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Under existing legislation, 1965.-A supplemental appropriation of $2,809 thousand for 1965 is proposed for increased operating expenses resulting from the enactment of four public laws (in thousands of dollars):
1. Public Law 88-355 (approved July 7, 1964). Authorizes the issuance of total disability income provisions for inclusion in National service life insurance policies to provide coverage to age 65.
2. Public Law 88-361 (approved July 7, 1964). Authorizes the provision of educational assistance to the children of veterans who are permanently and totally disabled from an injury or disease arising out of active military, naval, or air service during a period of war or the induction period.
3. Public Law 88-364 (approved July 7, 1964). Authorizes waiver of premium for certain veterans holding National service life insurance policies who become or have become totally disabled before their 65th birthday..
4. Public Law 88-664 (approved October 13, 1964). Revises the veterans' pension program, reopens the National service life insurance program for certain veterans, and provides for a new "modified life plan" of National service life insurance. (The supplemental appropriation is required for the pension portion of the law only.).........--
MEDICAL ADMINISTRATION AND MISCELLANEOUS OPERATING
For expenses necessary for administration of the medical, hospital, domiciliary, construction and supply, research, employee education and training activities, as authorized by law, [$14,200,000.] (5 U.S.C. chaps. 1, 16, 18, 21, 21A, 23-26, 30, 32, 36; 24 U.S.C. 30; 28 U.S.C. 1823; 31 U.S.C. 686; 38 U.S.C. 109(a), 111, 213, 230, 233, 234, 903, 1506, chaps. 17, 73, 81, 83, 85; 72 Stat. 12621264; 41 U.S.C. 5; Independent Offices Appropriation Act, 1965.) Note.-Excludes $2,016,000 for activities transferred in the estimates to "Construction of hospital and domiciliary facilities." The amounts obligated in 1964 and 1965 are shown in the schedule as comparative transfers.
1 Selected resources as of June 30 are as follows: Unpaid undelivered orders. 1963, $88 thousand (1964 adjustments, -$19 thousand); 1964, $72 thousand; 1965, $72 thousand; 1966, $72 thousand.
1. Medical, hospital, and domiciliary administration.— This covers the development, implementation, and administration of policies, plans, and broad objectives, and provides executive direction for all agency medical programs. Included are the central office headquarters, Washington, D.C., and immediate offices of regional representatives of the chief medical director responsible for supervision of medical programs conducted in specific geographic areas. 2. Education and training.-This provides (a) medical residency and internship training, and (b) postgraduate and inservice training to maintain and improve the quality of medical care. This also serves as a media for disseminating information on medical advances resulting from research efforts.
44 Proposed supplemental due to civilian pay increases..
Relation of obligations to expenditures: 10 Total obligations..
70 Receipts and other offsets (items 11-17)..
1 Selected resources as of June 30 are as follows: Unpaid undelivered orders 1963; $1,286 thousand; (1964 adjustments -$8 thousand); 1964, $2,410 thousand; 1965 $2,410 thousand; 1966, $2,410 thousand.
1. Medical research.-Medical research projects are 13,496 conducted in Veterans Administration laboratories or in universities or other institutions on a contract basis, whichever is more advantageous or economical.
For expenses necessary for carrying out programs of medical and prosthetic research and development, as authorized by law, to remain available until expended, [$37,000,000 $40,893,000, of which $1,275,000 shall be for prosthetic research and development activities. (38 U.S.C. 216, chap. 73; 76 Stat. 437; Independent Offices Appropriation Act, 1965.)
Program and Financing (in thousands of dollars)
In addition to amounts provided for the medical research program by direct appropriation, an amount of $9,116 thousand was available in 1964 in grants from the National Institutes of Health and from other organizations sponsoring research. Of this amount, $1,495 thousand represents grants made directly to the Veterans Administration, and grants totaling $7,621 thousand made to various medical schools with which Veterans Administration hospitals are affiliated. It is anticipated that approximately the same level of funding from these outside sources will be available in 1965 and 1966. An indeterminate amount of support is also furnished from funds budgeted for hospital operations for other services including housekeeping, personnel, supply, fiscal and engineering at the hospital level. neering at the hospital level. This estimate does not include funding of research construction projects which are a part of the Construction of hospitals and domiciliaries facilities appropriation.
2. Prosthetic research.-This is a research program to develop and test prosthetic, orthopedic, and sensory aids for the purpose of improving the care and rehabilitation of disabled eligible veterans, including amputees, para33.606 plegics, and the blind.
Object Classification (in thousands of dollars)
1. Medical research.
2. Prosthetic research..
Positions other than permanent.
Other personnel compensation.
21.0 Travel and transportation of persons....
26.0 Supplies and materials.
32.0 Lands and structures..
1,096,041 1,151,864 1,184,443
For expenses necessary for the maintenance and operation of hospitals, nursing homes, and domiciliary facilities; for furnishing, as authorized by law, inpatient and outpatient care and treatment to beneficiaries of the Veterans Administration including care and treatment in facilities not under the jurisdiction of the Veterans Administration, and furnishing recreational articles and facilities; maintenance, operation and acquisition of farms and burial grounds; repairing, altering, improving or providing facilities in the several hospitals and homes under the jurisdiction of the Veterans Administration, not otherwise provided for, either by contract, or by the hire of temporary employees and purchase of materials; purchase of [eighty-four] eight passenger motor vehicles for replacement only; uniforms or allowances therefor as authorized by law (5 U.S.C. 2131); and aid to State homes as authorized by section 641 of title 38, United States Code; [$1,115,935,000] $1,177,417,000, plus reimbursements: Provided, That allotments and transfers may be made from this appropriation to the Department of Health, Education, and Welfare (Public Health Service), the Army, Navy, and Air Force Departments, for disbursements by them under the various headings of their applicable appropriations, of such amounts as are necessary for the care and treatment of beneficiaries of the Veterans Administration. (5 U.S.C. chaps. 1, 16, 18, 21, 21A, 23– 26, 30, 32, 36, 37, 39; 38 U.S.C. 109(a), 111, 216, 217, 233, 234, 903, 1506, chaps. 17, 73, 81, 85; 72 Stat. 1262-1264; 41 Ú.S.C. 5; Independent Offices Appropriation Act, 1965.)
Program and Financing (in thousands of dollars)
Receipts and reimbursements from:
1,091,643 1,115,935 1,177,417
Transferred to "Operating expenses, Public
74 Obligated balance, end of year..
Balance not available, start of year..
Program by activities:
Balance not available, end of year..
Direct operating costs:
1. Maintenance and operation of VA facilities:
294,865 305,724 311,077
Expenditures from civilian pay increase
1 Selected resources as of June 30 are as follows: Unpaid undelivered orders, 1963, $8,758 thousand (1964 adjustments, -$114 thousand); 1964, $13,427 thousand; 1965, $13,427 thousand; 1966, $13,427 thousand.
This appropriation provides for the cost of care and treatment of eligible beneficiaries in Veterans Administration hospitals, domiciliary and nursing care beds, outpatient clinics, contract hospitals and nursing homes, and State domiciliary and nursing homes.
To be eligible for inpatient care and treatment, a bene1,060,319 1,122,444 1,139,295 ficiary must be a veteran of any war with a serviceconnected disability incurred or aggravated during a period of war, or, within the limits of Veterans Administration facilities, for any other disability if the veteran is unable to defray the expenses of necessary hospital, nursing home, or domiciliary care. Outpatient medical and dental treatment is provided to eligible veterans with disabilities by staffs of Veterans Administration outpatient clinics and 38,248 by physicians and dentists participating in the hometown medical care program; to veterans receiving vocational rehabilitation who require treatment to avoid interruption of training; to pensioners of nations allied with the United
6,657 5,879 10,357
1,085,797 1,145,864 1,177,543
General and special funds-Continued
States in World War I and in World War II; and to veterans of the Spanish-American War, Indian wars, Boxer Rebellion, and Philippine Insurrection. Veterans also are provided examinations in outpatient clinics for purposes of rating for compensation and pension, insurance, and determining their need for hospitalization or domiciliary care.
Increases in 1966 are for (a) the full year cost of the Government Employees Salary Reform Act of 1964, (b) within-grade salary increases, (c) activation of an additional 1,000 nursing home care beds beyond the 1,000 bed activation program begun in 1965, (d) new types of medical services in existing facilities, (e) increase in staffing levels for improved quality of medical care, (f) increased usage of utilities, communications, drugs, medicines, linens, prosthetic appliances, and medical supplies, (g) increased maintenance and repair requirements, (h) increased operating and building service equipment requirements, (i) an increase in medical fees paid under the hometown care program, (j) cost of public and private nursing home care authorized by Public Law 88-450 approved August 19, 1964 and (k) cost of filling prescriptions for drugs and medicines authorized by Public Law 88-664, approved October 13, 1964.
1. Maintenance and operation of Veterans Administration facilities (a) Neuropsychiatric hospitals.-This covers the operation of neuropsychiatric hospitals. The estimated costs for 1966 exceed 1965 by $9,831 thousand. Estimated operating levels are:
Average number of operating beds.
1964 actual 1965 estimate 1966 estimate 57,538
(f) Miscellaneous benefits and services. This covers items of expense not directly connected with medical care and treatment such as beneficiary travel, care of the dead, operation of personnel quarters at medical facilities, and the cost of furnishing supply, engineering, housekeeping, and other administrative support service to other Veterans Administration departments on departments on a nonreimbursable basis. The decrease in the estimated cost. under 1965 is $57 thousand.
hospitalization in other Federal hospitals for service and 2. Contract care-(a) Hospitalization.-This covers the non-service-connected disabilities where Veterans Administration facilities are not available. It also covers the use of non-Federal hospitals which are limited to treatment of service-connected disabilities, except that female veterans, veterans in training under the provisions of 38 U.S.C. 1506, and veterans in U.S. Territories and possessions may also receive treatment of non-service-connected disabilities. The net decrease in the estimated costs under 1965 of only $1 thousand is due to a decrease of 70 average daily patient load offset almost entirely by an increase in contract per diem payment rates.
Average daily patient load:
Other Federal hospitals...
Municipal and State hospitals..
(d) Domiciliary care.--This covers the cost of domiciliary care of veterans in Veterans Administration facilities including the operation of two pilot restoration centers. The decrease in the estimated cost under 1965 is $4,023 thousand because of the planned closing in 1965 of four domiciliaries. Estimated operating levels are:
Average number of operating beds.. Average daily member load....
1964 actual 1965 estimate 1966 estimate
Average employment (net, including consultants).
1964 actual 1965 estimate 1966 estimate 2,740
Average daily nursing load...
1964 actual 1965 estimate 1966 estimate
The requirements presented in this budget submission take into consideration the contemplated receipt in 1966 of an equivalent amount of property and supplies from other Federal agencies or from the General post fund, national homes, Veterans Administration, to that experienced in 1964 which had an acquisition value of $1,779 thousand. This does not, however, represent the value of the items when transferred.
A supplemental appropriation for 1965 is anticipated under Proposed for separate transmittal.
Object Classification (in thousands of dollars)
Average salary, grades established by 38 U.S.C.
Total number of permanent positions..
Average salary of ungraded positions...
Proposed for separate transmittal:
(b) Nursing home..
781,685 783,605 46,725 49,001 49,040 14,464 15,142 14,935
Under existing legislation, 1965.-A supplemental appropriation of $8,295 thousand is proposed for separate transmittal to cover the $7,500 thousand wage rate increases approved for wage board employees between July 1, 1963 and June 30, 1965, $215 thousand to be 97,296 applied to the net increased per diem rates in Federal and non-Federal contract hospitals, and $580 thousand for increased grants for State home care resulting from the implementation of Public Law 88-450 approved August 19, 1964.
1,094,162 1,154,670 1, 186, 215
COMPENSATION AND PENSIONS
For the payment of compensation, pensions, gratuities, and allowances (including burial awards authorized by section 902 of title 38, United States Code, burial flags, and subsistence allowances for vocational rehabilitation), authorized under any Act of Congress, or regulation of the President based thereon, including emergency officers' retirement pay and annuities, the administration of which is now or may hereafter be placed in the Veterans Administration, and for the payment of adjusted-service credits and certificates as provided in sections 401, [and] 601, and 647 of the Act of May 19, 1924, as amended, and for payment of amounts of compromises or settlements under 28 U.S.C. 2677 of tort claims potentially subject to the offset provisions of 38 U.S.C. 351, [$3,963,000,000 $4,142,000,000, to remain available until expended [.]: Provided,