"PART C-MISCELLANEOUS

"THE FEDERAL PERCENTAGE

"SEC. 721. For the purposes of this title

"(a) the Federal percentage for any State shall be 100 per centum less that percentage which bears the same ratio to 50 per centum as the per capita income of such State bears to the per capita income of the continental United States (excluding Alaska), except that (1) the Federal percentage shall in no case be more than 75 per centum or less than 333 per centum, and (2) the Federal percentage for Alaska and Hawaii shall be 50 per centum each, and the Federal percentage for Puerto Rico shall be 75 per centum; and "(b) the Federal percentages shall be promulgated by the Surgeon General between July 1 and August 31 of each even-numbered year, on the basis of the average of the per capita incomes of the States and of the continental United States for the three most recent consecutive years for which satisfactory data are available from the Department of Commerce. Such promulgation shall be conclusive for each of the two fiscal years in the period beginning July 1 next succeeding such promulgation: Provided, That the Surgeon General shall promulgate such percentages as soon as possible after the enactment of this title, which promulgation shall be conclusive for the fiscal year ending June 30, 1951.

"OPERATION OF STATE PLANS

"SEC. 722. In the case of any State plan under this part which has been approved by the Surgeon General, if the Surgeon General, after reasonable notice and opportunity for hearing to the State agency administering such plan, finds that in the administration of the plan there is a failure to comply substantially with any provision required by section 713 (a) to be included in the plan, the Surgeon General shall notify such State agency that further payments will not be made to the State until the Surgeon General is satisfied that there is no longer any such failure to comply. Until he is so satisfied he shall make no further certification to the Secretary of the Treasury with respect to such State. "ADMINISTRATION: FEDERAL HOSPITAL AND MEDICAL CARE COUNCIL

"SEC. 723. (a) The Surgeon General is authorized to make such administrative regulations and perform such other functions as he finds necessary to carry out the provisions of this title. Any such regulations shall be subject to the approval of the Administrator.

"(b) In administering this title, the Surgeon General shall consult with a Federal Hospital and Medical Care Council consisting of the Surgeon General, who shall serve as chairman ex officio, and ten members appointed by the Administrator. Four of the ten appointed members shall be persons who are outstanding in fields pertaining to hospital and medical care, at least two of whom shall be doctors of medicine and two of whom shall be hospital administrators, two members shall be persons experienced in the administration of voluntary prepayment plans for hospital and medical care, and the other four members shall be appointed to represent the consumers of hospital and medical care and shall be persons familiar with the need for hospital and medical care in rural or urban areas. Each appointed member shall hold office for a term of five years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term, and the terms of office of the members first taking office shall expire, as designated by the Administrator at the time of appointment, two at the end of the first year, two at the end of the second year, two at the end of the third year, two at the end of the fourth year, and two at the end of the fifth year after the date of appointment. An appointed member shall not be eligible to serve continuously for more than two terms but shall be eligible for reappointment if he has not served immediately preceding his reappointment. The Council is authorized to appoint such special advisory and technical committees as may be useful in carrying out its functions. Appointed Council members and members of advisory or technical committees, while serving on business of the Council, shall receive compensation at rates fixed by the Administrator, but not exceeding $25 per day, and shall also be entitled to receive an allowance for actual and necessary travel and subsistence expenses

while so serving away from their places of residence. The Council shall meet as frequently as the Surgeon General deems necessary, but not less than once each year. Upon request by four or more members, it shall be the duty of the Surgeon General to call a meeting of the Council.

"(c) In administering the provisions of this title, the Surgeon General, with the approval of the Administrator, is authorized to utilize the services and facilities of any executive department in accordance with an agreement with the head thereof. Payment for such services and facilities shall be made in advance or by way of reimbursement, as may be agreed upon between the Administrator and the head of the executive department furnishing them.

"STATE CONTROL

"SEC. 724. Except as otherwise specifically provided, nothing in this title shall be construed as conferring upon any Federal officer or employee the right to exercise any supervision or control over the administration, personnel maintenance, or operation of any hospital utilized for furnishing hospital and medical care pursuant to the provisions of this title.

"FEDERAL PAY-ROLL DEDUCTIONS FOR HOSPITAL AND MEDICAL CARE SUBSCRIPTION CHARGES

"SEC. 725. Upon the direction of any officer or employee of the Government of the United States, including members of the Armed Forces, requesting the Government to deduct from the salary of such person a fixed sum or percentage to be paid to any voluntary prepayment plan, said sum or percentage shall be deducted as requested and paid as directed. 'Officer or employee of the Government of the United States' as used herein shall include any officer or employee of any corporation the stock of which is wholly owned by the Government of the United States, as well as any officer or employee of any department, bureau, agency, or division of the Government of the United States.

"SEC. 726. Nothing in this title shall modify obligations assumed by the Federal Government under other statutes for the hospital and medical care of veterans or other presently authorized recipients of hospital and medical care under Federal programs."

SEC. 3. Section 1 of the Public Health Service Act is amended to read as follows:

“SECTION 1. Titles I to VII, inclusive, of this Act may be cited as the 'Public Health Service Act"."

SEC. 4. The Act of July 1, 1944 (58 Stat. 682), as amended, is hereby further amended by changing the number of title VII to title VIII and by changing the numbers of sections 701 to 714, inclusive, and references thereto, to sections 801 to 814, respectively.

[S. 1581, 81st Cong., 1st sess.]

A BILL To coordinate the health functions of the Federal Government in a single agency; to authorize grants to States for extending and improving the provision of medical, hospital, and dental services; to authorize grants to States for providing health examinations for school children and medical and dental treatment in certain cases; to amend the Hospital Survey and Construction Act (title VI of the Public Health Service Act) to extend its duration and provide greater financial assistance in the construction of hospitals; to amend the Public Health Service Act to authorize grants to States and political subdivisions in the development and maintenance of local public health units; to authorize studies and grants for increasing available manpower in the health professions; and for other purposes

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 "National Health Act of 1949."

SEC. 2. (a) The Congress hereby finds and declares

(1) that health and medical functions are widely scattered through many agencies in the Federal Government with resultant confusion and duplication of effort, and that because of this diffuse organization State health administrators and other State officials find it necessary to submit plans and budgets to numerous Federal officials responsible for health programs authorized under a large number of unrelated statutes; and

(2) that there are inadequacies in the distribution of public health services and of medical, dental, and hospital services in the United States, and

a shortage in professional personnel who provide such services, with the result that some persons are unable to secure such services to an adequate degree.

(b) The Congress hereby further declares that it is the policy of the United States

(1) to centralize in a single agency the activities of the Federal Government relating to health;

(2) to aid the States, through consultative services and grants-in-aid, in extending the provisions of medical, hospital, and dental services without discrimination to all individuals unable to pay the whole cost thereof, and in improving the manner in which such services are distributed; in providing medical and dental examinations to school children; and in expanding available hospital, clinical, and public-health facilities;

(3) to make provision for a study of training facilities and manpower requirements in the health professions and for temporary payments to medical schools for maintaining and increasing enrollment; and

(4) to make provision for voluntary deductions from the salaries of Federal employees of premiums directed by them to be paid to voluntary nonprofit health insurance funds.

TITLE I-NATIONAL HEALTH AGENCY

CREATION OF AGENCY

SEC. 101. (a) There is hereby created in the executive branch of the Government an independent agency to be known as the National Health Agency (hereinafter called the "Agency"), which shall be administered by a National Health Administrator (hereinafter called the "Administrator"), who shall be appointed by the President, by and with the advice and consent of the Senate, and who shall receive compensation at the rate of $15,000 per annum.

(b) The Administrator shall cause an official seal to be made for the Agency of such device as the President shall approve, and judicial notice shall be taken thereof.

(c) The Administrator, who shall engage in no other business, vocation, or employment, shall be a citizen of the United States and a doctor of medicine licensed to practice in one or more of the States who previously shall have demonstrated outstanding ability in the fields of medicine and administration.

PURPOSE OF AGENCY

SEC. 102. (a) It shall be the purpose of the Agency to aid and foster progress throughout the Nation in the fields of health and medicine.

(b) To carry out the purpose of subsection (a) the Agency shall

(1) encourage the development throughout the Nation of health services and facilities;

(2) advise and cooperate with other agencies and departments of the Federal Government, and with State governments and agencies, and with private agencies functioning in the field of health;

(3) collect and analyze statistics and make studies, investigations, and reports on conditions, problems, and needs in the field of health in the United States and in other countries, and disseminate and make available information in this field;

(4) make reports and recommendations with respect to the most efficient policies and methods for the promotion of health and related services; and (5) carry out such specific duties as may be entrusted to it by this and subsequent Acts of Congress, and exercise general supervision over the agencies transferred to it pursuant to section 103.

(c) Nothing in this title shall be deemed to transfer to the Agency any powers, functions, or duties exercised by the armed services or the Veterans' Administration.

TRANSFERS TO AGENCY

SEC. 103. (a) Upon the effective date of this title, as provided in section 109, there are hereby transferred to the Agency the following agencies, and their functions, powers, and duties: The Public Health Service, Saint Elizabeths Hospital, and the Food and Drug Administration.

(b) Upon the effective date of this title, as provided in section 109, there are hereby transferred to the Agency the functions and duties of the Children's Bureau

in the Social Security Administration concerned with the administration of title V, parts 1 and 2, of the Social Security Act, as amended, and the functions and duties of the Social Security Administration pertaining to research in the field of health.

(c) Upon the transfers provided for in subsections (a) and (b) all laws relating to any agency or functions transferred shall, insofar as such laws are not inapplicable, remain in full force and effect. Any transfer of personnel pursuant to this title shall be without change in classification or compensation, except that this requirement shall not operate to prevent the adjustment of classification or compensation to conform to the duties which may be assigned to such transferred personnel. All orders, rules, regulations, permits, or other privileges made, issued, or granted by any agency, or in connection with any function, so transferred, and in effect at the time of the transfer, shall, until modified, superseded, or repealed, continue in effect to the same extent as if such transfer had not occurred. No suit, action, or other proceeding lawfully commenced by or against any agency or any officer of the United States acting in his official capacity shall abate by reason of any transfer made pursuant to this title, but the court, on motion or supplemental petition filed at any time within twelve months after such transfer takes effect, showing necessity for a survival of such suit, action, or other proceeding to obtain a settlement of the questions involved, may allow the same to be maintained by or against the appropriate agency or officer of the United States.

(d) All personnel and property (including office equipment and records) of the agencies which are transferred under subsection (a) shall be transferred to the Agency.

(e) The personnel primarily concerned with, and the property (including office equipment and records) used in connection with, the functions transferred to the Agency under subsection (b) shall be transferred to the Agency.

(f) So much of the unexpended balances of the appropriations, allocations, or other funds available or to be made available for the use of the agencies and of officers and employees of the agencies transferred, and of agencies and officers and employees of agencies some or all of whose functions are transferred under this section, as the Director of the Bureau of the Budget with the approval of the President shall determine, shall be transferred to the Agency, but only for the use of such agency or function herein transferred to the Agency for whose use such appropriation, allocation, or other fund was originally provided. In determining the amount to be transferred, the Director of the Bureau of the Budget may include an amount to provide for the liquidation of obligations incurred against such appropriations or other funds prior to the transfer.

(g) The Director of the Bureau of the Budget is hereby authorized and directed to make a study of the activities of the several departments and agencies of the Federal Government with a view to determining whether any activities of such departments and agencies relating to health, but not transferred to the Agency by this title, should, in the interests of economy and efficiency of administration, be transferred to the Agency; and to complete such study and report the results thereof to the Congress on or before December 31, 1949.

CONSTITUENT UNITS

SEC. 104. (a) The Agency shall be composed of the following constituent units: (1) The Office of the Administrator; (2) the Public Health Service, which in turn shall assume the administration of Saint Elizabeths Hospital; (3) the Office of Medical, Dental, and Hospital Services; (4) the Office of Maternal and Child Health; (5) the Food and Drug Administration; and (6) such other constituent units as the Administrator finds necessary.

(b) The organization of the Food and Drug Administration shall remain unchanged except insofar as it may conflict with specific provisions of this title. The Surgeon General of the Public Health Service shall be appointed as provided in section 204 of the Public Health Service Act. The heads of the other constituent units of the Agency provided herein shall be appointed by the Administrator.

(c) The Director of the Office of Medical, Dental, and Hospital Services shall be a doctor of medicine licensed to practice medicine in one or more of the States, who previously shall have demonstrated outstanding ability in the fields of medicine and administration.

(d) Within the Office of Maternal and Child Health there shall be an Advisory Council on Maternal and Child Health to be appointed by the Administrator, which shall advise and consult with the head of the Office of Maternal and Child Health

in the formulation and administration of the medical and technical activities of said Office. Such council shall be composed of eight members, at least three of whom shall be doctors of medicine who are specialists in obstetrics or pediatrics. Each member shall hold office for a term of four years, except that any member appointed to fill a vacancy occurring prior to the expiration of the term for which his predecessor was appointed shall be appointed for the remainder of such term, and except that the first terms of the original members shall expire, as designated by the Administrator at the time of appointment, two at the end of one year, two at the end of two years, two at the end of three years, and two at the end of four years, after the date of appointment. At the time of appointment the Administrator shall designate one member to be chairman of the council.

Each member of the Advisory Council on Maternal and Child Health, while attending meetings of such council or while otherwise serving pursuant to this section, shall be entitled to receive compensation at a rate to be fixed by the Administrator, but not to exceed $50 per diem, and shall also be entitled to receive an allowance for actual and necessary traveling and subsistence expenses while so serving away from his place of residence.

AUTHORIZATION OF EXPENDITURES

SEC. 105. The Administrator is authorized to make expenditures (including expenditures for personal services and rent at the seat of government and elsewhere, for lawbooks, books of reference and periodicals, and for printing and binding) as may be necessary to carry out the provisions of this title, and as may be provided for by the Congress from time to time.

REPORT TO CONGRESS

SEC. 106. The Administrator shall make at the close of each fiscal year a report in writing to Congress and the President giving an account of all moneys received and disbursed by him and the Agency, describing the work done by the Agency, and making such recommendations as he shall deem necessary for the effective performance of the duties and purposes of the Agency.

AUTHORIZATION OF APPROPRIATIONS FOR ADMINISTRATIVE EXPENSES

SEC. 107. There are authorized to be appropriated for the administrative expenses of the Agency, including such expenses as are described in section 105, for the fiscal year ending June 30, 1950, and for each year thereafter, the sums necessary for such purposes.

ORGANIZATION STUDY

SEC. 108. The Administrator shall make a study of the organization and staffing of the Agency and of its constituent units, and, within one year after the effective date of this title, shall report to the Congress his findings and recommendations for promoting the more efficient and effective operation of the Agency.

EFFECTIVE DATE

SEC. 109. This title shall take effect July 1, 1949. The Administrator may be appointed by the President, and his appointment confirmed by the Senate, at any time after the enactment of this title, but such appointment shall not become effective until July 1, 1949.

TITLE II-GRANTS IN AID FOR EXTENDING MEDICAL, HOSPITAL, AND DENTAL SERVICES TO INDIVIDUALS UNABLE TO PAY THE WHOLE COST THEREOF; AND FOR OTHER PURPOSES

PART A-MEDICAL, HOSPITAL, AND DENTAL SURVEY

AUTHORIZATION OF APPROPRIATION FOR SURVEY

SEC. 201. In order to assist the States in making surveys preparatory to carrying out the purposes of part B of this title, there is hereby authorized to be appropriated the sum of $5,000,000, to remain available until expended. The sums appropriated under this section shall be used for making payments to