That, except in emergencies, those entitled to care by the United States Public Health Service will be admitted only when facilities of that service are not available. A seaman is in the service of a ship, although not on board and not engaged in his duties, as long as he is under the power and jurisdiction of competent Department of Defense authorities. Cases of traumatic injury or occupational disease incurred in the course of employment should be treated as Bureau of Employees' Compensation beneficiaries. (25) American seamen to include both officers and members of the crew outside the continental United States, its territories and its possessions. This category includes seamen aboard ships of United States registry such as those aboard Department of Defense time-chartered vessels of commercial operators; in emergency, to save life or prevent undue suffering, those aboard time-chartered vessels other than those referred to above; and those on privately owned and operated vessels. A seaman, whose condition would require retention in an Army medical treatment facility for a prolonged period of time, and when lack of transportation facilities prevents evacuation through the local ship's agent, may be evacuated through Army medical evacuation channels as soon as transfer without detriment to the patient is possible. No seaman in the service of a vessel of foreign registry will be evacuated to the continental United States. (26) Civilian employees of cost-plus-a fixed-fee contractors of the Department of the Army. (27) Civilian employees of the Office of the Secretary of Defense may be furnished medical care in Army medical treatment facilities outside the continental United States in the absence of civilian facilities. (28) Civilian employees of the Army, Navy and Air Force paid from either appropriated or nonappropriated funds, and their dependents (including librarians and service club personnel appointed under authority of §§ 557.1 through 557.6 and 557.10 through 557.12 of this chapter) may, in the absence of civilian facilities, be furnished medical care in Army medical treatment facilities outside the continental United States and at remote military installations in the continental United States. Oversea commanders will determine whether civilian medical facilities are adequate and meet acceptable American standards. (29) When it has been determined by the oversea commander that adequate civilian facilities are not available, certain categories of personnel peculiar to the oversea commands who contribute to the accomplishment of the oversea commander's mission may be furnished medical care in Army medical treatment facilities overseas. Some examples of personnel falling into this category are as follows: Accredited representatives of United States commercial organizations who are United States citizens, to include news correspondents, representatives of commercial airlines, oil companies, etc.; members of recognized religious missions who are United States citizens; entertainment personnel on tour in oversea commands; athletic consultants and civilian actress technicians, etc. (30) Designees of the Secretary of the Army. (31) Indigent and nonindigent civilians in extreme necessity to save life or prevent undue suffering. (32) Individuals who require medical evaluation in connection with consideration of their case by the Army Board for Correction of Military Records. [18 F. R. 3229, June 4, 1953, as amended at 18 F. R. 6281, Oct. 2, 1953; 19 F. R. 1581, Mar. 24, 1954] § 577.16 Hospitalization and disposition of nonmilitary patients. (a) Persons other than those in the military service may be retained in the hospital until hospitalization is no longer required: Provided, That facilities for their care are adequate and the individual is authorized such care. In other cases, the patient will be discharged from the hospital as early as his medical condition permits. (b) Civilians admitted to Army medical treatment facilities must conform in all particulars to the rules and regulations governing the operation of such facilities. In the event of failure or refusal to comply therewith, the patient at once becomes liable to discharge from the facility at the discretion of the facility commander. A patient discharged from a facility for disregard or disobedience of rules and regulations will be refused admission thereto or to any other Army medical treatment facility within 90 days after such discharge, except under emergency circumstances when earlier admission is necessary to save life or prevent undue suffering. Whenever beneficiaries of the Veterans' Administration are discharged from the hospital under the preceding conditions, the hospital commander will forward to the Administrator of the Veterans' Administration, through the regional manager, a report giving the patient's full name and address, the reasons for his early discharge, his condition at the time of discharge, and any other information which may be pertinent to the case. Similar action will be taken in cases of patients who are beneficiaries of other governmental agencies, when the report required above will be sent to the agency concerned. [17 F. R. 3847, May 1, 1952] § 577.17 Patients' effects-(a) General. These provisions have particular application to and are intended to cover the ordinary requirements of peacetime conditions. In time of war, when large numbers of patients are being received daily, strict adherence to the procedures prescribed in this section may be impracticable; therefore, such deviations as the commanding officer of the hospital concerned may deem necessary may be made to assure the safeguarding of patients' effects. (b) Responsibility. The commanding officer of a hospital is responsible that due care is observed in safeguarding the money, valuables, clothing, and other effects of patients admitted to hospital. The registrar ordinarily will be the custodian of money and valuables turned over to the hospital by patients for safekeeping. Patients (c) Money and valuables. will be informed by the admitting officer that the hospital will receive, for safekeeping, money and valuables, including watches, trinkets, personal papers, keepsakes, etc., and that receipts will be given for such articles by an individual authorized by the commanding officer. In case the patient is unconscious, he will be searched by the admitting officer, in the presence of a witness, for money and valuables, which will be receipted for by a commissioned officer and properly safeguarded. Money and valuables will be received and receipted for without condition or other evasion of complete responsibility by the commanding officer or by an officer, warrant officer, or any bonded individual designated by him. Money and valuables of considerable intrinsic value, such as watches and jewelry, will be deposited in a bank or locked in the hospital safe. Articles of lesser value may be stored in locked compartments in a well safeguarded storeroom. When a patient is discharged, transferred, dies, or deserts, his money and other valuables will be disposed of as prescribed for the disposition of effects other than public property. [13 F. R. 6790, Nov. 19, 1948] § 577.18 Rates of charge. Charges will be at the rates for the applicable fiscal year as prescribed in current Department of the Army regulations. [15 F. R. 8052, Nov. 23, 1950] § 577.21 Admission and treatment of American seamen in medical treatment facilities of Department of the Army outside continental United States, its territories, and its possessions-(a) General. This section governs hospitalization and outpatient treatment of American seamen aboard ships of United States registry (referred to in this section as "seamen") in medical treatment facilities of the Department of the Army. The term "seamen" as used in this section includes both officers and members of the crew. (b) Application. (1) This section is applicable to all medical treatment facilities of the Department of the Army outside the continental United States, its Territories, and its possessions. (2) Paragraph (d) (4) of this section will be observed by all commands and medical treatment facilities of the Department of the Army within continental United States. (c) Authorization. The following seamen are authorized to receive medical care and treatment as prescribed in §§ 577.15 and 577.18, when adequate facilities are available: (1) Seamen aboard Department of Defense time-chartered vessels of commercial operators. (2) In emergency, to save life or prevent undue suffering, seamen aboard time-chartered vessels other than those referred to in subparagraph (1) of this paragraph. (3) Seamen on privately owned and operated vessels. (d) Medical and surgical treatment. (1) Such medical and surgical care is authorized as is afforded by the facilities of the medical installation concerned, except as follows: (i) No elective medical or surgical treatment is authorized. (ii) No spectacles, artificial limbs, hearing aids, or artificial eyes will be provided. (2) Seamen hospitalized under this section, whose condition would require retention in an Army hospital for a prolonged period of time, and when lack of transportation facilities prevents evacuation through their local ship's agent, may be evacuated through Army medical evacuation channels as soon as transfer without detriment to the patient is possible, provided that no seamen employed by a vessel of foreign registry will be evacuated to the continental United States. (3) Seamen evacuated from overseas aboard Military Air Transport Service aircraft or aboard hospital ships or transports will not be considered to be in a hospital status while aboard and no per diem charge for medical care will be made. (4) Continuation of hospitalization or out-patient treatment by Army medical treatment facilities in continental United States is not authorized. The commanding officer at the port of debarkation will, upon arrival of the seamen evacuated from overseas, effect disposition in accordance with applicable regulations. (e) Dental treatment. Dental treatment will be limited to that necessary for the relief of pain or acute septic conditions, such as extractions and treatments, including temporary fillings. permanent fillings or replacements will be provided. No (f) Immunization and physical examination. Immunizations and physical examinations of the personnel covered by this section (excluding immunization and physical examination, which are an actual part of the in-patient or outpatient medical, surgical, or dental treatment authorized in paragraphs (d) and (e) of this section) may be furnished by the Department of the Army medical treatment facilities overseas, when adequate facilities are available. (g) Collection of charges. The medical treatment facility concerned will collect from the patient or from the patient's local ship's agent, charges for medical services at rates applicable to the fiscal year concerned. Remittances from the patient or the ship's agent will be made to the medical treatment fa cility concerned by cash or certified check. [16 F. R. 7824, Aug. 9, 1951] § 577.22 Admission to and treatment in medical facilities, Department of the Army, in continental United States and Alaska, of beneficiaries of Bureau of Indian Affairs-(a) General. The terms and conditions of these regulations, which are applicable to all commands and medical facilities of the Department of the Army in continental United States and Alaska, will govern hospitalization and out-patient treatment of beneficiaries of the Bureau of Indian Affairs in medical facilities of the Department of the Army in continental United States and Alaska, such treatment being authorized when adequate facilities for treatment are available. (b) Personnel to whom treatment outlined herein applies. The treatment outlined in this section applies to the following personnel, who are beneficiaries of the Bureau of Indian Affairs: (1) Enrolled Indians (or members of Indian tribes) in continental United States. (2) Indians (in Alaska). (c) Written authorization. Admission to medical facilities of the Department of the Army for hospitalization or outpatient treatment will be on written signed authorization of the superintendent of the applicable Indian Agency (for Indians in continental United States) or of the General Superintendent, Alaska Native Service, or his authorized representative (for Indians, Eskimos, or Aleuts in Alaska). The authorization will give the full name of the patient and will indicate whether he is an enrolled Indian (in continental United States) or an Indian, an Eskimo, or an Aleut (in Alaska); it will state that he is a beneficiary of the Bureau of Indians Affairs and is entitled to treatment at the expense of the Bureau; it also will give the diagnosis, if known. It is the responsibility of the commanding officer of the medical facility concerned to require such written signed authorization prior to admission of the patient for hospitalization or out-patient treatment. Only in case of emergency may a patient in this category be admitted to a medical facility of the Army for hospitalization or out-patient treatment without writ ten signed authorization. In such instances, it is the responsibility of the commanding officer of the medical facility to obtain properly prepared signed authorization as soon as practicable. (d) Medical and surgical treatment. Except as indicated in subparagraphs (1) and (2) of this paragraph, complete medical and surgical treatment will be furnished. (1) No elective medical or surgical treatment is authorized. (2) No artificial limbs, artificial eyes, or any other prostheses will be provided. Spectacles and hearing aids, which do not fall within the category of prosthetic appliances, will not be provided. (e) Dental treatment. Dental treatIment will be given only for emergency conditions and will be limited to that necessary for the relief of pain or acute conditions or when the dental condition is associated with serious illness requiring hospitalization. (f) Rates of charge. Charges will be at rates for pay patients in Army hospitals for the applicable fiscal year as published annually by the Department of the Army. [14 F. R. 5201, Aug. 19, 1949] § 577.24 Army and Navy Hospital, Hot Springs, Arkansas; regulations applicable. In accordance with the proviso in Executive Order 10272, July 10, 1951 (3 CFR, 1951 Supp.), all rules, regulations, and restrictions prescribed by the Department of the Army uniformly applicable to other Army hospitals are made applicable to Army and Navy Hospital, Hot Springs, Arkansas. [16 F. R. 11222, Nov. 3, 1951] DENTAL ATTENDANCE SOURCE: $ 577.40 to 577.46 appear at 18 F. R. 6238, Sept. 30, 1953. § 577.40 General (a) Definition. The term "dental care" as used in §§ 577.40 to 577.46 embraces the field of dentistry as commonly practiced by the dental profession. (b) Precedence in treatment. Persons requiring emergency treatment will receive first consideration. Persons on active military duty will have precedence over others authorized treatment under § 577.2. (c) Selection of professional procedures. Except as otherwise prescribed in this part, the selection of professional procedures to be followed in each case, including the use of special dental materials, will be left to the judgment of the dental officer concerned. The highest standards of dental treatment will be maintained. (d) Governing regulations. In general, §§ 577.1, 577.2, 577.5, 577.15 and 577.18 relating to medical care will govern dental care except as otherwise provided in §§ 577.40 to 577.46. Den § 577.41 For whom authorized. tal care is authorized for the same persons and under the same conditions as medical care (see §§ 577.1, 577.2, 577.5, 577.15 and 577.18), subject to the provisions of § 577.42 regarding dental care by civilian dentists. § 577.42 Dental care by civilian dentists-(a) For whom authorized. Subject to the conditions and limitations specified, dental care by civilian dentists at the expense of Army Medical Service funds is authorized for the following personnel and none other when the required care cannot be procured from available dental facilities of the Department of Defense or other Federal agencies outside the Department of Defense, provided that this authorization will not apply to personnel who obtain elective dentistry from civilian dentists: (1) Officers, warrant officers, and enlisted personnel of the Regular Army and cadets of the United States Military Academy when on a duty status or when absent on any authorized leave or pass. Charges incurred for civilian dental care when absent without leave are the sole responsibility of the individual concerned. (2) Officers, warrant officers, and enlisted personnel of the Army Reserve; the Federally recognized National Guard of the several States, Territories, and the District of Columbia; the National Guard of the United States; and the Army without specification as to component when ordered or called into active Federal service or when ordered to active or inactive duty training (see sec. 5, act of April 3, 1939 (53 Stat. 557) as amended, (10 U. S. C. 456)). (3) Members of the Reserve Officers' Training Corps en route to, or from, or during their attendance at camps of instruction under section 47a, National Defense Act (41 Stat. 778) as amended (10 U. S. C. 441). (4) Applicants for enlistment or reenlistment and inductees under the Uni versal Military Training and Service Act (65 Stat. 75) as amended (limited to necessary dental examination except as provided in subparagraph (5) of this paragraph). (5) Applicants for entry into the Army or inductees while undergoing observation. (6) Prisoners. (7) Prisoners of war, persons interned by the Army, and other persons in military custody or confinement. (8) Civilian seamen in the service of vessels operated by the Department of the Army. (b) Payment when not in line of duty. In the event a member of an Army reserve component (Army Reserve, National Guard and National Guard of the United States, or the Reserve Officers' Training Corps) is furnished dental care by a civilian dentist after termination of camp or the prescribed tour of active duty for training, for personal injury or disease contracted not in line of duty, the member concerned is personally responsible for payment of charges for dental care furnished by civilian dentists. (c) Emergency dental care. Prior approval of higher authority is not required for the employment of a civilian dentist for emergency dental treatment, which is defined as dental treatment for the relief of pain, or acute septic conditions, or of dental injuries caused by direct violence. Such care will be confined to the relief of the immediate emergency. Followup procedures are subject to the provisions of paragraph (d) of this section. (d) Routine or extensive dental care. (1) Civilian dentists may not be employed at public expense for the treatment of chronic lesions, filling operations, prosthetic replacements, and other prolonged or extensive procedures, such as those required following the relief of an immediate emergency, until specific approval for such employment has been received from the approving authority, provided that in the case of military personnel on detail without troops in foreign countries, dental service of this character which is urgently necessary may be procured at reasonable rates without prior approval of higher authority. (2) Application for authority to employ a civilian dentist for routine or extensive dentistry will be made as follows: (i) For patients and duty personnel assigned at class II Army medical installations and activities. The Surgeon General, Department of the Army, Washington 25, D. C. (ii) For patients and duty personnel at other installations and activities within the continental United States (including members of the Army Reserve and Reserve Officers' Training Corps of the Army). The appropriate continental army commander or the Commanding General, Military District of Washington, for their respective geographical areas. (iii) For patients and duty personnel at installations and activities outside the continental United States (including members of the Army Reserve and members of the Reserve Officers' Training Corps of the Army). The appropriate oversea commander. (iv) For members of the Federally recognized National Guard of the several States, Territories, and the District of Columbia and the National Guard of the United States. Chief, National Guard Bureau, Washington 25, D. C. (v) For military personnel in continental United States who are on leave, temporary duty, or detached service from oversea stations or who are awaiting reassignment from oversea stations. The appropriate continental army commander in whose area the patient's port of entry (aerial or water port of debarkation) is located. (vi) For members of Army military missions. The Officer in Charge. (vii) For members in the Army attache system. The military Attache. (3) In requesting authority to employ a civilian dentist, information will be given as follows: (i) Character and extent of the disability. (ii) Its origin or causation, and if due to external violence, what the violence was and when it occurred. (iii) Professional procedures considered necessary to correct it. (iv) Estimate of the time required for its correction and the probable cost thereof. (v) Statement of the duties upon which the patient is engaged and how his |