Number 2 July 20, 1970

Number 2 July 20, 1970 Mr. John P. Harrington, Superintendent Soldiers' Home in Holyoke Holyoke, Massachusetts 01040 Dear Mr. Harrington: You have requested my opinion with respect to five questions relating to the Soldiers' Home in Holyoke which have arisen as a result of the amendment of G. L. c. 6, § 71 by c. 470 of the Acts of 1969. General Laws c. 6, § 71, as amended, provides in pertinent part: "Said board of trustees [of the Soldiers' Home] shall have the management and control of said home ... In the man- agement and control of said home as aforesaid, said board of trustees shall (I) adopt, issue and promulgate reasonable rules and regulations governing outpatient treatment at, admission to, and hospitalization in, said home, and (2) appoint a superintendent and a medical director. The superintendent shall be the administrative head of the home and in charge of the domiciliary facilities but shall not have any control or supervision of the hospital, medical, surgical and outpatient facilities therein. He shall, subject to the approval of the board of trustees, appoint and may remove a treasurer and assistant treasurer, each of whom shall give bond for the faithful performance of his duties . . . The medical director shall be the head of the hospital and in charge of the medical, surgical and outpatient facilities. He shall appoint and may remove such physicians, nurses and othe'r medical staff as he P.D. 12 35 deems necessary for the proper and efficient operation of the facilities of the home under his charge and supervision . . ." For convenience, I will consider your questions as they appear in your request. 1. Your first question relates to that part of § 71 which states that "The superintendent shall be the administrative head of the home . . ." You ask whether the word "home" as used in this context connotes the Soldiers' Home in Holyoke "as the complete and entire state agency." I am of the opinion that the question requires no extended discussion, and I answer this question in the affirmative. 2. Your second question relates to that part of § 71 which provides as follows: "... The medical director shall be the head of the hospital and in charge of the medical, surgical and outpatient facilities. He shall appoint and may remove such physicians, nurses and other medical staff as he deems necessary for the proper and efficient operation of the facilities of the home under his charge and supervision ..." You ask whether the word "home" as used in this context refers only to the hospital section within the entire state agency, viz., the Soldiers' Home in Holyoke. The word "home" here means the entire state agency but in this context it is limited by the words "operation of the facilities . . . under his charge and supervision." Accordingly, the medi- cal director is the head of the hospital and in charge of the medical, sur- gical and outpatient facilities within the "home." Since questions one and two are answered in the affirmative, you ask in an unnumbered question whether the personnel who are in the hospi- tal, including the medical director, are subject to the administrative di- rection of the superintendent when said direction is not related to the professional care of patients. It is clear from a reading of § 71, as amended, that the superintendent is the administrative head of the Soldiers' Home in Holyoke. Thus, he is responsible for the management and operation of the entire home on an administrative level. However, the same section expressly provides that he shall not have control or supervision of the hospital, medical, surgical and outpatient facilities. Supervision of the hospital and other medical facilities is delegated to the medical director. Accordingly, in answer to your unnumbered question, it is my opinion that while the superinten- dent is responsible for the administration of the home, he cannot, in the performance of his duties, interfere in the control and supervision of the hospital or other medical facilities. I am unable, absent more facts, to give a more definite answer to your question, and it would appear that disputes as to control or supervision of personnel who are in the hospital relating to matters other than the professional care of patients would have to be resolved on a case by case basis, bearing in mind the division of powers and duties between the superintendent and medical director as set forth in G. L. c. 6, § 71. 36 P.D. 12 3. As the basis of your third question, you state that presently the superintendent certifies under the penalties of perjury that all vouchers processed for payment and charged against appropriations are true and correct and that there has been compliance with all laws of the Com- monwealth governing the disbursement of public funds. Since the superintendent, under the provisions of § 71, as amended, now has no control over the hospital and medical facilities, you ask whether the said superintendent will be held accountable and responsible and must certify under the penalties of perjury with respect to expenditures of state funds for the operation of a facility over which he has no control or supervi- sion or whether two separate appropriations are necessary. As the administrative head of the entire home with the power to ap- point and remove a treasurer and an assistant treasurer, the superinten- dent has the ultimate responsibility for the fiscal operation and manage- ment of the entire home, including the medical facilities. It is my opinion that the superintendent can determine whether expenditures made for the benefit of the medical facilities are true and correct without interfer- ing with the medical director's supervision of the hospital and other medical facilities. Accordingly, the superintendent must certify as to all expenditures and there is no need for two separate appropriations. 4. In your fourth question you state that in 1952 a determination was made that the nursing home and dormitory sections of the Soldiers' Home comprised the domiciliary unit of the home and the acute medical and surgical wards comprised the hospital unit. This determination was apparently made by the board of trustees in order to qualify for Federal aid to state homes, and you now ask whether the nursing home section still remains a part of the domiciliary unit. Since the board of trustees have the management and control of the home and are responsible for adopting rules governing out-patient treat- ment at, admission to, and hospitalization in, said home, it is my opinion that this is a question which must properly be determined by the board pursuant to its powers of managerial oversight found in G. L. c. 6, § 71. 5. In your fifth question you ask whether as administrative head of the home and the person in charge of the domiciliary facility of the home, you can direct or authorize the transfer of a member from the domiciliary unit to the hospital unit when, in your opinion, such a trans- fer is in the member's best interest. In my opinion, the answer to your fifth question is "no." Such a de- termination clearly involves a medical decision, and in this respect I note that the medical director has charge and control of the hospital unit. It is my further opinion that although the superintendent cannot direct or authorize the transfer of a member from the domiciliary unit to the hos- pital unit, he may certainly call a situation where such a transfer might be appropriate to the attention of the medical director and request him to make the determination. Finally, I note that the problems incident to P.D. 12 37 such a transfer could be dealt with by the promulgation of rules by the board of trustees pursuant to their rule-making powers referred to siiprn. Very truly yours, ROBERT H. QUINN Attorney General