« PreviousContinue »
to emergency measures necessary to (b) Hospitalization at first-class starelieve pain.
tions shall be at a per diem cost to the
officer, enlisted person, member of a (Sec. 326, 58 Stat. 697, as amended; 42 U.S.C. 253)
crew or other person concerned. Such
cost shall be at such uniform rate as 831.9 Dependent members of families; may be prescribed from time to time treatment.
by the President for the hospitalization To the extent and under the cir
of dependents of naval and Marine cumstances prescribed in this part, the
Corps personnel at any naval hospital. Service shall provide medical advice
(c) Hospitalization at first-class staand outpatient treatment at first-, sec
tions and out-patient treatment at ond-, and third-class medical relief sta
first-, second-, and third-class stations tions and hospitalization at first-class
may include such services and supplies stations to the dependent members of
as, in the judgment of the medical offifamilies of the following persons:
cer in charge, are necessary for reason(a) Coast Guard. Commissioned offi
able and adequate treatment. cers, chief warrant officers, warrant of
(d) Dental treatment shall be furficers, cadets, and enlisted personnel of
nished to the extent of available facilithe Regular Coast Guard, including
ties only at medical relief stations those on shore duty and those on de
where full-time officers are on duty. tached duty, whether on active duty or (Sec. 326, 58 Stat. 697, as amended; 42 U.S.C. retired; and regular members of the 253) United States Coast Guard Reserve and members of the Women's Reserve of
PROVISIONS APPLICABLE TO PERSONNEL the Coast Guard, when on active duty
OF FORMER LIGHTHOUSE SERVICE or when retired for disability. (b) National Ocean Survey. Commis
$31.11 Persons entitled to treatment. sioned officers, ships' officers, and To the extent and under the cirmembers of the crews of vessels of the cumstances prescribed in this part, the United States National Ocean Survey, following persons shall be entitled to including those on shore duty and medical, surgical, and dental treatthose on detached duty, whether on ac- ment and hospitalization by the Servtive duty or retired.
ice: Lightkeepers, assistant (c) Public Health Service. Commis- lightkeepers, and officers and crews of sioned officers of the Regular Corps of vessels of the former Lighthouse Servthe Service, whether on active duty or ice, including any such persons who retired, and commissioned officers of subsequent to June 30, 1939, have involthe Reserve Corps of the Service when untarily been assigned to other civilian on active duty or when retired for dis- duty in the Coast Guard, who were enability.
titled to medical relief at hospitals and
other stations of the Service prior to (Sec. 326, 58 Stat. 697, as amended; 42 U.S.C.
July 1, 1944, and who are now or here253)
after on active duty or who have been 831.10 Dependent members of fami- or may hereafter be retired under the lies; use of Service facilities.
provisions of section 6 of the act of
June 20, 1918, as amended (33 U.S.C. (a) A dependent member of the fam
763). ily of any person specified in 831.9 shall, upon presentation of satisfactory (Sec. 610(b), 58 Stat. 714, as amended; 33 evidence of such status, be entitled to
U.S.C. 7630) medical advice and out-patient treatment at first-, second-, and third-class
831.12 Use of Service facilities. medical relief stations and hospitaliza- Except as otherwise provided herein, tion at first-class stations if suitable the persons specified in $31.11 shall be accommodations are available therein entitled to medical, surgical, and denand if the condition of the dependent is tal treatment and hospitalization only such as to require hospitalization, both at medical relief stations and by desas determined by the medical officer in ignated physicians and designated dencharge.
tists, and the cost of services procured
planation as to the necessity and urgency therefor.
sewhere shall not be borne by the ervice. lec. 610(b), 58 Stat. 714, as amended; 33 .S.C. 7630)
(Sec. 610(b), 58 Stat. 714 as amended; 33 U.S.C. 7630)
831.14 Application for treatment; ac
tive duty personnel. An applicant for medical relief who is on active duty shall furnish a certificate identifying him. Such certificate shall be signed by an officer or other appropriate supervisory official of the Coast 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. 7630)
31.13 Use of other than Service facili
ties. (a) When a person specified in $31.11 rho is on active duty requires immeiate medical, surgical, or dental treatnent or hospitalization and the urrency of the situation does not permit reatment at a medical relief station or by a designated physician or desgnated dentist, an officer or other appropriate supervisory official of the Coast Guard may arrange for treatment or hospitalization.
(b) In every such case of treatment or hospitalization, a full report thereof shall be submitted to the Surgeon General through Coast Guard headquarters. As soon as practicable, unless the interests of the patient or the Government require otherwise, treatment or hospitalization shall be continued at a medical relief station or by a designated physician or designated dentist or at another appropriate Federal medical facility.
(c) When the necessary medical relief cannot be obtained from a medical relief station or a designated physician or designated dentist, preference shall be given to other Federal medical facilities when reasonably available and when conditions permit.
(d) Vouchers on proper forms covering expenses for treatment or hospitalization under the circumstances specified in paragraph (a) of this section shall be forwarded to the Surgeon General through Coast Guard headquarters. Each such voucher shall be accompanied by or contain a statement of the facts necessitating the treatment or hospitalization. Unreasonable charges for emergency treatment or hospitalization will not be allowed.
(e) Expenses for consultants or special services, or for dental treatment other than emergency measures to relieve pain, shall not be allowed except when authorized in advance by the headquarters of the Service or, in extraordinary cases, when subsequently approved by such headquarters upon receipt of report and satisfactory ex
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; 33 U.S.C. 7630)
831.16 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. 7630)
and provide care and treatment beneficiaries at Service expense. (40 FR 25816, June 19, 1975, as amended at ! FR 10318, Mar. 11, 1983)
PART 32-MEDICAL CARE FOR PER
SONS WITH HANSEN'S DISEASE AND OTHER PERSONS IN EMERGENCIES
BENEFICIARIES 32.6 Persons eligible.
PERSONS WITH HANSEN'S DISEASE 32.86 Admissions to Service facilities. 32.87 Confirmation of diagnosis. 32.88 Examinations and treatment. 32.89 Discharge. 32.90 Notification to health authorities re
garding discharged patients. 32.91 Purchase of services for Hansen's dis
BENEFICIARIES $32.6 Persons eligible.
(a) Under this part the following per sons are entitled to care and treatment by the Service as hereinafter pre scribed:
(1) Persons afflicted with Hansen's disease; and
(2) Non-beneficiaries for temporary treatment and care in cases of emergency.
(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 examination of aliens (see part 34 of this chapter) and
(3) Medical care for Native Americans (see part 36 of this chapter). (48 FR 10318, Mar. 11, 1983)
NONBENEFICIARIES; TEMPORARY TREATMENT
IN EMERGENCY 32.111 Conditions and extent of treatment;
charges. AUTHORITY: Secs. 320, 321 and 322(b), Public Health Service Act (42 U.S.C. 247e, 248 and 249(b)).
SOURCE: 40 FR 25816, June 19, 1975, unless otherwise noted.
PERSONS WITH HANSEN'S DISEASE
832.86 Admissions to Service facilities.
Any person with Hansen's disease who presents himself for care or treatment or who is referred to the Service by the proper health authority of any State, Territory, or the District of Columbia shall be received into the Service hospital at Carville, Louisiana, or into any other hospital of the Service which has been designated by the Secretary as being suitable for the accommodation of persons with Hansen's disease.
$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 and Human Services and any other officer or employee of the Department of Health and Human Services to whom the authority involved may have been delegated.
(d) Authorizing official means Service officers or employees duly designated by the Director, Bureau of Health Care Delivery and Assistance, to authorize
8 32.87 Confirmation of diagnosis.
At the earliest practicable date, after the arrival of a patient at the Service hospital at Carville, Louisiana, or at another hospital of the Service the medical staff shall confirm or disprove the diagnosis of Hansen's disease. If the diagnosis of Hansen's disease is confirmed, the patient shall be provided appropriate inpatient or outpatient
TREATMENT IN EMERGENCY
eatment. If the diagnosis is not conrmed, the patient shall be discharged. O FR 25816, June 19, 1975; 40 FR 36774, Aug. 1, 1975)
32.88 Examinations and treatment.
Patients will be provided necessary linical examinations which may be reuired for the diagnosis of primary or econdary conditions, and such treatnent as may be prescribed. 32.89 Discharge.
Patients with Hansen's disease will se discharged when, in the opinion of che medical staff of the hospital, optinum hospital benefits have been received.
$32.111 Conditions and extent of treat
ment; charges. (a) Persons not entitled to treatment by the Service may be provided temporary care and treatment at medical care facilities of the Service in case of emergency as an act of humanity.
(b) Persons referred to in paragraph (a) of this section who, as determined by the officer in charge of the Service facility, are able to defray the cost of their care and treatment shall be charged for such care and treatment at the following rates (which shall be deemed to constitute the entire charge in each instance): In the case of hospitalization, at the current interdepartmental reciprocal per diem rate; and, in the case of outpatient treatment, at rates established by the Secretary.
$32.90 Notification to health authori.
ties regarding discharged patients. Upon the discharge of a patient the medical officer in charge shall give notification of such discharge to the appropriate health officer of the State, Territory, other jurisdiction in which the discharged patient is to reside. The notification shall also set forth the clinical findings and other essential facts necessary to be known by the health officer relative to such discharged patient.
PART 34-MEDICAL EXAMINATION
Sec. 34.1 Applicability. 34.2 Definitions. 34.3 Scope of examinations. 34.4 Medical notifications. 34.5 Postponement of medical examination. 34.6 Applicability of Foreign Quarantine
Regulations. 34.7 Medical and other care; death. 34.8 Reexamination; convening of review
boards; expert witnesses; reports. AUTHORITY: 42 U.S.C. 216, 249, 252; 8 U.S.C. 1182, 1224, 1226; sec. 601 of Pub. L. 101-649.
8 32.91 Purchase of Services for Han.
sen's Disease Patients. Hansen's disease patients being treated on either an inpatient or outpatient basis at a hospital or clinic facility of the Service, other than the National Center for Hansen's Disease (Carville, Louisiana), may, at the sole discretion of the Secretary and subject to available appropriations, be provided care for the treatment of Hansen's disease at the expense of the Service upon closure or transfer of such hospital or clinic pursuant to section 987 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35). Payment will only be made for care arranged for by an authorizing official of the Service as defined in $32.1(f) of this part.
[46 FR 51918, Oct. 23, 1981)
8 34.2 Definitions.
As used in this part, terms shall have the following meanings:
(a) CDC. Centers for Disease Control, Public Health Service, U.S. Department of Health and Human Services.
(b) Communicable disease of public health significance. Any of the following diseases:
(4) Human immunodeficiency virus (HIV) infection.
(5) Leprosy, infectious.
(c) Civil surgeon. A physician, with not less than 4 years' professional experience, selected by the District Director of INS to conduct medical examinations of aliens in the United States who are applying for adjustment of status to permanent residence or who are required by the INS to have a medical examination.
(d) Class A medical notification. Medical notification of:
(1) A communicable disease of public health significance;
(2)(i) A physical or mental disorder and behavior associated with the disorder that may pose, or has posed, a threat to the property, safety, or welfare of the alien or others;
(ii) A history of a physical or mental disorder and behavior associated with the disorder, which behavior has posed a threat to the property, safety, or welfare of the alien or others and which behavior is likely to recur or lead to other harmful behavior; or
(3) Drug abuse or addiction.
(e) Class B medical notification. Medical notification of a physical or mental abnormality, disease, or disability serious in degree or permanent in nature amounting to a substantial departure from normal well-being.
(1) Director. The Director of the Centers for Disease Control.
(g) Drug abuse. The non-medical use of a substance listed in section 202 of the Controlled Substances Act, as amended (21 U.S.C. 802) which has not necessarily resulted in physical or psychological dependence.
(h) Drug addiction. The non-meds use of a substance listed in section 1 of the Controlled Substances Act, amended (21 U.S.C. 802) which has sulted in physical or psychological pendence.
(i) INS. Immigration and Naturalis tion Service, U.S. Department of Ja tice.
(j) Medical examiner. A panel phys cian, civil surgeon, or other physicis designated by the Director to perfor medical examinations of aliens.
(k) Medical hold document. A doci ment issued to the INS by a quarantin inspector of the Public Health Servia at a port of entry which defers the in spection for admission until the caus of the medical hold is resolved.
(1) Medical notification. A documer issued to a consular authority or th INS by a medical examiner, certifyin the presence or absence of:
(1) A communicable disease of publi health significance;
(2)(i) A physical or mental disorde and behavior associated with the dis order that may pose, or has posed, 1 threat to the property, safety, or wel fare of the alien or others;
(ii) A history of a physical or mental disorder and behavior associated with the disorder, which behavior has posed a threat to the property, safety, or wel fare of the alien or others and which behavior is likely to recur or lead to other harmful behavior;
(3) Drug abuse or addiction; or
(4) Any other physical abnormality, disease, or disability serious in degree or permanent in nature amounting to a substantial departure from normal well-being.
(m) Medical officer. A physician of the Public Health Service Commissioned Corps assigned by the Director to conduct physical and mental examinations of aliens.
(n) Mental disorder. A currently accepted psychiatric diagnosis, as defined by the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association, or by other authoritative sources.
(0) Panel physician. A physician selected by a United States embassy or consulate to conduct medical examinations of aliens applying for visas.