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1965 1966 estimate estimate

9,889

1,953 362 12,864

2,000

4,000

1,760

22,939

22,939

3,221

21,660

22,939 -6 3,221

-4,500 -5,000

4,500

21,075

21,631

21,631

17
12

26,160 2,022 -6,826

21,575

(b) Fellowships.-Grants are awarded to individuals in 2,170 order to increase the research manpower in the field of nursing. An estimated 75 fellowships will be supported in 1966, compared with an estimated 65 in 1965 and 66 in 1964.

412

9,980

3,000

4,000

(c) Training. Research training grants are made to graduate schools of nursing to establish and expand training programs and to provide stipends to nurses. Approximately 5 grants will be awarded in 1966, compared with 5 21,575 grants in 1965 and 1964.

2,013

Grants are provided for traineeships to prepare graduate nurses to be teachers, supervisors, and administrators in all fields of nursing. The estimated number of trainees in 1966 is approximately 1,918 in the long-term program and 5,000 in the short-term program for a total of about 7,000 trainees compared with 1,643 long-term and 5,000 shortterm trainees in 1965.

21,075

21,075

21,575

1966.

(e) Payments to diploma schools of nursing.-These grants are made to diploma schools of nursing to defray a portion of the cost of training students whose enrollment can be attributed to the Nurse Training Act of 1964.

2. Research, training, and technical services.-By means of research, consultation, application of research findings, and administration of grants, professional guidance and leadership are provided to meet the goals of adequate nursing care. An increase in this activity in 1966 will provide for the ongoing program in improvement of nursing practices, insure the economical use of the new funds resulting from the Nurse Training Act of 1964 by supply21,575 ing the supporting administrative services, and initiating a program of communication of nursing health knowledge. Object Classification (in thousands of dollars)

6,826 -7,910

21,328 20,491

1

16 12

Includes capital outlay as follows: 1964, $27 thousand; 1965, $15 thousand; 1966, $32 thousand.

Selected resources as of June 30 are as follows: Unpaid undelivered orders. 1963. $191 thousand (1964 adjustments, $5 thousand): 1964, $219 thousand; 1965, $219 thousand; 1966, $219 thousand.

1. Grants (a) Research.-Grants are made to institutions and to individuals to undertake projects in the area of nursing research. Approximately 63 research projects will be supported in 1966, compared with 55 in 1965 and 64 in 1964.

The division of nursing is concerned with the quality and quantity of nursing care essential to meet the health needs of the Nation. Its objective is the improvement of nursing practices of all kinds in hospitals, homes, health agencies and other allied medical care facilities. The problems related to education, nurse supply, distribution of nursing services, and nurse-patient relationships are dealt with by means of a balanced program of intramural research, consultation, research grants, fellowships, training grants, projects for improvement of nurse training, and payments to diploma schools of nursing.

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26.0 Supplies and materials..

31.0 Equipment.....

41.0 Grants, subsidies, and contributions....

99.0

Total obligations.....

1964 actual

752 17

2

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11,216

1965 1966 estimate estimate

1,116
35

3

1,154

173

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21,179

22,939

1,211 60

3

1,274

180

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30

19,562

21,575

PUBLIC HEALTH SERVICE-Continued

General and special funds-Continued

COMMUNITY HEALTH-Continued

NURSING SERVICES AND RESOURCES-continued
Personnel Summary

Total number of permanent positions..
Full-time equivalent of other positions.
Average number of all employees..
Average GS grade..

Average GS salary....

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1964 actual

HOSPITAL CONSTRUCTION ACTIVITIES

To carry out the provisions of section 318 and title VI of the Act, as amended, and parts B and C of the Mental Retardation Facilities Construction Act [(77 Stat. 284-290)] (42 U.S.C. 26612677), [$245,846,000] and, except as otherwise provided, the Community Mental Health Centers Act (42 U.S.C. 2681-2687), $303,304,000, of which [$150,000,000 $160,000,000 shall be for grants or loans for hospitals and related facilities pursuant to section 601(b) of the Public Health Service Act, [$70,000,000] $100,000,000 shall be for grants or loans for facilities pursuant to section 601(a) of the Public Health Service Act, [$2,500,000] $5,000,000 shall be for special project grants pursuant to section 318 of the Public Health Service Act, [$3,012,000] $12,568,000 (including not to exceed $6,900,000 for experimental hospital construction) shall be for the purposes authorized in section 624 of the Public Health Service Act, [$7,500,000] $10,000,000, to remain available until expended, shall be for grants for facilities pursuant to part B of the Mental Retardation Facilities Construction Act, and [$10,000,000] $12,500,000 shall be for grants for facilities pursuant to part C of the Mental Retardation Facilities Construction Act: Provided, That there may be transferred to this appropriation from "Construction of community mental health centers" an amount not to exceed the sum of the allotment adjustments made by the Secretary pursuant to section 202(c) of the Community Mental Health Centers Act: Provided further, That not less than $60,000,000 of the amount herein appropriated pursuant to section 601(b) shall be available for grants or loans for modernization or replacement of obsolete hospitals and medical facilities: Provided further, That funds made available for the purposes authorized in section 624 of the Act shall not be used to pay in excess of two-thirds of the cost of any experimental or demonstration construction or equipment project to which section 3(b)(4) of the Hospital and Medical Facilities Amendments of 1964 applies. (Department of Health, Education, and Welfare Appropriation Act, 1965.)

Program and Financing (in thousands of dollars)

Total, construction
grants.....

133

2

104

7.3

$7,387

1964 actual

1965 estimate

18,537
8,813

153

4 144

7.8 $7,737

213,351

1966 estimate

146,972 149,769
39,029 43,572

1965 1966 estimate estimate

159
7

154

7.8 $7,823

12,500

3,000

135,000

49.000
20.000

21,511
9.790 10,000

18,000

240,142

10,000

10,750

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Federal funds are provided on a grant or assist States, other public agencies, and nonp tions in the construction and modernization public health centers, etc.; special project pla and hospital and medical facilities research construction programs, other than the funds construction of university-affiliated facili mentally retarded, are allocated to the State of a formula which takes into account popul capita income.

1. Grants-(a) Construction of hospitals un Health Service Act.-Federal funds are pro construction and modernization of hospita care facilities, rehabilitation facilities, diagr nostic and treatment centers, public health related health facilities. The moderniza which starts in 1966 will provide funds for ment of quality care hospitals that have 252.750 tionally or structurally obsolete and

Includes capital outlay as follows: 1964, $36 thousand: 1

1966, $74 thousand.

2 Selected resources as of June 30 are as follows: Unpaid unde $282 thousand (1964 adjustments. $1 thousand); 1964, $2 $235 thousand; 1966, $235 thousand.

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increasingly inefficient or unsafe to operate. The $260 million requested for 1966 will provide a $780 million program for that year, assuming that the Federal participation will average 33%.

(b) Construction of facilities for the mentally retarded. Grants are made for the construction of university-affiliated facilities for the mentally retarded and for facilities for the mentally retarded. Funds available for the construction of university-affiliated mental retardation facilities are approved on a special project basis. The $22 million requested for 1966 will provide a $45 million program for that year, assuming that the Federal participation will average 50%.

2. Special project planning grants.-Grants are made to local lay and professional groups and organizations in the activation and continued operation of the areawide healthfacility planning program. The $5 million requested for 1966 will stimulate the organization and operation of such

groups.

3. Hospital and medical facilities research.-Funds are provided to permit research, experiments, and demonstrations relating to the effective development and utilization of hospital services and resources, and to make grantsin-aid to States, political subdivisions, universities, hospitals, and other public and private nonprofit institutions or organizations for such projects; funds are also provided to public and nonprofit agencies for the construction of experimental units of hospital and other health facilities.

4. Operations and technical services.-State agencies are provided technical assistance in making inventories of their hospitals, public health centers, and other health facilities in determining the type, size, and location of additional facilities required, and in developing programs, to meet the indicated needs. Technical assistance is also provided to States and to communities regarding the planning, programing, and design of hospital and other medical facilities, including facilities for the care of the mentally retarded. Proposed hospital and other health facility projects are reviewed to determine eligibility and compliance with the law and regulations. State plans and their annual revisions are reviewed and approved. Project applications, plans and specifications, wage rates, and contracts are reviewed for compliance with standards, and surveillance is maintained over projects under construction. Payments are computed and made as construction progresses and when final payment is in order.

Object Classification (in thousands of dollars)

Identification code 09-20-03700-1-651

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Total number of permanent positions.. Full-time equivalent of other positions. Average number of all employees.. Average GS grade.........

Average GS salary.

10

Personnel Summary

70

45

71

60 244,910

72 269,500 74

248,549 273,554 90

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CHEALTH PROFESSIONS EDUCATIONAL ASSISTANCE] CONSTRUCTION OF HEALTH EDUCATIONAL FACILITIES

2. Operations and technical services..

To carry out [parts] part B [and C] of_title VII and part A of title VIII of the [Public Health Service] Act, [$110,782,0001 $90,599,000, of which [$60,000,000 $45,000,000 is for grants to assist in construction of new teaching facilities pursuant to paragraph (1) of section 720 of the Act, [$20,000,000 $15,000,000 is for grants to assist in construction of new teaching facilities for dentists pursuant to paragraph (2) of section 720, [$20,000,000] $15,000,000 is for grants for replacement or rehabilitation of existing teaching facilities pursuant to paragraph (3) of section 720, [and $10,200,000 is for loans and for assisting in the establishment and operation of student loan funds pursuant to such part C] $5,000,000 is for grants to assist in construction of new or replacement or rehabilitation of existing facilities for collegiate schools of nursing pursuant to section 801; and $10,000,000 is for grants to assist in construction of new or replacement or rehabilitation of existing facilities for associate degree and diploma schools of nursing pursuant to section 801: Provided, That amounts appropriated herein for grants [and loans] shall remain available until expended.

[Loans and payments for the next succeeding fiscal year: For making, after March 31 of the current fiscal year, loans and payment to schools under part C of title VII of the Public Health Service Act for the first quarter of the next succeeding fiscal year such sums as may be necessary, and the obligations incurred and expenditures made hereunder shall be charged to the appropriation for that purpose for such fiscal year: Provided, That such payments to schools pursuant to this paragraph may not exceed 50 per centum of the amount authorized in such part C for this purpose for the next succeeding fiscal year.] (Department of Health, Education, and Welfare Appropriation Act, 1965.)

Note.-Excludes $15,488 thousand for activities transferred in the estimates
to "Community health practice and research."
is shown in the schedule as a comparative transfer.
The amount obligated in 1965

Program and Financing (in thousands of dollars)

Total program costs, funded-obligations....

Financing:

16 Comparative transfers to other accounts...

40

New obligational authority (appro-
priation)

1964 1965 actual estimate

Relation of obligations to expenditures: 10 Total obligations.............

70 Receipts and other offsets (items 11-17)...

253

2

221

7.8 $7,387

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287

3 264

7.8 $7,737

1964 actual

100,000

1966 estimate

496

299

3 283

7.8

$7,823

1965 1966 estimate estimate

100,496

10,286

110,782

75,000

15,000 599

90,599

90,599

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PUBLIC HEALTH SERVICE-Continued

General and special funds-Continued

COMMUNITY HEALTH-Continued

[HEALTH PROFESSIONS EDUCATIONAL ASSISTANCE] CONSTRUCTION OF HEALTH EDUCATION AL FACILITIES-Continued

Federal funds are provided on an individual project basis to assist in the construction of medical, dental, pharmaceutical, optometric, podiatric, osteopathic, and public health teaching facilities under the provisions of Public Law 88-129 (approved September 24, 1963) and the construction of schools of nursing under the provisions of Public Law 88-581 (approved September 4, 1964). These funds provide the basis for expanding and rehabilitating teaching facilities and represent an important step in increasing the supply of vitally needed physicians, dentists, nurses, and other health professions personnel.

1. Grants (a) Construction of teaching facilities for medical, dental, and other health personnel.-Grants are made to public and other nonprofit agencies and organizations for construction of teaching facilities for medical, dental, and other health personnel. As of July 31, 1964, institutions have submitted 184 letters of intent. Of these, 137 estimates have been received, indicating a need of over $1 billion in total construction costs. The $75 million requested for 1966 will provide a $150 million program for that year, assuming that the Federal participation will average 50%.

(b) Construction of teaching facilities for nurses.-Grants are made to public and other nonprofit organizations for construction of teaching facilities for nurses. As of July 31, 1964, institutions have submitted 67 letters of intent. Of these, 43 estimates have been received, indicating a need of over $65 million in total construction costs. The $15 million requested for 1966 will provide a $30 million program for that year, assuming that the Federal participation will average 50%.

2. Operations and technical services.-Planning agencies and sponsoring institutions are provided technical assistance in (a) assessing and evaluating their teaching facility needs, (b) determining the type, size, and location of additional facilities required, (c) developing coordinated and well-balanced teaching programs, and (d) planning, programing, and designing teaching facilities. Applications for aid in constructing teaching facilities are reviewed to determine their eligibility and compliance with the law and regulations. Site visits are made of proposed projects for the purpose of evaluating the validity of and need for teaching facilities proposed and establishing the basis for determination regarding relative priority. Plans and specifications are reviewed for compliance with standards, surveillance is maintained over contract awards, payment of approved wage rates and other aspects of construction, and payments are certified based on the inspections of site work. Funds for construction purposes are committed for the projects after consultation with the appropriate National Advisory Council. Payments are computed and made as construction progresses.

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Program and Financing (in thousands of dollars)—Continued

15,933

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(b) Training.-Grants are made to colleges and universities to provide support for the development and improvement of broad-based engineering and scientific 15,933 competencies required for environmental health research. Approximately 55 projects will be supported in 1966 as compared to 45 in 1965.

14,437 1

1 Includes capital outlay as follows: 1964, $35 thousand; 1965, $449 thousand; 1966, $409 thousand.

2 Selected resources as of June 30 are as follows: Unpaid undelivered orders 1963, $0; 1964, $154 thousand; 1965, $154 thousand; 1966, $154 thousand.

This appropriation finances extramural and intramural research and training activities which are basic to all environmental health programs. These activities, together with those funded by the categorical appropriations, make possible a unified approach to the study of the health of man in his total environment.

areas.

1. Grants (a) Research.-Research grants which are multicategorical in purpose or scope and which cannot be appropriately funded in a categorical appropriation are awarded to organizations and institutions for the conduct of basic research in all environmental health scientific This includes the establishment of institutes for research and research training which are located within academic institutions regionally distributed throughout the Nation. Approximately 59 projects will be supported in 1966 as compared to 37 in 1965 and 23 in 1964; 5 of the 59 projects proposed for 1966 will be university institutes for environmental health sciences.

2. Arctic Health Research Center.-At the research center in Alaska, studies are conducted on problems of environmental sanitation, endemic and epidemic communicable diseases, including diseases transmissible from animals to man, and the nutritional and physiological aspects of arctic life. The increase requested in 1966 will be used for the transfer of the environmental sanitation section from Anchorage, Alaska to the new water pollution control field laboratory in Fairbanks, Alaska.

3. Research, training, and technical services.-Research on problems of common interest to all environmental health programs is undertaken in environmental toxicology, epidemiology, and pesticides. The increase requested in 1966 will permit emphasis on development of more sensitive methods for toxicological analysis and biological assessment; expansion of the pesticide registration program, the pesticide intelligence system, and the nine community studies initiated in 1965, together with initiation of three new ones.

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