REGULATIONS RELATING TO THE MEDICAL CARE OF CERTAIN PERSONNEL OF THE COAST GUARD, COAST AND GEODETIC SURVEY, PUBLIC HEALTH SERVICE, AND FORMER LIGHTHOUSE SERVICE(1)
By virtue of the authority vested in me by the Public Health Service Act, approved July 1, 1944 (58 Stat. 682), and as President of the United States, I hereby prescribe the following regulations relating to the medical care of certain personnel of the Coast Guard, Coast and Geodetic Survey, and Public Health Service, and their dependents, and certain personnel of the former Lighthouse Service
PART I-DEFINITIONS
Sec.
1 Meaning of terms.
PART II-PROVISIONS APPLICABLE TO COAST GUARD, COAST AND GEODETIC SERVEY AND PUBLIC HEALTH SERVICE
2 Persons entitled to treatment.
3 Use of Service facilities.
4 Use of other than Service facilities.
5 Application for treatment; active duty personnel.
6 Personnel absent without leave.
7 Continuance of medical relief after loss of status.
8 Retired personnel; extent of treatment
9 Dependent members of families; treatment.
10 Dependent members of families; use of Service facilities.
PART III-PROVISIONS APPLICABLE TO PERSONNEL OF FORMER LIGHTHOUSE SERVICE
11 Persons entitled to treatment.
12 Use of Service facilities.
13 Use of other than Service facilities.
14 Application for treatment; active duty personnel.
15 Continuance of medical relief after loss of status.
16 Retired personnel; extent of treatment.
PART IV-REVOCATIONS
PART I-DEFINITIONS
SEC. 1 Meaning of terms. As used in these regulations, the term:
(a) "Act" means the Act approved July 1, 1944, 58 Stat. 682, entitled "An Act to consolidate and revise the laws relating to the Public Health Service, and for other purposes."
(b) "Service" means the Public Health Service.
(c) "Surgeon General" means the Surgeon General of the Public Health Service.
(d) "Medical relief station" means a first-, second-, third-, or fourth-class station of the Service.
(e) "First-class station" means a hospital operated by the Service.
(f) "Second-class station" means a medical relief facility, other than a hospital of the Service, under the charge of a commissioned officer.
(g) "Third-class station" means a medical relief facility, other than a hospital of the Service, under the charge of a medical officer or employee of the Service other than a commissioned officer.
(h) "Fourth-class station" means a medical relief facility designated by the Surgeon General, other than a first-, second-, or third-class station.
(i) "Designated physician" means a physician holding an appointment to act regularly for the Service for a class or classes of specified beneficiaries at a place where there is no medical relief station.
(j) "Designated dentist" means a dentist holding an appointment to perform dental service for the Service for a class or classes of specified beneficiaries.
(k) "Active duty" means active duty status as distinguished from being on inactive status or retired and includes periods of authorized leave or liberty.
(l) "Dependent members of families" in the case of male personnel means the lawful wife, the unmarried children (including stepchildren or adopted children) under 21 years of age, and the father or mother if in fact dependent upon such son for his or her chief support; and in the case of female personnel, the unmarried children (including stepchildren or adopted children) under 21 years of age if their father is dead or they are in fact dependent on such mother for their chief support, the father or mother if in fact dependent upon such daughter for his or her chief support, and the husband if in fact dependent upon such wife for his chief support: Provided, however, that in the case of members of the Women's Reserve of the Coast Guard the husbands of such members shall not be considered dependents.
PART II-PROVISIONS APPLICABLE TO COAST GUARD, COAST AND GEODETIC SURVEY AND PUBLIC HEALTH SERVICE
SEC. 2. Persons entitled to treatment. To the extent and under the circumstances prescribed in these regulations, the following persons shall be entitled to medical, surgical, and dental treatment and hospitalization by the Service:
(1) Coast Guard. (a) Commissioned officers, chief warrant officers, warrant officers, cadets, and enlisted personnel of the Regular Coast Guard, including those on shore duty and those on detached duty, whether on active duty or retired;
(b) Regular members of the Coast Guard Reserve when on active duty or when retired for disability;
(c) Temporary members of the Coast Guard Reserve when on active duty or in case of physical injury incurred or sickness or disease contracted while performing active Coast Guard duty;
(d) Members of the Women's Reserve of the Coast Guard when on active duty or when retired for disability;
(e) Members of the Coast Guard Auxiliary in case of physical injury incurred or sickness or disease contracted while performing active Coast Guard duty.
(2) Coast and Geodetic Survey. Commissioned officers, ship's officers, and members of the crews of vessels of the Coast and Geodetic Survey, including those on shore duty and those on detached duty, whether on active duty or retired.
(3) Public Health Service. (a) Commissioned officers of the Regular Corps of the Service, whether on active duty or retired.
(b) Commissioned officers of the Reserve Corps of the Service when on active duty or when retired for disability.
SEC. 3. Use of Service facilities. Except as otherwise provided herein, the persons specified in section 2 shall be entitled to medical, surgical, and dental treatment and hospitalization only at medical relief stations and by designated physicians and designated dentists, and the cost of services procured elsewhere shall not be borne by the Service.
SEC. 4. Use of other than Service facilities. (a) When a person specified in section 2 who is on active duty requires immediate medical, surgical, or dental treatment or hospitalization and the urgency of the situation does not permit treatment at a medical relief station or by a designated physician or designated dentist, an officer of the same service as the patient may arrange for treatment or hospitalization at the expense of the Service.
(b) When the circumstances are such that an officer of the same service as the patient is not available to make the necessary arrangements, the treatment or hospitalization may be obtained by or on behalf of the patient at the expense of the Service.
(c) In every case of treatment or hospitalization as defined in subsection (b) above, the responsible superior officer of the patient shall be notified as promptly as possible and a full report shall be submitted by such officer to the Surgeon General through appropriate official channels. As soon as practicable, unless the interests of the patient or the Government require otherwise, treatment or hospitalization shall be continued at a medical relief station or by a designated physician or designated dentist or at another appropriate Federal medical facility.
(d) When the necessary medical relief cannot be obtained from a medical relief station or a designated physician or designated dentist, preference shall be given to other Federal medical facilities when reasonably available and when conditions permit.
(e) Vouchers on proper forms covering expenses for treatment or hospitalization under the circumstances specified in paragraphs (a) and (b) of this section shall be forwarded to the Surgeon General through appropriate official channels. Each such voucher shall be accompanied by or contain a statement of the facts necessitating the treatment or hospitalization. Unreasonable charges for emergency treatment or hospitalization will not be allowed.
(f) Expenses for consultants or special services, or for dental treatment other than emergency measures to relieve pain, shall not be allowed except when authorized in advance by the headquarters of the Service or, in extraordinary cases, when subsequently approved by such headquarters upon receipt of report and satisfactory explanation as to the necessity and urgency therefor.
SEC. 5. Application for treatment; active duty personnel. (a) An applicant for medical relief who is on active duty shall furnish a certificate identifying him. Such certificate, in the case of Coast Guard personnel, shall be signed by an officer of the Coast Guard, and in the case of Coast and Geodetic Survey personnel, shall be signed by an officer of the Coast and Geodetic Survey. Commissioned officers of any of the services mentioned in section 2 and officers in charge of units may sign their own certificates. In an emergency, the officer in charge of a medical relief station, or a designated physician or designated dentist, may accept other evidence of status satisfactory to him.
(b) A temporary member of the Coast Guard Reserve except when on active duty or a member of the Coast Guard Auxiliary shall, when applying for medical relief, furnish a statement signed by a responsible superior officer setting forth the facts and circumstances giving rise to the need for medical relief. In emergencies, such statement shall be furnished promptly after the member has received the immediately required care and treatment. Such statement shall be presumptive evidence of the facts stated, but if investigation indicates that the injury, sickness, or disease was not incurred or contracted in the manner stated, further treatment may be denied.
SEC. 6. Personnel absent without leave. No member of any of the services enumerated in section 2 shall be entitled when absent without leave to medical relief except at a medical relief station or by a designated physician or designated dentist.
SEC. 7. Continuance of medical relief after loss of status. If a member is separated from any of the services enumerated in section 2, except persons specified in subsections (c) and (e) thereof who shall be entitled to treatment after separation under the conditions set forth in such subsections, while undergoing treatment by the Service, his treatment shall be discontinued immediately unless the physician in charge determines that the condition of the patient does not permit interruption of treatment, in which case the treatment shall be discontinued as soon as practicable and the condition of the patient permits. At that time he shall be discharged from treatment and shall not thereafter be afforded medical relief by the Service by reason of his previous service.
SEC. 8. Retired personnel; extent of treatment. (a) A retired member of the Coast Guard, coast and Geodetic Survey, or Public Health Service specified in section 2 shall be entitled to medical, surgical, and dental treatment and hospitalization at medical relief stations of the first-, second-, and third-class, upon presentation of satisfactory evidence of his status.
(b) Elective medical or surgical treatment requiring hospitalization shall be furnished only at hospitals operated by the Service.
(c) Dental treatment shall be furnished to the extent of available facilities only at medical relief stations where full-time dental officers are on duty; at other medical relief stations the dental treatment shall be limited to emergency measures necessary to relieve pain.
SEC. 9. Dependent members of families; treatment. To the extent and under the circumstances prescribed in these regulations, the Service shall provide medical advice and out-patient treatment at first-, second-, and third-class medical relief stations and hospitalization at first-class stations to the dependent member of families of the following persons:
(1) Coast Guard. Commissioned officers, chief warrant officers, warrant officers, cadets, and enlisted personnel of the Regular Coast Guard, including those on shore duty and those on detached duty, whether on active duty or retired; and regular members of the United States Coast Guard Reserve and members of the Women's Reserve of the Coast Guard, when on active duty or when retired for disability.
(2) Coast and Geodetic Survey. Commissioned officers, ships' officers, and members of the crews of vessels of the United States Coast and Geodetic Survey, including those on shore duty and those on detached duty, whether on active duty or retired.
(3) Public Health Service. Commissioned officers of the Regular Corps of the Service, whether on active duty or retired, and commissioned officers of the Reserve Corps of the Service when on active duty or when retired for disability.
SEC. 10. Dependent members of families; use of Service facilities. A dependent member of the family of any person specified in section 9 shall, upon presentation of satisfactory evidence of such status, be entitled to medical advice and out-patient treatment at first-, second-, and third-class medical relief station and hospitalization at first-class stations if suitable accommodations are available therein and if the condition of the dependent is such as to require hospitalization, both as determined by the medical officer in charge.
(b) Hospitalization at first-class stations shall be at a per diem cost to the officer, enlisted person, member of a crew or other person concerned. Such cost shall be at such uniform rate as may be prescribed from time to time by the President for the hospitalization of dependents of naval and Marine Corps personnel at any naval hospital.
(c) Hospitalization at first-class stations and out-patient treatment at first-, second-, and third-class stations may include such services and supplies as, in the judgment of the medical officer in charge, are necessary for reasonable and adequate treatment.
(d) Dental treatment shall be furnished to the extent of available facilities only at medical relief stations where full-time officers are on duty.
PART III-PROVISIONS APPLICABLE TO PERSONNEL OF FORMER LIGHTHOUSE SERVICE
SEC. 11. Persons entitled to treatment. To the extent and under the circumstances prescribed in these regulations, the following persons shall be entitled to medical, surgical, and dental treatment and hospitalization by the Service: Lightkeepers, assistant lightkeepers, and officers and crews of vessels of the former Lighthouse Service, including any such persons who subsequent to June 30, 1939, have involuntarily been assigned to other civilian duty in the Coast Guard, who were entitled to medical relief at hospitals and other stations of the Service prior to July 1, 1944, and who are now or hereafter on active duty or who have been or may hereafter be retired under the provisions of section 6 of the Act of June 20, 1918, as amended (33 U.S.C. 763).
SEC. 12. Use of Service Facilities. Except as otherwise provided herein, the persons specified in section 11 shall be entitled to medical, surgical, and dental treatment and hospitalization only at medical relief stations and by designated physicians and designated dentists, and the cost of services procured elsewhere shall not be borne by the Service.
SEC. 13. Use of other than Service facilities. (a) When a person specified in section 11 who is on active duty requires immediate medical, surgical, or dental treatment or hospitalization and the urgency of the situation does not permit treatment at a medical relief station or by a designated physician or designated dentist, an officer or other appropriate supervisory official of the Coast Guard may arrange for treatment or hospitalization.
(b) In every such case of treatment or hospitalization, a full report thereof shall be submitted to the Surgeon General through Coast Guard headquarters. As soon as practicable, unless the interests of the patient or the Government require otherwise, treatment or hospitalization shall be continued at a medical relief station or by a designated physician or designated dentist or at another appropriate Federal medical facility.
(c) When the necessary medical relief cannot be obtained from a medical relief station or a designated physician or designated dentist, preference shall be given to other Federal medical facilities when reasonably available and when conditions permit.
(d) Vouchers on proper forms covering expenses for treatment or hospitalization under the circumstances specified in paragraph (a) of this section shall be forwarded to the Surgeon General through Coast Guard headquarters. Each such voucher shall be accompanied by or contain a statement of the facts necessitating the treatment or hospitalization. Unreasonable charges for emergency treatment or hospitalization will not be allowed.
(e) Expenses for consultants or special services, or for dental treatment other than emergency measures to relieve pain, shall not be allowed except when authorized in advance by the headquarters of the Service or, in extraordinary cases, when subsequently approved by such headquarters upon receipt of report and satisfactory explanation as to the necessity and urgency therefor.
SEC. 14. Application for treatment; active duty personnel. An applicant for medical relief who is on active duty shall furnish a certificate identifying him. Such certificate shall be signed by an officer or other appropriate supervisory official of the Coast Guard. In an emergency, the officer in charge of a medical relief station, or a designated physician or designated dentist, may accept other evidence of status satisfactory to him.
SEC. 15. Continuance of medical relief after loss of status. If a person is separated while undergoing treatment by the Service, his treatment shall be discontinued immediately unless the physician or dentist in charge determines that the condition of the patient does not permit interruption of treatment, in which case the treatment shall be discontinued as soon as practicable and the condition of the patient permits. At that time he shall be discharged from treatment and shall not thereafter be afforded medical relief by the Service by reason of his previous service.
SEC. 16. Retired personnel; extent of treatment. (a) Any retired person specified in section 11 shall be entitled to medical, surgical, and dental treatment and hospitalization at medical relief stations of the first, second, and third class upon presentation of satisfactory evidence of his status.
(b) Elective medical or surgical treatment requiring hospitalization shall be furnished only at hospitals operated by the Service.
(c) Dental treatment shall be furnished to the extent of available facilities only at medical relief stations where full-time dental officers are on duty; at other medical relief stations the dental treatment shall be limited to emergency measures necessary to relieve pain.
PART IV-REVOCATIONS
All paragraphs of the Regulations for the Government of the United States Public Health Service, approved June 18, 1931, as amended April 7, 1934, May 15, 1934, December 27, 1937, June 2, 1938, May 19, 1939, July 5, 1939, September 28, 1939, May 11, 1940, July 8, 1940, December 16, 1940, July 24, 1942, July 28, 1943, and April 7, 1944, which have not been revoked heretofore, are hereby revoked(2).
HARRY S. TRUMAN
THE WHITE HOUSE,
March 12, 1946
(1) Codified in Part 4 of Title 42.
(2) 42 CFR and Cum. Supp., § § 1.15, 1.16, 1.43, 1.45, 1.61-1.85, and 2.1-2.207.