A-5675, NOVEMBER 13, 1924, 4 COMP. GEN. 445

A-5675: Nov 13, 1924

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WHERE A VETERAN WHO IS RECEIVING A PENSION THROUGH THE PENSION OFFICE IS HOSPITALIZED IN ST. THE PENSION IS CHARGEABLE WITH THE COST OF HOSPITALIZATION IN AN AMOUNT PROPERLY FIXED BY REGULATION OF THE SECRETARY OF THE INTERIOR UNDER THE ACT OF FEBRUARY 2. THE APPROPRIATION UNDER THE VETERANS' BUREAU IS CHARGEABLE ONLY WITH THE COST OF HOSPITALIZATION OVER AND ABOVE THE AMOUNT PROPERLY DEDUCTIBLE FROM THE PENSION. "IN ADVANCE OR AT THE END OF EACH MONTH" SHOULD REPRESENT ONLY THE COST OF HOSPITALIZATION LESS THE AMOUNT WHICH WILL BE PROPERLY CHARGEABLE TO THE PENSION. ADJUSTMENTS ON THE BASIS OF THE ACTUAL COST FOR THE HOSPITALIZATION WHERE PAYMENTS ARE MADE IN ADVANCE SHOULD BE MADE MONTHLY OR QUARTERLY AS MAY BE AGREED UPON BETWEEN ST.

A-5675, NOVEMBER 13, 1924, 4 COMP. GEN. 445

ST. ELIZABETHS HOSPITAL - TREATMENT OF INSANE PENSIONERS AT REQUEST OF THE UNITED STATES VETERANS' BUREAU UNDER SECTION 202 (10) OF THE WORLD WAR VETERANS' ACT OF JUNE 7, 1924, 43 STAT. 620,"VETERANS OF ANY WAR, MILITARY OCCUPATION, OR MILITARY EXPEDITION SINCE 1897, NOT DISHONORABLY DISCHARGED WITHOUT REGARD TO THE NATURE OR ORIGIN OF THEIR DISABILITIES," MAY BE HOSPITALIZED IN GOVERNMENT HOSPITALS OTHER THAN THOSE DIRECTLY UNDER THE CONTROL AND JURISDICTION OF THE VETERANS' BUREAU, INCLUDING ST. ELIZABETHS HOSPITAL, UNDER THE DEPARTMENT OF THE INTERIOR. WHERE A VETERAN WHO IS RECEIVING A PENSION THROUGH THE PENSION OFFICE IS HOSPITALIZED IN ST. ELIZABETHS HOSPITAL AT THE REQUEST OF THE VETERANS' BUREAU, THE PENSION IS CHARGEABLE WITH THE COST OF HOSPITALIZATION IN AN AMOUNT PROPERLY FIXED BY REGULATION OF THE SECRETARY OF THE INTERIOR UNDER THE ACT OF FEBRUARY 2, 1909, 35 STAT. 592, AND THE APPROPRIATION UNDER THE VETERANS' BUREAU IS CHARGEABLE ONLY WITH THE COST OF HOSPITALIZATION OVER AND ABOVE THE AMOUNT PROPERLY DEDUCTIBLE FROM THE PENSION. THE AMOUNT BILLED TO THE VETERANS' BUREAU BY ST. ELIZABETHS HOSPITAL FOR THE COST OF HOSPITALIZING A VETERAN RECEIVING A PENSION THROUGH THE PENSION OFFICE, IN ACCORDANCE WITH THE PROVISIONS OF THE ACT OF JUNE 5, 1924, 43 STAT. 429,"IN ADVANCE OR AT THE END OF EACH MONTH" SHOULD REPRESENT ONLY THE COST OF HOSPITALIZATION LESS THE AMOUNT WHICH WILL BE PROPERLY CHARGEABLE TO THE PENSION, IF AN ADVANCE PAYMENT, OR WHICH HAD BEEN PROPERLY CHARGEABLE TO THE PENSION IF AT THE END OF THE MONTH. ADJUSTMENTS ON THE BASIS OF THE ACTUAL COST FOR THE HOSPITALIZATION WHERE PAYMENTS ARE MADE IN ADVANCE SHOULD BE MADE MONTHLY OR QUARTERLY AS MAY BE AGREED UPON BETWEEN ST. ELIZABETHS HOSPITAL AND THE VETERANS' BUREAU.

COMPTROLLER GENERAL MCCARL TO THE SECRETARY OF THE INTERIOR, NOVEMBER 13, 1924:

I HAVE YOUR LETTER OF OCTOBER 9, 1924, REQUESTING DECISION OF QUESTIONS PRESENTED BY THE ADMINISTRATIVE ASSISTANT TO THE SUPERINTENDENT OF ST. ELIZABETHS HOSPITAL INVOLVED IN THE CASE OF MYER LANDERMAN, WHO IS BEING HOSPITALIZED AT THE REQUEST OF THE DIRECTOR OF THE UNITED STATES VETERANS' BUREAU. THE SUBMISSION IS PARTLY AS FOLLOWS:

WE HAVE RECEIVED UNDER DATE OF SEPTEMBER 25TH AN ORDER SIGNED BY FRANKT. HINES, DIRECTOR, U.S. VETERANS' BUREAU, AND COUNTERSIGNED BY W. J. HEFFNER, DISTRICT MEDICAL OFFICER, DISTRICT NO. 4; DIRECTING US TO RECEIVE IN SAINT ELIZABETHS HOSPITAL THE PERSON OF MYER LANDERMAN, UNDER PARAGRAPH 10, SECTION 202, W.W.V. ACT 1924, AS AN INSANE PATIENT OF THE U.S. VETERANS' BUREAU, TO BE CARED FOR AS PRESCRIBED BY THE ACTS OF CONGRESS APPROVED MARCH 3, 1875, AND MARCH 3, 1919.

MYER LANDERMAN WAS A FORMER PRIVATE IN COMPANY C, 3D U.S. INFANTRY, AND HAS BEEN TWICE ADMITTED TO THIS HOSPITAL, BOTH TIMES ON THE ORDER OF THE SECRETARY OF WAR. HE WAS ADMITTED THE FIRST TIME AUGUST 16, 1905, AND THE LAST TIME ON AN ORDER DATED MARCH 7, 1906, SIGNED BY THE MILITARY SECRETARY REQUESTING THE ADMISSION TO THE HOSPITAL OF MYER LANDERMAN UNDER THE AUTHORITY OF SECTION 4843, REVISED STATUTES OF THE UNITED STATES, AND IS STILL IN THE HOSPITAL.

MYER LANDERMAN IS A BENEFICIARY OF THE U.S. PENSION OFFICE UNDER PENSION CERTIFICATE NO. 1160154, RECEIVING A PENSION OF $30 A MONTH. OF THIS PENSION, UNDER THE ACTS OF FEBRUARY 20, 1905, AND FEBRUARY 2, 1909, AND THE VARIOUS REGULATIONS OF THE SECRETARY OF THE INTERIOR OF MAY 1, 1909, AS AMENDED FROM TIME TO TIME, ONE-SIXTH OF THIS AMOUNT IS SET ASIDE FOR THE PRISONER'S BENEFIT, THE BALANCE, NOT EXCEEDING $1.50 A DAY, TO BE CHARGED FOR HIS BOARD.

SECTION 202 (10) OF THE WORLD WAR VETERANS' ACT, DATED JUNE 7, 1924, 43 STAT. 620, PROVIDES AS FOLLOWS:

THAT ALL HOSPITAL FACILITIES UNDER THE CONTROL AND JURISDICTION OF THE BUREAU SHALL BE AVAILABLE FOR EVERY HONORABLY DISCHARGED VETERAN OF THE SPANISH-AMERICAN WAR, THE PHILIPPINE INSURRECTION, THE BOXER REBELLION, OR THE WORLD WAR SUFFERING FROM NEUROPSYCHIATRIC OR TUBERCULAR AILMENTS AND DISEASES, PARALYSIS AGITANS, ENCEPHALITIS LETHARGICA OR AMOEBIC DYSENTERY, OR THE LOSS OF SIGHT OF BOTH EYES REGARDLESS WHETHER SUCH ALIMENTS OR DISEASES ARE DUE TO MILITARY SERVICE OR OTHERWISE, INCLUDING TRAVELING EXPENSES AS GRANTED TO THOSE RECEIVING COMPENSATION AND HOSPITALIZATION UNDER THIS ACT. THE DIRECTOR IS FURTHER AUTHORIZED, SO FAR AS HE SHALL FIND THAT EXISTING GOVERNMENT FACILITIES PERMIT, TO FURNISH HOSPITALIZATION AND NECESSARY TRAVELING EXPENSES TO VETERANS OF ANY WAR, MILITARY OCCUPATION, OR MILITARY EXPEDITION SINCE 1897, NOT DISHONORABLY DISCHARGED WITHOUT REGARD TO THE NATURE OR ORIGIN OF THEIR DISABILITIES: PROVIDED, THAT PREFERENCE TO ADMISSION TO ANY GOVERNMENT HOSPITAL FOR HOSPITALIZATION UNDER THE PROVISIONS OF THIS SUBDIVISION SHALL BE GIVEN TO THOSE VETERANS WHO ARE FINANCIALLY UNABLE TO PAY FOR HOSPITALIZATION AND THEIR NECESSARY TRAVELING EXPENSES.

THE QUESTIONS FOR DETERMINATION ARE, FIRST, WHETHER GOVERNMENT HOSPITAL FACILITIES, OTHER THAN THOSE DIRECTLY UNDER THE "CONTROL AND JURISDICTION" OF THE BUREAU, ARE AVAILABLE FOR THE HOSPITALIZATION OF VETERANS OTHER THAN OF THE WORLD WAR; SECOND, IF SO, IS THE VETERANS' BUREAU OBLIGATED TO PAY THE FULL AMOUNT OF THE COST OF THE HOSPITALIZATION FOR SUCH A VETERAN WHO IS RECEIVING A PENSION THROUGH THE PENSION OFFICE, OR SHOULD THERE BE DEDUCTED FROM THE AMOUNT CHARGEABLE TO THE VETERANS' BUREAU THAT PORTION OF THE PENSION CHARGEABLE WITH THE CARE OF THE VETERAN UNDER LAWS PREVIOUSLY IN FORCE; AND, THIRD, WHAT SHOULD BE THE PROCEDURE FOR MAKING REIMBURSEMENT TO THE HOSPITAL.

FIRST. PARAGRAPH (10) OF SECTION 202 OF THE WORLD WAR VETERANS' ACT CONSISTS OF TWO PARTS; THE FIRST SENTENCE, COMPRISING ABOUT THE FIRST HALF OF THE PARAGRAPH, RELATES TO VETERANS OF THE SPANISH-AMERICAN WAR, THE PHILIPPINE INSURRECTION, THE BOXER REBELLION, OR THE WORLD WAR SUFFERING FROM SPECIFIED DISEASES. THIS PART IS A REENACTMENT OF SECTION 4 OF THE ACT OF APRIL 20, 1922, 42 STAT. 497, AS AMENDED BY THE ACT OF MARCH 4, 1923, 42 STAT. 1524. WITH RESPECT TO THESE VETERANS THIS OFFICE HAS HELD THAT THEY ARE "ON EQUAL FOOTING WITH WORLD WAR VETERANS WITH RESPECT TO MEDICAL AND HOSPITAL TREATMENT BY THE BUREAU" AND ARE, THEREFORE, ENTITLED TO TREATMENT IN GOVERNMENT HOSPITALS UNDER THE CONTROL OF THE WAR AND NAVY DEPARTMENTS. 3 COMP. GEN. 174. WHAT WAS THERE SAID WOULD APPLY EQUALLY TO THE MENTIONED CLASSES OF VETERANS HOSPITALIZED INST. ELIZABETHS HOSPITAL, UNDER THE DEPARTMENT OF THE INTERIOR. THE LAST HALF OF THE PARAGRAPH IS NEW LEGISLATION AND WOULD SEEM TO INCLUDE THE VETERANS SPECIFICALLY MENTIONED IN THE FIRST HALF AND ALSO ALL OTHER "VETERANS OF ANY WAR, MILITARY OCCUPATION, OR MILITARY EXPEDITION SINCE 1897, NOT DISHONORABLY DISCHARGED WITHOUT REGARD TO THE NATURE OR ORIGIN OF THEIR DISABILITIES.' THIS HOSPITALIZATION WHICH THE DIRECTOR OF THE BUREAU MAY AUTHORIZE IS LIMITED BY THE PHRASE "SO FAR AS HE SHALL FIND THAT EXISTING GOVERNMENT FACILITIES PERMIT.' THE TERM "GOVERNMENT FACILITIES" IS BROAD ENOUGH TO INCLUDE GOVERNMENT HOSPITALS OTHER THAN THOSE DIRECTLY UNDER THE "CONTROL AND JURISDICTION OF THE BUREAU" SUCH AS ST. ELIZABETHS HOSPITAL.

SECOND. SECTION 4849, R.S., AS AMENDED BY THE ACT OF FEBRUARY 2, 1909, 35 STAT. 592, PROVIDES, IN PART, AS FOLLOWS:

* * * DURING THE TIME THAT ANY PENSIONER SHALL BE AN INMATE OF THE GOVERNMENT HOSPITAL FOR THE INSANE, ALL MONEY DUE OR BECOMING DUE UPON HIS OR HER PENSION SHALL BE PAID BY THE PENSION AGENT TO THE SUPERINTENDENT OR DISBURSING AGENT THE HOSPITAL, UPON A CERTIFICATE BY SUCH SUPERINTENDENT THAT THE PENSIONER IS AN INMATE OF THE HOSPITAL AND IS LIVING, AND SUCH PENSION MONEY SHALL BE BY SAID SUPERINTENDENT OR DISBURSING AGENT DISBURSED AND USED, UNDER REGULATIONS TO BE PRESCRIBED BY THE SECRETARY OF THE INTERIOR, FOR THE BENEFIT OF THE PENSIONER, AND, IN CASE OF A MALE PENSIONER, HIS WIFE, MINOR CHILDREN, AND DEPENDENT PARENTS, OR, IF A FEMALE PENSIONER, HER MINOR CHILDREN, IF ANY, IN THE ORDER NAMED, AND TO PAY HIS OR HER BOARD AND MAINTENANCE IN THE HOSPITAL, THE REMAINDER OF SUCH PENSION MONEY, IF ANY, TO BE PLACED TO THE CREDIT OF THE PENSIONER AND TO BE PAID TO THE PENSIONER OR THE GUARDIAN OF THE PENSIONER IN THE EVENT OF HIS OR HER DISCHARGE FROM THE HOSPITAL; OR, IN THE EVENT OF THE DEATH OF SAID PENSIONER WHILE AN INMATE OF SAID HOSPITAL, SHALL, IF A FEMALE PENSIONER, BE PAID TO HER MINOR CHILDREN, AND, IN THE CASE OF A MALE PENSIONER, TO BE PAID TO HIS WIFE, IF LIVING; IF NO WIFE SURVIVES HIM, THEN TO HIS MINOR CHILDREN; AND IN CASE THERE IS NO WIFE OR MINOR CHILDREN, THEN THE SAID UNEXPENDED BALANCE TO HIS OR HER CREDIT SHALL BE APPLIED TO THE GENERAL USES OF SAID HOSPITAL: * * *

THE PROVISION IN THE WORLD WAR VETERANS' ACT FOR HOSPITALIZATION OF VETERANS OTHER THAN OF THE WORLD WAR SHOWS NO INTENTION TO REPEAL OR RENDER INOPERATIVE PRIOR LAWS OBLIGATING THE PENSIONS OF VETERANS FOR THEIR MEDICAL OR HOSPITAL CARE, AND IT IS A FUNDAMENTAL RULE OF STATUTORY CONSTRUCTION THAT SUCH A REPEAL BY IMPLICATION IS NOT FAVORED. IT WOULD SEEM THAT THE APPROPRIATION FOR MEDICAL AND HOSPITAL TREATMENT UNDER THE UNITED STATES VETERANS' BUREAU MAY BE OBLIGATED FOR THE COST OF HOSPITALIZING VETERANS OF WARS OTHER THAN THE WORLD WAR ONLY IN AN AMOUNT NOT PREVIOUSLY PROVIDED BY STATUTE. ACCORDINGLY, IN THIS CASE THE PENSION CONTINUES TO BE CHARGEABLE WITH THE AMOUNT PROPERLY FIXED BY REGULATIONS OF THE SECRETARY OF THE INTERIOR UNDER THE ACT OF FEBRUARY 2, 1909, AND THE APPROPRIATION OF THE VETERANS' BUREAU IS CHARGEABLE ONLY WITH THE COST OF THE HOSPITALIZATION OVER AND ABOVE THE AMOUNT DEDUCTED FROM THE PENSION.

THIRD. THE ACT OF JUNE 5, 1924, 43 STAT. 429, PROVIDES:

* * * PROVIDED, THAT DURING THE FISCAL YEAR 1925 THE DISTRICT OF COLUMBIA, OR ANY BRANCH OF THE GOVERNMENT REQUIRING SAINT ELIZABETHS HOSPITAL TO CARE FOR PATIENTS FOR WHICH THEY ARE RESPONSIBLE, SHALL PAY BY CHECK TO THE SUPERINTENDENT, UPON HIS WRITTEN REQUEST, EITHER IN ADVANCE OR AT THE END OF EACH MONTH, ALL OR PART OF THE ESTIMATED OR ACTUAL COST FOR SUCH MAINTENANCE AS THE CASE MAY BE, AND BILLS RENDERED BY THE SUPERINTENDENT OF SAINT ELIZABETHS HOSPITAL IN ACCORDANCE HEREWITH SHALL NOT BE SUBJECT TO AUDIT OR CERTIFICATION IN ADVANCE OF PAYMENT; PROPER ADJUSTMENTS ON THE BASIS OF THE ACTUAL COST OF THE CARE OF PATIENTS PAID FOR IN ADVANCE SHALL BE MADE MONTHLY OR QUARTERLY, AS MAY BE AGREED UPON BETWEEN THE SUPERINTENDENT OF SAINT ELIZABETHS HOSPITAL AND THE DISTRICT OF COLUMBIA GOVERNMENT, DEPARTMENT, OR BETHS HOSPITAL FOR THE CARE OF PATIENTS THAT HE IS AUTHORIZED BY LAW TO RECEIVE, SHALL BE DEPOSITED TO THE CREDIT ON THE BOOKS OF THE TREASURY DEPARTMENT, OF THE APPROPRIATION MADE FOR THE CARE AND MAINTENANCE OF THE PATIENTS OF SAINT ELIZABETHS HOSPITAL FOR THE YEAR IN WHICH THE SUPPORT, CLOTHING, AND TREATMENT IS PROVIDED, AND BE SUBJECT TO REQUISITION BY THE DISBURSING AGENT OF SAINT ELIZABETHS HOSPITAL, UPON THE APPROVAL OF THE SECRETARY OF THE INTERIOR.

WHILE THIS ENACTMENT APPARENTLY CONTEMPLATES CASES WHERE THE ENTIRE COST OF HOSPITALIZATION IS OBLIGATION OF ONE GOVERNMENT ESTABLISHMENT, THERE APPEARS NOTHING THEREIN TO INDICATE AN INTENT TO PRECLUDE ITS APPLICATION TO SUCH CASES AS THIS ONE. WHERE ONLY A PORTION OF THE COST IS CHARGEABLE TO THE VETERANS' BUREAU, THE AMOUNT BILLED TO THE VETERANS' BUREAU,"EITHER IN ADVANCE OR AT THE END OF EACH MONTH," SHOULD REPRESENT ONLY THE COST OF HOSPITALIZATION LESS AMOUNT WHICH WILL BE PROPERLY CHARGEABLE TO THE PENSION, IF AN ADVANCE PAYMENT, OR WHICH HAS BEEN PROPERLY CHARGEABLE TO THE PENSION IF AT THE END OF THE MONTH. THE ACT EXPRESSLY PROVIDES THAT "PROPER ADJUSTMENTS ON THE BASIS OF THE ACTUAL COST OF THE CARE OF PATIENTS PAID FOR IN ADVANCE SHALL BE MADE MONTHLY OR QUARTERLY, AS MAY BE AGREED UPON BETWEEN THE SUPERINTENDENT OF ST. ELIZABETHS HOSPITAL AND * * * ESTABLISHMENTS CONCERNED.' IN THIS CASE IT IS BETWEEN ST. ELIZABETHS HOSPITAL AND THE UNITED STATES VETERANS' BUREAU. THE AMOUNT PAID BY THE VETERANS' BUREAU IS REQUIRED TO BE DEPOSITED FOR CREDIT TO THE APPROPRIATION OF ST. ELIZABETHS HOSPITAL CURRENT WHEN SUCH SERVICES ARE PERFORMED OR PROVIDED. 4 COMP. GEN. 48. THE ADMINISTRATIVE ASSISTANT TO THE SUPERINTENDENT OF ST. ELIZABETHS HOSPITAL SUGGESTS THAT THE VETERANS' BUREAU BE GIVEN CREDIT ONLY AT THE END OF EACH FISCAL YEAR FOR THE AMOUNT DEDUCTED FROM THE PENSION. AS THE ACT OF JUNE 5, 1924, SUPRA, PROVIDES ONLY FOR ADJUSTMENTS MONTHLY OR QUARTERLY, THERE WOULD BE NO AUTHORITY FOR SUCH PROCEDURE. FURTHERMORE, THE PENSION IS PRIMARILY LIABLE FOR THE HOSPITALIZATION TO THE EXTENT PROPERLY DEDUCTIBLE, AND THE PROCEDURE SUGGESTED WOULD DEPRIVE THE VETERANS' BUREAU OF THE USE OF THE AMOUNT PROPER FOR CREDIT TO ITS APPROPRIATION FOR THE FISCAL YEAR DURING WHICH SUCH AMOUNT CAN BE OBLIGATED FOR EXPENDITURE.