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ce in which the station or hospital Dcated, to receive or dispose of the ent's money and effects. In any e in which the officer in charge has

actual notice of the appointment a legal representative, withdrawals y be made only by such representae or in accordance with his written ections. No delivery shall be made ler this paragraph unless (1) the perI receiving the money or effects ll sign an itemized receipt therefor, (2) the delivery is witnessed by two sons. The provisions of this paraaph do not prohibit withdrawals ide necessary by the provisions of is part for the disposition of money d effects left by patients on death or A departure from the station or hostal, or by the provisions of §35.10.

$5.9 Disposition of money and effects left by other than deceased patients.

Money and effects left on the premses by a patient shall be forwarded romptly to him. If because his wherebouts are unknown his money and efects cannot be delivered to him within 20 days after his departure, his money hall be deposited into the Treasury and credited to the account entitled 'Money and Effects of Former Patients (PHS (T) name of patient)," and his efTects shall be held for him for six months and then sold in accordance with §35.49, and the proceeds deposited into the Treasury and credited to the above account.

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$35.11 Clinical records; confidential.

A complete clinical record shall be maintained for each patient admitted to a station or hospital of the Service. Such records shall be confidential and shall not be disclosed except as may be provided elsewhere in regulations of the Service.

$35.12 Solicitation of legal business prohibited.

The solicitation, directly or indirectly, of legal business or of a retainer or agreement authorizing an attorney to render legal services, is prohibited in all stations and hospitals of the Service.

$35.13 Entry for negotiation of release or settlement.

(a) No person shall be permitted to enter a station or hospital of the Service for the purpose of negotiating a settlement or obtaining a general or special release or statement from any patient with reference to any illness or personal injury for which the patient is receiving care or treatment, or for the purpose of conferring with him as an attorney or representative of an attorney with reference to such illness or injury, unless the patient has signified his willingness to have such person enter for such purpose and, in the judgment of the officer in charge, the physical or mental condition of the patient will not thereby be impaired.

(b) Any person entering a station or hospital for a purpose enumerated in paragraph (a) of this section shall register in the manner prescribed by the officer in charge, and shall furnish for the records of the station or hospital the name of each patient by whom he has been received for such a purpose.

$35.14 Solicitation of legal business;

negotiation of release or settlement; assistance prohibited.

All employees of the Service and all persons attached in any capacity to a station or hospital, including patients, are forbidden to communicate, directly or indirectly, with any person for the purpose of aiding in the solicitation of legal business or in the negotiation of a settlement or the obtaining of a general or special release or statement from any patient with reference to any

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illness or personal injury for which the
patient is receiving care or treatment
therein. No patient is prohibited by
this section from communicating on
his own behalf with an attorney of his
choice or with other persons.

$35.15 Consent to operative proce-

Except in emergencies when the pa-
tient is physically or mentally incapa-
ble of consenting and the delay re-
quired to obtain the consent of his nat-
ural or legal guardian would seriously
endanger the patient's health, no oper-
ative procedure shall be undertaken
unless the patient or, in the case of a
minor or incompetent, his natural or
legal guardian gives his consent, nor
shall any major operative procedure or
the administration
anaesthetic be undertaken unless such
consent has been obtained in writing.
of a
The consent or refusal of consent shall
be made a part of the clinical record.

§35.16 Autopsies




mortem operations.
Autopsies, or other post-mortem op-
erations, including removal of tissue
for transplanting, may be performed on
the body of a deceased patient only by
direction of the officer in charge and
only if consented to in writing by a
person authorized under the law of the
State in which the station or hospital
is located to permit an autopsy or such
other post-mortem operation under the
circumstances of the particular death
involved. Restrictions or limitations
imposed by the person consenting
thereto on the extent of the autopsy or
other post-mortem operation shall be
observed. Documents embodying con-
sent shall be made a part of the clinical

[25 FR 6331, July 6, 1960]

§ 35.17 Fees and charges for copying,
certification, search of records and
related services.

A prescribed fee, in accordance with
the schedule in paragraph (c) of this
section, shall be collected for each of
the listed services.

(a) Application for services. Any person
requesting (1) a
record, clinical abstract, or other docu-
ment containing clinical information;
copy of a clinical


42 CFR Ch.1(10-14

or (2) a certification of a ch

facility having custody of the
or document; or (3) a search
records, shall make written
therefor to the Public Health
matter involved. Such
shall state specifically the p
record or document requested
purpose for which such copy
ment is desired to be used. The
tion shall be accompanied by a
in an amount equal to the pres
charge for the service rendered
it is not known if a clinical rea
other document is in existence
plication shall be accompanied
minimum deposit of $2.50.

(b) Authorization for disclos
furnishing of copies of PHS
containing confidential clinica
mation must comply with the re
ments of part I, title 42, Code c
eral Regulations, governing aut
tion for the disclosure of such inf

(c) Schedule of fees.

(1) Photocopy reproduction of a clinical record of
other document (through use of facility equipment
(a) Processing (searching, preparation of record
and use of equipment), first page
(b) Each additional page

(2) Certification, per document

(3) Unsuccessful searching, per hour (minimum
charge 1 hour)

(4) Clinical abstracts, per request

(5) Arranging commercial duplication of a clinical
record, per request

(6) If the requested material is to be transmitted by
registered mail, airmail, or special delivery mail, the
postal fees therefor shall be added to the other
fees provided above, unless the applicant has in-
cluded proper postage or stamped return enve
lopes for this purpose.

'The private concern which duplicates records for an ap cant will make a separate charge therefor and will bil De plicant directly.

(d) Waiver of fee. The prescribed
may be waived, in the discretion of th
medical officer in charge, under
following circumstances:

(1) When the service or document à
requested by another agency
Federal Government for use in carry-
ing out official Government business.
(2) When a clinical record
quested for the purpose of providing
of th
continued medical care to a Service
beneficiary by a non-Service physician.
clinic, or hospital, in which case
record will be forwarded only to
physician, clinic,
or hospital


the the con

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been the service or document is red by an attorney in the pros7 of a Service beneficiary's pernjury claim against a third pervolving the concurrent assertion overnment medical care claim 42 U.S.C. 2651-2653. In such case, vice or document requested will Xrnished only upon compliance gall additional requirements for lease of records in third party recases, including the proper exeof form PHS-4686, Agreement to Claim Upon Request.

When the service or document is sted by, and furnished to, a Memf Congress for official use.

When the service or document is ested by, and furnished to, a court eu of the personal court appear

of an employee of the Public th Service.

When the service or document is ired to be furnished free in accordwith a Federal statute or an Exec'e order.

3) When the furnishing of the service document requested without charge uld be an appropriate courtesy to a teign country or international orgamoration.

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Authorization of transfer.

Except as otherwise provided by law r regulation with respect to certain lasses of patients, the officer in 坶: harge of a station or hospital of the service may provide, without any cost o the patient, for the transfer of the patient either from such station or hospital to another station or hospital of the Service or to any non-Service station or hospital at which the patient may be received, or from any non-Service hospital at which he is receiving care or treatment as a patient of the Service to a station or hospital of the Service.


$35.22 Attendants.

Patients shall be transferred by such means and accompanied by such medical, nursing, or other attendants as

may be necessary to protect the health and safety of the patient and other persons likely to come into contact with him, including in the case of a prisoner such guards as may be necessary to assure his safekeeping. A female patient requiring the services of attendants shall be accompanied by at least one female attendant. Medical or nursing attendants shall be qualified to care for persons suffering from the type of disease or disorder with which the patient is afflicted and shall be provided with equipment and medicines necessary for the care of the patient.

Subpart C-Disposition of Articles Produced by Patients

§ 35.31 Retention by patients.

Subject to the rules of the station or hospital, patients may be accorded the privilege of retaining articles produced by them in the course of their curative treatment with the aid of materials furnished by the Service. Articles not retained by patients shall be disposed of as provided in this subpart. The provisions of this subpart do not apply to the products of industrial activities established for narcotic addicts.

§ 35.32 Board of appraisers.

The officer in charge shall appoint, from the personnel of the station or hospital, a board of three persons to serve at his pleasure. The board shall provide for the sale of articles having commercial value and shall keep appropriate records of such articles and their disposition.

§ 35.33 Sale; prices; deposit of proceeds.

The board shall determine and redetermine from time to time the prices at which articles are to be sold, and in doing so shall consider the cost of materials used, reasonable handling charges, and the fair market value of the articles. The sale price shall be indicated on each article by tag or other appropriate means, and a list of articles offered for sale and their respective sale prices shall be posted from time to time in the hospital or station area. In its discretion, the board may offer such articles for purchase by other patients or by charitable organi

zations before offering them for purchase to the general public. No article shall be sold or resold to any officer or employee of the Service. Moneys received from the sale of articles shall be deposited into the Treasury to the credit of the appropriation from which the materials for making such articles were purchased.

§35.34 Resale.

No article purchased under the provisions of this subpart shall be resold in the hospital or station area at a price to exceed the sale price fixed by the board for such article.

§35.35 Unsalable articles.

Articles having no commercial value shall be stored, destroyed, or otherwise disposed of as the officer in charge may direct.

Subpart D-Disposal of Money and Effects of Deceased Patients

§ 35.41 Inventory.

Promptly after the death of a patient in a station or hospital of the Service, an inventory of his money and effects left therein shall be made by two or more officers or employees of the Service designated for such purpose by the officer in charge.

§ 35.42 Notice upon death.

The officer in charge shall notify in writing all persons known to him to whom delivery of the patient's money and effects might be made hereunder, and, in the case of an alien patient, a consul of the country of his apparent nationality. Each person so notified shall be requested to furnish information concerning (a) the existence or whereabouts of any persons to whom delivery of the deceased patient's money and effects may be made pursuant to these provisions, and (b) the permanent residence or home of the deceased.

§ 35.43 Delivery only upon filing claim; forms; procedure.

(a) Delivery of the money and effects of a deceased patient shall be made only to a person who has filed a claim

therefor on a form prescribed by the Surgeon General.

(b) A claimant shall furnish, in addition to the information on the prescribed form, such additional informa tion as the officer in charge may consider necessary to establish the idertity of the claimant and the truth of his statements.

(c) A person filing a claim as a legal representative shall be required to present letters of administration or a certificate of a court attesting his qualification or appointment.

(d) If a claim is made after the money, or proceeds from the sale of the effects, of a deceased patient have been deposited in the Treasury, the claim shall be referred to the General Accounting Office. If the claim is for checks or evidences of indebtedness of the United States which have been trasnsmitted to the issuing agency pursuant to §§35.47 and 35.48, the claimant shall be referred to such agency.

§ 35.44 Delivery to legal representstive; to other claimants if value is $1,000 or less.

The money and effects of the deceased patient shall in all cases be delivered to the legal representative, if any, of his estate. If the value is $1,000 or less, and the officer in charge has neither notice nor other knowledge of the appointment or qualification of a legal representative, nor reason to believe that a legal representative will be appointed or qualified, he shall deliver all the money and effects, as soon as practicable after the expiration of 10 days from the sending of notices to one of the following in the indicated order of priority:

(a) A person, if any, designated in writing by the patient to receive the


(b) The patient's surviving spouse.

(c) The patient's child or children in equal parts.

(d) The patient's parent or parents in equal parts.

(e) Any other person who would be entitled to receive the money and effects under the law of the patient's domicile: Provided, That delivery of such money and effects may be made immediately upon application by one of the persons specified above if the of

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Notwithstanding any other provisions of this subpart, immediately upon completion of the inventory, checks drawn on the Treasurer of the United States shall be sent by safe means to the department, agency, or establishment of the Government of the United States issuing such checks. The transmittal shall be accompanied by a statement of the reasons therefor and of all available information which may aid the issuing unit in the disposition of the check transmitted. Notice of the disposition of any checks, with identifying information, shall be given to the person or persons, if any, to which money and effects are delivered in accordance with §35.44.

§35.48 Deposit of unclaimed money; sale of unclaimed effects and deposit of proceeds.

If, within 120 days after sending of notices no claim has been filed pursuant to the provisions of §35.43, the patient's money, consisting of all types of United States currency and coin, shall be deposited in the Treasury to the credit of the trust-fund account entitled "Money and Effects of Deceased

Patients, Public Health Service." If, within six months after the death of a patient, no claim has been filed pursuant to the provisions of §35.43, his effects (including foreign currency and coin but excluding Postal Savings Certificates and other evidences of indebtedness of the United States) shall be sold at public auction or by sealed bids to the highest bidder and the proceeds deposited to the credit of the trustfund account entitled "Money and Effects of Deceased Patients, Public Health Service." Postal Savings Certificates and other evidences of indebtedness of the United States shall be transmitted to the issuing department or agency with a statement of the occasion therefor.

$35.49 Sale of unclaimed effects; procedures.

The following provisions shall govern the sale of effects:

(a) Notice. Reasonable advance notice of proposed sales shall be posted at such prominent places in the station or hospital area as the officer in charge may designate. In addition, a notice shall be posted at the nearest post office, and notices shall be sent by mail to all known persons to whom delivery of money and effects of the patient may be made under the provisions of this subpart. The officer or employee who posts or sends notices of sales shall make an appropriate affidavit on a copy of the notice as to his action in that respect, including in his affidavit the names of persons to whom copies of the notices were mailed and the mailing dates. The copy of the notice on which the affidavit appears shall be retained in the files of the station or hospital.

(b) Form and contents of notice. Notice of proposed sales shall be given on a form prescribed by the Surgeon General. The notice shall include: an inventory of the effects to be offered for sale; the names of the patients from whom the effects were received; the precise date, time, and place when and where the sale will be held; a statement that the articles will be available for inspection immediately prior to sale, if sold at public auction, or on a day and during the hours appointed for the inspection of articles if sold by

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