The awareness of a shortage of physicians and other health personnel led the Ohio State University College of Medicine to consider means whereby the health personnel requirements of the future could be met. This led to many changes in the college of medicine in the training of physicians, but over 2 years of planning has also resulted in the formation of the school of allied medical services. The wisdom in this planning has subsequently been emphasized by studies of the Manpower Commission and also by the Coggeshall report for the Association of American Medical Colleges. The aim of this school is to improve the quality and the quantity of training in the allied health professions. The needs here are great to develop teachers for other programs, to improve the methods and to develop new ones, and, just as importantly, to train these people by optimal utilization of the facilities and medical faculty so that all can function to maximum efficiency. At their meeting in April 1966, the board of trustees, the Ohio State University, established the school of allied medical services under the College of Medicine, of the Ohio State University. This school will bring together curriculums in occupational therapy, physical therapy, medical technology, medical dietetics and medical illustration, awarding bachelor degrees in all of these disciplines. In addition, under this school will be certificate programs in orthoptics, physical therapy, and nurse anesthesiology. The school will include, as of July 1, 1966, approximately 250 students in these various programs, thus representing the largest school training health related professional people. The purpose of the formation of this school is basically to train more and better members of the allied health professions. Inclusion of the various disciplines in one school allows for better coordination of effort, more efficient utilization of faculty time particularly in the medical areas. But it allows also the earlier contact of students with patients in the hospital setting and an earlier opportunity therefore to begin working toegether. We, here at Ohio State, feel very strongly that the "health team" approach to health care is extremely important and it must be achieved if the health needs of our growing population are to be met. The school also furnishes the structure to develop new programs of instruction. Such programs supply the teachers of the future. The School of Allied Medical Services must perform another very important function, however. It must also function to further education of those graduates who are now working in the various cities and towns. Thus, a program of continuing education is being developed within the school to bring new techniques and advances in all areas to various community facilities throughout the State of Ohio. This will be developed utilizing the extensive educational radio network of the Ohio State University and later, as it is developed, the television network. Continuing education after graduation is essential if we expect to achieve maximum utilization of the manpower which is already at work. The Ohio State University College of Medicine, through the School of Allied Medical Services, therefore, supports very strongly H. R. 13196 because we feel that such a program as presented by this bill will enhance the further development of schools of allied health professions in the country. In this way, the workers in the health fields will be increased in number and quality, will improve the health care of our population and will free the physician's time for optimal functioning as the leader of the health team. NEW YORK N.Y., March 29, 1966. Re Allied Health Professions Personnel Training Act of 1966. House of Representatives, Washington, D.C.: Whereas the above act is designed to aid the medical and allied medical professions by offering assistance for construction of facillties for education, for advanced education for teachers and supervisors, for curriculum revision, etc.; and whereas occupational therapy makes a noteworthy contribution to physical and mental rehabilitation; and whereas occupational therapy is not specifically named in H.R. 13196; we the undersigned urge the informed consideration of the committee toward inclusion of "occupational therapy" In the wording as well as the intent of the proposed Allied Health Professions Personnel Training Act of 1966. Such inclusion would permit continuation of recruitment, education, and research for improvement in and further development of health service through the professional contribution of occupational therapy. MARTHA SCHNEBLY, New York. BOSTON, MASS., March 30, 1966. Re H.R. 13196. Hon. HARLEY STAGGERS, House of Representatives, Rayburn Building, Washington, D.R.: Whereas this act is designed to aid the medical and allied medical professions by offering assistance for construction and facilities for education for students and loans etc.; whereas occupational therapy makes a noteworthy contribution to physical and mental rehabilitation; whereas occupational therapy is not specifically names in H.R. 13196, the undersigned urges the informed consideration of the committee toward inclusion of occupational therapy in the allied health professions in wording as well as the intent of the proposed Personnel Training Act of 1966. Such inclusions would permit continuation of recruitment education and research for improvement in and further development of health services through the professional contribution of occupational therapy. VERONIA C. DOBRANSKE, Department of Occupational Therapy, Tufts University. AMERICAN HOSPITAL ASSOCIATION, Hon. HARLEY O. STAGGERS, Chairman, Committee on Interstate and Foreign Commerce, House Office Building, Washington, D.C. DEAR CONGRESSMAN STAGGERS: This statement is sent to you to express the views of the American Hospital Association in respect to H.R. 13196, Allied. Health Professions Personnel Training Act of 1966. The bill deals principally with two aspects of the training of certain health personnel. The first part proposes a new program for the training of personnel in the allied health professions. The second part deals with the refinancing of programs already existing in respect to certain health personnel. Our remarks will be directed largely to the first section of the bill. The Federal Government is, at the present time, participating in a variety of programs directed toward providing increased numbers of highly qualified physicians, dentists, podiatrists, pharmacists, osteopaths, optometrists, and nurses. There exists a large body of essential health personnel apart from the above-enumerated groups which are often referred to as "paramedical personnel." We assume it is this group to which the bill refers as "allied health professions." We shall discuss the need for specific data with respect to allied health professions personnel. We now have an overall picture indicting a large amount of unmet needs for such personnel. We know that significant amounts of health programing cannot be satisfactorily carried out unless these needs are met. We believe this legislation very wisely proposes that the Federal Government render assistance so that we may make a start in getting at the problem and avoid the loss of valuable time. At present, we lack a great amount of detailed information needed to provide guidance for long-term planning to meet the Nation's need for such personnel. It is essential that we obtain information providing a nationwide picture as to the numbers of such personnel now available, the quality of their preparation, the source of their education, the numbers of such personnel that are needed, and the financial problems confronted by such personnel in undertaking essential education. The American Hospital Association, jointly with the U.S. Public Health Service, is now undertaking a basic study which, it is hoped, will furnish much of the essential data needed. A questionnaire study is now being directed to all registered hospitals in the Nation with the purpose of inventorying categories of personnel. Following are some 30 such categories: This study should develop the numbers of such personnel now employed in hospitals, the qualifications of such personnel, the estimates of the needs for such personnel now as measured in terms of budgeted vacancies, and projections as to the estimate of the numbers of such personnel that will be needed in a year's time. The information will be obtained for a base period during the month of April 1966. PART G. TRAINING IN THE ALLIED HEALTH PROFESSIONS The bill is unnecessarily vague, we feel, as to its purpose. It fails to identify the term "allied health professions." In the main, the bill appears to be directed toward assisting colleges and universities in providing construction grants for facilities and for the modernization of existing facilities and for assistance in the costs of improving the educational programs within such institutions. The bill, therefore, gives little promise of assistance in correcting the Nation's shortages of such personnel. We believe the bill is in error in failing to include junior colleges and teaching hospitals within the program of grants and assistance. Of the categories being inventories, as mentioned above, in only perhaps six is a baccalaureate degree customarily required for practice within hospitals. The vast majority of the others can be adequately prepared in not more than 2 years with, in some cases, a third year preceptorship in a qualified institution. Therefore, to provide a program of Government assistance which would be directed only toward colleges and universities offering baccalaureate degrees fails to recognize the realities of the situation. Junior colleges and teaching hospitals are the appropriate places for training most of the needed categories of personnel who do not require a bachelor's degree. Although a degree is not required for most of the categories to practice within hospitals, person who teach these disciplines do need a degree. The bill does provide assistance for this type of education as it should. We believe the bill is in error in another basic respect. It assumes that responsibilities for meeting the shortages of health personnel in the Nation will be accepted by colleges and universities. There is, as yet, little evidence that such institutions of higher learning are willing to undertake the training programs for all, or even for many, allied health groups. We question, therefore, the assumption of this legislation that the Nation's need for such personnel will be met by colleges and universities. There are large numbers of hospitals presently engaged in the training of various categories of personnel among those appearing above. We must look to these hospitals, along with all other sources, to continue the training of essential allied health personnel if the Nation's needs are to be met. Therefore, if the Federal Government intends to provide assistance which will increase substantially the numbers of personnel in the allied health professions, then consideration should be given to providing various forms of assistance to junior colleges and to teaching hospitals which are willing and able to undertake the training of such personnel. The bill provides for construction grants, for basic improvement grants, for special grants, and for traineeships for advanced training, all limited to colleges and universities. Under present circumstances, we feel it is likely that the Federal Government will make available only limited funds for the overall program. We therefore question the wisdom of diverting funds to the construction of facilities at this time. We feel that funds made available should be directed to the actual training of allied health personnel. SECTION 4. LOAN REIMBURSEMENT PAYMENTS FOR HEALTH PERSONNEL Beginning with this section and for the remainder of the bill, there are a variety of provisions which appear to alter existing financial arrangements which assist students in various categories of health personnel to meet the costs of their education. Basically, we believe the language suggests changing programs from direct Federal financing to insuring financing from commercial sources. Our only comment on these sections is that we feel the change will substantially increase the costs of financing student loans. Therefore, whatever funds the Federal Government makes available will likely contribute less to meeting the needs of students than would direct Federal loans. There is another provision upon which we wish to comment specifically and that is the special forgiveness provision afforded physicians. Our understanding of the language of the bill is that it would permit a physician to receive a forgiveness of up to 100 percent of his loan providing he practices in a designated rural and low-income area. We would urge, therefore, that the bill be amended so as to provide that any nurse employed in a rural area characterized by low family income, as designated by the Secretary, may also be eligible to receive 100 percent forgiveness of the loan. SUMMARY In summary, there are three broad categories of allied health personnel which are needed: (1) Those which require a baccalaureate degree or advanced training, (2) those which require 2 years or more of training but do not require a baccalaureate degree, and (3) those which require 2 years or less of training. In order to meet the needs, therefore, assistance is required for the colleges and universities; assistance is required for junior colleges; and assistance is required for training programs in approved hospitals. The vast number of allied health professions personnel which are needed can be trained within the latter two institutions. We would recommend, therefore, that a new section be added to H.R. 13196 which would also include programs for the training of allied health personnel in junior colleges and which would provide for training programs in approved hospital schools. We would appreciate your including this statement in the record of the hearings on H.R. 13196. Sincerely, KENNETH WILLIAMSON, Hon. HARLEY O. STAGGERS, AMERICAN NURSES' ASSOCIATION, INC., Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. STAGGERS: The American Nurses' Association wishes to record its support of your bill H.R. 13196, which will increase the opportunities for the training of medical technologists and personnel in allied health professions and strengthen and improve existing student loan programs. We particularly commend the emphasis in the bill on extension and improvement of training programs for allied health professionals at the baccalaureate and higher degree levels. We are in complete accord that attention should be given to assistance to programs that prepare teachers, supervisors, and highly skilled specialists. For those who must eventually assume such responsibilities, a baccalaureate degree should be the minimum requirement. Although this aspect of the proposed legislation is not directly concerned with nursing our own experience over the last several years leads us to be most supportive of the direction your efforts have taken. As demands for nursing services have increased, large numbers of subprofessional workers, such as practical nurses and nurses aids, have been trained to free the professional nurse for functions requiring greater skill and judgment. Substantial Federal assistance has been available for these training programs. However, we have been acutely conscious of the need for well-qualified teachers in the programs and for supervisors to give direction in the work situation. Such a need must also exist in the allied health professions and it will increase as more and more auxiliary workers are trained to assist these professional practitioners. We believe the grant proposals whose objectives are to increase the number of admissions to programs, improve the quality of education in training centers, aid students through a traineeship program and provide for experimentation with new curriculums for training health technologists are well conceived and will contribute in raising standards of services. We hope very much that your committee will approve this legislation and thank you for the opportunity to share our views with you. Sincerely, Mrs. JUDITH G. WHITAKER, R.N., Executive Director. Hon. HARLEY O. STAGGERS, AMERICAN DENTAL HYGIENISTS' ASSOCIATION, Chairman, Interstate and Foreign Commerce Committee, DEAR MR. STAGGERS: The American Dental Hygienists' Association, the national organization representing the profession of dental hygiene, endorses the inclusion of dental hygiene in H.R. 13196, introduced March 2, 1966. The association agrees with the intent of this bill to support dental hygiene educational programs at the baccalaureate and graduate degree levels and urges passage of bill H.R. 13196. We respectfully request that this supportive statement be included in the written record of the March 29 and 30 hearings on this bill. Very truly yours, MARGARET E. SWANSON, Executive Secretary. Hon. HARLEY O. STAGGERS, House of Representatives, Washington, D.C. TEMPLE UNIVERSITY, Philadelphia, Pa., April 22, 1966. MY DEAR MR. STAGGERS: We wish to take this opportunity to offer the wholehearted support of Temple University to passage of H.R. 13196 introduced by you and upon which hearings have been held recently. Health services are no longer performed by the physician or dentist working alone. Your recognization of the national need for more personnel in the allied health professions is readily apparent from the wording of this proposal. You are to be congratulated for having the foresight to recognize that steps must be taken at this time to prevent the situation from becoming a national crisis. We at Temple University have been considering for some time the problem of how to satisfy the increasing demands from the health science professions and from society itself that we educate more men and women for the health care teams. We already had taken steps to increase the first-year classes of our schools of medicine and dentistry by 25 percent. This will not be enough. There is an urgent need to provide for the education of a group of allied health professionals who will assist these practitioners in today's practice of medicine and dentistry. Our recent investigations were climaxed last month with approval by the board of trustees to establish a College of Allied Health Professions at our Health Sciences Center. This new school will offer baccalaureate programs in medical technology, nursing, physical thereapy, occupational therapy, and medical records library science. These persons will become full members of the health care team. A copy of the proposal which was accepted by our board is enclosed for your information. The faculty of our Schools of Medicine, Dentistry, Pharmacy, and Nursing and the staff members of Temple University, have also recognized that they must depend more than ever upon judicious utilization of personnel in the allied health sciences in order to meet the health care needs of our society. To the long familiar |