THE CITY CHARITABLE INSTITUTIONS.

At the City Hospital the opening of Janeway Hall, the new staff house, and the superintendent's residence releases the central portion of the main building to hospital purposes, and the Commissioner of Public Charities has requested $150,000 for general interior remodeling.

Situated at the northern end of Blackwell's Island, the Metropolitan Hospital has a larger site than the City Hospital on the southern extremity. Hence the Metropolitan Hospital is capable of greater expansion than the City Hospital, and serves varied functions. In addition to the wards for medical and surgical cases, there are children's wards, infirmaries for tuberculosis, padded cells for alcoholics, and a leper colony. The enlargement of the Metropolitan Hospital contemplated in the general layout, has already begun and will extend over a period of years, during which time the routine of the hospital will be more or less disturbed. The new training school for nurses at the northern end of the grounds is completed and occupied. The former training school is used for the infirmary nurses. Additions to the tuberculosis infirmaries and a staff house are being erected. Ground is broken for a new pathological laboratory and morgue and an addition to the heating plant. The service building has undergone extensive repairs and the dock is equipped for the landing of patients. At the foot of East Ninety-first street a landing place has been secured, and it is proposed to receive ambulance cases from New York and Long Island City as soon as a boat is ready for this service.

1

The New York City Home for the Aged and Infirm, Manhattan Division, occupies the central portion of Blackwell's Island, between the penitentiary and workhouse, and has a capacity of 2,100, but in February, 1909, the census of inmates was 2,797, and the number October 1, 2,561. Of this number 600 were hospital patients and the remainder those who through old age, bad habits, shiftlessness or industrial inefficiency were unable to support themselves in New York City. The removal of able-bodied inmates from the City Home to the Farm Colony on Staten Island is desirable where their labor may be utilized to raise food supplies for the Department's institutions. The plant of the City Home has

been improved during the year. The new reception pavilions are in use, the Gibbs operating pavilion is completed, and a neurological pavilion, men's day room, and a Roman Catholic church are in process of construction, the church being paid for by private funds. The New York City Children's Hospital and School on Randall's Island serves three functions, viz.: it is a hospital for children, a school for feeble-minded children, and a custodial asylum for idiots, epileptics and adult feeble-minded persons. The defective inmates should be wards of the State, and their transfer to Letchworth Village, the new State Custodial Asylum, is contemplated upon its completion. At the close of the year there are over 1,000 such inmates awaiting transfer, thus greatly overcrowding the asylums.

THE NEW MUNICIPAL LODGING HOUSE.

The new Municipal Lodging House in East Twenty-fifth street was formally opened on February 15, 1909. It is a six story fireproof structure with a capacity of 750. It has modern conveniences, including laundry, baths, lavatories and drinking fountains, a pneumatic cleaning system, and a formaldehyde disinfecting plant, said to be the largest of its type ever built. The census varies from 475 in winter to 120 in summer. The institution should be used for the scientific study of vagrancy in its acute and chronic stages.

Great credit is due Hon. Robert W. Hebberd, the Commissioner of Public Charities, for the completion of this building promptly. The construction was slow and annoying; the work, begun in December of 1905, progressed well until November of 1906, when it was suspended upon the discovery of quicksand under the northeast corner of the site, pending decision of the corporation counsel regarding additional compensation for the contractor; subsequently the failure of the contractor and failure of his sureties to complete the work after they had undertaken to do so entailed further delay. Under a new contract the building was finally finished and occupied in February of 1909. The Commissioner of Charities exhausted every means to hasten its completion.

SEA VIEW HOSPITAL.

The approaching completion of the six pavilions under construction at Sea View Hospital for the treatment of tuberculosis will practically exhaust the $1,000,000 available from appropriations made in 1905; $1,350,000 appropriated in December, 1909, will provide such additional buildings and equipment as are necessary to fit the hospital for service although its completion as planned will still require from $800,000 to $1,000,000 more. Its location on the premises of the Farm Colony, Staten Island, combines the advantages of a retired and beautiful site on high ground, with an extensive view over Staten Island to the sea and such proximity to New York City that transportation for patients and their friends is a simple and inexpensive matter, and discharged patients will not suffer the ill effects of abrupt change of climate.

KINGS COUNTY.

At the Kings County Hospital the new Nurses' Home approaches completion; progress on the Pathological building has been slow; ground has been broken for a new hospital wing for male patients, to relieve the present crowded state of the men's wards; the segregation of tuberculosis patients has been partially accomplished in detached buildings, though women patients still remain in the main building.

The Home for the Aged and Infirm, Brooklyn Division, located near the Kings County Hospital, is seriously overcrowded; considerable improvements to plumbing and other equipment are in progress, but the transfer of inmates to the Farm Colony could not be hastened, nor could additional facilities be secured.

The new Coney Island Hospital is practically completed. Plans are made and money available for the remodeling of a building owned by the city for an emergency hospital in South Brooklyn. The erection of the new Bradford Street Hospital has begun and the enlargement of the Cumberland Street Hospital is in progress.

BELLEVUE AND ALLIED HOSPITALS.

Bellevue and Allied Hospitals have a total valuation exclusive of land of $7,142,000 and a capacity of 1,715. For the fiscal year ending September 30, 1908, the cost of salaries was approximately

$274,000, of provisions $206,000, of fuel and light $60,000, of medicine and surgical instruments $63,000, of repairs $120,000, making with some other items a total expenditure of over $770,000. The average weekly expense for the support of each. patient was $10.80 at Bellevue Hospital, $13.86 at Fordham Hospital, $12.92 at Gouverneur Hospital, and $16.04 at Harlem Hospital.

The new Bellevue Training School for Women Nurses, a six story, fireproof building is now occupied, and land has been acquired for the erection of a new Training School for male nurses. A laboratory, morgue and dormitory for male employees approach completion, a laundry is under construction and a new boiler house has been contracted for. Plans are drawn for another hospital pavilion and for this $500,000 is available. Among the most valuable new features of the work at Bellevue Hospital are the Tuberculosis Clinic which treated 1,472 new cases in the year ending October 1, 1909, and the Bureau of Social Service which aided 4,976 patients during the same period. This bureau has been organized within the year to systematize the work of the committees already busy and to guide and develop convalescent relief work in its broadest sense.

Construction work on the new Bellevue Hospital has been continued during the year. Two of the pavilions for patients are completed and occupied. They are so designed as to be practically a separate hospital, although all have general service, such as food, heat, light and laundry in common. In case of need the nominal separation may become complete and an entirely separate service established for each pavilion. The plans and interior arrangement of the wards represent the latest ideas in hospital construction, and when the new Bellevue is completed it will afford unexcelled facilities for medical and surgical work.

The erection of a nurses' home for Harlem Hospital is planned; together with a staff house it is urgently needed to give more room for hospital uses in the main building. Fordham Hospital is still adequate for its work, but the increase in average population makes it important to plan for increased accommodations in the near future. Gouverneur Hospital is seriously overcrowded; the dispensary quarters are especially inadequate; while no definite action has been taken, plans are maturing to relieve this situation.

DEPARTMENT OF INSPECTION.

PRIVATE CHARITABLE INSTITUTIONS.

During the year ending September 30, 1909, 18 new institutions were added to the list of private charities under the supervision of this Board, and four were closed. The 558 under supervision at the end of the fiscal year were visited and inspected at least once during the year. A total of 642 general inspections, 27 special inspections and inquiries, and 657 visits to institutions, public offices and individuals, were made by the inspectors. In the performance of this work these employees traveled in the aggregate 31,178 miles. Many of the institutions were also visited by commissioners and other officers of the Board during the year. Formal reports of all inspections were prepared and presented to the Board. These reports are carefully considered and classifiel on the basis of both "Plant" and "Management." Those which show practically no defects are placed in Class I; those showing less important defects are placed in Class II; and those indicating serious defects, evils, or abuses, are placed in Class III. All are forwarded to the managers with recommendations for the improvement of conditions when defects are found to exist, and in accordance with section 15 of the State Charities Law the managers of institutions in which serious defects or evils exist, are requested to advise the Board of the action taken to remedy the defects. In such cases prompt replies have been received and many of the defects remedied, while letters received from the managers indicate their appreciation of the criticisms and recommendations made by the Board. The reports indicate a continued improvement in the condition of the private charitable institutions. Classified on the basis of relief rendered, the number of institutions of each class is as follows: