Mr. JOHNSON of Oklahoma. Is that increase due to an increase in the estimated number of patients, or the increased cost of living, or both? Mr. ARNOLD. There is an increase there of $60 which is for the base salary of the medical superviser there, and an increase of $1,690 for the cost of maintenance.

There is a slight decrease of $50 for overtime pay, making the net increase $1,700.

The contract with the sanitarium company provides for a basic rate of $840 per patient per year, which is to be adjusted in accordance with the cost-of-living index of the Department of Labor. At the time that we prepared this estimate it was 104.2 percent. This appropriation provides for 322 patients per month at that rate, and one patient at St. Elizabeths.

At the end of December 1945, there were 333 patients at the sanitarium.

Mr. JOHNSON of Oklahoma. When will our contract with the sanitarium company at Portland expire?

Mr. ARNOLD. That contract expires in 1948.

Mr. JOHNSON of Oklahoma. What is the present rate per patient? Mr. ARNOLD. The present rate is $840 per year plus the 5.5 percent increase because of the increase in the cost of living as provided in the

basic contract.

Mr. JOHNSON of Oklahoma. Do you inspect this Morningside Hospital, where these patients are placed, regularly, intermittently, yearly, or do you ever inspect it?

Mr. ARNOLD. I understand in the past there has been regular inspection. I visited the sanitarium on my way back from Alaska in November. I found the physical conditions there very good.

Mr. JOHNSON. But you do not pretend to make a real inspection of the institution?

Mr. ARNOLD. No other inspection than the physical condition of the hospital. There is a member of the House Territories Committee Dr. Miller, who stopped off there on his trip to Alaska last summer, I have talked to him since he came back and he said from a professional standpoint he thought the institution was in very good shape.

POSSIBILITY OF CONSTRUCTION OF HOSPITAL FOR INSANE

Mr. JOHNSON of Oklahoma. That leads me to ask what the status of the plans is, if any, for a hospital for the insane being constructed within the borders of the Territory of Alaska.

Mr. ARNOLD. The contract expires in 1948, about 22 years off, and as I mentioned yesterday, the Governor and the Delegate and I have discussed the problem. Our feeling is that we should now push ahead and get plans prepared for an actual building to be constructed in the territory.

Mr. JOHNSON of Oklahoma. Of course, this is a sore spot with this committee. For years the committee has felt that there should be an institution that is adequate to house the people within the territory, and yet it has been felt the institution in Oregon has done a reasonably good job. If these people lived in the northwestern part of the United States the arrangement would probably be satisfactory.

During the recent trip of the members of this committee to Alaska we had in mind several things, but high on the priority list was to find suitable buildings, constructed, probably by the Army, that could be taken over for an institution of this kind. There were several places that the committee had in mind. I refer particularly to some very splendid buildings that the committee found at Excursion Inlet, a place where the Army has spent about $30,000,000 to $37,000,000 for a secret base. We visited that area. We have no criticism of the Army for having constructed the secret base, except for the fact that the Army kept right on building long after the Japanese had been driven out of the Aleutians. We were told that many of those buildings were started months after the enemy had been driven out of the Aleutians.

Our particular peeve with reference to the hospital phase is that we were told that a hospital had been picked up and moved from that area to Seattle and within a few days, they moved all the equipment for another hospital right back to the same base and put it in some very substantial buildings which I believe they called administration buildings.

When this committee was there some 700 German prisoners were tearing down these buildings. We radioed the Secretary of War suggesting that these semipermanent buildings be kept intact until the Indian Service could look them over, or the Interior Department could make up its mind whether or not it could use these buildings for an insane institution or for something else. I do not know whether those buildings are still there or not. The last information I had from the War Department was that they had not torn them down. Do you have any information about that?

Governor GRUENING. I think that they have left those main buildings intact.

Mr. JOHNSON of Oklahoma. Now, I have been told that a representative of the Interior Department looked them over and said that the location was not ideally suited for an insane institution. No one pretends to say that it is ideally suited for anything, but we have them. They are constructed. They seemed to be very well suited for the hospital that was there when we visited the institution. It does seem

to me that it would be far better to house the insane of Alaska in an institution of that kind where it would only be a few hours by water from Juneau than to insist upon sending them to the United States. It is an outrage to send those people all the way to the United States. I wonder, Governor, if you have in mind anything that you may be asking the legislature of Alaska to do with reference to the insane of Alaska.

Governor GRUENING. Well, I think that there is a feeling on the part of a great many people there-which I share-that the insane should not be sent outside the Territory. A good many of them like to be visited by their parents and relatives and friends, and traveling down to Portland is out of the question for most people. Wherever the asylum might be situated in Alaska there would be some parts of Alaska that would be pretty distant, but at least they would not be as far away as they are now. I think that we should have a building constructed in Alaska somewhere-if we cannot make use of existing buildings-that would be suitable. Now, whether these buildings in Excursion Inlet can be converted to such a use, whether the cost of adaptation and conversion would not be greater than the cost of new construction is a question. The docks which are essential are not built of treated piles, and we have a marine animal up there, the teredo worm, that eats these pilings very quickly if they are not treated.

In the normal course of events the entire piling would have to be replaced shortly. The Army built it for temporary use. They expected to use it only for a very short time so if it were deemed advisable to consider those buildings for some such purpose, really a study ought to be made to see how much it would cost to adapt them to make them suitable for this very special use. We might go to a place like Chilkoot Barracks and see all of the structures that are abandoned. That was built by the Army some 40 years ago and at first glance we are apt to say: "Now, would this not be wonderful for some purpose like a sanitarium or an industrial school?" and when we start to reckon the cost of maintenance and upkeep for an entirely different use than was originally intended, we find that the cost is prohibitive. And so what appears like an economy, through the utilization of something that was already built, proves in the long run to be an expense.

And I think that may be the situation with Excursion Inlet. You have one very definite problem there, and that is the difficulty of keeping personnel in isolated places. I know it is the custom more and more when tuberculosis sanataria are built to build them in cities, because it is next to impossible to keep nurses and attendants in some remote and isolated spot. They won't go there; you cannot hire them to come. And that is the problem at a place like Excursion Inlet, which is completely shut off from the rest of the world. You have to go by boat and there are no regular steamer services there. I think that is a problem that would have to be examined from those viewpoints.

Mr. JOHNSON of Oklahoma. I realize it has its drawbacks, but it also has its advantages.

It certainly is a quiet place. There is a clear, beautiful swimming pool, as beautiful as I ever saw, and it has a gorgeous setting. It is not only quiet and picturesque, but the lakes and inlet are abounding with fish. So from several standpoints it would be more advantsgeous than sending your insane over 1,000 miles to Morningside.

Governor GRUENING. That is one thousand miles from our southernmost point.

Mr. JOHNSON of Oklahoma. Now, if it cannot be used to advantage for an institution of this kind, it did seem to the committee, considering all the investment that has been made there, the improvements and the urgent need for hospitals, that it might be used for some other kind of institution.

For instance, when you tell us there is thirteen times as much tuberculosis among the natives in Alaska as among our Indians in the United States, it would seem it might be used for a sort of rest camp for your tuberculars, which would not require a great number of physicians and experts, nurses, etc.

Governor GRUENING. Well, now, look at the situation that would exist on transportation there. It would not be a regular stop-off place for steamships. You would have to have a special boat operate, and with the small amount of freight that would go there that would add greatly to the expense of operation.

Mr. JOHNSON of Oklahoma. Referring to ships, that is a thing also, since you mention it, where I see we have so many ships that the Navy is going to take 94 to 100 of them out and sink them.

Mr. NORRELL. Including the battleship Arkansas.

Mr. JOHNSON of Oklahoma. Yes, including the great battleship Arkansas-and also at least one large airplane carrier. To me it is the most asinine thing I ever heard of since the time we sank some ships after the Washington Peace Conference at which they sang or played the Star Spangled Banner. Then as I recall they sank only 14 ships in the name of peace. Now, if the Navy were going to attempt to sink one ship in its class of several different types of ships, that is one thing; but to sink 100 ships, 18 of which are modern new construction that we may need sooner than we now think, is inexcusable. Don't you think you might use one of those ships to very good ad- · vantage in Alaska to take care of the urgent need for better freight facilities to the various institutions in Alaska, and helping the Alaska Railroad, for example, that may not always be in the black to the tune of $6,000,000, as it is supposed to be now?

Governor GRUENING. Mr. Chairman, we are now engaged in exploring that whole shipping situation, which is of more than vital importance. It is a matter of life and death to the Territory, and we have had conferences with the Maritime Commission, with the War Shipping Administration, and the steamship line people, who do not seem to be inclined to continue to operate at even the present high rates. I do not know as yet what is going to become of it.

I would think out of this great number of ships that have been built some could be found that would either be suitable for the Alaskan trade, or be remodeled to make them so. I do not know about these ships they are going to sink; I thought they were naval vessels. Mr. JOHNSON of Oklahoma. When Colonel Johnson is here we may find that is the reason he is not getting the 10 Diesel locomotives that this committee has repeatedly asked the War Department to make available to the Alaska Railroad-engines that they need and need badly; but it is my information they are going to get what the little boy shot at-nothing; yet they are going to give them away to certain foreign countries.

This may sound a little bit aside from the issue; but, nevertheless, the fact of the matter is you need ships and you need them badly, and you could use ships just for the purpose of utilizing such places as Excursion Inlet, where the taxpayers have invested something like $30,000,000.

Mr. ARNOLD. Mr. Chairman, after the committee made that report, we all discussed the matter with the Governor and Colonel Albrecht. commissioner of health of the Territory, and he is continuing to look into that situation; although his reaction was, for the reasons the Governor has mentioned, that it would not be feasible.

COLLECTIONS FROM GUARDIANS AND RELATIVES OF INSANE OF ALASKA

Mr. JOHNSON of Oklahoma. I want to ask one other question. It was mentioned here yesterday, I believe by a member of the committee, Mr. Rooney-that you have only collected about $16,000 from relatives of the insane in Alaska for the care-and for the good care, I understand-they are receiving at Morningside Sanitarium.

No one ought to be deprived of having their loved ones in this institution if they are unable to pay, but certainly no one ought to be permitted to abuse the privilege who has money. And I understand a number of them do have money whereby they could pay something. Why has the Division been unable to collect more than $16,000?

Mr. ARNOLD. The chief reason is that the families of practically all the patients are indigent or have very limited financial resources. Approximately three-fourths of the patients are natives. Furthermore there is some question whether we can collect from them for their care prior to 1942. I'll be happy to submit for the record a detailed statement of the work performed by our Division on collections. (The statement referred to is as follows:)

STATEMENT OF WORK DONE BY DIVISION OF TERRITORIES AND ISLAND POSSESSIONS ON COLLECTIONS FROM GUARDIANS AND RELATIVES OF ALASKAN INSANE

The act of October 14, 1942 (56 Stat. 785, 48 U. S. C. sec. 48a), declares it to be the duty of the patients, their guardians, spouses, parents or adult children to reimburse the United States for the cost of care and treatment to such an extent as the Secretary of the Interior may find them able to pay. Reimbursement may not be sought from any other source. Since 1942, there has been an average of about 317 patients cared for annually at Morningside. Of the total patient roster, roughly three-fourths are indigent natives of Alaska, whose hospital records clearly indicate that they have no estates of their own, and who either have no known relatives or whose families clearly cannot contribute to their support. In these instances, any effort to secure reimbursement to the United States would be wasted. In the case of the other patients, we have sent to their guardians or families a questionnaire devised in the Division in 1943 to save the time and energy of clerical personnel and approved by the Bureau of the Budget and the General Accounting Office. This questionnaire supplies us with information as to the patient's estate and income and the income of the members of his family referred to in the statute, from which we may determine the extent of ability to pay. From the questionnaires sent out, we have uncovered, to date, assets totaling $111,436.21; administrative orders have not yet been issued in the most recently investigated cases.

Besides being able to collect from only a fraction of the patients, we are further limited by the terms of the statute. The charge assessed may in no case exceed the actual cost of care and treatment and is fixed by contract with the sanitarium company operating Morningside Hospital. Under the contract in effect when the statute was passed and until June 30, 1943, the monthly cost for each