B-87935, AUGUST 29, 1949, 29 COMP. GEN. 96

B-87935: Aug 29, 1949

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NOTWITHSTANDING THE FACT THAT SUCH VARIOUS FUNCTIONS IN CONNECTION WITH WHICH TRAINING IS PROPOSED MAY BE CLOSELY RELATED TO THE RESPONSIBILITIES IMPOSED BY SECTION 301. 1949: REFERENCE IS MADE TO LETTER OF JULY 15. IT IS STATED THAT THE QUESTIONS ARISE FROM THE NEED OF THE SERVICE TO HAVE AVAILABLE FROM TIME TO TIME FOR AREAS OF CRITICAL CONCERN SPECIAL MEDICAL. ARE OBTAINABLE ONLY THROUGH THE TRAINING AND INSTRUCTION OF RESERVE OFFICERS ON ACTIVE DUTY AND CIVIL- SERVICE EMPLOYEES. IT IS SAID. CANNOT BE MET ADEQUATELY BY RECRUITMENT SINCE INDIVIDUALS HAVING THE REQUISITE KNOWLEDGE AND SKILLS EITHER ARE NOT AVAILABLE IN SUFFICIENT NUMBERS OR ARE NOT AVAILABLE ON THE TERMS AND CONDITIONS OF GOVERNMENT EMPLOYMENT.

B-87935, AUGUST 29, 1949, 29 COMP. GEN. 96

OFFICERS AND EMPLOYEES - TRAINING - PUBLIC HEALTH SERVICE PERSONNEL TO EFFECTUATE THE PURPOSES OF SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, AS AMENDED, RESPECTING THE RESEARCH AND INVESTIGATE DUTIES OF THE SURGEON GENERAL, AND OTHER PROVISIONS EXPRESSLY RELATED THERETO, THE SURGEON GENERAL MAY ASSIGN RESERVE OFFICERS AND CIVIL-SERVICE PERSONNEL, UPON THE RECOMMENDATION OF THE APPROPRIATE ADVISORY HEALTH COUNCIL, TO OUTSIDE EDUCATIONAL INSTITUTIONS FOR TRAINING WITH TUITION AND RELATED FEES PAID AS ADMINISTRATIVE EXPENSES OF A PARTICULAR PROGRAM, AND WHILE SO ASSIGNED REGULAR COMPENSATION MAY BE PAID AND, IF TEMPORARILY AWAY FROM OFFICIAL HEADQUARTERS, ACTUAL TRAVELING EXPENSES MAY BE REIMBURSED AND PER DIEM IN LIEU OF SUBSISTENCE PAID IN ACCORDANCE WITH THE TRAVEL REGULATIONS. 19 COMP. GEN. 448, AMPLIFIED. UNLESS OTHERWISE AUTHORIZED BY SPECIFIC STATUTORY AUTHORITY, SERVICE PERSONNEL OF THE PUBLIC HEALTH SERVICE MAY NOT BE TRAINED AT GOVERNMENT EXPENSE FOR VARIOUS FUNCTIONS OF THE SERVICE NOT EXPRESSLY RELATED TO THOSE FUNCTIONS PRESCRIBED IN SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, AS AMENDED, RELATING TO THE RESEARCH AND INVESTIGATIVE DUTIES OF THE SURGEON GENERAL, OR IN OTHER PROVISIONS OF THE ACT CONTAINING AN EXPRESS REFERENCE THERETO, NOTWITHSTANDING THE FACT THAT SUCH VARIOUS FUNCTIONS IN CONNECTION WITH WHICH TRAINING IS PROPOSED MAY BE CLOSELY RELATED TO THE RESPONSIBILITIES IMPOSED BY SECTION 301.

COMPTROLLER GENERAL WARREN TO THE ADMINISTRATOR, FEDERAL SECURITY AGENCY, AUGUST 29, 1949:

REFERENCE IS MADE TO LETTER OF JULY 15, 1949, FROM THE ACTING ADMINISTRATOR CONCERNING THE EXTENT OF THE AUTHORITY OF THE PUBLIC HEALTH SERVICE, UNDER THE PUBLIC HEALTH SERVICE ACT, APPROVED JULY 1, 1944, 58 STAT. 682, AS AMENDED, TO PROVIDE--- AT INSTITUTIONS OUTSIDE THE SERVICE AND AT GOVERNMENT EXPENSE--- TRAINING AND INSTRUCTION TO REGULARLY EMPLOYED PERSONNEL OF THE PUBLIC HEALTH SERVICE. IT IS STATED THAT THE QUESTIONS ARISE FROM THE NEED OF THE SERVICE TO HAVE AVAILABLE FROM TIME TO TIME FOR AREAS OF CRITICAL CONCERN SPECIAL MEDICAL, SCIENTIFIC, OR TECHNICAL SKILLS THAT, IN MANY INSTANCES, ARE OBTAINABLE ONLY THROUGH THE TRAINING AND INSTRUCTION OF RESERVE OFFICERS ON ACTIVE DUTY AND CIVIL- SERVICE EMPLOYEES.

THIS NEED, IT IS SAID, CANNOT BE MET ADEQUATELY BY RECRUITMENT SINCE INDIVIDUALS HAVING THE REQUISITE KNOWLEDGE AND SKILLS EITHER ARE NOT AVAILABLE IN SUFFICIENT NUMBERS OR ARE NOT AVAILABLE ON THE TERMS AND CONDITIONS OF GOVERNMENT EMPLOYMENT, AND THAT IT IS OFTEN MORE EFFECTIVE AND ECONOMICAL TO PROVIDE ADVANCED TRAINING TO INDIVIDUALS ALREADY EMPLOYED AND EXPERIENCED WITH SERVICE OPERATIONS AND WITH ITS PROGRAM REQUIREMENTS THAN TO RECRUIT THOSE HAVING ONLY KNOWLEDGE OF A PARTICULAR SPECIALTY. ALSO, IT IS STATED THAT MEDICAL AND RELATED SCIENTIFIC DEVELOPMENTS OFTEN PRESENT NEW AREAS, SUCH AS RADIOBIOLOGY, IN WHICH SERVICE PERSONNEL MUST MAINTAIN THEIR EXPERTNESS IF RESPONSIBILITIES IMPOSED BY THE CONGRESS ARE TO BE FULLY DISCHARGED.

IN CONSIDERING A SIMILAR QUESTION ARISING UNDER THE NATIONAL CANCER INSTITUTE ACT, APPROVED AUGUST 5, 1937, 50 STAT. 559, 561, IT WAS HELD IN 19 COMP. GEN. 448 THAT SECTION 5 (F) OF THE SAID ACT, WHICH AUTHORIZED THE SURGEON GENERAL---

TO ADOPT, UPON RECOMMENDATION OF THE COUNCIL AND WITH THE APPROVAL OF THE SECRETARY OF THE TREASURY, SUCH ADDITIONAL MEANS AS THE SURGEON GENERAL MAY DEEM NECESSARY OR APPROPRIATE TO CARRY OUT THE PROVISIONS OF SECTIONS 1 AND 2 OF THIS ACT. VESTED IN THE SURGEON GENERAL AUTHORITY TO DETAIL OFFICERS AND EMPLOYEES OF THE PUBLIC HEALTH SERVICE FOR TRAINING AND INSTRUCTION COURSES TENDING TO INCREASE THEIR KNOWLEDGE OF THE CAUSE, PREVENTION, AND TREATMENT OF CANCER, THE TUITION TO BE PAID AS PART OF THE ADMINISTRATIVE EXPENSES OF THE NATIONAL CANCER INSTITUTE, AND THAT WHILE SO DETAILED SUCH OFFICERS AND EMPLOYEES MIGHT BE PAID THEIR REGULAR COMPENSATION, TRAVEL EXPENSES, AND PER DIEM IN LIEU OF SUBSISTENCE.

WHILE SECTION 611 OF THE PUBLIC HEALTH SERVICE ACT, 58 STAT. 714, EXPRESSLY REPEALED THE NATIONAL CANCER INSTITUTE ACT ON WHICH THE DECISION REFERRED TO ABOVE WAS BASED, THE PROVISIONS OF SECTION 5 (F) OF THE EARLIER ACT WERE SUBSTANTIALLY INCLUDED, WITHOUT LIMITATION TO CANCER, IN SECTION 301 (G) OF THE LATTER ACT. SUBSEQUENTLY, SECTION 301 WAS AMENDED BY SECTION 7 (B) OF THE NATIONAL MENTAL HEALTH ACT, APPROVED JULY 3, 1946, 60 STAT. 421, 423; SECTION 4 (F) OF THE NATIONAL HEART ACT, APPROVED JUNE 16, 1948, 62 STAT. 464, 468; AND SECTION 4 (F) OF THE NATIONAL DENTAL RESEARCH ACT, APPROVED JUNE 24, 1948, 62 STAT. 598, 601, AND AS THUS AMENDED NOW READS IN PART AS FOLLOWS:

SEC. 301. THE SURGEON GENERAL SHALL CONDUCT IN THE SERVICE, AND ENCOURAGE, COOPERATE WITH, AND RENDER ASSISTANCE TO OTHER APPROPRIATE PUBLIC AUTHORITIES, SCIENTIFIC INSTITUTIONS, AND SCIENTISTS IN THE CONDUCT OF, AND PROMOTE THE COORDINATION OF, RESEARCH, INVESTIGATIONS, EXPERIMENTS, DEMONSTRATIONS, AND STUDIES RELATING TO THE CAUSES, DIAGNOSIS, TREATMENT, CONTROL, AND PREVENTION OF PHYSICAL AND MENTAL DISEASES AND IMPAIRMENTS OF MAN, INCLUDING WATER PURIFICATION, SEWAGE TREATMENT, AND POLLUTION OF LAKES AND STREAMS. IN CARRYING OUT THE FOREGOING THE SURGEON GENERAL IS AUTHORIZED TO---

(G) ADOPT, UPON RECOMMENDATION OF THE NATIONAL ADVISORY HEALTH COUNCIL, OR, WITH RESPECT TO CANCER, UPON RECOMMENDATION OF THE NATIONAL ADVISORY CANCER COUNCIL, OR, WITH RESPECT TO MENTAL HEALTH, UPON RECOMMENDATION OF THE NATIONAL ADVISORY MENTAL HEALTH COUNCIL, OR, WITH RESPECT TO HEART DISEASES, UPON RECOMMENDATION OF THE NATIONAL ADVISORY HEART COUNCIL, OR, WITH RESPECT TO DENTAL DISEASES AND CONDITIONS, UPON RECOMMENDATIONS OF THE NATIONAL ADVISORY DENTAL RESEARCH COUNCIL, SUCH ADDITIONAL MEANS AS HE DEEMS NECESSARY OR APPROPRIATE TO CARRY OUT THE PURPOSES OF THIS SECTION.

IN VIEW OF THE CONCLUSION REACHED IN 19 COMP. GEN. 448, AND THE SIMILARITY OF THE PROVISIONS OF LAW CONSIDERED IN SUCH DECISION AND THOSE UNDER CONSIDERATION HERE, YOU ARE ADVISED THAT THIS OFFICE WOULD NOT BE REQUIRED TO OBJECT TO THE EXPENDITURE OF APPROPRIATED FUNDS, WHERE OTHERWISE AVAILABLE FOR THE ADMINISTRATIVE EXPENSES OF A PARTICULAR PROGRAM, TO DEFRAY THE COST OF TUITION AND RELATED FEES FOR RESERVE OFFICERS AND CIVIL-SERVICE PERSONNEL ASSIGNED, UPON THE RECOMMENDATION OF THE APPROPRIATE ADVISORY COUNCIL, TO OUTSIDE EDUCATIONAL INSTITUTIONS FOR TRAINING IN ORDER TO EFFECT THE PURPOSES OF SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, AS AMENDED, AND THE PROVISIONS OF THE ACT EXPRESSLY RELATED THERETO. WHILE SO DETAILED SUCH EMPLOYEES MAY BE PAID THEIR REGULAR COMPENSATION AND, IF TEMPORARILY AWAY FROM OFFICIAL HEADQUARTERS, MAY BE REIMBURSED ACTUAL TRAVELING EXPENSES AND PAID PER DIEM IN LIEU OF SUBSISTENCE IN ACCORDANCE WITH THE STANDARDIZED GOVERNMENT TRAVEL REGULATIONS.

WITH REGARD TO YOUR SECOND QUESTION IN THE MATTER, IT IS STATED IN YOUR LETTER THAT---

OUR SECOND QUESTION RELATES TO THE FACT THAT A NUMBER OF PROVISIONS IN THE PUBLIC HEALTH SERVICE ACT WHICH CONFER IMPORTANT RESPONSIBILITIES UPON THE SERVICE MAKE NO EXPRESS REFERENCE TO SECTION 301 ALTHOUGH THESE RESPONSIBILITIES IN FACT RELATE "TO THE CAUSES, DIAGNOSIS, TREATMENT, CONTROL, AND PREVENTION OF PHYSICAL AND MENTAL DISEASES AND IMPAIRMENTS OF MAN, INCLUDING WATER PURIFICATION, SEWAGE TREATMENT, AND POLLUTION OF LAKES AND STREAMS.' FOR EXAMPLE, OTHER PROVISIONS OF TITLE III OF THE ACT (SECTIONS 321 TO 326, 331, 341, AND 344) CALL UPON THE SERVICE TO PROVIDE MEDICAL CARE AND TREATMENT TO CERTAIN SEAMEN AND OTHER BENEFICIARIES. DISCHARGE THIS RESPONSIBILITY THE SERVICE OPERATES 26 HOSPITALS.

THREE TYPES OF TRAINING ILLUSTRATE THE NEEDS IN THIS AREA. FIRST, IN ORDER TO UTILIZE EFFECTIVELY RESERVE AND CIVILIAN MEDICAL AND RELATED PERSONNEL IN CLINICAL AND BUSINESS ADMINISTRATION OF PUBLIC HEALTH SERVICE HOSPITALS, THERE IS A NEED TO GIVE SELECTED INDIVIDUALS ADDITIONAL AND SPECIALIZED TRAINING IN HOSPITAL ADMINISTRATION AT A UNIVERSITY SCHOOL OF MEDICINE, GRADUATE SCHOOL, OR SCHOOL OF BUSINESS ADMINISTRATION. SECOND, MANY OF THE TYPES OF TRAINING LISTED ABOVE, SUCH AS TRAINING AT OUTSIDE INSTITUTIONS IN CLINICAL NURSING AND DENTISTRY, WOULD BE APPLICABLE TO MEET THE REGULAR CLINICAL NEEDS OF THE SERVICE HOSPITALS. THIRD, RESERVE OFFICERS SERVING A RESIDENCY PERIOD IN SERVICE HOSPITALS ARE OFTEN REQUIRED TO HAVE A PERIOD OF TRAINING FROM SIX TO TWELVE MONTHS AT AN OUTSIDE INSTITUTION IN ORDER TO COMPLY WITH THE RESIDENCY STANDARDS OF THE AMERICAN MEDICAL ASSOCIATION IN FIELDS IN WHICH SERVICE HOSPITALS ARE NOT EQUIPPED TO GIVE THE COMPLETE TRAINING.

WHILE THE RESPONSIBILITIES IMPOSED UPON THE PUBLIC HEALTH SERVICE BY THE VARIOUS OTHER SECTIONS OF THE PUBLIC HEALTH SERVICE ACT CITED IN YOUR LETTER MAY BE CLOSELY RELATED TO THE RESPONSIBILITIES IMPOSED BY SECTION 301, THERE APPEARS TO BE NO PROPER LEGAL BASIS FOR EXTENDING THE HOLDING OF 19 COMP. GEN. 448 TO INCLUDE TRAINING FOR THE VARIOUS FUNCTIONS OF THE SERVICE NOT EXPRESSLY RELATED TO SECTION 301 OF THE ACT OR TO OTHER PROVISIONS OF THE ACT THAT WERE EXPRESSLY ADOPTED TO CARRY OUT THE PURPOSE OF SUCH SECTION. ACCORDINGLY, IN THE ABSENCE OF A DEFINITE STATUTORY AUTHORIZATION FOR SUCH TRAINING--- SUCH AS THAT NOW CONTAINED IN SECTION 218 OF THE PUBLIC HEALTH SERVICE ACT, ADDED BY SECTION 8 OF THE ACT OF FEBRUARY 28, 1948, 62 STAT. 38, 47, WHICH AUTHORIZES TRAINING FOR COMMISSIONED OFFICERS OF THE REGULAR CORPS--- IT MUST BE HELD THAT THE TRAINING OF SERVICE PERSONNEL AT GOVERNMENT EXPENSE, WHERE SUCH TRAINING IS NOT EXPRESSLY RELATED TO THOSE FUNCTIONS OF THE PUBLIC HEALTH SERVICE PRESCRIBED IN SECTION 301 OF THE PUBLIC HEALTH SERVICE ACT, AS AMENDED, OR IN OTHER PROVISIONS OF THE ACT CONTAINING AN EXPRESS REFERENCE THERETO, IS NOT PROPER.