[Congressional Record Volume 150, Number 79 (Tuesday, June 8, 2004)]
[Senate]
[Pages S6625-S6626]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                     ALLIED HEALTH REINVESTMENT ACT

  Ms. CANTWELL. Mr. President, last week I introduced S. 2491, the 
Allied Health Reinvestment Act, with my colleagues, Senators Bingaman 
and Lieberman. As I mentioned at that time, the Allied Health 
Reinvestment Act will encourage individuals to seek and complete high 
quality allied health education and training by providing additional 
funding for their studies. This funding will help provide the U.S. 
healthcare industry with a supply of allied health professionals 
support the nation's health care system in this decade and beyond.
  The bill has a number of supporters. I would particularly like to 
express my appreciation to the Association of Schools of Allied Health 
Professions, ASAHP, for its support of the legislation as well as its 
ongoing efforts to address the need for allied health professionals and 
allied health faculty.
  ASAHP, founded in 1967, has a membership that includes 105 
institutions of higher learning throughout the United States, as well 
as several hundred individual members. ASAHP publishes a quarterly 
journal and also conducts an annual survey of member institutions. This 
annual survey, called the ``Institutional Profile Survey,'' is used 
for, among other purposes, collecting student application and 
enrollment data. These data substantiates that there is a pressing need 
to address existing allied health workforce shortages, which have been 
further exacerbated by declines in enrollment that have occurred for 4 
straight years.
  Using data from the Institutional Profile Survey, as well as the 
General Accounting Office, U.S. Census Bureau, and other sources, ASAHP 
has compiled what I believe to be a compelling rationale in its support 
for the Allied Health Reinvestment Act that I introduced. Mr. 
President, I ask unanimous consent that the text of this Rationale for 
an Allied Health Reinvestment Act from the Association of Schools of 
Allied Health Professions be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

            Rationale for an Allied Health Reinvestment Act

       Led by the Association of Schools of Allied Health 
     Professionals, a Washington-DC based organization with 105 
     colleges and universities as members, a coalition of 30 
     national organizations supports the enactment of an Allied 
     Health Reinvestment Act. S. 2491 was introduced in the 108th 
     Congress by Maria Cantwell (D-WA), Jeff Bingaman (D-NM), and 
     Joseph Lieberman (D-CT) and H.R. 4016 was introduced in the 
     House by Cliff Stearns (R-FL) and Ted Strickland (D-OH).
       The well-being of the U.S. population depends to a 
     considerable extent on having access to high quality health 
     care, which requires the presence of an adequate supply of 
     competently-prepared allied health professionals. Workforce, 
     demographic, and epidemiologic imperatives are the driving 
     forces behind the need to have such legislation enacted.


                        the workforce imperative

       Many allied health professionals are characterized by 
     existing workforce shortages, declining enrollments in 
     academic institutions, or a combination of both factors. 
     Hospital officials have reported vacancy rates of 18 percent 
     among radiologic technologists and 10 percent among 
     laboratory technologists, plus they indicated more difficulty 
     in recruiting these same professionals than two years prior.
       Fitch, a leading global rating agency that provides the 
     world's credit markets with

[[Page S6626]]

     credit opinions, indicates that labor expenses due to 
     personnel shortages will continue to plague hospitals and is 
     the biggest financial concern for that sector because it 
     typically costs up to twice normal equivalent wages to fill 
     gaps with temporary agency help.
       The Bureau of Labor Statistics (BLS) projects that in the 
     period 1998-2008, a total of 93,000 positions in clinical 
     laboratory science need to be provided in the form of 
     creating 53,000 new jobs and filling 40,000 existing 
     vacancies. Of the 9,000 openings per year, academic 
     institutions are producing only 4,990 graduates annually. BLS 
     projections in 2004 show that nine of the 10 fastest growing 
     occupations are health or computer (information technology) 
     occupations.
       Accredited respiratory therapy programs in 2000 graduated 
     5,512 students--21% fewer than the 6,062 graduates in 1999. 
     In 2001, the number of graduates from these schools fell 
     another 20% to 4,437. The BLS expects employment of 
     respiratory therapists to increase faster than the average of 
     all occupations, increasing from 21% to 35% through 2010. The 
     aging population and an attendant rise in the incidence of 
     respiratory ailments, including asthma and COPD, and 
     cardiopulmonary diseases drive this demand.
       Employment growth in schools will result from expansion of 
     the school-age population and extended services for disabled 
     students. Therapists will be needed to help children with 
     disabilities prepare to enter special education programs.
       The American Hospital Association has identified declining 
     enrollment in health education programs as a factor leading 
     to critical shortages of health care professionals. That 
     assessment is buttressed by data from 90 institutions 
     belonging to the Association of Schools of Allied Health 
     Professions. The following professions were unable to reach 
     enrollment capacity over a three-year period: cardiovascular 
     perfusion technology, cytotechnology, dietetics, emergency 
     medical sciences, health administration, health information 
     management, medical technology, occupational therapy, 
     rehabilitation counseling, respiratory therapy, and 
     respiratory therapy technician.
       Given the level of anxiety over the possibility of 
     terrorist attacks occurring in this country, in a study 
     released by the General Accounting Office (GAO) on April 8, 
     2003 that focused on the nation's adequacy of preparedness 
     against bioterrorism, it was reported that shortages in 
     clinical laboratory personnel exist in state and local public 
     health departments, laboratories, and hospitals. Moreover, 
     these shortages are a major concern that is difficult to 
     remedy.
       Laboratories play a critical role in the detection and 
     diagnosis of illnesses resulting from exposure to either 
     biological or chemical agents. No therapy or prophylaxis can 
     be initiated without laboratory identification and 
     confirmation of the agent in question. Laboratories need to 
     have adequate capacity and necessary staff to test clinical 
     and environmental samples in order to identify an agent 
     promptly so that proper treatment can be started and 
     infectious diseases prevented from spreading.
       Meanwhile, the U.S. population continues to become more 
     racially and ethnically diverse. A health care workforce is 
     needed that better reflects the population they serve. 
     Practitioners must become more attuned to cultural 
     differences in order to facilitate communication and enhance 
     health care quality.


                       The Demographic Imperative

       The U.S. Census Bureau reports that rapid growth of the 
     population age 65 and over will begin in 2011 when the first 
     of the baby boom generation reaches age 65 and will continue 
     for many years. The larger proportions of the population in 
     older age groups result in part from sustained low fertility 
     levels and from relatively larger declines in mortality at 
     older ages in the latter part of the 20th century. From 1900 
     to 2000, the proportion of persons 65 and over went from 4.1 
     percent to 12.4 percent.
       In the 20th century, the total population more than 
     tripled, while the 65 years and older population grew more 
     than tenfold, from 3.1 million in 1900 to 35.0 million in 
     2000.
       Among the older population, the cohort 85 years and over 
     increased from 122,000 in 1900 to 4.2 million in 2000. Since 
     1940, this age group increased at a more rapid rate than 65-
     to-74 year olds and 75-to-85 year olds in every decade. As a 
     proportion of the older population, the 85 and over group 
     went from being four percent of the older population to 12 
     percent between 1900 and 2000.


                     The Epidemiological Imperative

       The baby-boom generation's movement into middle age, a 
     period when the incidence of heart attack and stroke 
     increases, will produce a higher demand for therapeutic 
     services. Medical advances now enable more patients with 
     critical problems to survive. These patients may need 
     extensive therapy.
       According to Solucient, a major provider of information for 
     health care providers, profound demographic shifts over the 
     next twenty-five years will result in significant increases 
     in the demand for inpatient acute care services if current 
     utilization patterns do not change. An aging baby boom 
     generation, increasing life expectancy, rising fertility 
     rates, and continued immigration will undoubtedly increase 
     the volume of inpatient hospitalizations and significantly 
     alter the mix of acute care services required by patients 
     over the next quarter century. Nationwide, demographic 
     changes alone could result in a 46 percent increase in acute 
     care bed demand by 2027. Total acute care admissions could 
     also increase by almost 13 million cases in the next quarter 
     century--a growth of 41 percent from the current number of 
     national admissions. Currently, the aged nationwide account 
     for about 40 percent of inpatient admissions and about 49 
     percent of beds. By 2027, they could make up a majority of 
     acute care services--51 percent of admissions and 59 percent 
     of beds.
       Along with the aging of the population came an increase in 
     the number of Americans living with one, and often more than 
     one, chronic condition. Today, it is estimated that 125 
     million Americans live with a chronic condition, and by 2020 
     as the population ages, that number will increase to an 
     estimated 157 million, with 81 million of them having two or 
     more chronic conditions. Twenty-five percent of individuals 
     with chronic conditions have some type of activity 
     limitations. Two-thirds of Medicare spending is for 
     beneficiaries with five or more chronic conditions.
       Many individuals with chronic conditions rely on family 
     caregivers. Approximately nine million Americans provide such 
     services, and on the average, they spend 24 hours a week 
     doing so. Caregivers age 65-74 provide an average of 30.7 
     hours of care per week and individuals age 75 and older 
     provide an average of 34.5 hours per week.
       Women are more likely than men to have chronic conditions, 
     in part because they have longer life expectancies. These 
     same women are caregivers to other chronically ill persons. 
     In addition, 65 percent of caregivers are female, and of all 
     caregivers, nearly 40 percent are 55 years of age and older.
       Physicians report that their training does not adequately 
     prepare them to care for this type of patient in areas such 
     as providing education and offering effective nutritional 
     guidance. Allied health professionals can provide those 
     aspects of care, but many of them need better preparation to 
     treat and coordinate care for patients with chronic 
     conditions. While much emphasis is placed on curative forms 
     of care, additional efforts must be devoted to slowing the 
     progression of disease and its effects.

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