training desired. The report of this survey will be sent to the medical officer in charge, who, having determined the physical condition of the patient by examination, and recorded the findings in the case history, will return the survey to the training officer, by indorsement, expressing an opinion as to the general character and daily hours of work the patient is believed to be capable of performing. If the patient is to undertake training, Form 1973-E will be completed and indorsed " To the Federal Board for Vocational Education," and sent to the training officer with the survey. Form 1973-E will be completed as above directed and forwarded to the training officer on the 1st of each month thereafter, and no patient of a Public Health Service hospital may be given vocational training under the Federal Board for Vocational Education unless this form, properly completed and signed by the medical officer, for the current month is on file with the training officer having supervision of the training. The training officer of the Federal Board for Vocational Education to whom the patient is assigned for training will enter the specific kinds of work in which the patient is engaged and the number of hours employed daily, on Form 1973-D and Form 1973-E. Form 1973-D will be returned to the medical officer on the last day of each month, as directed by instructions for the use of these forms. Patients in Public Health Service Hospitals taking vocational training under the Federal Board for Vocational Education remain under the jurisdiction of the Public Health Service and while actually attending classes have the status of patients on pass." Each patient in a hospital of the service who is receiving vocational training under the Federal Board for Vocational Education, will be observed carefully each day, and if the physical or mental condition is in any way impaired by, or during the period of, such training, the training will be discontinued immediately and the training officer notified as to the cause and probable duration of the absence of the patient. The training will not be resumed until, in the opinion of the medical officer, the physical and mental condition of the patient is such as to justify continuance. Respectfully, RUPERT BLUE, Surgeon General Hospital Division Circular No. 41. VOCATIONAL TRAINING IN THE HOSPITALS OF THE SERVICE, TREASURY DEPARTMENT, Washington, March 6, 1920. To medical officers in charge United States Public Health Service, and others concerned: The Bureau of the Public Health Service and the Federal Board for Vocational Education have adopted a joint plan whereby beneficiaries of the Public Health Service, who are beneficiaries of the Federal Board, and whose mental and physical condition permits, may begin vocational training while in the hospitals of the service, in order that economic rehabilitation may go on simultaneously with physical restoration. In furtherance of this plan, under departmental authority dated December 22, 1919, medical officers in charge of stations of this service are authorized to assign space not required by the Public Health Service for school and shop purposes of the Federal Board for Vocational Education. Authority to furnish quarters and subsistence for instructors of the Federal Board for Vocational Educational at stations of the service may be granted by the Surgeon General upon recommendation of the medical officer in charge. Such quarters will not exceed one room for each instructor and will be furnished without cost, if available and desired, but no allowance in lieu thereof may be granted. The instructors so furnished quarters may not exceed approximately 5 per cent of the number of patients taking training under the Federal Board for Vocational Education. The cost of subsistence, if furnished, will be reimbursed to the proper service appropriation according to regulations. In accordance with the foregoing, the medical officers in charge will report as soon as practicable the amount of space which is available for the use of the Federal Board for Vocational Education. This space should be pleasant, well lighted, well ventilated, on the ground floor if possible, and equal to approximately 10 per cent of the bed space of the hospital. The space assigned and the instruction therein will be considered separate and apart from all other activities of the hospital except that it will be under the general supervision of the medical officer in charge, and will be inspected and maintained, as is other Government property on the reservation. As soon as these data are received the Federal Board for Vocational Education will be authorized by the Surgeon General to send representatives to such stations where conditions warrant to determine by survey the educational fitness of patients for training in the vocations desired. The medical officer in charge of the hospital will determine whether the physical and mental condition of the patient desiring training will permit such survey to be made or such training to be given the patient and otherwise comply with the instructions in Hospital Division Circular Letter No. 25, dated January 3, 1920. The Federal Board for Vocational Education will furnish the necessary instructors and equipment. These instructors while teaching in the hospitals wili be under the general administrative regulations of the Public Health Service and will, when requested, assist by advising in occupational therapy or in any way possible. The training instituted by the Federal Board for Vocational Education is educational and vocational in character, and should not be confused with occupational therapy which is an activity of this service and consists of diversional occupations for curative purposes. Patients will not be held in the hospitals of the service for training purposes after they are sufficiently recovered to warrant discharge. Full cooperation between the officers and personnel of the service and the representative of the Federal Board for Vocational Education is desired as tending to promote the welfare of the patients and the morale of the station. Respectfully, J. C. PERRY, Acting Surgeon General. FOLLOW-UP OBSERVATION AND CARE OF BENEFICIARIES OF THE FEDERAL BOARD FOR VOCATIONAL EDUCATION, TREASURY DEPARTMENT, To commissioned officers, acting assistant surgeons, and others concerned: 2. In each district there will be a vocational medical officer who, with his subordinate personnel, will operate in the office of, and under the direction of the district supervisor for the purpose of carrying out the provisions of these instructions, and who will act in the capacity of liaison officer between the district supervisor and the district medical officer of the board. The chief medical officer of the board will recommend or nominate a suitable physician for this position. 3. District supervisors are authorized to nominate and place on duty full or part time acting assistant surgeons, and to request of this bureau a detail of such nurses, at training centers of the Federal Board for Vocational Education as may be necessary to perform this work. Letters of nomination of acting assistant surgeons should show the nature of the work to be performed and the approximate numbtr of beneficiaries of the Federal board undergoing training. The district supervisor will confer with the district medical officer of the Federal Board for Vocational Education, who will be expected to assist the district supervisor in securing medical officers and to advise as to the number required at cities and towns where the board has men in training. He will also advise the district supervisor of the probable amount and nature of the work to be done, on which the district supervisor can determine and recommend appropriate compensation. Medical officers so appointed, or already on duty for this work, will be considered as constituting relief stations of the Public Health Service, and they will be under the administrative control of the district supervisor. 4. The duties of medical officers appointed under this provision, or already on duty for this work, will consist of (a) The inspection and report of the working and living conditions of the students, and the supervision of the work of the nurses. (b) The examination, at stated intervals, of all beneficiaries who have disabilities which render relapses or recurrences possible, and the rendering of reports on these examinations on forms issued by the board. (c) The care and treatment of beneficiaries of the board undergoing vocational training, who report themselves sick to the proper Federal board officer, and are properly referred to the medical officer. This includes providing medical care for such beneficiaries in training as are taken sick at their homes only until other arrangements, such as placing patient in hospital, can be made. The procedure necessary for carrying out this provision will be arranged between the Federal board officer and the medical officer on duty at the training centers. subject to the approval of the district supervisor and the district medical officer. (d) The examination, care, and treatment of other patients of the Public Health Service as may be necessary, complying with regulations and instructions governing same. (e) The rendering of reports on all examinations, care, and treatment of beneficiaries of the Federal board and other patients of the Public Health Service on Forms 1971-E and F, as prescribed by Hospital Division Circular No. 20 and subsequent instructions relating thereto. (f) The rendering of such other reports of all examinations made and the treatments given as shall be required by this bureau through the district supervisor. All reports shall be forwarded to the district supervisor, attention vocational medical officer. 5. A beneficiary in training may be entitled to examination, care, and treatment (a) As a claimant of the Bureau of War Risk Insurance, when the disease or disability was incurred in, or is incident to, military service, as stated in the war-risk insurance act, and when the provisions of this act have been complied with. (b) As a beneficiary of the Federal Board for Vocational Education, when the disease or disability was not incurred in, or is not incident to, military service, nor is due to his own willful misconduct, under the regulations of the Federal board. Medical officers will use reasonable care in determining the responsibility for any expense incident to the examination, care, and treatment, and forward such bills as are apparently chargeable to the Federal Board of Vocational Education, such as prescriptions, X-ray, ambulance, hospitalization, etc., to the district supervisor, attention vocational medical officer, without vouchering. 6. The district medical officer will furnish each month to the district supervisor a list of the men in training in each school or training station in his district compiled from statistical report of the board. The district medical officer will furnish to the medical officers on duty at training centers a brief of the medical history of each man needing follow-up observation, when so requested. 7. It is expected that unnecessary paper work will be omitted, and that district supervisors, district medical officers, and medical officers on duty at training centers will work together to see that reports are rendered on every man who needs observation, but that unnecessary reports will not be rendered on men who are not in need of observation. One report of physical examination will be made on each man in training on the prescribed form one month after training has commenced, or as soon thereafter as possible. Subsequent reports will be made at stated intervals only on men who have disabilities which render relapses or recurrences possible. All tuberculosis cases will be examined and reported on monthly. Other disabilities will be reported every 30, 60, or 90 days, as the case seems to require in the opinion of the medical officer or at the request of the district supervisor. Surgeon General. (Thereupon, at 12 o'clock noon, the committee took a recess until 2 o'clock p. m.) AFTER RECESS. The CHAIRMAN. The committee will please come to order. TESTIMONY OF MR. SAMUEL N. QUILLIN. (The witness was duly sworn by the chairman.) The CHAIRMAN. You may give your full name and you address to the stenographer. Mr. QUILLIN. Samuel N. Quillin, temporary address, Ventosa Apartment, Washington; home address, Indianapolis, Ind. The CHAIRMAN. Mr. Quillin, you are the auditor for the board, are you not? Mr. QUILLIN. Yes, sir. The CHAIRMAN. How long have you been there? Mr. QUILLIN. My official relations began August 1, 1919. The CHAIRMAN. That was after the rehabilitation work was entered upon? Mr. QUILLIN. Yes, sir; that was after the passage of the last law. The CHAIRMAN. You have been there ever since in the same position? Mr. QUILLIN. Yes, sir. The CHAIRMAN. There has been some question as to the payment of the bills of the board. Have you a statement of any sort to make? Mr. QUILLIN. I can make a general statement. The CHAIRMAN. It might be just as well for me to ask you some specific questions. Mr. QUILLIN. Yes; I would be glad if you would. The CHAIRMAN. There appeared before the committee a representative of the Columbia University and he stated he had difficulty in securing payment of the bills. Mr. QUILLIN. I will confess I have never heard any of the testi- EXHIBIT A.-Vouchers received at central office, Federal Board for Vocational EXHIBIT A.-Vouchers received at central office, Federal Board for Vocational Education, Washington, D. C., in favor of Columbia University, New York, N. Y.-Continued. This includes all vouchers received at central office in favor of Columbia University up to May 15, 1920. EXHIBIT B.-Vouchers received at central office, Federal Board for Vocational Education, Washington, D. C., in favor of Columbia University Extension Teaching, New York, N. Y. This includes all vouchers received at central office in favor of Columbia University Extension teaching up to May 18, 1920. EXHIBIT C.-Vouchers received at central office, Federal Board for Vocational Education, Washington, D. C., in favor of Columbia University Press Book Store, New York, N. Y. |