salaries in private practice. But still and all, my staff are dedicated to the work they are doing here, and obviously if they wanted to make money, they would go someplace else. What they want to do is the work they can do here.

Mr. PACKARD. Any further questions?

Thank you very much. We appreciate it.

We are very pleased now to have with us and introduce to Members of the committee and everyone here Admiral John Eisold, who is the Attending Physician for the House.

I don't know whether you have a statement that you would like to make, but the time is yours.

OFFICE OF THE ATTENDING PHYSICIAN

Dr. EISOLD. Thank you, sir, Mr. Chairman, Mr. Fazio. I am pleased to be working on the Hill and I am delighted to appear before the committee, I would be more than happy to invite any questions you might have for myself or my AA, Mr. Burg, who has accompanied me here today.

Mr. PACKARD. Thank you.

Questions?

Mr. FAZIO. Not at the moment.

Mr. MILLER. I don't mean to be the one to keep questioning, but, I am new to this committee.

Mr. PACKARD. We love it.

Mr. MILLER. I am a college professor. I always tell the students on the first day, there is no such thing as a dumb question.

What do you do when people come and want to stop by your office with a cold or something?

SERVICES PROVIDED BY OFFICE OF ATTENDING PHYSICIAN

Dr. EISOLD. One of the things that has impressed me the most is the scope of services we provide. Quite frankly, it far exceeds coordinating the Members' care.

As you can imagine, a large organization like Capitol Hill with 35,000 workers and 1.5 million visitors, would provide those services that you would expect a responsible organization to be able to accomplish, such as nursing stations throughout the Hill to be able to take care of minor problems, for the staff members. This saves them time from going back and forth for simple things that can be taken care of on the job. We are first response for emergency calls with our ambulance. And we provide services to the pages that come here. As you can imagine, their parents are very interested in their care. We are like their family away from home.

There are also environmental and preventive medicine obligations. We have responded recently to some questions that had to do with paint fumes in the building. Through the sanitation expert we have, we have been able to discover why the fumes were accumulating and have been able to rectify that problem.

The flu shot program, teaching CPR to people throughout the Hill, and providing the ability to give immunizations to people that are going overseas on official travel are examples of other services.

And there are still many other-services that are provided to everyone that works or visits at the Capital.

89-935 95-5

Mr. PACKARD. You are on call for emergencies for tourists.
Dr. EISOLD. Yes, that's correct.

Mr. PACKARD. All the tourists that come.

Dr. EISOLD. We have quite a list of interesting situations that come up, from squirrel bites to fractured limbs. In fact, the majority of all emergency services provided are to other than members of Congress.

I think that no time like the present makes it more clear that when people are very busy, they either may deny their care or delay their care. With the hours that people are keeping our ability to be able to recognize problems and attend to them quickly without people missing work is very important to the Members and the hundreds of thousands of people they represent.

ATTENDING PHYSICIAN USER FEE

Mr. MILLER. How do we work the cost? We get charged?

Dr. EISOLD. I am the clinician and do stay out of the realm of worrying about who comes to my door.

Mr. MILLER. Don't we pay a fee?

Mr. THORNTON. Yes, we do.

Mr. MILLER. I started last year.

Mr. PACKARD. Most of us are insured and so if there is treatment that requires something more extensive-your insurance would kick in. But there is also a fee that I think each Member pays. Mr. FAZIO. At least I think that is true on the House side.

Mr. PACKARD. We have removed any freebies. Drugs are not provided for us now. We obtain those from a regular pharmacist or pay for them if they are provided by

If it requires extensive treatment, you go out to one of the hospitals, and there your insurance, of course, covers it.

Mr. MILLER. Is your salary in this budget or in the Navy budget? Dr. EISOLD. Historically it is in this budget. It is compensated by the House, is my understanding.

NUMBER OF EMPLOYEES ON ATTENDING PHYSICIAN PAYROLL

Mr. MILLER. How many people are on the Navy payroll? Is everybody?

Dr. EISOLD. We have 19 civilians and 13 active-duty personnel. To follow along with the question you asked before about the_reimbursement, and my describing the scope of the clinic's work, I really wanted to express that a lot of what we do has no direct responsibility to the Members, but is more the cost of doing business for any large organization with 35,000 employees and 1.5 million visitors each year.

NURSES STATIONS

Mr. PACKARD. What relationship does your office have with the nurses' stations that are here in the different office buildings, both House and Senate side, and how are you dealing with the Accountability Act as it relates to the nurses' stations? Dr. EISOLD. We have a very close They really communicate with us have, and we make regular visits to

relationship with the nurses. about _clinical questions they each First Aid Room.

Mr. PACKARD. Are they a separate operation or do they come under your jurisdiction?

Dr. EISOLD. They come under our jurisdiction. We review their treatment logs, the patient visits, and do quality assurance on their scope of practice. We have very well-constructed procedural guidelines that we keep, review and update on a regular basis.

BUDGET REDUCTIONS-ATTENDING PHYSICIAN

Mr. PACKARD. I want to compliment you on your budget submittal. Yours is one of the few that is listed that has actually shown a reduction from one year to the next. I see $1.5 million in 1994 of actual expense; it is down to $1.3 million in the 1995 budget year, and your budget proposal for the 1996 budget year is $1.26 million, which is a steady reduction in your operations.

Dr. ÉISOLD. I appreciate that. Being new here, I can only speak for the fiscal responsibility that the staff has had throughout the years. They are very conscious of trying to do things as efficiently as possible but accomplish the mission that we all feel proud to be a part of.

Mr. PACKARD. I appreciate your comments.

I think it does emphasize the point, in answer to Mr. Miller's question, that the Attending Physician is not just for the Members only, that office services a wide spectrum of needs here on Capitol Hill that involves the public and the employees in emergency and other needs. I think that is an important point for the Members of the subcommittee to be aware of.

Mr. Thornton.

Mr. THORNTON. Thank you, Mr. Chairman.

I really am impressed with the efficient and effective way the office is operated, and I cannot help but note that we spend five times as much for lawyers as we do for doctors in this organization. Dr. EISOLD. I will not make any comment on that, sir.

Mr. THORNTON. The services that the lawyers provide are very important, but I think having an Attending Physician available for tourists, for other people is also important. How many doctors are on a ship of the line like the new carriers?

Dr. EiSOLD. On the new carrier you will have a compliment usually of around eight to 10 doctors or health-care providers.

Mr. THORNTON. So you are not overstaffed compared with the range of the services that you provide.

Dr. EISOLD. No, sir, we are not. We certainly are not.

Mr. THORNTON. In fact, I really wonder how you stretch as broadly as do you to provide the services to everyone who enters this building and becomes eligible for treatment, in the case of an emergency, by your office.

Dr. EISOLD. I appreciate that, sir. It is a very dedicated crew. And again, I am new, but I am very impressed with the quality and enthusiasm of the work they do. It truly is a patriotic mission that they feel is important to do because keeping the Members healthy and on the job, is a priority.

Mr. THORNTON. Mr. Chairman, I think we did make a useful change a couple of years ago. It was thought that it might be a perk that we could have a doctor available when somebody got sick, so we now pay for that service with our own contribution and

through our insurance coverage, lest there be any mistake that we are getting something for nothing. We are paying for it just like everybody else.

NO FREE HEALTH CARE FOR MEMBERS

Mr. FAZIO. Would you yield on that?

I find continually I have constituents who believe that somehow we are given free health care and there is no need for health insurance. We are very pleased to benefit along with many other Federal workers in what is a very good system, but we often hear that some Member has been taken to Walter Reed Hospital for care or what have you.

In that sort of instance, our health insurers reimburse the military. So there isn't really any free health care here. And any question about the outpatient question here has been resolved by the Members' personal contribution. So I hope that will-and occasionally this rhetoric is stirred up by national health care debates. Hopefully we have put to bed any misimpression.

Mr. PACKARD. It won't be put to bed, but it should be.
Mr. FAZIO. It is a forgone hope, I realize that.

Mr. PACKARD. We have tightened up-this is certainly one of the areas we have tightened up, and I think it is because the public brought it loudly to our attention. I think we have done the right thing.

I want to recognize Roger Wicker who has also joined us.

Mr. MILLER. He is an attorney, too, by the way.

Mr. PACKARD. He took a cut in pay to come here, too.

Mr. WICKER. I am not saying a word.

DISCUSSION ON ATTENDING PHYSICIAN AMBULANCE

Mr. MILLER. There is an ambulance parked outside near the steps. Explain to me the rationale and how costly that is to maintain. I have heard criticism of that in the past.

Dr. EISOLD. Clearly that ambulance is a very fundamental part of the organization. We respond to over 200 emergencies a year. The overwhelming majority are not Members. They are staff and visitors painters who fall off a ladder, visitors who have acute coronary insufficiency, or others with a variety of medical problems. It is important, and it is a rule of thumb for any response team, whether it is here or anywhere, that you need to go prepared for the worst. We have a team comprised of five people that will respond when we get the call in the office for anyone that needs our services.

We clearly can reach any emergency quicker than D.C. Fire and Rescue, simply because of the proximity of that ambulance and because of the proximity to our people. And so really within minutes we can respond anywhere on the Hill and provide acute intervention.

The ambulance supports emergency care, and if needed, that ambulance could be used, to get somebody to the hospital if there was a delay in getting an ambulance from D.C. Fire and Rescue. And we have in the past.

It is not Member-specific; it will be used for tourists, workers or anyone.

Mr. MILLER. It is not full-time for them, those five people that respond?

Dr. EISOLD. No sir. Everybody that joins the staff goes to EMT school and the physicians go to advanced cardiac life-support training.

When not on an emergency run, those five people go right back in and do other jobs as technicians or physicians.

Mr. PACKARD. I am informed that other large agencies like the Library of Congress have their own physician services, so it is not unique to the Congress.

AREA COVERED BY OFFICE OF ATTENDING PHYSICIAN

Mr. MILLER. We just cover the office buildings in Congress, the Capitol itself, is that right? You don't go to the Library of Congress or Botanic Garden?

Dr. EISOLD. If you took the perimeter of Capitol Hill, we will respond anywhere.

Mr. MILLER. Does the Library of Congress fall in there?

Dr. EISOLD. Yes, indeed. I think we are the only true response team. They have perhaps some first-aid stations. There are nursing stations throughout the Hill. But in terms of actual 911-type response, this is your only capability.

Mr. PACKARD. Roger, do you have questions?

Mr. WICKER. No.

Mr. PACKARD. There is a vote on, and so we will wrap it up. Thank you very much, Doctor, for being with us. I just have a couple of questions, and maybe some of us will, to kind of wrap this up.

UNOBLIGATED, UNUSED FUNDS

In reading over your very comprehensive report in writing, there are several-in fact, most areas show an unexpended balance for 1994. And it varies. Some, just a few thousand, some a few 100,000, some a very few million. What do we do with those figures?

Mr. ANFINSON. We de-obligate them after a period of time. 1994 dollars are still being spent in some areas.

Mr. PACKARD. Some still can be obligated or spent? They can be spent? Okay. So those figures could change. Is that why we carry balances for a period of time?

Mr. ANFINSON. That is right.

Mr. PACKARD. And then when it reaches a point where it is obviously not going to be spent, what do we do? Reprogram those Mr. ANFINSON. No, we don't reprogram. It ceases to become available to us.

Mr. PACKARD. The money goes back to the Treasury?

Mr. FAZIO. Actually, Mr. Chairman, if you would yield, I think technically it never really is drawn on the Treasury.

Mr. ANFINSON. Well, that is correct.

Mr. FAZIO. In effect anything that has not been drawn down upon has never been taken out.

Mr. PACKARD. There is no movement.

Mr. ANFINSON. The money is never transferred.