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THE VISITING COMMITTEE AS AN AID TO THE SAFE CONDUCT OF PUBLIC HOSPITALS: WITH SPECIAL REFERENCE TO THE WORK OF THE NEW YORK CITY VISITING COMMITTEE OF THE STATE CHARITIES' AID AS

SOCIATION.

MRS. GEORGE STEPHENSON BIXBY.

Acting Chairman of Employment Committee, a Sub-Committee of the New York Visiting Committee of the State Charities' Aid Association, New York, N. Y.

In olden times there was reserved to the king and to founders of eleemosynary institutions the power of visitation. In that way, the proper management of such institutions was supposed to be ensured. In modern times there has grown up the practice of private, or semi-private, visiting of institutions conducted by state and municipal government. It is a long time since the public at large has been entirely barred out from visiting public institutions, but it is not many years since a serious sense of responsibility has been developed in the community for the conduct of charitable institutions.

At first private individuals were admitted without legal right, but later laws have been passed conferring authority to visit certain institutions; and the development of this practice has had great influence on the conduct of charitable institutions of a public character.

*Read by Mr. Bailey B. Burritt of New York.

As a corrective of abuses, and as an incentive to progress, this latter day form of visitation is a powerful influence.

NEW YORK CITY VISITING COMMITTEE.

The New York City Visiting Committee of the State Charities Aid Association has come to be recognized as a trustworthy and powerful organization, possessing both progressive and conservative elements and, by its element of permanency, having the power of accumulating experience, and becoming expert in the best sense of the term.

The following section of the constitution of the New York City Visiting Committee expresses the views of its members as to the objects of such a committee:

The objects of the committee are to visit systematically the institutions under the control of the Department of Public Charities of New York city, and of the Board of Trustees of Bellevue and allied hospitals, to secure such improvements as will contribute to the mental, moral and physical well-being of the inmates of these institutions, and to carry on such other lines of work as may be approved by the Board of Managers of the State Charities Aid Association.

To tell what the New York City Visiting Committee is, and what is does, is to show without need for argument that it has more than justified its existence, and that it is an institution that could not now be dispensed with.

The New York City Visiting Committee is made up of citizens, both men and women, authorized by the New York Supreme Court on the nomination of the State Charities Aid Association, of which this committee is a part, who systematically devote a portion of their time to visiting the hospitals and other charitable institutions of the city, coming in touch with inmates and officials alike. These visitors have authority to see everything, but have no administrative power. Their work is carried on in a friendly spirit of coöperation with the authorities, rather than in an attitude of criticism.

Supported by private effort, and without the power to spend a dollar of public money, this visiting committee has come to be recognized as a powerful body by the force of public opinion, and by virtue of its skill and prudence in dealing with the subjects which come before it.

IMPORTANCE OF THE WORK.

The visiting committee's advice and recommendation are given and respectfully received on important subjects and in regard to the expenditure of vast sums of money. In the spring of this year it advised as to items for the city budget, aggregating over four and a half millions of dollars. Its recommendations and protests are always received with respect, and in the majority of instances its advice has been followed to lasting advantage.

The public municipal hospitals, alms-houses and lodging houses which are visited, care for nearly nine thousand patients and inmates, and with the affiliated bureaus and offices employ over 3,000 persons; the total expense to the city being about $3,000,000 annually.

THE METHODS OF THE NEW YORK CITY VISITING COMMITTEE.

Careful reports of conditions observed by visitors are submitted to the responsible authorities, the Board of Trustees of Bellevue and Allied Hospitals and the Commissioner of Public Charities. By freuqent informal conferences with the superintendents of the various institutions, early attention is secured for less important matters. Through the courtesy of the heads of departments, plans of buildings, proposed improvements, and occasionally administrative measures are carefully considered in advance, and the opinion of the committee is submitted for consideration. Communications are addressed to the Board of Estimate and Apportionment as to the needs of the municipal charities, both for current expenses and for issues of corporate stock for permanent improvements. Representatives of the committee appear before this board and also before the Board of Aldermen and its committees, to urge appropriations for public charities, sufficient in amount and wisely apportioned.

A FEW EXAMPLES OF THE COMMITTEE'S WORK.

In 1873, a year after the New York County Visiting Committee was organized, the committee established the Bellevue Training School for Nurses, the first training school for nurses in a general hospital in America, which did away with the old system of having prisoners care for the patients. The commttee also contributed largely to the establishment of the Municipal Lodging House for the temporary care of homeless and destitute men and women at the expense of the city.

Beginning with the time that the reports of its visitors showed almost hopelessly bad conditions and few improvements, the committee's representations to the officials and its public reports have been effective in securing more nearly adequate appropriations, especially during the past ten years, to provide reasonably good quarters for the nurses and employees of the city institutions, who had been shamefully neglected and housed for many years in overcrowded, unsanitary quarters, producing disease and infirmity.

It has procured better fire protection for public hospitals, better classification of the inmates, and employment for the aged and infirm.

As an example of the constructive work of the committee may be mentioned its study, in the autumn of 1907, of the plans for new buildings to cost over a million dollars, with careful and detailed suggestions thereon, based upon the opinion of members of the committee who frequently visit the public institutions, and of expert advisers. Many of the suggestions of the committee were adopted and will thus be of lasting value to the sick and infirm.

Another important part of the committee's work has been its frequent and emphatic presentation of the need for adequate wages for the lower grades of hospital employees, many of whom come directly in contact with the patients. The city authorities now recognize more and more fully that the elevation of the standards for such employees has a direct and vital bearing on the care of the sick and infirm.

Even to those who appreciate the value of constructive and preventive work, the above account of what may be accomplished by a visiting committee will doubtless be more or less uninteresting. But there is a more appealing side of this work, which arouses the interest and sustains the patient efforts of the visitors.

Several years ago the Brooklyn committee established a kindergarten for the children at the Kings County Hospital, in the maintenance of which the members of the committee and of an auxiliary committee of young girls take a lively and effective interest. A similar interest is taken in the children in the Randall's Island Children's Hospitals and Schools whom the committee has been enabled to supply with many toys, pictures and other gifts, through the interest and generosity of the Island Mission. Many of them have been visited recently in their own homes to learn the conditions to which they go upon discharge, and to help in improving their after-care in order that the benefit of the treatment in the institutions may not be lost, and that they may not be returned again as public charges.

PROVIDING WORK FOR THE INFIRM.

The New York City Visiting Committee's sub-committee on Employment for Infirm maintains a salaried teacher to visit the aged, crippled and infirm who are unable to do active work, and whose lives would be inexpressibly dreary without some light employment, and to instruct them in basket weaving, bead work and rug making.

Sales of articles made by the crippled and infirm are held by the employment committee, the proceeds going directly to the infirm workers.

The friendly visiting of the aged and infirm men and women in the city homes and the provision of light employment for those who are incapable of supporting themselves, but for whom the time would pass very slowly without something to occupy them, requires a great deal of tact and perseverance, but the results are most gratifying. The chaplain of the Home for the Aged and Infirm on Blackwell's Island wrote as follows of the beginning of this employment work:

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