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Show IDS ISSUED i tram Drmation as to Avail-lability Avail-lability of Treatment Stations. cers Instructed to See 'atients Are Provided Proper Relief. i al to The Tribune. ISHIXGTON, May IP. James H. s, acting secretary of the treasur-, mnectiou with Surgeon General rt Blue of tho Public Health Served Serv-ed Colonel Henry D. Lindsley of Sureau of War Risk Insurance, has 3 the following instructions to :al officers of the Public Health ce which should be of especial in-; in-; to discharged soldiers: In order that the public health ser-jnav ser-jnav provide hospital and sanitarium '".ies" for discharged, sick and dis- soldiers, sailors and marines, army iiavy nurses cnale and female), pa-i pa-i of the war risk insurance bureau, tcordance with public act No. 326, ived March 3. 1519. it is desirable that officers al all service relief stations d be informed as to the course it sired to pursue to "acquaint persons loned in the act with the hospital ties of the public health service open em, and to request them to apply, ;y are in need of treatment, to the ; health service officers in charge .lief stations. Many of these per-do per-do not know that the public health :e has been charged with this duty. iers to Be Issued. jrefore, the service will Issue, in a .ays, a poster which will be displayed d "postorfices, informing them that may receive treatment, upon appll-a, appll-a, at the places named. The state municipal health officers, the repre-tives repre-tives of the National Tuberculosis .iation and the American Red Cross been requested to refer any of these na (whom they may know of) need-eiief need-eiief to these szarfons. Many of the state boards of health ' records of discharged sick and dis-soldiers, dis-soldiers, sailors and marines, army ,nayy nurses (male and female,, pa-i pa-i of the war risk insurance bureau, .eir states, and officers of the ser-snould ser-snould communicate with the state h officers in an endeavor to procure information, in order that they may itain the residence of these men and m those who should apply at the par-ir par-ir relief station of their rights. Of- should in all cases cooperate with state board of health and work in ony therewith. ' Main Objects. Other means of publicity, such as s to' benevolent and relief societies, als of corporations. and others, d be used to spread the- knowledge le availability of the public health :e stations for the treatment of bene- ies of the bureau of war risk insur- I but no expense for newspaper ad- ' ring should be incurred, unless pre- 1 ly authorized by the department. 1 Officers of the service are informed I there-are two main objects to be ac- i lished in their work in connection j beneficiaries of the war risk insur- ' bureau. One is to have a phvsical 1 lination made of each discharged sick ; sabled soldier, sailor or marine, army navy nurse (male fnd female), pa-i pa-i of the war risk insurance bureau, has received an honorable discharge ' after October 6. 1917, in order that ay receive the compensation to which he Is entitled, and the second is that the service may provide such medical treatment treat-ment as is required. A copy of the war risk insurance, act is inclosed, and it I should be carefully studied in order that j officers may be familiar with their duties in the matrer and the rights of the bene-I bene-I ficlaries "mentioned) Officers Instructed. 5. This letter is written to Inform the officials in charge of relief stations that treatment must be furnished to patients t entitled to same and that they are charged to see that the proper measures ' are employed to provide this relief. The instructions given below should be fol-! fol-! lowed as far as practicable, but where ! authority has not been granted by the 1 bureau, and injury to the patient would '. result from delay in obtaining proper authority, au-thority, the officer in charge shouid take i the necessary steps to furnish relief to the patient under the provisions of the exigency paragraph of the service regulations, regu-lations, and the necessity for this action , should be clearly stated on the face of the , voucher when the bill for the expenditure . Is rendered. i The citation of the exigency paragraph for emergency expenditures, in line witi the foregoing instruction, is hereby specifically spe-cifically authorized by the department, in view of the impracticability of providing specific authority in every individual case, but officers r.re instructed that every ev-ery care should be taken to avoid unnec-; unnec-; essary expenditures and to protect the financial interests of the service. In addition ad-dition to the exigency paragraph, this circular letter may also be cited as authority. au-thority. Telegraphic request may be made ' upon the surgeon general of the public health service in case additional clerical or other assistance is required. Application Blanks. I 6. When a discharged sick or disabled i soldier, sailor or marine, army and navy nurse ('male and female), patients of the war risk insurance bureau, applies to the ! medical officer in charge of a relief sta-I sta-I tlon, an application blank, bureau of war j risk Insurance form No. - 526, should be i furnished to him to fill out. Upon re-' re-' ceipt of this application, bureau circular i letter No. 159 of March 20, 1919, should be consulted and. If it is apparent that the person is a beneficiary of the bureau of war risk insurance, the medical officer of-ficer in charge should direct him to re-I re-I port to his office for examination, or to a nearer station, as mentioned below. Upon his arrival, the physical examination examina-tion should be made in accordance with the instructions contained in tho inclosed blank, which is of the same import as form No. 504, mentioned in bureau circular circu-lar letter No. 159, and which blank should be substituted for form 504, and the completed com-pleted blank should be forwarded to the chief medical, adviser, bureau of war risk insurance. Persons needing immediate imme-diate treatment should be furnished the same without waiting to have form No. 52ii completed. A claimant may be furnished treatment treat-ment upon the presentation of his honorable honor-able discharge, or certified copy thereof (but this discharge must be dated on or after October 6, 1917), the application blank being forwarded at a later date; and the words "on or after October 6, 1917," apply also to the discharge mentioned men-tioned in the closing lines of the first paragraph of bureau circular letter No. 159. In case complete physical examination examina-tion cannot be made In the office of the medical examiner, the patient should be placed in the hospital to remain until the examination is completed. 7. After the completion of th examination, exami-nation, if the man is in need of relief, the kind of treatment required, either out-patient or hospital, ehould be furnished fur-nished by the medical officer in charge. Extra Charges. S. If the applicant resides at a place nearer another relief station than the one at which his application has been received, re-ceived, the application, provided he does not apply in person, should be sent to the officer in charge of the station nearest the applicant's residence, who should be requested to take charge of the applicant's appli-cant's case, and the applicant should be informed of the action taken. If the applicant lives more than 100 miles from a relief station, ho should be instructed to apply for admission to a hospital, selected se-lected by the officer in charge, near the patient's home, and instructions should be sent to the resident physician of this hospital to admit the man, at a rate not exceeding $2.50 per day, to make physical examination upon the proper blank, and to furnish him the necessary treatment. This procedure should also be taken if the patient is unable to proceed to the i hospital at the relief station. Only ward ! treatment Is authorized by law, but the usual extra charges will be paid for use , 1 of operating room. X-ray plates, and services ser-vices of an anesthetist. A circular regarding re-garding dental work is Inclosed. 9. The arrangement with the hospital 1 should include medical and surgical treatment, treat-ment, hut persons requiring severe operations opera-tions should, if possible, be sent to the ho&pltal at the relief station. Recommendations For Care. 10. If the patient is unable to travel, and it Is impracticable to have him admitted ad-mitted to a hospital, recommendations for his care and treatment at his home should be made to the chief medical adviser ad-viser of the bureau of war risk insurances insur-ances with a statement of -the necessity therefor, after an examination made by a physician selected by the public health service officer. The fee for examination by a physician not paid a monthly salary is S3 for each examination. All questions relating to home treatment, wherever it Is deemed absolutely necessary, are to be taken up with the bureau of war risk insurance. in-surance. 11. The travel expenses of the beneficiary benefi-ciary to the place of examination, the hospital expenses while he is being examined, ex-amined, and his expense in returning to his home are payable by the bureau of war risk insurance, together with the wages which the man loses while the examination is being made. 12. The expense incident tos outpatient out-patient and hospital ca.re and travel from one hospital to another after the patient, begins to receive treatment is chargeable to the public health service. (See paragraph para-graph 14, below.) Transportation And Meals. 13. Transportation and meal requests are inclosed. These requests are the forms of the public health" service and ! when the travel expense is chargeable to the bureau of war risk insurance the request should be changed so that the expenditure will be chargeable to the ! proper bureau. I 14. The statement In paragraph 12, 1 relative to the public health service be-; be-; lng responsible for the payment of hospital hos-pital expenses, does not refer to marine hospitals or contract stations established before March 5. 1919. as the expenses for treatment at these places is still chargeable charge-able to the bureau of war risk insurance. 15. The expense of furnishing artificial artifi-cial limbs and prosthetic apparatus generally gen-erally is chargeable to the bureau of w?r risk "insurance, and all matters relating to this special work should be referred to the chief medical adviser before taking action. 16. When conditions will permit, the usual procedure as to authorization of expenditures must be observed. 17. It is contemplated to treat patients pa-tients as far as practicable In the district dis-trict in which they make application, but patients suffering from 'hronic diseases and those which can re benefited by change of rlima te, or by being sent to special hospitals, will be transferred to other places by special a uthori'.y of the bureau of the public health service. ' 1?. It should be remembered that acceptance ac-ceptance of hospital ca re and tve-a tment on the part of claimants is entirely voluntary. |