Page images

schools are in those throes of verging on Mr. QUIE. Undoubtedly there are a sulted in a request specifically of the collapse without the traditional funds, number of colleges and universities in President in two or three fields. Naalbeit, they would like to have.

the country that are going to expand tional Defense Education Act was Mr. HARRIS. May I say to the gen- their enrollment.

formed. Engineers, mathematicians, tleman that on page 19 of the report the After we have set this precedent, at certain types of scientists were needed. gentleman will find a quote from the least, there should be no more opposition We went into that field because there American Council on Medical Education to providing the same type of basic and was an immediate need which the Presiand they did refer to the fact that there professional improvement grants to any dent said affected the security of this were, as the gentleman from Illinois (Mr. college or university for increasing en- country. I felt it was right because this SPRINGER] mentioned, 10 that were in rollment?

was a need with which the Defense Dedire circumstances and possibly 12 that Mr. SPRINGER. May I say we do not partment was actually confronted. I am were in need, and some question as to approach this as general education. The putting this in on a similar, not as an whether they could continue unless gentleman may assume that. We ap- excuse, but on a similar basis. I am not something were done.

proach this in the Subcommittee on surrendering this any further than I Mr. QUIE. Madam Chairman, will the Health and Safety because we believe have indicated so far.

have indicated so far. I know how the gentleman yield?

this affects a vital interest, which is the gentleman feels about this. Mr. SPRINGER. I yield to the gen- health of the country. We do approach Mr. HARRIS. Madam Chairman, will tleman from Minnesota.

this simply as an educational matter. the gentleman yield? Mr. QUIE. I would like to ask the We would have no jurisdiction to do any- Mr. SPRINGER. I yield to the gentlegentleman if the committee considered thing with reference to anything other man. the implication that this legislation than what I am talking about, the health Mr. HARRIS. With reference to what might represent a precedent with refer- of this country. That is our philosophy. the gentleman from Minnesota said, I ence to the basic improvement grants Mr. QUIE. Well, as far as you have

want to call attention to the fact that and the special improvement grants, be- been able to establish, the need for doc

there were other professions in the field cause I understand this is the first time tors, on that principle, at least this com

of health making the same claim to us any college or university would receive mittee would not be in opposition to that

and we did not include them in this money which would go directly for cur- same type of assistance?

program because we did not have the rent operating expenses such as salaries

Mr. SPRINGER. I would want to re

record to prove that the need existed. and administrative expenses. serve that until I knew the nature of the

Mr. SPRINGER. There was discusMr. SPRINGER. Insofar as I know need, and the extent of the need. I do

sion on these problems in the committhis is the first instance. not take this as basic college education

tee and this would have been expanded Mr. QUIE. So, this is the first time or as graduate education. I take this as

by at least five or six more professions. that this has been done? something which has been defined to this

But we did not feel the need was there. Mr. SPRINGER. Yes. committee as far as the health of the

In fact there is at least one in the bill Mr. QUIE. If the gentleman will country is concerned. I would not want

that I had serious reservations on and I yield further, we went at great length to go beyond that in my dialog with the

do have today serious reservations on it into this when the Higher Education and gentleman.

but by a narrow margin it was put in Academic Facilities Act was up for con

the bill.

Mr. QUIE. The gentleman does recogsideration, and there was some discus- nize this is precedent-setting when we

Mr. QUIE. And veterinarians were sion of this when the facilities part of will pass this legislation?

left out by the committee's action. the medical bill came up in the last Con

Mr. SPRINGER. We believe this is a

Mr. DON H. CLAUSEN. Madam gress; that is the question of direct

Chairman, will the gentleman yield? grants to private and church-related in- precedent based on the health of the

Mr. SPRINGER. I yield to the genstitutions, because we do have a con

country. stitutional question involved.


Mr. HARRIS. Madam Chairman, will Did the constitutional question come the gentleman yield?

Mr. DON H. CLAUSEN. I have before before the Committee on Interstate and

Mr. SPRINGER. I yield to the gen

me a letter from the president of one of

my junior colleges in California. He says Foreign Commerce at all, since I note tleman from Arkansas.

we are supporting the Rogers amendthat there are 13 of the 84 schools which

Mr. HARRIS. Is it not a simple state

ment in H.R. 3141 which would permit are church related and 11 of the 47 ment of fact that instead of catching up

the benefits of the nurses training act to dental schools that are church related ? we are actually losing ground in provid

come to junior colleges with registered Mr. SPRINGER. May I say to the ing adequate manpower so far as doctors

nurses programs. I note the gentleman gentleman from Minnesota that I think and other medical personnel are con

from Colorado (Mr. ROGERS] and the we approached this on this premise. I cerned, to meet the needs of the future,

chairman on the floor. I have been told doubt that there was a lot of discussion, and with the expanding population and

that this particular amendment was inbut we approached it on the premise that with the greater demands that are be

cluded in the committee bill. in the medical schools they are not going ing thrown on the professional people in

Mr. SPRINGER. It is in the bill. to teach religion. this field? We have simply got to do

Mr. DON H. CLAUSEN. So I can asWhen we had the facilities bill up in something on a long-term basis if we

sure the president of this college that his 1963—and I will stand corrected by my meet it in the future. chairman if my information is false— Mr. SPRINGER. That was in essence

particular request is already covered?

Mr. SPRINGER. That is correct. we provided in that legislation that there what I am trying to say. could not be used any funds of any kind

Mr. DON H. CLAUSEN. I thank the Mr. QUIE. Just one more comment:

gentleman. to even build any building in which there It is just that. A number of other prowas so much as a chapel.

fessions have made the same kind of Mr. HARRIS. Madam Chairman, I Mr. QUIE. That is correct, or the claim to us. You will recall the need for yield 10 minutes to the gentleman from teaching of any sectarian course.

engineers, technicians, and a number of California [Mr. COHELAN). Mr. SPRINGER. We did try to eli- others. Then the humanities came in. Mr. COHELAN. Madam Chairman, I minate any possibility that any church- We are caught now in a war with an- would like to make clear initially that related school could use any funds for other nation, in labor management dif

other nation, in labor management dif- I strongly support the basic provisions anything other than the purely bricks ficulties, the poverty matter, and the of this Health Professions Educational and mortar building of a medical facility. other struggles. I recognize we do have Assistance Act. Our Nation's health can

Under this legislation we feel we have health needs, but I recognize the other be no stronger than the availability and it in the position where none of this areas feel just as much a need. I want to the skills of our health personnel—of could be used for any other purpose ex- point this out today so that we may our doctors, dentists, and nurses. Yet cept teaching and that kind of opera- know we are setting a precedent for the the greatest breach in our health detion. future.

fenses today is the critical lack in many I do admit that there will have to be Mr. SPRINGER. May I say that in areas of such personnel. This legislasome regulation made by the Secretary the general broad field we have not done tion is designed to deal specifically with in this matter to assure that this will be anything in the field of education. this problem and I believe that it should true.

There was Sputnik in 1957, and that re- be strongly supported.

But, Mr. Chairman, I am seriously dis- rials, correspondence with the school, to a medical school by experts in the turbed about one amendment to this and listings of the program.

medical field, is doubly important beotherwise meritorious bill, an amend- Certainly, these fees are not unreason- cause the performance of the graduates ment which was added by the committee able when placed in perspective with the

able when placed in perspective with the involves the life and health of the people. in executive session without the oppor- importance of this work and the fees By the same token, it is equally importunity of public discussion or dissent. charged by other professional accredit- tant that programs in nursing education This is an amendment which provides ing bodies.

be accredited by experts in nursing eduthat in the field of nursing alone of all A third and very serious allegation is cation in order to assure the public of the health professions, accreditation, that the accreditation provisions con- quality preparation of future nurses who which is the requirement for receiving tained in the Nurse Training Act can be will be caring for them. The CommisFederal assistance, would not be made modified without impairing the goals of sioner of Education recognized the necesby the recognized accrediting body with that act. This assumption just does not

that act. This assumption just does not sity for this type of professional comin the profession. withstand the test of experience.

petence in the accrediting of nursing This bill provides that in medicine, There is danger in permitting State or education programs by designating the dentistry, osteopathy, and optometry, ac- regional accreditation, when experience National League for Nursing as the nacreditation of all educational programs has shown that the highest percentage tional accrediting body for all types of will be made by each group's accredit- of nurses are graduated by nationally nursing programs specified in the Nurse ing body. But not for nursing. This accredited programs and the highest per- Training Act of 1964. amendment, adopted by the committee centage of passing scores on licensure ex- Madam Chairman, I have taken the without hearings, means that accredita- aminations are achieved by graduates of time to make these rather extensive retion by the National League for Nursing nationally accredited schools.

marks because I believe this particular for baccalaureate and associate degree The record of nationally accredited amendment to H.R. 3141 has been inadeprograms in nursing could no longer be schools of nursing demonstrates that

schools of nursing demonstrates that quately and insufficiently considered. I a requirment for receiving Federal funds they are able to attract, maintain, and intend to vote today for the overall prounder the Nurse Training Act of 1964. graduate the largest numbers of stu- gram which the original provisions of

It is both obvious and imperative that dents. Seventy-five percent of all stu- this bill so constructively advance. But the quality of nursing and other health dents are enrolled in the 717 nationally I believe and I urge that the Rogers care be maintained and improved. To accredited programs. A higher propor

accredited programs. A higher propor- amendment, which is both unnecessary accomplish this, I believe it is essential tion of graduates from accredited pro- and harmful, be deleted from the final that the accrediting body within the pro- grams pass State board examinations measure which is approved by the Confession itself should be the judge of the and are licensed to practice. The ac

gress. quality of the preparation.

credited associate programs had a 10- Mr. BENNETT. Madam Chairman, I Madam Chairman, several arguments percent failure on State boards, while rise in support of H.R. 3141, legislation have been advanced in support of this the nonaccredited programs had a 25- to improve the educational quality of amendment and I have asked for this percent failure on State boards. The

The schools of medicine, dentistry, and allied time today since there was no opportu- Federal support of nonaccredited pro- sciences by providing scholarships to nity at the time the committee consid- grams is wasteful of public funds as well

grams is wasteful of public funds as well needy students and aid for school conered this amendment to discuss them. as being costly to the individual student struction.

First it is alleged that in the field of who has completed a training program I have also introduced legislation to nursing education there have been “de- and is then unable to pass a licensing

and is then unable to pass a licensing accomplish the same purpose as H.R. lays in the processing of applications for examination as a safe practitioner of

examination as a safe practitioner of 3141, including H.R. 2366 and H.R. 8751. accreditation.” This just is not so. nursing.

I have long had interest in providing Since passage of the Nurse Training The effect of lowering the quality of assistance to schools teaching students in Act in August of 1964, a total of 167 pro- nursing education would be tragic when the health professions. It was my privgrams applied for reasonable assurance there have been and are continuing to

there have been and are continuing to ilege in the last Congress to support and of accreditation, the standing which en- be such striking advances in the devel

be such striking advances in the devel- take an active part in the passage of the ables a school to apply for Federal funds opment of the medical sciences and the

opment of the medical sciences and the Health Professions Educational Assistunder the Nurse Training Act. Each of nurse is faced with greater and greater

nurse is faced with greater and greater ance Act of 1963, of which I was a cothese 167 applications was considered responsibilities and decisionmaking in introducer. The long-range planning to and 113 were granted reasonable assur- the care of the sick. It is imperative

the care of the sick. It is imperative produce the needed doctors to serve our ance.

that we at least maintain the current Nation's growing population, including Το accomplish this, the National standards of nursing education and it is the construction of medical schools and League of Nursing planned closely with unthinkable that we would do anything

unthinkable that we would do anything scholarships to needy students in the field the Public Health Service, with the Com- to lower the quality of nursing education.

to lower the quality of nursing education of medicine, is one of our most challengmissioner of Education, and the schools A fourth point which has been made ing problems, and I have been happy to themselves. The schools were informed is that accrediting or approval agencies

is that accrediting or approval agencies take an active part in this endeavor. well in advance of the dates for sub- shall be those which are responsible for

As a member of the House Armed Serymitting reports, visits, and meetings of accrediting or approving the educational ices Committee I have witnessed how this the review panels.

institution as a whole rather than only national problem of inadequate medical A second allegation has to do with the nursing programs conducted in the schools and not having enough doctors expense. This likewise is not justified. institution. The inconsistency of this affects our national defense mission. It For reasonable assurance, institutions provision should be readily clear.

was with this in mind that I introduced offering new nursing programs are Accreditation by a regional association legislation in this field back in the 84th charged an accrediting fee of $100, plus gives approval of an institution in its Congress, and I have continued to have the travel and per diem expenses of two totality. A particular program within a very great interest in it. In this sesvisitors. Institutions offering estab- the institution may be very weak. State sion of Congress I have reintroduced lished nursing programs are charged an approval establishes minimum standards measures to establish an Armed Services accrediting fee of $100.

only. These vary from State to State as Medical School-H.R. 272—and to proSchools that are agency members of the quality of the educational systems

the quality of the educational systems vide for scholarships to medical and denthe National League for Nursing pay an vary. The Federal Government cannot tal students who would serve in the accrediting fee to cover the cost of travel in all reason, equity, and fairness afford

in all reason, equity, and fairness afford armed services for a period of time after and daily expenses of the two accrediting to give financial support to a nursing

to give financial support to a nursing they completed their education-H.R. visitors at the time of the visit. Visits education program in one region of the 2365. These measures would help to are made approximately every 6 years. country whose standards might be too eliminate the "doctor's draft” and are

For junior colleges nonagency mem- low to make it eligible for that support now pending in the Armed Services Combers of the National League for Nurs- if it were located in some other region. mittee. ing—a fee of $1,500 is charged at the Furthermore, this general accredita- The facts and figures about the crititime of the visit every 6 years to assist in tion is not the same as specialized ac- cal demand for doctors and teaching fadefraying the cost of the visit, convening creditation of a specific program. Spe- cilities have been well publicized. In the board of review, processing of mate- cialized accreditation, given for example

cialized accreditation, given for example October 1959, the report of the Surgeon

General's Consultant Group on Medical chairman and the Committee on Inter- construction, replacement, or rehabilitaEducation pointed out that the expected state and Foreign Commerce on taking tion of teaching facilities for the train1975 population of 235 million will re- a leadership role in this problem of pro- ing of physicians, dentists, professional quire a total of 330,000 doctors of medi- viding adequate medical facilities and public health personnel, optometrists, cine and osteopathy. This would neces

This would neces- doctors to meet the demands of the pharmacists, and podiatrists. An apsitate the annual graduation of 11,000 future.

propriation of $160 million per year students, an increase of approximately This legislation is needed now, and I would be authorized. 3,600 over the 1959 graduates. In the hope the House acts favorably.

Second. The bill extends for 3 addiPresident's message to Congress on Mr. FARNSLEY. Madam Chairman, tional years, until July 1, 1969, the curhealth, earlier this year, he said that we I ask unanimous consent that the gentle- rent program making grants to schools would need 346,000 physicians in 10 years, man from Rhode Island (Mr. FOGARTY] of medicine, dentistry, and optometry almost 60,000 more than we now have. may extend his remarks at this point in for the operation of student loan funds The Association of American Medical the RECORD and include extraneous and permits the extension of such loans Colleges reported in 1963 that 3,500 addi- matter.

to students at schools of pharmacy and tional medical doctors must be graduated The CHAIRMAN. Is there objection podiatry. An appropriation of $25 mileach year from medical schools by 1975. to the request of the gentleman from lion per year is authorized for this This is supporting evidence to the need Kentucky?

purpose. for more doctors.

There was no objection.

Third. In a new provision, the bill auA survey in 1963-64 showed the ex

Mr. FOGARTY. Madam Chairman, I thorizes a 4-year program of basic and penses of single medical students were rise to speak in favor of H.R. 3141, the special improvement grants to schools about $2,700 a year, and of married stu- Health Professions Educational Assist- of medicine, osteopathy, dentistry, and dents who had more than one child, ance Amendments of 1965.

optometry to enable these schools to in$5,200. Fifty percent of the income of

These amendments extend and expand

crease the scope and quality of their the single student comes from gifts and the present Health Educational Profes- teaching programs as other funds have loans from his family. Earnings account sions Assistance Act of 1963, an act that served to aid their research programs. for 30 percent, and only 8 percent comes from nonrepayable grants. Among mar

was one of the most significant land. Total appropriations authorized for this ried students with no children, 57 per

marks in health legislation that I have purpose would amount to $200 million cent of the income derives from the of a century in the Congress. Passage seen in the course of nearly a quarter over the next 4 fiscal years.

Fourth. The bill establishes a new 4earnings of the spouse, and only 16 per- of that historic measure by the 88th year program under which grants are cent from the family.

Congress, after earlier Congresses had to be made to schools of medicine, denOne-half of last June's medical school considered the problem of the dwindling tistry, osteopathy, and optometry from graduates came from families with in- supply of medical manpower in the which scholarships may be awarded up comes exceeding $10,000 a year.

It is essential that medical schools United States, but had failed to act, to $2,500 per year per student. accept talented young people from every makes our course of action here today Fifth. Finally, the proposed bill also

carries an amendment to expedite aclevel of income status. This is not the so clear that we have to do no more case now. The high cost of a medical than follow a blazed trail, and enlarge creditation of nursing schools which education prevents many qualified stu

it and smooth it out. This is what H.R. have experienced difficulty receiving dents from pursuing medical careers. 3141 is designed to do.

Federal aid because of the delays and The Federal Government has an obli

In his health message to Congress last expense associated with the accreditagation to the Nation's health and well- January President Johnson—whose per- tion procedure. The new provision con

sonal interest in the health field is known siders programs of nurse education acbeing, to help where it can properly help to all of you—summarized what must be credited if they are furnished by a junior in filling this medical gap. The Government has done much in this field, and

done. He pointed out that the need for college or college approved or accredited now 51 percent of total medical school trained health personnel continues to by either a regional or State approving expenditures are provided by the Gov- outstrip the supply, and that high operat- agency. ernment.

ing costs and shortage of operating As one who supported the Nurse I have contacted the medical associa- funds are endangering our health pro- Training Act of 1964, and as one who tions directly involved in my legislation

fessions educational system. He said has long been aware of the deepening and have favorable replies. Bernard J. that the high costs of medical school need for more nurses in this country, Conway, secretary, council on legislation must not be permitted to deny access

must not be permitted to deny access I am in sympathy with any move that American Dental Association, wrote me:

to the medical profession for able youths will increase the quantity of nurses. The American Dental Association has, in that the number

of low- and middle-income families, and However, I believe that we must be care

of physicians and ful that there is no decline in the quality the past, favored Federal financial support other health professions must be sharply of nursing care in our efforts to augment for the operational costs of dental schools and scholarships for dental students. To the increased if we are able to meet future the numbers of nurses. I am afraid extent that H.R. 2366 would supply Federal needs.

that this is being lost here. funds under appropriate safeguards, the as- The President also recommended legis- Under the amendments made by the sociation could approve your proposal in lation to authorize formula grants to Nurse Training Act of 1964, schools of principle.

help cover basic operating costs of our nursing are prohibited from receiving Dr. Campbell A. Ward, presi- health profession schools, and project assistance under the legislation unless dent, American Osteopathic Association, grants to enable these schools to experi- they are accredited by a recognized acwrote:

ment and demonstrate new and improved crediting body approved for this purWith regard to the bill, H.R. 2366, which educational methods. And he urged, pose by the Commissioner of Education, amends the Health Professions Educational scholarships for medical and dental with certain exceptions. These excepAssistance Act of 1963, I recall that our os- students who could not enter or com- tions are, I think, generous. In the case teopathic witness before the House Com- plete their professional training without of new schools, or schools receiving spemerce Committee in testimony . advo- such assistance.

cial improvement grants, or grants for cated Federal scholarship aid as necessary to increase the pool of available superior stu

After lengthy hearings before my dis student loan funds, the schools may be dents, and the need continues. I am sure

tinguished colleague, the gentleman considered as accredited and, therefore, the program advocated in your bill would from Arkansas (Mr. HARRIS]—soon to be eligible for participation in the programs be of great assistance in the improvement a Federal judge—H.R. 3141 which we are under the act, if reasonable assurances and extension of physician training in our considering today proposes to carry are provided that at the time specified institutions.

out the President's recommendations in the law, the school will be accredited The American Medical Association fa- through a series of amendments to the

through a series of amendments to the by the body or bodies recognized for this vors part, but not all, of these legislative existing law.

purpose. proposals, as shown by the printed hear- Briefly, these amendments would ac- I recall that the American Nurses Asings on the bill. complish the following:

sociation, testifying in behalf of the inThe urgent need for this legislation is First. Extend for 3 years the current clusion of nurses in the Health Profeswell documented. I congratulate the program of matching grants to aid the sions Educational Assistance Act of 1963,


pointed out that the number of nurses cation through legislation such as H.R. 3141 Percentage of full-time nurse-faculty in graduating from collegiate courses would would be tragic, and I know you will do your diploma programs by highest earned have to double from 4,000 in 1960 to at utmost to see that the proposal does not credential and accreditation status

become law. least 8,000 in 1970. We have narrowed

With heartfelt gratitude for your continued the gap a little, and we have so far made interest in nursing, and with kindest personal

Accredited Not

accredited no compromise with the quality of nurses regards, I am. training. I regret that I cannot support Very truly yours,

Highest earned credential: this portion of this otherwise excellent



0.2 bill, H. R. 3141, which we are considering State Director of Nursing Education.

Master's degree.


16.6 here, today.




Associate degree..


2.3 At this point, I would like to include



32.0 several letters I have received from per- Hon. JOHN E. FOGARTY,

Providence, R.I., August 26, 1965. sons in my Second Congressional Dis- House Office Building,

4. A higher proportion of graduates from trict of Rhode Island with whom I am Washington, D.C.

accredited programs pass State board examin agreement on this proposal:

DEAR MR. FOGARTY: Because of your vital

inations and are licensed to practice. STATE OF RHODE ISLAND AND PROVI

and continuing interest in the health of our instance in 1963–64 only 6 percent of candiDENCE PLANTATIONS, DEPARTMENT

citizens, I urge your consideration of mat- dates from accredited baccalaureate proOF HEALTH, ters outlined in this letter.

grams failed licensing examinations comProvidence, R.I., August 23, 1965.

It has come to my attention that the pared with 19 percent from programs not Hon. JOHN E. FOGARTY,

Committee on Interstate Commerce of the accredited. House Office Building,

U.S. House of Representatives, meeting in Washington, D.C. executive session, adopted technical

Accredited Not accredited DEAR MR. FOGARTY: I am most grateful to

amendment to H.R. 3141, the Health Proyou for the opportunity you provided in fessions Educational Assistance Amendments of 1965, which reads: "any program of nurse

Type of program Number Percent Number Percent meeting with Miss Brandt and myself last

of of of of week in your office. My tardiness in respond- education, offered by a diploma school nurs

candi- failures candic failures ing sooner is due to a vacation leave. ing, means a program accredited by a rec


dates Your counsel proved to be most valuable. ognized body or bodies approved for such Commissioner Keppel was also supportive, purpose by the Commissioner of Education,

Baccalaureate.. 3, 696 6 744 19 interested, and concerned. The opportunity

and when applied to any collegiate or asso- Associate degree.- 144 10 1, 133 25 ciate degree program of nurse education,



20, 118 to have met Dr. Shannon and to have shared


24 our concerns regarding the technical amend

means a program provided by an educational ment attached to H.R. 3141 was most satisfyinstitution approved or accredited by either

I sincerely hope that this technical amenda regional accrediting agency or a State aping

ment will not pass because I believe that it proval agency." On our return to Rhode Island, we in

is not in the best interests of patients. formed Miss Margaret Kelleher of the techIn essence this means that baccalaureate

Sincerely, nical amendment which caused her and her and associate degree programs in nursing

MILDRED E. SCHWIER, would no longer be required to achieve acboard grave concern. I am certain that she

Director of Nursing. has been in communication with you.

creditation by the National League for NursWe

ing in order to qualify for receiving Fedsincerely trust, at this writing, that a sincere eral funds under the Nurse Training Act of

HOSPITAL ASSOCIATION OF RHODE ISLAND, concern has been affected to halt the pro1964. It is my opinion that this would seri

Providence, R.I., August 27, 1965. posal from becoming law.

Hon. JOHN E. FOGARTY, Thank you for your kind, personal atten- ously jeopardize the quality of nursing care for patients attended by graduates of the

House Office Building, tion. Sincerely, programs which have failed to apply for or

Washington, D.C.


which failed to qualify for National League
for Nursing accreditation. My opinion is

and Public Welfare Committee has amended
based on the following facts:

H.R. 3141, medical school bill, to remove Division of Public Health Nursing. 1. The National League for Nursing pro

from the accreditation program of the NaSTATE OF RHODE ISLAND AND gram in accreditation is designed to involve

tional League for Nursing both college and schools of nursing in improving their pro

2-year junior college schools of nursing. On PROVIDENCE PLANTATIONS DEPARTMENT OF HEALTH, grams in the interest of graduating more

behalf of the hospital schools in our State Providence, R.I., August 18, 1965.

I have telegraphed Senator PELL, who as you competent nurses. Since 1952 the number of accredited programs has increased from

know is a member of this committee, urging Hon. JOHN E. FOGARTY, about 150 to 707. This number includes

that he oppose this amendment and strongly House Office Building, diploma programs, baccalaureate programs,

support continuation of the National League Washington, D.C. and associate degree programs. It represents

for Nursing accreditation program as writDEAR MR. FOGARTY: I have learned with the majority of nursing programs in the

ten into the original bill before it is regreat concern of the provisions of the techUnited States.

ported out of committee. nical amendment attached to H.R. 3141 since

2. Accredited programs attract and gradu- pital schools is needed in this regard and

Your continued support in behalf of hosI, as well as my associates in nursing educa

ate the majority of students. Seventy-five tion in Rhode Island, support in full the ac

to help resolve for the future their status creditation program of the National League percent of all students are enrolled in National League for Nursing accredited pro

and financing. I believe that any action for Nursing.

by Government which further beclouds or grams. The quality of nursing care rendered by

3. The National League for Nursing accred

diminishes the absolutely essential role of graduates of schools of nursing depends, in

the hospital school will do irreparable damno small measure, on the type of education ited programs are able to attract faculty bet

age to the end which you and I are striving received by the student nurse. Quality nurster qualified to guide students toward safe

to serve-optimum care of the sick and ining care for the citizens of our country is and sound nursing practice. For instance, a

jured. faculty study conducted by the National the greatest challenge facing schools of nursLeague for Nursing in 1964 showed the fol

Your awareness in regard to health care ing today, and toward this end they have received immeasurable assistance from the Na- lowing distribution of educational credentials needs and problems is probably unmatched among faculty of accredited and not ac

in the history of our Congress. Your knowltional League for Nursing. credited baccalaureate degree and diploma

edge of the great need to achieve a dramatic I am proud to tell you that all of the pro

breakthrough in nursing supply, even in programs. fessional schools of nursing in Rhode Island

relatively high resource areas, such as Rhode have achieved the distinction of accredita- Percentage of full-time nurse-faculty in

Island, led to the creation of the Surgeon tion by the National League for Nursing, and

baccalaureate programs by highest earned General's Consultant Group on Nursing. Yet, that this accreditation program has done

credential and accreditation status

after the protracted efforts of this group and more to upgrade the standards of nursing ed

the implementation of its recommendations, ucation in this state than any other move

Accredited Not ac- the problems of supply persist and the fiment. I should also add that I had the privi


nancing dilemma of hospital sponsors grows lege of serving on the National League for

steadily worse. Nursing's Board of Review for the accreditaHighest earned credential:

I have yet to find the opportunity to distion of schools of nursing for 7 years. In this Doctoral...


1.4 cuss with you the deliberative process of capacity, I had the experience of witnessing

Master's degree.



this task force and its report_I visited your Baccalaureate.


28.1 equally dramatic improvements in the schools

Associate degree

office several times for this purpose when I

3.6 of nursing throughout the country. To undo Diploma...

.9 was in Washington attending its meetingsthe progress made in the field of nursing edu

but I am certain that you know of my extreme disappointment in the lack of em- tistry—the loan provisions of the 1963 act

tistry—the loan provisions of the 1963 act opathic, and optometric schools under a phasis and support for diploma schools. to aid the health professions. This is the new program of so-called basic im

In this current move to separate diploma act which we are amending and extend- provement and special improvement schools from other nursing education by ing today.

grants. To get basic grants, schools means of different accreditation authorities

These statistics are indeed encourag- must increase their enrollment by 212 I see a continuation of the process which received preponderant support in the Sur

ing, but to be realistic we must recognize percent or a minimum of five students. geon General's group. There are those ar. that at best we can only hope to hold To get the special grants, they must conticulate members within the profession and the present ratio of physicians and other tinue spending non-Federal funds at a those in general education who vehemently health personnel to our population at a

health personnel to our population at a specific rate. That is the mechanical criticize and oppose any assistance to di- time when our population is growing and side of it. ploma schools because “they are not the increasing demands are being made upon On the philosophical side, these two mainstream of American education,” and health manpower, which is already in such assistance would tend “to perpetuate short supply. health manpower, which is already in grants are designed to help schools of

medicine, dentistry, osteopathy, and opthis anachronism in education.” I am not negative in regard to legitimate goals of

Just to give a glimpse of future needs- tometry improve their strength and prothe profession for self-improvement-the to maintain the present inadequate ratio grams. The basic improvement grant achievement of advanced status and better of physicians to population, we will need would provide a larger proportion of the compensation—as I believe that this is 346,000 physicians by 1975. We have less

346,000 physicians by 1975. We have less budget of underfinanced schools than it needed to make nursing more attractive vis- than 290,000 today, and even with the

than 290,000 today, and even with the would of budgets of better endowed a-vis other career opportunities for women. aid of health professions assistance we schools. Inadequately supported schools Neither am I opposed to assistance programs will get only about 9,000 graduates per

will get only about 9,000 graduates per could use these funds to improve stufor collegiate based nursing education.

dent-faculty ratio, attract more highly However, I believe the desire of the nursing year by 1975. profession to achieve self-determination, and

We will be short about 15,000 dentists qualified faculty, and to strengthen basic the goal of professional educators to absorb by 1980.

curriculum. More adequately supported this important segment of education for

workers who guard schools could use these grants for exwomen, together do great disservice to the against air and water pollution, radia

against air and water pollution, radia- perimenting with new ideas in profesunmet need of the American people for more

tion, epidemics—to name only a few na- sional health education. The special nurses.

tional dangers—are being trained in only improvement grant would provide the This continuing controversy, which thus

13 schools. ,

Indeed, there are actually incentive for development of specific far has successfully denied deserved support

fewer public health physicians in this to the main source of supply for professional

programs or departments within inade

quately supported schools, and more fornurses, must not be additionally encouraged country today than there were 15 years to the further detriment of diploma schools.

ago-a shocking example of the neglect tunate schools could use them to develop I believe that more confusion and uncer- of a vital health profession.

new programs in rapidly expanding fields tainty regarding the future of diploma To provide for the national deficit in such as genetics and biophysics. schools would result inexorably from the

pharmacists and optometrists, it is esti- Because these two kinds of grants passage of the amended version of H.R. 3141.

mated that the current number of grad- would be made on the basis of need, they Instead, what is clearly needed is emphasis

uates must be doubled, to maintain cur- will tend to narrow the gap in quality beon the essentiality of the diploma school for fulfilling national health care goals so that rent population ratios.

tween individual schools. They will innecessary financial support by society-not And schools of podiatry must triple sure the more adequate preparation of the hospitalized patient or third party their number of graduates, if current all future physicians and dentists and in agency-may be achieved. In my opinion, ratios are to be maintained by 1980.

this way increase the standards of medithis recognition and support is inevitable.

Precisely because current ratios are cal care for all our citizens. Roadblocks, such as those referred to above,

It is of special concern to all of us which confuse or delay the establishment of inadequate in all of these health profes

that at least 10 medical schools are in affirmative public policy for diploma schools, sions, it is particularly gratifying to me should be vigorously opposed as being conto note that H.R. 3141 extends the stu

serious financial straits at a time when

this Nation has to look to these schools trary to the public interest. dent loan program for another 3 years,

to provide more and more trainingI will appreciate an opportunity to talk boosts the amount from $2,000 to $2,500, with you further about this important and adds pharmacists and podiatrists to

for medical graduates, for practicing problem whenever you desire.

the list of those eligible for such loans. physicians, for ancillary health workers. Sincerely,

A related provision of H.R. 3141 adds It is incomprehensible to me that at this WILLIAM K. TURNER,

same time the American Medical AssoFederal scholarship authorization for the Chairman, Council on Hospital first time for full-time medical, dental,

ciation opposed this operating fund proFinancing and Government Relations.

vision of H.R. 3141 in committee because osteopathic, and optometric students. Mr. Chairman, it is extremely en

it regarded these funds as a step toward Some of you may recall that earlier

"Federal domination of medical educacouraging, I think, that the Health Pro- this year I introduced a bill before this

tion.” It is not, I think, necessary to fessions Educational Assistance Act has House-H.R. 6000—to provide Federal already caused a significant increase in scholarships not to exceed $2,500.

dignify that old charge with an answer.

At the enrollment at medical and dental that time I pointed out that it is a sad

Those of us concerned with health schools and that if the trend con- instance of economic discrimination that

matters must face certain facts. As the tinues—the continuation of this program half of last June's medical school gradu

President said in his health message last represented today by H.R. 3141 will mean ates came from families with incomes of

January: that we may be able to at least maintain over $10,000 a year. Surely there are

We must fact the fact that high operatin this country the current ratio of medi- many young people from low- and mid

ing costs and shortage of operating funds cal, dental, and other health profes- dle-income families well qualified to be

are jeopardizing our health professions edusional manpower to population during come physicians and dentists but who

cation system. * * * Several underfinanced

medical and dental schools are threatened the 1970's.

are blocked by lack of finances from with failure to meet educational standards. In 1962, for example, the total first realizing their abilities.

New schools are slow to start, even when year enrollment in medical schools in the

In the past three Congresses I intro

construction funds are available, due to lack United States was 9,200; it is estimated duced bills to provide Federal assistance

of operating funds. that next month, the first year enroll- in awarding scholarships to students of Finally, I want to emphasize that this ment will total 9,925. In 1962, the total medicine and dentistry. The scholar- is no partisan measure. I want to urge first year enrollment in dental schools ship provision was stricken from those every Member of this House-Republiwas 3,680; it is estimated that next bills. I ask this Congress to carefully can as well as Democrat- to give careful month the first year enrollment will total consider this bill and not take similar consideration to this bill. Health mat3,850. Substantial increases have also action. The need for qualified, well

action. The need for qualified, well- ters should know no politics, because occurred in public health, nursing, phar- trained health personnel is so grave that

trained health personnel is so grave that disease is no respecter of political party macy, and optometry enrollments. this time we must not fail to do what we allegiance. In our health in the health These significant increases are attribu- can to meet this urgent need.

of our citizenry—is our country's table—in part, at least—to the programs Finally, I want to touch upon the pro- strength. of construction assistance and-for stu- vision in H.R. 3141 authorizing Federal Mr. MATSUNAGA. Madam Chairdents of medicine, osteopathy, and den- operating funds for medical, dental, oste- man, I rise in support of H.R. 3141, the


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