A-5773, JANUARY 5, 1925, 4 COMP. GEN. 586

A-5773, JANUARY 5, 1925, 4 COMP. GEN. 586

MEDICAL TREATMENT IN CONTRACT HOSPITALS - VETERANS OF SPANISH-AMERICAN WAR, PHILIPPINE INSURRECTION, AND BOXER REBELLION CONTRACT HOSPITALS ARE NOT "UNDER THE CONTROL AND JURISDICTION" OF THE VETERANS' BUREAU WITHIN THE MEANING OF PARAGRAPH 10, SECTION 202 OF THE WORLD WAR VETERANS' ACT OF JUNE 7, 1924, 43 STAT. 620, AND MAY NOT GENERALLY BE USED FOR THE HOSPITAL TREATMENT OF HONORABLY DISCHARGED VETERANS OF THE SPANISH-AMERICAN WAR, THE PHILLIPINE INSURRECTION, AND THE BOXER REBELLION SUFFERING FROM CERTAIN SPECIFIED DISEASES, BUT IN THOSE JURISDICTIONS OUTSIDE THE UNITED STATES WHERE NONE BUT CONTRACT HOSPITAL FACILITIES ARE AVAILABLE FOR THE TREATMENT OF THE MAIN BODY OF BENEFICIARIES OF THE BUREAU, SUCH VETERANS MAY BE TREATED THEREIN AS AN EXCEPTIONAL ACTION.

DECISION BY COMPTROLLER GENERAL MCCARL, JANUARY 5, 1925:

THERE IS FOR CONSIDERATION AND DECISION THE QUESTION AS TO WHETHER UNDER THE PROVISIONS OF LAW THAT AUTHORIZE THE HOSPITALIZATION AND TREATMENT OF BENEFICIARIES OF THE UNITED STATES VETERANS' BUREAU, THE HOSPITALIZATION AND TREATMENT OF VETERANS OF THE SPANISH-AMERICAN WAR, THE PHILIPPINE INSURRECTION, AND THE BOXER REBELLION, SUFFERING FROM NEUROPSYCHIATRIC AND TUBERCULAR AILMENTS AND DISEASES SPECIFIED IN THE LAW, PAYMENT IS AUTHORIZED FOR TREATMENT FURNISHED SPANISH-AMERICAN WAR VETERANS IN PRIVATE HOSPITALS UNDER CONTRACT WITH VETERANS' BUREAU.

THE PARTICULAR CASE NOW INVOLVED IS THAT OF A PAYMENT MADE TO THE PHILIPPINE ISLANDS ANTI-TUBERCULOSIS SOCIETY FOR HOSPITALIZING AND TREATING TWO VETERANS OF THE SPANISH-AMERICAN WAR UNDER CONTRACT OF DECEMBER 6, 1923, WHO WERE ADMITTED TO THAT HOSPITAL ON JUNE 30, 1924.

THE FIRST PROVISION OF LAW THAT WAS ENACTED, MAKING AVAILABLE THE HOSPITAL FACILITIES OF THE VETERANS' BUREAU TO THE VETERANS OF THE SPANISH -AMERICAN WAR, WAS SECTION 4 OF THE ACT OF APRIL 20, 1922, 42 STAT. WHICH PROVIDES:

THAT ALL HOSPITAL FACILITIES UNDER THE CONTROL AND JURISDICTION OF THE UNITED STATES VETERANS' BUREAU SHALL BE AVAILABLE FOR VETERANS OF THE SPANISH-AMERICAN WAR, THE PHILIPPINE INSURRECTION, AND THE BOXER REBELLION, SUFFERING FROM NEUROPSYCHIATRIC AND TUBERCULAR AILMENTS AND DISEASES.

AFTER DECISION OF THIS OFFICE OF SEPTEMBER 30, 1922, 2 COMP. GEN. 251,HOLDING, AMONG OTHER THINGS, THAT NEITHER THIS LAW NOR THE ACT MAKING APPROPRIATIONS FOR CARRYING OUT ITS PROVISIONS AUTHORIZED THE PAYMENT OF ANY EXPENSES FOR TRANSPORTATION OF SUCH VETERANS TO AND FROM SUCH HOSPITALS, THE LAW WAS AMENDED BY SECTION 4 OF THE ACT OF MARCH 4, 1923, 42 STAT. 1524, BY ADDING THERETO THE PHRASE "INCLUDING TRANSPORTATION AS GRANTED TO THOSE RECEIVING COMPENSATION AND HOSPITALIZATION UNDER THE WAR RISK INSURANCE ACT.'

AS REENACTED AS PARAGRAPH 10, SECTION 202, OF THE WORLD WAR VETERANS' ACT OF JUNE 7, 1924, 43 STAT. 620, THIS PROVISION NOW READS:

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 AILMENTS OR DISEASES ARE DUE TO MILITARY SERVICE OR OTHERWISE, INCLUDING TRAVELING EXPENSES AS GRANTED TO THOSE RECEIVING COMPENSATION AND HOSPITALIZATION UNDER THIS ACT. * * *

SECTION 9 OF THE ACT OF AUGUST 9, 1921, 42 STAT. 149, IMPOSED UPON THE DIRECTOR OF THE VETERANS' BUREAU THE DUTY AND RESPONSIBILITY OF PROVIDING HOSPITALIZATION AND MEDICAL TREATMENT TO BENEFICIARIES OF THE BUREAU, AND AUTHORIZED HIM TO UTILIZE FOR THAT PURPOSE THE THEN EXISTING AND FUTURE FACILITIES OF THE PUBLIC HEALTH SERVICE, THE WAR, NAVY, AND INTERIOR DEPARTMENTS, THE NATIONAL HOME FOR DISABLED VOLUNTEER SOLDIERS, AND SUCH OTHER GOVERNMENT FACILITIES AS MIGHT BE MADE AVAILABLE FOR THE PURPOSES OF THAT ACT. HE WAS FURTHER AUTHORIZED TO SECURE ADDITIONAL HOSPITAL FACILITIES WHEN NECESSARY AND IT WAS PROVIDED THAT:

IN THE EVENT GOVERNMENT HOSPITAL FACILITIES AND OTHER FACILITIES ARE NOT THUS AVAILABLE OR ARE NOT SUFFICIENT, THE DIRECTOR MAY CONTRACT WITH STATE, MUNICIPAL, OR PRIVATE HOSPITALS FOR SUCH MEDICAL, SURGICAL, AND HOSPITAL SERVICES AND SUPPLIES AS MAY BE REQUIRED * * *.

THIS PROVISION WAS REENACTED IN THE WORLD WAR VETERANS' ACT, SUPRA, IN THE IDENTICAL LANGUAGE QUOTED. SEE SECTION 10, ACT OF JUNE 7, 1924, 43 STAT. 610.

SECTION 9111 OF THE REGULATIONS OF THE UNITED STATES VETERANS' BUREAU PROMULGATED MAY 8, 1923, CANCELING AND SUPERSEDING REGULATIONS OF OCTOBER 10, 1922, IS AS FOLLOWS:

VETERANS OF THE SPANISH-AMERICAN WAR, PHILIPPINE INSURRECTION, AND BOXER REBELLION, EXCEPT THOSE PERSONS WHOSE DISCHARGE FROM THE SERVICE WAS DISHONORABLE, MAY RECEIVE TREATMENT AT HOSPITALS UNDER THE CONTROL AND JURISDICTION OF THE UNITED STATES VETERANS' BUREAU FOR NEUROPSYCHIATRIC AND TUBERCULOUS AILMENTS AND DISEASES. NO TREATMENT SHALL BE GIVEN IN CONTRACT HOSPITALS.

THIS REGULATION, IN SO FAR AS THE TREATMENT IN CONTRACT HOSPITALS IN THE PHILIPPINE ISLANDS OF THE VETERANS OF THE PARTICULAR WARS NAMED IS CONCERNED, WAS MODIFIED BY THE DIRECTOR OF THE VETERANS' BUREAU APRIL 2, 1924, IN VIEW OF THE FACT THAT GOVERNMENT FACILITIES FOR THE TREATMENT OF THE SPECIFIED DISEASES WERE NOT AVAILABLE IN THOSE ISLANDS.

THE LAW MAKES THE HOSPITAL FACILITIES "UNDER THE CONTROL AND JURISDICTION" OF THE BUREAU AVAILABLE FOR THE CLASS OF VETERANS IN QUESTION. THERE ARE, BROADLY, TWO CLASSES OF HOSPITAL FACILITIES USED BY THE BUREAU--- THE NORMAL ONE OF "CONTROL AND JURISDICTION," WHERE THE OPERATION, INCLUDING OWNERSHIP OR RENTAL OF THE HOSPITAL, IS WHOLLY WITH THE GOVERNMENT; THE OTHER, THE EXCEPTIONAL ONE WHERE THE HOSPITAL FACILITIES ARE OBTAINED BY THE BUREAU BY CONTRACT ON THE BASIS OF RATES FOR A SPECIFIED NUMBER OF PATIENTS OR BEDS. IN THIS LATTER CLASS TRUE ,CONTROL AND JURISDICTION" OF THE HOSPITAL FACILITIES IS NOT IN FACT WITH THE BUREAU OR GOVERNMENT AUTHORITIES, BUT WITH THE PRIVATE AUTHORITIES. HAVING THIS IN MIND, A CONCLUSION MIGHT WELL BE REACHED THAT THE LAW INTENDED IN ITS SPECIFICATION OF "CONTROL AND JURISDICTION," THE HOSPITAL FACILITIES WHERE OPERATION WAS WITH THE GOVERNMENT. IT MUST UNDOUBTEDLY BE CONCLUDED THAT THE LAW GIVES NO AUTHORITY TO INCREASE OR OBTAIN HOSPITAL FACILITIES BY CONTRACT OR OTHERWISE FOR THE PURPOSE OF FURNISHING SUCH TREATMENT OF THE CLASS OF VETERANS IN QUESTION. THERE MAY BE A CONDITION, AS APPEARS TO BE THE INSTANT CASE, AND PARTICULARLY OUTSIDE OF THE UNITED STATES, OF ONLY CONTRACT HOSPITAL FACILITIES FOR THE MAIN BENEFICIARIES OF THE BUREAU INTO WHICH MAY BE PLACED ONE OF THE CLASS IN QUESTION AS AN EXCEPTIONAL ACTION AND NOT AS PROVIDING OR A USE GENERALLY OF SUCH FACILITIES FOR SUCH CLASS.

THE TREATMENT IN THE CONTRACT HOSPITALS IN THE PHILIPPINE ISLANDS BEING SO UNDERSTOOD, PAYMENT IS AUTHORIZED ACCORDINGLY.