The Office of the Attending Physician in the U.S. Congress

CRS Report for Congress
Received through the CRS Web
The Office of Attending Physician in the U.S.
Congress
Mildred L. Amer
Specialist in American National Government
Government and Finance Division
Summary
The Office of Attending Physician (OAP) was established by congressional
resolution in 1928 to meet the medical needs of Members of Congress.1 Over the years,
the services offered by the office have expanded. During the anthrax scare on Capitol Hill
in 2001, it coordinated all the testing of the Capitol complex as well as the care and
treatment of Members and staff who may have been exposed to the bacteria. The office
has always been headed by a naval officer who is a physician. Six Navy doctors have
served as attending physician.2 The staffing and funding of the office have traditionally
been shared by Congress and the Department of the Navy. For additional information,
please refer to CRS Report 96-585, Health Benefits for Members of Congress. This
report will be updated if there are major changes in the Office.
Services Offered. The mission of the OAP is to provide primary care, and
emergency, environmental, and occupational health services in direct support of Members
of Congress, staff, pages, visiting dignitaries, and tourists. The office also treats the
justices of the Supreme Court and maintains a liaison with military and civilian hospitals
to facilitate necessary referrals of patients requiring hospitalization.3


1 Although there was no medical office for Congress until 1928, an account of Senatorial privileges
in 1911 described the “readily accessible assortment of drugs and viands, tonics and recuperatives”
available [for Senators]. See Williard French, “Senatorial Privileges and Expenses,” The
Independent, June 15, 1911, p. 1304.
2 They have included Drs. George Calver (1928-1966), Rufus Pearson (1966-1973), Freeman
Carey (1973-1986), William Narva (1986-1990), Robert Krasner (1990-1994), and the current
physician, Dr. John Eisold, who was appointed in 1995.
3 Only incumbent Members of Congress may receive medical and emergency dental care in the
military hospitals in the Washington, D.C., area upon recommendation of the attending physician,
through long-standing approval by the secretaries of the various military branches or in their own
right as current members or former members of the military. Such treatment was first authorized
(continued...)
Congressional Research Service ˜ The Library of Congress

Early in his service, Dr. George Calver, the first attending physician, “started the
policy of an annual physical examination as a means of bettering the state of health of the4
Members of the House and Senate.” The five attending physicians who have succeeded
Dr. Calver have continued this tradition by offering examinations as well as a full range of
other services. However, only those Members and officers of Congress who pay an annual
fee are eligible for the variety of non-emergency care offered by the office.5
The Members and officers of the House and Senate who elect to receive routine care
are provided laboratory, X-ray, physical therapy, and electrocardiographic services, as well
as 24-hour assistance and referrals. They may also voluntarily establish medical records
and are encouraged to participate in a preventive health program through annual
examinations. Medical information is confidential, but will be sent to private physicians
upon request of the patient. In addition, the office:
!offers CPR and first aid instruction to congressional staff;
!cooperates, and when requested, participates with the Military District of
Washington, the chief of the Capitol Police, the architect of the Capitol,
and other appropriate officials in planning medical support for potential
disasters;
!is responsible for mitigating the medical consequences in the event of a
chemical/biological problem by providing a highly trained, readily
deployable, fully equipped team of medical professionals;
!provides medical support for inaugurations, joint sessions of Congress,
visiting heads of state, and other special events at the Capitol;
!serves as coordinator for various medical screening programs (including
drug testing), blood drives, bone marrow registries, and health fairs for
congressional staff;
!supervises the operation of six satellite first aid rooms located in the
Capitol complex that provide support to staff and tourists;
!administers allergy shots to staff, conditional upon their providing the
serum, and for a nominal fee, will give staff flu shots;
!provides Members and staff immunizations prior to official congressional
travel;
!has a highly trained medical response team and is responsible for all 911
calls in the Capitol complex; and
!provides tourists with emergency care services that vary from giving
minor first aid to assisting those suffering potentially life-threatening
emergencies.


3 (...continued)
by President Franklin Roosevelt. This treatment is not free of charge. For inpatient care, Members
are billed at the full reimbursable rate for the treatment they receive. Their health insurance (for
which they must also pay) may cover these expenses after a deductible and co-payment are met.
4 U.S. Congress, House Committee on Appropriations, Subcommittee on Legislative Branch
Appropriations, Legislative Branch Appropriations for 1964, hearings, 88th Congress, 1st session,
May 15, 1963 (Washington: GPO, 1964), p. 334.
5 Former Members of Congress are not eligible for routine services.

In 1996, Dr. John Eisold, the current attending physician, established a new triage,
emergency response team composed of the current Members of Congress who are
healthcare providers.6 This team could augment the OAP response to mass casualty
incidents.
In 1997, the office entered into an agreement with the capitol police to provide the
officers with physical examinations, thus eliminating the need to contract out for this
service. Also, the environmental and health division of the office manages programs which
evaluate and control environmental factors that may affect the health of persons who work
in or visit the Capitol and congressional office buildings. At one time, the office sold
prescription drugs, but that practice was discontinued in 1987.7
Creation of the Office. The OAP was established in 1928, following several
medical emergencies involving Members, three of whom died. In each case, there was a
lengthy delay before a doctor arrived. In the aftermath of those emergencies,
Representative Fred Britton (D-IL), chairman of the House Naval Affairs Committee,
consulted Speaker Nicholas Longworth about the placement of a Naval medical officer at
the Capitol.
Subsequently, on December 5, 1928, during the 70th Congress, Representative Britten
introduced House Resolution 253, which passed unanimously that same day.8 It stated:
Resolved, That the Secretary of the Navy is hereby requested to detail a
medical officer of the Navy to be in attendance at the Hall of the House of
Representatives during sessions of the House.
On December 8, 1928, the Secretary of the Navy assigned to this position Lieutenant
Commander George Calver, who was serving at the old Naval Dispensary in Washington.
He remained as attending physician until his retirement in October 1966. Dr. Calver
initially worked in the Democratic cloakroom and later was assigned office space in the
Capitol in rooms H-165 and H-166, where the office continues to be located.
In June 1929, Senator Royal Copeland (D-NY), who was also a doctor, introduced
Senate Concurrent Resolution 14 to request the Secretary of the Navy to detail a medical
officer for duty as a physician to both the House and the Senate, thus extending Dr.
Calver’s services to the Senate. The measure was referred to the Senate Naval Affairs
Committee, reported favorably, and passed unanimously by the Senate on April 7, 1930.9


6 Julie Eilperin, “Congress’s Own E.R.,” Roll Call, March 11, 1996, pp. 1, 33.
7 In 1975, at the recommendation of the General Accounting Office, a revolving fund was
established for the deposit of money received from sales of medicine in the office. However,
effective, October 30, 1987, the purchase and sale of prescription drugs was discontinued. U.S.
General Accounting Office, Revolving Funds, Office of Attending Physician Revolving Fund Can
Be Terminated, GAO/AFMD-8929 (Washington: GPO, 1988), p. 2.
8 “H.Res. 253,” Congressional Record, vol. 70, December 5, 1928, p. 101.
9 U.S. Congress, Senate Committee on Naval Affairs, Providing for the Detail of a Medical
Officer of the Navy for Duty as Physician to the Senate and House of Representatives, report to
(continued...)

Subsequently, it was referred to the House Committee on Accounts. Although neither the
committee nor the full House took action on that proposal, Dr. Calver later stated that after
Senate Concurrent Resolution 14 passed the Senate, the Secretary of the Navy ordered him10
to “look after both houses.” Since that time, the OAP has provided medical services to
both Representatives and Senators.
Until 1992, the OAP provided its services at no charge. Since the 102nd Congress as
part of an overall review of congressional benefits, Members have been required to pay for
prescriptions and routine medical care in the OAP.11
On April 9, 1992, the Senate adopted Senate Resolution 286, which established fees
for the routine services provided and directed the Senate Rules and Administration
Committee to promulgate regulations governing those services and the collection of fees.12
On May 1, 1992, the new fees were implemented in the Senate; and on June 17, 1992, the
Rules Committee adopted the regulations. These regulations require the Secretary of the
Senate to collect fees for services received from the OAP as well as for the use of the
Senate health and fitness facilities.
Also on April 9, 1992, the House adopted administrative reform legislation that
included provisions requiring the House Administration Committee, in consultation with
the Speaker, to eliminated various “perquisites of the House.”13 Included in the
committee’s review were the services of the attending physician. Subsequently, in October
1992, the committee instituted a fee for Members receiving routine care from the attending
physician as well as those using the House health and fitness facility.
In the FY1993 Legislative Branch Appropriations Act, the House established an
account for the deposit of fees received from Members and officers for services provided14
them by the attending physician. The amounts deposited are to be available for the
operations of the OAP. In the same law, the Secretary of the Senate was first authorized
to withhold fees from the salaries of Members and officers of the Senate who use the
services of the attending physician and to remit such fees to the U.S. Treasury.15


9 (...continued)
accompany S.Con.Res. 14, 71st Congress, 2nd session, S.Rept. 71-328 (Washington: GPO, 1930);
and “Medical Officer for Senate and House,” Congressional Record, vol. 72, April 7, 1930, p.

6606.


10 U.S. Congress, House Committee on Appropriations, Subcommittee on Legislative Branch
Appropriations, Legislative Branch Appropriations for 1964, hearings, 88th Congress, 1st session,
May 15, 1963 (Washington: GPO, 1964), p. 334.
11 Kenneth Cooper and Helen Dewar, “Congress Cuts Perks,” Washington Post, April 4, 1992, pp.
A1, A7; and Karen Foerstel, “Perk Panic,” Roll Call, March 23, 1992, pp. 1, 20.
12 “Payment of Fees,” Congressional Record, vol. 138, April 9, 1992, p. 8925.
13 “Providing for Consideration of House Resolution 423, House Administrative Reform Resolution
of 1992,” Congressional Record, vol. 138, April 9, 1992, pp. 9030-9076.
14 P.L. 102-392, 106 Stat. 1710.
15 See 106 Stat. 1710, 1723.

Funding for the Office. The attending physician has been on the payroll of the
Navy. Since 1930, Congress has appropriated funds for the supplies and equipment needed
by the office.16 A survey of annual legislative branch appropriations acts since 1930
indicates that the expenses for the supplies and equipment in the office are in the section
of these acts labeled “Joint Items.”
Congress has also authorized allowances for the attending physician and active duty
Naval medical corpsmen who began assisting in the office in 1929. Those allowances are
for the civilian office attire required of those working in the office, cost of living
adjustments, and overtime pay expenses not covered by the Navy.
The allowance for assistants was first authorized in 1930.17 Over time, Congress has
increased the number of medical assistants in the Office of Attending Physician and the
amount of their annual allowances.18 It has been the recent practice for the attending
physician to request that increases in allowances and number of Navy personnel entitled to
receive such allowances be included in the annual legislative branch appropriations acts.19
The allowance for the attending physician (currently $1500 a month) was first authorized
in 1939.20


16 The first appropriation, for $750, was in the FY1931 Legislative Branch Appropriations Act
(P.L. 71-311, 46 Stat. 511). In its accompanying report, the Appropriations subcommittee said:
“Under provisions of House Resolution 253, approved December 5, 1928, a medical officer of the
Navy is detailed to the House of Representatives to be in attendance during sessions of the House.
The contingent fund has not heretofore been available for medical supplies and equipment for the
emergency room and the physician’s office and the committee is of the opinion that some amount
should be available for the purpose instead of relying entirely upon the Navy for such necessities.”
U.S. Congress, House Committee on Appropriations, Subcommittee on the Legislative Branch,
Legislative Appropriations Bill, Fiscal 1931, report to accompany H.R. 11965, 71st Congress, 2nd
session, H.Rept. 71-1320 (Washington: GPO, 1930), p. 3.
17 H.Res. 279 (71st Congress), from the Committee on Accounts stated: “That until otherwise
provided by law, there shall be paid out of the contingent fund of the House an allowance not to
exceed $30 per month each for two assistants in the office of the attending physician starting
December 1, 1929.” “Allowance to the Two Assistants in the Office of Attending Physician of the
House,” Congressional Record, vol. 72, July 1, 1930, p. 12212; and U.S. Congress, House
Committee on Accounts, Authorizing the Payment of An Allowance from the Contingent Fund ofstnd
the House to the Assistants in the Office of the Attending Surgeon, 71 Congress 2 session,
H.Rept. 71-2048 (Washington: GPO, 1930). The allowance was to be paid retroactively to those
assistants had been working since December 1929. The supplemental allowance first appeared in
the FY1932 Legislative Branch Appropriations Act (P.L. 71-691, 46 Stat. 1182).
18 Previously, the increases were in authorizing resolutions from the Committee on Accounts and
its successor, the Committee on House Administration (from 1947) with funds then included in the
annual legislative branch appropriations acts. Most recently, the FY2000 Legislative Branch
Appropriations Act (P.L. 106-57, 113 Stat. 416) provided for two additional technicians and
an allowance for an additional medical officer on the staff
19 The FY1956 Legislative Branch Appropriations Act (P.L. 84-242, 69 Stat. 512) raised the
assistants’ allowance for the first time, and there is no indication that the House Administration
Committee recommended the increase.
20 Second Deficiency Appropriation Act of FY1940 (P.L. 76-668, 54 Stat. 629).

Because the Navy felt that it was not receiving full reimbursement in its
appropriations for personnel assigned to the OAP, Congress in 1975 began the present
practice of reimbursing the Navy for expenses incurred for military personnel and vehicles21
assigned to the office. These reimbursements are credited to the Navy’s annual
appropriation. Congress, in the annual legislative branch appropriations acts, provides
reimbursements to the Navy as well as the allowances for personnel assigned to the OAP.
Personnel. The Office of Attending Physician has 17 Navy medical personnel as
well as one technical assistant who is the of chief of staff. He is appointed by the attending
physician, subject to the approval of the Speaker of the House and is on the payroll of the22
Clerk of the House.
There are also 14 nurses on the payroll of the Architect of the Capitol. They assist
the attending physician and staff the six health units located throughout the Capitol23
complex. Since January 1, 1975, all nurses hired have been required to be registered
nurses. 24
Recent Developments. In 2001, when anthrax tainted mail was discovered in the
Capitol complex, the Office of Attending Physician coordinated the response with the
Centers for Disease Control, the office of the U.S. Surgeon General, the Capitol Police,
and the Environmental Protection Agency. This response included extensive testing and
treatment of Members and staff who may have been exposed and the eradication of the
anthrax spores from the buildings where they were found. When the spores were initially
detected in mid-October, the office worked around the clock to establish staff testing
centers at several locations. Subsequently, the office was part of the team that devised the25


procedures for decontamination of the offices involved.
21 FY1975 Second Supplemental Appropriations Act, P.L. 94-32, 89 Stat. 185; and FY1976
Legislative Branch Appropriations Act, P.L. 94-59, 89 Stat. 283).
22 The position of administrative assistant was created in the FY1947 Legislative Branch
Appropriations Act (P.L. 79-479, 59 Stat. 633).
23 Dr. George Calver, the first attending physician, addressed the employment of nurses in
testimony before the House Legislative Branch Appropriations Subcommittee in 1963: “There were
restrooms provided for the women employees in each office building and the Capitol. These were
operated by ladies untrained in medical procedures. I gradually ... hired a trained nurse with
permission of the Speaker and the chairman of the committee or a similar authority in the Senate.”
U.S. Congress, House Committee on Appropriations, Subcommittee on Legislative Branch
Appropriations, Legislative Branch Appropriations for 1964, hearings, 88th Congress, 1st session,
May 15, 1963 (Washington: GPO, 1964), p. 334.
24 Pursuant to the FY1975 Supplemental Appropriations Act (P.L. 94-554, 88 Stat. 1777).
25 Avram Goldstein and Leef Smith, “Hundreds in Area Seek Anthrax Screenings,” Washington
Post, October 18, 2001, p. A18; and Damon Chappie and Mark Preston, “‘Doc’ Answers the Call
of Crisis,” Roll Call, October 22, 2001, pp. 1, 18.