responsibility which is placed upon us by the provisions of the Legislative Reorganization Act of 1946 and by the rules of the House. It will be the purpose of the subcommittee to discharge this responsibility in a manner which will bring credit to the subcommittee and will strengthen the agencies which administer the programs authorized by laws which emanate from this committee. At this time, without objection, I will insert in the record, the bill H.R. 2410 and letters from the Bureau of the Budget, and the Department of Health, Education, and Welfare both addressed to Mr. Harris, the chairman of the full committee, which are favorable to this legislation. (H.R. 2410 and the letters referred to follow :) [H.R. 2410, 88th Cong., 1st sess.] A BILL To amend the Public Health Service Act to provide greater flexibility in the organization of the Service, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Public Health Service Organization Amendments of 1963." SEC. 2. Section 202 of the Public Health Service Act (42 U.S.C. 203) is amended to read as follows: "ORGANIZATION "SEC. 202. (a) The Service shall consist of (1) the Office of the Surgeon General, (2) the National Institutes of Health, (3) the Bureau of Medical Services, (4) the National Library of Medicine, and (5) such other bureaus or other constituent units as the Surgeon General may find appropriate for the organization of the Service and the efficient administration of its functions and as may be approved by the Secretary. The Surgeon General shall assign the several functions of the Service among such units. "(b) The Surgeon General may establish within any units established by or pursuant to subsection (a) such divisions, sections, or other subordinate units as he finds necessary; and from time to time may abolish, transfer, or consolidate divisions, sections, and other subordinate units, and units established pursuant to cause (5) of subsection (a), and assign their functions and personnel in such manner as he finds necessary for the efficient operation of the Service; except that, without the approval of the Secretary "(1) no unit established pursuant to clause (5) of subsection (a) may be abolished, “(2) no division may be established or abolished and no division may be transferred, and "(3) no such units or divisions may be consolidated. The Surgeon General may, whenever he deems it appropriate in view of any changes in functions assigned to any unit established by or pursuant to subsection (a), redesignate such unit, but only if such redesignation is approved by the Secretary. "(c) The Surgeon General may delegate to any officer or employee of the Service such of his powers and duties under this Act, except the making of regulations, as he may deem necessary or expedient." SEC. 3. (a) Subsection (a) of section 205 of such Act (42 U.S.C. 206) is amended by striking out "to administer the Office of the Surgeon General,". (b) Subsection (b) of such section is amended to read as follows: "(b) Any commissioned officer assigned to be the Director of the National Institutes of Health, the Chief of the Bureau of Medical Services, or the chief of any bureau established pursuant to clause (5) of section 202 (a) shall, while so assigned, have the grade of Assistant Surgeon General. The Surgeon General shall assign commissioned officers to be, respectively, Chief Medical Officer of the United States Coast Guard, Chief Dental Officer of the Service, and Chief Sanitary Engineering Officer of the Service and, while so assigned, they shall each have the grade of Assistant Surgeon General." (c) The first sentence of subsection (c) of such section is amended by striking out "eight positions created by" and inserting in lieu thereof "positions created by or pursuant to". The last sentence of such subsection is amended by striking out ", and while so serving they shall each have the title of Assistant Surgeon General". SEC. 4. The Surgeon General is authorized to replace the Bureau of State Services management fund with a management fund or funds with such titles as he may prescribe to be operated in accordance with that section of the Act of September 2, 1960, entitled "Bureau of State Services Management Fund" (74 Stat. 755, 765). SEC. 5. This Act shall become effective at such time as the Secretary of Health, Education, and Welfare may specify after the month in which it is enacted, but in no event later than the first day of the third calendar month following the month in which this Act is enacted. SEC. 6. As used in the amendments made by this Act, the term "Secretary" means the Secretary of Health, Education, and Welfare. EXECUTIVE OFFICE OF THE PRESIDENT, Hon. OREN HARRIS, BUREAU OF THE BUDGET, Washington, D.C., April 22, 1963. Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. CHAIRMAN: This will acknowledge your letter of February 14, 1963. requesting the views of the Bureau of the Budget on H.R. 2410, a bill to amend the Public Health Service Act to provide greater flexibility in the organization of the Service, and for other purposes. The bill originally was prepared by the administration to carry out the President's recommendations for reorganization of the Public Health Service contained in his special health message of February 27, 1962, to the 2d session of the 87th Congress. In that message, the President stated as follows: "Changes in recent years have greatly increased the responsibilities of the Public Health Service. Some major organizational changes are necessary in order to help this agency carry out its vital tasks more effectively. I will shortly forward to the Congress a proposal which will make these reorganizational changes possible. It will permit more effective administration of community health programs and those dealing with the health hazards of the environment." The President renewed this recommendation in his special health message of February 7, 1963, to this Congress. You are advised that enactment of H.R. 2410 would be in accord with the President's program. Sincerely yours, PHILLIP S. HUGHES, Assistant Director for Legislative Reference. Hon. OREN HARRIS, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Chairman, Committee on Interstate and Foreign Commerce, DEAR MR. CHAIRMAN: This letter is in response to your request of February 14, 1963, for a report on H.R. 2410, a bill to amend the Public Health Service Act to provide greater flexibility in the organization of the Service, and for other purposes. This bill embodies the provisions of the draft bill submitted to the Congress by this Department on June 26, 1962. For the reasons stated in the President's health messages of 1962 and 1963, and in the enclosed letter to the Speaker transmitting the draft bill, we urge enactment of H.R. 2410. Sincerely, ANTHONY J. CELEBREZZE, Secretary. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, Speaker of the House of Representatives, Hon. JOHN MCCORMACK, Washington, D.C. DEAR MR. SPEAKER: I am enclosing for your consideration a draft of a bill to amend the Public Health Service Act to provide greater flexibility in the organization of the Service. As the President pointed out in his 1962 health message to the Congress, some major changes in organization are needed to enable the Service to carry out its greatly increased responsibilities. With one notable exception, the present provisions of the Public Health Service Act give the Surgeon General broad discretion with respect to the delegation of statutory authorities and the assignment of functions among the various bureaus, divisions, and other units of the Service. The exemption referred to is contained in section 202 of the Act, which specifies that the Service "shall consist of (1) the Office of the Surgeon General, (2) the National Institutes of Health, (3) the Bureau of Medical Services, and (4) the Bureau of State Services. ***" Thus, both the number and the names of the principal organizational units of the Service are prescribed by statute and may not be modified by administrative action. Although this four-unit organization pattern was well suited to the needs of the Service in 1943, when this statutory provision was originally enacted, more than 20 new peacetime programs, some involving major new functions, have subsequently been assigned to the Service by legislative or administrative action. Organizational changes to reflect these program changes are particularly needed with respect to programs currently administered through the Bureau of State Services. Intensive studies of these programs indicate the desirability of grouping them into two main categories, with a separate bureau for each category. One category would include those programs and activities concerned with the development of adequate community health services and facilities and with the control of communicable diseases. The other category would embrace programs and activities focused primarily on the prevention and control of environmental health hazards, and related measures for the conservation of resources essential to health. Some administrative actions have already been taken in recognition of the need for regrouping of these programs and units. However, the statutory specification of the number and designations of major bureaus of the Service does not permit these actions to be carried to their logical conclusion-i.e., the abolition of the present Bureau of State Services and its replacement by two new bureaus. Another organizational change that would be desirable, but which cannot be effected under present statutory limitations, is to establish the National Library of Medicine and the National Center for Health Statistics as separate constituent units of the Service. Although full bureau status is not warranted for either of these units, their specialized functions and operations are not appropriate for assignment to any one bureau or to the Office of the Surgeon General. The enclosed draft bill would amend section 202 of the Public Health Service Act in three respects. First, while retaining as statutory constituent units the Office of the Surgeon General, the National Institutes of Health, the Bureau of Medical Services, and the National Library of Medicine, it would delete the statutory reference to the Bureau of State Services. Second, it would authorize the Surgeon General, with the approval of the Secretary, to supplement these statutory units with additional bureaus or other constituent units when required for the efficient administration of the Service, and to redesignate any bureau or constituent unit when necessary to reflect a change in its functions. In addition to these substantive amendments, the proposed revision of section 202 would delete the requirement, which is no longer necessary, that the National Institutes of Health "shall be administered as a part of the field service." The proposed changes in the statutory provisions relating to the major bureaus of the Service are paralleled by corresponding changes in the provisions relating to bureau chief positions. Section 205(a) of the act now calls for the assignment of regular officers of the Commissioned Corps to each of the three named positions and provides that officers so assigned shall have the grade of Assistant Surgeon General. The draft bill would substitute a more flexible authorization for the assignment of officers to such positions, but it would continue the provision that officers so assigned shall have the grade of Assistant Surgeon General. In addition, the bill would authorize the Surgeon General to replace the Bureau of State Services Management Fund with one or more management funds to be operated in accordance with existing law. Such authority would permit the adjustment of management funds to parallel future changes in bureau structure and designation. Finally, the draft bill would delete from section 205 (a) of the act the present requirement that the Deputy Surgeon General shall "administer the Office of the Surgeon General." With the increasing need by the Surgeon General for a deputy to assist him in the general administration of the Service as a whole, such a statutory identification of the deputy with one subordinate unit of the Service is no longer appropriate. As indicated by this summary of its principal provisions, the bill is limited to amendments relating to the organization of the Service and in no way extends or modifies the substantive or program authorities of the Surgeon General or of the Service. Except for minor administrative expenses incidental to the changes in the organization of the Service, the bill will entail no additional costs to the Government, and no additional appropriations will be requested by this Department to implement the provisions of the bill when enacted. We shall appreciate it, therefore, if you will refer the enclosed draft bill to the appropriate committee for early consideration and action. The Bureau of the Budget advises that enactment of this proposed legislation would be in accord with the program of the President. Sincerely, ABRAHAM RIBICOFF, Secretary. Mr. ROBERTS. It is a pleasure to have you, Dr. Terry, the Surgeon General of the Public Health Service, as our first witness. I also have two publications which have been furnished for the benefit of the committee to which I will make reference, as I am sure the Surgeon General will probably do in his statement. One is the Public Health Service, consisting of background material concerning the administration and organization of the Public Health Service, and the other is a Compilation of Selected Public Health Laws, including particularly the Public Health Service Act, the Federal Water Pollution Control Act, and acts relating to air pollution, both with the date of April 1963. STATEMENT OF DR. LUTHER L. TERRY, SURGEON GENERAL; ACCOMPANIED BY DR. DAVID PRICE, DEPUTY SURGEON GENERAL; DR. JAMES M. HUNDLEY, ASSISTANT SURGEON GENERAL FOR OPERATIONS; AND ELTON WOOLPERT, ASSISTANT TO THE SURGEON GENERAL FOR LEGISLATION, PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Dr. TERRY. Thank you, Mr. Chairman. Mr. Chairman and Mr. Harris, I have with me this morning on my far left Dr. David Price, the Deputy Surgeon of the Public Health Service; on my immediate left Dr. James Hundley, Assistant Surgeon General for Operations in my immediate office; and on my right Mr. Elton Woolpert, Assistant to the Surgeon General for legislation. Mr. Chairman, I have, as you are aware, a very long statement here prepared, but in light of the understanding which we had received from you and your committee, it was felt that this was the best way by which we could make a firm foundation for an understanding of many of the programs and activities of the Public Health Service. I would like the opportunity, Mr. Chairman, if you and the members of the committee are willing, to go through this statement. However, if you find that it is unnecessarily long at any stage, I will be happy to brief it for you. Mr. ROBERTS. I think we will leave the method of proceeding up to you, Mr. Terry. Dr. TERRY. Thank you, Mr. Chairman. I am very pleased to have this opportunity to open these hearings. Mr. HARRIS. Mr. Chairman, before Dr. Terry proceeds, in view of the fact that I have a good many irons in the fire this morning and today, I would like to make a few comments at this time about these hearings which reflect some of my thinking. I think these comments will probably further clarify what I had in mind last year during the course of the drug bill and other legislation on the floor of the House. I am fully cognizant of the importance of these hearings. Mr. Roberts, as Chairman of this subcommittee, has already given some indication of the purpose of these hearings and outlined the course of action. this subcommittee should take in obtaining a clearer picture of the programs administered by the Public Health Service and your depart ment. I want these to be thorough hearings, Doctor. I want to go into every phase and have a complete analysis and explanation of the entire program. I do not wish to indicate any criticism at all. I am merely saying that this is what we wish, and that is to find out the facts. Therefore, there are several reasons why I have asked this subcommittee, under the direction of our very able and esteemed chairman, Mr. Roberts, to proceed with the hearings on this legislation. First, the bill that I have introduced here, H.R. 2410, would grant to the Public Health Service broad authority to reorganize its structure. The grant of such broad authority by the Congress requires careful consideration. It is a vehicle that we are also using to look into the public health program fully and completely. Second, there has been substantial criticism, both within the Congress and outside of the Congress, with regard to the manner in which some of these programs have been administered. This criticism, in my judgment, should be gone into carefully in connection with the proposed legislation as one of the purposes of these hearings. Third, questions have been raised as to whether the regulatory or police functions of the Public Health Service, as distinguished from the service, research, supportive, and formal responsibilities, should be separated in some manner organizationally. This is an important area which the hearings should examine, and I would like to suggest rather critically so. Fourth, there have been contentions that the coordination between the Public Health Service and its sister agency, the Food and Drug Administration, which is in the Department of Health, Education, and Welfare, leaves much to be desired, and that the organizational pattern of the Department of Health, Education, and Welfare in this regard should be strengthened. This aspect, in my judgment, should be explored Mr. Chairman, during these hearings. Fifth, there are some questions whether the present division of the responsibilities and functions between the Public Health Service and the Food and Drug Administration are appropriate in the light of modern scientific developments or whether some realinements are indicated. I hope this will be gone into thoroughly during the course of these hearings. Also, our committee for many years has dealt with the health and food and drug problems on a piecemeal basis. I believe it is time to take inventory of existing programs in order to gain a picture of the |