When on July 1, 1908, the Bureau of Hospitals closed its work, the work of the Associated Charities was further enlarged by the carrying into effect of the following suggestions by Miss Felton, the general secretary of the Associated Charities:
“In regard to the care of the sick, I respectfully suggest the following plan:
“That for the month of July no appropriation for the hospital work be made in advance, but that the bills presented at the end of the month, after being approved, be paid from the Relief Funds. By the first of August the number of patients in the hospitals will be very materially reduced, and I think that a grant of $1,500 per month will carry the hospital work. This would allow us 30 patients at an average cost of $50. By placing all our children in the Children’s Hospital at the rate of $25 per month and many of our maternity cases in the Lying-in Hospital at the rate of $7.00 per week, and by taking advantage of the sanitariums for some of our cases in a more or less convalescent state, we can easily bring the cost down to $50 per patient. I think it would be advisable not to restrict the grant to the care of patients in the hospitals, but to make it for the care of the sick outside of their homes. This would enable us to economize in many cases by boarding out, in private families, convalescents who might thus be cared for at a lower rate than in the hospitals. This applies especially to babies and little children. We can also make use of Miss de Turbeville’s and Miss Ashe’s Home in appropriate cases, I think, at a rate of $15 per month.
“I figure that a grant of $4,500 per month will carry the hospital work, relief in the form of groceries and medicines, the special money grants under $50, and the administration expenses of our offices. Mr. Bogart and I have gone over the expenses very carefully and have materially reduced them wherever we thought it was possible. We think this is the lowest estimate on which we can carry the work on anything like an adequate basis.
“Our administration expenses should not be considered as simply the expenses of distributing a certain relief fund, because now that we are working under Associated Charities methods, we are expending a great deal of time in actual service for the poor, in trying to secure employment and planning to make them self-supporting, thus reducing the necessity for relief. Work of this sort, of course, requires a great deal more time on the individual case than where the question to be considered is simply the granting or withholding of a sum of money.
“To administer the hospital work in the most economical manner involves a considerable amount of work to the office force, as it means planning for patients who are ready to leave the hospital and who often have no place to go or no proper accommodations. We have reduced the force since the cutting down of the housing work, and I think that everyone here is working to the utmost limit.
“I respectfully suggest that a monthly appropriation of $4,500 be made to the Associated Charities for its work, to be expended as follows:
| Hospital work | $1,500 | |
| Unemployed | 200 | |
| Material relief | 1,500 | |
| Administration expenses | 1,300 | ” |
4. CONCLUDING REMARKS
Whether the weaknesses of the centralized system as revealed by the San Francisco Relief Survey are inherent can be determined only by future experiment, for there is no way of measuring the relative value of the two systems described in this chapter.