NOT FOR RELEASE UNTIL AUTHORIZED BY THE COMMITTEE MEMORANDUM FOR THE CHAIRMAN Re: Medical Care Programs of the March 1, 1973 By directive dated October 14, 1972, the Committee requested that a study be made of the management of the medical care programs of the Veterans Administration, and implementation of work load and patient care standards as specified in the Appropriations Act. The study has been completed and the results are included in this report. I. INTRODUCTION A. Directive By directive dated October 14, 1972, the Committee requested that a study be made of the management of the medical care programs of the Veterans Administration (VA), and implementation of work load and patient care standards as specified in the Appropriations Act. The Committee requested that particular attention be directed to the number of operating beds, average daily patient census, and staff/patient ratios necessary for the system to provide necessary medical care for eligible veterans. B. Scope of Inquiry At Washington, D. C., the Investigative Staff interviewed appropriate officials of the VA Central Office and examined pertinent files, records, statutes, regulations, statistical data, and special studies. The Investigative Staff visited VA hospitals at Richmond, Virginia; Cincinnati, Ohio, Dayton, Ohio, Chillicothe, Ohio; Bay Pines, Florida; Tampa, Florida; San Francisco, California, Palo Alto, California, Martinez, California; Livermore, California; Boston, Massachusetts, Bedford, Massachusetts, Brockton, Massachusetts; West Roxbury, Massachusetts, and the VA outpatient clinic at St. Petersburg, Florida. At these locations, interviews were conducted with hospital officials, nurses, attendants, and patients, and pertinent records were reviewed. C. Background The VA is responsible for providing medical treatment and care to eligible veterans as authorized by law (Title 38, U.S. Code). The principal medical care programs of the VA provide for maintenance and operation of VA hospitals, nursing homes, domiciliaries, and outpatient clinics, for furnishing inpatient and outpatient care and treatment to eligible veterans; and care of veterans in contract hospital and nursing home facilities not under the jurisdiction of the VA. There were also programs for training health-science personnel to increase the manpower supply in these scarce category fields, and aid to state or territorial homes for support of veterans eligible for care by the VA. The Department of Medicine and Surgery (DM&S) is one of three operating departments of the VA and is headed by a Chief Medical Director who is respon sible to the Administrator of Veterans Affairs for all VA medical programs. Currently, the VA operates 168 hospitals, 18 domiciliaries, 80 nursing home units, and 205 outpatient clinics. The FY 1973 Appropriations Act (Public Law 92-383) contained a special provision in the VA medical care appropriation pertaining to VA hospitals which stated: "...That the foregoing appropriation shall not be used to provide for less than an average of 98,500 operating beds, nor to furnish inpatient care and treatment to an average daily patient load of less than 85,500 beneficiaries, nor to provide an average staff/patient ratio of less than 1.49 to 1 in all Veterans Administration hospitals during the fiscal year 1973....* |