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The Bureau of Medical Services (BMS) was a unit of the
United States Public Health Service The United States Public Health Service (USPHS or PHS) is a collection of agencies of the Department of Health and Human Services concerned with public health, containing nine out of the department's twelve operating divisions. The Assistant S ...
(PHS) that existed in two incarnations. The first was one of three principal operating agencies of PHS from 1943 until 1966, while the second was a division of the PHS Health Services Administration from 1973 until 1982. Both incarnations of the bureau had the principal responsibility of operating the PHS hospital system that had been founded in 1789. Upon the formation of BMS in 1943, the system had already reached its peak of 30 hospitals, and this number decreased throughout BMS's existences as hospitals were closed. The first incarnation of BMS also had responsibilities in medical examination of foreigners entering the country, funding construction of hospitals by the states, researching the effective utilization of medical personnel and services, and providing healthcare to Native Americans. The original BMS was broken up at the beginning of the Public Health Service reorganizations of 1966–1973, but a second incarnation of BMS was established at their end as a division of the Health Services Administration within PHS. This incarnation of BMS inherited only the hospital system and closely related functions, with the other programs located in other divisions. The system reached its final number of nine in 1970, and the system was abolished in 1981 with all but one hospital transferred to other organizations. The bureau was merged with another division in 1982 to form the current Bureau of Primary Health Care. The other divisions of the original BMS now form the
Indian Health Service The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally-recognized Nativ ...
, part of the Healthcare Systems Bureau of the
Health Resources and Services Administration The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services located in North Bethesda, Maryland. It is the primary federal agency for improving access to health care services for peop ...
, the
Division of Global Migration and Quarantine The Division of Global Migration and Quarantine (DGMQ) is the part of the U.S. government responsible for U.S. Quarantine Stations and issuing quarantine orders. It is part of the National Center for Emerging and Zoonotic Infectious Diseases with ...
of the
Centers for Disease Control and Prevention The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georg ...
, and
Federal Occupational Health Federal Occupational Health (FOH) is a non-appropriated agency currently within the Program Support Center of the U.S. Department of Health and Human Services. It is the largest provider of occupational health services in the U.S. federal governm ...
within the
Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...
Program Support Center Program, programme, programmer, or programming may refer to: Business and management * Program management, the process of managing several related projects * Time management * Program, a part of planning Arts and entertainment Audio * Programm ...
.


As operating agency of the Public Health Service


Formation

The
Marine Hospital Service The Marine Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the United States Merchant Marine, the U.S. Coast Guard and other federal beneficiaries. The Marine Hospital Service evolved ...
, the predecessor of the U.S. Public Health Service (PHS), first divided itself into divisions in 1899. By 1943, PHS contained eight administrative divisions, plus the
National Cancer Institute The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. T ...
,
St. Elizabeths Hospital St. Elizabeths Hospital is a psychiatric hospital in Southeast, Washington, D.C. operated by the District of Columbia Department of Behavioral Health. It opened in 1855 under the name Government Hospital for the Insane, the first federally ope ...
, and
Freedmen's Hospital Howard University Hospital, previously known as Freedmen's Hospital, is a major hospital located in Washington, D.C., built on the site of the previous Griffith Stadium. The hospital has served the African-American community in the area for over ...
under the direct supervision of the Surgeon General. These divisions often had overlapping scopes, which was seen as administratively unwieldy. Additionally, some of these had been created and specified through several pieces of legislation that were inconsistent in their scope, while some had been created internally by PHS or delegated from its parent agency, the
Federal Security Agency The Federal Security Agency (FSA) was an independent agency of the United States government established in 1939 pursuant to the Reorganization Act of 1939. For a time, the agency oversaw food and drug safety, education funding, administration of ...
. A 1943 law () collected PHS's divisions into three operating agencies. These were the
National Institute of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1 ...
for laboratory research, the
Bureau of State Services The Bureau of State Services (BSS) was one of three principal operating agencies of the United States Public Health Service (PHS) from 1943 until 1966. The bureau contained the PHS divisions that administered cooperative services to U.S. states ...
for administering cooperative services to
U.S. state In the United States, a state is a constituent political entity, of which there are 50. Bound together in a political union, each state holds governmental jurisdiction over a separate and defined geographic territory where it shares its sov ...
s through technical and financial assistance, and the Bureau of Medical Services for direct patient care through hospitals and clinics. In 1943, BMS consisted initially of the Hospital Division, Foreign Quarantine Division, and Office of Nursing.  It also initially contained the Mental Hygiene Division, which was separated as the
National Institute of Mental Health The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the prima ...
and moved into the
National Institutes of Health The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1 ...
in 1949.


Hospital system

As of 1957, the hospital system provided free healthcare to merchant seamen; active and retired
Coast Guard A coast guard or coastguard is a maritime security organization of a particular country. The term embraces wide range of responsibilities in different countries, from being a heavily armed military force with customs and security duties to ...
personnel, officers of the PHS Commissioned Corps and
Coast and Geodetic Survey The United States Coast and Geodetic Survey (abbreviated USC&GS), known from 1807 to 1836 as the Survey of the Coast and from 1836 until 1878 as the United States Coast Survey, was the first scientific agency of the United States Government. It ...
, and their dependents; members of the general public with
leprosy Leprosy, also known as Hansen's disease (HD), is a long-term infection by the bacteria '' Mycobacterium leprae'' or '' Mycobacterium lepromatosis''. Infection can lead to damage of the nerves, respiratory tract, skin, and eyes. This nerve dam ...
or
narcotic The term narcotic (, from ancient Greek ναρκῶ ''narkō'', "to make numb") originally referred medically to any psychoactive compound with numbing or paralyzing properties. In the United States, it has since become associated with opiates ...
s addiction; and federal employees with compensable job-related illnesses and injuries.
Occupational health Occupational safety and health (OSH), also commonly referred to as occupational health and safety (OHS), occupational health, or occupational safety, is a multidisciplinary field concerned with the safety, health, and welfare of people at wor ...
programs for federal employees were part of the Division of Hospitals during most of the bureau's existence, but they were split out into a separate division for two brief periods, during 1947–1949, and 1966–1967. In 1943, the hospital system had reached its peak of 30 hospitals. During 1944–1953, a wave of closings eliminated nine of the ten Marine Hospitals that had not been upgraded since the 1920s, the
Savannah A savanna or savannah is a mixed woodland-grassland (i.e. grassy woodland) ecosystem characterised by the trees being sufficiently widely spaced so that the canopy does not close. The open canopy allows sufficient light to reach the ground to ...
hospital being the sole exception. In addition, the general hospitals in
Louisville Louisville ( , , ) is the largest city in the Commonwealth of Kentucky and the 28th most-populous city in the United States. Louisville is the historical seat and, since 2003, the nominal seat of Jefferson County, on the Indiana border. ...
, Kirkwood, and Cleveland, and the tuberculosis sanatorium at
Fort Stanton Fort Stanton was a United States Army fort near Lincoln, New Mexico. Army Fort It was built in 1855 by the 1st Dragoon and the 3rd and 8th Infantry Regiments to serve as a base of military operations against the Mescalero Apaches. Numerous ca ...
were closed, and
Freedmen's Hospital Howard University Hospital, previously known as Freedmen's Hospital, is a major hospital located in Washington, D.C., built on the site of the previous Griffith Stadium. The hospital has served the African-American community in the area for over ...
was transferred to
Howard University Howard University (Howard) is a Private university, private, University charter#Federal, federally chartered historically black research university in Washington, D.C. It is Carnegie Classification of Institutions of Higher Education, classifie ...
. As of 1957, the Division of Hospitals operated 13 hospitals, 24 outpatient clinics, plus two neuropsychiatric hospitals and the National Leprosarium, and contracted with 155 other locations. In 1965, there were 12 general hospitals and the 3 special hospitals.


Other functions

The Foreign Quarantine Division provided examination and vaccination of foreigners entering the country, as well as pest control programs for ships and airplanes. The Division of Health Facilities Construction was established in 1947.  In 1949, the Division of Hospital Facilities was transferred from Bureau of State Services, and they were merged into the Division of Hospital and Medical Facilities in 1955.  This division was transferred back to the Bureau of State Services around 1960. The division's function was to fund construction of hospitals by the states through the
Hill–Burton Act The Hospital Survey and Construction Act (), commonly known as the Hill–Burton Act, is a U.S. federal law passed in 1946, during the 79th United States Congress. It was sponsored by Senator Harold Burton of Ohio and Senator Lister Hill of Alab ...
, and research into effective utilization of hospital facilities. In 1949, Divisions of Medical and Hospital Resources, Dental Resources, and Nursing Resources were established.  The Division of Hospital and Medical Resources was abolished in 1953, and the latter two mere merged into their counterparts in the Bureau of State Services in 1960. These divisions researched the effective utilization of dental and nursing personnel and services. The Division of Indian Health was acquired from
Bureau of Indian Affairs The Bureau of Indian Affairs (BIA), also known as Indian Affairs (IA), is a United States federal agency within the Department of the Interior. It is responsible for implementing federal laws and policies related to American Indians and Al ...
in 1955.


Reorganization period

BMS was abolished at the beginning of 1967 in the first of four major reorganizations of PHS. Most of BMS's divisions joined with the
Bureau of State Services The Bureau of State Services (BSS) was one of three principal operating agencies of the United States Public Health Service (PHS) from 1943 until 1966. The bureau contained the PHS divisions that administered cooperative services to U.S. states ...
' Community Health Divisions to form the Bureau of Health Services in 1967, and then became part of the Health Services and Mental Health Administration (HSMHA) in 1968. The Division of Hospitals became the Federal Health Programs Service, the Division of Indian Health became the
Indian Health Service The Indian Health Service (IHS) is an operating division (OPDIV) within the U.S. Department of Health and Human Services (HHS). IHS is responsible for providing direct medical and public health services to members of federally-recognized Nativ ...
, and the Division of Hospital and Medical Facilities became the Health Facilities Planning and Construction Service. The Division of Foreign Quarantine, however, was taken over by the Communicable Disease Center in 1967 to eventually become its
Division of Global Migration and Quarantine The Division of Global Migration and Quarantine (DGMQ) is the part of the U.S. government responsible for U.S. Quarantine Stations and issuing quarantine orders. It is part of the National Center for Emerging and Zoonotic Infectious Diseases with ...
. A second wave of hospital closings during 1965–1970 closed the three remaining general hospitals at inland locations along the
Mississippi River The Mississippi River is the second-longest river and chief river of the second-largest drainage system in North America, second only to the Hudson Bay drainage system. From its traditional source of Lake Itasca in northern Minnesota, it fl ...
and
Great Lakes The Great Lakes, also called the Great Lakes of North America, are a series of large interconnected freshwater lakes in the mid-east region of North America that connect to the Atlantic Ocean via the Saint Lawrence River. There are five lakes ...
, as well as the Savannah hospital. In addition, the psychiatric hospitals at Lexington and
Fort Worth Fort Worth is the List of cities in Texas by population, fifth-largest city in the U.S. state of Texas and the List of United States cities by population, 13th-largest city in the United States. It is the county seat of Tarrant County, Texas, T ...
, as well as
St. Elizabeths Hospital St. Elizabeths Hospital is a psychiatric hospital in Southeast, Washington, D.C. operated by the District of Columbia Department of Behavioral Health. It opened in 1855 under the name Government Hospital for the Insane, the first federally ope ...
, were transferred to other organizations, and the
Galveston Galveston ( ) is a coastal resort city and port off the Southeast Texas coast on Galveston Island and Pelican Island in the U.S. state of Texas. The community of , with a population of 47,743 in 2010, is the county seat of surrounding Galves ...
hospital was replaced with one acquired by PHS in nearby Nassau Bay. This left eight general hospitals in the system, along with the National Leprosarium. HSMHA was broken up in 1973. The Federal Health Programs Service became a new Bureau of Medical Services within the Health Services Administration (HSA), and the Indian Health Service was also moved into HSA. The Health Facilities Planning and Construction Service merged with the Community Health Service (which had come from the Bureau of State Services) to form the Bureau of Health Resources Development within the Health Resources Administration (HRA). The Indian Health Service would later be promoted to operating agency status in 1988.


As division of the Health Services Administration

The second incarnation of the Bureau of Medical Services was strictly the successor of the old Division of Hospitals rather than the entire old bureau, as the other divisions were placed elsewhere in PHS. In 1980, BMS ran eight general hospitals in
Boston Boston (), officially the City of Boston, is the state capital and most populous city of the Commonwealth of Massachusetts, as well as the cultural and financial center of the New England region of the United States. It is the 24th- most p ...
,
Staten Island Staten Island ( ) is a borough of New York City, coextensive with Richmond County, in the U.S. state of New York. Located in the city's southwest portion, the borough is separated from New Jersey by the Arthur Kill and the Kill Van Kull a ...
,
Baltimore Baltimore ( , locally: or ) is the most populous city in the U.S. state of Maryland, fourth most populous city in the Mid-Atlantic, and the 30th most populous city in the United States with a population of 585,708 in 2020. Baltimore was ...
,
Norfolk Norfolk () is a ceremonial and non-metropolitan county in East Anglia in England. It borders Lincolnshire to the north-west, Cambridgeshire to the west and south-west, and Suffolk to the south. Its northern and eastern boundaries are the North ...
,
New Orleans New Orleans ( , ,New Orleans
Nassau Bay,
San Francisco San Francisco (; Spanish for " Saint Francis"), officially the City and County of San Francisco, is the commercial, financial, and cultural center of Northern California. The city proper is the fourth most populous in California and 17th ...
, and
Seattle Seattle ( ) is a seaport city on the West Coast of the United States. It is the seat of King County, Washington. With a 2020 population of 737,015, it is the largest city in both the state of Washington and the Pacific Northwest region of ...
, plus 28 outpatient clinics and the National Leprosarium. It also included separate divisions for Coast Guard medical services, federal employee occupational health, and emergency medical services. The PHS hospital system had been the target of efforts to close the entire system since the mid-1970s, but these efforts were hampered by a federal law that required the system to be funded to at least the 1973 level, and the opposition of Senator
Warren Magnuson Warren Grant "Maggie" Magnuson (April 12, 1905May 20, 1989) was an American lawyer and politician who represented the state of Washington in Congress for 44 years, first as a Representative from 1937 to 1944, and then as a senator from 1944 to 19 ...
, who retired in 1980. This law was repealed in 1981 as the result of pressure from the
Reagan administration Ronald Reagan's tenure as the 40th president of the United States began with his first inauguration on January 20, 1981, and ended on January 20, 1989. Reagan, a Republican from California, took office following a landslide victory over ...
. This forced the end of PHS hospital system by the end of 1981, with the last eight hospitals transferred to other organizations. The Reagan Administration's intention was to completely close the hospitals that were in poorer condition, but this faced opposition from local groups concerned about decreases in hospital capacity. The administrator of the Seattle Hospital even refused to stop admitting patients even after being specifically directed to do so by authorities in Washington, leading to a confrontation between him and eight federal inspectors. The opposition led to Congress approving additional funds to improve the hospitals to state and local standards, so they could continue to be operated by other agencies or organizations. Ultimately, five hospitals were transferred to non-governmental entities, two to the
Department of Defense Department of Defence or Department of Defense may refer to: Current departments of defence * Department of Defence (Australia) * Department of National Defence (Canada) * Department of Defence (Ireland) * Department of National Defense (Philippi ...
, and one to the State of
Louisiana Louisiana , group=pronunciation (French: ''La Louisiane'') is a state in the Deep South and South Central regions of the United States. It is the 20th-smallest by area and the 25th most populous of the 50 U.S. states. Louisiana is border ...
. PHS would however continue to operate the National Leprosarium until 1999. In 1982, the Health Services Administration merged with the Health Resources Administration to form the
Health Resources and Services Administration The Health Resources and Services Administration (HRSA) is an agency of the U.S. Department of Health and Human Services located in North Bethesda, Maryland. It is the primary federal agency for improving access to health care services for peop ...
. As part of the merge, the Bureau of Medical Services merged with the Bureau of Community Health Services to form the Bureau of Health Care Delivery and Assistance, which was renamed the Bureau of Primary Health Care in 1992. The Division of Federal Occupational Health remained in the merged bureau, but by 2003, it had been transferred to the
Program Support Center Program, programme, programmer, or programming may refer to: Business and management * Program management, the process of managing several related projects * Time management * Program, a part of planning Arts and entertainment Audio * Programm ...
, part of the Office of the Assistant Secretary for Administration.


Hospitals

This is a list of Public Health Service hospitals active after 1943. For a list including hospitals that ceased operating prior to 1943, see
List of U.S. Marine Hospitals This is a list of U.S. Marine Hospitals and Public Health Service Hospitals that operated during the system's existence from 1798 to 1981. The primary beneficiary of the hospitals were civilian mariners known as the Merchant Marine, although they ...
. The links are to the hospital rather than the city. They are grouped by the date that they were closed, transferred to another organization, or downgraded to a clinic. * 1999: ** Carville, Louisiana ( National Leprosarium) * 1981: ** Boston **
Staten Island Staten Island ( ) is a borough of New York City, coextensive with Richmond County, in the U.S. state of New York. Located in the city's southwest portion, the borough is separated from New Jersey by the Arthur Kill and the Kill Van Kull a ...
** Baltimore ** Norfolk ** New Orleans ** Nassau Bay, Texas **
San Francisco San Francisco (; Spanish for " Saint Francis"), officially the City and County of San Francisco, is the commercial, financial, and cultural center of Northern California. The city proper is the fourth most populous in California and 17th ...
**
Seattle Seattle ( ) is a seaport city on the West Coast of the United States. It is the seat of King County, Washington. With a 2020 population of 737,015, it is the largest city in both the state of Washington and the Pacific Northwest region of ...
* 1965–1970: ** Savannah **
Detroit Detroit ( , ; , ) is the largest city in the U.S. state of Michigan. It is also the largest U.S. city on the United States–Canada border, and the seat of government of Wayne County. The City of Detroit had a population of 639,111 at ...
** Memphis ** Chicago ** Galveston ** Washington, D.C. (
St. Elizabeths Hospital St. Elizabeths Hospital is a psychiatric hospital in Southeast, Washington, D.C. operated by the District of Columbia Department of Behavioral Health. It opened in 1855 under the name Government Hospital for the Insane, the first federally ope ...
) ** Lexington (psychiatric hospital) **
Fort Worth Fort Worth is the List of cities in Texas by population, fifth-largest city in the U.S. state of Texas and the List of United States cities by population, 13th-largest city in the United States. It is the county seat of Tarrant County, Texas, T ...
(psychiatric hospital) * 1944–1953: ** Washington, D.C. (
Freedmen's Hospital Howard University Hospital, previously known as Freedmen's Hospital, is a major hospital located in Washington, D.C., built on the site of the previous Griffith Stadium. The hospital has served the African-American community in the area for over ...
) ** Manhattan Beach, Brooklyn, New York ** Cleveland ** Fort Stanton, New Mexico (tuberculosis sanatorium) ** Kirkwood, Missouri **
Vineyard Haven, Massachusetts Vineyard Haven is a community within the town of Tisbury, Massachusetts on the island of Martha's Vineyard. It is listed as a census-designated place (CDP) by the U.S. Census Bureau with a population of 2,114 as of the 2010 census. The area was ...
**
Mobile, Alabama Mobile ( , ) is a city and the county seat of Mobile County, Alabama, United States. The population within the city limits was 187,041 at the 2020 census, down from 195,111 at the 2010 census. It is the fourth-most-populous city in Alabama, ...
**
Portland, Maine Portland is the largest city in the U.S. state of Maine and the seat of Cumberland County. Portland's population was 68,408 in April 2020. The Greater Portland metropolitan area is home to over half a million people, the 104th-largest metropo ...
** San Juan, Puerto Rico **
Ellis Island Immigrant Hospital The Ellis Island Immigrant Hospital (also known as USPHS Hospital No. 43) was a United States Public Health Service hospital on Ellis Island, in New York Harbor, that operated from 1902 to 1951. The hospital is part of the Statue of Liberty Nat ...
** Neponsit, New York ** Buffalo **
Pittsburgh Pittsburgh ( ) is a city in the Commonwealth of Pennsylvania, United States, and the county seat of Allegheny County. It is the most populous city in both Allegheny County and Western Pennsylvania, the second-most populous city in Pennsylv ...
** Evansville, Indiana **
Louisville Louisville ( , , ) is the largest city in the Commonwealth of Kentucky and the 28th most-populous city in the United States. Louisville is the historical seat and, since 2003, the nominal seat of Jefferson County, on the Indiana border. ...


Chiefs

The Chief of the Bureau of Medical Services was one of the positions holding the title of Assistant Surgeon General. This list only contains chiefs of the original, operating-agency-level BMS. * Ralph C. Williams (1943–1951) * Jack Masur (1951–1956) * John W. Cronin (1956–1958) * James V. Lowry (1958–1964) * Leo J. Gehrig (1964–1965) * Carruth J. Wagner (1965–1966)


References

{{Reflist Historical agencies of the United States Public Health Service