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Congress. It is not out of the general fund of the Treasury but is an authorization to use the trust fund in the same way that the Bureau of Old Age and Survivors' Insurance is managed.

Mr. JONAS. I think this item could be adjusted down to about a 9month basis, too, Mr. Chairman. Do you think so?

Mr. THOMAS. Yes.

Mr. JONAS. You have got this figured on a 12-month basis. Two months have now passed.

Mr. KELLY. I believe this is computed on a 9-month basis.

Mr. LUND. We made our computation on a 10-month basis because as I remember it related to a start by OASI on September 1.

Mr. JONAS. Congratulations. Some of your associates haven't done that.

Mr. LUND. Our projection further indicates there is a difference of $5,000 as far as our costs are concerned for every 2-week period this start is delayed.

Mr. JONAS. I have no other questions.

Mr. THOMAS. Thank you, gentlemen, very much.
It is always pleasant to see you.

WEDNESDAY, AUGUST 16, 1961.

CIVIL DEFENSE MEDICAL STOCKPILE ACTIVITIES

WITNESSES

DR. JAMES M. HUNDLEY, ASSISTANT SURGEON GENERAL FOR PROGRAM

DAVID S. BRUNSON, CHIEF, STOCKPILE MANAGEMENT BRANCH G. RICHARD CLAGUE, ACTING CHIEF FINANCE OFFICER

JAMES F. KELLY, DEPARTMENT BUDGET OFFICER

RICHARD BOWMAN, EXECUTIVE OFFICER

W. D. JONES, DEPUTY CHIEF, STOCKPILE MANAGEMENT BRANCH JOHN W. HAMBLETON, BUDGET ANALYST

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Mr. THOMAS. We have a group here from HEW dealing with civil defense medical stockpile activities-the supplemental estimate for which is contained in House Document No. 224 in the amount of $26 million.

It seems to me we have heard of that subject before. We have with us Dr. James Hundley. We have with us Mr. Brunson, Chief, Stockpile Management Branch; Mr. Clague, Acting Chief Finance officer. We have Mr. Bowman, executive officer; Mr. Jones, Deputy Chief, Stockpile Management Branch; and Mr. Hambleton, budget analyst. Welcome, gentleman. We receive you with open arms.

GENERAL STATEMENT

Dr. Hundley, you may include your prepared statement in the record at this point.

(The statement follows:)

GENERAL STATEMENT OF ASSISTANT SURGEON GENERAL FOR PROGRAM, PUBLIC HEALTH SERVICE

Mr. Chairman and members of the committee, the Department of Health, Education, and Welfare has the responsibility of planning a program that will assure that the health needs of the civilian population are met in the event of a national disaster. One of the very important areas in this program is assisting the States and their communities to implement effectively their emergency survival plans by the stockpiling of essential medical supplies and equipment and prepositioning these materials where they will be immediately available for use if disaster strikes.

The 1962 budget requested $25 million for the purchase of additional medical supplies and equipment for the medical stockpile. As the committee is aware, the President has recently reviewed and reoriented the entire civil defense program. In the course of this review he has concluded that there is an urgent need for greater provision of emergency medical materials ready for use in the event of such an emergency. To this end he has requested an additional $25 million for medical supplies and $1 million required for efficient procurement, maintenance and, utilization of these materials.

Studies have shown that total stockpile requirements for medical equipment, supplies, and materials for use in the event of a civil defense emergency will require very large sums of money. This step of the emergency effort will permit the provision of a 30-day supply of drugs and supplies prepositioned with the 1,000 hospitals requested in the regular 1962 budget and, to an extent, with approximately 1,900 emergency hospitals now available. This is the most critical need and it would be unwise, in our judgment, to defer further the development of this aspect of the medical stockpile program.

The present medical stockpile consists of 1,932 200-bed emergency hospitals and backup supplies and equipment. Each of the hospitals is packed in about 351 boxes in such a way as to permit 30 persons in a community to set up and

put into operation a 200-bed unit with operating rooms, X-ray wards, laboratory and other essential services in about 4 hours. The 200-bed unit can be used as an independent hospital or as an expansion unit for an existing hospital depending upon the specific emergency requirements of the community. The bulk of these 1,932 hospitals is already prepositioned in local communities and in all 50 of the States, ready for immediate planned use in the event of an emergency. There will be an actual need for 7,500 more of these 200-bed emergency hospitals in the event of a major disaster. The moneys requested in the 1962 budget would permit the purchase of 1,000 more, thus reducing the deficit to 6,500.

The bulk supplies and equipment now on hand are held at 30 warehouses, located about the country. This material provides a backup capability to supply the needs of the communities after the first 30 days postattack.

Some of these materials, particularly drugs and other similar supplies, require replacement with fresh stocks and, to the extent possible, these will be replaced. A major portion of the $25 million will be used to purchase supplies to preposition with the 1,000 new hospitals and the hospitals already located throughout the country. These additional supplies will permit the hospitals to operate a full 30 days without replenishment of expendable supplies.

The expendable supplies in presently prepositioned civil defense emergency hospitals permit operational capability for only 3 to 4 days. We believe that the operational capability of the hospitals should be expanded to 30 days as quickly as possible. This increment of medical supplies dispersed in local communities increases the potential effectiveness of community emergency health operational survival plans.

The remaining $1 million of the $26 million additional request is required to support administrative activities in stockpile management. Included are estimated expenses for handling additional materials, exchanging replacements, disposal of replaced materials, providing more adequate quality control to cope with problems of aging or the prevention of aging of materials, and for the establishment of an effective onsite inspection, inventorying, and maintenance program in order to maintain a constant state of readiness of emergency hospitals prepositioned in communities.

The administration has placed a very high priority on the attainment of full capability in civil defense. This supplemental request will permit the Department of Health, Education, and Welfare to double its efforts in 1962 toward the attainment of this goal in the area of emergency medical stockpiling.

PURPOSE OF THE SUPPLEMENTAL ESTIMATE

Mr. THOMAS. I understand you want to buy about $25 million worth of 200-bed emergency hospitals, and you do have approximately 1,900 on hand now. You have got a thousand more in this year's appropriation bill. That makes 2,900. Now you want to run it up to 3,900. Dr. HUNDLEY. Mr. Chairman, could I correct your summary? You are off by 1,000, I believe.

Mr. THOMAS. I tried to build you up a little or did I take away from you?

Dr. HUNDLEY. We have 1,932 emergency hospitals at the moment. The regular 1962 budget request through OCDM would have provided approximately 1,000 additional 200-bed hospitals. The present request is for no additional hospitals. It is for medical supplies to expand the capability of the existing hospitals.

Mr. THOMAS. Maybe I cannot read my own writing.

Dr. HUNDLEY. That is recapitulating what the fiscal year 1962 regular budget would have provided.

Mr. THOMAS. You do not want to buy any more?

Dr. HUNDLEY. We are not at this moment proposing to buy any additional emergency hospitals.

Mr. THOMAS. What do you propose to do with this $26 million?

Dr. HUNDLEY. $25 million is for medical supplies and equipment, $1 million is for the expenses of procurement and maintenance of these supplies. The supplies are to have two major purposes.

Mr. THOMAS. There are no more hospitals?

Dr. HUNDLEY. No, sir. Two major purposes: One, to expand the capability of the existing hospitals, the 1,932 that exist, and the 1,000 new ones from a 3-day operational capability to a 30-day operational capability in terms of supplies and equipment. The second purpose is to replace some of the stocks in the existing hospitals and in the reserve depots that have deteriorated to the point where they are medically not useful.

JUSTIFICATION OF THE ESTIMATE

Mr. THOMAS. Put this printed language in the record that appears in the justification.

(The pages referred to follow :)

CIVIL DEFENSE MEDICAL STOCKPILE ACTIVITIES

INTRODUCTION

The funds herein requested are in addition to funds already provided in the Independent Offices Appropriation Act for 1962, which funds are to be transferred to the Department of Health, Education, and Welfare from the appropriation, "Emergency supplies and equipment, Office of Civil and Defense Mobilization" in accordance with the President's order placing the responsibility for medical stockpile activities upon the Secretary of Health, Education, and Welfare. The funds to be transferred will permit the procurement of sufficient medical supplies and equipment to assemble 1,000 additional civil defense 200bed emergency hospitals. In addition, the funds transferred will provide for continued maintenance of materials in the present medical stockpile including warehousing, transportation, instorage quality control, and limited replacement of antibiotics and vaccines.

The following table indicates the purposes for which the funds will be used:

1. Procurement..

2. Onsite inspection, inventory, and maintenance of prepositioned materials. 3. Quality control and surveillance of stocks.

4. Transportation of materials.

5. Contractual services and packaging materials for rehabilitation of civil defense emergency hospitals..

6. Warehouse operations...

Total estimate...

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TRANSFER OF FUNDS FROM OCDM

Mr. THOMAS (reading):

The funds herein requested are in addition to funds already provided in the Independent Offices Appropriation Act for 1962, which funds are to be transferred to the Department of Health, Education, and Welfare from the appropriation, "Emergency supplies and equipment, Office of Civil and Defense Mobilization" in accordance with the President's order placing the responsibility for medical stockpile activities upon the Secretary of Health, Education, and Welfare.

Those funds you have taken over from OCDM as far as hospitals and medical supplies are concerned?

Dr. HUNDLEY. Well, we expect to. This responsibility has been now delegated to us by the President.

Mr. THOMAS. It has been delegated to you?

Dr. HUNDLEY. Yes, sir; as of 2 days ago.

Mr. THOMAS. You have complete authority now.

Dr. HUNDLEY. Yes, sir.

Mr. THOMAS. Their funds which are going in their stockpiles, and the hospitals and medicine, et cetera, will be transferred to you?" Dr. HUNDLEY. Yes, sir.

NUMBER OF EMERGENCY HOSPITALS

Mr. THOMAS (reading):

The funds to be transferred will permit the procurement of sufficient medical supplies and equipment to assemble 1,000 additional civil defense 200-bed emergency hospitals.

Where is that man who told me I was wrong a while ago? He said we had 1,900 on hand now, 1,000 in independent offices and now you are coming in for another thousand?

Mr. KELLY. No, sir; funds to be transferred will permit this 1,000. The funds to be transferred are funds you provided in the independent. offices bill.

Mr. THOMAS. It is a transfer of that 1,000. I cannot read, then. Go ahead. It is my error.

How many hospitals will that give you?

Dr. HUNDLEY. It will give us a total of 2,932.
Mr. THOMAS (reading):

In addition, the funds transferred will provide for continued maintenance of materials in the present medical stockpile including warehousing, transportation, instorage quality control, and limited replacement of antibiotics and vaccines.

FUNDS TO BE AVAILABLE IN 1962

In your revised estimate, procurement is $50,800,000; maintenance and materials, $425,000; quality control and surveillance of stocks, $630,000; transportation of materials, $520,000; rehabilitation, $275,000; warehouse operations, $2,118,000.

That is your full 1962 budget, then?

Dr. HUNDLEY. Yes, regular and supplemental.

Mr. THOMAS. And including your funds here of $26 million?
Dr. HUNDLEY. And including those transferred from OCDM.
Mr. THOMAS. No, appropriated funds of exactly $26 million. That
is the picture, is it not?

Dr. HUNDLEY. You mean the funds in the regular 1962 budget?
Mr. THOMAS. Yes.

Dr. HUNDLEY. We do not know exactly what we will get in the 1962 budget. We know what we asked for.

Mr. THOMAS. Your assumption plus the present budget gives you a total of $54,768,000.

Dr. HUNDLEY. That is right.

Mr. THOMAS. How will you spend the money you are seeking here, the $26 million?

Dr. HUNDLEY. This would be spent for two major purposes.

Mr. THOMAS. Let us go to the detailed breakdown.

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