COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX641 50437 RC201 .5 .Un32 1920 Revised rules and re U.S. - Interdepartmental social hygiene board, ... Revised rules and regulations governing expenditures from state allotments of the Chamberlain-Kahn funds. RECAP Columbia ^niter^ttp intljfCttpotlfWgork THE LIBPIARIES iHebical %ibvavv Digitized by the Internet Arciiive in 2010 witii funding from Open Knowledge Commons http://www.archive.org/details/revisedrulesreguOOunit UNITED STATES INTERDEPARTMENTAL SOCIAL HYGIENE BOARD :: :: WASHINGTON. D. C. REVISED RULES AND REGULATIONS EXPENDITURES FROM STATE ALLOT- MENTS OF THE CHAMBERLAIN-KAHN FUNDS FOR THE PREVENTION, TREAT- MENT, AND CONTROL OF VENEREAL DISEASES FOR THE FISCAL YEAR 1921 JUNE. 1920 WASHINGTON GOVERNMENT PRINTING OFFICE 1920 UNITED STATES, INTERDEPARTMENTAL SOCIAL HYGIENE BOARD :: :: WASHINGTON, D. C. REVISED RULES AND REGULATIONS 11^^=^^=:^===: governing 1^=^^^^===:^=: EXPENDITURES FROM STATE ALLOT- MENTS OF THE CHAMBERLAIN-KAHN FUNDS FOR THE PREVENTION, TREAT- MENT, AND CONTROL OF VENEREAL DISEASES FOR THE FISCAL YEAR 1921 JUNE, 1920 WASHINGTON GOVERNMENT PRINTING OFFICE 1920 UNITED STATES Interdepartmental Social Hygiene Board. Washington, members. officers. David K. Houston, Secretary of the Treasury. Newton D. B.\ker, Secretary of War. JosEPHus Daniels, Secretary of the Navy. AssT. StJEG. Gen. C. C. Pierce, U. S. Public Health Service. Col. p. M. Ashblt.n, Medical Corps, U. S. A. Lieut. Commandee J. R. Phelps, Medical Corps, U. S. N. CHAIRMAN OF THE BOARD. JosEPHUS Daniels, Secretary of the Navy. EXECUTIVE committee. Asst. Sueg. Gen. C. C. Pierce, U. S. P. H. S., Chairman. Col. p. M. Ashbuen, U. S. A. Lieut. Commander J. R. Phelps, U. S. EXECUTIVE SECRETAEY T. A. Storet, M. D., Ph. D. (2) RULES AND REGULATIONS GOVERNING EXPENDITURES FROM THE STATE ALLOTMENTS OF THE CHAMBERLAIN-KAHN FUNDS FISCAL YEAR 1921. APPEOPRTATIONS. 1. Appropriations 1919 and 1920. — The Sixty-fifth Congress appropriated the sum of $1,000,000 for each of the fiscal years 1919 and 1920, to be paid to the various States for the use of tlieir boards or departments of healtli in the prevention, control, and treatment of venerea] diseases; this sum to be allotted to each State on the basis of tlie 1910 population in accordance v:ith the rules and regiilaiions of the Secretary of the Treasury. 2. Cliamberlain-Kalin Act. — This act is known as the Chataber- Tain-Kahn Act and constitutes Chapter XV of the "Act making 1 appropriations for the support of the Arm}" for the fiscal year ending June thirtieth, nineteen hundred and nineteen." This act reads in part as follows : United States Interdepartmental Social Hygiene .Board: That there' is hereby created a board to be known as the United States Interdepartmental Sccial Hygiene Board, to consist of the Secretary of War, the Secretary of the Navy, and the Secretary of the Treasury as ex officio members, and of the Sm'geon General of the Army, the Surgeon General of the Public Health Service, or of representatives desig- nated by the Secretary of Wai', the Secretary of the Na\'y', and the Secretary of the Treasury, respectively. * * * That there is hereby appropriated out of any moneys in the Treasury not otherwise appropriated * * * the sum of §1,000,000, which shall be paid to the States for the use of their respective boards or departments of health in the prevention, control, and treatment of venereal diseases; this sum to be allotted to each State, in accordance with the rules and regulations prescribed by the Secretary of the Treasury in the proportion which its population bears to the population of the continental United States, exclusive of Alaska and the Canal Zone, according to the last preced- ing United States census, and such allotment to be so conditioned that for each dollar paid to any State the State shall specifically appropriate or otherwise set aside an equal amount for the prevention, control, and treatment of venereal diseases, except for the fiscal year ending June thirtieth, nineteen hundred and nineteen, for which the allotment of money is not conditioned upon the appropriation or setting aside of money by the State, pro\dded that any State may obtain any part of its allotment for any fiscal year subsequent to June thhtieth, nineteen hundred and nineteen, by specifically appropriating or otherwise setting aside an amount equal to such part of its allotment for the prevention, control, and treatment of venereal diseases. 3. Rules and regulations of the Secretary of the Treasury. — Under date of September 4, 1918, the Secretary of the Treasury promulgated rules and regulations which provided that State allot- ments shall be expended along general standard lines for all States and in accordance vntli an accounting system to he forwarded hi/ the (3) United Stahs JnterdeT'drtmeniaJ Socio/ Ilyr/lfne Board. Hence the roi^ulations of this i)oaifl L'ovoniiii.o; these expenditures are given the effect of law. These regulations of the Secretary of the Treasiuy are as follows: REOULATIOXS Promulgated by the Secretary of the Treasury, under which State boards or State departments of health receive the allotment of funds provided in section B. Chapter XV, of the act approved July 9, entitled "'An act making appropriations for the support of the Army for the fiscal year ending June 30, 1919."' The act provides that $1,000,000 shall be distributed to the States for the use of their respective boards or departments of health in the prevention, control, and treat- ment of venereal diseases, this sum to be allotted to each State, in accordance with rules and regulations prescribed by the Secretary of the Treasury, in the proportion which its population bears to the population of the continental United States, exclu- sive of Alaska and the Canal Zone, according to the last preceding United States census. State boards or departments of health receiving their respective allotments shall agree to the following cooperative measines under which their appropriation shall be expended: 1. Put into operation, through a legislative enactment or a State board of health regulation having the effect of law, regulations in conformity with the suggestion.'? approved by the Surgeons General of the Army, Navy, and United States Public Health Service, for the prevention of venereal diseases. The mmimum requirements of these rules are: (a) Venereal diseases must be reported to the local health authorities in accordance with State regulations approved by the United States Public Health Service. (6) Penalty to be imposed iipon physicians or others required to report venereal infections for failure to do so. (c) Cases to be investigated, so far as practicable, to discover and control sources of infection. (d) The spread of venereal diseases should be declared unlawful. (e) Provision to be made for control of infected persons that do not cooperate in protecting others from infection. (f) The travel of venereally infected persons within the State to be controlled by State boards of health Ijy definite regulations that will conform in general to the interstate regulations to be established. (g) Patients to be given a printed circular of instructions informing tliem of the necessity of measures to prevent the spread of infection and of the importance of continuing treatment. 2. An officer of the Puljlic Health Service shall be assigned to each State receiving allotments for the general purpose of cooperating with the State health officer in su- pervising the venereal-control work in the State. This officer to be selected by the State health authorities and to be approved and recommended for appointment by the Surgeon CJeneral of the Public Health Service. The salary of this officer will be paid by the State out of the funds made available from the allotment, except a nomi- nal sum of .$10 per month, which will he paid liy the United States Public Health Service. In tluwe States where a bureau of venereal diseases has already been es- tabli.shed, with a full-time medical officer in charge, the present incumbent may be recommended for appctintment by the State health officer, and, with the approval of the Surgeon (leneral, United States Pul)lic Health Service, he will be appointed as an officer of the Public Health Service. The general plan of work for the State bureau of venereal diseases will V)e: ifi) Securing reports of venereal infections from physicians and others required to report in accordance with State laws. (b) Suppressive measures, including the isolation and treatment in detention hos- pitals of infected persons who are unable or un\\illing to take measures to prevent themselves becoming a menace to others, the establishment of free clinics for the treatment of venereal diseases, and the elimination of conditions favorable to the spread of venereal infections. [C) Extension of facilities for early diagnosis and treatment through laboratory facilities for exact diagnosis and scientific determination of condition before release as noninfectious, in accordance with the standardized procedure that will be pre- scribed by the United States Public Health Service. id) Educational measures to include informing the general public, as well as infected indi^•iduals, in regard to the natiire and manner of spread of venei'eal diseases and the measures that should be taken to combat them. (e) Cooperation with local civil authorities in their efforts to suppress public and clandestine prostitution. The clinics referred to under (b) will form centers from which the other measures may be conducted by discovering the presence of infec- tions, the seeming of data for enforcing the regulations for reporting these diseases, and the institution of educational measures appropriate to particular communities. The immediate reduction in venereal-disease foci resulting from clinic treatment will result in a marked decrease in the prevalence of such diseases in both the military and civil population. (/) Accurate detailed records must be kept of all the acti^ities of the venereal- disease work. These will include careful records of each case treated, amount of arsphenamine used, final results, and disposition made of patients. Copies of these' records must be forwarded to the Surgeon General, United States Public Health Service, as a report at such intervals as they may be requested, and in accordance with instructions regarding the form of report. 3. Local funds that may be available, or that may become available from legis- lative appropriations or any other source for veneral-disease control, shall be used by the State or city health authorities ha^ing jmisdiction for the extension of the work, and such local funds must not be conserved through the expenditure of the funds that are allotted by the Congress through the United States Interdepartmental Social Hygiene Boarfj.. 4. In extension of the educational measures the State's health authorities and its bureau of venereal diseases shall exert their efforts and influence for the organization of a State venereal-disease committee that will be unofficial in character, but a valuable cooperative agency for furthering the comprehensive plan for nation-wide venereal-disease control. 5. The State health authorities shall take such measures as may be found practicable and decided upon in conference between the Public Health Ser\ice and State board of health representatives for the pm'pose of securing such additional legislation as may be required for the development of control of the spread of A'enereal infections. Action shall be taken to limit or suppress the activities of advertising '"specialists" and quacks by prosecuting them under State laws, or such other measures as may be applicable and effective. 6. In expending the sum allotted a State, the rules and regulations to be promul- gated by the United States Interdepartmental Social Hygiene Board for the expenditure of the 81,000,000 civilian quarantine and isolation fund under control of the Secretary of War and Secretary of the Xavy shall be given consideration by Public Health Ser\ice and State board of health representatives, so that the military necessities of each particular State may receive the consideration due its relative importance, and so that funds from the two sources mav be correlated. (J 7. The State aUotment shall be expended along general standard lines for all States and in accordance vith an accounting system, to be foncarded by the United States Inter- departmental Social Hygiene Board, approximately as follows: (a) For treatment of infected persons in hospitals, clinics, and other institutions, including arsphenamine and other drugs, 50 per cent of the allotment. (6) In carrj-ing out educational measures, 20 per cent. (c) In carrying out repressive measures, 20 per cent. id) In general administration and other activities of venereal-disease control work, 10 per cent. (This distribution is provisional and subject to modification after conference and agreement between each State and the United States Public Health Ser\ice to best meet the needs of the particular State. ) 8. In carrj-ing out the general Government program the administrative organiza- tion of the United States Public Health SerAice will be available at all times to State organizations in cooperative work, and assistance ^vill be given to States when- ever possible through the detail of employees, the secixring of arsphenamine, provid-' ing literature for the educational measures and in such other ways as may be found practicable as the work develops. W. G. McAdoo, Secretary of the Treasury. V\'ashixgtox, D. C, September 4, 1918. 4. Appropriation for fiscal year 1921. — For the fiscal year ending June 30, 1921, Congress provided in the sundry civil bill the follo^^dng appropriation for the cooperative work with the States: The duties and powers conferred upon the United States Interdepartmental Social Hygiene Board by Chapter XV of the Army appr(ipriation act approved July 9, 1918, with respect to the expenditure of the appropriations made therein are extended and made applicable to the appropriations y'or similiar purposes made in this act. * * -s * * * * For allotment to the various States for prevention, treatment, and control of venereal diseases, $450,000; and the unexpended balance on June 30, 1920 (approximately $300,000), of the appropriation heretofore made for this purpose is continued and made available during the fiscal year 1921 : Provided, That no part of this sum shall be allotted to any State unless such State, in a manner satisfactory to the board, shall have complied vith, and shall have given assurance of continued compliance uith. the condition and regu- lations gorerning such allotments and the expenditures that m.ay be made therefrom. 5. Reduction in appropriation for 1921. — It will be noted from the above act of Congress that the Federal Goverinnent's appropria- tion for allotment to the States was reduced from SI, 000, 000 for 1919 and $1,087,831.41 for 1920 to 8450,000 plus the unallotted balance of June 30, 1920. 0. Allotment to States 1921. — At the present writing the exact amount which will be available for allotment to States for the pre- vention, control, and treatinent of venereal diseases is not definitely known, and will not be until after July 1, for the reason that Congress appropi-iated the unexpended balance (the balance for which the States tlid not (|ualify for by s])ecificall3' ap])ropriating or otherwise setting aside an equal amount). At the time this appropriation was being considered by Congress it was estimated this unexpended balance would be approximately $350,000, but since some States have qualified subsequently, this estimated balance will be very materially decreased. States will be advised regarding the exact total and the allotment to each as soon as it is definitelv determined. ALLOTMENTS PEECENTAGE POPULATIOX. 7. Basis of allotments to States. — In accordance with the act of Congress directing that papnents to be made to the States be allotted to each State in proportion which its population bears to the population of the continental United States according to the last preceding United States census, the allotments for 1919-20 and 1921 are based on the followincr table: Population of Continental United States. Census of 1910. state. Population. Percentage. i 1 State. Population. Percentage. 2,138,093 204, 354 1.. 574, 449 2, 377, .549 799, 024 1, 114, 756 202, 322 331,069 752, 619 2, 609, 121 325,594 5,63.8, .591 2,700,876 2,224,771 1,690,949 2,289,905 1,6.56,388 742,371 1,295,346 3,366,416 2, 810, 175 2,075,708 1,797,114 3,293,335 376,053 1,192,214 2. 324715 1 Nevada 81,875 430, 572 2,537,167 327,301 9,113,614 2, 206, 287 557, 056 4,767,121 1,657,1.55 672, 765 7,665,111 542, 610 1,51.5,100 583, 888 2,184,789 5, 896, 542 373,351 3.5.5,9.56 2,061,612 1,141,990 1,221,119 2, 333, 860 145,965 0. 089021 .222191 1. 711874 2. 585072 . 868766 1,2120.57 . 219981 . 359966 .818311 2. 836856 . 354013 6. 130751 2. 936620 2.41895S 1. 838542 2. 489777 1. 800965 . 807168 1.408409 3. 660251 3. 055457 2. 25688.5 1. 953974 3. 580791 . 408876 1. 296275 1 New Hampsliire . 468154 I New Jersey- 2. 758622 New Mexico . 355870 9. 909089 North Carolina 2. 398861 N orth Dakota . 627424 Ohio 5. 183216 Florida Oklahoma 1. 801799 . 731487 8. 334155 Rhode Island . 589972 South Carolina 1.647671 . 634852 Tennessee 2.37-5487 Texas 4.236649 Utah . 405939 . 387026 2.2415.58 1. 241668 1.327704 2. 537570 Mississippi Missouri . 158705 Total 91,972,266 100 Nebraska UNEXPENDED BALANCES, 1919-20. 8. Comptroller's decision. — Under date of May 18, 1920, the Board addressed a letter to the Comptroller of the Treasury in part as follows : If a State, in accordance with the above quoted section of the act, did "specifically appropriate or otherwise set aside" an amount equal to the Federal allotment for the fiscal year ending June 30, 1920, and by so doing complied with the act. does this action of the State create a liability against the appropriation made by Congress lohich may be paid by the Board after June 30, 1920? If the action of the State in specifically appro- priating or otherwise setting aside an equal amount may be considered as creating a liability against the appropriation, the Board ivould like to continue making monthly disbursements of 50 per cent of the paid vouchers submitted, rather than to pay over to the States before June 30, in a lump sum the balance due them, and, therefore, it is respect- fully requested that you advise me if the Board is authorized to use its judgment as to the advisability of making monthly payments, or paying in full, after the expiration of the fiscal year, any balance due a State on its allotment for the fiscal year ending June 30, 1920. 1 In reply to that letter the comptroller advised as follows: The authority to make allotments to the State given by the act of June 30, 1919 (40 Stat., 886), is in accordance with rules and regulations prescribed by the Secre- tary of the Treasury. The allotment itself is in such cases the actual incurrence of lia- bility against the appropi-iation, and that having been made within the fiscal year the subsequent data required do not affect the use of the appropriation. board's regulations regarding payment of balances. 9. In accordance with this ruling the Board has adopted the following rules regarding payments of the balance due the State for the fiscal years 1920 and 1921: (a) In the discretion of the Board no further payments will be made to a given State from its allotment that became available for the Federal fiscal year 1920 until that State has spent and satisfactorily' accounted for the allotment paid over to it for the Federal f seal year 1919.^. (h) When a given State shall have expended and satisfactorily | accounted for the entire allotment paid over to it by the Board for the Federal fiscal year 1919 the Board, in its discretion, will pay over to the treasurer of that State, in a lump sum, the entire bal- ance of the allotment due that State for the Federal fiscal year 1920. (c) In the discretion of the Board no payment will be made to a given State from its allotment for the Federal fiscal year 1921 until that State has expended and satisfactorily accounted for the joint halance on hand, that is, for its allotment from the Government and also for its own balancing appropriation covering that allotment from the Government for the Federal fiscal year 1920. (d) States will, however, commencing July 1, 1920, begin making disbursements from their State appropriations, for the fiscal yea? - 1921, accounting for the same on a pinlc colored voucher form to b©- provided by the Board for that purpose. The}" will do this regard- less of whether or not the Board is withholding payments for any prior fiscal year. These vouchers which are to be paid entirely from the State appropriations for the fiscal year 1921, will be sub- mitted to the Board monthly and summarized on the ^9wfc colored monthly report to be provided b}^ the Board for that purpose. The Board will audit these vouchers as received, but withhold making 50 per cent payment until the previous allotment or allotments for prior fiscal years are accounted for and approved hy the Board. state certificates. 10. Certifying to State appropriations. — Before any State may receive any ])ortic)n of its allotment for which it has qualified by specifically a])])r<)])riating or otherwise setting aside a specified sum of money, it will be necessary for the State treasurer to deliver to the United States Interdepartmental Social Hygiene Board, properly 13 UNIFORM ACCOUNTING. 26. In order that all States may have a uniform system of account- ing, the Board has prepared special voucher forms and monthly report forms to be used by all States in transmitting their accounts to Wash- ington for settlement. ' VOUCHER FORM. 27. All disbursements made from these funds (both State and Federal), including salary payments and reimbursement for travel, are to be submitted on the special form of the Board. 28. Year 1919. — In disbursino- the remainder of the allotment for the fiscal year 1919, the white voucher Form No. 8 and white monthly report Form No. 9 will be used. 29. Years 1920 and 1921.— In disbursing the balance of the 1920 joint State and Federal fund, the blue voucher Form No. 8-A and the blue monthly report Form No. 9-A will be used, and in disbursing the joint State and Federal fund for the fiscal year 1921 the pink voucher Form No. 8-B, and the pink monthly report Form No. 9-B, will be used. 30. Use of right form. — Special attention is directed to the use of the right form when forwarding disbursements to the Board. Youchers submitted on the wi'ong forms will be returned. 31. Number of voucliers to be made. — These vouchers may be made in duplicate, triplicate, or c[uadruplicate, in accordance with the special recjuirements of each State. One copy shall be forwarded to the United States Interdepartmental Social Hygiene Board in Washington, D. C, and one or more copies may be retained by the State. 32. Signatures. — The State officers must assume all responsibility for liabilities incurred in connection with the expenditures of these funds, must prepare the voucher forms approving the same as correct, obtafti the signature of the payee and the certificate of the paying offi- cial. The paying official must in all cases obtain the personal signa- ture of the payee and certify to the payment. Vouchers signed for the payee per someone else can not be accepted unless a satisf actoiy explanation accompanies the voucher, but salary and traveling ex- pense vouchers under no circum.stances will be accepted unless they bear the payee's personal signature. Rubber stamp signature of the approving official or the pa^'ing official is not acceptable unless initialed by the person designated to use the same, and in such cases a letter must be forwarded to the board advising the name of the per- son authorized to initial and submitting a specimen of the rubber stamp signature and initials of person designated as they will appear on the vouchers. 33. Company or corporation. — Where a voucher is certified in the name of a company or corporation, the name of the person 14 writing the company or corporate name, as well as the capacity in which he signs, must appear. Example: "Chicago Edison Co., per John Smith, member of firm," or "secretary" or "treasurer,'' as the case may be. A complete signature with a rubber stamp is not acceptable. 34. More than one item. — One voucher may contain any number of items, but must be made out in the name of hut one individual, firm, or corporation. Where there are a number of items appearing on the bill, the invoice of the payee may be attached to the vouchei', and a statement made on the face of the voucher "as per invoice hereto attached," extending the total and classifying as if one item, but in all such cases the itemized invoice must be attached to the voucher transmitted to this office. 35. Reimbursement for casli purchases. — An official making numerous small purchases and paying cash at the time from his personal funds and obtaining receipted bills for such purchases may, by attach- ing such miscellaneous receipts to a voucher drawn payable to himself,, obtain reimbursement for such expenditures. In all such cases he will be required to list on the voucher the vendors' names and the amounts paid each. The voucher forwarded to this office must also have the receipted hills attached. This procedure is authorized only in cases of emergency or where the purchase amounts to less than $1 and is not to be interpreted as authorizing the use of subvouchers covering small monthly or periodical payments such as telephone, ice, rent,, etc., to avoid forwarding individual vouchers, and in no case must such a reimbursement voucher contain a payment for personal service. 36. Travel expenses. — Reimbursement of travel expenses must be handled as follows : In no case will travel expenses be allowed which are not confined to the usual expenses incurred for the ordinary com- forts of a traveler. Receipts should be obtained for transportation and hotel bills, when possible to do so, but it will be unnecessary to obtain receipts for meals and the various small incidental expenses of travel unless required by the State. When supplies are purchased while in a travel status, receipted in- voices of the dealer must be attached to the travel voucher to sub- stantiate the claim. If certified statements of travel expenses made on a State form are available, it is requested that the same be attached to the voucher transmitted to this office. If, however, State officials require these statements and invoices, copies should be made for transmittal with the voucher. In the absence of such a statement or copj^^, the travel expense should be itemized as completely as possible on the face of the voucher, as the mere statement "Traveling expenses" is not con- sidered sufficient. 15 If it should be necessar}^ to use taxicabs or automobiles while in a travel status, the voucher should contain the following notation: /'No other means of transportation available." Where a State authorizes automobile mileage and the same is paid from the State appropriation and submitted on the special State form covering ouch expenditure, it will be allowed by the Board. "Travel outside of the State will not be approved unless authorized by the Board. Books containing blank receipts conveniently printed and small daily expense account books for travelers will be supplied b}" the Board upon request. 37. Salaries. — In making vouchers covering payment of salary for services rendered, the date ''from'' and ''to" which payment is being made (both these dates inclusive) must be shown on voucher, as well a,s the designation of position (i. e., stenographer, V. D. officer, etc.) and the monthly or annual rate of compensation. 38. No employee of the United States Interdepartmental Social Hygiene Board shall receive any salary, travel expense, allowance, or compensation of any nature whatsoever from any State for services rendered in connection with their official duties. CLIMCS. 39. Preparation of voucher. — In preparing voucher to cover reimbursement to clinics, detention houses, and like institutions for salaries, treatment, maintenance, supplies, or equipment, the voucher must be accompanied by an itemized statement giving details of the expenditures incurred. 40. Advance payments. — In no case shall any amounts be advanced to these institutions or clinics before the liabilities are actual!}^ incurred by them. 41. Subsidies to clinics. — Payments in advance of the actual performance of the service or the deliver}^ of the supplies is strictly forbidden by Federal law and wiU not be allowed under anij circum- stance. Therefore, advance payraents to clinics under the name of "subsidies" is prohibited by the Board and no such payments shall be made in advance of the expiration of the period covered by the designated ' ' subsid}^ ' ' However, there is no obj ection to making such pay-ments on a monthly basis, provided the paijmenis are not made until the expiration of the month designated in the voucJier. OBTAINING SIGNATURES TO VOUCHERS. 42. In advance of payment. — In order to secure signatures to vouchers promptly and thus avoid any delay in obtaining reimburse- ment, it is suggested that the vouchers be completely prepared, w^ith the exception of the approvals and voucher number, and forwarded to 16 the payeo with a form k^ttor requesting that the voucher he properly signed and returned, stating that check will be forwarded promptly upon the return of the same. This is the procedure followed by all the Government departments and is recommended in the disburse- ment of this fund by the States. There can be no reasonable objec- tion raised b}' the payee, for the reason that the States are responsible and reliable and the form letter requesting the signature in advance of the payment is ample protection to the payee in case the payment shoidd not be made as promised. 43. After the payment is made.— In States where the procedure is to forward the vouchers for signature with the State warrant, or after the payment has been matle, the vouchers so forwarded should not be given a number until it is returned. This will avoid the neces- sit}- for holding vouchers otherwise ready to submit pending the receipt of one or two vouchers forwarded for signature and not returned in time to be included in the disbursements for the month. These delayed vouchei-s may then be given a number whenever received and transmitted to the Board with the next regular report. BOOKS, PERIODICALS, AXD AUTOMOBILES. 44. Prohibited. — Particular attention is called to the fact that the use of this appropriation for the purchase of books, newspapers, or periodicals, or the purchase of any motor-propelled or horse-drawn vehicle for carrying passengers or any expenses in connection with the operation thereof is prohibited. The Board prohibits also the hiring of such vehicles where the hiring by itscontinuousness is the effuivalent of a purchase. 45. Hire ol'taxicabs and automobiles. — However, when a person is in a travel status, temporary hiiing of vehicles as a means of trans- portation between places inacc<'ssible l)}- common carrier is authorized, but when it is found necessary to temporarily hire taxieabs or auto- mobiles the voucher should contain the following notation, ''So other means of transportation available." 46. Purchase of books ami periodicals. — Regarding the pur- chase of books and periodicals the Bpard feels that resources of this type should ah-eady ])e in the ])ossession of a State department or board of health, and if it sliouhl be found necessary to make any additions tliereto, it should be done with strictly State funds and vouchers covei-ing such ]);iynients not submitted to the Board. 47. Purcliase of office rurniture. Th(> cost of strictly oilice fur- niture, such as desks, chairs, typewi-iters, adding machines, electric fans, etc., is not consid(>re