Proposed for separate transmittal:

PROPOSED HEALTH LEGISLATION

Program and Financing (in thousands of dollars)

Identification code

1. Medical stockpile. The goal of this activity is to insure to the greatest extent possible the availability of adequate and usable medical supplies and equipment for civilian needs in time of disaster. Medical supplies and equipment are assembled into emergency hospitals that are pre-positioned in strategic locations under written agreement between the Federal Government and the custodial State. Funds previously appropriated provided for 2,820 such hospitals. The estimate for 1966 provides 09-20-1234–1–1–651 for the partial replacement of deteriorated supplies in the stockpile; the procurement of supplies to increase the operational capability of 1,930 pre-positioned hospitals having a 3-day supply to a 30-day supply of materials; increased maintenance activities of stock surveillance and quality control measures; and for placement of reserve bulk stocks in secured underground storage facilities.

2. Emergency health training and community preparedness. This program is concerned with the preparation of the Nation to meet its health needs in emergency situations through the development of plans and programs covering emergency health services, civilian health manpower, and health resources; implementation of emergency plans and programs in every State and community; development and initiation of training and health resources programs at the national and regional levels, and provision of assistance to States and communities toward achievement of emergency health capabilities; and through development of health rehabilitation and restoration plans to be utilized during the recovery period following an enemy attack or peacetime natural disaster.

Object Classification (in thousands of dollars)

Program by activities:

10 Community health facilities, services and
medical education (costs-obligations) _ _
Financing:

40 New obligational authority (proposed sup-
plemental appropriation).

Relation of obligations to expenditures:

71 Total obligations (affecting expenditures).
Obligated balance, end of year..

74

90

Expenditures.

Under proposed legislation, 1966.-Legislation is recommended:

1. To begin a 5-year program to establish regional medical care, research, and training complexes to be operated in conjunction with university medical schools and planned jointly with the communities to be served. Each would include regional centers capable of providing complicated expensive diagnostic and treatment services for a variety of ailments, including heart disease, cancer and stroke. These centers would be supported by diagnostic and treatment stations in existing community hospitals. Grants will be available for construction and operating expenses.

2. To authorize a 5-year program of grants to support initial staffing costs of community mental health centers

Net operating income or loss. Nonoperating income: Proceeds from sale of equipment...

Analysis of retained earnings:

1

24.0 Printing and reproduction.

1

25.1 Other services...

26.0 Supplies and materials.

31.0 Equipment...----

254 2

256

13

12

Average GS salary.

$5,397

$6,139

Average salary of ungraded positions.

$4,675

$4,433

65

180

5.5

The Bureau of State Services management fund finances the research services, business operations, program direction, and program services provided by the staffs of the Office of the Bureau Chief for the community health and the environmental health programs, and the Sanitary Engineering Center in Cincinnati, Ohio. Formulas for determining the contribution from each appropriation are designed to reflect utilization of services performed by the management fund.

The centralized staffs of the environmental health and community health offices of the bureau chief, and the Sanitary Engineering Center provide supporting services to program activities as follows:

Research services provides the central administration and operations of services required for the conduct of research activities in environmental health programs at the Sanitary Engineering Center. Included are such $4,575 services as technical reporting, library and reference services, biometric services, laboratory equipment design

$6,074

Γι'

and construction, and the operation and maintenance of buildings.

Business operations provides the centralized business management services for the community health and the environmental health programs of the Bureau of State Services and the business management services furnished by the central staff at the Sanitary Engineering Center. The activity includes such services as financial management, personnel management, information activities, grants management, procurement, supply and property management, contract negotiation, management analysis, and messenger, file, and mail services.

Program direction provides for the executive direction and supervision of the environmental health and the community health activities of the Bureau of State Services.

Program services provides for overall program planning, review and development activities, environmental health facilities planning, and coordinates community health research grants programs. It also provides for the associate regional health directors for environmental health and their staffs, located in the nine regional offices of the Department.

Object Classification (in thousands of dollars)

1964 actual

1965 1966 estimate estimate

417

24

4,539

11.3

Positions other than permanent.....

46

11.5

Other personnel compensation....

22

4,606

12.0 Personnel benefits..

341

395

21.0 Travel and transportation of persons.

22.0 Transportation of things.......

23.0 Rent, communications, and utilities.

24.0 Printing and reproduction....

25.1 Other services..

32.0 Lands and structures.

26.0 Supplies and materials.

31.0 Equipment....

NATIONAL INSTITUTES OF HEALTH MANAGEMENT FUND
Program and Financing (in thousands of dollars)

7.8

$5,805

1 Includes capital outlay as follows: 1964, $536 thousand; 1965, $1,188 thou-
sand; 1966, $1,565 thousand.
Selected resources as of June 30 are as follows: Unpaid undelivered orders,
1963, $2,439 thousand (1964 adjustment, $55 thousand); 1964, $2,257 thou-
sand; 1965, $2,257 thousand; 1966, $2,257 thousand.

Reimbursements from non-Federal sources are derived from the sale of meals
to employees and others (42 U.S.C. 290).

The National Institutes of Health management fund was established to facilitate the conduct of operations of the National Institutes of Health which are financed by two or more appropriations. The activities of the fund are financed primarily from advances and reimbursements from the several institutes. Formulas for determining the contribution from each institute are designed to reflect utilization of services performed by the management fund. Taken into consideration are such factors as the number of activated beds in the clinical center, number of laboratory workers, total personnel, and dollar level of grant, direct research, and direct operations funds obligated by the Institute. A small portion of the funds comes from reimbursements from outside sources, principally cafeteria receipts, and from other Government agencies.

The centralized organizations of the National Institutes of Health provide supporting services to all programs as follows:

1. Research supporting services provide the central ad-
ministration and operation of services for the conduct of
research activities such as the planning and supervising
the design, construction, and development of new research
facilities; providing laboratory animals, culture media,
and glassware; design and fabrication of laboratory instru-
mentation; operating the NIH medical reference library
including the translation of medical literature; scientific
photography and medical arts; maintenance and altera-
tion of all physical facilities including utility services; and
environmental engineering services.

2. Clinical supporting services consist of the operation
of the 516-bed clinical center together with the laboratory
space required for the treatment of research patients.
3. Administrative management includes personnel, sup-
7.344 ply, financial management, office services, plant safety,
management audit and analyses, audit of activated grants,
and printing and reproduction.

400