Executive Order  No. 50: (1st Series) Civil defense and emergency regulations for hospitals and hospital service

WHEREAS, the prosecution of the existing war between the United States and certain foreign countries may result in enemy action, certain operations undertaken to deal with such action or the danger thereof or other activities causing unusual hardship and distress to civilians, including injury and illness; and

WHEREAS, the Government of the United States, acting through the Office of Civilian Defense and other agencies, has requested that the hospital facilities of the Commonwealth and the several counties be organized and prepared to care for civilians suffering illness or injuries as a result of such action, operations or activities and has indicated that it will contribute to the payment of the cost thereof; and

WHEREAS, it is both desirable and necessary that the available resources of any or all of the hospitals operated by the Commonwealth and the several districts thereof be organized and activated to receive and care for civilians suffering injury or illness from such action, operations or activities notwithstanding that certain of said hospitals are operated exclusively to receive, care for and administer to persons suffering from particular injuries and illnesses; and

WHEREAS, in the interest of the public health, safety and welfare authority to deal effectively and adequately with the consequences of such enemy action or such operations or other activities should be granted forthwith so that appropriate preparatory action may be undertaken without delay:

NOW, THEREFORE, I, Leverett Saltonstall, Governor of the Commonwealth of Massachusetts, acting under the provisions of Acts of 1941, chapter 719, Acts of 1942, chapter 13, sections 2 and 3, and all other authority vested in me, do hereby issue this order as a measure necessary and expedient for meeting the supreme emergency of the existing state of war be- tween the United States and certain foreign countries.

1. The following phrases as used in this order shall have the following meanings unless the context otherwise requires:

(A) "Civilian war casualty," any civilian who is injured or becomes ill as a result of (1) any enemy action; (2) any action taken by the military, naval or air forces of the United States or of the Commonwealth to resist or avoid enemy action; (3) any action taken in connection with a blackout, air raid alarm or other authorized protective or preventive measure; (4) any action taken by saboteurs or enemy agents.

(B) "Civilian hospital evacuee," any civilian who, hospitalized in any hospital within the Commonwealth for any cause, is ordered by the director of the medical division of the Massachusetts Committee on Public Safety to be removed from such hospital because such hospital has been or is likely to be damaged by enemy action, including action by saboteurs or because the facilities of all or any part of such hospital are required or desired for the care of war casualties or otherwise.

(C) "Emergency base hospital," that portion of any hospital under the control of the Department of Public Welfare, the Department of Public Health, the Department of Mental Health or the trustees of any hospital district established in any county which is organized or activated for the reception, care and treatment of civilian war casualties or civilian hospital evacuees in accordance with the provisions of this order.

2. The Commissioners of the Departments of Public Welfare, Public Health and Mental Health are hereby severally authorized, and the trustees of any hospital district established in any county are hereby authorized, to make arrangements and to enter into agreements in accordance with the provisions of this order with the director of the medical division of the Massachusetts Committee on Public Safety, subject to the approval of the executive director of said committee and the Governor, for the use of any hospital or part thereof within the control of said departments or districts as an emergency base hospital for such period of time as may be determined by said commissioners or trustees and said medical director.

3. The director of the medical division of the Massachusetts Committee on Public Safety shall direct, control and supervise, in accordance with the provisions of this order, the admission to and the discharge from every emergency base hospital of all persons admitted thereto and the evacuation of all civilian hospital evacuees for transfer to an emergency base hospital or to any other place of refuge. The director of the medical division of the Massachusetts Committee on Public Safety may require each emergency base hospital to keep such uniform records of the admission, care, treatment and discharge of all persons admitted thereto as he may deem advisable, and he may prescribe uniform rules and regulations therefor.

4. The superintendent of any hospital in which an emergency base hospital is established shall be in charge thereof and shall be designated as the administrator thereof. Except as otherwise provided in this order he shall exercise the same degree of control over the operation of the emergency base hospital as is exercised by him over the operation of the hospital in which said emergency base hospital is established. Likewise, he shall be charged with the same responsibility therefor.

5. The medical staff of an emergency base hospital shall consist of such members of the medical staff of the hospital within which such emergency base hospital is established as the superintendent thereof may from time to time assign thereto, together with such doctors of the United States Public Health Service as the Surgeon General of such Public Health Service, upon the request of the director of the medical division of the Massachusetts Committee on Pubic Safety, may from time to time assign thereto. Such doctors of the United States Public Health Service, acting as members of the staff of any emergency base hospital, shall be under the supervision of the administrator thereof and they shall receive no sustenance, quarters, compensation or other reimbursement for their services from the Commonwealth of Massachusetts or from any department, division, district or political subdivision thereof.

6. The nurses and the technical, administrative, domestic or other employees needed for the operation of an emergency base hospital shall be such nurses and such other employees of the hospital in which the emergency base hospital is established as the superintendent thereof may from time to time assign thereto, together with such other additional nurses and such additional technical, administrative, domestic or other employees as the superintendent may from time to time appoint. Any such additional appointments shall be temporary and at the discretion of the superintendent of such hospital and shall not be subject to chapter 31 of the General Laws. The compensation of such additional nurses and such additional technical, administrative, domestic or other employees shall be fixed by said superintendent.

7. The Commissioners of the Departments of Public Welfare, Public Health, Mental Health and the trustees of every hospital district established in any county or counties may accept beds, mattresses or other hospital equipment from the United States Office of Civilian Defense for use in any emergency base hospital or for storage in any building or space under his or their control, and shall release the same to the Office of Civilian Defense upon demand, but shall not pay any charge for rent, use, wear, depletion or destruction of any such equipment.

8. Such sums as may be allocated by the Governor or appropriated by the General Court to the use of the Departments of Public Welfare, Public Health, Mental Health or the trustees of any hospital district for the purchase of hospital supplies for emergency base hospitals established within hospitals under the control of said departments or of any district may be used by the Commissioner of any such department or the trustees of any such district to purchase, in accordance with the rules and regulations governing purchases by such departments or districts, such supplies, exclusive of beds, mattresses and such other hospital equipment as may be sufficiently furnished by the United States Office of Civilian Defense, as may be determined by the director of the medical division of the Massachusetts Committee on Public Safety. Such hospital supplies as may be purchased by any of the aforesaid Commissioners or trustees, in accordance with this order, shall be kept in a convenient and safe location and shall be used in any emergency base hospital under the control of said department or district when the same are needed. Said supplies and equipment shall at all times remain in the control of the department or district for which they were purchased and may be used by said department or district when no longer required for use in the emergency base hospital.

9. Hospital supplies and equipment used in an emergency base hospital, exclusive of the beds, mattresses, and such other hospital equipment as may be sufficiently furnished by the United States Office of Civilian Defense, shall be supplied by the hospital in which the emergency base hospital is established and by the department of the Commonwealth or district which maintains said hospital.

10. The Commissioners of the Departments of Public Welfare, Public Health, Mental Health are hereby severally authorized, and the trustees of any hospital district established in any county are hereby authorized, to enter into agreements with any public or private hospital or with any individual or corporation for the lease of such medical or hospital sup- plies or equipment as may be approved by the director of the medical division of the Massachusetts Committee on Public Safety for such period of time as may be approved by the Governor. Every such agreement shall describe and identify the supplies and equipment leased thereby with all practical detail and shall provide for the return of said supplies and equipment at the termination of the lease in substantially the same condition that the same were in at the inception of the lease. Every such agreement shall further provide for the payment of compensation to the lessor for the depletion, depreciating use, damage or destruction of the property leased thereby. Such compensation shall be paid from any funds allocated therefor by the Governor or appropriated by the General Court and shall be determined by the director of the medical division of the Massachusetts Committee on Public Safety, subject, however, to the approval of the Governor and Council. Any lessor of supplies and equipment so leased, to whom no compensation is awarded or who is dissatisfied with the amount awarded him, may have the same determined in accordance with the provisions of chapter 79 of the General Laws.

11. The cost of feeding the patients and personnel of every emergency base hospital shall be determined by the superintendent of the hospital within which such emergency base hospital is established, subject to the approval of the Commissioner of the department or of the trustees of the hospital district having control of such hospital.

12. Such sums as may be allocated by the Governor or appropriated by the General Court to the use of the Departments of Public Welfare, Public Health, Mental Health or the trustees of any hospital district for the compensation of such additional nurses and additional technical, administrative, domestic or other employees of any emergency base hospital, and for feeding the patients and personnel of any such hospital, may be used by said Commissioners or trustees for such compensation and food, and any balance remaining shall be returned to the Commonwealth.

13. Every state, county or district hospital shall receive and care for any civilian hospital evacuee, civilian war casualty, or military war casualty until such person can be dis- charged or transferred to an emergency base hospital or to any other hospital.

14. The director of the medical division of the Massachusetts Committee on Public Safety shall make claim against the Government of the United States for reimbursement for the cost of the care and treatment provided for patients in emergency base hospitals, and such medical director shall be furnished by the administrator of every emergency base hospital and by the Commissioner of the department and the trustees of the hospital district having control of said hospitals, with such information and records as he may request and as may be necessary to make such claim.

15. Funds paid or advanced to the Commonwealth or to any department thereof by the Government of the United States or any agency thereof by way of reimbursement or advancement for the cost of care and treatment provided or to be provided in emergency base hospitals pursuant to the provisions of this order shall be paid over to the State Treasurer forthwith and may be expended without specific appropriation.

16. Funds advanced to any hospital district of the Commonwealth by the Government of the United States or any agency thereof for the cost of care and treatment to be provided by emergency base hospitals pursuant to the provisions of this order shall be paid over to the county treasurer forthwith and may be expended without specific appropriation.

17. The receipt by any person of any assistance whatsoever pursuant to this order, including in such term temporary removal from his place of residence or from any hospital in which he may be a patient, shall not be deemed or held to affect in any manner the acquisition or retention of settlement rights of such person in any city or town of the Commonwealth.

GIVEN at the Executive Chamber in Boston, this sixth day of January, in the year of our Lord one thousand nine hundred and forty-three, and of the Independence of the United States of America, the one hundred and sixty-seventh.

By His Excellency the Governor,
Leverett Saltonstall

Frederic W. Cook,
Secretary of the Commonwealth