U.S. VETERANS’ BUREAU January 18, 1922.
_GENERAL ORDER NO. 68_
Subject: ORGANIZATION AND ADMINISTRATION OF THE SECTION OF PHYSICAL
RECONSTRUCTION, MEDICAL DIVISION, U.S. VETERANS’ BUREAU.
The following General Order is hereby promulgated, effective this date,
for observance by all officials and employees of the U.S. Veterans’
Bureau.
1. The Section of Physical Reconstruction is under the Medical Division,
and includes Occupational Therapy, Pre-Vocational Training, and
Physiotherapy in hospitals and dispensaries, and Follow-Up Nursing
outside of hospitals.
2. The internal management of hospitals of the Army, Navy, Public
Health, National Soldiers’ Homes, St. Elizabeth’s Hospital, and Contract
Hospitals falls under the jurisdiction of the several services
mentioned, or in private and State institutions under the
superintendent.
3. Occupational Therapy, Pre-Vocational Training, and Physiotherapy are
a part of the hospital care and treatment, and fall under the management
of the Medical Officer in charge of each institution, and do not come
under the jurisdiction of the District manager or the District Medical
Officer.
4. Institutions formerly known as Training Centers have been divided
into two groups:
(a) All centers called Vocational Schools are under the
Rehabilitation Division.
(b) All centers in hospitals will be called Reconstruction Centers
and are under the Medical Division.
_ARMY_
In all Army Hospitals serving the U.S. Veterans’ Bureau beneficiaries
reconstruction work will be established, and personnel, equipment, and
expendable materials for Occupational Therapy, Pre-Vocational Training,
and Physiotherapy will be furnished through the Surgeon General of the
Army and paid for by the U.S. Veterans’ Bureau on a pro rata basis for
such service to its beneficiaries.
_NAVY_
In all Naval Hospitals serving U.S. Veterans’ Bureau Beneficiaries
Physical Reconstruction will be established and the personnel,
equipment, and supplies for Occupational Therapy, Pre-Vocational
Training, and Physiotherapy will be furnished by the U.S. Veterans’
Bureau for its beneficiaries in such hospitals.
_PUBLIC HEALTH SERVICE HOSPITALS_
The Occupational Aides and Physiotherapy Aides in Public Health Service
Hospitals will be furnished by that service. The teachers in
Pre-Vocational Training will be furnished by the Veterans’ Bureau. The
Physiotherapy Aides will be directly under the Medical Officer in Charge
of Physiotherapy, or, if no such officer is assigned, under the ward
surgeons. The Occupational Aides will work directly under the
Reconstruction Officer, if there is one assigned; if not, under the ward
surgeons. Teachers and workers in Pre-Vocational Training will be
directly under the Educational Director. The entire personnel of the
hospital will be under the direction of the Medical Officer in Charge.
Supplies and equipment for Occupational Therapy and Physiotherapy will
be furnished by the Public Health Service. Supplies and equipment for
Pre-Vocational Training will be furnished direct by the Veterans’
Bureau.
_NATIONAL SOLDIERS’ HOMES_
In all National Soldiers’ Homes Reconstruction service will be
established, and personnel, equipment, and supplies for Occupational
Therapy, Pre-Vocational Training, and Physiotherapy will be furnished by
the U.S. Veterans’ Bureau. The Aides in Physiotherapy are to work under
the direction of the Medical Officer (Physiotherapist) assigned, or, if
there is not such an officer, directly under the ward surgeons. The
Occupational Aides and teachers in Pre-Vocational Training will be under
the direction of the Educational Director. The personnel detailed to the
Homes are under the direction of the Medical Officer in Charge.
_ST. ELIZABETH’S HOSPITAL_
Physical Reconstruction has been established as a part of the work in
St. Elizabeth’s Hospital. The personnel, equipment, and supplies for
Occupational Therapy, Pre-Vocational Training, and Physiotherapy will be
furnished by the U. S. Veterans’ Bureau. The Physiotherapy Aides will be
under the direct supervision of the Medical Officer assigned to the
Physiotherapy Section, or, if no such officer is assigned, under the
Medical Officers in charge of the patients being treated. The
Occupational Aides and teachers in Pre-Vocational Training will be
directly under the Educational Director. All personnel will be under the
general direction of the Medical Officer in Charge.
_CONTRACT HOSPITALS_
In all Contract Hospitals, where the number of beneficiaries justifies,
the Reconstruction Service will be established. All Personnel and
equipment will be furnished by the U. S. Veterans’ Bureau. The
Occupational Aides and teachers in Pre-Vocational Training will be
directly under the Educational director. Physiotherapy Aides will be
directly under the ward surgeons. The personnel assigned will be under
the general direction of the Medical Officer in Charge.
_PROPERTY ACCOUNTABILITY_
The Educational Director in a center at a hospital will designate an
employee under his jurisdiction as a Property Custodian, which Property
Custodian will make the same semi-annual reports to Central Office as
are required of District Property Custodians by General Order #52.
The accounting for physiotherapy supplies and equipment will be in
accordance with General Order No. 52.
_SUPPLIES_
Supplies and equipment for Physical Reconstruction in hospitals other
than Army and Public Health Service will be requisitioned from Central
Office. Requisitions must be prepared in accordance with Field Order No.
43.
_SECURING PERSONNEL_
The personnel in the Reconstruction service is obtained through Central
Office from Civil Service register. When the Educational Director at a
hospital desires additional personnel he will make request through the
commanding officer of the hospital to Central Office direct, stating the
qualifications of individual required. Central Office will then make the
most advantageous assignment possible and order the individual to report
for duty at the designated station. In securing personnel for
dispensaries and for follow-up nursing, the request will come from the
officer in charge through the District Medical Officer and District
Manager to Central Office, stating the qualifications of individual
required. The Reconstruction Section will secure the name or names of
individuals and request the District Medical Service Section to secure
the appointment of the same through Personnel Division, and notify the
District Office of the date the same shall go on their payroll and the
amount of salary they shall receive. All personnel in the Reconstruction
service, except the Occupational Aides and Physiotherapy Aides in Public
Health Hospitals and Army Hospitals, will be on Central Office payroll.
This will include teachers and occupational aides.
_TRANSFERS_
Transfers of personnel in hospitals will be made by Central Office upon
the recommendation of the Commanding Officer and the Educational
Director. Transfers of personnel on the District Office payroll in
dispensaries and the follow-up nurses may be made within the District by
the District Manager. If it is an interdistrict transfer, the same must
be made by Central Office. All surplus personnel, either in hospitals,
National Soldiers’ Homes, or in District Office, or in Sub-District
Office, should be reported promptly to Central Office.
_COMMUNICATIONS_
All communications from Central Office to personnel in a hospital will
be routed through the Medical Officer in Charge of hospital. All
communications from personnel in a hospital will be sent through the
Commanding Officer to proper destination. All communications to
personnel in Reconstruction Section outside of hospitals will be sent
through the District Manager to its destination. All communications from
personnel outside of hospitals within a District shall be sent through
the District Manager to its destination.
_SUPERVISION OF OCCUPATIONAL THERAPY AND PRE-VOCATIONAL TRAINING_
There shall be a sufficient number of supervisors of Occupational
Therapy and Pre-Vocational Training employed and placed on Central
Office payroll to properly supervise the work in all districts. Their
duties shall be to supervise the work under the direction of Central
Office, to keep Central Office fully advised as to the condition of the
work and the needs of each reconstruction center they visit, and to
recommend any changes in personnel, giving reasons for recommendations.
_PHYSIOTHERAPY_
There shall be a medical officer skilled in Physiotherapy designated as
Chief of Physiotherapy for each district. He may be a part-time or a
full-time man, as the necessity requires. His duty shall be to supervise
and direct the installation of the equipment in the District and
Sub-District Offices, and, upon request from Central Office, to visit
and report upon the work in any hospital in his district. His line of
communication will be through the District Medical Officer and the
District Manager to Central Office; and Central Office’s line of
communication will be to the District Manager—Attention, Chief of
Physiotherapy.
_FOLLOW-UP NURSING_
Field Order No. 18 covers the entire matter of Follow-Up Nursing.
[Illustration:
C. R. Forbes.
Director, U. S. Veterans’ Bureau.
]