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you will have very considerable and substantial efforts made without the Government, and the community will reap the benefit. For instance, in the city of Boston not a dollar is given from the public treasury to any privately operated charitable institution.
The CHAIRMAN. That is because they have their own institutions.
Mr. Wilson. Nevertheless, there is no city probably in the world, and certainly not in the United States, that has as many private institutions as large and as well endowed and supported as the city of Boston has.
The CHAIRMAN. For instance, we have in Chicago the county hospital, which is essentially the municipal hospital, and it is a wonderful institution.
EASTERN DISPENSARY AND CASUALTY HOSPITAL.
The CHAIRMAN. For the Eastern Dispensary and Casualty Hospital you have an estimate of $6,700. What do you mean by · Casualty Hospital”!
Mr. Wilson. That happens to be the legal name under which it goes.
The CHAIRMAN. They handle emergency cases?
Mr. Wilson. Yes, sir; emergency cases arising from any kind of casualty. For instance, if a woman is very ill at home or if a man is very ill at home, we do not send them here, but we will send them to a general hospital. These are usually cases originating in some public casualty on the streets or from some accident.
The CHAIRMAN. For the Eastern Dispensary and Casualty Hospital you are asking $6,700. Where is this institution?
Mr. Wilson. The Eastern Dispensary and Casualty Hospital is in the northeast section. It is at Eighth and Massachusetts Avenue NE.
The CHAIRMAN. For 1920 you had $25,000 for this institution, $15,000 for 1921, and your appropriation for 1922 is $5,000. For 1923 you estimated for only $5,000.
Mr. Wilson. Yes, sir; but that will be grossly inadequate. The explanation is this: That institution in the past three or four years has declined to take or to keep District of Columbia patients when they could avoid it. They did take accident cases when they oecurred, but they encouraged them to get out and go to other hospitals as promptly as they could. That was because they were caring for patients of the Public Health Service, who paid them more than we were paying. They said, “We are poor and are not endowed, and are hardly able to live."
The CHAIRMAN. What did you pay them?
Mr. Wilson. Two dollars per day, and the Public Ilealth Service paid them $3 per day.
The Chairman. Is that what you pay them now?
Mr. Wilson. Yes, sir; the rate was $1.75 and then was increase i to $2.
The CHAIRMAN. Of course, you do not have to send your cases there?
Mr. Wilson. We do in this way, that we have to send emergency cases to the nearest hospital. We provide that they shall go to the nearest hospital.
The CHAIRMAX. What advantage is there in that?
Mr. Wilson. It is because of the shorter time involved. If a man is knocked down in the street we want to get him to the hospital in 10 minutes rather than in 20 minutes, if possible. In such instances a doctor goes with the ambulance, and he can render first aid in stopping a hemorrhage, or something of that sort.
The CHAIRMAN. If you should not get this amount you would not, of course, create a deficiency, would you !
Mr. Wilson. Under the law there is no legal obligation against the Government, and each contract, of course, is made in conformity with the law. In the case of all the other institutions the Government has not been accustomed to recognize the obligation to meet deficiencies, but in the case of the two hospitals that handle accident cases the Government has been accustomed to recognize the obligation. There is a great discrepancy in our estimate here, but that is wholly because this hospital went out of our business as far as it could and went into the business of caring for Public Health Service patients, on account of the higher rate of compensation. Now the Public Health Service has discontinued its work at this institution and they are anxious to get our business.
The CHAIRMAN. The only reason you reduced the estimate to $5,000 was because you did not expect that the Public Health Service would surrender the use of the hospital?
Mr. Wilson. That is true. For several years you will notice that we did not use it.
The CHAIRMAN. How much of this appropriation of $5,000 for 1922 have you available?
Mr. Wilsox. We have spent about $1.400 more than the appropriation, or we are obligated to that extent.
The CHAIRMAN. So that, as a matter of fact, you are really obligated for $1,400 now?
Mr. Wilson. Yes, sir; that much more than the appropriation. The CHAIRMAN. How many patients have you there?
Mr. Wilson. Twenty-seven. Last year the average was only 3, the year before it was 9, and the year before that the average was 24.
MUNICIPAL LODGING HOUSE AND WOOD YARD.
The CHAIRMAX. For the municipal lodging house and wood yard you ask $1,000 for maintenance. Why do you ask that amount?
Mr. Wilson. Because of the greatly increased demand. That is not an actual deficiency at this moment. We had $200 in the maintenance fund on the 1st of February. As you know, there have been a good many more people looking for work, or people of the type known as the homeless man, than formerly, and for the first time in 10 years we have had the lodging house crowded. We have been running at the rate of about 20, and now we have 50 every night, which is the total capacity. Some are turned away because we can not accommodate them. I took the matter up with the commissioners, and one or two private efforts have been started to help out in lodging homeless men. I said to the commissioners that for about 30 cents per day we could care for the men so far as food is concerned. The lodging house accommodates 50 men, and that would amount to $15 per day. For the 60 days in February and March that would amount to $900. Then for April, May, and June it would fall off, and $300 more would meet the situation. With that amount, we thought that we would likely be able to take everybody who might apply and give them two meals. They do somework in the way of sawing wood in the yard.
The CHAIRMAN. What does the wood sawing amount to?
Mr. Wilson. To a little bit more than the cost of handling it. That goes into the Treasury each year. For the last two years it has been a very nominal amount. We used to turn in a few hundre! dollars.
The CHAIRMAN. In 1921 you expended, under this head, $1,995.19?
The CHAIRMAN. Do you think you will need $1,000 for the next four months?
Mr. Wilson. Yes, sir; for the reasons I have just submitteil. We could go ahead, of course, and have no deficiency. We could use the lodging house and not feed the men, but we felt that we shoulel submit that matter to you and let you decide it. We think that with $1,000 we could probably receive and feed those men up to the capacity of the lodging house for the balance of the fiscal year.
The CHAIRMAN. Why should you feed them?
Mr. Wilson. If a man has to be provided with a place to sleep he is apt to beg the price of a meal, and we think that it should be the policy of such an institution to avoid that, if possible. We can give the men plenty of work to do. There are only three persons employed there in taking care of the house, and there is something for these people to do. The scrubbing, cleaning, making the bels. and work of that kind, is done by these men.
ERECTION OF A NEW LODGING HOUSE.
The ('HAIRMAN. You are asking $33,000 for the erection of a new municipal lodging house?
Mr. Wilson. Yes, sir.
Mr. Wilson. It is authorized by law, as indicated in the bill. It was appropriated for in the act of 1916.
The CHAIRMAN. Was that appropriation of $40,000 used? Mr. Wilson. No, sir. Approximately $10,000 was used in the purchase of a lot. The building plans were prepared by the municipal architect, and therefore there is no charge against this appropriation other than for the land.
The CHAIRMAN. This is not a deficiency?
Mr. Wilson. I thought it was. There is an appropriation here authorized for this specific purpose, and this is an additional amount required to carry it out.
The CHAIRMAN. This is not a good time to build, because it costs too much. It will cost you at the rate of $1.66 for every dollar's worth of work you get now.
Mr. Wilson. I know it is amazing, and I am very much disappointed.
The CHAIRMAN. It was up to $2.46, and now it is $1.46. If we wait a little longer it may be down to $1.
Mr. Wilson. It is too high.
Mr. WILSON. On Louisiana Avenue, just a little west of the old District Building, near Sixth Street.
Mr. BYRNs. Where is the present municipal lodging house?
Mr. Wilson. Just a little west of the corner of the Courthouse Square.
SUPPORT OF THE INDIGENT INSANE.
ST. ELIZABETHS HOSPITAL.
The CHAIRMAN. For the support of the indigent insane of the District of Columbia at St. Elizabeths Hospital you are asking $148,000. What is that for?
Mr. Wilson. This is simply the best estimate that the auditor's books show, and it is a deficiency that is likely to occur through the operation of law, over which we have no control whatsoever, except in a very
way, in that we do deport as soon as we can nonresident cases. You will notice that the estimate was $900,000 for 1923, and now the estimate is $50,000 more than that, or a total of $950,000.
The CHAIRMAN. The appropriation for the current fiscal year is $800,000.
Mr. Wilson. Yes, sir; and the bills for six months amount to $477,141.14.
The CHAIRMAN. That is for the first six months?
Mr. Wilson. One thousand seven hundred and sixty-two last year, and it is a little bit more now. The number is not varying greatly.
The CHAIRMAN. These are all District patients?
Mr. Wilson. All District of Columbia patients; yes, sir. There are Federal patients, too, as you know, and the total number is approximately 4,000, as I recall.
The CHAIRMAN. That would be about $600 per patient, would it not?
Mr. Wilson. The auditor tells me $532.90. You understand it is a little more than double what it was—that is, what it was five years ago-and it is fixed by the Secretary of the Interior under the law, and from that we have no appeal.
The CHAIRMAN. You would have no discretion in this matter, would you?
Mr. WILSON. None at all.
The CHAIRMAN. How many patients did you say?
Mr. WILSON. One thousand seven hundred and sixty-two last year, and there are a few more this year. There is a slight increase over last year.
DEPORTATION OF NON RESIDENT INSANE.
The CHAIRMAN. The next item is for the deportation of nonresident insane persons, for which you ask a deficiency appropriation of $1,000.
Mr. Wilson. Yes, sir.
Mr. Wilson. We have used $3,364 out of the $5,000, leaving us a balance of a little less than $1,630.
The CHAIRMAN. Is that for the first six months?
Mr. Wilson. Yes; practically seven months. We have not been able to get the very last dollar.
The CHAIRMAN. What cases does this cover?
Mr. Wilson. No; in no instance. Under a reciprocal arrangement the same thing obtains as to patients sent here. They will send back to us patients that belong to the District, but we never reimburse them and they do not reimburse us. That is the universal custom. There are just a few institutions—but not any of the States--that are good enough to send for a patient if he escapes, but only a few. Unless a patient has escaped they never do it.
The CHAIRMAN. Do you consider this appropriation more economical than to care for them!
Mr. Wilson. Yes, sir; I do. I can conscientiously make Mrs. West's bargain with you and say that with this $1.000 we will save you many times $1,000, because otherwise we would have to keep these patients for an indefinite time. Most of them live for a long time, because they are largely men-a few of them are women-who are hale and well. They are able to get about the country, and they get away from other places. As shown on page 10 of our report, the total number of patients admitted to the hospital from 1905 to 1921 was 6,792, and the actual number we deported in the same time was 1,500 out of that 6.792. In other words, we have taken away just a fraction over 20 per cent of them.
The CHAIRMAN. And you sent them to their homes?
Mr. Wilson. Mostly to their homes; the law is a little liberal: it says to their friends or to the place of their legal residence. Sometimes we can get a friend to receive a patient, or if they have a legal residence we can always get them back there.
Mr. Donovan. That finishes with the District, except as to one item that is on the way to you through the Budget. Unfortunately it was overlooked in the preparation of these estimates. The item to which I refer is $1,500 additional for postage on official mail matter for this fiscal year.
The CHAIRMAN. Why do you need $1,500 ?