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Mr. Howard Gatewood
Page 3

January 12, 1976

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showed how Hardwood was measured.

Outlined how Hardwood shrinks in thickness and width in the drying process.

Outlined the long established practice in the Industry of adding a shrinkage factor to the tally when measurement was made after kiln drying. Showed them paragraph 2 pages 47, and the Shrinkage Table on page 98 of the Rules Book, and explained why were being eliminated.

Outlined to them the entire story--as I have heard it--of the
controversary regarding the addition of a shrinkage factor to

the measurement of kiln dried lumber, since it started in California
and up to the present time.

Outlined to them my opinion on the matter (as outlined carlier in this letter)

The reaction and suggestion of the Burcau:

1. The could speak only for the State of Michigan.

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We are being "stampeded" into a serious change of method, custom, and policy, and the change is not warranted not needed.

They s no deception nor fraud in the measurement method as
formerly practiced in the Industry, nor no attempt to mislead
the buyer.

The recognize that particular industries have particular problems
in weights or measures that are peculiar to only certain commodities
or certain industries. Therefore, variations or exemptions of
the laws are frequently made to accomodate this. Example--the
measurement of S4S softwood boards and dimension being permitted
on the basis of rough sizes, which has been approved by thes
National Conference of "eights and Measures, (They gave me a
Xerox copy of formal approval).

Hr. Howard Gatewood
Fage 4

January 12, 1976

5.

In the absence of specific laws or regulations to the contrary, they recognize and approve industry customs or methods for weights and measures unless they are deceptive or misleading.

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7.

8.

The National Council of Weights and Measures

c/o United States Department of Commerce

National Bureau of Standards

Washington, D.C. 20234

Attention: Mr. Harold F. Wollin - Chief

Office of Weights and Measures

for the approval of the industry practice of adding the appropriate shrinkage factor to the measurement of Hardwood Lumber measured after kiln drying, as outlined in the NILA Rules Book.

As far as the activity of Van Keulen & Winchester Lumber Company
in the State of Michigan is concerned, ve may continue our former
method of measurement with the approval of the Michigan Bureau,
unless the National Council rules otherwise in the future.
However, they firmly believe the National Council will approve the
Industry petition.

In the petition to the National Council, we may feel free use the name of the Michigan Bureau and its' chief officials:

Mr. Frank Nagele

Weights and Measures Specialist

Dr. Edward C. Heffren, Assistant Chief
Food Inspection Division

Howard, in view of all this, the policy of my Company (until we are convinced otherwise) will be to continue to measure our shipments of lumber in the same manner that we have always practiced in the past. We will not be changing to the "net footage" concept on kiln dried lumber.

Now, as regards the 3'rd purpose of this letter, I request: MILA--as the spokesman for the Hardwood Industry--to file the application with the National Council of Weights and Measures as outlined in paragraph B-6 and B-8 above. I assume this requires approval of your Board. If so, I would hope it could be accomplished quickly, before the present trend of capitulation and change gets so far down the road as to be irreversible..

Mr. Howard Gatewood
Page 5

January 12, 1975

Would you please give me your reaction as soon as possible, because if NILA is unable to pursue this I feel that I must do so individually or perhaps with the cooperation of other industry people who might feel as I do.

Yours very truly,

VAN KEULEN & WINCHESTER LUMBER COMPANY

BLU.K.

Robert Van Keulen

RVK: Bjz

P.S.

I enclose copies of the approval by the National Council of Weights and
Measures of the Softwood measurement of surfaced boards and dimensions.

Enclosures

Senator NUNN. Our next witness is Mr. Edward Fechtel, president of the Georgia Hospital Association.

We are delighted to have you and you may proceed in whatever manner you see fit.

TESTIMONY OF EDWARD J. FECHTEL, JR., ADMINISTRATOR, ST. MARY'S HOSPITAL, ATHENS, GA., AND PRESIDENT, GEORGIA HOSPITAL ASSOCIATION

Mr. FECHTEL. Mr. Chairman, I am Edward J. Fechtel, Jr., Administrator of St. Mary's Hospital, Athens, Ga. and president of the Georgia Hospital Association, representing over 200 health care institutional providers as member institutions, including most of the hospitals in Georgia and over 1,500 personal members. We appreciate this opportunity to present the views of our association on matters of Congressional control of administrative rulemaking.

Our association wishes to commend the subcommittee for holding hearings and considering this issue in Georgia. We especially commend you as one of our distinguished Senators from Georgia and as chairman of the Senate Government Operations Subcommittee on Oversight Procedures and the distinguished Representative Elliott N. Levitas of Decatur, Ga., as principal sponsors of two major bills to deal with this very difficult issue.

In the course of our testimony, we would like to briefly discuss some of the problems that the hospital field faces with the regulatory process at the present time; to give some indications of the magnitude of the issue; to provide briefly some specific references to regulations and assessment of their impact on hospital operations; and finally to provide a series of recommendations for the subcommittee's consideration in the future study of the matter.

The published Code of Federal Regulations is separated into 50 titles by subject matter. Over 60,000 pages of regulations were published in the Federal Register in 1975. As of January 30, over 4,800 pages of regulations have been published in the Federal Register.

During the past decade, hospitals have been hit with a barrage of governmental regulations which, as the committee knows, have the force of law. These regulations are developed and promulgated by a variety of governmental agencies, boards, and departments in the executive branch. Not infrequently, the uncoordinated promulgation of regulations have included requirements that do not appreciably improve care to patients but significantly increase costs. At the same time, actions are being taken to hold down payments for services to levels that do not take into account the cost increases mandated by Government. Sometimes payment limits seem to be imposed in ignorance of the differences between holding down Government payments and holding down hospital costs. Regulatory actions have not only dealt with matters affecting the very financial integrity of institutions but have also intruded directly and inappropriately into the operation of such institutions.

During the year ending September 30, the American Hospital Association identified some 105 proposed regulations as having specific relevance to hospitals. Six of the 50 titles in the Code of Federal

Regulations as mentioned earlier are of special interest to hospitals with title 20 regarding medicare and title 45 regarding medicaid being of primary interest.

Regulations for these two titles alone are so voluminous that many institutions must subscribe to a publication service to assure receipt of current changes. One such service currently includes three volumes of information relating solely to title 20 and title 45, numbering over 10,000 pages. The January 20 issue of page changes to these three volumes numbered over 280 pages. Mr. Chairman, we agree with you in your earlier testimony in this issue, that "Today we are paying the price of growing Government in terms of over-regulation and a mountain of Federal paperwork," and Congress "must end it by effective oversight of the bureaucracies."

The volume, frequency, and complexity of initial and revised regulations applicable to medicare and medicaid is overwhelming. In addition to the three-volume reference index of 10,000 pages our State has recently instituted, though somewhat belatedly, 12 separate volumes of provider procedure manuals for the administration and operation of our medicaid program. Additionally, administrators must abide by over 70 pages of State rules and regulations on the operations of licensed hospitals in Georgia.

I wish to assure the committee that our hospitals of Georgia do not uniformly staff any "regulatory interpretation or compliance sections," for the timely, effective, and economical application of such regulations. Such actions are usually accomplished by a host of bureaucratic "checkers checking the checkers" from life safety codes, Occupational Safety and Health Act regulations, utilization review of facilities, and a host of other regulatory issues to comply with specific requirements to have a prescribed sign posted to advertise a hospital's policy on "uncompensated on free charity care" which it may be required to provide by Federal regulations.

Sixty percent of the hospitals in Georgia are of less than 100 beds in size and usually staffed by one administrator-seldom an assistant administrator and with few department heads who could appropriately interpret the column of Federal regulations applicable to the myriad of medicare and medicaid requirements.

I assure the committee that such staffs are not frequent callers on the newly established "Dial-a-Reg"-phone No. 323-5022-in Washington for any advance look at the Federal regulations to be published tomorrow-they are trying to remain current with the regulations published yesterday or the day before.

Mr. Chairman, I would like now to present some specific references to various regulations of financial significance to hospitals and a very brief assessment of the impact of such on hospital operations.

In 1969, in adopting the nursing cost differential the Social Security Administration provided by regulations that "further studies will be conducted periodically to determine the amount of inpatient routine nursing salary cost differential and how such a differential should be applied in the future." Nevertheless, in 1975 the Administration promulgated a regulation eliminating this justified differential. This regulatory action was taken precipitously as a cost-cutting measure with no justification based on new studies or any other evidence of the change in the cost of providing nursing care to the aged.

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