LETTER TO HONORABLE JAMES T. McINTYRE, JR. FROM ALAN K. CAMPBELL

• Document Type: CREST
• Collection: General CIA Records
• Document Number (FOIA) /ESDN (CREST): CIA-RDP83-00156R000300050090-1
• Release Decision: RIFPUB
• Original Classification: K
• Document Page Count: 5
• Document Creation Date: December 15, 2016
• Document Release Date: December 9, 2003
• Sequence Number: 90
• Publication Date: March 15, 1979
• Content Type: LETTER

Personnel Management. Washington, D.C. 20415
Approved For Release 2004/05/12 CIA-RDP83-00156R000300050090-1
March 15, 1979
I:onorable James T. McIntyre, Jr.
Director
Office of Management and. Budget
Attention: Assistant Director for
Legislative Reference
Dear Mr. McIntyre:
This is in response to your request for the views and recoT_-ner.daI'_- ions
of the Office of Personnel Management on the Department of State's
draft bill "To amend Chapter 79 of title 5, United States Code, to
authorize the head of each agency to establish a health care program
which "Will provide for physical examinations and immunizations for
employees and their dependents assigned overseas and for the payment
of travel expenses and the cost of treatment: of an illness or injury
incurred by an employee or his dependents while assigned abroad under
certain conditions." -
This draft bill is part of the effort to implement the recommendations
of the lrY,ter-Agency Committee on Overseas S1loc;ances and Benefits for
U.S. Employees, which made a comprehensive review of such allowances
and. benefits for the purpose of assuring uniformity and equity of.
administration in the future.
All agencies are currently authorized, under chapter 79 of title. 5,
United States Code, to establish health service programs for employees,
for emergency treatment of on-the-job illness or injury, preemployment
and other examinations, and preventive programs relating to health.
Foreign affairs agencies are authorized to establish much broader
programs for their employees assigned abroad. The draft bill would
authorize all agencies to establish programs similar to those for the
foreign affairs agencies.
-Authorize physical examinations and i-unizations at Government
expense for employees and their dependents prior to their
departure for assignment abroad; and periodic examinations and
ir_=nizatioris during and at the end of assignments abroad;
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 Apox"es ~e~2004/0 i/'=2~? OAuRDPO3 iO& ( 3dbsboj'-ral
health benefits plan for hospitalization or treat:~snt of an
illness or injury incurrred by employees or their dependents,
which necessitates hospitalization as a consequence of unusual or
hazardous circumstances at a post of duty outside the United
States; and
-Permit transportation for payment of travel expenses -.hen
employees or dependents suffer illness or injury requiring
radical care which is not available at the post outside the U.S.
We strongly support the principle of accessability to quality medical
care for all employees and dependents, and recognize that some overseas
areas which present a greater health risk than exists in the United
States are often precisely the areas where good nedical care is not
available. Therefore, we support the purposes of the draft bill.
However, we object to some of its provisions.
Regulatory authority. A major defici.en;y of the bill, in our view, is
that it would authorize the head of every agency to prescribe separate
'
regulations under which medical care'and transportation for medical
care would be provided for the agency's employees. Such broad authority,
would inevitably exacerbate the inequities the draft bill is intended to
correct. Employees of different agencies at the same post would
still be treated differently, and morale problems would continue. We
therefore urge.that the draft bill. be amended to provide that, the
President or his designee shall prescribe regulations to implement the
provisions of the bill.
Job-related medical problems. There are a number of duty posts in
foreign areas where, because of the general level of sanitation,
climate or environment; employees.and dependents are likely to exper-
ience a greater incidence of medical/health problems than would be
encountered in the United States. Medical technology should be able.
either to identify potential problems at each area in advance, or'to
relate a specific problem to a local environmental health risk.
The language of the draft bill expresses recognition of the Government's
obligation to pay for at least a part of the medical care that may be
needed because of local environmental conditions. Yet, the bill
proposes that the health benefits plan. be the primary source of payment,
with the Government paying expenses beyond those for which a health
benefits plan would not pay where hospitalization is necessary or
where illness is due to unusual or hazardous conditions of the post.
We do not believe that the Federal Employees Health Benefits (FEtiB)
program was intended to accommodate those unusual. health problems that
may occur because the Government sends employees and dependents to
locations with a health risk potential significantly greater than in
domestic areas. This has the effect of charging the cost of what are
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 essen ia_ 4-u-- ~ w-v~r.>?:::.,o ~J..._...~.. -- o------- --- -- -
progre that is intended to cover only non,-job related problems. The
potent`~r~~rl2fl~4/06/ba~cf!?Dt-(d~R~OQ8~S0: ~'cr
FEUB for all employees and for the Government.
We recownend that the following provisions be incorporated into the
draft bill:
1. That the Department of Health, Education, and. Welfare, or a
designee, be required to identify those posts where there exist
unusual health risks, i.e., those not likely to be found in the
United States, and the probable medical problems that could
arise as a result of those factors. This approach would provide
an independent review, and a measure of objectivity about the
conditions at the various duty posts.
2. That any medical /health problems experienced b} employees and
dependents as a result of duty at those posts identified by HEW
be considered as job-related. This. would place those health
problems within the framework of the Federal workers' compensation
program under chapter 81-of title 5, United States Code. This
would mean that all necessary treatment, medication, and the like
.would be fully paid by the Go crnmer-t..
While we do not, of course, administer the worker's compensation
program, it appears true that these unusual health conditions as they
may affect employees are already covered; dependents-are not n ow
covered. Thus, the proposed bill should be amended to provide coverage
for dependents under the ,7or'kers' compensation prograri, but only for '
those health problems experienced as a result of the unusual conditions
which exist at some overseas posts, as identified by HEW.
If any clarification is needed regarding coverage under the workers'
compensation program for employees, then chapter 81 of title 5 should
be amended to provide the necessary coverage. It is undesirable to
have two statutes when an existing statute can, with necessary modifi-
cation, serve the same purpose. -
The Department of Labor, which administers the Federal workers' compen-
sationprogram, should be given an opportunity to conment on the above
recommendations. -
Mon--fob related -medical problems. We fully support the bill's author-
ization for agencies to establish appropriate health care facilities
to assure that employees and dependents have access to adequate health
care- for both Job-related a:td* non-job related-health problems.- Use of
.the authority, however, should be restricted to those locations where
adequate local private health facilities and/or personnel are not
available and where the number of employees and dependents makes it
economically feasible to establish such facilities. Provision should
be made for reasonable fees to be charged employees availing themselves
of such facilities.
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 pa -1e t. o#~~~t'.~ is of non.-job related problems. should be the personal
respoppiN1W1'Ly? Tasee2~14~Q 1 o CtI R9 3-@Q_ f~(~3Qi9 00 1in the
Transportation for medical care. The draft bill would authorize such
transportation or reimbursement for expens_S of transportation for
medical care when posts outside the United States are unusually isolated
or remote. We urge that the provisions be extended to include some
domestic and non-foreign areas. We believe this to be so necessary that
we have been considering including it in our 1980 leg slative program;
however, we believe that this draft bill is a bore appropriate vehicle.
There are many posts in Alaska, for example, where there are no health
facilities at all or those that are available cannot provide more than
routine or emergency treatment. Even within, the contiguous 48 States,
some agencies, such as the Forest Service, have duty posts where the-
only access is by light aircraft. Dependents are permitted at these
posts and there are times when medical. evacuation is needed. 'Employees
and dependents should not have to pay the often extraordinary transport-
ation and subsistence costs in order to get to a location where the -
proper medical care is available.
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United States.
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Thus, we believe this section of the bill. should be amen e
for transportation to the closest competent medical facility domesti-
cally to the sane extent that transportation would be provided in' a
foreign area, i.c., where there is no qualified person or facility at
or near the post to provide the necessary treatment.
We believe that the term "transportation` should be defined to include,
in addition to transporting people, payment for shipping prescription
medication not available locally, and medical devices and specialized
equipment (artificial limbs, braces, and the like) that may need
replacement or repair. -
Finally, we suggest that transportation be provided for emergency.
dental care and treatment if it is not available at the post.
Repeal of other statutes
The State Department`s letter of transmittal cites the fact that there
is a patchwork of legislative authorities that in total provide for
inequitable treatment of employees and dependents of some agencies_
The draft bill however, would continue the preferential treatment for
Foreign Service and CIA employees.. -We believe t1 hat these provisions-
should be repealed as well. They provide for fully paid medical care
and treatment for Foreign Service and CIA employees regardless of
whether quality treatment is available locally or whether the illnes.s
is job-related or not. The basic purpose of the Interagency Com.-1ir_tee's
work was to develop a rational approach which would insure equitable
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 be covered under PEHB plans. We believe that repeal of these statutes
is crucial to the accomplishment of the purpose of the draft bill-
You also asked that we indicate any cost of this draft bill for the
Office of Personnel Planagement. We have no employees in areas that -
would be covered by the bill, so this agency would effect no saving.
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Oat _ Failure
treatment for a employees ove sea
to repeal those provisions will not meet that desirable objective.
Rather, there will continue to be significantly different treatment
bet;;een employees of the foreign affairs agencies and CI,'t and employees
of other 'agencies.
The enactment of the provisions for the Foreign Service and the CIA
preceded the enactment of the Federal Employees Health Benefits program-
Since enactment of that program, there is no justifiable basis for
providing `ully subsidized medical care and treatment simply because an.-
employee and dependents are stationed in a foreign country, when many
foreign countries have excellent health facilities where treatment would
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