B-125206, AUGUST 2, 1960, 40 COMP. GEN. 72

B-125206, AUGUST 2, 1960, 40 COMP. GEN. 72

VETERANS - FEDERAL AID TO STATES - HOMES FOR DISABLED VETERANS THE GEORGIA STATE WAR VETERANS' HOME AT MILLEDGEVILLE, GEORGIA, WHICH IS LOCATED ON THE GROUNDS OF A STATE HOSPITAL, DESIGNATED BY A GEORGIA STATUTE AS AN INTEGRAL PART OF THE VETERANS' HOME, WHICH ALSO HOUSES SOME VETERANS LISTED AS PATIENTS OF THE HOSPITAL, IS NOT TO BE DENIED FEDERAL- AID PAYMENTS UNDER 38 U.S.C. 641-643 BY REASON THAT THERE IS NO PARTICULAR DEGREE OF PHYSICAL SEPARATION OF THE BUILDINGS OF THE HOME AND THE BUILDINGS OF THE HOSPITAL NOR DOES THE STATUTE REQUIRE THE CONCLUSION THAT THE HOME AND HOSPITAL ARE ONE INSTITUTION; THEREFORE, THE HOME MAY CONTINUE TO BE CONSIDERED ELIGIBLE TO RECEIVE FEDERAL AID FOR ELIGIBLE VETERANS MAINTAINED AT THE HOME. IN THE COMPUTATION OF FEDERAL-AID PAYMENTS TO A STATE FOR A VETERAN IN A STATE HOME UNDER 38 U.S.C. 641, WHICH LIMITS THE PAYMENT TO ONE HALF THE COST OF THE VETERAN'S MAINTENANCE UP TO A MAXIMUM OF $2.50 PER DAY, THE GOVERNMENT'S SHARE OF THE COST MUST BE BASED ON THE ACTUAL COST ATTRIBUTABLE TO THE OPERATION OF THE STATE HOME RATHER THAN SOME OTHER AMOUNT ARBITRARILY DESIGNATED AS COST.

TO THE ADMINISTRATOR, VETERANS ADMINISTRATION, AUGUST 2, 1960:

YOUR LETTER OF MARCH 29, 1960, REFERS TO OUR LETTER OF NOVEMBER 18, 1957, B-125206, TO YOU, CONCERNING THE RECOGNITION OF THE GEORGIA STATE WAR VETERANS' HOME AT MILLEDGEVILLE, GEORGIA, AS A ,HOME" WITHIN THE MEANING OF THE ACT OF AUGUST 27, 1888, AS AMENDED, 24 U.S.C. 134. IN CONNECTION WITH CODIFYING TITLE 38 OF THE U.S.C. INTO POSITIVE LAW AND BRINGING INTO THAT TITLE OTHER ACTS RELATING TO VETERANS, THE ACT OF 1888 WAS REPEALED BY SECTION 14 (10) OF PUBLIC LAW 85-857, 72 STAT. 1269, AND THE AUTHORITY TO MAKE FEDERAL-AID PAYMENTS TO A STATE HOME AS DEFINED IN 38 U.S.C. 101 (19) NOW IS CONTAINED IN 38 U.S.C. 641-643. THESE LATTER PROVISIONS DO NOT DIFFER MATERIALLY FROM THE PROVISIONS OF THE REPEALED ACT.

YOU STATE THAT THE VETERANS ADMINISTRATION UNDERTOOK AN INTERNAL AUDIT OF THE GEORGIA STATE WAR VETERANS' HOME IN SEPTEMBER 1958, AND CONDUCTED A SURVEY OF THE HOME FROM NOVEMBER 30 TO DECEMBER 3, 1959, AND THERE ARE ENCLOSED WITH YOUR LETTER COPIES OF THE REPORTS OF THE AUDIT AND THE SURVEY FOR OUR INFORMATION.

IT IS OBSERVED BY YOU THAT THE INTERNAL AUDIT AND SURVEY REPORTS CONTAIN FACTS WHICH INDICATE THAT THE GEORGIA STATE WAR VETERANS' HOME MAY NOT BE MEETING THE REQUIREMENTS OF THE ABOVE-CITED STATUTES, AS INTERPRETED BY OUR DECISIONS, FOR THE PAYMENT OF FEDERAL AID TO THE STATE OF GEORGIA FOR VETERANS MAINTAINED IN THE HOME. YOU NOTE THAT IN OUR DECISION OF APRIL 26, 1953, 35 COMP. GEN. 583, CONCERNING THE RECOGNITION OF THE OKLAHOMA STATE WAR VETERANS FACILITY AT NORMAN, OKLAHOMA, WE POINTED OUT THAT THE BUILDINGS USED AT THE FACILITY WERE "ENTIRELY SEPARATED BY DISTANCE AND HIGH WIRE FENCE FROM THOSE OCCUPIED BY THE PATIENTS OF THE CENTRAL STATE MEMORIAL HOSPITAL.' YOU ADVISE THAT THE REPORTS ENCLOSED WITH YOUR LETTER DO NOT REFLECT THE SAME KIND OF PHYSICAL SEPARATION OF THE BUILDINGS OF THE GEORGIA STATE WAR VETERANS' HOME AND THE BUILDINGS OF THE MILLEDGEVILLE STATE HOSPITAL. YOU NOTE THAT THE REPORTS ALSO SHOW THAT THERE IS NO PHYSICAL SEPARATION OF HOSPITAL AND HOME PATIENTS AMONG THE RESIDENTS OF THE GEORGIA STATE WAR VETERANS' HOME.

YOUR LETTER THEN REFERS TO THE FOLLOWING PROVISION OF THE GEORGIA STATE STATUTES (1SECTION 1101, TITLE 78, GEORGIA CODE ANNOTATED):

* * * FOR THE PURPOSE OF SECURING TREATMENT OR HOSPITALIZATION, THE ADJACENT FACILITIES OF * * * MILLEDGEVILLE STATE HOSPITAL * * * ARE HEREBY ESTABLISHED AS AN INTEGRAL PART OF THE GEORGIA WAR VETERANS' HOME AND MAY BE UTILIZED TO CARE FOR ELIGIBLE VETERANS.

YOU ASK WHETHER, IN THE LIGHT OF THE ABOVE-QUOTED STATUTORY LANGUAGE AND THE FACTS CONTAINED IN THE INTERNAL AUDIT AND SURVEY REPORTS, IT CAN BE SAID THAT THE HOME AND HOSPITAL ARE IN FACT TWO SEPARATE AND DISTINCT INSTITUTIONS. YOU STATE THAT APART FROM THE PROVISIONS OF THE STATUTE ESTABLISHING THE HOME, FOR COMMITMENT PURPOSES THE HOME AND HOSPITAL MUST BE CONSIDERED BY STATE OFFICIALS AS A COMBINED SINGLE INSTITUTION, SINCE OTHERWISE THERE WOULD APPEAR TO BE NO AUTHORITY FOR THE "TRANSFER" OF COMMITTED VETERANS FROM THE HOSPITAL TO THE HOME UNDER SECTION 49-605 OF THE GEORGIA CODE.

YOUR LETTER CONTINUES IN PART AS FOLLOWS:

A COPY OF THE AGREEMENT DATED JULY 9, 1957, BETWEEN THE VETERANS HOME COMMISSION OF GEORGIA AND THE GEORGIA DEPARTMENT OF PUBLIC WELFARE ESTABLISHING THE RATE OF $3.50 PER DAY FOR EACH ELIGIBLE VETERAN CARED FOR IN THE HOME WAS PREVIOUSLY FURNISHED YOUR OFFICE. HOWEVER, THE DATA OBTAINED BY THE INTERNAL AUDIT AND SURVEY CONCERNING THE ACTUAL PER DIEM COST OF THE OPERATION OF THE HOME RAISES THE FURTHER QUESTION WHETHER THE STATE INTERAGENCY CONTRACT RATE MAY BE ACCEPTED AS THE BASIS FOR COMPUTING FEDERAL AID PAYMENTS TO THE GEORGIA STATE WAR VETERANS' HOME.

GENERALLY, THE LATER OF THE TWO REPORTS ENCLOSED WITH YOUR LETTER, I.E., THE SURVEY REPORT DATED FEBRUARY 1, 1960, COVERING THE SURVEY CONDUCTED FROM NOVEMBER 30 TO DECEMBER 3, 1959, DOES NOT DIFFER MATERIALLY IN MANY RESPECTS FROM THE SURVEY REPORT (DATED AUGUST 26, 1957) CONSIDERED BY US IN CONNECTION WITH OUR LETTER OF NOVEMBER 18, 1957, TO YOU, WHEREIN WE STATED THAT:

IN OUR LETTERS OF OCTOBER 13, 1955, FEBRUARY 24, AND APRIL 26, 1956, B- 125206, WE STATED OUR VIEW TO BE THAT FEDERAL AID UNDER THE 1888 ACT IS AUTHORIZED TO STATE INSTITUTIONS FURNISHING PRIMARILY DOMICILIARY CARE FOR THE DISABLED ELIGIBLE VETERANS, THAT IS, SHELTER, FOOD AND CLOTHING AND INCIDENTAL MEDICAL CARE BUT NOT TO INSTITUTIONS FURNISHING PRIMARILY HOSPITAL CARE OR TREATMENT--- HOWEVER SUCH INSTITUTIONS MAY BE DENOMINATED BY THE STATE. WE ALSO EXPRESSED THE VIEW THAT THE FACT THAT THE DISABLED VETERANS MAY BE IN AN INSTITUTION BY COMMITMENT RATHER THAN VOLUNTARILY IS NOT SIGNIFICANT IN DETERMINING WHETHER THE INSTITUTION IS A "HOME" WITHIN THE MEANING OF THE ACT AND THAT, AS YOUR ADMINISTRATION'S SURVEY REPORT DISCLOSED THAT THE FACILITY AT NORMAN, OKLAHOMA, IN EFFECT FURNISHED DOMICILIARY CARE TO THE VETERANS HOUSED THEREIN AND ONLY INCIDENTAL MEDICAL CARE, IT CONSTITUTED A HOME WITHIN THE MEANING OF THE 1888 ACT.

THE PRESENT SURVEY REPORT INDICATES THE MILLEDGEVILLE, GEORGIA, INSTITUTION ALSO FURNISHES PRIMARILY DOMICILIARY CARE, APPROXIMATELY 80 PERCENT OF THE INMATES RECEIVING ONLY SUCH CARE AND THAT THE REMAINING APPROXIMATELY 20 PERCENT ARE RECEIVING HOSPITAL CARE OR TREATMENT. THE SURVEY REPORT OTHERWISE INDICATES THE CONDITIONS ARE NOT SUBSTANTIALLY DIFFERENT FROM THOSE AT NORMAN. THEREFORE, OUR VIEW IS THAT THE MILLEDGEVILLE INSTITUTION ALSO MAY QUALIFY AS A HOME, AND IF YOU SO DETERMINE AND AUTHORIZE PAYMENTS ACCORDINGLY WE WILL INTERPOSE NO OBJECTION THERETO.

AS INDICATED IN YOUR LETTER, WE POINTED OUT IN 35 COMP. GEN. 583 THAT THE BUILDINGS USED AT THE VETERANS FACILITY, NORMAN, OKLAHOMA, WERE "ENTIRELY SEPARATED BY DISTANCE AND HIGH WIRE FENCE FROM THOSE OCCUPIED BY THE PATIENTS OF THE CENTRAL MEMORIAL HOSPITAL.' HOWEVER, THIS WAS ONLY ONE OF THE FACTORS CONSIDERED BY US IN REACHING THE CONCLUSIONS SET FORTH IN 35 COMP. GEN. 583. THE SURVEY REPORT ENCLOSED WITH YOUR PRESENT LETTER DISCLOSES THAT THE GEORGIA STATE WAR VETERANS' HOME IS A SEPARATE BUILDING (THE CABINESS BUILDING) LOCATED ON THE GROUNDS OF THE MILLEDGEVILLE STATE HOSPITAL; THAT AT THE ENTRANCE OF THE GROUNDS THERE IS A SIGN INDICATING THAT BOTH STATE INSTITUTIONS ARE LOCATED ON THE GROUNDS; AND THAT A SIGN AT THE APPROACH TO, AND OVER THE CANOPY OF, THE CABINESS BUILDING INDICATES THAT THAT BUILDING IS THE GEORGIA STATE WAR VETERANS' HOME.

WE FIND NOTHING IN 38 U.S.C. 641-643, OR THE REPEALED 1888 ACT, AS AMENDED, OR THE AVAILABLE HISTORIES THEREOF, WHICH REQUIRES A PARTICULAR DEGREE OF PHYSICAL SEPARATION OF THE BUILDINGS OF A STATE WAR VETERANS' HOME FROM THE BUILDINGS OF OTHER STATE INSTITUTIONS. IN OUR OPINION, IT WOULD NOT BE UNUSUAL FOR A STATE, OR THE FEDERAL GOVERNMENT, TO HAVE TWO STATE AND TWO FEDERAL INSTITUTIONS, AS THE CASE MAY BE, IN SEPARATE BUILDINGS ON THE SAME GROUNDS. FURTHER, THERE IS NOTHING IN YOUR LETTER OR THE REPORTS ENCLOSED THEREWITH TO INDICATE THAT THE PHYSICAL SEPARATION OF THE BUILDINGS OF THE GEORGIA STATE WAR VETERANS' HOME AND THE BUILDINGS OF THE MILLEDGEVILLE STATE HOSPITAL IS ANY DIFFERENT NOW THAN IT WAS ON THE DATE OF OUR LETTER OF NOVEMBER 18, 1957, TO YOU, AND THE LETTER OF DECEMBER 4, 1957, FROM THE ADMINISTRATOR OF VETERANS' AFFAIRS TO US, WHEREIN HE, IN EFFECT, DETERMINED THAT THE GEORGIA STATE WAR VETERANS' HOME AT MILLEDGEVILLE MET THE REQUIREMENTS FOR FEDERAL-AID PAYMENTS.

ALSO, WHILE THE AUDIT AND SURVEY REPORTS MAY SHOW THERE IS NO PHYSICAL SEPARATION OF HOSPITAL AND HOME PATIENTS AMONG THE RESIDENTS OF THE GEORGIA STATE WAR VETERANS' HOME, THE SURVEY REPORT DISCLOSES THAT---

AT THIS MEETING IT WAS DEVELOPED THAT THE MILLEDGEVILLE STATE HOSPITAL IS UNDER THE JURISDICTION OF THE DEPARTMENT OF PUBLIC HEALTH AND THAT THE GEORGIA WAR VETERANS' HOME IS UNDER THE JURISDICTION OF THE VETERANS' HOME COMMISSION. SEPARATE APPROPRIATIONS ARE MADE BY THE STATE LEGISLATURE FOR THE OPERATION OF THE MILLEDGEVILLE STATE HOSPITAL AND FOR THE OPERATION OF THE GEORGIA STATE WAR VETERANS' HOME. SEPARATE BUDGET ESTIMATES ARE PREPARED FOR THE OPERATION OF THE MILLEDGEVILLE STATE HOSPITAL AND FOR THE OPERATION OF THE GEORGIA STATE WAR VETERANS' HOME. THE BUDGET ESTIMATE FOR THE OPERATION OF THE MILLEDGEVILLE STATE HOSPITAL IS SUBMITTED BY THE SUPERINTENDENT OF THE MILLEDGEVILLE STATE HOSPITAL. COST OF CARE AND MAINTENANCE FOR PATIENTS OF MILLEDGEVILLE STATE HOSPITAL AND FOR NON- FEDERAL AID CASES IN THE GEORGIA WAR VETERANS' HOME ARE INCLUDED IN THE HOSPITAL BUDGET. THE BUDGET ESTIMATE FOR THE GEORGIA STATE WAR VETERANS' HOME IS SUBMITTED BY THE VETERANS' HOME COMMISSION. COST OF CARE AND MAINTENANCE FOR THAT PORTION OF THE POPULATION IN THE HOME ELIGIBLE FOR FEDERAL AID PAYMENTS IS INCLUDED IN THE PART OF THE BUDGET FOR THE HOME PREPARED BY THE VETERANS' HOME COMMISSION.

THE EMPLOYEES ON THE DEPARTMENT OF VETERANS' SERVICE PAYROLL ALSO PERFORM DUTIES IN CONNECTION WITH THE FUNCTIONS OF THE COUNTY SERVICE OFFICE. THE DATE OF THE SURVEY THERE WERE 226 VETERANS IN THE GEORGIA STATE WAR VETERANS' HOME. OF THIS NUMBER 152 WERE ELIGIBLE FOR FEDERAL AID AND 74 WERE NOT ELIGIBLE FOR FEDERAL AID. IN THE MILLEDGEVILLE STATE HOSPITAL THERE WERE 234 VETERAN-PATIENTS. THE 74 INELIGIBLE VETERANS IN THE GEORGIA STATE WAR VETERANS' HOME FOR THE MOST PART WERE VETERANS WITH PEACETIME SERVICE. THE 74 INELIGIBLE VETERANS WERE NOT MAINTAINED IN THE GEORGIA STATE WAR VETERANS' HOME AT THE EXPENSE OF THE HOME, BUT WERE INCLUDED WITH THE PATIENTS OF THE MILLEDGEVILLE STATE HOSPITAL IN THE BUDGET ESTIMATES FOR FUNDS FOR THE OPERATION OF THE MILLEDGEVILLE STATE HOSPITAL. A QUESTION IS RAISED AS TO WHETHER THE INCLUSION OF THESE PATIENTS OF THE MILLEDGEVILLE STATE HOSPITAL WITH RESIDENTS OF THE GEORGIA STATE WAR VETERANS' HOME PREVENTS A "PHYSICAL SEPARATION" OF THE MILLEDGEVILLE STATE HOSPITAL AND THE GEORGIA STATE WAR VETERANS' HOME.

IN OUR OPINION THE USE OF THE GEORGIA STATE WAR VETERANS' HOME TO HOUSE SOME VETERANS LISTED AS PATIENTS OF THE HOSPITAL, AT THE EXPENSE OF THE STATE, IS AN INTERNAL MATTER AND DOES NOT NECESSARILY PRECLUDE THE VETERANS' FACILITY FROM BEING CONSIDERED A "1HOME" WITHIN THE MEANING OF 38 U.S.C. 101 (19). THE ABOVE-QUOTED MATERIAL FROM THE SURVEY REPORT INDICATES THAT THOSE VETERANS IN THE HOME NOT ELIGIBLE FOR FEDERAL AID MAY HAVE BEEN LISTED AS PATIENTS OF THE HOSPITAL FOR BUDGETARY REASONS.

FURTHERMORE, THE LANGUAGE OF THE GEORGIA STATUTE, QUOTED IN YOUR LETTER AND QUOTED ABOVE, DOES NOT REQUIRE THE CONCLUSION THAT THE HOME AND HOSPITAL ARE ONE INSTITUTION. IT IS ONLY FOR THE PURPOSE OF SECURING TREATMENT OR HOSPITALIZATION THAT THE "ADJACENT FACILITIES" OF THE MILLEDGEVILLE STATE HOSPITAL ARE ESTABLISHED AS AN INTEGRAL PART OF THE GEORGIA STATE WAR VETERANS' HOME. IN OUR OPINION OF THE HOME AND HOSPITAL WERE CONSIDERED TO BE A SINGLE INSTITUTION BY THE STATE THERE WOULD HAVE BEEN NO NECESSITY FOR THE ABOVE-QUOTED STATUTORY PROVISION. ALSO, THE TRANSFERRING OF COMMITTED VETERANS FROM THE HOSPITAL TO THE HOME DOES NOT NECESSARILY REQUIRE THE CONCLUSION THAT THE STATE OF GEORGIA CONSIDERS THE HOME AND HOSPITAL AS A COMBINED SINGLE INSTITUTION. THIS AGAIN APPEARS TO BE AN INTERNAL MATTER AND, AS INDICATED IN YOUR LETTER, THE MATTER OF COMMITMENT IS A STATE PROBLEM SUBJECT ONLY TO THE REQUIREMENT THAT THE ESSENTIAL NATURE OF THE HOME BE NOT THEREBY MATERIALLY ALTERED. THE SURVEY REPORT DISCLOSES THAT A DETERMINATION HAS BEEN MADE BY THE DEPARTMENT OF MEDICINE AND SURGERY, VETERANS ADMINISTRATION, THAT THE VETERANS IN THE HOME ARE PRIMARILY RECEIVING "1DOMICILIARY CARE.' THUS, THE TRANSFER OF THE COMMITTED VETERANS FROM THE HOSPITAL TO THE HOUSE HAS NOT MATERIALLY ALTERED THE ESSENTIAL NATURE OF THE HOME.

THE QUESTION OF ELIGIBILITY FOR FEDERAL-AID PAYMENTS UNDER 38 U.S.C. 101 (19), 641, 642 AND 643, IS A MATTER PRIMARILY FOR DETERMINATION BY THE ADMINISTRATOR OF VETERANS' AFFAIRS. IN THE LIGHT OF THE FOREGOING WE WILL INTERPOSE NO OBJECTION IF YOU CONTINUE TO RECOGNIZE THE GEORGIA STATE WAR VETERANS' HOME AT MILLEDGEVILLE, GEORGIA, AS A "HOME" WITHIN THE MEANING OF THAT TERM AS DEFINED IN 38 U.S.C. 101 (19), SO AS TO QUALIFY THE STATE OF GEORGIA TO RECEIVE FEDERAL AID FOR ELIGIBLE VETERANS MAINTAINED IN THAT HOME.

AS TO THE BASIS FOR COMPUTING FEDERAL-AID PAYMENTS TO THE GEORGIA STATE WAR VETERANS' HOME, 38 U.S.C. 641, AS AMENDED BY PUBLIC LAW 86 625, 74 STAT. 424, LIMITS THE FEDERAL-AID PAYMENT TO A STATE FOR A VETERAN IN A STATE HOME TO "ONE-HALF OF THE COST OF SUCH VETERANS' MAINTENANCE IN SUCH STATE HOME," UP TO A MAXIMUM OF $2.50 PER DAY FOR EACH ELIGIBLE VETERAN. THEREFORE, IT IS OUR VIEW THAT THE DETERMINATION OF THE GOVERNMENT'S SHARE OF THE COST MUST BE BASED ON THE ACTUAL COST ATTRIBUTABLE TO THE OPERATION OF THE STATE HOME INVOLVED, RATHER THAN SOME OTHER AMOUNT ARBITRARILY DESIGNATED AS "COST.' ACCORDINGLY, A STATE INTERAGENCY CONTRACT RATE NOT BASED ON "ACTUAL COST" MAY NOT BE ACCEPTED AS THE BASIS FOR COMPUTING FEDERAL AID PAYMENTS TO THE GEORGIA STATE WAR VETERANS' HOME. CONCERNING PARAGRAPH 13 OF THE SURVEY REPORT, WE BELIEVE THAT THE TOTAL ALLOWABLE COST SHOULD NOT INCLUDE THAT PART OF THE SALARIES OF STATE EMPLOYEES LOCATED AT THE STATE HOMESITE ATTRIBUTABLE TO THE PERFORMANCE OF ROUTINE FUNCTIONS SIMILAR TO THOSE PERFORMED BY OFFICERS OF SERVICE ORGANIZATIONS. WE UNDERSTAND THAT THE VETERANS ADMINISTRATION DOES NOT PAY SALARIES OF EITHER NATIONAL OR STATE SERVICE ORGANIZATION EMPLOYEES.