Mr. FASONE. Title V of the United States Code provides the recourse for this problem. Under this law, when we encounter recruitment or retention problems at a facility, and when the problems are a result of noncompetitive salaries, we can ask the Office of Personnel Management to let us pay higher pay rates than the general schedule provides. In reviewing these requests OPM requires us to submit a considerable amount of data on the extent of our problem and the competition we are trying to beat. We have had some difficulties in meeting the law's criteria as it is interpreted by OPM.

Now a medical center director may suffer a high police turnover problem and the week-to-week problems of staff shortages, overtime costs, and the inexperience of newly hired police officers for quite some time. After exhausting the means available to recruit and retain police without sacrificing performance standards, the director may then direct his personnel officer to initiate the several surveys and the internal data collection necessary to submit a title V special pay request.

These external wage comparison surveys and internal data collection requirements must be based on 1 year's experience to constitute a complete submission. When a facility has not done this before, it can be quite time-consuming. Under current procedures, once this required information has been submitted to OPM, it takes 4 to 8 months to get approval or disapproval. Special salary rates were granted for our police officer positions at our medical centers in New York City, Northport, Chicago, Dallas, and Palo Alto, Calif. However, because of the lack of success and the effort involved in processing such requests, we have not submitted a special salary rate for VA police officers since April 1983.

In the specific case of our New York City area medical centers, the salary increases granted in June 1983, following a submission in June 1980, were lower than those requested by the VA and are not expected to improve recruitment and retention appreciably. Special salary rates are subject to annual review and OPM renewal. When special salary rates for our medical center in Milwaukee were granted in 1980 a 30-percent annual turnover rate was successfully reduced to 5 percent. In 1983, the special salary rates were withdrawn by OPM due to the medical center's inability to demonstrate a continued retention problem and because of a lengthy list of applicants for VA police officer positions, which existed on the area OPM office register.

Mr. Chairman, we are keenly aware of the necessity to provide a highly effective umbrella of security over out patients, our employees, and our property. We are also certain that the desired protection can be achieved through highly qualified and well-trained security personnel. The handling of security and law enforcement at our medical centers is unique. To be fully effective, it requires that we have the means of recruiting and retaining well-qualified individuals who can serve as police officers in the VA's medical envi

ronment.

Our incident rates in the areas of both personal and property crime remain unsatisfactorily high, much higher than the published incidents of crimes, offenses, and law enforcement actions experienced by the several other self-protection forces of other Federal agencies. A sampling of our fiscal year 1983 offense reports shows 17,579 thefts and robberies, 9 rapes and 12 attempted rapes. Our police responded to 40,000 disturbances and over 4,000 assaults requiring 79 uses of the VA police nonlethal weapon. Our police also confiscated almost 4,000 weapons. They made almost 13,000 stops of suspicious persons and 3,700 arrests. Over 170,000 offenders were issued violation notices and another 48,000 citations into U.S. district courts across the Nation were completed. Our total loss of accountable Government and personal property alone exceeded $5 million.

A complete summary of our crime reports for the past 5 years is submitted for possible inclusion in the record.

[Subsequently, the Veterans' Administration furnished the following information:]

The DM&S Security Service maintains an annual summary of offenses and law enforcement activities. This summary is a condensation of a detailed management information report system through which all medical centers provide offense and enforcement activities on a monthly basis. This material follows:

ANNUAL SUMMARY-DM&S UNIFORM MONTHLY CRIME REPORT (RCS 10-259)

1 Not reportable in fiscal years 1979, 1980, 1981, and 1982.

119,610 $3,890,007 $4,663,417 $5,479,050 $5,308,852 $5,187,683

2 Accountable government and reported personal property losses only. Does not include losses of expendable supplies and linen losses.

Mr. FASONE. The vulnerabilities to criminal actions at medical centers greatly exceed those of typical Federal properties, such as office buildings and parks. Illustrations of these peculiar vulnerabilities are as follows. A Veterans' Administration medical center contains a repository for the bulk storage of a minimum 90-day supply of over 125 drugs of potential abuse. In addition, a VA medical center typically contains two pharmacy facilities and between 20 and 100 nursing stations containing 2-day supplies of narcotics. The VA medical center as a repository of potential drugs of abuse has become a unique target of the attainment of drugs through burglary, robbery, conspiratorial theft, and pilferage.

All VA medical centers operate from one to three silver recovery units with a total annual recovery of $2.5 million in silver bullion. I will not read the rest of my testimony describing the several unique vulnerabilities of our medical centers.

Mr. Chairman, as the immediate program manager responsible for VA security operations, I welcome the intent of H.R. 4792 and I thank you for the opportunity to testify. I will be glad to answer any questions.

Mr. EDGAR. Thank you very much for your statement. The full text of your statement will be made a part of the record, without objection.1

I yield to my colleague, John Paul Hammerschmidt, for the first questions.

Mr. HAMMERSCHMIDT. Thank you, Mr. Chairman. Dr. Custis, the Veterans' Administration previously furnished medicines to service-connected veterans who were being treated by non-VA doctors. On page 4 of your statement, you discuss possible verification that prescriptions are actually written for service-connected disabilities. How did you handle the program before, and why would the passage of H.R. 3876 complicate the administration of the pharmacy program, inasmuch as you used to do the very thing that the bill would allow? Moreover, why would greater resources be necessary to do something that was previously provided for in the budget process?

Dr. CUSTIS. Sooner or later, Mr. Hammerschmidt, I would want John Murphy to answer at least a portion of that question. If I may ask him to start, then I will add to his remarks.

Mr. HAMMERSCHMIDT. Please proceed.

Mr. MURPHY. I am actually quite embarrassed to have to start out by asking our own panel a question, which is, previously, in practice, was there a distinction made as to whether a private physician's prescription was for service-connected or non-service connected disability?

Dr. CUSTIS. There was not.

Mr. MURPHY. That would be the answer, Mr. Chairman, that under prior practice no effort was made to ascertain whether the prescription was for the care of a service-connected or for non-service connected condition.

Mr. HAMMERSCHMIDT. Well, apparently, you had money in your budget to fill these prescriptions before the legal issue arose, before your counsel made that ruling and I wonder why it would cost you extra now if we legislate to erase that counsel's decision, that legal issue.

Mr. MURPHY. As to what was in the budget, I would have to defer to Dr. Custis.

Dr. CUSTIS. I think we are talking, Mr. Hammerschmidt, more about a cost avoidance than a cost savings. But you are absolutely right. The costs of providing this service came out of funds that were available. The use of those funds for this purpose has been discontinued; as a result we have already achieved an estimated $6.4 million cost avoidence.

Mr. HAMMERSCHMIDT. So it is really a budget bookkeeping item rather than a real tangible cost savings?

Dr. CUSTIS. Well, it's tangible in that money previously used for this purpose has been applied to our total drug bill. Our total drug bill has gone up precipitously. In 1980, it was around $250 million. In 1983, it was $435 million. More and more new and expensive medications are coming on the market and we expect that this new escalation in cost is going to continue.

The cost avoidance, were this proposal not to be enacted, would be in the neighborhood of $6.4 million a year.

Mr. HAMMERSCHMIDT. You had a comment, Ms. Quandt?

MS. QUANDT. Yes, I would like to add that the provision of prescription drugs here at issue was not based on any policy. There were no published policies from central office which authorized VA medical centers to furnish these medications. Therefore, where it occurred there had been no review of those prescriptions. With passage of this bill, however, we would be required to be certain that prescription coming in is for a service-connected condition. That accounts for the administrative add-on.

Mr. HAMMERSCHMIDT. I see. Well, as I mentioned in my opening statement, and perhaps the chairman did, too, that should we enact this legislation, we, obviously, would want safeguards written in the rules and guidelines by the VA to protect the public interest. Mr. EDGAR. Would the gentleman yield?

Mr. HAMMERSCHMIDT. I yield to the chairman.

Mr. EDGAR. In your opposition you state that you have certain problems of moving back to the way in which you handled it prior to the decision by your counsel not to provide that service. If Congress mandates, by passing the law, which you are opposed to, can you handle it?

Dr. CUSTIS. Yes, sir, we wouldn't have any choice and we would. Mr. EDGAR. So that all of the rules, regulations, procedures, how to do it, you could handle?

Dr. CUSTIS. Yes, sir.

Mr. EDGAR. Thank you.

Mr. HAMMERSCHMIDT. Thank you, Dr. Custis, for your responses. I am going to move on to another area now because I am going to have to leave for another commitment. But I know that my colleagues probably want to pursue that issue a little further.

Let me change over to the security issue briefly, Dr. Custis, and you may want Mr. Fasone to respond to this, on a provincial matter, I would like for you to please elaborate on your security employee training program in Little Rock, Ark.

Dr. CUSTIS. I would like Mr. Fasone to respond except to say that I have always had the impression and been reassured that it was a very valuable program and it's doing an excellent job.

Mr. FASONE. Our 40-hour training program at Little Rock, Ark. is based upon the qualification requirements of each of our police officers as having included 2 prior years of police experience or the substitute education. In other words, we don't bring in recruits to the VA. We bring in people who have served with full power of police arrest authority granted by other governmental agencieslocal, State, or Federal.

The purpose of our 40-hour training program right now is to bring these people into a full Federal and VA orientation to outline to them what our internal requirements and day-to-day operations

are.

Mr. HAMMERSCHMIDT. I wonder if you would elaborate on the issue of your security employees carrying loaded firearms. Please give us the pros and cons of the way you view that matter.

Mr. FASONE. I view it as unnecessary. The experiment that we have carried on for the past 11 years has been so successful that we have pretty much proven that, as in the tradition of the British police department, that it is not necessary for a peace officer or a constable to always carry a firearm. I think our track record clearly indicates the success of this.

We do feel, thinking ahead, that if there is a national emergency, such as an international conflict, that we will lose a considerable number of our police officers to military duty and that our drug supplies do become frantically needed by the same element in the community, at that point we would very seriously have to go to firearms.

Mr. HAMMERSCHMIDT. Have any of your officers ever been wounded or killed because they couldn't protect themselves from lack of loaded firearms?

Mr. FASONE. In the past calendar year, one of our officers was shot in the thigh while trying to disarm a patient who was brandishing a .45 caliber automatic. Yes, we do have instances such as that.

The officer was disarming the offender, who was a deranged psychiatric patient, by the way. We feel that as long as the officer does not have to make a weapon selection, which calls for taking a .38 from his holster and shooting the patient, that he will be forced to resort to every possible means available to dissuade the person to bring a successful conclusion to the incident and so far it has worked beautifully.

Mr. HAMMERSCHMIDT. Well, to your knowledge, does the private sector or other governmental hospital, such as State, county or city, have security employees who have loaded guns?

Mr. FASONE. To my knowledge, most of them do.

Mr. HAMMERSCHMIDT. On a less violent part of your security, you mentioned pilferage, embezzlement, that sort of thing. One of our staff people brought to my attention that up at the Roosevelt Hospital in New York the loss of linen and towels and those sorts of things is a major cost in their overhead in that hospital. I am sure that must be a major part of your security apparatus' concern.

Mr. FASONE. It certainly is and we are taking steps. We have an initiative going right now which employs the use of our undercover people in trying to determine the major reason for our loss of linen. We have a careful, structured investigation underway at this time.

Mr. HAMMERSCHMIDT. Dr. Custis, I am assuming that in your accounting structure that some way those losses show up. Can they be quantified, identified on a hospital-by-hospital basis? Do you have any such records on what the losses are?

Dr. CUSTIS. Ms. Quandt assures me that we can provide that for the record.