thorized by a law, for some single work or object, to be distinctly specified therein." The construction of the State charitable institutions may be fairly considered a "single work or object although it may have several divisions, for all the State charitable and reformatory institutions are parts of one comprehensive system of care for wards of the State, and taken together represent a single phase of public activity and responsibility. THE DIET IN CHARITABLE AND REFORMATORY INSTITUTIONS UNDER THE SUPERVISION OF THE STATE BOARD OF CHARITIES. The large number of persons who are dependent upon the public for support and who, through the operation of the State Poor Law, are committed to charitable institutions, makes the supply of food, its preparation and service a most important matter to the managers of such institutions. When it is considered that in the charitable institutions of the State, all ages are found, as well as all conditions of infirmity, it is apparent that selection of the proper kinds of food as well as their economic preparation requires expert knowledge. The art of preparing raw articles of food for easy and complete digestion has become a special and valuable branch of knowledge requiring familiarity with the chemical compensation of the food materials, their proper combination, and final preparation by the process of cooking. In the family home, the character of the daily food service is largely dependent upon the family purse, the supplies to be found in the market, and the skill which has been acquired by the cook or that member of the family responsible for the preparation of the meals. It is possible under ordinary circumstances to have a wide variety in the family dietary, for the markets everywhere are open and the only limitation to variety is that of ability to pay. In institutions, however, there can not be the same freedom of choice in foods, for what would not be considered extravagance in a purchase for family requirements may be very extravagant in the general purchases of an institution. A few persons may be fed with even the more costly foods without any serious effect upon the family finances, but in an institution where hundreds. must be considered and provided for, the addition of a few cents to the daily per capita cost of meals is a serious matter. Besides this consideration, institutions are not usually in locations which make daily marketing possible. They are compelled to adhere to dietaries which are seldom changed except by the seasons, and contracts for supplies are made months in advance of time required for use. For this reason advantage can seldom be taken of favorable price changes. The cost of food has increased over 15 per cent since 1904, and the institutions have felt the advance seriously in some instances making radical changes in the dietary necessary that the cost may not exceed the amounts of money available. An experienced Dietitian in the employ of the Board would be of service to institutions, especially those maintained by the public, and the necessary salary could be saved many times over by the economies which expert supervision of this character would suggest. Frequently managers and public officers have made requests for advice in regard to diet, and the Board has published two suggestive pamphlets upon the subject. These have been and are in great demand, but should be supplemented by the advice of a trained Dietitian, who in visits to institutions could take up the special problems in each, and thus render assistance in a manner most likely to be productive of good results. Institutions having a population of 200 or more should employ a competent person to take charge of the preparation and service of food. The inmates will be directly benefited by the greater variety and better preparation of the daily diet, and the institution through the more economical methods adopted in the kitchens and dining-rooms. It is not possible for institutions to regulate or control the market price of supplies, but greater attention to practical economies, and better service will go far toward minimizing the effect of any serious increase in prices. THE CAMPAIGN AGAINST TUBERCULOSIS. During the past year a remarkable campaign has been waged by the State Charities Aid Association and the State and local. health authorities against tuberculosis. By lectures, addresses, stereopticon views, photographs, exhibits at fairs and other places, posters, leaflets and books, the people have been instructed as to the nature of the disease and the best methods of prevention. The Boards of Supervisors in the several counties have given special attention to the provision of hospital care for persons afflicted with the disease, and in several instances have voted to establish county hospitals. In the counties of Chemung, Orange, Onondaga and Erie, private citizens have presented to the public tracts of land, buildings and hospital equipment for the treatment of patients suffering from tuberculosis. The city of New York has made large appropriations for new buildings which are to be used for tubercular patients, and in addition, has provided for the completion of the Sea View Sanatorium on Staten Island. This institution will accommodate 1,000 patients, and the estimated cost of the equipment and buildings is $3,000,000. In addition to this great new hospital, the city of New York has enlarged the Tuberculosis Infirmary of the Metropolitan Hospital on Blackwell's Island and has provided for other pavilions which, when completed, will have cost $1,050,000 and have wards for approximately 700 patients. Add to these the number of beds now maintained by the city in other hospitals, and 2,500 patients in all stages of the disease can be cared for when these buildings are opened. The results of the general interest taken in the efforts to prevent the further extension of tuberculosis will be an immediate decrease of the death rate from this disease, by improved sanitary standards of living in the home and in the condition of the shops, with the consequent increased efficiency, and longer period of wage earning ability. THE SUPERVISION OF CHARITABLE INSTITUTIONS AND NOT DIRECTLY IN RECEIPT OF Under the decision of the Court of Appeals in 1900 in "The People ex rel. The State Board of Charities v. The New York Society for the Prevention of Cruelty to Children," charitable societies and institutions under private control, which are not in receipt of public money, raised by general taxation, are excluded from the benefits of State inspection and supervision. In the ten years since this decision was rendered, the number of such societies and institutions has increased from about 600 to more than 750. Their annual expenditures are estimated at over $10,000,000, and they have many thousands of beneficiaries and inmates. As these asylums, hospitals, reformatories, homes, agencies, societies, and other similar organizations are entirely supported by private funds in their charitable work, they are not required by law to report to any State department, and their statistics are necessarily roughly estimated, and those compiled and published by the State are inaccurate, incomplete, and consequently misleading in regard to the number of persons wholly or partially maintained by charity, and to the value of property, endowments, and foundations devoted to charitable purposes, and also to the incomes received and their expenditure. The special duties of these institutions include the care of aged, infirm and sick persons, the protection and education of dependent children, the guardianship and training of defectives, and the custody and reformation of delinquents. The responsibility of the State for the supervision of these classes especially, as well as others in need of help or maintenance, is generally recognized and does not need explanation or argument. It is the duty of the State to protect its dependent wards and private institutions undertaking any part of this duty assume at once a quasi-public character. They now are supported by the people in whole or in part even though not in receipt of public funds raised by general taxation; they receive from the public, in many cases, exceptional privileges, such as gifts of land, exemption from taxation, and free water. Hence their work is of vital interest to the public and the State has the right to insist that they perform their duties well and faithfully, and to know from frequent examinations how they administer their affairs, that they devote their funds to the purposes intended by their benefactors, and that they do not abuse those entrusted to their care. For these purposes and to this extent, the State should exercise supervision over them. Visitation and inspection by the State assures a three-fold service to the institution, to its beneficiaries, and to its bene factors. It protects the giver of properties, endowments, or donations against their diversion to improper or unintended uses. The importance of such a safeguard increases with the notable growth of endowments and foundations established for special charitable ends. State inspection in a measure assures the welfare of the helpless and dependent. It has been proved by a large experience that disinterested and competent investigation of the condition of dependent persons placed in asylums or homes is important both for their own good and for the interests of the public. State supervision also inspires confidence and thus benefits the institution, and no properly conducted institution need. fear it, for its purposes are helpful and beneficent, not inquisitorial or intrusive. To instruct, to hold up high ideals and guard against imposture, to introduce better methods of work and thus increase efficiency, to harmonize and correlate public and private charitable agencies and efforts, as well as to gather and spread information and knowledge, are some of the objects sought to be accomplished by this Board in the interest of the State. If evils or abuses are found, the interests of innocent persons concerned and the public welfare demand that the wrongs be righted without concealment or mitigation of the offense, and thus repetition be made impossible. From time to time institutions of a charitable nature, under private control, realizing the advantages of State supervision have, through their managers or superintendents, formally requested visitation and inspection by the State Board of Charities. These managers desire that the statistics of their work and those of similar institutions be gathered and published. They not only send copies of the annual reports to the Board, but express willingness to submit more detailed information if afforded opportunity. None of these requests can be granted until the law is so amended that the State may visit and inspect and require full reports from them. Many of these institutions were incorporated pursuant to law by the State Board of Charities and therefore should continue subject to its supervision. For these reasons, the State should |
