or reformatory institution, and with suitable clothing.

§ 33.6 Prisoners, ex-prisoners, and probationers, transportation furnished upon discharge.

Every prisoner, ex-prisoner, and probationer shall be furnished with transportation, by the cheapest usually travelled route, to the place of conviction or of bona fide residence within the United States, or to such other place within the United States as, in the opinion of the medical officer in charge, may afford the best opportunity for permanent rehabilitation. As used in this section, "United States" includes all places, continental or insular, subject to the jurisdiction of the United States, except the Canal Zone.

[25 FR. 43, Jan. 5, 1960]

§ 33.7 Voluntary patients; admission and transportation upon discharge.

(a) A person seeking admission as a voluntary patient to one of the hospitals of the Service shall submit an application on a form prescribed by the Surgeon General. The medical officer in charge shall cause each applicant to be examined as soon as practicable after the applicant has presented himself for admission to the hospital and shall determine whether the applicant is an addict and whether the applicant may be cured of his addiction by care and treatment in the hospital, and such officer shall estimate the maximum time necessary to effect such cure and advise the applicant of such determinations.

(b) Voluntary patients shall be charged for their subsistence, care, and treatment in the hospital at a rate to be determined by the Surgeon General. Those patients, however, who have been determined by the medical officer in charge, on the basis of information concerning their financial resources and responsibilities, to be financially unable to pay shall not be so charged. The medical officer in charge may determine or redetermine the financial ability of a patient to pay at any time prior to or during the course of care and treatment of such patient at the hospital. In the absence of misrepresentation concerning a patient's financial resources or responsibilities, such determination or redetermination shall not have any retroactive effect upon the pay or non-pay status of the patient.

(c) Upon the discharge of any indigent voluntary patient as cured, the cost of his transportation, including subsistence allowance while traveling, may be paid by the Public Health Service to any place within the continental United States which, in the opinion of the medical officer in charge, will afford the best opportunity for such patient's permanent rehabilitation. Determinations of indigency for this purpose shall be made by the medical officer in charge and may be based upon information submitted by the patient concerning his financial resources and responsibilities.

34.18 84.14

Medical and other care; death. Reexamination; convening of boards; expert witnesses; reports.

AUTHORITY: The provisions of this Part 34 issued under sec. 215, 58 Stat. 690, as amended, sec. 234, 66 Stat. 198; 42 U.S.C. 216, 8 U.S.C. 1224. Sec. 322, 325, 58 Stat. 696, as amended 697, as amended, secs. 212, 326, 66 Stat. 182, as amended 200; 42 U.S.C. 249, 252, 8 U.S.C. 1182, 1226.

SOURCE: The provisions of this Part 34 appear at 21 F.R. 9829, Dec. 12, 1956, unless otherwise noted.

§ 34.1 Applicability.

The provisions of this part shall apply to:

(a) The medical examination of (1) aliens applying for a visa at a consulate of the United States, (2) aliens arriving in the United States, and (3) aliens presented or referred by the Immigration Service in connection with determination of their admissibility into the United States, and

(b) The medical and other care, and burial, of aliens admitted to Public Health Service stations and hospitals at the request of the Immigration Service. § 34.2 Definitions.

As used in this part, terms shall have the following meanings:

(a) Immigration Service. The Immigration and Naturalization Service of the Department of Justice.

tions made at a designated place or in a designated area.

[21 F.R. 9829, Dec. 12, 1958, as amended at 26 F.R. 9856, Oct. 20, 1961; 35 F.R. 15289, Oct. 1, 1970]

§ 34.3 Examinations; female aliens.

Female aliens shall be examined only in the presence of a female nurse or other female, or by a female physician.

§ 34.4 Scope of examinations.

(a) General. In performing examinations and reexaminations, medical examiners shall give consideration to only those matters that relate to the physical or mental condition of the alien and shall issue certificates or notifications of a defect, disease, or disability or previous occurrence of one or more attacks of insanity as hereinafter provided only if the presence of such defect, disease, or disability or previous occurrence of one or

of the following diseases:

(1) Chancroid.

(2) Gonorrhea.

(3) Granuloma inguinale.

(4) Leprosy, infectious.

(5) Lymphogranuloma venereum.
(6) Syphilis, infectious stage.

(7) Tuberculosis, active.

(c) Medical certificate. A document issued to the Immigration Service by a medical examiner, reporting the presence of any physical or mental defect, disease, or disability, or the previous occurrence of one or more attacks of insanity, in an alien.

(d) Medical notification. A document issued to a consular authority by a medical examiner, reporting the presence of any physical or mental defect, disease, or disability or the previous occurrence of one or more attacks of insanity, in an alien. Medical notification shall be made on the form prescribed for reporting the results of the medical examination of applicants for visas.

(e) Medical officer. A physician of the Public Health Service assigned or detailed by the Surgeon General of the Public Health Service to make mental and physical examinations of aliens.

(f) Medical officer in charge. A medical officer charged by the Surgeon General with responsibility for the conduct and supervision of all medical examina

(1) Persons subject to requirement for chest X-ray examination and serologic test. Except as provided in subparagraph (2) of this paragraph, a chest X-ray examination for tuberculosis and a serologic test for syphilis shall be required as part of the examination of:

(i) All applicants for immigrant visas; (ii) All students and exchange visitors who are required by a consular authority to have a medical examination upon application for a nonimmigrant visa;

(iii) All other applicants for a nonimmigrant visa who are required by a consular authority to have a medical examination if such X-ray examination and serologic test are considered necessary by the medical examiner; and

(iv) All aliens outside the United States who apply for conditional entry and all aliens in the United States who apply for adjustment of status, under the immigration laws and regulations.

(2) Exceptions. Neither a chest X-ray examination nor a serologic test for syphilis shall be required if the alien is under the age of 15: Provided, That a tuberculin test may be required where there is evidence of contact with a known case of tuberculosis or other reason to suspect infection with tuberculosis and a chest X-ray examination required in the event of a positive reaction, and a serologic test where there is reason to suspect infection with syphilis. Additional exceptions to the requirement for a chest

Guard. In an emergency, the officer in charge of a medical relief station, or a designated physician or designated dentist, may accept other evidence of status satisfactory to him.

(Sec. 610 (b), 58 Stat. 714 as amended; 33 U. S. C. 763c)

831.15

Continuance of medical relief after loss of status. If a person is separated while undergoing treatment by the Service, his treatment shall be discontinued immediately unless the physician or dentist in charge determines that the condition of the patient does not permit interruption of treatment, in which case the treatment shall be discontinued as soon as practicable and the condition of the patient permits. At that time he shall be discharged from treatment and shall not thereafter be afforded medical relief by the Service by reason of his previous service.

(Sec. 610 (b), 58 Stat. 714, as amended; 88 U.S. C. 763c)

§ 31.16 Retired personnel; extent of

treatment.

(a) Any retired person specified in § 31.11 shall be entitled to medical, surgical, and dental treatment and hospitalization at medical relief stations of the first, second, and third class, upon presentation of satisfactory evidence of his status.

(b) Elective medical or surgical treatment requiring hospitalization shall be furnished only at hospitals operated by the Service.

(c) Dental treatment shall be furnished to the extent of available facilities only at medical relief stations where full-time dental officers are on duty; at other medical relief stations the dental treatment shall be limited to emergency measures necessary to relieve pain.

(Sec. 610, (b), 58 Stat. 714, as amended; 33 U.S. C. 783c)

32.89

Discharge.

32.90

Notification to health authorities regarding discharged patients.

SEAMEN ON FOREIGN FLAG VESSELS 32.106 Conditions and extent of treatment; rates; burial.

NONBENEFICIARIES; TEMPORARY TREATMENT IN EMERGENCY

32.111 Conditions and extent of treatment; charges.

AUTHORITY: Sec. 2, 321, 322, 58 Stat. 682, 695, 696 as amended; 42 U.S.C. 2, 248, 249. Sec. 32.86 to 32.90 issued under sec. 331 and 332, 58 Stat. 696, 698 as amended; 42 U.S.C. 255, 256.

SOURCE: 40 FR 25816, June 19, 1975, unless otherwise noted.

DEFINITIONS

§ 32.1 Meaning of terms.

All terms not defined herein shall have the same meaning as given them in the Act.

(a) "Act" means the Public Health Service Act, approved July 1, 1944, 58 Stat. 682, as amended;

(b) "Service" means the Public Health Service;

(c) "Secretary" means the Secretary of Health, Education, and Welfare and any other officer or employee of the Department of Health, Education, and Welfare to whom the authority involved may have been delegated.

(d) "Seamen" includes any person employed on board in the care, preservation, or navigation of any vessel, or in the service, on board, of those engaged in such care, preservation, or navigation, but does not include the owner or joint owners of a vessel or the spouse of any such owner, except owner-operators as described in § 32.6 (a) (12);

(e) "Vessel" includes every description of watercraft or other artificial contrivance used, or capable of being used, as a means of transportation on water, exclusive of aircraft and amphibious contrivances;

(f) "Authorizing Official" means Service officers or employees duly designated by the Director, Division of Hospitals and Clinics to authorize and provide care and treatment to beneficiaries at Service expense;

(g) "Active Duty," with respect to an enrollee of the United States Maritime Service, means that the enrollee is on the active list of that service, as distinguished from being on inactive status, and includes absence on authorized leave or liberty;

(h) "Commercial fishing operations" means the gathering of any form of either fresh water or marine animal life for sale on a commercial basis through available markets.

(4) Seamen on vessels of the Mississippi River Commission;

(5) Officers and crew members of vessels of the Fish and Wildlife Service;

(6) Enrollees in the United States Maritime Service on active duty and members of the Merchant Marine Cadet Corps;

(7) Cadets at State maritime academies or on State training ships;

(8) Seamen-trainees while participating in maritime training programs to develop or enhance their employability in the maritime industry;

(9) Persons afflicted with Hansen's disease;

(10) Seamen on foreign flag vessels other than those seamen employed on foreign flag vessels specified in subparagraph (2) of this paragraph;

(11) Non-beneficiaries for temporary treatment and care in case of emergency;

(12) Persons who own vessels registered, enrolled, or licensed under the maritime laws of the United States, who are engaged in commercial fishing operations, and who accompany such vessels on such fishing operations, and a substantial part of whose services in connection with such fishing operations are comparable to services performed by seamen employed on such vessel or on vessels engaged in similar operations.

(b) Separate regulations govern: (1) The medical care of certain personnel, and their dependents, of the Coast Guard, National Oceanic and Atmospheric Administration and Public Health Service (see Part 31 of this chapter); (2) physical and mental examinations of aliens (see Part 34 of this chapter);

(3) care and treatment of narcotic addicts (see Part 33 of this chapter); and (4) Medical Care for Indians. (See Part 36 of this chapter.)

(c) While regulations of the Public Health Service are not required with respect thereto, circular instructions by the Service cover the care and treatment or physical examination of the following:

(1) Persons not otherwise eligible for treatment for purposes of study:

(2) Persons detained in accordance with quarantine laws;

(3) Persons detained by the Immigration and Naturalization Service, for treatment at the request of that Service;

(4) Persons entitled to treatment under the Federal Employees' Compensation Act and extensions thereof;

(5) Beneficiaries of other Federal agencies on a reimbursable basis;

(6) Medical examinations of;

(i) Employees of the Alaska Railroad and employees of the Federal Government for retirement purposes;

(ii) Employees in the Federal classified service, and applicants for appointment, as requested by the Civil Service Commission for the purpose of promoting health and efficiency;

(iii) Seamen for purposes of qualifying for certificates of service; and

(iv) Employees eligible for benefits under the Longshoremen's and Harbor Workers' Compensation Act, as amended as requested by any deputy commissioner thereunder.

AMERICAN SEAMEN

§ 32.11 Scope of benefits.

(a) American seamen (hereinafter referred to in §§ 32.11 to 32.23, inclusive, as seamen) shall, on presenting evidence of eligibility, be entitled to medical, surgical, and dental treatment or hospitalization at medical care facilities operated by the Service or, in accordance with these regulations, at Service contract medical facilities at the expense of the Service.

(b) Where medical facilities of the Service are not available, medical care and services may be obtained from contract medical providers designated by the Service. Expenses for medical care and services obtained from non-Service providers or in non-Service facilities not arranged for by the Service in behalf of seamen is not an obligation of the Service and will not be paid.

§ 32.12 Provision of services.

(a) When a seaman requires medical, surgical and dental treatment or hospitalization which the Service is unable to provide in the local Service operated facility, or in the case of an emergency, arrangements for such medical, surgical, and dental treatment or hospitalization at the expense of the Service shall be made by an authorizing official.

(b) If eligibility cannot be established at the time of application by the seaman or by the person who applies in his behalf, the applicant shall be notified that the authorization for treatment is conditional and that the payment of reasonable expenses by the Service for such treatment shall be subject to proof of eligibility.

(c) The authorizing official shall keep himself informed regarding the progress of the case in order that treatment or hospitalization shall not be unnecessarily prolonged.

§ 32.13 Application for treatment.

(a) In nonemergency cases, a sick or disabled seaman, in order to obtain the benefits of the Service, must apply in person, or by proxy if too sick to do so, to an authorizing official as specified in § 32.12, and must furnish satisfactory evidence of his eligibility for such benefits.

(b) In emergency cases, a sick or disabled seaman shall, upon admission for such condition or as soon thereafter as is practicable under the circumstances, either personally or by proxy, notify the nearest authorizing official of the fact of such admission and treatment and shall furnish appropriate identification and satisfactory evidence of eligibility for such benefits.

§ 32.14 Evidence of eligibility.

(a) As evidence of his eligibility a seaman must present a properly executed master's certificate, or a continuous discharge book, or a certificate of discharge, showing that he has been employed on a registered, enrolled, or licensed vessel of the United States. The certificate of the owner or accredited commercial agent of a vessel as to the facts of the employment of any seaman on said vessel may be accepted in lieu of the master's certificate where the latter is not procurable. When an applicant cannot furnish any of the foregoing documents, his certification as to the facts of his most recent (including his last) employment as a seaman, stating names of vessels and dates of service, may be accepted as evidence in support of his eligibility. Documentary evidence of eligibility, excepting continuous discharge books and certificates of discharge, shall be filed at the medical care facility of the Service where application is made. Where continuous discharge books and certificates of discharge are submitted as evidence of eligibility, the pertinent information shall be abstracted therefrom, certified by the officer accepting the application, and filed at the station.

(b) Except as otherwise provided in §§ 32.11 to 32.23, inclusive, documentary evidence of eligibility must show that the applicant has been employed for 60 days of continuous service on a registered, en