[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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