Hospital Survey and Construction Act (or Hill-Burton Act ) is a US federal law passed in 1946, during the 79th United States Congress. It is sponsored by Senator Harold Burton of Ohio and Senator Lister Hill of Alabama.
In November 1945, President Harry S. Truman delivered a special message to Congress where he outlined a five-part program to improve the health and health care of Americans. The Hospital Survey and Construction Act responds to President Truman's first proposal, which calls for the construction of hospitals and related health care facilities, and is designed to provide federal grants and loan guarantees to improve the physical crops of the state hospital system. Money is set to the state to reach 4.5 beds per 1,000 people. The states allocate the money available to their various municipalities, but the legislation provides a rotation mechanism, so an area that receives funding moves to the bottom of the list for further funding.
Facilities that receive Hill-Burton funding must comply with several conditions:
- They are not permitted to discriminate based on race, color, national origin, or belief, although separate but equal facilities in the same area are permitted. The US Supreme Court ruled this separation in 1963 when it rejected the assurance of the decision of the Fourth Circuit Simkins v. Cone .
- Facilities that receive funding are also required to provide "reasonable volume" of free care each year for residents in the area of ​​facilities requiring maintenance but unable to pay. The hospital was initially asked to provide care without compensation for 20 years after receiving the funds. Federal money is also only given in cases where states and local municipalities are willing and able to match federal grants or loans, so the federal part accounts for only one-third of the total cost of construction or renovation.
- The state and locality are also required to prove the economic viability of the facility in question. This does not include the poorest municipality of the Hill-Burton program; most of the funds go to the middle class. It also serves to shore up economically unfit hospitals, slowing down the developments generated by market forces. Once Medicare and Medicaid are enacted, participation in those programs is added to the list of requirements for access to Hill-Burton funding.
The reality, however, does not nearly meet the written requirements of the law. During the first 20 years of the existence of the law, there are no rules to determine what constitutes "reasonable volume" or to ensure that the hospital provides free care altogether. This did not improve until the early 1970s, when lawyers representing the poor began suing the hospital for disobeying the law. Hill-Burton was set to expire in June 1973, but was extended for a year in the last hour. In 1975, the Act was amended and became the Title XVI of the Health Service Act. The most significant change at this point is the addition of several regulatory mechanisms (defining what constitutes inability to pay) and moving from a 20-year commitment to the requirement to provide free maintenance forever. However, it was not until 1979 that compliance was set.
Video Hill-Burton Act
References
- The Health and Human Services website: [1]
- Section 48 of the Federal Regulatory Code on the National Archives website: - 42: 1.0.1.11.76.4.39.8.24
- Public Health Service Act at F.D.A. website: [2]
- Resource and Service Administration Website: [3]
- KOB Testimony Statement Robert D. Reischauer Deputy Director of the Congressional Budget Office Prior to the Subcommittee of the Housing and Community Development Committee on Banking, Finance and Urban Affairs, US House of Representatives May 17, 1979 on the CBO website: [4]
- Starr, Paul. American Social Transformation . New York: Basic Book, 1982.
- Stevens, Rosemary. In Disease and Wealth: American Hospital in the Twentieth Century. 1st ed. The Johns Hopkins University Press, 1999.
Source of the article : Wikipedia
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