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files the deed, the county assessors and board of review fix his tax, and he pays at the county treasurer's office. If divorce is his misfortune, he reaches it through the county courts. In sickness, the county hospital is his refuge. If reason totters, for whatever cause, the county psychopathic hospital and the county judge receive and care for him. If poverty overtakes his family, the county agent gives relief; and when old age finds him in want, the county infirmary opens her arms to receive him. If sudden death overtakes him, the county coroner gives final service. Thus, from the cradle to the grave, the county is the governing body closest to the home. She is the mother, whose children turn to her in time of need. It is then plainly the duty of the administrator of public charity or welfare to have the human relation of his task so richly developed that the dependent or erring child will be reclaimed, the sick will be healed, or if incurable, his pathway will be cheered, the psychopathic will be humanely and sympathetically managed, the old will be cared for with homelike gentleness, and the criminal will be reclaimed, if a victim of circumstance, and treated with justice, but nevertheless in such manner as to deter others from following his example, and will be so guarded as to protect the community, whom it is likewise the officials' duty to serve.

Efficiency with humanity.—In exercising this duty the county official must endeavor to get what efficiency is possible consistent with humanity. We are given certain laws under which to operate, and nearly every one of these laws is the result of the theoretical thoughts of far-seeing individuals, which, when drawn and enacted, often lack the practical side of application. The public charity budget must be formed not only with a view to economy, but clearly with a purpose to that efficiency which conserves the comfort, self-respect, and happiness of those under its care. However, for the sake of alleged efficiency, never sacrifice the purposes of charity, for then the same would be but abstract efficiency without practical achievement.

We in Cook County, Illinois, keeping both of those points in view and seeking to coordinate economy with efficiency and humanity, have discovered many things. For instance, we have found that an electric oven fed by our own Oak Forest plant not only pays for itself in full, but yields an excellent product of three thousand loaves of bread a day, of a quality which satisfies our nearly four thousand inmates. Mattress renovators, employed the year around, are not only an economy, but, better still, give wholesome beds and a more comfortable life to our people. Gingham, bought in 1,000-yard lots, but in fifty artistic colors and designs, costs little more than 1,000 yards of dull, drab denim, but when each selects her own, cheer and hope is given to a dull old life where little color existed. An orchestra composed of inmates, under tutelage of regular employees, involves little expenditure, but to every old or crippled man there comes better courage when he plays his favorite instrument, as in better days. Corps of visiting surgeons and doctors and an advisory council save suffering and life; especially in our tuberculosis infirmary a competent corps of doctors has reduced

our deaths 112 in 1925 below 1924, although our number of inmates has increased. None can measure the benefit to be given by the six hundred radio head sets installed in our tuberculosis hospital, the patients thus regaining touch with the world left behind. The great dining room twice a week is turned into a moving picture house; pictures are put on the screen by regular employes, and are combined with vaudeville numbers by visiting artists who rejoice to drive the 20 miles from Chicago to give cheer to an eager audience of twelve hundred old and crippled inmates. A country store in the midst of the wards furnishes extras at absolute cost, and encourages little gifts of money for wholesome purposes by those visiting the patients. All of these various things that I have mentioned have been planned with an idea of bringing real human relation into what otherwise might be an abstract cold relief.

Special cottages for borderline cases.—It is not merely to poor and sick relief that we must give our attention, but among many other duties we are charged with the care of the wards of the juvenile court. In studying these problems we have decided to open at Oak Forest cottages for borderline cases from the children's courts. Behavior problems will be studied, and we hope much help will be rendered thereby, and that the reclaiming of these children to become useful members of society will be accomplished in a healthful atmosphere.

Child placing in homes. Our budget for the last three years allowed the sum of $30,000 in 1924, $90,000 in 1925, and $150,000 in 1926 for child placing in families, thus lessening the number put in institutions. The rapid increase in appropriations indicates the measure of success that we have obtained from this endeavor. This is done through the juvenile court, working through child placing bureaus of the various religious societies in cooperation with our own agencies, and it is with great satisfaction that the members of the Board of Cook County Commissioners look to the results of this endeavor. A child in a real home means a future sturdy humane citizen.

Politics have no place in administering public charity.-Cooperative effort in the public charities field has been our fortune under the efficient and humanitarian administration of the president of our board. Political differences have no place in the policy of an elected body toward its public charities. To the credit of Cook County, Illinois, be it said that our board, equally divided politically, works as a unit in lifting the standards in institutions. I trust that this is universally true. Right choice of superintendents cannot be overestimated. In my belief it takes consecration to this work to make such an official competent for the task.

Coordination of public welfare bureaus.—With the approval of the Board of Commissioners an act was passed by the Illinois legislature in 1925 providing for a coordinated bureau of public welfare, under which all relief agencies are being consolidated. This consolidation will make for more effective results and more constructive service in human relations to our people. Civil service examinations are now being held to select a director of the new enlarged Social Serv

ice Bureau, under the supervision of a civic committee including social service and business specialists. One of the big things will be that the relief work of the county agent will be absorbed and carried on under this bureau.

Attitude of citizens. Of necessity, any local government receives advice, criticism, and sometimes cooperative service from the varied social and philanthropic organizations which are working through civic, church, and other avenues to similar ends of service for the unfortunate and handicapped. It is the duty, as well as the privilege, of every citizen to cooperate with and to improve, where possible, the governmental service. The circle of truth must be complete in all its segments. A large segment of this circle is philanthropic and humanitarian work that must, and should, be done for the unfortunate. Another segment is the classified and tried methods by which this work can be done. Other important segments are the salaries which shall be paid the civil service laws which control appointments and the relationship of this work to our outside organizations. The public official must consider other important segments, such as the laws which govern the transaction of his public duties, the moneys which come to a given department through taxation, and which come from percentage levies dependent upon the amount of taxes paid. He must reckon with budget making, these budgets having time limits and being dependent upon the corporate fund and upon fees received, and he knows that no provision is made for debts incurred by overexpenditures. Bonds must be issued through legal processes, with sinking funds provided by law for payment of the same.

These hard facts, with many others, make important segments of the circle of truth which, in my experience as a public official, are not comprehended by many of our citizens who seek the opening of new departments, enlarged salaries, and other changes of policy. Likewise, too, many of our elected officials have but little knowledge of the foundations of organized charity and the great progress made in the field of specialized education.

It is with earnest mind that I suggest to you, my fellow-officials, and to you, my friends and co-workers who are interested in social welfare and organized charity, that we urge a more careful study on the part of public officials of the organization of social work and charitable institutions. We earnestly ask at the same time that our philanthropic citizens with high purposes for the benefit of mankind make deeper studies into the legal and financial limitations of government service. When this is done and we get fuller cooperative work on the part of the citizens, the public officials, social workers, and charitable organizations, then indeed all fields of social service, including public charity, will see the fruition of endeavor, and we will achieve that goal of human relations which may well be that charity, now translated "love," of which it is said, "Charity vaunteth not itself; charity suffereth long and is kind."

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A. L. Bowen, Editorial Writer, "Illinois State Journal," Springfield

During the last two years scandal in the administration of penal reformatory and charitable institutions has been a continuous sensation. Every section of the country, almost every state, has been involved. Crime in all its ramifications has complicated the management of prisons and the administration of pardon and parole laws. Charitable institutions, especially those dealing with nervous and mental diseases, have disclosed their weaknesses and their lamentable failures whenever the inquiring finger has been pointed at them.

Looking deeper, can it be said that our state hospitals have made progress comparable with that our general hospitals have made? Do they stand in public esteem as high? Have the American people the confidence in these institutions they display daily in their general hospitals? Does the public respect the medical service in our state hospitals as it respects medicine and surgery in private practice and general hospitals? Can it be said that our prisons are doing a better job than they did fifty years ago? Those states that have divested themselves of contract labor were compelled to do so by the effective vote of union labor rather than by any internal initiative. What, may I ask, has been substituted for the contract system? Everywhere we hear the miserable plaint that idleness is the curse of our prisons. Do you really believe that there is genuine reason for general idleness?

With few exceptions, superintendents of charitable, and wardens of penal, institutions are selected on the basis of their political availability. Medical staffs and medical work in these two classes of institutions are stagnant. We rarely hear of anything coming from them that is illuminating or helpful. Institutional atmosphere everywhere is heavy with the negativism that is inseparable from its political inheritance. All the way down through the ranks of our public eleemosynary institutions and service we see the effects of some blighting hand, crushing initiative, deadening ambition, repelling science, discouraging experience and professionalization, encouraging incompetency by doling out as spoils that which should be assigned to students and scientific men.

What is the reason that medical organizations and medical schools have ignored nervous and mental diseases and all the behavioristic problems that have a mental or nervous slant? The state has monopolized the care and treatment of these diseases and has closed its so-called "hospitals" with locked doors and barred windows. It has made prisons of them, not hospitals. Its political frigidness has resisted medical advances. It has frowned upon the presence of medical research within the walls of its institutions. We cannot blame men of medical genius for their distrust of the state and its selfish habits. They refuse to be hampered by the senseless routine and bewildering maze of bureaucracy that encompass state hospital administration, or to be associated with the low ideals and professional lethargy that stand out like the towers and architectural

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adornments with which so many of its institutions are burdened. The openminded scientific viewpoint must be suspicious of the politically sequestered material, so carefully guarded in the jealous interest of machine politics.

The state insists upon monopolizing the care and treatment of these types, but it refuses to accept all the responsibility that is implied. The work that the national mental hygiene society and its few affiliated state societies are trying to do on limited funds, solicited from the public, is work that the state should be doing out of its own revenues. Why should it be insisted that the value of mental hygiene first must be demonstrated to the state by private initiative? I do not believe it. Mental hygiene requires no demonstration. It is inseparable from the functions of the state hospital and is detached only because our politically shaped norms do not care and have not the energy and the vision to change themselves. Every subscriber to the support of mental hygiene knows he is giving his money to a purpose that is not a private welfare service, but distinctly and clearly a state duty which the state cowardly avoids.

How much advance can you measure in our general hospitals for the benefit of the mental patient? How many general hospitals are prepared to care for an emergency mental case? Is it not into the filthy jail that the acute mental sufferer is cast to await the convenience of the court? At a period in his trouble when the most skilful treatment should be given him he is subjected to treatment that can have only the one result of intensifying his distraction and preventing his recovery. No health facility today is so badly needed in the local hospital as a mental ward.

Have we any idea why this defect remains unremedied? Why have not general hospitals and state hospitals cooperated for the benefit of the mental sick? Why do the jail and the cruel practices of our commitment system remain to taunt us as a residual dark age conception? What educational propaganda have our state hospitals conducted among the people to remove from their minds the superstitions that cling to them respecting insanity and all forms of nervous and mental disorders? Several states have made some advance in improving their commitment laws, but at best they are not what a scientific consideration of this subject suggests.

I would not leave the impression that the field has been entirely barren of good fruits. In recent years many outstanding demonstrations have been made here and there, showing conclusively that better conditions are possible than those we endure. Many devoted men and women have expended their energies in discovery and in demonstrations, although the average rate of progress of our eleemosynary service has been shockingly slow and infested with both active and passive obstacles.

Spoils politics has been one almost insurmountable obstruction. It needs no condemnation from me. It is condemned even by those most culpable. There is not a governor in the union today who will not deny that he practices the offense in his administration, and every one of them will join in the popular

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