Veterans' Administration, summary of activities as of Oct. 31, 1940—Continued

NOTE.-60,314 cases had 2 actions, 14,309 had 3 actions, 8,651 had 4 actions, 1,282 had 5 actions, 191 had 6 actions, 39 had 7 actions, 15 had 8 actions, 4 had 9 actions, and 1 had 10 actions.

Number of individuals receiving out-patient treatments during October.
Number of individuals examined during October for.

Pensions and compensation..

Insurance

Determination of need of hospitalization or domiciliary care.

Out-patient treatment (veteran).

Out-patient treatment (others)..

Civil Service Commission.

Employees' Compensation Commission

Allied pensions

Civilian Conservation Corps.

Works Projects Administration.

Railroad Retirement.

3,069

460

141

64

22

36

3,792

32.375

36, 996

8,546 926 14. 124 9,724

954

2, 101

154

32

71

112

252

Veterans' Administration, summary of activities as of Oct. 31, 1940-Continued BENEFICIARIES RECEIVING HOSPITAL TREATMENT FOR DOMICILIARY CARE AUTHORIZED BY VETERANS' ADMINISTRATION

BENEFICIARIES RECEIVING HOSPITAL TREATMENT OR DOMICILIARY CARE CLASSIFIED BY WARS

Includes 272 non-Veterans' Administration cases not classified by wars.

1,195 16, 333 17, 528 74, 668

272 57, 140

PRESENT BED SITUATION AND PROPOSED CONSTRUCTION PROGRAM

In view of the fact that an appropriation is being requested to provide additional hospital beds in 1942, I believe it may be well to outline briefly our present bed situation and the proposed construction program.

As of October 31, 1940, there were 57,140 patients receiving hospital care and 17,528 veterans receiving domiciliary care authorized by the Veterans' Administration. The number receiving hospital care was classified by type of disease, as follows: Tuberculosis, 4,927; neuropsychiatric diseases, 33,569; general medical and surgical conditions, 17,983; observation, 323; and 338 patients not classified as to type of disease, which include Veterans' Administration beneficiaries receiving temporary hospitalization to complete their physical examinations; Civilian Conservation Corps enrollees; beneficiaries of the Employees' Compensation Commission and other Government departments; and allied ex-service men. As of the same date 232 facilities and hospitals were being utilized for this care and treatment, of which 87 were under the direct jurisdiction of the Veterans' Administration, 35 were operated by other Government agencies, and 110 were civil and State institutions.

The total of 57,140 hospital patients and 17,528 domiciliary cases remaining under care as of October 31, 1940, classified as to war in which service was rendered, is as follows:

During the period beginning with the act of March 3, 1919 (Public, No. 326, 65th Cong.), and ending with the act of June 27, 1940 (Public, No. 668, 76th Cong.), the Congress has specifically authorized and appropriated the sum of $161,074,267 for new hospital, domiciliary, and out-patient dispensary facilities. In addition there has been expended from July 1, 1923, to June 30, 1940, approximately $25,165,821 from regular fiscal funds for permanent improvements and extensions to Veterans' Administration facilities. This latter figure does not include expenditures for the purpose indicated at the former National Homes for Disabled Volunteer Soldiers prior to consolidation with the Veterans' Administration in July 1930. Subsequent to this consolidation there has been expended from the general post fund, established by the former National Homes, the sum of $1,126,174 for improvements. The Veterans' Administration has also been allotted for improvements and new construction, the sum of $3,041,650 from the National Recovery Act of 1933 and $13,268,200 from the Public Works Administration Appropriation Act of 1938. In all, a total of $203,676,112 has been made available for construction purposes during the past 21 years. As the result of such construction funds now available, all of which are definitely obligated or allocated and the work now under way or soon to be started, it is anticipated that new construction during the fiscal years 1941 and 1942 will result in 3,214 additional hospital beds and a net increase of 314 domiciliary beds. The 59,637 hospital beds under the control of the Veterans' Administration as of June 30, 1940, will then have increased to 62,851 and during the same period domiciliary beds will have increased from 19,197 to 19,511.

With the development of the national emergency the Veterans' Administration has shared in the study given to the medical treatment and care of those who might be disabled as the result of our defense program. Consideration has already been given as to the place the Veterans' Administration would occupy in our medical preparedness, having in mind its great nucleus of strictly medical facilities and highly trained medical staff. With the Army not immediately prepared to meet the medical and hospital requirements of an enlarged force, two problems were presented, first, the relinquishment by the Veterans' Administration of beds used in military and naval hospitals, and second, the extent to which Veterans' Administration facilities could be used to meet the increased needs of the armed forces, particularly those facilities located in the vicinity of enlarged

Army posts. A policy to meet these problems was adopted by the Federal Board of Hospitalization and approved by the President in September 1940. This policy provided (1) that the additional requirements of the armed forces due to expansion be met by the relinquishment by the Veterans' Administration of beds occupied in Army and Navy hospitals and by the addition through new construction of beds to existing service hospitals; (2) that in areas where maneuvers are held the temporary general hospital needs of the Army and Navy be met by the nearest general hospitals of the Veterans' Administration; and (3) that in the event of a major national emergency the general facilities of the Veterans' Administration be utilized by members of the armed forces who are injured or incur disabilities in service and whose physical rehabilitation by the Army is not feasible. There was also presented the problem of the Veterans' Administration providing beds to meet the requirements of the additional hospital load which will result through immediate expansion of the armed forces. The Veterans' Administration is required by law to provide hospitalization for members of the Regular Establishment who are discharged for disabilities incurred in service or who are in receipt of pension. It is believed that this load can best be met initially through acceleration of construction of the projects included in the 10year construction program. The Veterans' Administration and the Federal Board of Hospitalization are now making a study of the anticipated load which may result from the increased personnel of our armed forces to the end that the necessary funds may be provided for the erection of beds in advance of the demand occasioned by serious disabilities suffered by members of the armed forces. The Veterans' Administration is conscious of the fact that in assuming the additional load of hospital cases its obligation to the veterans of our wars has not been changed. It anticipates the erection of new beds to meet any additional load occasioned by the increased personnel of the Army and Navy so that the hospital service now rendered to veterans of past wars will not be curtailed. However, no provision has been made in the current budget estimate for funds for such additional beds as may subsequently be found necessary as the result of this study.

I hope this summarization has given the committee a general idea of what we are doing and what may be expected and I will now proceed with an analysis and explanation of each appropriation item in the order that they appear in the bill

SALARIES AND EXPENSES

There is requested under this title for the fiscal year 1942, the sum of $104,726,912. This appropriation covers all expenses of administration including salaries and operating expenses of the Central Office in Washington, the field offices, hospitals, homes, and supply depots; the cost of travel and examination of beneficiaries; payment of burial expenses and reimbursements for such expenses; repairs and alterations to hospitals, homes, and property in which Veterans Administration facilities' are housed and to the equipment utilized; payments to contract facilities wherein Veterans' Administration patients are hospitalized; reimbursements to States at the statutory rate for those veterans cared for in State Soldiers' Homes who are eligible for admission to Veterans' Administration hospitals or homes; the cost of administration of the National Service Life Insurance; in general, all items of expense which are not direct monetary benefits to the veterans.

CHANGES IN LANGUAGE REQUESTED

For the fiscal year 1942 the following changes in wording under "Salaries and expenses" are requested in accordance with instructions from the Bureau of the Budget:

On page 31, line 17 (under the heading Veterans' Administration) of Public, No. 459, 76th Congress, April 18, 1940 (Independent Offices Appropriation Act, 1940), delete the words "and rentals." This change is suggested inasmuch as rental of space in the District of Columbia will hereafter be paid from an appropriation of the Public Buildings Administration, Federal Works Agency.

Also beginning on line 20 of the same page delete the words "for expenses incurred in packing, crating, drayage, and transportation of household effects and other property, not exceeding in any one case five thousand pounds, of employees when transferred from one official station to another for permanent duty and when specifically authorized by the Administrator," and substitute the wording "transfer of household goods and effects as provided by the Act of October 10,

1940 (Public, No. 839, 76th Congress), and regulations promulgated thereunder." This change is suggested for the purpose of bringing the language of the act into accord with the provisions of Public, No. 839, October 10, 1940.

On page 32, line 19, of Public, No. 459, insert the words "Federal Security Agency" immediately preceding the word "Public" and place the words "Public Health Service" in parentheses. This change is suggested inasmuch as the Public Health Service has been transferred to the Federal Security Agency.

DISTRIBUTION OF INCREASE IN ESTIMATE FOR SALARIES AND EXPENSES

The appropriation estimate for 1942 in the amount of $104,726,912 represents an increase of $3,512,232 over the actual appropriation of $101,214,680 for 1941. In order to arrive at an accurate analysis of this item it is necessary to determine a basic figure for 1942 and this is accomplished by eliminating from the 1941 appropriation figure all amounts representing nonrecurring items. By applying to this basic figure the estimated increases for new or expanding activities, it is possible to explain in more complete detail the differences represented in the estimate for 1942. The following tabulation accomplishes this purpose and indicates specifically the accounting symbols under which the net increases are shown: Regular appropriation, 1941 act..

Deduct nonrecurring and other items not required
in 1942:

Passenger carrying and other motor vehicles.
Initial equipment....

$101, 214, 680

-$205, 500

-328, 374

Transfers and reimbursements for hospitaliza

tion, etc...

-352, 582

Unobligated balance 1941 act..

-1, 214, 680

As I proceed with my statement and take each item up individually, I will explain the purpose of these increases and the necessity for the amounts requested. The major portion of the increase of $5,613,368 is due to the need for additional employees and supplies to operate the increased number of hospital and domiciliary beds in the course of construction, or to be constructed, which will be utilized during the fiscal year 1942; and for new employees who will be required in connection with the administration of the National Service Life Insurance. Attention is also invited to the fact that in arriving at the base for 1942 there was deducted from the 1941 appropriation as a non-recurring item, the amount of $1,214,680 which is listed as an unobligated balance in the 1941 Act. This estimated balance has been shown in the Budget estimate in accordance with a letter addressed to the Bureau of the Budget, wherein it was stated that this amount could be placed in the reserve as an ultimate potential saving to the appropriation. While every effort is being made to forestall the necessity for