B-134478, JANUARY 7, 1958, 37 COMP. GEN. 462

B-134478: Jan 7, 1958

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THAT THE FOREGOING APPROPRIATION IS PREDICATED ON FURNISHING INPATIENT CARE AND TREATMENT TO AN AVERAGE OF 141. IF A LESSER NUMBER IS EXPERIENCED SUCH APPROPRIATION SHALL BE EXPENDED ONLY IN PROPORTION TO THE AVERAGE NUMBER OF BENEFICIARIES FURNISHED SUCH CARE AND TREATMENT. ( ITALICS SUPPLIED.). 900 WAS INCREASED TO $671. 900 AND THE NUMBER OF BENEFICIARIES TO BE FURNISHED CARE AND TREATMENT WAS REDUCED FROM 141. 900 FOR REIMBURSABLE SERVICES) WAS CREDITED TO THE " INPATIENT CARE" APPROPRIATION ACCOUNT BY APPROPRIATION WARRANT FROM THE GENERAL FUND OF THE TREASURY. AS AND WHEN REIMBURSEMENTS WERE REALIZED. THE APPROPRIATE ACCOUNT WAS CREDITED WITH THE COLLECTIONS. THE OBLIGATIONS INCURRED UNDER THIS APPROPRIATION DURING THE FISCAL YEAR 1957 WERE LESS THAN THE GROSS AMOUNT OF $671.

B-134478, JANUARY 7, 1958, 37 COMP. GEN. 462

APPROPRIATIONS - VETERANS ADMINISTRATION - INPATIENT CARE - COLLECTIONS THE APPROPRIATION FOR INPATIENT CARE IN THE INDEPENDENT OFFICES APPROPRIATION ACT, 1957, WHICH PROVIDES $670,116,900 INCLUDING THE SUM OF $7,216,900 FOR REIMBURSABLE SERVICES, MAY NOT BE REGARDED AS AUTHORITY TO OBLIGATE AND EXPEND THE GROSS AMOUNT WITHOUT REGARD TO THE REIMBURSABLES IN VIEW OF THE LEGISLATIVE HISTORY WHICH ESTABLISHES BEYOND A REASONABLE DOUBT THAT CONGRESS INTENDED ONLY THE NET AMOUNT AFTER DEDUCTION OF THE REIMBURSABLES TO BE THE AMOUNT DERIVED BY APPROPRIATION FROM THE GENERAL FUND OF THE TREASURY. THE TERM "SUCH APPROPRIATION" AS USED IN THE LIMITATION RESPECTING THE NUMBER OF PATIENTS TO BE FURNISHED INPATIENT CARE AND TREATMENT REFERS TO THE GROSS AMOUNT APPROPRIATED, INCLUDING THE SUM FOR REIMBURSABLE SERVICES.

TO THE ADMINISTRATOR, VETERANS ADMINISTRATION, JANUARY 7, 1958:

ON NOVEMBER 21, 1957, THE FORMER ADMINISTRATOR REQUESTED OUR DECISION CONCERNING THE AMOUNT OF THE APPROPRIATION " INPATIENT CARE" CONTAINED IN THE INDEPENDENT OFFICES APPROPRIATION ACT, 1957, 70 STAT. 399, 349. THAT APPROPRIATION PROVIDES:

FOR EXPENSES NECESSARY FOR THE MAINTENANCE AND OPERATION OF HOSPITALS AND DOMICILIARY FACILITIES AND FOR THE CARE AND TREATMENT OF BENEFICIARIES OF THE VETERANS ADMINISTRATION IN FACILITIES NOT UNDER THE JURISDICTION OF THE VETERANS ADMINISTRATION AS AUTHORIZED BY LAW * * * $670,116,900, INCLUDING THE SUM OF $7,216,900 FOR REIMBURSABLE SERVICES PERFORMED FOR OTHER GOVERNMENT AGENCIES AND INDIVIDUALS * * * PROVIDED FURTHER, THAT THE FOREGOING APPROPRIATION IS PREDICATED ON FURNISHING INPATIENT CARE AND TREATMENT TO AN AVERAGE OF 141,100 BENEFICIARIES DURING THE FISCAL YEAR 1957 INCLUDING MEMBERS IN STATE OR TERRITORIAL HOMES, AND IF A LESSER NUMBER IS EXPERIENCED SUCH APPROPRIATION SHALL BE EXPENDED ONLY IN PROPORTION TO THE AVERAGE NUMBER OF BENEFICIARIES FURNISHED SUCH CARE AND TREATMENT. ( ITALICS SUPPLIED.)

THE AMOUNT OF $670,116,900 WAS INCREASED TO $671,116,900 AND THE NUMBER OF BENEFICIARIES TO BE FURNISHED CARE AND TREATMENT WAS REDUCED FROM 141,100 TO 140,100 BY THE THIRD SUPPLEMENTAL APPROPRIATION ACT, 1957, 71 STAT. 176, 179.

THE NET AMOUNT OF $663,900,000 ($671,116,900 LESS $7,216,900 FOR REIMBURSABLE SERVICES) WAS CREDITED TO THE " INPATIENT CARE" APPROPRIATION ACCOUNT BY APPROPRIATION WARRANT FROM THE GENERAL FUND OF THE TREASURY. AS AND WHEN REIMBURSEMENTS WERE REALIZED, THE APPROPRIATE ACCOUNT WAS CREDITED WITH THE COLLECTIONS. THE OBLIGATIONS INCURRED UNDER THIS APPROPRIATION DURING THE FISCAL YEAR 1957 WERE LESS THAN THE GROSS AMOUNT OF $671,116,900 AND THE NUMBER OF BENEFICIARIES FURNISHED CARE AND TREATMENT WAS IN EXCESS OF 140,100. THE OBLIGATIONS INCURRED, HOWEVER, ARE IN EXCESS OF THE AMOUNT OF CASH APPROPRIATED FROM THE GENERAL FUND PLUS THE COLLECTIONS RECEIVED THROUGH SEPTEMBER 30, 1957. THIS IS DUE TO THE FACT THAT THE EARNED RECEIVABLES WERE ONLY $6,389,722, OR $827,178 LESS THAN THE AMOUNT OF $7,216,900 FOR REIMBURSABLE SERVICES STATED IN THE ACT, AND THE FACT THAT EVEN SOME OF THE EARNED RECEIVABLES WILL NEVER BE COLLECTED.

THE FORMER ADMINISTRATOR CONTENDS THAT THE SUM APPROPRIATED UNDER THE APPROPRIATION " INPATIENT CARE, 1957" IS AN AUTHORITY GRANT TO OBLIGATE AND EXPEND IN FURNISHING HOSPITAL CARE AND TREATMENT REGARDLESS OF FINANCING SOURCE (I.E., TREASURY WARRANT OR REIMBURSEMENTS) SUBJECT ONLY TO THE PROVISION RELATING TO THE AVERAGE NUMBER OF BENEFICIARIES AND PRESENTS THE FOLLOWING QUESTIONS FOR DECISION:

FIRST. WHETHER IN VIEW OF THE FOREGOING CONSIDERATIONS THE APPROPRIATION FOR " INPATIENT CARE, 1957," SHOULD HAVE BEEN ESTABLISHED BY THE TREASURY DEPARTMENT IN THE AMOUNT OF $671,116,900? * *

SECOND. IF THE TERM "SUCH APPROPRIATION" DOES NOT REFER TO THE DEFINITE SUM APPROPRIATED, TO WHAT DOES IT REFER? * * *

THIRD. IF THE ANSWER TO THE FIRST QUESTION IS IN THE AFFIRMATIVE, WHAT DISPOSITION SHOULD BE MADE OF RECEIPTS FOR REIMBURSABLE SERVICES PERFORMED FOR OTHER GOVERNMENT AGENCIES AND NDIVIDUALS? * * *

FOURTH. IF THE ANSWER TO THE FIRST QUESTION IS IN THE NEGATIVE, WHAT SUM SHOULD THE VETERANS ADMINISTRATION PROPERLY CONSIDER IN RELATION TO THE PATIENT LOAD LEVEL STIPULATED IN THE APPROPRIATION LANGUAGE TO FINANCE THE OPERATION OF HOSPITALS IN THE EXPECTATION THAT FULL COLLECT WILL BE RECEIVED (AND IN THE ABSENCE OF CREDIT OR BORROWING AUTHORITY) TO MATCH ESTIMATED REIMBURSABLE SERVICES? * * *

AS STATED IN THE LETTER, THE LANGUAGE ON REIMBURSEMENTS IN THIS APPROPRIATION FIRST APPEARED IN THE SECOND INDEPENDENT OFFICES APPROPRIATION ACT, 1954, 67 STAT. 187, UNDER THE APPROPRIATION HEADING "MAINTENANCE AND OPERATION OF HOSPITALS.' THE LANGUAGE INVOLVED WAS $555,000,000, INCLUDING THE SUM OF $7,000,000 FOR REIMBURSABLE SERVICES PERFORMED FOR OTHER GOVERNMENT AGENCIES AND INDIVIDUALS.' WE AGREE THAT THE $7,000,000 WAS A LIMIT ON THE AMOUNT OF REIMBURSEMENTS WHICH COULD BE USED UNDER THE APPROPRIATION. WE ALSO AGREE THAT THE AMOUNT OF $555,000,000 WAS FIXED IN RELATION TO THE OPERATION OF 114,315 HOSPITAL BEDS TO MAINTAIN AN 102,370 AVERAGE DAILY PATIENT LOAD, BUT WE CANNOT AGREE THAT IT WAS A FIXED OBLIGATIONAL AND EXPENDITURE AUTHORITY OF $555,000,000 WITHOUT REGARD TO REIMBURSEMENTS.

IN THE COMPARATIVE STATEMENT OF APPROPRIATIONS FOR 1953, ESTIMATES FOR 1954, AND AMOUNTS RECOMMENDED IN THE BILL FOR 1954, AT PAGE 16 OF HOUSE REPORT NO. 550, 83D CONGRESS, ST SESSION, ON THE SECOND INDEPENDENT OFFICES APPROPRIATION BILL, 1954, THE AMOUNT OF $548,000,000 IS SHOWN AS THE AMOUNT OF THE APPROPRIATION RECOMMENDED IN THE HOUSE BILL ( H.R. 5690) FOR 1954. THE AMOUNT IS FOOTNOTED AS FOLLOWS: "AND IN ADDITION $7,000,000 FOR REIMBURSEMENTS FOR SERVICES PERFORMED FOR OTHER GOVERNMENT AGENCIES AND INDIVIDUALS.' THE LANGUAGE IN THE HOUSE BILL IS IDENTICAL WITH THE LANGUAGE AS ENACTED AND QUOTED ABOVE. ALSO, A DETAILED STATEMENT EXPLAINING THE NEED FOR EACH APPROPRIATION ITEM FOR THE VETERANS ADMINISTRATION IN THAT BILL AS PASSED BY THE HOUSE OF REPRESENTATIVES, WHICH IS PRINTED IN THE SENATE HEARINGS, PP. 156-159, ON THE SECOND INDEPENDENT OFFICES APPROPRIATIONS FOR 1954, CLEARLY SHOWS THAT THE VETERANS ADMINISTRATION CONSIDERED THE $555,000,000 HERE INVOLVED TO BE COMPOSED OF $548,000,000 PLUS AN ADDITIONAL AMOUNT OF $7,000,000 TO BE OBTAINED FROM REIMBURSEMENTS.

ONLY THE AMOUNT OF $548,000,000 WAS CREDITED TO THE 1954 ACCOUNT BY APPROPRIATION WARRANT FROM THE GENERAL FUND OF THE TREASURY. SIMILARLY, ONLY THE GROSS AMOUNT LESS THE AMOUNT FOR REIMBURSABLE SERVICES HAS BEEN APPROPRIATED FOR SUBSEQUENT FISCAL YEARS THROUGH 1958. THE BUDGET ESTIMATES FOR THE FISCAL YEARS 1955 THROUGH 1958 SHOW ONLY THE NET AMOUNT AS THE AMOUNT OF THE APPROPRIATION. THE BUDGET, AT PAGE 178, SHOWS THE ESTIMATE OF THE APPROPRIATION FOR 1957 TO BE $662,900,000 AND THE TABLE " PROGRAM AND FINANCING" REVEALS THAT AN ADDITIONAL AMOUNT OF $7,216,900 WILL BE DERIVED FROM ADVANCES AND REIMBURSEMENTS.

AT PAGE 116 OF THE HOUSE HEARINGS ON THE THIRD SUPPLEMENTAL APPROPRIATION BILL, 1957 ( H.R. 7221), THE CONTROLLER OF THE VETERANS ADMINISTRATION, IN EXPLAINING THE NEED FOR AN ADDITIONAL AMOUNT OF $3,000,000 FOR THE APPROPRIATION " INPATIENT CARE, 1957" STATED THAT "THE AMOUNT APPROPRIATED FOR THE FISCAL YEAR 1957 WAS $622,900,000, WHICH WAS THE FULL AMOUNT REQUESTED.' IN HOUSE REPORT NO. 386, 85TH CONGRESS, ON THAT HOUSE BILL, THE HOUSE COMMITTEE ON APPROPRIATIONS STATES: "IN PROVIDING THE ENTIRE $662,900,000 REQUESTED IN THE BUDGET ESTIMATE AT THE BEGINNING OF THE YEAR, THE COMMITTEE CONSIDERED SUCH AMOUNT TO BE MORE THAN ADEQUATE FOR THE ENTIRE YEAR.'

THE LEGISLATIVE HISTORY OF THIS APPROPRIATION, IN OUR OPINION, ESTABLISHES BEYOND ANY REASONABLE DOUBT THAT THE CONGRESS INTENDED THAT ONLY THE AMOUNT OF $662,900,000 UNDER THE APPROPRIATION IN THE INDEPENDENT OFFICES APPROPRIATION ACT, 1957, PLUS THE AMOUNT OF $1,000,000 APPROPRIATED IN THE THIRD SUPPLEMENTAL APPROPRIATION ACT, 1957, WAS TO BE DERIVED BY APPROPRIATION FROM THE GENERAL FUND OF THE TREASURY. THE FIRST QUESTION MUST, THEREFORE, BE ANSWERED IN THE NEGATIVE.

IN ANSWER TO THE SECOND QUESTION, THE TERM "SUCH APPROPRIATION" REFERS TO THE AMOUNT OF ,$670,116,900, INCLUDING THE SUM OF $7,216,900 FOR REIMBURSABLE SERVICES PERFORMED FOR OTHER GOVERNMENT AGENCIES AND INDIVIDUALS," THAT IS, THE AMOUNT OF $662,900,000 TO BE DERIVED FROM THE GENERAL FUND OF THE TREASURY PLUS ESTIMATED REIMBURSEMENTS IN THE AMOUNT ESTIMATED BY THE VETERANS ADMINISTRATION TO BE COLLECTED. THE TOTAL AMOUNT AVAILABLE ADMITTEDLY DEPENDS UPON THE ACCURACY OF THE VETERANS ADMINISTRATION'S ESTIMATE OF THE REIMBURSEMENTS TO BE RECEIVED.

SINCE THE FIRST QUESTION IS ANSWERED IN THE NEGATIVE, NO ANSWER TO THE THIRD QUESTION IS REQUIRED.

IN ANSWER TO THE FOURTH QUESTION, THE AMOUNT TO BE CONSIDERED IS THE AMOUNT OF FUNDS APPROPRIATED PLUS THE MOST CURRENT ESTIMATE OF REIMBURSEMENTS TO BE RECEIVED FOR SERVICES PERFORMED FOR OTHER GOVERNMENT AGENCIES AND INDIVIDUALS, BUT INCLUDING ANY RESERVES DETERMINED NECESSARY TO PREVENT ANY OBLIGATION OR EXPENDITURE IN EXCESS OF THE AMOUNT OF THE APPROPRIATION PLUS REIMBURSEMENTS TO BE RECEIVED. THE ESTIMATE OF THE REIMBURSEMENTS MAY HAVE TO BE REVISED AT VARIOUS TIMES DURING THE YEAR. IT IS TRUE THAT THE BUREAU OF THE BUDGET HAS APPORTIONED THE GROSS AMOUNT SET OUT IN THE APPROPRIATION, BUT, AS STATED IN SECTION 13 OF BUREAU OF THE BUDGET CIRCULAR NO. A-34, THE INCLUSION OF SUCH ESTIMATES IN DETERMINING THE AMOUNTS AVAILABLE FOR APPORTIONMENT IN NO WAY AUTHORIZES AN AGENCY TO OBLIGATE OR EXPEND IN EXCESS OF THE AMOUNTS TO BECOME AVAILABLE FROM SUCH SOURCES.

WE ADMIT THAT THERE ARE ADMINISTRATIVE DIFFICULTIES INVOLVED IN CARRYING OUT A PROGRAM FINANCED IN THIS MATTER, BUT WE CANNOT APPROPRIATE AN AMOUNT OF $671,116,900 FROM THE GENERAL FUND OF THE TREASURY WHEN THE APPROPRIATION LANGUAGE SEEMS TO INDICATE THAT ONLY $663,900,000 WAS APPROPRIATED AND ITS LEGISLATIVE HISTORY CLEARLY SHOWS THAT ONLY THAT AMOUNT WAS INTENDED TO BE APPROPRIATED. THE METHOD OF FINANCING THE PROGRAM IS A MATTER WHICH WILL HAVE TO BE WORKED OUT WITH THE CONGRESS.