THURSDAY, FEBRUARY 10, 1955. FREEDMEN'S HOSPITAL WITNESSES DR. CHARLES E. BURBRIDGE, SUPERINTENDENT DR. PAUL B. CORNELY, MEDICAL DIRECTOR H. HERBERT BAIRD, BUDGET AND FISCAL OFFICER DR. JACK MASUR, CHIEF, BUREAU OF MEDICAL SERVICES DR. G. HALSEY HUNT, ASSOCIATE CHIEF, BUREAU OF MEDICAL SERVICES RALPH BAHN, BUREAU OF MEDICAL SERVICES EDMUND BAXTER, CONSULTANT, SPECIAL INSTITUTIONS, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE JAMES F. KELLY, BUDGET OFFICER, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (Previous testimony on Freedmen's Hospital may be found beginning on page 70.) Mr. FOGARTY. The committee will come to order and we will resume with Freedmen's Hospital. I am going to ask to have inserted in the record these two new tables that have been provided by you. (The tables referred to follow:) SALARIES AND EXPENSES, FREEDMEN'S HOSPITAL REIMBURSEMENT FOR INDIGENT CASES Mr. FOGARTY. You had available, in 1955, $2,880,000 and you are asking for $2,880,000, or no increase or decrease as far as appropriated money is concerned. For payments, you received $988,000 in 1955 and you think it will be the same in 1956. Does that include the District of Columbia, their share of the cost of caring for indigent patients. Dr. BURBRIDGE. This includes $300,000 from the District of Columbia. Mr. FOGARTY. That is because of the arrangements you had with the District last year? Dr. BURBRIDGE. We have had the arrangement for several years with the District of Columbia. Mr. FOGARTY. How about Maryland and Virginia? Dr. BURBRIDGE. Reimbursement from the States is an amount estimated for 1956 as being $20,000. Mr. FOGARTY. For the two States. Dr. BURBRIDGE. For the two States or any other States from whom we received indigent cases. Mr. FOGARTY. What did they pay in 1955, Virginia and Maryland? Dr. BURBRIDGE. $20,000, 1955, and $20,000 estimated for 1956. Mr. FOGARTY. How about '54? Dr. BURBRIDGE. $12,500, approximately. Mr. FOGARTY. They are paying a little more of their way than they were previous to the time we began to discuss it, is that correct? Dr. BURBRIDGE. Yes. Mr. FOGARTY. Do you expect any added improvement in this coming year? Dr. BURBRIDGE. The estimate for 1956 is the same as the estimate for 1955, which means that we envision no increase over '55. Mr. FOGARTY. Have they given you any reason why they will not pay their proportionate share of the cost of taking care of these indigents? Dr. BURBRIDGE. In the last 2 years particularly we have initiated a restrictive policy where we admit to medical services only those cases from the States where we have prior certification for the payment of the bill. In addition to that we have emergency cases from Virginia and Maryland who come in prior to having financial eligibility determined. However, those have decreased. The point I am making is that all elective cases that we are receiving now, are cases for whom we are provided certification. Mr. FOGARTY. What is this item of $765? Mr. KELLY. This is the comparable transfer to the Office of the Secretary. EXPLANATIONS OF LAPSES AND SHIFTS IN FUNDS Mr. FOGARTY. In '55 you had 744 positions, and you had an average of 64 lapses. Is that correct? Dr. BURBRIDGE. Yes. Mr. FOGARTY. But you show an increase of 28 in lapses in 1956. What is the reason for that? Dr. BURBRIDGE. Well, the increase in the lapse figure for 1956 was occasioned by the anticipated decrease in patient load in our TB hospital, which simply means that the amount of money in the budget estimates for 1956 is an amount which will allow the employment of no more than 652 persons. Mr. FOGARTY. Six hundred and fifty-two? Dr. BURBRIDGE. That is right. Mr. FOGARTY. What are you doing with the money that you are saving on positions, then? Dr. BURBRIDGE. The money being saved on the reduction in positions for 1956 is partially offset by $62,000 in fringe benefits which require that we defray the cost of converting CPC's to wage-board schedules under Public Law 763. Mr. FOGARTY. Is that mandatory? Dr. BURBRIDGE. Yes. Mr. FOGARTY. So these conversions have been made under that law. Is that correct? Dr. BURBRIDGE. That is correct. Mr. FOGARTY. At an additional cost of $62,000? Dr. BURBRIDGE. That is right. Mr. FOGARTY. Where is the rest of it? Dr. BURBRIDGE. The rest of it is occasioned by an increase in the general hospital of $77,531, which, when added to the other decreasing items, will give us a total net decrease of $45,205. This sum is the difference between the amount of money in "Personal services for 1955," and the amount of money in "Personal services for 1956." This is shown in the other form given you, the "Analysis of increases and decreases," at the bottom of the page. You see, the plus and minus items come to a net of $45,205. NEW POSITIONS Mr. FOGARTY. So you are taking 38 positions out of the TB hospital and you are going to add 10 in the general hospital; is that correct? Dr. BURBRIDGE. That is right; with a net loss of 28. Mr. FOGARTY. Tell us about the 10 additional positions. Dr. BURBRIDGE. The 10 additional positions include the nursing personnel needed to meet the requirements of the District of Columbia's Code for staffing maternity and infant-care divisions in hospitals. In other words, the District of Columbia in, I think it was March 1954, issued a regulation which required that there be certain staffing in maternity and new-born areas in hospitals. The additional number of positions is intended to meet the requirements of this regulation. Mr. FOGARTY. Are you going to have any trouble getting nurses? Dr. BURBRIDGE. No, sir; we will have no difficulty. Mr. FOGARTY. Didn't your opening statement show that your nursing program was going down a little bit, or the number of nurses starting this year is down from what you had before? Dr. BURBRIDGE. The average number of nurses we carry in the nurses school is 100 or slightly over 100 and that has been there for several years. Mr. FOGARTY. I thought the justifications showed that the number entering this year was different. Mr. BAIRD. That has reference to our housing for nurses. We can only accommodate 108 student nurses and we have to take into consideration those remaining to get the number we can recruit from the outside. Mr. FOGARTY. In other words, you have no trouble recruiting them. You could get more if you had room for them? Do you have anything else to add? Dr. BURBRIDGE. The medical director of the hospital is behind me and maybe he would want to say something, Mr. Chairman. Mr. FOGARTY. He is one of your outstanding doctors. be happy to have him say a few words if he wishes. |