginning with the 1954-55 school year are given in table 47. Amounts for individual States and Territories in 1958-59 for this training, which includes short-term and long-term training and rehabilitation research fellowships, are reported in column 17 of table 3. The $3,971,000 expended in the 1958-59 school year and reported in table 47, provided support to 145 institutions for 1,025 long-term trainees.

Table 47.-FEDERAL FUNDS EXPENDED FOR TRAINING AND TRAINEESHIPS IN VOCATIONAL REHABILITATION: 1954-55 TO 1959-60

SHORT-TERM TRAINING AND REHABILITATION RESEARCH Federal support of short-term, specialized training and instruction in technical aspects of vocational rehabilitation services is authorized under section 7 of the act of 1954. Rehabilitation research fellowships are also authorized in order to enlarge and enrich our research resources through the development of competent research workers in professional fields which contribute to the vocational rehabilitation of disabled persons. Fellowships may be awarded to assist qualified candidates to: (1) Obtain advanced training in rehabilitation research; (2) increase their competence or broaden their experience in rehabilitation research; or (3) carry out a research project which holds promise of making a significant contribution to advancing our knowledge and

understanding of the vocational rehabilitation of disabled persons. Qualified persons in any of the professional fields which contribute to the vocational rehabilitation of physically or mentally handicapped persons may apply for a predoctoral, postdoctoral, or special fellowship.

The amount for short-term training and rehabilitation research fellowships for each year from 1954-55 to 1959-60 is specified in column 4 of table 47. In 1958-59, grants totaling $828,000 were made to 79 institutions for 2,270 short-term trainees. Also, 13 rehabilitation research fellows were supported from this amount. Data for these programs for Vocational Rehabilitation were provided by the Office of Vocational Rehabilitation.

PUBLIC HEALTH SERVICE

Dating back to July 16, 1798, with the establishment of marine hospitals to care for American merchant marine seamen, the scope of Federal responsibility and service in public health has been greatly expanded. In 1939, this responsibility and service was transferred from the Department of the Treasury to the Federal Security Agency. The Public Health Service as now constituted in the Department of Health, Education, and Welfare, is charged with responsibilities for protecting and improving the health of the people of the Nation.

Major functions of the Public Health Service are: (1) To conduct and support research and training in the medical and related sciences, and in public health methods and administration; (2) to provide medical and hospital services to persons authorized to receive care from the service, to aid in the development of the Nation's hospitals and related facilities, and to prevent the introduction of communicable diseases into the United States and its possessions; and (3) to assist the States and other governments in the application of new knowledge for the prevention and control of disease, the maintenance of a healthful environment, and the development of community health services. Information and education are important in achieving these objectives. Among the educational programs of the Public Health Service, the following seven programs are described in this section: (1) Training at the Communicable Disease Center; (2) education in hospitals; (3) education of State and local public health personnel; (4) training programs to improve Indian health; (5) public health research fellowships; (6) public health traineeships and training grants; and (7) training at the Robert A. Taft Sanitary Engineering Center. Figures reported exclude amounts for research plant facilities and project grants. Data for all programs reported here were provided by the Public Health Service.

COMMUNICABLE DISEASE CENTER

The Communicable Disease Center of the Public Health Service is located in Atlanta, Ga. Two types of training sponsored by the center are described below under field training and laboratory training. Field training.-Emphasis is placed on training in new or improved methods of disease control to: (1) Provide practical field training to State and local public health personnel in general health theories, standards, techniques, and practices; (2) enable State and local public health personnel to perform their duties more adequately; (3) assist in training other State personnel; (4) assume greater responsibilities in the investigation and control of diseases; and (5) provide demonstration and consultation services to States to help them in the development and improvement of State public health training programs or encourage them to establish and operate their own training programs.

Table 48.-FEDERAL FUNDS EXPENDED, NUMBER OF COURSES OFFERED, AND NUMBER OF TRAINEES FOR EDUCATIONAL PROGRAMS OF THE COMMUNICABLE DISEASE CENTER: 1951-52 TO 1959-60

Laboratory training.-Courses are offered to all grades of employed laboratory personnel of State and local health departments to: (1) Develop accuracy and dependability in the diagnostic ability of professional laboratory workers; (2) acquaint them with the best methods and apparatus available for each procedure; (3) familiarize them with the basic principles underlying each step; and (4) allow for interchange of ideas and discussion of problems with other students in group seminars. These training courses are designed to improve the quality of diagnostic work by intensive refresher training in laboratory specialties with emphasis on newer developments and on the practical aspects of diagnostic laboratory procedures.

Table 48 gives a 9-year summary of Federal funds expended, number of courses offered, and the number of trainees for the two training programs.

EDUCATION IN HOSPITALS

Educational activities in hospitals of the U.S. Public Health Service (USPHS), and Freedmen's Hospital in the District of Columbia, include those related to training in: (1) clinical training for student nurses; (2) elementary and secondary schooling for patients with leprosy in the USPHS Hospital at Carville, La.; and (3) medical record library science. The total amount of Federal funds expended for these three programs was $215,000 for the 1958-59 school year. This is reported in column 4 of table 2 for "education in hospitals," and is the sum of the three amounts reported for 1958-59 in columns 2, 4, and 6 of table 49. These activities indicate the responsiveness of the Federal Government in meeting the needs of the Nation for training in special competencies and also consideration for the problems of individual patients in obtaining their basic educational requirements.

CLINICAL TRAINING OF STUDENT NURSES

Clinical training is provided at Freedmen's Hospital for approximately 82 student nurses enrolled in the School of Nursing. The hospital employs instructional staff members exclusively for this training program at an estimated cost of $199,000 for the 1959-60 school year. Columns 2 and 3 of table 49 indicate the estimated Table 49.-ESTIMATED FEDERAL FUNDS EXPENDED AND NUMBER OF STUDENTS PARTICIPATING IN EDUCATIONAL PROGRAMS CONDUCTED IN HOSPITALS: 1950-51 TO 1959-60

Federal funds expended and the number of students participating in this program during the past 10 years.

ELEMENTARY AND SECONDARY EDUCATION OF PATIENTS

Three teachers, employed at a total annual salary of approximately $20,000 for the 1959-60 school year, provide formal basic education to patients at the Carville, La., Leprosarium. At present, about 65 child patients attend classes and receive elementary through high school instruction, depending upon their needs. A number of adult patients also participate in the educational program. Columns 4 and 5 of table 49 indicate the estimated Federal funds expended and the number of students in attendance under this program during the past 10 years.

TRAINING IN MEDICAL LIBRARY SCIENCE

The Public Health Service Hospital at Baltimore, Md., offers training in medical library science for qualified college graduates. Classes admit approximately 10 students. The course consists of 50 weeks of instruction which includes formal lectures, individual conferences and laboratory work, and practice in medical record theory, procedures, and management. Three registered medical record librarians, several members of the medical record section, and the professional and management hospital staff participate in this training. Consultants in various specialties provide guest lectures.

Quarters and subsistence available to the students cost an estimated $5,000 of Federal money during 1959-60. Fifty-nine students have graduated from the course since it was organized in 1950. Columns 6 and 7 of table 49 give a 10-year summary of estimated Federal funds expended and number of students participating in this training program.

EDUCATION OF PUBLIC HEALTH PERSONNEL

The enactment of title VI of the Federal Social Security Act in 1936 provided the first Federal funds to be granted for programs of education sponsored by the State health agencies. Part of the funds appropriated each year as grants for the extension of public health services have been used by the States for personnel training in order to improve the quality of State and local health services to the general public. Trainees are afforded opportunities to extend their technical and scientific knowledge so they can be more effective through the training programs. Through these orientation and on-the-job training programs, public health personnel in the States are assisted in keeping abreast with changes and progressive developments in public health services.