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to inforce proper methods in the conduct of institutions and in the admission of inmates. Such a power is too great to intrust to any one man, but it might as properly be intrusted to a board as the power to regulate the admission to the public schools is intrusted to a board.

SELF-GOVERNMENT FOR TIIE DISTRICT OF COLUMBIA.

Moreover, the committee believes that the District of Columbia is entitled to the largest amount of self-government consistent with the supervision of Congress over all the concerns of the capital city. In the case of charities, where the appropriations already amount to nearly half a million dollars a year, it is quite as proper to have a board of charities as it is to have a board of school inspectors. The people of the District are keenly alive to the importance of such a centralizing agency to promote efficiency and to correct the present abuses. Before the committee came the secretary of the associated charities (a most efficient organization, wholly supported by residents of the District, that is constantly providing for the poor), who strongly advocated a board of charities, such as is in now in operation in New York, Massachusetts, Ohio, Minnesota, and other States.'

The charities committee of the Washington Board of Trade also advocated the establishment of a board of charities, and presented the draft of a bill that is less comprehensive and less detinite than that proposed by this committee.” A committee from the Washington Civic Center also appeared before the committee to advocate the establishment of a board, citing instances of lack of care for real dependents." The Medical Society of the District of Columbia, in a communication printed in connection with this report, urge the establishment of such a board to correct the serious abuses they point out in the administration of medical charities.4 The Board of Children's Guardians discuss the same question in its relation to their work among the dependent children and present strong arguments to prove the advantages of a general supervision of the instrumentalities for child-caring:5

THE NEED OF REGULATION SHOWN BY THE NUMBERS SEEKING AID.

The need of some system for dealing with the entire subject of Dis. trict charities is made apparent by the size of the figures representing the dependent population of Washington. During 1896 no fewer than 26,600 persons were treated in District hospitals, supported wholly or in part from the public treasury. Adding the number treated in dispensaries and by the physicians to the poor, the total number of persons receiving medical treatment in public institutions was 58,180, or about 21 per cent of the population. To this number should be

Hearings, p. 11.
2 Hearings, pp. 13 and 159.
3 Hearings, pp. 19-23.

4 See Appendix B.
• Hearings, pp. 149–158.

added 1,014 children in subsidized institutions, 1,342 women who were admitted to subsidized homes, and 6,547 men who were provided for at public expense, making a total of 67,083 persons who received care in institutions wholly or partly supported from Congressional appropriations. The meaning of these figures is that during four years a number of persons at least equal to the entire population of the District of Columbia receives public aid. Nor do these figures include the blind, the deaf and dumb, or the insane. Even if no abuse existed in the admission of persons to the institutions, still ordinary humanity would suggest that where such large numbers of people are cared for by public institutions there should be some regulation of such agencies, with a view to making them most effective.

INSTITUTIONS ('NABLE TO MAKE SUITABLE REGULATIONS.

It will not be seriously questioned-indeed, the authorities of the institutions admit—that grave abuses exist in the matter of providing for those who are abundantly able to provide for themselves. The difficulty, however, is beyond the power of any one institution to remedy; and so long as the size of Congressional appropriations is based on the number of persons cared for, so long will each institution endeavor to attract to its doors as many persons as possible. It is manifestly a wrong to the community thus to encourage imposition and fraud; and it is also a wrong to the taxpayer of the District and to the Treasury of the United States to allow so flagrant an abuse to continue.

REFORMS EFFECTED IN NEW YORK.

The question is, Will the proposed remedy be effective? The best answer to this is the experience of the State of New York. In the report of the State board of charities for 1896 (pp. 102-103) this statement is made:

The purpose of the constitutional provision, under which the board is empowered to make rules for the reception and retention at public charge of inmates of private charitable institutions, was to guard against improper admissions and unnecessary retention, and the test of efficiency in the rules adopted is the extent to which they answer this purpose. A sufficient trial has not as yet been given the new system to enable the board fairly to measure results, but the indications are favorable, for from the returns on file in the office of the department from the various institutions throughout the State for the care of orphan, dlestitute, and dependent children it appears that there has been a substantial decrease in the number of this interesting and numerous class of public beneficiaries. The returns show 13,152 admissions from January 1 to December 31, 1896, and during the same period 11,332 discharges, or an actual decrease of 880, to which should be added 368 that up to December 31 had been taken off the public pay roll, though still present in the institutions. This shows a net decrease of 1,248 in the number of inmates who were a public charge in the 120 reporting institutions.

The rules of the board were formulated with the view ofeffecting cooperation between this board, the supreine supervising authority, the officers of the private charities, the commissioners, superintendents, and other local officers of the poor, anl the finance departments or disbursing officers of the various localities.

SAVING EFFECTED.

In the city of New York, where this system was first inaugurated and this cooperation has been most fully established, it is conservatively estimated that the saving effected by the reduction thereunder in the number of (lependents is, during the short period in which it has been in operation, twentyfolel greater than the total expense incurred in its execution.

It is now several years since the New York commissioners of this board first began to call the attention of the board and the public to the annual increase of public dependents in the city institutions and the consequent enormous increase of the burden of expense. Previous to the adoption of the rules, the commissioners of charities had no authority over the dependents maintained in private charitable institutions at the expense of the city. Such inmates were admitted to the institutions either on commitment of a police justice or under the provisions of special acts without the intervention of any constituted authority representing the municipality, and were retained much at the pleasure of the officers of the institutions. There was absolutely no local supervisory authority, and it is not surprising that, under conditions calculated to foster dependence, the metropolis stands unrivaled throughout the world for the proportion of dependents to its population. The city generously accepted the maintenance of paupers from all over the world, and a more improvident system of public relief of destitution never elsewhere existed, or was so long maintained.

Vearly every nationality is represented in the population of the large city institutions, and the examination of the individual historical records of the children inmates suggests the confusion of tongues in biblical days. The jargon of names unmistakably betrays the fact that it is not entirely, or even principally, for the destitute or distressed of our own State or country that we are bearing the burdens of taxation, but that the fame of our generosity and careless methods has spread to nearly every corner of the habitable world. Where there was no supervision, it is not surprising that the number of private institutions and the number of their dependents inordinately extended, and it is in the expansion of the private charities that the great increase in the burden of providing for public dependents has accrued. It is possible that the institutions did not make strenuous efforts to reduce the number of their inmates when to do so meant a material reduction of income.

The State board of charities had not the full power to act then which came to it afterwards by the action of the constitutional convention. But the influence of special papers upon the subject, which first emanated from this board, was felt by other organizations and associations, so that, when the hour was ripe by the eclucation of the public mind and ly the access of additional powers conferred upon the board by article 8, section 14, of the constitution, action was at once taken, the results and the promise of which are extremely gratifying.

('OOPERATION MADE EFFECTIVE.

The cooperation between authorities sought to be effected by the rules has been very satisfactorily established in the city of New York. The accounts of the different institutions are given a rigid examination in the office of the comptroller, who insists in every instance that the certificate of this board that the institution has complied with the rules established by the board for the reception and retention of inmates, and also that the acceptances of the commissioners of charities of the persons for whose maintenance payment is desired, shall accompany the bill. In order that the commissioners can intelligently grant such certificates, they have employed a staff of six examiners, whose cluty consists of inquiry and investigation into the state and circumstances of the slependents, and of their claims through destitution and legal settlement upon the charitable of the city. To these otticers of the commission none whatever of the powers and duties of this board are delegated, but they remain solely the agents of the commissioners of charities for the purposes indicated.

It was at the urgent request of this board that the appointment of these examiners was made and funds provided by the boarel of estimate and apportionment for their compensation. The boaril regards as the most important of the rules it has estal)lished that which requires an acceptance from the local officer of the poor before any person, child or adult, can be admitted as a public charge upon the locality he терresents, and it is under this rule that the commissioners of charities have estal)lished, in their proper function, that of general supervision over all the charitable concerns of the city.

REJECTION OF INWORTILY APPLICANTS.

The results consequent upon the operation of this rule laid (lown by this board and enforced by the commissioners of the department of public charities of the city of New York in the period from March 1 to December 31, 1896, are the rejection, as public charges, of 3,761 cases of children and adults, and an estimated annual saving to the city of $450,000.

Previous successive years have been marked by a steadly increase of public dependents out of all proportion to the increase of population, but the present indications warrant a confident belief that the board has at last been able, through the additional powers conferred upon it by the constitution and law, to check the heretofore continually advancing tide of pauperism.

PARALLEL BETWEEN NEW YORK ANI) WASHINGTON.

The case of New York City, with its enormous iuflux of foreigners, is · paralleled by that of Washington, with the great numbers of persons who annually visit the seat of government to seek office, to prosecute claims, or to enjoy the privilege of free care and treatment for which the city has become noted throughout the land. It has come within the observation of the committee that children are sent to Washington from States beyond the Mississippi to enjoy free asylum and hospital privileges; the statistics of the hospitals show that the neighboring States take advantage of these privileges to a great degree, and the officers of institutions assert that in many instances patients are publicly assisted to come here.

It is stated that women have been known actually to spend three years in idleness in one public iustitution after another in the District, and the facilities for so doing are at band. Under the present system a womav may come to Washington and with perfect security from publicity may give birth to a child and then herself receive years of support, while her child, without her intervention, can be passed through a chain of institutions that support it for eighteen years, largely at the cost of the District! Such a system is as bad for the individual as it is for the community. While it may be impossible wholly to reform this abuse, yet it is possible to minimize it by suitable rules regulating the admissions and discharges to public institutions. As the discussion of the situation proceeds, other arguments for the establishment of a board of charities and the application of such a solution to existing problems will follow. The committee will now take up in some detail the questions submitted for its consideration in the act in accordance with which it was created.

..

SEOTARIAN INSTITUTIONS.

One question asked in the act is as follows:

What portion, if any, of appropriations heretofore made to them [institutions] has been used for the purpose of maintaining or aiding, luy payment for serrices, expenses, or otherwise, any church or religious denomination, or any institution or society which is under sectarian or ecclesiastical control!

The Providence Hospital is owned by the Sisters of Charity of Emmetsburg, Md., and is conducted by them. The institution is not primarily a charitable institution. Persons seeking hospital care are admitted at a charge for board and lodging varying according to the accommodations furnished, and in addition they pay for medical attendance such sums as may be agreed upon between the physicians and the patients. Any physician in good standing may send it patient to the hospital and there treat him. The hospital also receives an income from medical students who attend clinics.

The United States has a contract with the hospital, by which the institution agrees to care for an average of 15 patients sent by the Surgeon-General of the Army, and for this service receives the sum of $19,000 annually, making the average daily cost to the Government 54.9 cents per day per patient.

It appears from the report of the sanitary officer of the District of Columbia? that during the fiscal year ending June 30, 1897, 301 persons were admitteci to the Providence Hospital at the instance of the District authorities, and that the whole number of patients treated in the hospital during the year ending October 31, 1896, was 2,219. The hospital conducts an emergency service, admitting those persons who are brought to the hospital by the police ambulance or who make applicaion for treatment. According to the testimony of Surgeon-General Sternberg, the hospital furnishes him a list inonthly, showing the names of the patients and the date of their admission and discharge.?

After the hospital has treated monthly 95 charity patients it is entitled to the full proportion of one-twelfth of the annual appropriation of $19,000. The average during 1896 was from 112 to 115 charity patients treated each day, but no greater sum than $199,000 per annum was paid. The list furnished to the Surgeon-General monthly gives the names of the patients, their nativity and occupation, the disease from which they suffer, and the date of admission and date of discharge. Some cases remain for several days or several months; in other cases the patient is treated and sent away on the same day.

Theoretically, all patients are admitted on the order of the SurgeonGeneral; practically, cases are admitted by the Sister in charge, who simply makes a report to the Surgeon-General. There appears to be no adequate examination into the question as to whether the persons need

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