One of the plain lessons of the San Francisco experience is that any rehabilitation work should have as an adjunct a bureau to which may be referred cases requiring immediate relief in kind.
If such a bureau had been organized on July 1, it might have made use of the district force, the investigators sending recommendations directly from the district offices to the bureau for immediate action. True, the district offices did have small emergency funds placed in their hands by the Associated Charities, which in turn was reimbursed by the Rehabilitation Committee; but the expenditures from these funds were necessarily very small and could not secure, for instance, the purchase of sewing machines. A great deal of friction also would have been avoided. The number of complaints would have been much smaller and there would have been no interruption in the efficient progress of the rehabilitation work itself.
When the Rehabilitation Committee early in July was in shape to enter on the active second period of the rehabilitation work, there remained certain shreds of the old emergency tasks. In Chapter I of this part[132] an account is given of the effort made to adjust the work of the camps and the sections after the withdrawal of food issues, when there was felt to be a gap in organization.
[132] See [Part II], [p. 111].
In order partially to meet this situation the Bureau of Special Relief was organized on August 15 following the plan made by Mr. Bicknell, of the Rehabilitation Committee, to handle applications for relief in kind, in order that these need not be delayed and that the Committee might be left free to deal with the larger problem of rehabilitation.
The Bureau, when it began its work on August 15, was prepared to give prompt medical assistance, nursing, and aid in kind to applicants throughout the city. Later in the month the Bureau was authorized to issue orders in small lots for sewing machines, tools, and furniture. The Bureau had no authority to make cash grants.
The central office was established on Gough and Geary Streets, in rooms easily accessible on the ground floor, and here were quartered the superintendent, his secretary, bookkeeper, stenographer, messengers, one or two drivers, and two or three clerks, the number varying with the volume of the work. During the greater part of the Bureau’s ten months of service, two physicians,[133] two nurses, as well as from three to seven investigators were visiting constantly for it. The original plan was to have an investigator at each of the section offices, with one or two in addition at the central office, to make visits at large. Applications were sometimes received at the central office in person, but the greater number came by mail or telephone direct from applicants or from those who reported instances of need. The applications were telephoned to the Bureau agent in whose district the case was located. Within a few hours the family was visited and a report was telephoned to the office. A Bureau clerk had meanwhile received a report from the Rehabilitation Committee files as to whether any action had already been taken on the case.
[133] The two physicians who visited for the Bureau also served as agents for the Bureau of Hospitals to determine the eligibility of applicants for admission to the accredited hospitals. This co-operation made a separate medical staff unnecessary. An arrangement was made with two existing societies to care for maternity cases in their own homes. This service was given with no charge upon the relief fund except for certain medical supplies.
Many cases were reported by members of the section committees with the idea that the Bureau would in the interim give care, the Rehabilitation Committee, which of necessity worked more slowly, not being able quickly to make disposition of a case. In this way the work of the Bureau supplemented that of the Rehabilitation Committee and minimized the danger of families suffering from unavoidable delays in the forming and carrying out of a rehabilitation plan. The superintendent, with the information before him, decided whether to give or withhold aid. If aid were to be granted, definite orders for relief were immediately telephoned to merchants with whom arrangements had been previously made. The orders were later confirmed by letter. The aid given by the Bureau of Special Relief finally covered shelter, food (rations or restaurant meals), clothing, furniture, tools, sewing machines, and medical aid of all sorts including special appliances, dentistry in emergency need, and, upon a physician’s prescription, special diet.
A visitor called on each family in her charge at least once a week. On a stated day each week she sent in a report which covered all families under her care, and which stated whether the help given in groceries, meat, or milk, should be continued one week longer, with an estimate of how long in each case relief would be necessary. When a family seemed likely to require rations indefinitely, it was until October transferred to Camp 6 and after that date to Ingleside camp, as the Bureau did not provide assistance indefinitely. After the middle of January, 1907, all orders were issued for two weeks so as to lessen the required visits to each family to one in two weeks. Orders for food and merchandise were placed with merchants located as closely as possible to the residences of applicants, and grocers were held to a high standard of service, both as to quality and quantity of goods and as to promptness of delivery. Special tests were set from time to time to see that the order system worked as planned. In the case of clothing orders the Bureau agent usually went with the applicant to help make selection of clothing.