Access to health care services is a major issue being addressed by individuals and groups at every level of government and by many other organizations in our society. Health planners and providers are concerned with physical access as well as financial access to health services for citizens. Access to health care services is directly related to the health manpower available to deliver these services and the proper utilization of this manpower.

The General Assembly of Virginia recognized the need for improving the access of primary health care to Virginia's citizens by improving the utilization of health manpower, particularly in rural areas. This recognition was demonstrated in HJR 127 adopted during the 1972 session directing the State Council of Higher Education for Virginia "to develop and recommend training curricula and an implementation plan for paramedical personnel." A companion resolution (HJR 131) directed the State Health Department "to develop criteria and recommend legislation related to paramedical personnel."

The State Health Department in responding to House Joint Resolution 131 will be defining the roles of assistants to physicians and dentists, identifying appropriate certification requirements (if any), and indicating the extent of required supervision, control and direction.

The State Council of Higher Education has utilized its Committee on Education for Health Professions and Occupations (Appendix I) as the primary resource in responding to the General Assembly. Members of the Committee as well as staff members of the State Council have served on the Consultative Group to the State Commissioner of Health in the study of legislation needed for the functioning of paramedical personnel. Since the studies of the two state agencies were felt to be interdependent, a sub-committee of the State Council's Committee and the Consultative Group were established for joint effort and liaison.

A copy of the first draft of this report was mailed to twenty-seven individuals (Appendix II) representing educational programs, professional associations, and licensing agencies for their review and suggestions. Thirteen responses were received with suggestions for clarification, additions, or changes in the content. The suggestions of the respondents were most useful and many of the suggestions have been incorporated in the report.