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crease in the number of employees who had to be quartered on the Carson campus, as is shown by the following' figures:

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This increase, plus expansion of the agency services, necessitated our continuing in use the very old dilapidated and several-times condemned employees' building which had been marked for complete abandonment when the new employees' units were constructed. This ancient building is the original Carson Indian School administration building erected about 1890. It is a 2-story, frame building and constitutes a serious fire hazard. The various rooms in the building are heated by individual stoves-27 in all. The building is in an extremely dilapidated condition, sagging and bulging from decay, and should be abandoned. However, bad as its facilities are, they are the only quarters available for some 31 persons. This total of 31 persons includes 20 employees, the remaining 11 being members of employee-family groups domiciled in apartments in this old building. Maintenance and repair costs, to keep this building habitable at all, are excessive. This request, coupled with new quarters authorized in the recent Public Works Administration program should enable us to rehouse this portion of the personnel.

Mr. JOHNSON of Oklahoma. What does that item provide?

Mr. GREENWOOD. This item provides for an employees' building at the Carson Agency, for the use of employees stationed at that point. It contemplates the erection of a native-stone building containing six apartments.

TACOMA SANATORIUM, WASH.

Mr. JOHNSON of Oklahoma. For the Tacoma Sanatorium you submit the following item:

Tacoma, Wash.: Sanatorium and general hospital plant, $500,000, and in addition thereto the Secretary of the Interior may incur obligations and enter into a contract or contracts not exceeding the total amount of $815,000, and his action in so doing shall be deemed a contractual obligation of the Federal Government for the payment of the cost thereof, and appropriations hereafter made for continuing construction of the project shall be available for the purpose of discharging the obligation or obligations so created: Provided, That not to exceed $228,525 may be used to acquire from the Puyallup Tribe of Indians the land and improvements now constituting the Tacoma Indian Sanatorium as authorized by the act of August 11, 1939 (53 Stat. 1405).

JUSTIFICATION OF ESTIMATE

Mr. GREENWOOD. I submit the following justification in support of the estimate:

Tacoma Sanitorium, Washington; purchase of existing plant and land from the Puyallup Indians and the erection of a new plant, $500,000, and a contractual authorization of $815,000.-This is a renewal of a request that was included in the estimates last year but was disallowed by the Bureau of the Budget owing to the absence of legislative authority to acquire the present plant and site from the Puyallup Indians. The requisite authority was granted by the act of August 11, 1939 (Public, No. 384, 76th Cong., 1st sess.) which provides:

"That the Secretary of the Interior be, and he is hereby, authorized to acquire, from the Puyallup Tribe of Indians of Washington, for Indian sanatorium purposes, tracts numbered 6 and 7, containing thirty-eight and fifty one-hundredths acres, including all tribal-owned improvements thereon, of the Indian addition to the city of Tacoma, Washington, established under the Act of March 3, 1893 (27

Stat. 633); title to be conveyed to the United States by such tribal officials as the Puyallup Tribal Council shall authorize by resolution and by such form of relinquishment or deed as the Secretary of the Interior may designate.

"SEC. 2. In order to carry out the provisions of section 1 hereof there is hereby authorized to be appropriated, out of any money in the Treasury of the United States not otherwise appropriated, the sum of $228,525, which sum shall be distributed by the Secretary of the Interior in equal shares to the members of the Puyallup Indian Tribe, determined in accordance with the constitution and bylaws of the tribe approved May 13, 1936, as of the date of the passage of this Act, under such rules and regulations as he may prescribe: Provided, That acceptance by each individual, or by his or her natural or legal guardian or heirs, of the pro rata share of the amount hereby authorized to be appropriated shall be recognized as completely extinguishing any and all right or interest such member of the tribe might have had in said property.

"SEC. 3. The fulfillment of the provisions of section 2 hereof shall not bar the hospitalization of or medical attention of members of the Puyallup Tribe at the Indian sanatorium referred to in section 1."

The buildings constituting the Tacoma Indian Sanatorium were constructed many years ago from tribal funds and on tribal land as part of the Cushman School plant. For some years prior to July 1, 1929, the plant was rented from the tribe by the Veterans' Administration and was operated as a veterans' hospital. It was discontinued as such because it constituted a fire hazard, lacked modern hospital facilities, and, having been erected for school purposes, it did not provide suitable facilities for the proper hospitalization of patients. For the past 9 years the plant has been operated, under lease, by the Indian Service. During that time, it has become a medical center for the Indians of Washington, Oregon, Idaho, Montana, Nevada, northern California, and Alaska. It is the only Government hospital in the Northwest where Indians can secure medical and surgical treatment by specialists. The average number of patients admitted annually exceeds 1,000 and from 600 to 800 major operations are performed there each year.

Owing to the extremely poor condition of the present buildings, the time has arrived when they must be replaced or the plant abandoned in order to eliminate the very real danger to the lives of patients and staff that is ever present. This was forcefully brought to our attention last year when the sanatorium warehouse was destroyed by fire. Within 3 minutes after the fire was discovered, the entire structure was in flames, and it was entirely consumed in the space of an hour. The record that the Tacoma Sanatorium has made since it was opened as an Indian Service institution proves that there is a real need for a sizable general hospital and sanatorium in the Northwest. Tacoma is ideally located for a hospital of this character. It is in the center of Indian population in Washington west of the Cascade Mountains and yet accessible to specialists and consultants from metropolitan centers. It is easily reached by water, rail, air, and automobile. The site is an unusually beautiful and healthful one, overlooking on one side the Puyallup Valley with Mount Rainier in the background and, on the other side, Commencement Bay on Puget Sound. The climate is so mild that green lawns may be maintained the year round.

The Government now owns, in the vicinity of the existing plant, 5 acres of land containing a flowing spring of excellent water sufficient to supply a small city for domestic purposes. A right-of-way from the present site to the spring is also owned by the Government. Within the last few years there has been installed at the sanatorium a new pipe line costing $25,000 which it is estimated will be serviceable for at least 50 years. During the period that the plant has served as a school and a hospital, there has been expended approximately $200,000 for permanent improvements such as sewers, steam tunnels, water and sewer systems, landscaping and paving. These facilities would be available should the present buildings be replaced.

All things considered, it seems that the logical and economical course to pursue is to acquire the existing plant from the Puyallup Tribe and to reconstruct it on the present site. As the sanatorium serves many tribes in addition to the Puyallup, it is only just and right that these Indians should be compensated for their property. They are willing to dispose of it to the Government for the amount authorized to be appropriated by the act of August 11, 1939.

None of the present buildings utilized for hospital purposes is worth saving. Their condition is vividly described in a report by the superintendent with which

he submitted photographs to substantiate his statements. There follows an excerpt from the report:

"Upon examination of the enclosed photographs it will be observed that fire escapes are all built flush against the sides of building. From experience encountered in fire which destroyed our warehouse on June 20 last, we have learned that the fire escape should lead out and away from buildings because the fire in a wooden or frame building is so intense on the outside that rescue would doubtless be impossible if patient were to be carried alongside burning wall. It is a predominant condition in all of the buildings that halls and passageways leading to fire escapes are invariably narrow and contain sharp bends, making the rescue of stretcher cases extremely difficult if not altogether impossible. Observation of the photographs would convince one that cases tied to frames would likely be impossible of rescue, considering the fact that experience with the burning warehouse-photographs enclosed-indicate that rescuers would have perhaps no longer than 5 minutes, and then only providing the fire was discovered immediately.

"Attention is invited to frayed electric wiring. When the hospital was first occupied in July of 1929 it was noticed that wiring was poor. Two electricians were employed by the day to rewire buildings. Their services were retained almost a year and great improvements were made in the system. Then an electrician was placed on the pay roll. He is busy constantly rewiring and working to better the system. But even then, such a mass of wiring exists in the 35 buildings and on poles on the ground, that we are unable to bring all of the wiring where it will entirely pass the city electrical wiring code, and it is still dangerous in places. We can assure the office, however, that the danger from fires has been constantly on our minds and that we are constantly improving and endeavoring to eliminate the danger as much as possible.

"We wish to point out in photographs how one building is bulged, and that the foundation is so rotten that it will not hold together longer. It is useless to attempt repair-the entire structure is affected by dry rot. Photographs show another building so rotten that the station carpenter can jab a small screw driver into the wood and it wall fall into powder. Another building-see photo of ward E-is so rotten that paint will scarcely stay on the boards. There is another building (No. 10)-no photograph taken-that is in extreme state of decay. In this building paint will not stay on rotten siding. None of the wards are entirely free from dry rot, making them difficult to keep clean and rendering danger of collapsing walls to some extent. Time and again we find that in seeking to replace rotten parts with new lumber difficulty is encountered in finding a connecting piece of the existing building sufficiently solid to drive nails in. In many cases what first appears to be a simple repair job often proves to be a major affair because so much must be removed to locate a solid part on which to connect.

"In the surgical ward, extreme difficulty is encountered in moving patients because of lack of any elevator, making it necessary to carry patients on a stretcher from one floor to another up and down the only stairway which is winding and narrow. An obstacle exists between rooms in sterilizer room, necessary to prevent steam pipes from protruding, but being a nuisance nevertheless. Another inconvenience that should not exist consists in the fact that X-ray is not in the same building with the surgery. Patients must be hauled back and forth between buildings. Because of lack of space, drug room and laboratory are also in a separate building from surgery. Much time is lost in traveling from one building to another by employees in discharge of their duties. Another matter, not previously discussed, is lack of proper plumbing facilities. If these buildings must be kept, then a survey of the plumbing situation must be made. We believe that to put the plumbing in a real sanitary condition, providing sufficient vents, etc., and removing unorthodox pipe arrangements, etc., to comply with building code as to plumbing, it would cost thousands of dollars.

"Finally, we desire to point out that on account of loss by fire of our storehouse, a makeshift storeroom has been provided in occupational therapy shop. Insufficient room is available. We have been forced to store many articles in other buildings already being used for other hospital functions, and cramping us immeasurably. This cramped condition exists in the dining rooms-makeshift-provided to care for ambulatory patients when the main dining room was condemned."

Utility connections, supervision, and contingencies---.

A thorough survey was recently made of the existing plant, which disclosed that with the exception of three dwellings, it would be unwise, as well as uneconomical, to undertake a remodeling program, owing to the structural condition of the buildings. It is, therefore, proposed to raze all of the present structures except the superintendent's residence and two physicians' houses, and to erect the following facilities:

1. Sanatorium and general hospital, providing 311 beds_Equipment

Utility connections, supervision, and contingencies--

2. Nurses' residence (40 nurses). Equipment-‒‒‒‒

3. Attendants' building (40 employees). Equipment-.

$590, 400 119, 000 38,500

$747, 900

85,600

5,000

8, 400

99, 000

76, 800

5,000

Utility connections, supervision, and contingencies_

7,555

89, 335

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As indicated above, this estimate contemplates the erection of a single building of brick construction to provide 311 tuberculosis, general medical, and surgical beds. The topography of the site for the structure is such that one end of the basement will be above ground. It is planned to equip this part of the basement for use as an out-patient department including a dispensary, a dental clinic, and a general laboratory and treatment rooms. Located in the basement also will be the oil-burning heating plant and a limited amount of storage space. The ground floor will contain the administrative offices, kitchen, X-ray and occupational-therapy rooms, an autopsy room, and 4 six-bed wards for orthopedic cases. On the first floor will be located 16 wards providing 116 beds for tubercular patients and 6 six-bed wards for general medical cases, in addition to treatment and service rooms and lavatories. The second floor will contain 12 wards with 82 beds, 4 terminal rooms, 3 operating rooms, 4 recovery rooms, and a physician's rest room. The third floor is planned to provide 4 six-bed wards for general surgical cases, 2 private rooms, and an obstetrical section consisting of 2 nurseries, 1 delivery room, 4 wards containing 21 beds, and 2 private rooms. On the fourth floor will be located an employees' recreation room and library, and a pathological laboratory. The building will be equipped with an elevator and all necessary appliances for the treatment of the several classes of patients to be accommodated therein.

It is proposed to erect a nurses' home consisting of a two-story and basement brick structure to house 41 nurses. Single rooms will be provided for the staff nurses and a two-room and bath apartment for the chief nurse. The basement

will contain a dining room, living room, kitchen, laundry, heating plant, and storage facilities. A smaller but similarly constructed building will be erected to house 40 attendants. This structure has been so planned as to permit the segregation of male and female employees.

It will be noted that only 3 new dwellings are to be constructed for the occupancy of married employees and that there will be only 6 dwellings in all. This represents a considerable reduction in the number of individual houses provided at present. It is believed that this reduction is justified in view of the proximity of the sanatorium to the city of Tacoma where housing facilities may be rented by those employees whose services are not required during the night.

Worthy of note also is the fact that this estimate does not include a central heating plant. After careful study, it has been concluded that it will be more economical from the standpoint of initial cost as well as operation and maintenance to install individual heating plants in the new buildings.

The erection of the facilities embraced in this estimate will constitute a long step forward in the effort that has been made in recent years to make available the benefits of modern medical science to a greater number of Indians in need of medical services. The reluctance of these people to accept such services has been largely overcome and there is an increasing number of them seeking medical treatment. This has not been accompanied, however, by a corresponding expansion of facilities and personnel to serve them. An appropriation of $500,000, together with a contractual authorization in the sum of $815,000 for the construction of a more extensive plant than is now maintained at Tacoma, is, therefore, urgently recommended. The entire amount of the estimate is not requested at this time as it is not anticipated that a larger amount of cash than is indicated will be required during the first year of construction. In order, however, that we may be in a position to take advantage of such economies as might be effected by awarding a contract or contracts for the complete construction and equipment of the proposed new plant, an authorization is requested to incur contractual obligations in excess of the amount of the appropriation.

PROPOSED LOCATION OF SANATORIUM

Mr. JOHNSON of Oklahoma. Tell us why that is estimated for. Mr. GREENWOOD. At the present time we are renting from the Puyallup Tribe the buildings and grounds comprising the Tacoma Sanatorium. The buildings were originally constructed for school purposes. I do not know the exact age of them, but they are in a deplorable condition. I have some pictures here that I would like to show the committee, which indicate the character of the construction, and what would happen if a fire should occur at that plant.

It

Mr. LEAVY. I might say, Mr. Chairman, that I am very familiar with this situation. It is not in my district, but it is in the Sixth Congressional District over on the coast. I spent some time there last summer. Congress passed legislation providing for the acquisition of this property from the Indians, fixing the maximum price for the purchase of it. It is, perhaps, one of the most beautiful sites, so far as surroundings are concerned, as could be found anywhere in the United States. It was never built for hospital purposes. was never intended to be used as a hospital, but was built for school purposes a great many years ago. All of them are frame buildings, and some of them have actually fallen into decay. One part is now condemned. and no one is allowed to go into it. The timbers have rotted out. There are some 350 Indians there, mostly youngsters. Most of them are TB patients, but a number of them are there for major surgery. They come there from all over the Northwest section of the country, some coming from Pine Ridge, as I recall, and some from Alaska. That is the only place where they can get major

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