AGE-ADJUSTED DEATH RATES BY COLOR AND SIX: Dr. TERRY. Examples of some of the kinds of data they produce are included. I. Public Health Service role in carrying out functions in other Federal agencies: I would like to direct your attention briefly to a type of role we play which is perhaps unique among Federal agencies. Being the principal civilian health agency, we are frequently called upon to assume tasks or provide staff to carry out functions that are the basic responsibility of another Federal agency. I have already mentioned several of these, such as Coast Guard, Federal prisons, Peace Corps, and AID. However, there are many more. I call your attention to page 145 of the committee print which illustrates the scope and variety of this role. Even this list is incomplete. It might include 5,502 of our staff operating the Indian health program, since the overall responsibiilty for the American Indians rests with the Department of the Interior. Also, the list does not include staff we have assigned to State and local health departments. These number in the hundreds. At times we assign officers to act as State or local health officers although we discourage this as much as possible. In most instances, this type of arrangement has been made when an agency without any established health or medical staff undertakes a program which has a health or medical component, or which require health or medical support services. In other instances, the need is for liaison in areas where we have close operating responsibilities. In other instances, we have loaned officers to create a health or scientific capability in another agency; for example, the Federal Aviation Agency. For a few years after World War I, we attempted to provide medical services for what we now call the Veterans' Administration. However, they gradually created their own medical capability, although some veterans still receive care in Public Health Service hospitals when they are more convenient than veterans hospitals. Today, the role of the Public Health Service in the functions of other Federal agencies includes activities of four general types: 1. It operates medical care programs for other Federal agencies. 2. It provides medical services for the clientele or beneficiaries of other Federal agencies. 3. It assigns personnel to other Federal agencies for purposes related to the Nation's health. 4. It gives direct or collaborative assistance to other Federal agencies in connection with health and scientific activities of mutual con cern. We are pleased to assist other agencies whenever possible. In general, it represents an efficient and satisfactory procedure to both parties. Most of these assignments are on a reimbursable basis. However, our shortages in many categories of personnel are becoming so acute that we cannot meet many of the requests which are made of us. We are also aware that some legislation pending in the Congress, such as the Youth Conservation Corps, would undoubtedly create further demands for staff. Mr. Chairman, I would like also to submit a fuller report for the record which presents more detailed information on our activities in carrying out functions for and with the other Federal agencies. Mr. ROBERTS. Without objection, that will be included. (The report referred to is as follows:) THE ROLE OF THE PUBLIC HEALTH SERVICE IN CARRYING OUT FUNCTIONS IN OTHER FEDERAL AGENCIES One of the main functions of the Public Health Service since its earliest beginnings has been to provide other Federal agencies with medical services. supply them with health personnel, and cooperate with them in a wide variety of activities to further the Nation's health. The role of the Service has never been confined to its own programs; it has always included many activities designed especially for the benefit of other Federal programs. Today the role of the Public Health Service in the functions of other Federal agencies includes activities of four general types: 1. It operates medical care programs for other Federal agencies. 2. It provides medical services for the clientele or beneficiaries of other Federal agencies. 3. It assigns personnel to other Federal agencies for purposes related to the Nation's health. 4. It gives direct or collaborative assistance to other Federal agencies in connection with health and scientific activities of mutual concern. These activities are financed in various ways. The Department of Justice seeks the funds for medical care in the Bureau of Prisons. Funds for Coast Guard medical care are sought as a part of our own appropriation requests. In the Indian health program we prepare and propose the budget as a part of the Department of the Interior budget. Assignment of staff to other agencies is generally on the basis of reimbursable detail. Medical care for personnel who are not legally designated PHS beneficiaries is generally on a reimbursable basis. The following outline lists the principal agencies assisted and briefly describes the assistance given, in each of the four types of activities. 1. Operates medical-care programs for other agencies: DEPARTMENT OF COMMERCE Coast and Geodetic Survey: Provides medical care as needed for the 195 commissioned officers and 109 retired officers of the Survey and their dependents. Provides commissioned officers as ships' physicians aboard vessels making oceanographic surveys in remote areas of world. Five officers are assigned to these tours of duty. Maritime Administration: A PHS officer serves as chief medical officer of administration, providing professional consultation and service. Three officers provide health care for cadets at U.S. Merchant Marine Academy. DEPARTMENT OF THE INTERIOR Bureau of Indian Affairs: Conducts comprehensive health program for 380,000 American Indians and Alaska natives. Division of Indan Health has 5,300 employees including 488 commissioned officers. Annual budget is $55,834,000; in addition $9,335,000 is available for construction. (Responsibility for health services for Indians and Alaska natives was transferred by the Congress from Bureau of Indian Affairs to Public Health Service in 1955; previously, PHS detailed officers to BIA for health program. Although appropriation requests are presented in connection with Department of the Interior, Public Health Service has independent authority for conduct of health program.) DEPARTMENT OF JUSTICE Bureau of Prisons: Provides comprehensive medical care for 23,689 Federal prisoners, including operation of 23 hospitals and 7 infirmaries. Assigns 103 officers and 178 other employees to program. Annual budget is $2,510,000. DEPARTMENT OF LABOR Bureau of Employees' Compensation: Operates medical program of BEC which provides medical care, treatment, and rehabilitation services for Federal employees, and other eligible persons, who are injured on duty or become ill from causes related to their work. Program encompasses 21⁄2 million Federal employees and 1 million other persons including war claims group, the old Civilian Conservation Corps, District of Columbia employees, employees of private industry in the District and longshore and harbor workers. There are about 125,000 new injury claims among Federal employees each year. Six medical officers and six other physicians are assigned by PHS to administer medical, rehabilitation, training, and safety aspects of program and serve as technical advisers in adjudication of claims. The annual budget is $150,000. PEACE CORPS Directs medical program. Supplies commissioned officers for key medical care positions. Examines candidates, gives immunizations and medical care to members. Forty-four officers are assigned, 34 of whom are stationed in 30 foreign coun tries. DEPARTMENT OF THE TREASURY Coast Guard: Operates medical program for the 31,000 active members of Coast Guard, 10,000 retired members, and 45,000 to 50,000 dependents. Ninetysix officers and other employees are assigned full-time. There were 8,000 ad missions of Coast Guard members and dependents to PHS hospitals in 1962; and 6,400 admissions to other hospitals with cost paid by PHS. Also, 229,300 visits were made to PHS outpatient facilities. Provides medical and dental officers for cutters and patrol ships. Each year 40 to 50 officers make short tours in Atlantic and about 12 in Pacific. PHS officers in charge of hospitals, clinics, or quarantine stations act as Coast Guard district medical officers in 10 of the 12 districts. The annual budget is $1,037,000. FEDERAL AGENCIES At request of Federal agencies desiring this assistance, operates employee health units providing on-the-job health services including: Treatment of conditions requiring emergency attention; preemployment and other examinations; referral of employees to private physicians and dentists; and preventive health programs. There are 39 units serving about 60,000 Federal employees in Washington, D.C., and nearby field locations, and in several other cities over the country. More than 250,000 visits are made to the units each year. Nine medical officers, 21 part-time physicians, and 92 other employees are assigned to administration and operation of the Federal employee health program. The annual budget is $844,769. 2. Provides medical services for clientele or beneficiaries of other Federal agencies: CIVIL SERVICE COMMISSION Examines applicants for civil service appointment and civilian employees of Government to determine fitness for duty and eligibilty for disability retirement. DEPARTMENT OF DEFENSE Army, Navy, Air Force, Marine Corps: Provides medical care for military personnel and dependents where military facilities are not available, and where PHS facilities are available. FEDERAL JUDICIARY PHS officers assigned to medical staff of Bureau of Prisons, Department of Justice, perform psychiatric examinations, under certain conditions, of offenders whose competency for trial has been questioned; of youth and young adult offenders; and of certain other offenders. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Social Security Administration, Bureau of Family Services: Gives psychiatric care and treatment to U.S. nationals returned to this country by Department of State because of mental illness. DEPARTMENT OF JUSTICE Examines persons subject to prosecution who claim physical inability to appear in court. Federal Bureau of Investigation: Examines applicants for employment as special agents. Immigration and Naturalization Service: Gives physical examinations and, in some cases, treatment to alients arriving at air, sea, and land border ports of the United States. DEPARTMENT OF LABOR Bureau of Employment Security: Conducts medical screening and disease control program for farmworkers recruited from Mexico. DEPARTMENT OF STATE Bureau of Security and Consular Affairs: Examines visa applicants at certain U.S. consulates and notifies consular officers of findings. Foreign Service: Provides medical care and treatment of Foreign Service personnel and dependents, where PHS facilities are available. |