80TH CONGRESS 2d Session } SENATE { REPORT No. 1581 AMENDING THE PROVISIONS OF TITLE VI OF THE PUBLIC HEALTH SERVICE ACT RELATING TO STANDARDS OF MAINTENANCE AND OPERATION FOR HOSPITALS RECEIVING AID UNDER THAT TITLE JUNE 9 (legislative day, JUNE 1), 1948.-Ordered to be printed Mr. TAFT, from the Committee on Labor and Public Welfare, submitted the following REPORT [To accompany H. R. 6339] The Committee on Labor and Public Welfare, to whom was referred the bill (H. R. 6339) to amend the provisions of title VI of the Public Health Service Act relating to standards of maintenance and operation for hospitals receiving aid under that title, having considered the same, report favorably thereon without amendment and recommend that the bill do pass. PURPOSE OF THE BILL The purpose of the bill is to amend the hospital survey and construction provisions of the Public Health Service Act (title VI of the Public Health Service Act) so as to restore to eligibility, to participate in Federal grants for hospital construction under those provisions, a State which has ceased to be eligible for such grants because of its failure to enact, prior to July 1, 1948, legislation requiring compliance with standards of maintenance and operation by hospitals receiving such grants. Under present law, States which have not enacted such legislation by July 1, 1948, are permanently barred from thereafter participating in the benefits of the hospital-construction program. The bill would restore such a State to eligibility upon enactment of such legislation. EXPLANATION OF THE BILL Part C of title VI of the Public Health Service Act provides for Federal grants to aid in the construction of hospitals. The amount of these grants within a State is limited to the amount allotted to the State from the Federal funds available for this purpose. An allotment is made to a State only if the State has had its plan of hospital construction approved by the Surgeon General prior to or during the fiscal year for which the allotment is made. Section 623 (a) (7) of the Public Health Service Act requires the State plan to provide minimum standards of maintenance and operation for all federally aided hospitals. Section 623 (d) provides that if any State has not enacted legislation by July 1, 1948, requiring compliance with minimum standards of maintenance and operation in the case of hospitals which shall have received Federal aid under the act, such State shall not be entitled to any further allotments under the act. The bill amends the Public Health Service Act so as to permit States which have ceased to be entitled to further allotments because of failure to pass appropriate legislation to become reentitled to allotments if and when they subsequently enact such legislation. Under the proposed amendment, a State which enacts such legislation after July 1, 1948, will be entitled, so long as it complies with other requirements in the law, to an allotment for the fiscal year in which such legislation is enacted and for the preceding fiscal year. This retroactive feature is designed to avoid penalizing States whose legislatures do not meet during the fiscal year 1949 but who enact appropriate legislation at the first opportunity thereafter. Since legislation designed to meet the requirements of section 623 (d) of the Public Health Service Act ordinarily takes the form of a hospital licensure law, the States enacting such legislation should have a reasonable time within which to set up the necessary administrative machinery, make investigations and studies, formulate suitable standards, and enable existing institutions to bring their operations into conformity with such standards. The proposed amendment would also accomplish this purpose. The pending bill has the approval of the Federal Security Agency, as will appear from the following letter, dated April 20, 1948, addressed to the President pro tempore of the Senate. The honorable the PRESIDENT PRO TEMPORE, FEDERAL SECURITY AGENCY, United States Senate, Washington 25, D. C. DEAR MR. PRESIDENT: I am enclosing for your consideration a draft of a bill to amend section 623 (d) of title VI of the Public Health Service Act (added by the Hospital Survey and Construction Act, Public Law 725, 79th Cong.). This section requires each State to enact prior to July 1, 1948, legislation providing that federally aided hospitals must comply with minimum standards of maintenance and operation. As the section is presently written a State which fails to enact the indicated legislation prior to July 1, 1948, cannot thereafter under any circumstances become entitled to further allotments of Federal funds for hospital construction. The purpose of the proposed bill is to amend section 623 (d) so as to permit any such State to become reentitled to its construction allotments if and when it does subsequently enact the legislation in question. As you know, the Hospital Survey and Construction Act added a new title VI to the Public Health Service Act and part C of that title provides for Federal grants to aid in the construction of hospitals and health centers by public and other nonprofit agencies. The amount of grants within any State is determined by the State's allotment. An allotment is made to a State only if the State has had its plan of hospital construction approved by the Surgeon General prior to or during the fiscal year for which the allotment is made. Section 623 (a)` (7) of the Public Health Service Act requires the State plan to provide minimum standards of maintenance and operation for federally aided hospitals to be fixed in the discretion of the State. Section 623 (d) provides "If any State, prior to July 1, 1948, has not enacted legislation providing that compliance with minimum standards of maintenance and operation shall be required in the case of hospitals which shall have received Federal aid under this title, such State shall not be entitled to any further allotments under section 624." Under this provision a State which has not by July 1, 1948, passed legislation requiring compliance with standards of maintenance and operation loses the right to receive further allotments under part C of title VI. Even if the State subsequently enacts such legislation it will not be restored to eligibility for allotments. In other words, States not qualifying under section 623 (d) by July 1, 1948, will thereafter be permanently barred from participating in the benefits of this program. This seems the only reasonable interpretation of the language of the section quoted above. The purpose of section 623 (d) is, of course, to induce States to enact laws giving legislative authority to their standards of hospital maintenance and operation. It is anticipated that by July 1, 1948, almost all States will have complied with the requirements of section 623 (d). Legislation meeting the requirements of that section has already become law in a majority of the States and it is anticipated that similar statutes will be enacted in at least two other States which have legislative sessions this year. In other States the interpretation of existing statutes is under consideration; it is anticipated that in most cases these statutes as construed by the proper State legal authorities will meet the requirements of the Federal Act. It is believed, therefore, that no more than three or four States will fail to comply with section 623 (d) by July 1 of this year. Under these circumstances the purpose of the section has been substantially fulfilled. This Agency has no desire to weaken the requirement that federally aided hospitals be made subject to standards of maintenance and operation and that there be legislative authority for the enforcement of these standards. We believe, however, that it would be appropriate to modify the section so that the few States which fail to meet the July 1, 1948, deadline may be restored to eligibility for continued participation in the hospital survey and construction program if and when they do subsequently enact the indicated legislation. This would retain the requirement for enforcement of standards of maintenance and operation for all federally aided hospitals and at the same time would furnish an inducement to the few States which will not have brought themselves within the requirement by July 1, 1948, to enact suitable legislation. The enclosed draft is intended to accomplish this purpose. Under it a State failing to enact the required legislation by July 1, 1948, would be deprived of further construction allotments until it passed an appropriate statute. Upon the passage of such legislation the State would, if it complied with the other requirements of part C of title VI of the Public Health Service Act, be entitled to an allotment under that part for the fiscal year in which the legislation is enacted and for the preceding fiscal year. This retroactive feature is designed to avoid penalizing States which, because their legislatures meet only once every 2 years, will experience some delay in meeting the requirements of the proposed section 623 (d). The enclosed draft also provides, in effect, that legislation, enacted prior to July 1, 1948, in order to meet the requirements of section 623 (d), need not require compliance with minimum standards immediately upon enactment, but may delay such compliance until July 1, 1948, or, at the option of the State, for a reasonable period of time after enactment. Legislation enacted for this purpose generally takes the form of a hospital licensing law which sets up a licensing body to formulate and enforce standards. States enacting legislation of this character should be allowed a reasonable time, after enactment of the enabling statute and before the standards thereunder are made fully operative, in which to establish the necessary administrative machinery, make investigations and studies, formulate suitable standards, and enable existing institutions to bring their operations into conformity. I shall appreciate it if you will be good enough to refer the enclosed draft to the appropriate committee for action. The Bureau of the Budget advises that there is no objection to the submission of this proposed legislation to the Congress for its consideration. Sincerely yours, OSCAR R. EWING, Administrator CONCLUSION In view of the foregoing, your committee is of the opinion that the enactment of this bill is necessary to the proper completion of the hospital construction program authorized by part C of title VI of the Public Health Service Act, and therefore recommends the prompt approval of H. R. 6339. AUTHORIZING THE ISSUANCE OF A STAMP COMMEMORATIVE OF THE TWO-HUNDREDTH ANNIVERSARY OF THE FOUNDING OF THE CITY OF ALEXANDRIA, VA. JUNE 9 (legislative day, JUNE 1), 1948.-Ordered to be printed Mr. LANGER, from the Committee on Post Office and Civil Service, submitted the following REPORT [To accompany S. 2739] The Committee on Post Office and Civil Service, to whom was referred the bill (S. 2739) to authorize the issuance of a stamp commemorative of the two hundredth anniversary of the founding of the city of Alexandria, Va., having considered the same, report favorably thereon and recommend that the bill, without amendment, do pass. GENERAL STATEMENT The intent of S. 2739 is to allow sufficient time well in advance that the Postmaster General may, during 1949, prepare, design, and issue a 5-cent air-mail postage stamp, such stamp to be a fitting tribute of recognition of the bicentennial of the city of Alexandria, Va. The city of Alexandria is one of the oldest municipalities in the country. In 1949 it will celebrate its two hundredth anniversary. It was from Alexandria that Washington started out with General Braddock on their disastrous offensive against the French and the Indians. It was the home town of both George Washington and Robert E. Lee, and the old Christ Church, in which they both worshipped, still stands. Almost every street is marked with some historie relic. The committee believe it would seem to be entirely appropriate that the Federal Government take notice of this event through issuance of a special stamp during 1949. Alexandria was part of the original 10-mile square area of the District of Columbia. The Virginia Conservation Commission, Commonwealth of Virginia, over the signature of Mr. H. J. Eckenrode, director of the division of history and archeology, has helpfully prepared further historical facts relating to the earliest days of Alexandria, as follows: |