These standards are essential if the sick and injured throughout the United States are to receive a comparable quality of professional nursing care and students of nursing throughout the United States are to be comparably prepared to give the needed nursing care. The California association enthusiastically supports the American Nurses Association in its efforts to remove from this legislation the amendment which puts an end to this historic role.

Madam Chairman, I would hope the 89th Congress, which has given this Nation medicare, community health programs, the Health Research Facilities Act, a mental health staffing program, and now this health professions educational assistance amendments legislation-and probably later a bold new approach to the old enemies of heart, stroke, and cancer-I hope it will not be said that we followed up this fine program for the health care of America, by leaving a surgical sponge inside the patient.

Mr. SPRINGER. Madam Chairman, I have no further requests for time. I reserve the balance of my time.

Mr. HARRIS. Madam Chairman, I yield 5 minutes to the gentleman from California [Mr. Moss].

Mr. MOSS. Madam Chairman, I want to congratulate my distinguished friend from California, the gentleman who preceded me in the well, for his belated discovery of this surgical sponge. It was not apparent to the gentleman at the time it was offered in committee as an amendment. In fact there was a noticeable lack of opposition to what I regarded then and regard now as an excellent amendment, a reasonable amendment, one consistent in every respect with the highest standards of training, one which permits the 74 junior colleges in my State and the more than 119 in the Nation desiring to engage in the program, aimed at increasing the supply of qualified nurses in this Nation, to undertake that very responsible role.

Madam Chairman, I have the privilege of representing one of the very oldest junior colleges in this Nation, the Sacramento Junior College. I was privileged to attend that junior college. It has had for many years a program of nursing, as have numerous other junior colleges in California. They are not going to be able to meet the heavy expenses-I am not even certain that they can participate fully-without major changes in State law. I do not believe those in opposition to the amendment today are qualified to tell me whether or not participation by the California junior college system would require major changes in the laws of the State. But these are institutions accredited as educational institutions. They have not heretofore been called upon to seek individually the accreditation of professional groups. They have not been required to do it in engineering or in medicine or in law or any of the other professional activities in which they engage.

They give only an associate degree and, contrary to the inference clearly

The difference between their showing on tests for licenses in my State and the scores achieved by the baccalaureate nurses and by those who train at the hospitals is of no significant percentage. Their performance in their profession Their performance in their profession evaluated by appropriate interviews 2 evaluated by appropriate interviews 2 years after entering the profession finds years after entering the profession finds that they are accepted as being as competent in every respect as those with whom they compete. One of the pressing problems in this Nation is to expand the number of institutions engaged pand the number of institutions engaged in certain programs of training. One of the areas in which that expansion can take place most readily is at the community college level, and it will if we have no impairment of the ability of these institutions to fulfill their assigned task.

that is the test, the practical test of the adequacy of the program of training offered by the junior colleges.

Mr. COHELAN. Madam Chairman, will the gentleman yield?

Mr. MOSS. I yield to the gentleman. Mr. COHELAN. The gentleman knows I am a strong supporter of the junior college program including the nursing program. The only thing that separates us is the issue of accreditation and the availability of Federal funds for this purpose. The reason this Member now speaking supports this so strongly is that I want to maintain the standards in this very important field of nursing. I may say to the gentleman, with all of his allegiance to the junior college program, he has not said one thing about why a junior college should not be accredited by the National League for Nursing.

require a private group to spell out the

Mr. COHELAN. The gentleman has made a very fine statement, and has spoken at great length on our junior college program in California. But the gentleman is aware that the program as suggested by the amendment in the bill will, of course, have national implications and that the standards are not the same. The gentleman is aware of that?

Mr. MOSS. The gentleman is not willing to concede that that is necessarily so.

Mr. COHELAN. The gentleman will recall I discussed it at great length yesterday. There are 131 junior college programs in the United States, and out of the 131 programs there are 26 that are members of the National League for Nursing.

Mr. MOSS. Before I yield further, may I say that we did discuss this yesterday. The gentleman recognizes that we had an impossible task in reconciling the figures we were using. As a matter As a matter of fact, the figures just cited by the gentleman vary considerably from the figures he cited yesterday.

Mr. COHELAN. I merely want to say that I am perfectly willing to allow the figures to stand in the RECORD, and to be judged by any reasonable person, including the gentleman now in the well. I have no quarrel with the figures. I have no quarrel with the figures. But there is a very important issue of accreditation which pertains to junior college programs, because, unlike some of these other professions the gentleman referred to, in giving an associate arts degree and an R.N. after 2 years leads to the practice of nursing.

Mr. MOSS. I want to correct a statement just made. The receipt of the R.N. degree only gives a hunting license to go out and try to demonstrate competence and qualification through taking the same examination that would be given to a baccalaureate graduate in nursing. If they are able to do that, and it is a highly competitive area, and to do it with scores that compare favorably with those having had a 4-year course, then I think

hand of the lack of adequate standards, as a condition precedent to a public institution receiving funds to aid in the training of people in a profession when the demand for graduates and for qualified personnel is far greater than the supply, as it is at the moment.

The CHAIRMAN. The time of the gentleman has expired.

Mr. SPRINGER. Madam Chairman, I yield 1 minute to the gentleman from Nebraska [Mr. CUNNINGHAM].

Mr. CUNNINGHAM. Madam Chairman, I want to respond to the distinguished Member from California, if he would take the well.

Mr. MOSS. Go ahead and respond. Mr. CUNNINGHAM. Would you take the well, I cannot hear you.

Mr. MOSS. The gentleman, I thought, wanted to respond. I did not know he wanted conversation.

Mr. CUNNINGHAM. The gentleman said the other day in committee that the California Nursing Association favored the Rogers amendment. Well, this is just not so.

Mr. MOSS. The gentleman has had that explained to him and he impugns my integrity-the gentleman knows that on the word of my friend, the gentleman from Florida [Mr. ROGERS], who had received a communication from the California League of Nursing and inadvertently represented to me as the California Nurses Association. I stated that. I told the gentleman since that was an error.

The CHAIRMAN. The time of the gentleman has expired.

Mr. SPRINGER. Madam Chairman, I yield 1 minute to the gentleman from Nebraska.

Mr. CUNNINGHAM. This is an unusual situation. The gentleman from California indicated that the present method of accreditation is quite unusual. I point out from the document from the Office of Education, it is not at all unusual. Engineers are accredited by the professional engineering development arm of their organization. Dental hygienists, dental technologists, and dental assistants programs are accredited by the

American Dental Association. Many medical sciences such as medical technology, physical therapy, et cetera, are given approval or accredited by the Council on Medical Education. So the gentleman from California is in error.

The CHAIRMAN. The time of the gentleman from Nebraska has expired.

Mr. SPRINGER. Madam Chairman, I yield 5 minutes to the gentleman from New Jersey [Mr. CAHILL).

Mr. CAHILL. Madam Chairman and Members of the Committee, I am sure that all Members of the House subscribe wholeheartedly to the intent of the act under discussion, and that all of us agree we must in this country improve the medical education and the supply of doctors for our people.

I wonder, however, how many share my views that the intent and the purpose of this act are not adequately implemented.

I do not know how many share my experience, but in the 7 years that I have been a Member of this body, I found hundreds and hundreds of young qualified men and women seeking admission into medical schools who could not gain admission because there was no room for them, yet I have never found one who could gain admission who could not obtain the funds to pay for the tuition. I have taken this time to discuss briefly one section of the bill, though I would like to discuss many features of the bill which I do not believe have received sufficient study. I wish to discuss the section in relation to scholarships.

As I read page 24 of the bill, subsection (c) (2) provides for scholarships to be awarded to students from low-income families, but there is nothing in the bill to describe what is meant by "low-income family."

I wonder, for example, if the criteria of a low-income family is the same criterion established under the so-called poverty bill. If it is, then I would certainly be the first to agree that this would be a fair norm, standard, and criteria.

I find nothing at all in the bill which indicates the basis upon which these scholarships are to be granted. Will it be by written examination? Will it be by nationwide examination? Will the examination be different in the east from what it is in the west, the north, or the south? Who will establish the criteria?

Ten percent of the students of a medical school are going to be entitled to an outright grant of $2,500 with no provision to repay, in spite of the fact that we all know that doctors in this country-justifiably, I might add-are of the highest income bracket, generally speaking, of all groups of citizens.

There is no provision to repay this grant. There is no provision that any of the recipients must participate in any particular field of medicine, even though I am sure the chairman of the committee and the learned Members of the House who are members of the medical profession recognize that today there is a crying need in the field of psychiatry. There is no doubt that many of the fields of medicine today are undermanned. Many of the areas of our

country today are understaffed. Many towns and communities in rural areas of our country today do not have physicians.

Yet there is nothing in this bill, as I read it, to make it necessary or mandatory for any recipient of any scholarship to serve in any of these areas or to participate in any specific branch of the medical field.

As a matter of fact, as I read this bill, a man could get a scholarship for $2,500 for 4 years and he could quit medicine. He could go to Europe to practice medicine. I do not see any prohibition in the bill which would prevent any recipient of this scholarship from practicing medicine in England or in Ireland or in Italy or in the islands.

The CHAIRMAN. The time of the gentleman from New Jersey has expired.

Mr. CAHILL. I wonder if the gentleman could extend to me some additional time.

Mr. SPRINGER. Madam Chairman, I can yield the gentleman only 1 additional minute.

Mr. CAHILL. Madam Chairman, I shall ask for additional time under the 5-minute rule to discuss this, because I want to make clear to the committee that I favor scholarship programs. I think they are essential. I think the needy children of our country who want to become doctors should become doctors. But I do not think the criteria are spelled out in this bill. I do not think the safeguards and protections are in this bill.

Now, let me add one other thing. Do all of you in this committee realize that before a young man can receive this scholarship he first has to be enrolled in a medical school? Now, how is he going to get enrolled in a medical school if his family cannot afford to pay for it? Why would any boy make an application to go into a medical school when he knows in advance he does not have the money to pay for it? It seems to me that this scholarship should be established prior to acceptance in medical school so that all the boys of our country will know that they can go if they want to.

The scholarships are desirable; the criteria is not specified and the opportunity is not open to all qualified young men.

At an appropriate time I intend to offer an amendment to improve this portion of the bill.

Mr. HARRIS. Madam Chairman, I yield 5 minutes to the gentleman from Florida [Mr. ROGERS].

Secondly, there is the college degree program called the baccalaureate degree, which means a young lady goes to a school for a 4-year program and gets her degree. Then she has to take a State examination. If she passes that examination, she may become an R.N. If she does not, she cannot be a nurse.

Then we have diploma schools where nurses are trained in hospital schools and as soon as they finish training here again they have to take an examination if they want to become a registered nurse. If one cannot pass that examination, she will not be a registered nurse.

It is these examinations that are setting the standards presently of our nurses. You would think from hearing the conversation here today that this junior college program was something that just cropped up with the passage of this bill last year. Well, that is not so. We have had this nurse training program going on for about 15 or 16 years. It has proved itself. These nurses are being used in hospitals today and are well accepted by the doctors and by the public. In fact, last year, 1964, saw 2,000 nurses come to help fill the critical need from the junior college program. 2,000. They passed their exam. Their quality was high, and they are now performing those duties just as any other nurse. I doubt if a patient is asking, once the nurse has passed the examination, "Did you come from an associate degree school or do you have a baccaulaureate degree, or did you come out of a hospital school?"

What we need are nurses, and that is what this bill is directed to. I had just felt in looking at the situation that if we are getting presently 2,000 nurses from the junior colleges, and do you know how many of those schools are accredited by the National League of Nurses? Three. We have been turning out nurses from junior colleges since 1950, and there are only 3 accredited out of 131 schools. We hope we will get about 55 more junior colleges right away to come into the program. These standards can be maintained high. However, I do not think we ought to make these junior colleges go to a private organization-a private organization-to get their clearance before tax dollars are given to the nursing schools and students to study nursing, or for them to set up a program of nursing when the critical need of nursing is so great that we cannot meet the estimated total that we have been told year after year in our committee would require 800,000 nurses by 1970.

Let me say this. The Surgeon General has said that we need 800,000 nurses in 1970. We cannot possibly fill that need. All we can hope to obtain is about 560,000.

Madam Chairman, I do not know how many Members have read Life magazine of this week. Life magazine says the medical doctor shortage in this country is critical and the nursing situation is even more critical. In the words of Life magazine-and you ought to read it— "the nursing situation is even worse than the doctor shortage. The nursing home situation is so critical that Congress has put off until January 1, 1967, the start of

the nursing home benefits under the law that we just passed." Think of that.

Do you know that they have just issued a call for nurses to go to Vietnam? Do you realize the demand that there is going to be as we crank into these programs-the old-age benefits and nursing homes? We need to produce every qualified nurse we can.

I do not want to let down standards. But I think where a junior college is accredited by a regional accrediting office, or by a State accrediting agency, that should be sufficient.

I do not think, with this critical situation, that we ought to require these junior colleges to join an organization and pay a fee to this private organization to come down and look over the school in the beginning before Federal funds can be used. The National League of Nursing sends two persons to look over the program, and I am sure they do a good job. Then 6 years later they check again. However in the junior colleges most of these nursing programs are set up in close cooperation with State nursing

groups. I know ours is in Florida.

Let me tell you what has happened in the State of Florida. They say these nursing programs do not turn out very well from the junior college. Let me tell you how junior college graduate nurses turned out in my State. In 1964 the result of the registered nurses exam

showed that of the three competing schools of graduates, the associate degree students—that is, the junior college students-made the most impressive record. They finished above the other two

types of graduates in two of the five categories on the exam; second in the other three; and their percentage of failure was lower than the baccalaureate degree for the entire exam, and only a fraction above the diploma schools.

The average that the associate degree nurses got was the highest in two of the five categories and the second highest in the other three. They were never last in any category or in any part of the

exam.

Madam Chairman, we must meet a national need. We must have a realistic program. We need nurses, I say to my colleagues, and competent nurses. And if these young ladies can be trained as we envision it, we can help fill the need. They are going to have to pass the exam before they can take their place, and this is as it should be.

Mr. SPRINGER. Madam Chairman, I yield such time as he may require to the gentleman from Michigan [Mr. GRIFFIN].

Mr. GRIFFIN. Madam Chairman, I rise to indicate my strong support for the Rogers amendment which has been incorporated in the committee bill, H.R. 3141, and to associate myself with the remarks of the gentleman from Florida

[Mr. ROGERS).

Title I of the Nurse Training Act of 1964 provides assistance for construction and expansion of facilities for 2 years nursing programs. Titles II and III of the act provide that junior colleges which have associate nursing programs may receive certain special improvement

Unfortunately, however, the act has been interpreted by the Commissioner of Education so as to require that a junior college must be accredited by a private organization, the National League for Nursing, in order to be eligible for such assistance.

In Michigan a number of junior colleges have associate degree nursing programs. They are, and they have been, They are, and they have been, turning out graduates who successfully pass the State examination, who meet State qualifications, and who are admitState qualifications, and who are admitted as registered nurses.

Despite the fact that over a period of years these Michigan institutions of higher education have proved and established their qualifications to educate nurses in accordance with State standards, they are now precluded from participation in the Nurse Training Act because they are not accredited by the National League of Nursing. These same junior colleges are accredited to the same junior colleges are accredited to the extent required to meet State standards. In my view, the interpretation placed on the present law by the Commissioner of Education, requiring accreditation by this private organization, is unduly restrictive and not in the public interest.

As a Nation, we need a great many more nurses. It is difficult to see how this pressing National need can possibly be met unless we fully utilize our junior colleges to help train nurses. Without question, the Nurse Training Act of 1964 will fall far short of its goal unless the Rogers amendment becomes law.

Accordingly, Madam Chairman, I wish to commend the gentleman from Florida [Mr. ROGERS] for his leadership on this important matter, and I hope that any effort to delete the Rogers amendment from the bill will be soundly defeated.

Mr. SPRINGER. Madam Chairman, I yield 1 minute to the gentleman from Nebraska [Mr. CUNNINGHAM].

Mr. CUNNINGHAM. Madam Chairman, if I may have the attention of the gentleman from Florida [Mr. ROGERS], I think we ought to get the record straight. He mentioned a fee for these junior colleges. Do you know what the fee is? I understand it is only $100.

Of course, we need nurses, but we want good, qualified nurses. And, I might say again that there are approximately 100 junior colleges that participate in nurse training. The National League for Nursing has only been able to fully accredit three of these because the colleges have not requested national accreditation. However, 32 additional programs have received reasonable assurance of accreditation.

Now, Madam Chairman, the whole problem here is that the junior colleges need national accreditation to enable them to turn out qualified nurses. They want to be accredited because they want funds from the Federal Government; that is the nub of the problem.

Mr. O'BRIEN. Madam Chairman, I had intended to introduce amendments to the Health Professions Educational Assistance Amendments of 1965 to provide for participation by podiatry institutions in part (e)-grants to improve

scholarship grants to schools, but I have decided to fight on another and more propitious day.

Enactment of H.R. 3141 in its present form without providing podiatry institutions the opportunity to participate in all facets, creates real danger that the quality of education in podiatry will deteriorate and that the number of podiatrists that can be trained will not be sufficient to meet the foot health needs of the Nation. of the Nation. All parts of the bill should provide opportunity for participation by podiatry institutions as now do the sections on the extension of the construction program, and student loans.

It is not common knowledge that foot health problems are of serious proportions. A 1951 Public Health Service Report on the physical status of the men examined through selective service in World War II disclosed that twice as many registrants were rejected for foot problems, 1.4 percent, as were for dental problems, 0.7 percent. Of those examined, 90.1 per 1,000 registrants had foot defects as compared with 116.1 per 1,000 for dental defects.

While these numbers are significant,

the incidence of foot problems in the rapidly expanding older population makes real demands on the podiatrists.

The 1961 White House Conference on

Aging in one report stated: "The institutionalized or home-care patient once moving about with pain-free feet is more easily motivated for total rehabilitation. Eighty-five percent of these older people have foot problems." Over 40 percent of the practicing podiatrists serve the elderly in nursing homes, and one out of three serves homes for the aged.

From studies reported at the hearings on H.R. 3141, we learn that in 1978, if the present capacity of the colleges is unchanged, the deficit of podiatrists will be considerably more than 4,700. The situation cannot be changed materially until the facilities of the colleges are expanded. In order to care for the deficits in the number of podiatrists needed by 1980, and to improve the number needed to supply the profession in keeping with increases in population, the podiatry colleges will have to graduate about 600 students annually beginning with 1968. This is approximately three times their present capacity.

In 1960, the American Podiatry Association established a special commission on the status of podiatry education, to examine from a broad point of view the profession's educational program and advise on steps necessary to improve this program. Copies of the report, "Podiatry Education in the 1960's" were supplied Members of Congress in a previous session when hearings were being held on proposed legislation for assistance to health professions education. The special commission consisted of three educators from the field of higher education, an M.D. medical educator, and a practicing podiatrist, a member of the board of trustees of a podiatry college. A significant recommendation was "that the American Podiatry Association represent to the appropriate legislative and

executive officials of the Government the need and social advisability of making financial provisions for podiatry education, in ways similar to those made for the other health sciences."

to

The colleges were advised strengthen their faculties with considerably more full-time teachers and administrative officers, and to provide salaries commensurate with their responsibilities. The commission also noted a need to markedly increase scholarships and loan funds for students.

At the hearings on H.R. 3141, information was provided on college operations over the past 5-year period. Enrollment is up over 40 percent; operating expenditures have risen 131 percent; the average cost of education per student has jumped from $980 to $1,680; the number of full-time instructors has increased 107 percent.

In 1966, the APA will devote almost 40 percent of its total budget to the improvement of podiatry education. Measures include scholarships, fellowships, faculty improvement grants and other matching grants to the schools.

The five podiatry colleges are all private, nonprofit institutions. None receive public funds in support of their operation. Without Federal support, podiatry colleges will not be able to train sufficient numbers of podiatrists and to train them well enough to meet the needs of our increasing population. The training program is a minimum of 6 years, 2 years of prepodiatry and 4 years in the professional school; and those desiring to develop special knowledges and skills, such as in foot surgery, will have to devote an additional year or two of study.

Scholarship grants are needed in colleges of podiatry for the same reasons as in other health professions schools; that is, to make it possible for the less affluent but highly capable young people to enter the profession. At present, scholarships are available to fewer than two percent of podiatry students. Without such financial aid, and with the rising costs of attending professional schools, there is great danger that these professions in the future will be manned by persons who can surmount the financial barrier, but who are not necessarily the most capable people.

Another reason for including colleges of podiatry in the provisions for scholarship grants is to provide freedom of choice for young people who wish to prepare for professional health service. Obviously, freedom of choice is narrowed when one field of study offers financial inducements while a competing field does not. It is sound policy to encourage young people to enter those fields of service in which their major interests lie and for which they have aptitude.

Furthermore, it should also be noted that many students, particularly the less affluent, will inevitably be attracted to professional fields which offer financial help, often regardless of their major interests. Thus, a lack of scholarships in podiatry, when other health fields have them, would seriously handicap the colleges of podiatry in their efforts to recruit a fair share of talent.

There is an incongruity in having colleges of podiatry excluded from the scholarship and educational improvement grants when they are included for ment grants when they are included for construction grants and student loans.

I urge my colleagues in the House to support at an early date legislation helping the public through help to colleges of podiatry.

Mr. FINDLEY. Madam Chairman, the problem of providing America with enough good doctors deserves our attention.

Most doctors are already heavily loaded and doubtless will become more so as social security medicare becomes effective January 1. Advances in medical science and hospital technology fortunately enable each doctor to care for more patients. Doctors can usually serve emergency cases best in the hospital rather than the home, and this practice lets the doctor make better use of his own time. House calls have become almost a thing of the past.

But even these favorable trends will not suffice to provide America with enough good doctors.

About 7,500 new doctors begin practice each year. Our estimate puts at 11,000 the number of new doctors that 11,000 the number of new doctors that will be needed each year by 1975.

Several years ago I proposed a nationwide program to stimulate interest in medical careers and to provide student financing where needed. financing where needed. I proposed "Junior Intern" clubs to be conducted by doctors in high schools to stimulate youthful interest in medical careers, also youthful interest in medical careers, also a private-financed revolving loan fund a private-financed revolving loan fund so medical students could borrow as much as needed for the long period of professional training.

The House bill would establish a revolving fund at low-interest rate, with volving fund at low-interest rate, with repayment not to begin until 3 years after medical training is complete. Although I would have preferred a privately financed revolving fund, I consider the loan fund to be in the public interest.

Another feature, however, strikes me as totally unwise. It provides grants as high as $2,500 a year for medical stuhigh as $2,500 a year for medical students, with no obligation for repayment.

Doctors can well afford eventually to repay money advanced to them during student days. What is needed is loan money.

Mr. RHODES of Arizona. Mr. Chairman, I rise as chairman of the Republican policy committee to report the action taken at our meeting Tuesday, August 31. August 31. The committee adopted a statement on the Health Professions Educational Assistance Amendments of 1965, H.R. 3141, which I would now like to read:

will afford adequate and appropriate assistance to our medical, dental, and other health

profession schools and students.

of the current program of matching grants to aid the construction, replacement, or rehabilitation of teaching facilities for the training of physicians, dentists, professional public health personnel, optometrists, pharmacists, and podiatrists. The current program which H.R. 3141 extends has funded 63 first year places. It is the type of assistance projects and has made possible 2,279 new that Republicans traditionally have supported and endorsed.

Therefore, we endorse the 3-year extension

Similarly, the student loan program that is extended for 3 years is a sound and meritorious program. Of the 152 schools of medicine, dentistry, osteopathy and optometry that are eligible, 147 have established student loan funds and to date there have been more than 10,000 student borrowers.

We are especially concerned by the provisions of H.R. 3141 which provide basic and special improvement grants to medical schools which can be used for any purpose including salaries and administrative expenses. For the first time, the Federal Govproviding a portion of the operating funds ernment may assume the responsibility for of every school of medicine, dentistry, osteopathy, and optometry in this country. Every such school, rich or poor, large or small, public or private, that files an application for a basic grant, and gives reasonable assurances that it will increase its first year enrollment by 22 percent or by five students, whichever is greater, will be paid $12,500 plus $250 for each full-time student the first year, and $25,000 plus $500 for each full-time student the next 3 years. And every such school that is recommended by the National Advisory Council and satisfies the Surgeon tain or to provide for accreditation or speGeneral that it will use the money to maincialized functions, will be paid a special grant not to exceed $100,000 the first year; $200,000 the second year; $300,000 the third year; or $400,000 the fourth year.

This is a dramatic shift from the present program of selective assistance to one of outright Federal subsidy. Furthermore, there is no participation or coordination by a State agency. All payments flow from the Surgeon General directly to the recipient school. Certainly these grants are significantly different from the brick and mortar grants and the specific grants that have until now constituted the Federal assistance to higher education. Therefore, we urge that these provisions be stricken from the bill.

Mr. ROGERS of Florida. Mr. Chairman, I should like to address myself for a moment to the provisions of this bill which will revise the current system of securing accreditation for schools of nursing under the Nurses Training Act of 1964.

The committee bill contains a provision which will allow the official accreditating body to be a regional accrediting agency or State approval agency in the case of schools which offer associate degree programs of of nurse training. This provision will correct an obvious deficiency in the existing law which was even recognized by the Office of Education when it designated the National League for Nursing as the sole accrediting body for funds, under the act of 1964. At that time the Office of Education stated that amendment of the law might be necessary in view of the special circumstances which many of the junior colleges were in.

The part that the associate degree programs have been playing in our

country has been well documented in the general debate but I would like at this time to insert in the RECORD Some state

ments, provided by the National Association of Junior Colleges, which reflect the feeling and need for the amendment which is contained in the committee bill: STATEMENTS REGARDING QUALITY OF ADN

PROGRAMS EXCERPTED FROM RECENT CORRESPONDENCE

Helen M. Wolfe, president, California League for Nursing, January 15, 1965:

"The quality of California associate degree programs in nursing can be documented by student performance on the licensing examination and in the work situation. This

includes the following results in the California State test pool examination:

"1959 (967 examinees):

Mean for all five tests

Albert E. French, president, State University of New York, Agricultural and Technical College, Canton Branch, August 17, 1965:

"The community colleges in New York State have been successful in training registered nurses in associate degree programs. One such college had yet to have a failure in the State board examinations a year or so ago after more than 5 years of operation. The advisory committee at this college found general satisfaction among employers of nurses with graduates of associate degree programs."

James L. Wattenbarger, director, Division of Community Junior Colleges, State of Florida, Department of Education, August 17, 1965:

"The quality of these programs has been unquestioned from the start. We used guidelines developed by the nursing profes

We applied the same careful planning procedures and analysis of quality all along the way. The success of our programs may be in part measured by the success of the graduates in their State examination. The percentage of students who successfully pass their State board examinations is very high. The enclosed graph shows these facts for November 1964."

William G. Dwyer, president, Board of Regional Community Colleges, Commonwealth of Massachusetts, August 20, 1965:

"Since the early 1950's, community colleges have offered associate degree programs in Nursing. Students completing this course of study have enjoyed outstanding success in the State R.N. examinations. This approach to providing more nurses was developed under a Kellogg grant and represents a change in training from an apprenticeship (3-year diploma school program) to an educational program (2-year ADN at a junior/ community college)."

Edward Simonsen, president, California president, California Junior College Association, August 27, 1965:

"The success of associate in arts degree graduates in State licensure examinations has been excellent. Cooperating hospitals, the medical profession, and the communities have been most enthusiastic about the programs."

Preston N. Tanis, director, Northwestern Michigan College, August 24, 1965:

"During the past 3 years, we have been able to develop an associate degree nursing program which was badly needed for some time in this part of Michigan. To date, our graduates have satisfactorily passed their State board examinations and have been admitted without any difficulty as registered nurses."

Randolph Newman, president, Santa Rosa Junior College, August 19, 1965:

"Santa Rosa Junior College has had a The program is under our jurisdiction and program in professional nursing since 1945. is subject to accreditation by the State of is subject to accreditation by the State of California Board of Nursing Education and Nurse Registration. We have graduated 391 students from our program and its quality is indicated by the fact that during all of these years only four have failed to pass the licensing examination which would permit them to follow the profession in this State." Roy F. Bergengren, Jr., president, Daytona Beach Junior College, August 24, 1965:

"We have an outstanding associate degree program in nursing education and have

graduated highly successful classes. Ours is one of a number of Florida programs established with the assistance of the Kellogg Foundation and the State Board of Nursing." Oscar H. Edinger, Jr., president, Mount San Antonio College, August 19, 1965:

"The quality of our nursing program and its enthusiastic community and professional support is amply attested to by the eagerness by which our graduates are sought, and by the enthusiastic participation of the advisory committee on which is represented almost every major medical facility in the district. We have maintained a 100 percent placement record of graduates, and many of them have rapidly risen to leadership and supervisory positions. The college placement office and the department chairman of nursing consistently receive more job orders than the number of students that can be accommodated in the program. It is common practice for doctors' offices, civil service agencies, and hospitals to send brochures, application forms, and descriptive materials describing the benefits to be derived from employment with their institutions as inducements for our students."

H. R. Buchser, president/superintendent, San Jose City College, August 23, 1965:

"That our nursing program is of high quality if reflected in our graduates' success in the RN examination, in which they have constantly scored in the top quarter in competition with graduates from all California schools of nursing. Our program is strongly supported by hospitals, the medical and nursing association, and the Citizens Advisory Committee in the community."

Mr. SPRINGER. Madam Chairman, I have no further requests for time.

schools of medicine, dentistry, osteopathy, and optometry to improve the quality of their educational programs.

Mr. HARRIS. Madam Chairman, a parliamentary inquiry.

The CHAIRMAN. The gentleman will state it.

Mr. HARRIS. I am sorry, Madam Chairman, but I do not recall the revisions of the rule, but is it the intention to read the entire amendment?

The CHAIRMAN. The Chair will state to the gentleman from Arkansas that the amendment is being read by section. Mr. HARRIS. By section? The CHAIRMAN. By section. Mr. HARRIS. Very well.

The CHAIRMAN. The Clerk will read.
The Clerk read as follows:

"Basic improvement grants

"SEC. 771. (a) Subject to the provisions of subsection (b), the Surgeon General may make basic improvement grants as follows:

"(1) For the fiscal year ending June 30, 1966, each school of medicine, dentistry, osteopathy, or optometry whose application for a basic improvement grant for such year has been approved by the Surgeon General shall be paid the sum of $12,500 plus the product obtained by multiplying $250 by the number of full-time students in such school.

"(2) For each fiscal year in the period beginning July 1, 1966, and ending June 30, 1969, each such school whose application has been approved for such a grant for such year shall be paid the sum of $25,000 plus the product obtained by multiplying $500 by the number of full-time students in such school.

"(b) The Surgeon General shall not make a grant under this section to any school unless the application for such grant contains or is supported by reasonable assurances that for the first school year beginning after the fiscal year for which such grant is made and each school year thereafter during which such a grant is made the first-year enrollment of full-time students in such school will exceed the highest first-year enrollment of such students in such school for

any of the five school years during the period July 1, 1960, through July 1, 1965, by at least 22 per centum of such highest first-year enrollment, or by five students, whichever is greater. The requirements of this subsec

The CHAIRMAN. There being no further requests for time, pursuant to

"(c) For the purposes of this part and

The Clerk read as follows:

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Health Professions Educational Assistance Amendments of 1965". Educational improvement grants and scholarship grants to schools of medicine, dentistry, osteopathy, and optometry

SEC. 2. (a) Title VII of the Public Health Service Act is amended by adding at the end thereof the following new parts:

"PART E- GRANTS TO IMPROVE THE QUALITY OF SCHOOLS OF MEDICINE, DENTISTRY, OSTEOPATHY, AND OPTOMETRY

"Authorization of appropriations "SEC. 770. There are authorized to be appropriated $20,000,000 for the fiscal year ending June 30, 1966, $40,000,000 for the fiscal year ending June 30, 1967, $60,000,000 for the fiscal year ending June 30, 1968, and $80,000,000 for the fiscal year ending June 30, 1969, for grants under this part to assist

shall include provisions relating to determination of the number of students enrolled in a school, or in a particular year-class in a school, as the case may be, on the basis of estimates, or on the basis of the number of students enrolled in a school, or in a particular year-class in a school, in an earlier year, as the case may be, or on such basis as he deems appropriate for making such determination, and shall include methods of making such determinations when a school or a year-class was not in existence in an earlier year at a school.

"(d) For purposes of this part and part F, the term 'full-time students' (whether such term is used by itself or in connection with a particular year-class) means students pursuing a full-time course of study leading to a degree of doctor of medicine, doctor of dentistry or an equivalent degree, doctor of osteopathy, or doctor of optometry or an equivalent degree.

"Special improvement grants "SEC. 772. (a) From the sums appropriated under section 770 for any fiscal year and not required for making grants under section 771, the Surgeon General may make an additional grant for such year to any school of