6 1 garten or admission to the first grade of the public schools, 2 shall be given a tuberculin test by the Government of the 3 District of Columbia." 4 TITLE IV-AMENDMENT OF THE ACT RELATING 5 6 TO HOSPITAL LIENS SEC. 401. The first section of the Act entitled "An Act 7 to establish a lien for moneys due hospitals for services 8 rendered in cases caused by negligence or fault of others 9 and providing for the recording and enforcing of such liens", 10 approved June 30, 1939, as amended (D.C. Code, sec. 3811 301), is amended by striking out "or the District of Colum12 bia," where such term first appears, and by inserting im13 mediately before the word "which" the following: "and any hospital, institution, or facility operated by the govern15 ment of the District of Columbia, whether in the District of 16 Columbia or elsewhere". 14.. 17 TITLE V-EXEMPTION OF MEDICAL AND DEN 18 19 20 222223 21 TAL OFFICERS OF THE DISTRICT OF COLUM BIA FROM THE DUAL PAY AND CONFLICT OF-INTEREST STATUTES SEC. 501. Subsection (d) of section 5533 of title 5, 22 United States Code, is amended (a) by striking out "and" 23 24 at the end of clause numbered (6); (b) by striking out the period at the end of clause numbered (7) and inserting in 25 lieu thereof"; and"; and (c) by adding the following 7 1 clause numbered (8): "(8) pay received by a medical or 2 dental officer for employment in public health programs of 3 the Government of the District of Columbia." 4 SEC. 502. Officers and employees engaged in rendering 5 medical or dental services in public health programs of the 6 government of the District of Columbia and paid in whole or 7 in part by fees received from private practice or out of funds 8 contributed by medical schools, or from grants contributed 9 by private foundations, and the persons, corporations, or 10 associations paying such fees or making such contributions, 11 shall not be subject to the provisions of section 209 of title 12 18, United States Code. 13 TITLE VI-AMENDMENT OF THE ACT REGULATING THE PRACTICE OF THE HEALING ART 14 15 SEC. 601. Section 25 of the Act entitled "An Act to 16 regulate the practice of the healing art to protect the public 17 health in the District of Columbia," approved February 27, 18 1929 (D.C. Code 2-121), is amended by striking out the 19 proviso. GOVERNMENT OF THE DISTRICT OF COLUMBIA, The PRESIDENT, MY DEAR MR. PRESIDENT: The Commissioner of the District of Columbia has the honor to submit for consideration by the 91st Congress a bill "To provide improvements in the administration of health services in the District of Columbia, and for other purposes." The bill, which may be cited as the "District of Columbia Health Improvement Act", contains four titles. Title I of the bill amends section 21-501 of the District of Columbia Code by expanding the definition of the term "public hospital" to include any facility operated or supervised by the District of Columbia which is utilized for the care and treatment of mentally ill persons. As presently defined the term has the effect of limiting commitments of the mentally ill to St. Elizabeths Hospital or D.C. General Hospital. The amendment proposed by title I will authorize the commitment of such persons for care and treatment to other equally suitable health facilities. Title II extensively revises the so-called District of Columbia Milk Act enacted February 27, 1925. The amendments proposed by this title will allow the importation into the District of Columbia of safe, wholesome milk without requiring previous inspection by District authorities, where inspection and certification of the sources of supply have already been adequately accomplished by a milk sanitation rating officer certified by the Secretary of Health, Education, and Welfare. The amendments also update the provisions of the 1925 Act and bring it generally into harmony with those in effect in a majority of the States. A major effect of the proposed legislation is elimination of the need to inspect dairy farms located outside the District of Columbia producing milk used in the District, as required by present law, thereby resulting in considerable savings. The Washington "milk shed" is growing increasingly short of supply to furnish the needs of the District of Columbia and the remainder of the Metropolitan Area. This shortage is cumulative and will become greater because the economic factors creating the shortage are increasing. The Commissioner believes that there is now no public health reason whatsoever that would indicate, the necessity of refusing to permit the sale within the District of any wholesome milk from any of the certified sources within the United States. The title further provides for the issuance of a local permit for the sale or importation into the District of any milk, cream, milk product, or frozen dessert, and for the seizure and destruction of unsafe dairy products. Under title III of the bill all children applying for enrollment in kindergarten and each child entering the first grade of the public schools of the District of Columbia will be required to undergo a tuberculin test at District expense. Approximately 50% of the children entering school are now, with parental consent, voluntarily tested for tuberculosis. In 1968 this percentage of testing caused the discovery of eight new active cases. If tuberculin tests were made mandatory, as required by this title, public health authorities estimate that probably five active tuberculosis cases would be discovered each year. Current staffing and facilities of the Department of Human Resources (the District Government agency which administers the laws relating to the public health) are sufficient for the investigation, diagnosis, consultation, and the necessary chemo-prophylaxis that would be required by the institution of a mandatory and inclusive testing program. The Commissioner believes that while some additional hospitalization may be made necessary by a widespread testing program, such testing should result, in the long run, in a decrease of the hospitalization of tuberculosis patients through early discovery and treatment. Title IV amends the first section of the law relating to the establishment and enforcement of hospital liens (D. C. Code, sec. 38-301). Existing law provides that a hospital maintained by the District Government in the District of Columbia shall have a lien against damages recovered by injured persons from those liable for their injuries. Accordingly, the District can assert such a lien as to persons receiving care and treatment at D. C. General Hospital, but cannot establish or enforce a lien against recoverable moneys as to persons under care at Glenn Dale Hospital which is located in the State of Maryland. Enactment of this title will enable the District to assert a lien for moneys due for services rendered in cases caused by the negligence or fault of others in any hospital, institution, or facility operated by the District of Columbia, whether physically located in the District or elsewhere. This provision should result in some increase of revenue to the District of Columbia. For the foregoing reasons the Commissioner of the District of Columbia strongly urges the favorable consideration of the proposed "District of Columbia Health Improvement Act". Sincerely yours, GRAHAM W. WATT, Assistant to the Commissioner. For: WALTER E. WASHINGTON, Commissioner. The CHAIRMAN. We are delighted to welcome you, Doctor. STATEMENT OF DR. RAYMOND L. STANDARD, JR., DIRECTOR, DISTRICT OF COLUMBIA DEPARTMENT OF PUBLIC HEALTH; ACCOMPANIED BY DR. MALCOLM HOPE, ASSOCIATE DIRECTOR FOR ENVIRONMENTAL HEALTH Dr. STANDARD. Thank you, Mr. Chairman. I would like to introduce Dr. Malcolm Hope, Associate Director for Environmental Health. In behalf of Philip J. Rutledge, Director of the Department of Human Resources, and myself, I welcome this opportunity to appear before you today in connection with S. 3648, the District of Columbia Health Improvement Act. At the opening I should like to say that this measure as submitted by the Mayor-Commissioner contained four titles. The bill as introduced in the Senate contains two additional titles. Of these titles, the two most important from the viewpoint of the Department of Public Health are the title II amendments to the Milk Act and the title III provision calling for mandatory tuberculin testing of children prior to their initial entry into the school system. Title I is a clarifying amendment to the District of Columbia Hospitalization of the Mentally Ill Act. At the present time our definition of a "public hospital" is limited to a hospital or institution. This clarifying amendment would more appropriately include not only our community mental health centers but also permit the utilization and development of new concepts for institutional care of the mentally ill such as the nursing or convalescent home. This is in line with the action which has been taken by some of the other States. It will also tend to keep us abreast of the recent action of the Joint Commission of the Accreditation of Hospitals which has decided that it would be advisable for a new and better qualified body to handle the accreditation of facilities for the treatment of the mentally ill. Such a new body has been created-the Joint Commission of Accreditation of Psychiatric Facilities. The U.S. Court of Appeals for the District of Columbia Circuit has also pointed the way toward utilizing units such as the convalescent home and the foster-care home for purposes of commitment and treatment of the mentally ill. The enactment of title II of Senate bill 3648, District of Columbia Health Improvement Act, would modernize the District's Milk Act (District of Columbia Code, sec. 33-301 et seq.) to harmonize its provisions with those in effect in the great majority of jurisdictions in the United States. A number of changes have taken place since the Milk Act was enacted in 1925, including the following: 1. The State public health service program for certification of interstate milk shippers was established in 1950. The CHAIRMAN. Dr. Standard, why don't we incorporate your prepared statement in the record in its entirety? I gather from your statement that you support uniformity and you are in support of the legislation. Dr. STANDARD. Yes, sir. The CHAIRMAN. Is there anything special that you want to emphasize in that statement? Dr. STANDARD. Nothing other than we feel that the issue in terms of the Milk Act is critical. There are others who have supported our action. There has been a request for some delay, but I think that other testimony will be presented later. The CHAIRMAN. Thank you both very much for your statement and for taking the time and effort to be with us. Dr. Hope, thank you very much. Dr. HOPE. Thank you. Dr. STANDARD. Thank you very much, Mr. Chairman. (Prepared statement follows:) PREPARED STatement of Dr. Raymond L. Standard, Jr., Mr. Chairman and members of the committee: On behalf of Phillip J. Rutledge, Director of the Department of Human Resources, and myself, I welcome this opportunity to appear before you today in connection with S. 3648, the D.C. Health Improvement Act. At the opening I should like to say that this measure as submitted by the Mayor-Commissioner contained four Titles. The bill as introduced in the Senate contains two additional Titles. Of these Titles, the two most important from the viewpoint of the Department of Public Health are the Title II Amendments to the Milk Act and the Title III provision calling for mandatory tuberculin testing of children prior to their initial entry into the school system. Title I is a clarifying amendment to the District of Columbia Hospitalization of the Mentally Ill Act. At the present time our definition of a "public hospital" is limited to a hospital or institution. This clarifying amendment would more appropriately include not only our community mental health centers but also permit the utilization and development of new concepts for institutional care of the mentally ill such as the nursing or convalescent home. This is in line with the action which has been taken by some of the other States. It will also tend to keep us abreast of the recent action of the Joint Commission of the Accreditation of Hospitals which has decided that it would be advisable for a new and better qualified body to handle the accreditation of facilities for the treatment of the mentally ill. The United States Court of Appeals for the District of Columbia Circuit has also pointed the way towards utilizing units such as the convalescent home and the foster-care home for purposes of commitment and treatment of the mentally ill. The enactment of Title II of Senate Bill No. 3648. District of Columbia Health Improvement Act, would modernize the District's Milk Act (D.C. Code, Sec. 33-301 et seq.) to harmonize its provisions with those in effect in the great majority of jurisdictions in the United States. A number of changes have taken place since the Milk Act was enacted in 1925, including the following: 1. The State Public Health Service Program for Certification of Interstate Milk Shippers was established in 1950. This program is now operational in all contiguous States. The criteria under which the program is being conducted provide for application of the 1965 PHS Grade "A" Past. Milk Ordinance and other pertinent standards thereby insuring a high quality of safe milk. 2. State and local health jurisdictions are staffed to permit full discharge of their responsibility under the Interstate Milk Shipment Program. 3. Technological developments in the milk industry have reduced the sanitation problems incident to transportation of milk over long distances. |