Allied health legislation redux

Journal of Allied Health, Fall 2003 by Elwood, Thomas W

THE YEAR 2003 will be characterized by a significant effort to enact federal legislation to address allied health workforce issues. Several professions are experiencing a decline in student applications to and enrollment in academic institutions. As the educational pipeline undergoes shrinkage, some professions already are experiencing workforce shortages. The situation is disturbing in many respects, but it hardly is unique. As the following account shows, allied health has traveled this path before. The challenge is to create a set of conditions to deal with the current problem and prevent its recurrence.

Major Legislation From Yesteryear

Personnel shortages affected many health professions in the 1960s. Apart from the more distinct classifications of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, nursing, and public health, many other professions lacked a common identifying name. Before introducing legislation to correct workforce shortages, a unifying label had to be designated for these other professions for federal support to be directed their way.

A meeting was convened in Washington, D.C., for the purpose of producing such a rubric. Government officials and deans at universities where various health programs were housed were unable to do so. Finally, a secretary who was present to take notes at the meeting suggested that a new grouping of health professions be created and that it be called allied health. This individual's name has long since been forgotten, but the name she bestowed is part of a legacy that has endured since 1966.

On March 1, 1966, President Lyndon Johnson requested Congress in his domestic health and education message to enact legislation that would deal with the problem of allied health workforce shortages. Excerpts follow:

A nation's greatness is measured by its concern for the health and welfare of its people. Throughout the history of our democracy, this commitment has grown and deepened. The health of our people is essential to the pursuit of happiness. Today we can set ambitious goals for the future. To insure continuing progress, we must:

* Strengthen our system of health care

* Train needed health workers

* Increase our research efforts

* Take additional steps to meet special health problems

Critical specialties remain dangerously understaffed-medical technologists, biomedical engineers, dental hygienists, and other college-trained health workers. These personnel, allied with doctors, dentists, and nurses, constitute the modern health care team. They extend the reach and the scope of the physician. I recommend a 3-year program to provide grants for training in allied health professions:

* To construct and to improve needed educational facilities

* To offer fellowships for students in advanced training

* To stimulate institutions to develop new types of health personnel1

Congress Takes Action

The next day, Rep. Harley O. Staggers (D-WV), the powerful Chairman of the House Interstate and Foreign Commerce Committee, introduced H.R. 13196, a draft bill of the Administration. Fifteen days later, a companion bill, S. 3102, was introduced by the equally formidable Senator Lister Hill (D-AL), Chairman of the Senate Labor and Public Welfare Committee. Hearings were held in the House of Representatives on March 29-31, 1966. On March 30, HEW secretary John W. Gardner testified that an increasing demand for health services had created a demand "for a virtual army of health workers at the sub-professional level."

HR 13196 was reported as amended by the House Interstate and Foreign Commerce Committee (H. Rept.1628) on june 16, 1966. The bill was amended and passed by a 364-0 roll-call vote of the House 1 week later.

On the other side of Capitol Hill in the Senate, S. 3102 was reported as amended by the Senate Labor and Public Welfare Committee (S. Rept. 1722) on October 13, 1966. The bill was passed by voice vote on the Senate floor the following day. The House concurred in the Senate amendments by voice vote on October 17. President Johnson signed PL. 89-751, the Allied Health Professions Training Act, into law on November 3, 1966.

The legislation authorized federal grants in the following amounts for: construction, rehabilitation, or replacement of training centers:

FY 1967 $3 million

FY 1968 $9 million

FY 1969 $13.5 million

Allied health professions training centers were defined as centers providing training for at least 20 persons in an allied health professions curriculum in addition to offering associate, bachelor, or higher degrees. Grants would be limited to two thirds of construction costs for new training centers or facilities for expansion and to one half the cost of replacement or rehabilitation of existing facilities. Basic improvement grants were authorized for training centers totaling $5,000 for each allied health professions curriculum plus $500 for each full-time student. Special improvement grants for any one center would be limited to $100,000 each fiscal year.