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General SHULER. I don't make many decisions, Mr. Chairman. They are made higher up.
ENLISTED MEN's BARRACKs CoMPLExES, FORT DIx, N.J.; FoET KNox, KY.; FoRT JACKson, S.C.; AND FoRT LEONARD WOOD, MO.
Senator STENNIs. After all, you adopted the pattern of the three battalions. I was about to say we could approve all this. I think we will have to weigh this against the Fort Riley pattern. You will make a go of that, if you get the money.
General SHULER. Yes, sir; but we will not have to tear this apart. It is not yet designed and site adapted.
Senator STENNIS. Is there anything else you wish to say on these?
General SHULER. Not on these.
Senator STENNIS. We will consider all your testimony applying to all four of these items.
General SHULER. Yes, sir.
Senator STENNIs. Thank you.
General SHULER. As I said before, Mr. Chairman, we have given the committee fairly complete backups and writeups. ... Senator STENNIS. We want a complete showing on that, because it is an important matter, it seems to me.
Installation: Fort Monroe, Va.
Item Budget House Restoration request action requested Conarc Headquarters----------------------------------------- $4,950,000 || –$4,950,000 $4,950, 000
REASONS FOR RESTORATION REQUEST
The importance of the Conarc mission in relation to the overall mission of the Army is a measure of the urgency of this project. The proper location for this headquarters has been carefully studied by DOD and the Army. After considering all logical available facilities, it has been determined that Fort Monroe is best suited for the purpose. Since no building or group of buildings exist that can be economically converted and obtain the required degree of operational efficiency for this headquarters, a new structure is necessary.
Reevaluation has confirmed that Fort Monroe is the most Suitable location for Conarc Headquarters and that the proposed structure is the most economical and feasible solution to the requirement. The estimate has been reaffirmed by the current 20-percent design status.
HEADQUARTERS ADMINISTRATION BUILDING, CoNTINENTAL ARMY COMMAND
General SHULER. The next item, sir, is tab C, which is the request for the headquarters building at the Continental Army Command. This item, sir, was authorized and was denied us in the House Appropriations Committee hearings. This is quite important to us, sir. Addressing myself to the contention of the House that we have not studied long and far enough on where this headquarters should be, I can reply, sir, we have made many, many studies over the last 4 or 5 years, and we have tried to get, this project up to the Congress a number of years but it was blocked coming up here by our making these studies. We could not get it out of the Pentagon or the Bureau of the Budget. But they are both sold on this now, that this is where it should be. It is a very inefficient plant the commanding general has to operate out of. He controls all the Continental Armies. He has all the equipment to maintain all over the 48 States. He supervises the training of the troops. The training centers and our diVisions are under the Continental Army general. It is an extremely important command. I think he deserves, sir, an efficient headquarters to operate from. He has a much worse headquarters than any of the Armies under him, much worse. . It is scattered over 20 buildings. We are very hopeful, having had this authorized this year, that we could convince the Congress on the appropriations. I certainly hope this committee can restore this project. Senator STENNIS. What was it the House said? General SHULER. They said we had not studied enough on where to but it, and also that the plans and specifications were only 5 percent. Now we are up to 20 percent. It is a headquarters-type facility. I don't foresee any trouble, sir, on our estimate. Senator STENNIS. The next item.
ENLISTED MEN's BARRACKs, FoRT BENNING, GA.
Installation: Fort Benning, Ga.
Item Budget House Restoration request action requested Enlisted men's barracks without mess------------------------ $657,000 —$657,000 7,000
REASONS FOR RESTORATION REQUEST
The urgency of this project, which proposes the construction of a 263-man barracks adjacent to Martin Army Hospital, emanates from the inherent dangers to the patient's welfare and even his life, which exists when sufficient medical personnel are not readily available to the patient-care facility to provide adequate emergency coverage. This principle has long been recognized. Additional medical personnel are always needed in the event of vehicle accidents, fires, training accidents, local disasters, and other unforeseen emergencies in which personnel are injured. The nature of training conducted at Fort Benning intensifies this consideration. The distance separating the hospital and the available barracks on the main post at Fort Benning, Ga., creates problems in notifying or locating the proper individual or individuals, arranging for transportation, and travel to the hospital. This takes valuable time and lives may be lost while the necessary personnel are collected. This vital time loss would be greatly reduced if medical personnel were quartered within walking distance from the hospital.
In order to partially compensate for this undesirable situation at Fort Benning relative to the barracks locations, the hospital commander, in order to provide for 24-hour-a-day coverage on 7-day-a-week basis must extend the hours of duty of a number of different technicians who are needed in emergency cases. Some technicians are on duty 72 hours per week. These long tours of duty create a morale problem among the detachment members.
In the hospital detachment, there is a limited number of X-ray, laboratory, electrocardiogram, and surgical technicians. These men cannot be on duty all the time, but if they are in an adjacent barracks, they are readily available if and when emergencies arise and their services are needed. Patient care is being jeopardized by the present situation that exists at Fort Benning, Ga.
There are other reasons and benefits to be realized if this barracks is built adjacent to the hospital. These are as follows:
(a) An additional messhall must be operated to feed the medical detachment in the barracks area. If the barracks were in the hospital area, only the hospital mess would be used.
(b) In the military administration of the medical detachment, there is necessity for members of the unit to visit the detachment office for various reasons. Due to bus scheduling such a trip can waste as much as 2 hours. This is a waste of the man's time which adversely effects the care of patients. A barracks adjacent to the hospital eliminates this waste of time.
(c) Each man must undergo a specified amount of military training. Due to the lack of training facilities in the hospital and the type of training given, this training must be given in the barracks area. The difficulties in transportation result in the man's being away from his duty longer than is necessary. If the barracks were in the hospital area this time loss would be greatly reduced.
General SHULER. The next item is on tab E. This is an enlisted men's barracks at Fort Benning, Ga., which we have already covered, ‘SII’. Senator STENNIs. Yes. I remember you covered that.
Installation: Brooke Army Medical Center, Fort Sam Houston, Tez.
Budget House AppropriaItem request action tion requested Administration and classroom building, Medical Field Service School------------------------------------------------------ $8,300,000 || –$8,300,000 $8,300,000
REASON FOR RESTORATION REQUEST
The Medical Field Service School is unique in its mission and function which is to train personnel in all apsects of the role of the Army Medical Service in support of the Army in garrison as well as in ground combat. Because of the dissimilarity of the combat roles of the three military services, the training at this school is different from the other service schools. For example, a physician comes into the Army as a trained professional. Through a short intensive training period he is trained as a military officer, having to know Army organization, modes of Operation, and problems inherent in his Service. He must be taught to function and practice medicine in any Army organization and under the conditions of ground warfare. The same principles and doctrine do not pertain to the other military services because their combat role is dissimilar. The physician in the Navy would be primarily concerned with a medical service aboard ship, while the Air Force physician would be concerned with a medical Service Of a fixed installation in the vicinity of an airfield. The Army physician is trained to establish field type hospitals, under tentage or other improvised shelter, in highly mobile as well as static situations in support of varying ground combat situations, which may be conducted in various parts of the world where there are significant and unusual environmental health hazards.
The Army Medical Field Service School must train technicians to operate in both Army fixed and field medical installations. Any combined training would result in a requirement for additional training in the role and missions of the particular service.
The Medical Field Service School is part of a large medical training complex. The complex includes Brooke General Hospital, Wilford Hall U.S. Air Force Hospital, the medical training center, the 4th U.S. Army Area Medical Laboratory, regional dental activity, and medical field units stationed there. For example, both Brooke General Hospital and the regional dental activity are used in connection with teaching 15 officer courses and 8 enlisted courses. To conserve talent and retain the highest caliber of instruction, in 1964, personnel from Brooke Army Medical Center delivered 228 hours of instruction at the school. This medical training complex was consolidated when the Medical Field Service School was moved to Fort Sam Houston, Tex., in 1947, after an exhaustive study which showed the many advantages in locating the school at this installation. In the mid-1950's, the medical training center was moved to Fort Sam Houston, Tex., which has many advantages and effected economies and efficiencies. To move any part of the Medical Field Service School to any other installation would eliminate and break up a favorable training situation or environment that has been established. None of the other large general hospitals, which is an essential part of this training complex, has the necessary space and supporting facilities to assume this diversified training mission accomplished by the Medical Field Service School. A centralized training complex enhances the accomplishment of the mission of the Army Medical Service. The Department of Defense, during 1964, did make a study of the training facilities of the various military departments including the Medical Field Service School. The Department of the Army was advised that the review had been finalized and that findings indicated that the existing facilities in all of the service schools were fully utilized and no specific unused capacity was available to accommodate the medical training requirements of the other services. The design of this project has progressed through a feasibility study and concept stage and at the present time the design is 25 percent complete. The present schedule provides for award of the construction contract prior to the end of the current fiscal year. A recent cost estimate made by the architectengineer shows the cost estimate to be reasonable and that a complete and usable building can be provided within the requested funds. (See statement of Senator Yarborough on p. 887.)
Installation: Fort Sam Houston, Tez.
Item Budget House Restoration request action requested Medical Laboratory, 4th Army-------------------------------- $1,300,000 || –$1,300,000 $1,300,000
REASONS FOR RESTORATION REQUEST
The existing 4th U.S. Army Medical Laboratory facility is inadequate in nearly every respect. The 22,307 square feet of space presently used by this facility is comprised of seven different buildings which were constructed between 1917 and 1944. None of these buildings were designed for laboratory use. In addition to their being inefficient in design for laboratory use and uneconomical to operate, these buildings do not provide the space essential to effectively perform the assigned mission. Lack of a proper system for the extraction of pathogenic, toxic, and explosive aerosols and vapors generated in work areas renders the present Operation hazardous to laboratory personnel. It is not economically feasible to either expand or modernize any of these currently occupied buildings. The inadequacy in space is being intensified by an increasing laboratory workload. In the past 5 years, as a national trend, the requirements for medical laboratory work in both military and civilian medical care facilities have increased 10 percent per year. During this same 5-year period, workloads at the 4th U.S. Army Medical Laboratory have increased 64 percent—an average annual increase of 13 percent. Space and facilities must recognize this growth and be planned to accommodate the projected workloads. New missions and responsibilities have been assigned to the 4th U.S. Army Laboratory. Among these are additional responsibilities in the field of water and air pollution and in the field of industrial hygiene, particularly involving hazards connected with propellents associated with the more sophisticated weapons systems. The accomplishment of these functions requires additional space. The experience gained with operation of the recently constructed 2d U.S. Army Medical Laboratory has confirmed that a building of Similar size is required for the workload of the 4th U.S. Army Medical Laboratory. While the detailed plans of this proposed laboratory were incomplete at the time of the committee hearings, the plans of the 2d U.S. Army Medical Laboratory are being adapted to fit the workloads and site of the 4th U.S. Army Medical Laboratory. The cost estimate of this project is validated by the actual costs of the recently completed 2d U.S. Army Medical Laboratory.
Installation: Fort Benjamin Harrison, Ind
Item Budget House
U.S. Army hospital------------------------------------------- $2,088,000 || –$2, so $2,088,000
REASONS FOR RESTORATION REQUEST
An exhaustive study of medical workloads and facilities was conducted at Fort Benjamin Harrison, Ind. Findings and conclusions were that omission of obstetrical facilities would effect considerable economies with no undue hardships being imposed upon the patients. The reasons for omitting such facilities are as follows: (a) The requirement for obstetrical facilities in this hospital would be based upon an average Of 27 live births per month which results in a daily average of 4.4 beds occupied by obstetrical patients. This is a small obstetrical workload. (b) The operation of an obstetrical service for such a small number of patients is an expensive and uneconomical operation. For example, in a cost study of obstetrical care in Army hospitals, it was found that the average cost per case was $283.60. The cost per case at Valley Forge General Hospital, Where the workload is comparable to Fort Benjamin Harrison, was $573.36. A Similar high cost per case at Fort Benjamin Harrison Hospital could be expected. (c) Fort Benjamin Harrison is located in the environs of Indianapolis, Ind. Many of the assigned personnel live throughout that city. A study showed many of the obstetrical cases at Fort Benjamin Harrison Hospital lived closer to Civilian hospitals where obstetrical care was available than to the hospital at Fort Benjamin Harrison. If these obstetrical cases had been given permits to use the civilan hospital, as authorized under provisions of the Dependent Medical Care Act, adequate care would have been immediately available to them with no undue hardship. (d) The survey by the Department of Defense team showed there is a capaCity within the civilian community to assume the Fort Benjamin Harrison Obstetrical workload. This capability does not exist for general medical- and Surgical-type care. Therefore, beds were programed for dependents for this type of care. (e) The costs of providing the necessary facilities such as a post partum ward, an obstetrical suite, nursery, and Obstetrical clinic in the Fort Benjamin Harrison Hospital would be $346,000. (f) A large staff is required for a relatively small patient workload. Staffing requirements in the Fort Benjamin Harrison Hospital to provide 24-hour, 7day-week coverage is as follows: One obstetrician; seven nurses; and nine subprofessional personnel. (See statement of Senator Yarborough on p. 888.)
HospitaL BUILDING, FoRT BENJAMIN HARRIsoN
General SHULER. We have already covered with Senator Yarborough the next two items, so I won’t go into them any further. The next item is tab H, which is a hospital, a new hospital at Fort Benjamin Harrison. Now there was only one contention made on this, sir, by the House Appropriations Committee, and that was that, since they require obstetrical facilities to be in all of our new hospitals and this did not provide any, they denied this appropriation. This was approved for authorization.
ABSENCE OF OBSTETRICAL FACILITIES
The reason that it does not have obstetrical facilities is because the Department of Defense made a very thorough survey of the environs, assisted by the Army, and we have agreed in this particular instance that the closeness of adequate facilities in the community will take care of this function. So it comes right to that proposition. The House feels we should put facilities in the hospital in spite of the study. We feel that it would be wasteful to operate this way, and we should rely on the community.