HOSPITAL CONSTRUCTION MONDAY, JUNE 17, 1968 HOUSE OF REPRESENTATIVES, COMMITTEE ON THE DISTRICT OF COLUMBIA, Washington, D.C. The subcommittee met, pursuant to notice, at 10 a.m. in room 1310, Longworth House Office Building, Hon. B. F. Sisk (Subcommittee Chairman) presiding. Members Present: Representatives Sisk (Subcommittee Chairman), Whitener, Walker, and Gude. Also Present: James T. Clark, Clerk; Hayden S. Garber, Counsel; Sara Watson, Assistant Counsel; Donald Tubridy, Minority Clerk; and Leonard O. Hilder, Investigator. Mr. SISK. The committee will come to order. Subcommittee No. 5 has before it this morning certain bills to authorize project grants for construction and modernization of hospitals and other medical facilities here in the District. Without objection, H.R. 6526, by our distinguished Chairman of the full Committee, Mr. McMillan, will be made a part of the record. Also, S. 1228, by Senator Bible, the Chairman of the Senate Committee on the District of Columbia, together with the Senate Report (S. Rept. 944) thereon, will be made a part of the record, to indicate the extent to which there is a difference in the two bills. (The bills, H.R. 6526 and S. 1228, and S. Rept. 944 follow :) (H.R. 6526, 90th Cong., 1st sess., by Mr. McMillan (by request) on Mar. 2, 1967) A BILL To authorize project grants for construction and modernization of hospitals and other medical facilities in the District of Columbia Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "District of Columbia Medical Facilities Construction Act of 1967”. AUTHORIZATION OF APPROPRIATIONS SEC. 2. There are authorized to be appropriated for the fiscal year ending June 30, 1967, and for each of the next three fiscal years, such sums as may be necessary to enable the Secretary of the Department of Health, Education, and Welfare (hereafter referred to as the Secretary), to make grants to assist in the modernization of public or nonprofit private hospitals and in the construction or modernization of public health centers, long-term care facilities, diagnostic or treatment centers, rehabilitation facilities, facilities for the mentally retarded, and community mental health centers in the District of Columbia. Sums so appropriated shall remain available until expended. APPROVAL OF APPLICATIONS SEC. 3. (a) An application for a grant with respect to any project may be approved by the Secretary under this Act only if an application for a grant with respect to such project has been filed under the Medical Facilities Acts (which for purposes of this Act means title VI of the Public Health Service Act or, where appropriate, title II or part C of title I of the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963) and (1) has been approved under the Medical Facilities Acts and the application filed under this Act is for additional funds in connection therewith, or (2) has been denied under the Medical Facilities Acts because insufficient funds are available from the allotments of the District of Columbia under such Acts to permit approval of the application. In determining whether to approve an application for a grant with respect tc any project in the District of Columbia under the Medical Facilities Acts, the availability of additional funds for such project under this Act shall be taken into consideration; and, in any such case, approval under the Medical Facilities Acts may be made contingent upon the approval of an application with respect to such project under this Act and upon such additional funds being made so available. (b) The Secretary shall establish criteria for determining the order in which to approve, under this Act, applications for grants with respect to projects. Such criteria with respect to construction projects for the same type of facility (or for modernization projects) shall be the criteria developed by the State agency of the Ditsrict of Columbia pursuant to the State plan approved under the Medical Facilities Acts. (c) In the case of any project with respect to which an application for a grant is filed under this Act and with respect to which an application for a grant has been denied under the Medical Facilities Act, such application under this Act may be approved only if there is compliance with the same terms and conditions (including determination, in accordance with the applicable State plan. that the project is needed) as are applicable to applications for grants under the Medical Facilities Act, other than the availability of sufficient funds in the appropriate allotment of the District of Columbia, (d) An application for a grant under this Act with respect to any project may not be approved unless an opportunity to review the application has been afforded to a body, found by the Secretary to be a responsible metropolitan areawide planning body, and any recommendations of such body that were timely made have been considered by the appropriate State agency of the District of Columbia and have been submitted to the Surgeon General in connection with the application. PAYMENTS SEC. 4. (a) Payments under this Act with respect to any project shall be made in the manner provided under the Medical Facilities Act for payments of the Federal share of the cost of projects for which applications are approved under such Acts; except that such payments shall also be subject to such reasonable conditions as the Secretary deems appropriate to safeguard the Federal interest. (b) The total of the payments made under this Act with respect to any project, together with any payments with respect thereto under the Medical Facilities Act, may not exceed– (1) in the case of a construction project for a long-term care facility, a diagnostic or treatment center, or a rehabilitation facility, 66% per centum of the cost of such project; and (2) in the case of any other project (including a modernization project). 50 per centum of the cost of such project. RECOVERY OF PAYMENTS SEC. 5. Payments under this Act shall be subject to recovery or recapture under the same conditions and to the same extent as is provided under the Medical Facilities Acts with respect to payments made thereunder. MEANING OF TERMS SEC. 6. The terms used in this Act shall have the same meaning as when used in the Medical Facilities Acts. (S. 1228, 90th Cong., 1st sess., by Mr. Bible (by request) on Mar. 8, 1967) AN ACT To authorize project grants for construction and modernization of hospitals and other medical facilities in the District of Columbia Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "District of Columbia Medical Facilities Construction Act of 1968". AUTHORIZATION OF APPROPRIATIONS SEC. 2. There are authorized to be appropriated for the fiscal year ending June 30, 1968, and for each of the next three fiscal years, such sums as may be necessary, not to exceed in the aggregate $36,227,000, to enable the Secretary of the Department of Health, Education, and Welfare (hereafter referred to as the Secretary), to make grants to assist in the modernization of public or nonprofit private hospitals and in the construction or modernization of public health centers, long-term care facilities, including extended care facilities, diagnostic or treatment centers, rehabilitation facilities, facilities for the mentally retarded, and community mental health centers in the District of Columbia. Sums so appropriated shall remain available until expended. APPROVAL OF APPLICATIONS SEC. 3. (a) An application for a grant with respect to any project may be approved by the Secretary under this Act only if an application for a grant with respect to such project has been filed under the Medical Facilities Acts (which for purposes of this Act means title VI of the Public Health Service Act or, where appropriate, title II or part C of title I of the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963) and-! (1) has been approved under the Medical Facilities Acts and the application filed under this Act is for additional funds in connection therewith, or (2) has been denied under the Medical Facilities Acts because insufficient funds are available from the allotments of the District of Columbia under such Acts to permit approval of the application. In determining whether to approve an application for a grant with respect to any project in the District of Columbia under the Medical Facilities Acts, the availability of additional funds for such project under this Act shall be taken into consideration; and, in any such case, approval under the Medical Facilities Acts may be made contingent upon the approval of an application with respect to such project under this Act and upon such additional funds being made so available. (b) The Secretary shall establish criteria for determining the order in which to approve, under this Act, applications for grants with respect to projects. Such criteria with respect to construction projects for the same type of facility (or for modernization projects) shall be the criteria developed by the State agency of the District of Columbia pursuant to the State plan approved under the Medical Facilities Acts. (c) In the case of any project with respect to which an application for a grant is filed under this Act and with respect to which an application for a grant has been denied under the Medical Facilities Acts, such application under this Act may be approved only if there is compliance with the same terms and conditions (including determination, in accordance with the applicable State plan, that the project is needed) as are applicable to applications for grants under the Medical Facilities Acts, other than the availability of sufficient funds in the appropriate allotment of the District of Columbia. (d) An application for a grant under this Act with respect to any project may not be approved unless an opportunity to review the application has been afforded to a body, found by the Secretary to be a responsible metropolitan area-wide planning body, and any recommendations of such body that were timely made have been considered by the appropriate State agency of the District of Columbia and have been submitted to the Secretary in connection with the application. PAYMENTS SEC. 4. (a) Payments under this Act with respect to any project shall be made in the manner provided under the Medical Facilities Acts for payment of the Federal share of the cost of projects for which applications are approved under such Acts; except that such payments shall also be subject to such reasonable conditions as the Secretary deems appropriate to safeguard the Federal interest. (b) The total of the payments made under this Act with respect to any project, together with any payments with respect thereto under the Medical Facilities Acts, may not exceed― (1) in the case of a construction project for a long-term care facility. including extended care facilities, a diagnostic or treatment center, or a rehabilitation facility, 66% per centum of the cost of such project; and (2) in the case of any other project (including a modernization project). 50 per centum of the cost of such project. RECOVERY OF PAYMENTS SEC. 5. Payments under this Act shall be subject to recovery or recapture under the same conditions and to the same extent as is provided under the Medical Facilities Acts with respect to payments made thereunder. MEANING OF TERMS SEC. 6. The terms used in this Act shall have the same meaning as when used in the Medical Facilities Acts. Passed the Senate December 15, 1967. FRANCIS R. VALEO, Secretary. Referred to the Committee on the District of Columbia, House of RepresentaJanuary 15, 1968. [90th Cong., 1st sess., Senate Rept. No. 944, Calendar No. 929] DISTRICT OF COLUMBIA HOSPITAL-MEDICAL FACILITIES CONSTRUCTION ACT The Committee on the District of Columbia, to which was referred the bill (S. 1228) to authorize the establishment of enabling authority legislation for construction and modernization of hospital and other medical facilities in the District of Columbia, having considered the same, reports favorably thereon with amendments and recommends that the bill as amended do pass. The amendments are as follows: (1) On the first page, line 4, strike out "1967" and insert in lieu thereof "1968". (2) On the first page, line 7, strike out "1967" and insert in lieu thereof "1968". (3) On the first page, line 8, immediately after "necessary", insert a comma and the following: "not to exceed in the aggregate $36,227,000,”. (4) On page 2. line 3, immediately after the second comma, insert the following: "including extended care facilities,". (5) On page 4, line 10, strike out "Surgeon General" and insert in lieu thereof "Secretary". (6) On page 4, line 25, immediately after the first comma, insert the following: "including extended care facilities,". PURPOSES OF THE BILL The purpose of the bill is to authorize supplementary Federal assistance for the District of Columbia government for modernization of public or nonprofit private hospitals, and for the construction of such health centers, long-term and extended care facilities, diagnostic or treatment centers, rehabilitation facilities, community mental health centers, and facilities for the mentally retarded. The bill would provide additional Federal project grants to those now available under various programs provided by the Medical Facilities Acts (which for purposes of this bill means title VI of the Public Health Service Act, including the Hill-Burton program, or, where appropriate, title II or pt. C of title I of Mental Retardation Facilities and Community Health Construction Act of 1963). Briefly, this legislation establishes the administrative and programing machinery for this intended or supplemental aid for projects required to be approvable under construction aid programs-the Hill-Burton program, or the mental retardation facilities of the mental health center construction programs. In summary, the bill provides as follows : (1) For the funding authorization, for purposes of the act for fiscal year ending June 30, 1968, and for each of the next 3 fiscal years, commencing with the fiscal year ending June 30, 1969, and concluding with the fiscal year ending June 30, 1971. (2) For a maximum funding authorization of $36,227,000, or the portion thereof as is necessary and supported by the appropriate national program authority and by approval of the Secretary of the Department of Health, Education, and Welfare. Supplemental aid would be conditioned upon the sole ground of insufficient funds under the District's allotments under the respective nationwide programs. (3) For two types of Federal grants to the District of Columbia government: (a) Supplementary grants to make up the difference between funds provided for a project under the regular, Federally sponsored Hill-Burton, mental retardation or mental health center programs, and the amount of funds required to constitute the higher Federal share authorized by this new legislation; and (b) Grants for projects enabled to qualify for grants under the HillBurton, mental retardation or community mental health center programs, provided an application has been filed for a grant under the appropriate program and has been denied because the project had insufficient priority or because sufficient funds were unavailable in the applicable allotment to the District to permit approval of the application. (4) For approval of grants for construction of long-term and extended care facilities, diagnostic or treatment centers, or rehabilitation facilities that may not exceed (a) 66% percent of the cost of long-term-care or an extended care facility, diagnostic or treatment centers, or rehabilitation facilities; or (b) 50 percent of the cost of any other project. (5) For special Federal assistance only if there is compliance with the same terms and conditions (including determination that the project is needed in accordance with the appropriate State plan for health facilities in the District) as are applicable to the grants under the Hill-Burton, mental retardation or mental health center construction programs. Accordingly, such proposed projects would be reviewed to assure compliance with the State plan and priority system required under the Federal Hill-Harris mental retardation or community mental health centers program. Such projects would be required to meet construction and equipment standards contained in regulations adopted to implement such programs. (6) For a mechanism by which a responsible metropolitan areawide planning body may comment upon the merits of each application. This particular phase is especially noteworthy because it provides a device by which local representatives, both professional and lay, may consider construction proposals in relationship to the needs and plans of other health institutions or programs in the Washington, D.C., metropolitan area, wherein the three jurisdictions of the States of Maryland and Virginia and the District of Columbia are concerned. BACKGROUND OF FEDERAL AID TO THE DISTRICT OF COLUMBIA The unique responsibility of the Federal Government to provide financial assistance for the construction of hospitals and other medical facilities in the District of Columbia has been recognized by the Congress for more than 20 years. In 1946, Congress enacted the Hospital Center Act, authorizing the appropria 95-621-68 |