zsnm,iMi:w7 o? vsto-utb; nO u.l'.'X»,*.;,»Wi i.tvO sVjOi’i i.,Lo a.ud DOJacrtiARiss A Kiatopieal 3iaie«£ni boreri^g the Devalcp^nt of the hospital &rd Domol. lie.*/ iVc^ra.-.; February 1811 thr ot:.. -;h February 1950 "AT 1951 Research Dir is ion Co erdina t ion •se.Tvl .ce Veterans Agratalstarat ion , ..ashln^ton 25 s D # C> 3 2 > ?. lu. 3 L - // - v5~V JrtS OT: •;* Id .) OULUMB^ UNWtRS\Tt LIBRARIES AV>K 26 1954 Tills V nooovi : iA.l. Oomr :'• V’Onl fcOSpit* 3-Xa iri 0:1 v bled into t v V:> Xldry care • 3 V (2j a list of a! 1 i. > . u now opodo t ad by u : 0 :d Oh date cn b/j: a C- f -dbi* and OiOthods Of of tfete-ar. a, it and rt< • : • I \*.ey \.95C- ;: * . v V :-5 bn .v •. « ■are of nov. ,r •. 's/he dote, t %-ponro.rg herein ham* bv&n **«© tn- iidjoninn soar©# s.s k v >card2: Of ihfl ?, Q.f if r . •••• ?ical: ion ,. :h-;:;.oxnio *:..f the Gff.i-r 3 o' ': :io V&pity ; dr:in:Lotra-,;.cr . ifcsugfct Ser v1.ee , ;^bcj'4a d£ the Office ci" thtj A«i5X®t4rit -in.. •• ’• f " io:^ in'i;:LrU:; Ho fsrisr^-s a . :i , oaar' , Ij-, Cwge and %fe : rf ?hi ip B„ , Hi4tc y of •fe'lica.1 and iktfdcUi^y Caro ci* vaiorans, rfUitary 76 ? 113-113; Harah iPib v «• die , Hospital and jtoni ©jQd&ty, Cars _v. ni eo the i? v ~i94o'r issrty t *?» Federal Board of Hospital! nation at tin r* 3 $%*st> of th--:' ^resident of the United State s* r - &mm.x Z*fk.m of Veteran* gdKdjn 5.strf,tl..o2t npsyifcdi] tv prepared for th* Congm* " S“Arm^'~ Services by the Veterans Kovwasb®r 19A7 ••«• Fobru&ry 1940, ^Thi.y st-aUraant v v vev prepared by Xlra* £dtJ*:.r b» dorsine, Analyst , Ii ob ,t lvilen-s.1 on: i.^yaia Uni'-..., Retearch hi ^1? ton , Ga>o?o Uiii boo •>:,' n.-n: .,’ C f.1 :l of tie ASfeisfcsnt Ad:f»iiiisfcrnto?s oc no nr. ■*«?.' coo;;«orptei >>.<;!.- • in Turn;- oniu,- tho historical and current data repeated. PART 1 OF MEDIC AIi AHD SOHCXUAf.f CARE FOR TH1 VStfm?? Federal cave was not provided for- disable v r.-.otwa aftar ih© Rrr.ro;. vblt.u ■:;r/ War but certain at*, tee mafia provisions "or the- creasing of * wtade , . Xr--: r* medical practice we.s not d©v*&©pad -.ben vo the uxte&t it 2.6 todl^y , ho^pl* t&nzsticn vms not considered neceawavy except to,- the tro&fcmmt of iha nos’- vrrger.t case a,- Apparently there was very little dounioci Ay tfc? o.n-a srrl©$.n an for medical or hospital care to be furnish ad by -.U:- Government . Tho- nitrober of l>::,< who incurred diseovi vUetf In 'the f'r-r of 1312 ?m» r.o-t sufficiently great tc warrant legislation a^Ukcvd:.3y^ aedr-.oel .raid horiplXf Caret other than th&t yro-Xbcd by the leglslXtios n i'eted February 2b* 1811, This Act antho?:l.7.i!d the conot: 'uction of a permanent host* for disabled naval officer 3 * saoneu, and sun* ins d h The corners ‘:,.,:'o.e we.** laid la Philadelphia t*> April 3, ld27. f but the home Was art ocrupHd -isctH 1333, Subsequently J; 3.h was v.sefi both as a hoist s.acl general hospital*. Trt-htm^ for disabled veterans of tho Indian Wars < 1332 - 1353 } and the Mexicajj »?ai* \lb46-'V'tv'} ft«.s iurnished oy the Naval IJone at PU if .*. : o $.1 ph la f a : 3 d . the U., 8, bold.Lera' Here at Washington, D, CU„ is tUll in existence.. Tbs other known as the Wesifu n nhia^ Asylus:, at HarrodfteT., Kentucky, was authorised for sale by Congress or Jv.:n> 15 . 1360c March 3 ? 1355 y Congress enacted a law to *s ! t&bXi;sh an institution for th ® ^sa^* of thy and navy* add the civilian population, of vhe District of Columbia, Originally the institution was known as the (k>verm©at Hospital Congr e& rior ?&.l wt of July 1, • Dur i nr; the Civil ffar, it became necessary to furnish relief for veteran* • ,;:o n--i<3 been mt charged for disabilities ana for whoa Army regulations pro- ‘-ided no ?,&.un .Temporary domiciliary facilities., *±tl casperisartet- , established to provide care until the veteran was phy.ilc.ally able to return home. Ey Sirch 1463, 25 teaporary The first home mb opened in 1§66 at Tagus , ’oHine., Because of an increasing number of disabled -• additional homes were established at various localities throughout the Uvtro States .. Before the National Homes sere four-asd, relief societies neis iornel u> <$cm states to collect funds tor the estat. , ii&h«o«.t oj -•• 0 '**"** fi ,., (l oca was opened at Scroton Heights, Connecticut, in 12U. htmtmll? thee a • tec3 *ere turned over to the acte.iruntmtSov, of the soveral states in ’^ich - I hey were located. In other states the first step for the. M>taoU«;i»en». or ths „ute Howes was taken toy .the State hegia|atu?e3, apw^ristione le.tr, t > * no. thou lard for that purpose* Tvv^.mvnt for the dibbled of the Span! eh -^American : ibx and the PhlUpora* Insurrection was fumisned by Aray and Navy bospi tala, Aden m*vx>z& cetiei n. ,.-. smarted thueve ..oldiers and sailors were discharged, TboPe, r-ov-^ve TO C 3 the h * r>‘ p **j j ‘OToC V ' taa va ri-yC . \ V. }■■• ..)•. ' a t • •'* N V ..• }• i •.A' C , • • *»* . > -<•* ..A to a. r. ■ y Of- ‘lU i‘‘ llaval doii i*? at <^ Sf'} ',• I C tde 1 . r t „ v tel a nc* w: •> V*. PU psycho 0 « o v/ere trf ..r.ri ir ly known HO the A: ;var nnrsnt jiosj >1 tal 4'v.jt iha Oo to 0 c j-‘ 21 ? 1191 v v> r*. t. Secro •a r> ;:i.V la v a; 3prnve -v.l ».Ti t •: 4- v C !.‘i t i on a vr sara 3 t. tu 0 ir .r o.'uor-* ;.. t* •/ cot i { ~ c 'V : 5 ■' vetcaana Ui v .•* l to be borne by bbr kttny ■ \ ft*; Vue -vcbronce of t ie Unit «»c. 0 cafes -ft t a AocM Vltr j HuVLi •:• tea , Coa.\;rc3£j era# tad Oc.ur or 6* illy, provided that persons with ■ V . : ■ i.; .' ? ■ ■ : ■ ■ , sd to b 2 y 1 . . *r i ir elly *1 bene ti fctf a s a 5 . f furnishing doaleill&ry care ftr disabled veterans., Extensive prepare tildhs t< care Cor the disable bad been &&de op be- th I t »c8 .-. a tended that tit disabled torv • e ra er. :ihi'ulct he diWobar^ed from the sernico until their d Vru/iH Air . Improvement > However .. the play : tf&rs not carried out as the devitalised wen ve ■ b* K'ious Ti to their ioaics and to ci v < Ary and the Mry not a .,: / Xirgeon G^n^ral oC fch& 0* 31 Put i Health Service wee directed to arw lospital eg re to ditsdeh World V/ar X yfierabs: with oepvice~icooned:t lisabilitiee* Thi» ear© T* tni shed, raTaiv’e , at. Ms : el other 0 Public law llto. 65th Congress. Approved Mareh .1, 1919* and Public l-m .Ml , ohth Congresry approved liter ch 4 6 19- 1 *• authorised app c opr la tier- a for th* Jke.**, >'iic health 3 s - . yib C 11 ; — . lit* .1 / Honortnlo ©can* ted for A;v.eric;..n satea an a otcer tJtmef i.fciar:! .at> of one W> ■* 1 .. s , >'• o b 1 i e *i r a .; in 3 ervi e n , •: purchase., or construction of hospitals by the Treasury Department and the i tram* far of certain leases, sites, and hospitals from the War Department or other tevO-samt agencies for the use of the U, d, Public Health Service for the care of florid far I re ter ana * On August 9 ;; 1921 , the Sweet Act y Public Law 4V » 67th Congress, created v •* S, Veterans bureau and wj. th xt. merged, the Bureau oi Par dish Insurance and the Rehabilitation Division of the Federal Board for vocational Education, The control and supervision of ail veterans* relief activities were delegated to the director of this Bureau- On April 29, 1922, the President issued Executive Order 3669 authorizing U.u transfer to the Veterans > Bureau of all 4 hospitals and dispensaries which we:* being administered by the U» S, Public Health Service for the care of Worli War I veterans.. Public Law .194, 67th Congress, approved April 20, .1922, was the beginning of an expanding hospitalization prate urn for veterans* This Act authorized appropriations to .provide for the coiJtv notion of additional hospital facilities and to provide medical and hospital -,-re for veterans of the r pan! sh -American War., the Philippine Insurrection, ant the Boxer Rebellion, for the treatment of neuropsy chiatri c or tuberculous liabilities.* This was the first legisla- tion teat extended the services of the Veterans 8 Bureau to veterans other than thos# Ot World ?var j. , and the first tisx$ ubat medical or hospital treatment, outside a soldiers* home Hospital, via s lathorired for veterans with disabilities 4 other than those incurred in service... .die World '&r Veterans 1 Act of 1924> Public Law 242, odth Congress y was enacted on June 7 of that year. This let liberalized provisions of existing laws by extending hospitalization to any Veteran (not dishonorably discharged) • of any war since 1897, regardless of the origin of hio disability, whenever existing facilities were available, provided that preference in admissions be given to those veterans unable to pay. The effect of this law v&s an enormously increased load in existing hospitals . Consequently , it became necessary to plan a program of hospital construction . During the period 1984 to 1933 , legislation war enacted which authorized appropriations for the development and expansion. of this hospital construction program . Public Lava 5 36, 71st Congress, approved July 3., 1930, authorised the President to consolidate and coordinate governmental activities affecting war veterans. Accordingly, on J;dy 21, 1930, the President issued Executive Order 5393 authorizing the consol: Cation of the U„ 3* Veterans* Bureau, the Bureau of Pensions, and the Natioml Home for Disabled Volunteer Soldiers into ore establishment to be known sn the Veterans'’ Administration- «> The Ficonoirjy Act, Pubi .o Law 2, 73rd Congress, was enacted on March 2 j p 1933 « Ibis Act and the Pit sidentdal regulations issued thereunder restricted hospitalisation and domiciliary care to honorably discharged veterans with service-connected disabilities, veterans with tuberculous or neuropsychiatric ailments , and veterans > ith permanent disabilities of nonservice— conne c ted origin where the veteran, was without adequate means of support* Subse- quent legislation durjig the years 1933-1935, 1939, and 19 41 not only removed the restrictions of, tie Economy Act but further liberalized eligibility for hos- pital or domic ilia r care. Section 6 of Public Law 2, 73rd Congress de amended by Public Late 312, 74th Congress, approved August 23, 1935, as amended and the Veterans 3 Re .-.l&tionb as amended constitute the basic law governing eligibility for * A hospitalization and medical care. ~ \ the controlling legislation now reads as follows s n The Adminifttra tor of Vet.erft.mj * Affaire is hereby author is eel unaer such limi tatioiite s> he may pee-- scribe av.»d with la the limits of exi^tin* Veterans' Administra ticn facilities , to furnish to men discharged from the Army , Navy ,. Marine Corps * or Coast Guard for disabilities incurred in .line of duty or to those in receipt of pension for serv ica-connecred disability and no veterans of any *?av, including the Boxer Rebellion and the Ff ilippiae Insurrection , domiciliary care where hey -ire suffering from pern. neat disabilities* tuberculosis, or $europ*sy chi a trie ail- ments and medical .nd hospital treatment for diseases or injuries ? Pro vided , That ary vetara/ of any war who was not dishonorably discharged, suffering from disability, din.-ase, or defects, who is in need, of hospi tali zot:? on or domiciliary ch\c and is urn He to defray the necessaty expenses therefor ( including, U'sju- pertain on to am from the Vetemn'^ } Administration facility } £ . shall bo fur hi shed necessary hasp . all cation or domiciliary care {including tr&nspor tat. ion ) in any Veterans * .idniinistration facility, within the limitations existing in such facilities, / -’respective of whether the disability * disease* or defect m;s due. to iervirc The statement under oath of. the &p, 1 leant, pa sue a form as rosy be v sscribfN: by the tdministr tor of Veterans 3 Affairs «&&H be accepted as suff icier evidence of inability to defray necessary expenses J* 2/ Put ic hm 10 , 7Sth Congress,, enacted on torch 17 1 1943# granted to World Via r 11 * sterans hoar -italisat ion and aomi ciliary cure on a parity with veterans of tov . /J Vfer I.. 'The impact of the demand for houpifaiizabieri by the now veterans of : .lv id War XI was felt in the hospital load beginning in 1943* During World War XI, the construction of VA hospitals was retarded due to :hr (/irficulty in obtaining labor and material* The Servicemen 5 3 Readjustment 2/ Pub I i ( l&y» 312, Sec* 6* "7 Act, PhMie law 346, ?3th Congress, approved June 22, 1944, designated the Veterans Administration an essential war agency. This designation entitled the U “ ^ ioritl0 *' second onl * t0 tfte few Departments, in personnel, equipment , supplies, and materials. This Act also Authorized the appropriation of *>30 ,000,090 for the construction of additional hospital facilities; and the transfer for use t* the Veterans Administration of Army and Nary hospitals con- structed fw ® alrtiB * tt6t ’ wh8n the y became surplus to the needs of the military servlets. Many of these hospitals we e of temporary or- semi-permanent construc- tion and some have Oeen, or eventually will be, replaced by permanent Veterans Adir.ini s t r a t Ion ho apt r,a 1 1 , On February 23.. 19-3 VA was operating 111 hospitals with a patient load of slightly more than 9f thousand. In addition, approximately IX thousand U patients were hospitelizt.1 in other federal Government, municipal. State, or private institutions. Vi also provides outpatient medical and dental care but the gied.,er p*- 1 ot thiw service is furnished in or through the VA regional office..-. Hundreds of thousand of - Kerens receive in their own communities outpatient treatment performed by physicians and dentists on a fee basis. sixteen VA domicil:, iry establishments were in operation on February 23. 1950 " lth Elightly *° r * than 17 thousand members receiving care. VA beneficiaries ro State Soldiers' Hares on Februuty 2d, 1950, totalled about seven thou. and.. The federal Govenu&nj rcimbur es the states for one-half the per capita, cost 01 veteran oalntenanci , or $500 per man-year, whichever is less. Forty -oh e hospitals, to provide 13,300 beds, we e under construction I on . fcbtuory 2o, 19p0. Of this number, 23 hospitals were expected to be com- plett-' during calendar year 1950 and Id during calendar year 1951 or shortly thereafter. Addition i under construction at seven existing hospitals will provide 1B00 lucre hospital beds. Three new Hospitals recently completed but not yet in operation vdll turn: The revised VA construction program in effect on provided for construction of 16 hospitals in addition or under construction and six additions or conversions and an addition ,sh 920 bods February 28 « 1950 to those in existence at existing hoapita r ,:r ■ •i " h J * a B ' ■< u> ■J h r~* O <•-3 t -i Vi* to H C& m vi> * *vi H to o :• i >Q §* -« a P cy O •>>> £> o ■ .? 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