Dr. HELLER. Yes, Mr. Keefe, we have been successful in getting the majority of the States to adopt suitable laws to assist in controlling venereal diseases, through the aid of the American Social Hygiene Association. I might say that this organization has done yeoman work of an advisory nature on legal matters. The States, for the most part, have reasonably adequate laws to handle the problem. In addition, we have been successful in getting most of the States to use a system of contact reporting and referral of patients. The Army and the Navy have been very cooperative in furnishing contact reports on individuals from whom the sailor or the soldier allegedly obtained the infection, to the town of Oshkosh, for instance, or other municipalities, and thereby helping their officials to get in touch and treat the individual who has been the source of the infection. We have been working along that line, Mr. Keefe, and it is desired, Mr. Chairman, this next year, to utilize more of the funds in this direction than ever before, and to get the States to accentuate this phase of the program. STATEMENT SHOWING VENEREAL DISEASE RATE BY STATES Mr. KEEFE. In previous years you have inserted a table, as I recall, showing the venereal disease rates in the various States of the Union. Have you such a table available now? Dr. HELLER. We have inserted in previous years, Mr. Keefe, the table showing the selective service data, and we can again furnish it. Mr. KEEFE. I recall that a table has been carried, Mr. Chairman, and I think you will recall, each year, and this is along the line of the questions that you have asked as to what is happening in the States. Will you insert a similar table this year? Dr. HELLER. Yes. Dr. HARLOW. May I understand a little better just what you would like us to include in the table? Mr. ENGEL. I think we ought to get the figures broken down to indicate whether they are white or black. Dr. PARRAN. We have not made any additional analysis during this quarter on the selective-service figures. Mr. KEEFE. You have the figures for last year? Dr. PARRAN. We do have. (The information requested follows:) TABLE 1.-Syphilis rates per thousand white and Negro men aged 21–35 in the United States based on 1,895,778 selectee serologic reports and arranged in descending order by States, U. S. Census Division and Region TABLE 1.—Syphilis rates per thousand white and Negro men aged 21–35 in the United States based on 1,895,778 selectee serologic reports and arranged in descending order by States, U. S. Census Division and Region-Continued TABLE 1.-Syphilis rates per thousand white and Negro men aged 21-35 in the United States based on 1,895,778 selectee serologic reports and arranged in descending order by States, U. S. Census Division and Region-Continued 44. North Dakota. 30. 1 U. S. Census Division: 1. East South Central___ Syphilis rate 9.6 9. 1 7.3 7.0 6.9 6.6 109. 5 102.9 26. 9 25.8 28. Pennsylvania. 24. 7 Mr. ENGEL. Public health, marine hospitals under the Public Health Service, have taken care primarily of patients of the merchant marine? Dr. PARRAN. And the Coast Guard. Mr. ENGEL. You have carried that on for some time? Dr. PARRAN. For many years. Mr. ENGEL. And the Coast Guard patients are handled during war time in pursuance of an obligation that you have had for years in taking care of those patients? Dr. PARRAN. Yes; we have had that obligation since 1798. Dr. PARRAN. We do where Navy facilities are not available for emergency cases. Mr. ENGEL. Does the Navy hospital treat marine patients? Dr. PARRAN. It does; and the Army and Navy hospitals overseas have taken the responsibility of taking care of the sick and injured merchant marines so we have not extended our hospital facilities to overseas areas. Mr. ENGEL. Have you had any criticism, Doctor, against the Public Health Service because of failure on the part of the marine hospitals to provide a rehabilitation program to merchant seamen who have been injured in war service or who are casualties because of merchant marine war service? Dr. PARRAN. I do not recall any substantial criticism. I know that the problem of rehabilitation of merchant seamen is very different from the men who are enlisted in the armed forces. In the armed forces the men who are under military discipline as you know, take whatever kind of treatment is prescribed for them. The merchant marine sailor is a voluntary patient, and the tendency now, with the huge demand for employment is for such patients to try to get out of the hospitals just as soon as they can, even though they have not been completely rehabilitated. We have been working very closely with Mr. Shortley in the vocational rehabilitation service. Mr. ENGEL. Have you under consideration a program providing for all marine hospitals in addition to those you have? Dr. PARRAN. We have been seeking additions to existing facilities. We are overcrowded to a dangerous point now, particularly along the west coast. Mr. ENGEL. For merchant seamen and Coast Guard? Dr. PARRAN. Yes. And as a result of the huge overloading which we are now faced with-10 or 15 percent above the total rated capacity-the Navy is taking as many of the Coast Guard men as it can to just ease our patient load for the time being. ADDITIONAL HOSPITAL NEEDS Mr. ENGEL. What about building a hospital at Staten Island? Dr. PARRAN. We have a hospital there at a rated capacity of about 900 patients and we have been treating as many as 1,200 patients. A month or so ago when there was an explosion of a tanker in the harbor the commanding officer from the front steps of his building saw the situation, and rushed to the hospital and discharged something like 150 patients who still needed hospital treatment, in order to make room for the casualties which came in from that explosion. Mr. ENGEL. Have you had any provision with which to take care of the disabled because of their having tuberculosis? Dr. PARRAN. We care for some at Fort Stanton, N. Mex. Also we have cared for the tuberculous patients at our Staten Island hospital. An appropriation that the Deficiency Subcommittee acted on promptly resulted in our getting a lease on a hospital in the city of New York, a 300-bed tuberculosis hospital at Neponset Beach. That hospital, however, having been closed for some years is now undergoing repairs, and we hope to get patients into it within a short time. Mr. ENGEL. Would you care to take a moment and give us a little outline of your plans? Dr. PARRAN. We feel it is very urgent that we should provide additional hospital facilities on the west coast. The program provides for a total of 2,200 more beds, including (1) at Seattle, Wash., an extension to the Marine Hospital, from 350 to 500 beds, involving remodeling and enlarging the hospital facilities. (2) At San Francisco, Calif., extension of the marine hospital; a total of 650 beds involved in remodeling, enlarging and constructing over-all facilities. (3) At Los Angeles, Calif., a new 300 bed general hospital, and 300 bed tuberculosis hospital, jointly, with separate blocks for tuberculosis patients. Subsequently this hospital will require, or may require expansion into a total of 500 beds. (4) At Honolulu, T. H., a new 250-bed general hospital is urgently needed. I can say that the Army has indicated its ability to lend us temporarily 100 beds or so which will postpone or might postpone the need for construction there until after the war. (5) In the State of Florida, a new 200-bed hospital. There is no hospital south of Savannah, Ga., since we let the one go at Key West because the Navy needed that. (6) At New York City a new 400-bed general hospital on Manhattan Island. (7) At Port Chester, N. Y., on land acquired by gift in 1944, a new 150-bed hospital, and a 500-bed tuberculosis hospital at Mr. ENGEL. What about Charleston, S. C.? Dr. PARRAN. At Charleston, S. C., we have no hospital, but use some contract facilities there, and also use Army and Navy facilities. Mr. ENGEL. You have to have legislation authorizing construction of new hospitals? Dr. PARRAN. Public Law 410 authorizes the Surgeon General, with the approval of the President, to acquire sites and construct additional hospital facilities. Mr. ENGEL. That legislation has been passed? Dr. PARRAN. The basic legislation authorizing the acquisition of sites and construction has been passed. The custom has been followed in the past and I assume will continue to be followed, that appropriations for hospitals are secured through the Public Buildings Administration. The Public Buildings Administrator submits the estimate and not the Public Health Service, just as in other Federal buildings such as post offices. Mr. ENGEL. You mean that the Public Buildings Administration recommends or determines whether or not a new hospital should be constructed? Dr. PARRAN. The Public Buildings Administration asks us concerning our hospital needs. We have submitted a list, yes, to the Public Buildings Administration which it has together with other projects. Mr. ENGEL. And from there where does it go? Dr. PARRAN. From there it goes first to the Budget for approval; then to the Appropriations Committee, along with the approved lists of such projects, as I understand it, in connection with public buildings. Mr. ENGEL. What I was getting at is that the legislative authority for construction of these hospitals or the expansion of them is already authorized by law and it is just a matter of getting the appropriation. Dr. PARRAN. Yes. CONTROL OF TUBERCULOSIS Mr. HARE. We will insert in the record at this point page 212 of the justifications providing the appropriation for control of tuberculosis. (The statement referred to follows:). Control of Tuberculosis, Public Health Service |