CONTENTS S. 1228: To authorize project grants for construction and modernization of hospitals and other medical facilities in the District of Columbia.......... Bucher, William M., executive director of the Hospital Council of the National Capital Area, Inc----- Burleigh, William, Assistant Director, Division of Hospital and 23 53 Ferrer, Dr. Reinaldo A., Associate Director for Medical Care, District of Columbia Department of Public Health.. Grant, Dr. Murray, Director, District of Columbia Department of Hahn, Gilbert, Jr., President of the Board of Trustees, Washington Loughery, Richard M., Administrator, Washington Hospital Center.. Mintener, Bradshaw, president of the Hospital Council of the National Moyer, Thomas F., Assistant Corporation Counsel for the District of Peterson, Dr. Paul Q., Director, Bureau of Health Services, U.S. LETTERS, REPORTS, EXHIBITS, AND MEMORANDUMS District of Columbia General Hospital: Annual Report of the Associate Director for Hospitals concerning "Problems, Needs, Goals, and Recommendations of the Medical Divisions of the District of Columbia General Hospital," a position paper prepared by the directors of the Georgetown, George Wash- Duncan, Hon. John B., D.C. Board of Commissioners, letter dated August 28, 1967 to Hon. Wayne Morse, subcommittee chairman, in reply to questions pertaining to health problems and D.C. General Hospital---- Federation of Citizens Associations of the District of Columbia, Dr. Edward A. Kane, chairman, health committee, resolution approved June 8, 1967, Government of the District of Columbia: Department of Public Health, Dr. Murray Grant, Director, letter dated June 13, 1967, to Hon. Wayne Morse with enclosed outline of financial requirements of the District of Columbia Department of Public Health Advisory Council, Lorin E. Kerr, M.D., chairman, letter dated May 2, 1967, to Hon. Alan Bible recommending enact- ment of S. 1228, with attached letter from Mr. Watson Rulon, Jr., vice chairman, Public Health Advisory Council for the District of Tobriner, Hon. Walter N., President, District of Columbia Board of Letter dated February 15, 1967, to the President requesting intro- Letter dated August 22, 1967, to Hon. Wayne Morse commenting on the proposed amendments to S. 1228 presented by Dr. Peterson, deputy director, Bureau of Health Services, U.S. Health Facilities Planning Council for Metropolitan Washington, D.C., "Hospital Halts Lab Purchases in Fund Crisis-Officials DISTRICT OF COLUMBIA HOSPITAL AND HEALTH FACILITY CONSTRUCTION AND MODERNIZATION MONDAY, AUGUST 21, 1967 U.S. SENATE, SUBCOMMITTEE ON PUBLIC HEALTH, EDUCATION, WELFARE, AND SAFETY OF THE COMMITTEE ON THE DISTRICT OF COLUMBIA, Washington, D.C. The subcommittee met, pursuant to notice, at 10:32 a.m. in room 6226, New Senate Office Building, Senator Wayne Morse (chairman of the subcommittee) presiding. Present: Senators Morse (presiding), and Kennedy of New York. Also present: Richard E. Judd, professional staff member; Owen J. Malone, associate counsel; James S. Medill, assistant counsel; and Howard A. Abrahams, assistant counsel. Senator MORSE. The hearing will come to order. We will proceed with our first bill this morning, S. 1228, to provide financial assistance for the modernization of public and nonprofit hospitals and for construction and modernization of other health facilities in the District of Columbia. There should be inserted in the record at this point a copy of the bill; a copy of the staff memorandum analyzing the bill; a letter from the Honorable Walter N. Tobriner, president of the District of CoJumbia Board of Commissioners, dated February 15, 1967, requesting the introduction of S. 1228; a letter from Mr. William T. Hannan, Chairman of the Board, Health Facilities Planning Council for Metropolitan Washington, dated May 16, 1967, recommending enactment of S. 1228; a letter from Hon. Wilbur J. Cohen, Under Secretary, Department of Health, Education, and Welfare, dated August 18, 1967, recommending enactment of S. 1228 with certain minor amendments; a resolution submitted by Dr. Edward A. Kane, chairman, Health Committee, Federation of Citizens Association of the District of Columbia, approved June 8, 1967, recommending enactment of S. 1228; a letter of Dr. Lorin E. Kerr, chairman, Public Health Advisory Council for the District of Columbia dated May 2, 1967, recommending enactment of S. 1228, and attached letter from Mr. Watson Rulon, Jr., chairman, Public Health Advisory Council for the District of Columbia, dated June 1, 1966. (The letters and documents referred to follow :) [S. 1228, 90th Cong., first sess.] A BILL To authorize project grants for construction and modernization of hospitals and other medical facilities in the District of Columbia Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "District of Columbia Medical Facilities Construction Act of 1967" AUTHORIZATION OF APPROPRIATIONS SEC. 2. There are authorized to be appropriated for the fiscal year ending June 30, 1967, and for each of the next three fiscal years, such sums as may be necessary to enable the Secretary of the Department of Health, Education, and Welfare (hereafter referred to as the Secretary), to make grants to assist in the modernization of public or nonprofit private hospitals and in the construetion or modernization of public health centers, long-term care facilities, diagnostic or treatment centers, rehabilitation facilities, facilities for the mentally retarded, and community mental health centers in the District of Columbia. Sums so appropriated shall remain available until expended. APPROVAL OF APPLICATIONS SEC. 3. (a) An application for a grant with respect to any project may be approved by the Secretary under this Act only if an application for a grant with respect to such project has been filed under the Medical Facilities Acts (which for purposes of this Act means title VI of the Public Health Service Act or, where appropriate, title II or part C of title I of the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963) and (1) has been approved under the Medical Facilities Act and the application filed under this Act is for additional funds in connection herewith, or (2) has been denied under the Medical Facilities Acts because insufficient funds are available from the allotment of the District of Columbia under such Acts to permit approval of the application. In determining whether to approve an application for a grant with respect to any project in the District of Columbia under the Medical Facilities Acts, the availability of additional funds for such project under this Act shall be taken into consideration; and, in any such case, approval under the Medical Facilities Acts may be made contingent upon the approval of an application with respect to such project under this Act and upon such additional funds being made so available. (b) The Secretary shall establish criteria for determining the order in which to approve, under this Act, applications for grants with respect to projects. Such criteria with respect to construction projects for the same type of facility (or for modernization projects) shall be the criteria developed by the State agency of the District of Columbia pursuant to the State plan approved under the Medical Facilities Acts. (c) In the case of any project with respect to which an application for a grant is filed under this Act and with respect to which an application for a grant has been denied under the Medical Facilities Acts, such application under this Act may be approved only if there is compliance with the same terms and conditions (including determination, in accordance with the applicable State plan, that the project is needed) as are applicable to applications for grants under the Medical Facilities Acts, other than the availability of sufficient funds in the appropriate allotment of the District of Columbia. (d) An application for a grant under this Act with respect to any project may not be approved unless an opportunity to review the application has been afforded to a body, found by the Secretary to be a responsible metropolitan area wide planning body, and any recommendations of such body that were timely made have been considered by the appropriate State agency of the District of Columbia and have been submitted to the Surgeon General in connection with the application. PAYMENTS SEC. 4. (a) Payments under this Act with respect to any project shall be made in the manner provided under the Medical Facilities Acts for payment of the Federal share of the cost of projects for which applications are approved under such Acts; except that such payments shall also be subject to such reasonable conditions as the Secretary deems appropriate to safeguard the Federal interest. (b) The total of the poyments made under this Act with respect to any project, together with any payments with respect thereto under the Medical Facilities Acts, may not exceed (1) in the case of a construction project for a long-term care facility, a diagnostic or treatment center, or a rehabilitation facility, 66% per centum of the cost of such project; and (2) in the case of any other project (including a modernization project), 50 per centum of the cost of such project. RECOVERY OF PAYMENTS SEC. 5. Payments under this Act shall be subject to recovery or recapture under the same conditions and to the same extent as is provided under the Medical Facilities Acts with respect to payments made thereunder. MEANING OF TERMS SEC. 6. The terms used in this Act shall have the same meaning as when used in the Medical Facilities Acts. U.S. SENATE, COMMITTEE ON THE DISTRICT OF COLUMBIA, Memorandum to members of the Public Health, Education, Welfare, and Safety Re: S. 1228, to authorize project grants for construction and modernization of hospitals and other medical facilities in the District of Columbia. Date of hearing: Monday, August 21, 1967, at 10:30 A.M. The purpose of the bill is to authorize Federal assistance for the District of Columbia, supplementary to that now available under various programs provided by the Public Health Service Act, including the Hill-Burton program and the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 for modernization of public or non-profit, private hospitals and the construction of public health centers, long-term care facilities, diagnostic or treatment centers, rehabilitation facilities, facilities for the mentally retarded, and community mental health centers. Section 2 of the bill authorizes the appropriation for four fiscal years of sums as may be necessary to carry out the program. Section 3(a) authorizes the Surgeon General of the Public Health Service to make grants to assist in the contstruction and modernization of hospitals and other medical facilities in the District if an application, with respect to the project, has ben denied under the Hill-Burton program or other Federal programs, because of insufficient funds allotted to the District or if it has been approved under those programs in an amount less than required for the project. Section 3 (b) directs the Surgeon General to establish criteria for the order of approval of applications which shall be the same criteria as those developed by the District of Columbia "state agency," pursuant to a plan approved under the Medical Facilities Act. Section 3(c) provides that applications for grants under the bill may be approved only if they comply with the terms and conditions for applications under the Medical Facilities Act, other than the availability of sufficient funds. Section 4(b) of the bill specifies that total payments, together with payments under the Medical Facilities Act, may not exceed 66% percent of the cost of a long-term care facility, diagnostic or treatment center, or a rehabilitation facility; or 50 percent of the cost of any other projects. Private, non-profit, medical facilities in the District have been unable to take full advantage of existing Federal programs for two reasons. First, sponsors of projects for such construction in the District of Columbia experience serious difficulty in raising the non-Federal share of the cost thereof. Second, the allotment of funds, which is based on per capita income and population, to the District is low in relationship to the health facility construction problem. The need for this legislation is accentuated with the coming of the Medicare program, which is expected to increase the demand for hospital beds. The problem |