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CAPITOL GUIDE SERVICE

Senator SASSER. The fiscal year 1980 budget request for the Capitol Guide Service is $610,000, an increase of $17,000 over the previous year.

Would you please describe the activities of the Capitol Guide Service and give the subcommittee an explanation of this proposed increase.

Mr. MALSTROM. First, Mr. Chairman, this appropriation includes funds for salaries, agency contributions, longevity compensation, and expenses of the Capitol Guide Service. The Capitol Guide Service actually is the group of individuals who provide the tour service through the U.S. Capitol Building, where there are the early morning tours, the senatorial tours, and the normal everyday tours for individual tourists who come through the Capitol Building. The Capitol Guide Service is on the job virtually every day of the year. The increase of $17,000 is the result of a revised longevity program for the Capitol guides, who are part of that program, and the increased amount of $7,000 for expenses such as uniforms, supplies, stationery, and so forth.

Senator SASSER. Well, Mr. Malstrom, we appreciate your very fine testimony here today before our subcommittee, as well as your cooperative efforts throughout the year with the subcommittee and its staff. I hope you will keep up the good work.

Mr. MALSTROM. I hope so, sir. And any time I can assist, I would be glad to.

Senator SASSER. Thank you.

SUBCOMMITTEE RECESS

The subcommittee will stand in recess until 2 p.m., tomorrow, February 21, 1979, when we will continue hearings on the fiscal year 1980 legislative branch budget.

Thank you.

[Whereupon, at 3:03 p.m., Tuesday, February 20, the subcommittee was recessed, to reconvene at 2 p.m., Wednesday, February 21.]

LEGISLATIVE BRANCH APPROPRIATIONS FOR

FISCAL YEAR 1980

WEDNESDAY, FEBRUARY 21, 1979

U.S. SENATE,

SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS,

Washington, D.C.

The subcommittee met at 2:15 p.m., in room 1114, Everett McKinley Dirksen Office Building, Hon. Jim Sasser (chairman) presiding.

Present: Senator Sasser.

JOINT ITEMS

OFFICE OF THE ATTENDING PHYSICIAN

STATEMENT OF FREEMAN H. CARY, M.D., THE ATTENDING PHYSICIAN

BUDGET REQUEST

Senator SASSER. The subcommittee will come to order.

We are pleased to have with us this afternoon Dr. Freeman H. Cary, the attending physician of the Congress, who will testify in support of a fiscal year 1980 budget request in the amount of $459,000. Dr. Cary, I note that your budget request represents a decrease a decrease of $6,000 below the previous year—and that is one of the few instances where we find a decrease of the Legislative Branch budget. I want to applaud you, sir, for your frugality, and I hope that your example will be copied by many, many others. Dr. Cary, one of the reasons we asked you to come before us today is the matter of assigning a full-time pharmacist to the Capitol pharmacy. You are aware of the concern, I think, of myself and of Senator Huddleston and of the interest this has sparked in the pharmacy profession around the country. I hope that you will have something positive to report on this issue today.

You may proceed, Dr. Cary.

Dr. CARY. Mr. Chairman, thank you for the privilege of appearing before you to discuss the appropriation for and in the operation of the office of the attending physician.

Mr. Chairman, I am well aware of your concern and Senator Huddleston's concern as well as the concern of other Members who have received inquiries about the operation of our pharmacy. In view of this, I have asked that a full time naval registered pharmacist be assigned to my staff.

I have submitted a comprehensive statement for the record, but in the interest of time, I will attempt to summarize my statement.

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Although our work load has continued to increase yearly, our staff is essentially the same as it has been for the past several years.

OFFICE VISITS AND UPDATING SERVICES

My office recorded 86,015 visits in fiscal year 1978 compared to 78,558 visits in fiscal year 1977, an increase of 9.5 percent. We are constantly trying to update the services which can be provided Members. Based on the premise that each Member represents an average of 475,000 constituents, it is obvious that any procedure that we can do to save the time of Members is important. To preclude the Member of having to travel to Bethesda Naval Hospital or Walter Reed Army Hospital for their consultations, we have regularly scheduled surgery, surgical proctology, orthopedic, dermatology and podiatry clinics in my office. Other clinics are held on a periodic basis. We provided an estimated 975,000 dollars worth of services last fiscal year.

There are first aid rooms located in each of the House and Senate Office Buildings which are staffed by registered nurses. Tourists are seen on an emergency basis and staff personnel may visit these units for minor ailments and routine injections.

Capitol pages are youngsters and in many instances away from home for the first time, so we have taken the responsibility to be their primary physician. We keep permanent medical records on each of them and have authorization for treatment from their parents.

INSTRUCTION PROGRAMS

My office provides first aid instruction and instruction in cardiopulmonary resuscitation to the Doorkeepers and U.S. Capitol Police. We have also had a very successful CPR program in which several hundred staff members have been trained in this lifesaving technique.

My office, along with the staff clubs, sponsor various medical screening programs that are held on Capitol Hill throughout the year, such as hearing tests for Hill employees, the National High Blood Pressure Month program, breast cancer screening tests, eye screening programs, and so forth. We are presently working on plans to provide clinical programs for those who desire to quit smoking.

PHYSICAL EXAMINATIONS FOR U.S. CAPITOL POLICE

Last year we took on the additional responsibility of performing preemployment physical examinations on recruits for the U.S. Capitol Police Department, as well as performing annual physical examinations on U.S. Capitol Police personnel over 55.

This, Mr. Chairman, concludes my statement. I will be glad to answer any further questions or supply any additional information the subcommittee may wish to include in this hearing.

Thank you.

[The statement follows:]

STATEMENT OF FREEMAN H. CARY, M.D.

Thank you for the privilege of appearing before you to discuss the appropriation for and the operation of the Office of the Attending Physician, U.S. Congress.

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The Fiscal Year '80 estimates submitted for the operation. of my office was for $459,000.00. This is a decrease of $6,000.00 over my appropriation for FY '79.

Although our work-load continues to increase yearly, our staff is essentially the same as it has been for the past several years.

My office recorded 86,015 visits in FY '78 compared to 78,558 visits in FY '77, an increase of 9.5%. Briefly, I would like to explain the operation of my office.

Members of Congress are provided full outpatient care by the Office of the Attending Physician, which includes x-ray, laboratory, physiotherapy, electrocardiograms, pulmonary function tests, pharmacy service and immunizations for foreign travel. An ambulance is available for any emergency need which may occur when the Congress is in session. We provide the opportunity and encourage Members to participate in health programs, such as annual physical examinations for the early detection and prevention of disease, follow-up visits for ongoing health problems and treatment of acute illnesses.

When inpatient or consulting service is indicated, the Member is referred to the appropriate consultant at Walter Reed Army Medical Center, the National Naval Medical Center, or private physician if desired. The statutory authority which authorizes Members of Congress medical care in military hospitals is other than specific. The Secretary of the Army and the Secretary of the Navy controls the authorization for admission to Army and Navy medical facilities. The Secretary of the Navy has for the past fifty or more years, as a matter of policy, authorized the admission of Members of Congress to the Naval

Hospital, Bethesda, Maryland, at no expense to the Federal Government. It has been the practice for many years to regard the health of top civilian officers of the government as a particular concern of the government which justifies the use of government facilities in the manner authorized by existing regulations. Charges for such care are established by the Office of Management and Budget and are revised periodically. the established general rate is $242.00 per day. This cost covers all inpatient services. There are no charges for outFatient visits because the hospital facilities are considered an extension of the outpatient care provided by the Office of the Attending Physician.

Currently,

Dependents of Members are not entitled to treatment in the Office of the Attending Physician or in the military hospitals except in instances where a Member of Congress is a retired member of the Uniformed Services. However, our office does

assist in getting dependents to an appropriate physician or medical facility upon request.

There are first aid rooms located in each of the House and Senate Office Buildings. These units are staffed by a registered

nurse. Tourists are seen on an emergency basis, and staff personnel may visit these units for minor ailments where simple, over-the-counter medications are dispensed, if needed. Staff members requiring more extensive care are referred to local

Routine

physicians, if they do not have their own physician. injections, such as allergy injections are given upon the written request of the patient's private physician.

Pages are youngsters and in many instances are away from home for the first time, so we act as their primary physician and we ensure that they are referred to appropriate medical sources for consultation and treatment when indicated. We keep permanent medical records on them and have authorization for treatment from their parents.

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