into one allotment. Upon a showing by the State of a construction schedule where highest priority projects would utilize all available funds to meet the needs of such State for construction of such facilities, the Surgeon General shall approve such request." I hope that you will give serious consideration to this view. Sincerely yours, JOSEPH E. CANNON, M.D., M.P.H. STATE OF MONTANA, Hon. ARNOLD H. OLSEN, Congress of the United States, House of Representatives, Washington, D.C. DEAR CONGRESSMAN OLSEN: The Nebraska State Board of Health proposes an amendment to the Hill-Burton bills now being studied in Congress. This proposal would be advantageous to Montana. It is as follows (to be inserted in the section providing for alloting the appropriation among the several States and territories): "Provided, That any State having an annual allotment of less than $2% million may request the Surgeon General to merge all categorical funds into one allotment. Upon a showing by the State of a construction schedule where highest priority projects would utilize all available funds to meet the needs of such State for construction of such facilities, the Surgeon General shall approve such request." Montana would have less need for hospital modernization than States with large metropolitan areas. We could use our allocation to better advantage for new construction. Senator Roman L. Hruska, Nebraska, is studying this proposal. If you feel that this amendment would be worthwhile, it is suggested that Senator Hruska have your viewpoint. House of Representatives, House Office Building, DEAR MR. RIVERS: In the consideration by the Congress of the United States as to the amendments and extension of the Hill-Burton Act, it is our earnest opinion in the department of health and welfare that the best interest of the State would be served if the categorical allocations to Alaska, a minimum allotment State, could be merged into one category. Because of the minimum allotments to Alaska and the high construction costs, we could better plan our hospital replacements if we could combine general hospital, diagnostic and treatment center, long-term care facilities, etc., into grants for one project. The State of Nebraska has presented a proposal which reads as follows: "Provided, That any State having an annual allotment of less than $2 million (Alaska's allotment has been $550,000 under minimum allotment provisions) may request the Surgeon General to merge all categorical funds into one allotment. Upon a showing by the State of a construction schedule where highest priority projects would utilize all available funds to meet the needs of such State for construction of such facilities, the Surgeon General shall approve such a request." We would be in agreement with the above provisions and so recommend unless you have knowledge of any adverse effect. Sincerely yours, HENRY A. HARMON, Deputy Commissioner. Hon. HOWARD CANNON, MAY 12, 1964. U.S. Senator, Senate Office Building, DEAR SENATOR CANNON: You may recall that over the past many years Nevada has advocated and strived to attain changes in Hill-Burton legislation that would allow minimum allotment States more freedom with the use of their Federal allocations by allowing transfers between all categories whether they fall under part C or part G of the act. The limited funds received by minimum allotment States oftentimes makes it extremely difficult to do a project in a way that is the most beneficial to both sponsor and public. For example, in Nevada (we receive but $200,000 per year to assist with general, mental, and tuberculosis hospital construction) in a hospital project that costs $1,500,000, the Federal share will range from $500,000 to $1 million and require our entire annual hospital allotment for 22 to 5 years. The problems created by "splitting" a project over several years make full participation impractical, if not impossible, and as a consequence, results in a project receiving something less than the total allowable Federal share. On the other hand, freedom to transfer between all Hill-Burton categories would enable us to develop projects in a more nearly equitable manner. E. A. Rogers, M.D., State health officer of Nebraska, has sent me a copy of a proposed amendment to the Hill-Burton Act that Nebraska is asking be inserted in that section providing for allotting the appropriations among the several States and territories. The proposal is as follows: "Provided That any State having an annual allotment of less than $21⁄2 million may request the Surgeon General to merge all categorical funds into one allotment. Upon a showing by the State of a construction schedule where highest priority projects would utilize all available funds to meet the needs of such State for construction of such facilities, the Surgeon General shall approve such request." Dr. Rogers also advises that Senator Roman L. Hruska is studying this proposal at their request and should you feel you can support this provision, may I ask that you express your views to Senator Hruska. You will find it noteworthy that even though Nebraska is not a minimum allotment State that she, too, is experiencing problems in not being allowed the freedom of using her Hill-Burton funds to the best possible advantage. Sincerely, DANIEL J. HURLEY, GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED States, E. A. ROGERS, M.D., M.P.H. Department of Health Section of Hospitals and Medical Facilities, DEAR DR. ROGERS: The proposed amendment to the Hill-Burton Act which you submitted in your letter is indeed, in my opinion, an extremely desirable one, and I would recommend that it be endorsed fully. Unfortunately we have no congressional delegation, but I am requesting that the Governor of the Virgin Islands, through the Department of the Interior, endorse this proposal which will obviously help the smaller States and territories. Very sincerely yours, MELVIN H. EVANS, M.D., STATE OF DELAWARE, Hon. FRANK B. MORRISON, DEAR GOVERNOR MORRISON: Thank you for your letter of May 7 regarding proposed bills now pending before Congress to amend the Hill-Burton Act. I have been advised by the Delaware State Board of Health that their representative met with 12 health officers from other States in Chicago recently to discuss among other things, this matter. The current urgency is that legislation be passed promptly to assure that there will not be a temporary halt in the HillBurton program within the States. Dr. Floyd I. Hudson, Delaware's representative to the meeting in Chicago, states that they were assured that the Harris bill, H.R. 10041, would promptly pass the House as soon as it has been approved by the committee. The amendments which you mention in your letter were also discussed at this meeting and the feeling was that they would be helpful to many of the smaller States but would be opposed by the larger ones. In view of the fact that an amendment would delay the renewal of the Hill-Burton authority, the conclusion was reached that it would not be wise to attempt such an amendment this year. Cordially yours, E. A. ROGERS, M.D., M.P.H., ELBERT N. CARVEL, DEPARTMENT OF HEALTH AND WELFARE, DEAR DR. ROGERS: In reply to your recent letter regarding your suggestion for change in the proposed revision of the Hill-Burton Act, I should not be favorable to the suggested change. I believe it would defeat the purposes of the act, which are to emphasize the various categories of medical facilities need. However, I believe in maximum flexibility in the transfer of the State's allotments among the various categories of need, if there are insufficient satisfactory applications to encumber individual category funds in a fiscal year. Sincerely yours, DEAN FISHER, M.D., Commissioner. The CHAIRMAN. If there is anyone who would like to file any statement on this matter, we would be very happy to have him file it with Mr. Barclay. We would only ask that you submit your statement by Friday of this week. The subcommittee will now stand in recess. (Whereupon, at 11:40 a.m., the subcommittee adjourned, subject to the call of the Chair.) о LABOR AND PUBLIC WELFARE UNITED STATES SENATE EIGHTY-EIGHTH CONGRESS SECOND SESSION ON S. 2528 and S. 2725 BILLS TO BROADEN THE BASE OF FEDERAL ASSISTANCE TO STATES IN THE COMPUTATION OF GRANTS FOR IMPACTED AREAS AND TO PROVIDE STANDBY DISASTER ASSISTANCE 36-177 O JULY 29 AND 30, 1964 Printed for the use of the Committee on Labor and Public Welfare U.S. GOVERNMENT PRINTING OFFICE WASHINGTON: 1964 |