B-169747, JUNE 24, 1970, 49 COMP. GEN. 871

B-169747: Jun 24, 1970

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THE TERM "CLINIC" MAY BE INTERPRETED TO INCLUDE ANY MEDICAL ORGANIZATION WHICH IS CAPABLE OF CONTRACTING FOR AND FURNISHING MEDICAL SPECIALIST SERVICES AT VETERANS ADMINISTRATION FACILITIES. NOR ARE THE SERVICES OF SPECIALISTS WHO ARE NOT PHYSICIANS PRECLUDED UNDER SECTION 4117. 1966) NOR THE LEGISLATIVE HISTORY THEREOF CONTAINS A DEFINITION OF THE TERM "CLINIC" OR AN INDICATION OF HOW THAT TERM MAY HAVE BEEN UNDERSTOOD AND USED BY THE CONGRESS WHEN ENACTING SUCH PROVISION. YOU SUGGEST THAT THE TERM BE DEFINED TO INCLUDE ANY ORGANIZATION WHICH IS CAPABLE OF CONTRACTING FOR THE FURNISHING OF SCARCE MEDICAL SPECIALIST SERVICES. THE PURPOSE OF SECTION 4117 IS TO ENABLE THE VETERANS ADMINISTRATION TO PROCURE THE SERVICES OF MEDICAL SPECIALISTS WHICH.

B-169747, JUNE 24, 1970, 49 COMP. GEN. 871

VETERANS ADMINISTRATION -- CONTRACTS -- MEDICAL SCHOOLS -- SERVICES OF MEDICAL SPECIALISTS TO ENABLE THE VETERANS ADMINISTRATION TO OBTAIN BY CONTRACT THE PROFESSIONAL SERVICES OF SCARCE MEDICAL SPECIALISTS AND THUS AVOID IMPAIRING THE EFFECTIVENESS OF THE AUTHORITY IN 38 U.S.C. 4117 TO CONTRACT WITH MEDICAL SCHOOLS AND CLINICS FOR SUCH SERVICES, THE TERM "CLINIC" MAY BE INTERPRETED TO INCLUDE ANY MEDICAL ORGANIZATION WHICH IS CAPABLE OF CONTRACTING FOR AND FURNISHING MEDICAL SPECIALIST SERVICES AT VETERANS ADMINISTRATION FACILITIES, NOR ARE THE SERVICES OF SPECIALISTS WHO ARE NOT PHYSICIANS PRECLUDED UNDER SECTION 4117, AS NOTHING IN THE LANGUAGE OR LEGISLATIVE HISTORY OF THE SECTION REQUIRES THE TERM "MEDICAL SPECIALIST" TO BE DEFINED TO ENCOMPASS ONLY PHYSICIANS, AND THE TERM MAY BE CONSTRUED TO INCLUDE ANY PROFESSIONAL OR TECHNICIAN WHO PERFORMS SPECIALIST SERVICES RELATED TO PROVIDING MEDICAL CARE AND ATTENTION.

TO THE ADMINISTRATOR, VETERANS ADMINISTRATION, JUNE 24, 1970:

WE REFER TO YOUR LETTER OF MAY 4, 1970, REQUESTING OUR DECISION ON TWO MATTERS INVOLVING THE CONTRACTING AUTHORITY OF THE VETERANS ADMINISTRATION UNDER SECTIONS 213, 4114(A)(1)(B) AND 4117 OF TITLE 38, UNITED STATES CODE.

YOUR FIRST QUESTION CONCERNS SECTION 4117 WHICH PROVIDES:

THE ADMINISTRATOR MAY ENTER INTO CONTRACTS WITH MEDICAL SCHOOLS AND CLINICS TO PROVIDE SCARCE MEDICAL SPECIALIST SERVICES AT VETERANS' ADMINISTRATION FACILITIES (INCLUDING, BUT NOT LIMITED TO SERVICES OF RADIOLOGISTS, PATHOLOGISTS, AND PSYCHIATRISTS).

YOU POINT OUT THAT NEITHER THE LAW (PUBLIC LAW 89-785, APPROVED NOVEMBER 7, 1966) NOR THE LEGISLATIVE HISTORY THEREOF CONTAINS A DEFINITION OF THE TERM "CLINIC" OR AN INDICATION OF HOW THAT TERM MAY HAVE BEEN UNDERSTOOD AND USED BY THE CONGRESS WHEN ENACTING SUCH PROVISION. YOU BELIEVE THAT A RESTRICTIVE DEFINITION OF THE TERM "CLINIC"--E.G., AN INSTITUTION EQUIPPED FOR DIAGNOSIS AND TREATMENT OF OUTPATIENTS--WOULD DEFEAT THE OBJECTIVE OF SECURING THE PERSONAL SERVICES OF SCARCE MEDICAL SPECIALISTS TO BE PERFORMED AT VETERANS ADMINISTRATION FACILITIES. THEREFORE, YOU SUGGEST THAT THE TERM BE DEFINED TO INCLUDE ANY ORGANIZATION WHICH IS CAPABLE OF CONTRACTING FOR THE FURNISHING OF SCARCE MEDICAL SPECIALIST SERVICES.

THE PURPOSE OF SECTION 4117 IS TO ENABLE THE VETERANS ADMINISTRATION TO PROCURE THE SERVICES OF MEDICAL SPECIALISTS WHICH, DUE TO SCARCITY, OTHERWISE WOULD BE DIFFICULT OR IMPOSSIBLE TO OBTAIN. SINCE A STRICT DEFINITION OF THE TERM "CLINIC," AS SET FORTH IN OUR EXAMPLE ABOVE, APPARENTLY WOULD IMPAIR THE EFFECTIVENESS OF SUCH LEGISLATION, WE BELIEVE THAT THE TERM REASONABLY MAY BE INTERPRETED TO INCLUDE ANY MEDICAL ORGANIZATION WHICH IS CAPABLE OF CONTRACTING FOR AND FURNISHING THE SERVICES IN QUESTION.

YOUR SECOND INQUIRY CONCERNS SUBSECTION 4114(A)(1)(B) OF 38 U.S.C. WHICH PROVIDES: SEC. 4114. TEMPORARY AND PART-TIME APPOINTMENTS; RESIDENCIES AND INTERNSHIPS.

(A)(1) THE ADMINISTRATOR, UPON THE RECOMMENDATION OF THE CHIEF MEDICAL DIRECTOR, MAY EMPLOY, WITHOUT REGARD TO CIVIL SERVICE OR CLASSIFICATION LAWS, RULES, OR REGULATIONS--

(B) PHYSICIANS, DENTISTS, NURSES, AND OTHER PROFESSIONAL AND TECHNICAL PERSONNEL ON A FEE BASIS.

YOU QUESTION WHETHER THE AUTHORITY GRANTED UNDER THAT SUBSECTION MAY BE USED IN CONJUNCTION WITH THE GENERAL CONTRACTING AUTHORITY PROVIDED BY 38 U.S.C. 213 SO AS TO PERMIT THE VETERANS ADMINISTRATION TO CONTRACT FOR THE PERSONAL SERVICES OF THE PROFESSIONAL AND TECHNICAL PERSONNEL REFERRED TO IN SUBSECTION 4114(A)(1)(B). WE UNDERSTAND THAT THE PRIMARY REASON FOR SEEKING SUCH AUTHORITY IS TO ENABLE THE VETERANS ADMINISTRATION TO OBTAIN, BY CONTRACT, THE PERSONAL SERVICES OF VARIOUS SCARCE MEDICAL SPECIALISTS WHO ARE NOT PHYSICIANS. WE UNDERSTAND THAT THE VETERANS ADMINISTRATION HAS ASSUMED THAT THE SERVICES OF SPECIALISTS WHO ARE NOT PHYICIANS MAY NOT BE PROCURED UNDER SECTION 4117, DISCUSSED ABOVE.

WE FIND NOTHING IN THE LANGUAGE OF SECTION 4117 OR THE LEGISLATIVE HISTORY THEREOF WHICH REQUIRES THAT THE TERM "MEDICAL SPECIALIST" BE DEFINED TO ENCOMPASS ONLY PHYSICIANS. RATHER, IT IS OUR OPINION THAT THE TERM MAY BE CONSTRUED AS INCLUDING ANY PROFESSIONAL OR TECHNICIAN WHO PERFORMS SPECIALIST SERVICES RELATED TO PROVIDING MEDICAL CARE AND ATTENTION. QUESTION 2 IS ANSWERED ACCORDINGLY.