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on duty, and we have seven Catholic sisters, and we are only giving domicilary care. We are not supplying hospital care, because we have not the funds with which to do that. These patients demand very careful medical and surgical treatment. We hope to be able to place our nurses and Catholic sisters so as to apply the medical and surgical treatment necessary, and enough of them to properly handle the patients.

The CHAIRMAN. Is it possible to procure any of this equipment from existing Government supplies?

Dr. LAVINDER. In the matter of equipment of any other kind, it is against the orders for us to buy anything unless it first passes through the hands of the Chief Coordinator. If he says that the supplies desired are not in existence or are not in existing Government stocks, we can buy it. There is no requisition purchased unless it goes through him.

The CHAIRMAN. Do you get better prices when you buy through the coordinator ?

Dr. LAVINDER. He does not buy the supplies, but if we want something we ascertain whether it can be supplied from stock already on hand free of charge.

Mr. KELLEY. What does the War Department charge you for supplies you procure for them—the original purchase price of the materials or the current price?

Dr. LAVINDER. When we buy from them we take it at an estimated price that is a fair price, without regard to the current price. We do not always pay for things that we get from the Army. We get from the Army now a good many things free of charge. In the case of the Navy, there is a certain difference in the law, and we have to reimburse the Navy at the rate of a certain estimated cost. We do not buy from them at the market price, and it is simply a question of reimbursing their funds. Mr. KELLEY. You are not paying war prices?

Dr. LAVINDER. No, sir. Both the War Department and Navy Department have been mighty good about it, and they have favored us wherever they could.

Mr. Wood. Is there a farm in connection with this leper colony?

Nr. LAVINDER. There is a small one, and the patients want the employment.

Mr. Wood. What is the proportion of leprosy as between the sexes, or is one more susceptible than the other?

Dr. LAVINDER. Not that I know of.
Mr. KELLEY. You have both men and women at this place!
Dr. LAVINDER. Yes, sir.

The C'HAIRMAN. According to this statement on the pink sheet. you will have overdrawn this fund of $80,000 so that you would have $181,846 available if you got this $200,000.

Dr. LAVINDER. Yes, sir.
The CHAIRMAN. Are you sure that will carry you through?

Dr. LAVINDER. Yes, sir; the $200,000 would carry us through, or that is what we figure on. We have been urged several times to put up tents, and things like that, but we have always opposed it.

The CHAIRMAX. Do you have a record of all the cases of this sort in the United States?

Dr. LAVINDER. No, sir. If we could have a place to properly care for them, that would stimulate the health authorities in all the States who look out for the lepers. They are afraid to do so now, because they will get them on their hands, but if they find that there is a place for them, they will look them up. They are afraid to do so now, because they will get them on their hands, but if they find that there is a place for them, they will look them up. They are afraid to stir the thing up now, because they can not do anything with them.

HANDLING OF LEPER CASES.

Mr. Wood. How do you take a leper in charge? Suppose there is a leper in a certain family, and the family is opposed to having him taken away?

Dr. LAVINDER. We can not do that. I do not think the law would permit us to do that. The law is mandatory upon us to take them when they want to come.

The CHAIRMAN. How could you segregate them if you can not take them?

Dr. LAVINDER. Our experience teaches us that the lepers will seek an asylum of this sort. Life soon becomes an absolute burden to them, because everybody shuns them, and they can not go into any community freely.

Mr. KELLEY. You have authority to segregate smallpox, have you not?

Dr. LAVINDER. Yes, sir. The CHAIRMAN. I suppose these cases could be quarantined? Dr. LAVINDER. The local authorities do that. They are afraid of them and drive them about.

The CHAIRMAN. If they are quarantined away from everybody, they will naturally seek an asylum like this?

Dr. LAVINDER. Yes, sir; they will want to come there. When you can isolate a couple of hundrell of these people together at a place like this they are happy and contented. They are not unhappy when they can be taken care of in a place where they can have the decencies of life and be made comfortable. We are fortunate in having a commanding officer out there who is well suited for the work. He was in the leper hospital in the Philippine Islands for four or five years. He is an attractive man personally and all of the patients like him. He puts a good spirit in them, and they are liappy and contented.

ST. LOUIS LEPERS.

Mr. KELLEY. What about the St. Louis cases?

The CHAIRMAX. There are several cases in St. Louis about which they are very much concerned, and we have had some correspondence with the people out there. I understand that they have also been in correspondence with the Public Health Service.

Dr. LAVINDER. Yes, sir.

The CHAIRJAN. The correspondence that I have had with them leads me to believe that it is the purpose to take those cases to this home as soon as the money is available.

Dr. Busby. Yes, sir; we are trying to be as impartial as possible in going over the applications on file, and the St. Louis lepers are among the first on the file.

PERCENTAGE OF APPROPRIATION SET ASIDE.

Mr. Byrns. Doctor, I understood you to say a while ago that you set aside about 10 per cent of the appropriation under this act?

Dr. LAVINDER. Yes, sir.
Mr. BYRNS. Was that at the beginning of the fiscal year?

Dr. LAVINDER. No, sir; that was done since Gen. Dawes organized the Budget Bureau. When he organized the Budget Bureau, he called the departments together and said that he expected everybody to make some reduction in their expenditures and to set aside a certain amount that could be saved.

Mr. Byrns. Did that apply to the lump-sum appropriations as well as the appropriations under this act ?

Dr. LAVINDER. It applied to the total.

Mr. BYRNS. You say that that money is still available. Do you expect to spend it?

Dr. LAVINDER. We hope not.
Mr. BYRNS. You are not doing that now?
Dr. LAVINDER. No, sir.
Mr. Byrns. What are your expectations as to that?

Dr. LAVINDER. So far as this appropriation is concerned, we hoped to be able to live within it without spending that money. We have not touched it.

Mr. Byrns. You have not touched it?
Dr. LAVINDER. This $200,000 would come out of it.
Mr. Byrns. How about the other funds set aside?

Dr. LAVINDER. I can not say about the other funds. They do not come under my supervision.

Dr. CREEL. We had to ask for the release of $25,000 that we proposed to save out of pay of personnel and $7,500 out of field investigations.

Mr. Byrns. That money, of course, is still available if you need it!

Mr. HUDDLESOX. Yes, sir; but we will not spend it unless it is absolutely necessary.

The C'HAIRMAN. By this estimate you would expend $200,000 of it!
Mr. HUDDLESON. Yes, sir.
The CHAIRMAN. That will not be replaced ?
Mr. HUDDLESON. No, sir; we can not replace it.

The CHAIRMAN. You do not know whether you will have to take it all or not?

Mr. HUDDLESON. Not unless something unforeseen comes up. We figured that very carefully.

The CHAIRMAN. Do you propose to continue to save $400,000 any. how, regardless of this $200,000?

Mr. HUDDLESON. My understanding was that this $200,000 would come out of the $400,000 that we proposed to save.

Mr. KELLEY. You have the legal authority to use that $100,000 that you are proposing to save?

Dr. LAVINDER. Yes, sir.
Mr. KELLEY. Then, why should you bother us with that?

Dr. LAVINDER. We have not the authority to use it for this purpose.

Mr. KELLEY. You want more money for this purpose ?
Dr. LAVINDER. Yes, sir.

Mr. KELLEY, And you want to take it out of the $400,000 that you are proposing to save from other purposes?

Dr. LAVINDER. Yes, sir. I would like to add this, that the cost accounting system shows a cost of $3.11 per day, which is too low, and that is because we have not the money. It should be about $4.20 per day.

Mr. KELLEY. I think you stated that a while ago.
Dr. LAVINDER. I wanted to make that point clear.
Mr. KELLEY. How did you make this saving of 10 per cent?

Dr. LAVINDER. When they told us to cut it, we simply took our allotments and cut them accordingly and tried to live within the amount as reduced. Of course, the money is still available.

Mr. BYRNs. Is not the situation, then, this that under that order something like $400,000 has been withdrawn or taken away from you or withheld, and now you are asking for $200,000 more?

Mr. LAVINDER. No, sir; we are asking for $200,000 out of that $100,000.

Mr. HUDDLESON. We did that at the request of Gen. Dawes's commission. In this case we do not want the money, but we only want the limitation in the appropriation charged so that the limitation of $80,000 will be $280,000.

Mr. Byrns. Then, as a matter of fact, if the estimates submitted by the bureau are allowed by the committee it will amount to an appropriation of $200.000 in addition to the $400,000 that is being withheld ?

Mr. HUDDLESON. On the basis of the estimates; yes, sir; but my understanding is that we are not to request $200,000, but are simply to request a change in the wording of the appropriation.

Mr. KELLEY. In purchasing supplies for the Public Health Service, what do you say about the prevailing market price now as compared with the market price prevailing at the time you prepared your estimates? There has probably been a decline of more than 10 per cent?

Dr. LAVINDER. I would not like to say how much the figures have declined.

Mr. KELLEY. Is it not probable that the budget commissioner at the time you were making the suggestion was working on the basis of the decline in prices!

Dr. LAVINDER. It may have been.

Mr. HUDDLESON. I think he said after a time-not then-but that he expected a decline during the year.

Mr. KELLEY. And the 10 per cent cut would give you just as much money as you expected to use at the time the appropriation was made.

QUARANTINE SERVICE.

The CHAIRMAN. For the quarantine service you are asking for $389,000, which is in addition to the $350,000 you already have?

Dr. CREEL. Yes, sir.
The CHAIRMAN. Be kind enough to tell us the necessity for this?

70214-21- 31

Dr. CREEL. Mr. Chairman, for a number of years we have followed the practice of using repayments from fees collected for the subsisting of crews and passengers held in quarantine and for the chemicals used in the fumigation of vessels; and in the various estimates sent to Congress we have never taken into consideration those two items, assuming that they would be taken care of automatically, whether the expenditure be large or small. For instance, a year ago, when we were collecting data as to the cost of operating the New York quarantine station, we wrote to the officer in charge at that time, asking specifically what his cost of maintenance was, and got the figure of $347,000, but he stated at that time, “ It must be borne in mind that $250,000 of this item was spent for additional subsistence at Hoffman Island for crews and passengers.”

We submitted an estimate for the maintenance at New York, asking only for $100,000, assuming then that whatever we collected for subsistence issued to crews and passengers would reimburse the appropriation and the total amount would be taken care of. Last spring the comptroller ruled that that was illegal and improper and should be discontinued. This deficiency is requested in order to permit the operation of the quarantine stations with the fees going into the General Treasury. · The CHAIRMAN. You have not half the immigration this year that you had last year!

Dr. CREEL. Mr. Chairman, quarantine activities are affected not only by immigrants but also returning naturalized citizens and native travelers. The chief item is the inspection of the ships and crews. That is to say, the crews coming into New York Harbor probably are as great in number throughout the year as incoming immigrants.

As soon as we received the decision of the comptroller we came to this committee last year and asked for a deficiency to operate the New York quarantine station-$285,000 in amount. We expended only $250,000, turning back $35,000; but we collected in fees $350,000. In other words, the Government's net profit for that four months was $100,000.

FEES FOR QUARANTINE INSPECTION.

(See p. 486.)

Mr. KELLEY. You get fees for the quarantine inspection?
Dr. CREEL. The last Congress provided that fees should be charged.
Mr. KELLEY. From the passengers?

Dr. CREEL. No; for the ships, for service rendered. The fees are for the fumigation of vessels, for the inspection of vessels, the inspec. tion of passengers, for vaccination, and for the subsisting of such passengers and crews as are held in quarantine. The situation, of course, would be automatically cared for if we had authority to use the fees for subsisting passengers and crews and for the fumigation. That would still permit the collecting of fees for the inspection of vessels and passengers, which would go into the General Treasury. and which would probably amount to $300,000.

The CHAIRMAN. You do collect the fees now?

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