Report of the city of Somerville 1955, Part 11

Author: Somerville (Mass.)
Publication date: 1955
Publisher:
Number of Pages: 368


USA > Massachusetts > Middlesex County > Somerville > Report of the city of Somerville 1955 > Part 11


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During the course of the year we wrote a series of articles expressly for the purpose of clarifying certain issues which may have become clouded. The Somerville Journal provided com- plete coverage for these multi-column articles in the issues of September 22, September 29 and December 15. The first essay explained the reasons behind our annual transfers of money within the departmental accounts, the second detailed the ele- ments contributing to the progressively higher medical costs incurred by the department, and the third elaborated the rea- sons making it necessary for the Bureau of Old Age Assistance


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ANNUAL REPORTS


to prosecute legally liable sons and daughters who defiantly re- fuse to comply with the provisions of Chapter 118A of the General Laws which require support of needy parents. The Boston American also made the latter release its leading article.


Both the JOURNAL and the AMERICAN carried our news releases of November 3 and December 7. The first pertained to the forthcoming upward adjustment of Old Age Assistance grants to include an item of $2.50 monthly for transportation (effective Jan. 1, 1956) and the second concerned the right of assistance recipients to move to any community of their choice in the Commonwealth. The latter release was attributable to the numerous inquiries directed to the department due to the expiration of the rent control law and the consequent increase in rentals.


The General Agent was guest speaker on four major occa- sions during the year including the Lions Club Annual ($25) Dinner in May, the Tenth Anniversary Banquet of the Public Welfare Employees' Union in April, the regular meeting of the Arlington Rotary Club on October 5 and the opening session of the Somerville Conference of Social Work on October 11. Our remarks on proposed legislation to amend the Contributory Retirement System delivered at the Union banquet, constituted a lead story in the Boston American (April 6) and also received prominent attention in the JOURNAL (April 7).


It should also be set down for the record that statements in our Annual Report for the year 1954 were liberally publicized (after the printed document became available) by the Boston American on June 4 and by the Somerville Journal on June 2.


Apropos the same general subject, it should likewise be mentioned that the RECORD published by the First National Stores carried a feature article on our Board member John J. Conway in its December number, and the Somerville JOUR- NAL reprinted the same. Under this caption it may also be worth mentioning that the General Agent was unanimously elected Chairman of the Legislative Committee of the Massa- chusetts Public Assistance Administrators Association at an assembly in the Hotel Bancroft, Worcester, in December.


During the year the Agent attended meetings of the M.P.A.A.A. in Fall River, Amherst, West Boylston and Wor- cester. He also was in attendance at the Northeastern States Regional Conference of the American Public Welfare Associa- tion in New York in September and at the Round Table Con-


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WELFARE DEPARTMENT


ference of the A.P.W.A. in Washington, D.C. Nov. 29-Dec. 4. The latter convention marked the Silver Anniversary of the A.P.W.A. and was by far the most excellent national gathering, of its kind ever attended by the undersigned.


Reflective of credit on the Department is the fact that early in the year our Medical Care Consultant Dr. Ciro M. Giobbe was named an Associate Fellow in Proctology by the International College of Surgeons.


CUMULATIVE BURDENS


It is not generally realized that over the course of years, the Welfare Department has been a sort of receptacle or if we wish to be more gracious, a receiver general for a host of func- tions which belong primarily to other Departments but the financial burden of which devolves exclusively and to our mind, improperly on the Welfare Department. Some of these functions are fixed by law or by ordinance, others are at- tributable to custom.


In referring to this subject we intend no criticism whatso- ever of other municipal departments. We are simply raising questions as to the justice, the efficiency and the supposed economy of the conditions now obtaining.


In the first place it has become the duty of the Welfare Department to determine the legal settlement of persons ap- plying for admission through the local Board of Health, to County tuberculosis sanitoria and to perform similar functions in respect to the parents of premature infants whose hospital- ization is chargeable to the Health Department. This time- consuming work is done without reimbursement of any kind. Some communities have found it practical to engage a profes- sional Social Worker in the Health Department for the purpose mentioned, and where Health Departments meet the standards for Federal aid such an arrangement is obviously more eco- nomical. We think that the Health Department should be self-sufficient in this regard and that local Welfare Boards should be relieved of providing settlement service for the same. The logic of this position can hardly be gainsaid in view of the vast sums of money now being expended for every type of service related to health.


The Welfare Department likewise pays the salaries of the City Physician and his two Associates although these profes- sional men engage in a manifold of unrelated activities. For


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ANNUAL REPORTS


example, it is the duty of this Staff to visit policemen and fire- men absent from duty and to write reports to the Department Heads about their findings, which do not include physical examinations. During 1955, a total of 80 such calls were made to the homes of policemen and 60 to firemen. The Welfare Department for reasons not readily ascertainable, finances this service without reimbursement, as it also does the services of the City Physicians when they are called upon to examine pris- oners held in the Police Station and persons putatively commit- table to mental hospitals.


For many years now the Welfare Department has been sub- sidizing the express service which delivers surplus commodities supplied by the U. S. Government to school cafeterias, al- though the School Department has the most generous budget provisions of all Departments. This anomalous situation cannot in our opinion, be justified.


We have elsewhere alluded to the fact that for too many years the Welfare Department has been providing public as- sistance for veterans and their dependents who to our mind, should definitely be cared for by the Veterans' Services De- partment which was established precisely to preclude the pauperization of veterans. Moreover, although recipients of veterans' benefits are by statute given the privilege of physi- cians of choice, the services of the City Physician and the Wel- fare Clinic are utilized by them without reimbursement of the Welfare Department. Furthermore, our Department has been compelled to pay costly hospital bills for veterans and their families simply because of the indiscriminate invocation of un- realistic technicalities as a barrier to their receipt of Veterans' Benefits.


It is high time to our way of thinking, that the Welfare Department unshouldered some of the unwelcome accretions which have climbed up its back during the past decades of laissez-faire. When the Annual Budget of this Department is being considered, no one seems to be aware that in more senses than one, we are our brother's keeper.


Another function of the Welfare Department (which is almost entirely unknown to the general public) is that of evalu- ating and deciding the merits of petitions presented by various civic, fraternal and charitable organizations desiring to conduct "Tag Days." This duty was wished upon the Welfare Depart- ment by the provisions of Chapter 101, Section 33 of the Gen- eral Laws (1921) and requires the Welfare Administrator to


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WELFARE DEPARTMENT


notify the Police Department as well as the petitioner of his determinations.


While we do not consider this statutory demand especially onerous in itself, it is an additional fixed responsibility, another straw on the camel's back. During 1955 permits to hold "Tag Days" were granted 14 different groups.


ORGANIZATIONAL STUDY


The Report which finally issued from the so-called "Or- ganizational and Procedural Study" undertaken by the State Welfare Department at the request of our Board, was received in August 1955. The Study was begun in April 1954.


The principal recommendations of the Study were the establishment of an "Integrated Intake Division", the "integra- tion" of categorical caseloads and the differentiation of the clerical force (integrated a few years ago at the instance of the State Department) into five sections: Medical, Fiscal, Re- sources, Personnel and General Clerical.


The State Report also advocated broadening the scope of the duties of the Supervisor of Domestic Relations so that cases concerning legally liable relatives in the categories of Old Age Assistance and Disability Assistance would fall within his prov- ince. This would isolate this aspect of case work from the regular Social Workers in these two Divisions and concentrate it under the jurisdiction of one person. This recommendation is in diametric opposition to the officially expressed attitude and implementing action of the Department in respect to the social work already allocated to the Supervisor of Domestic Relations (affecting the Aid to Dependent Children and the General Relief Divisions), regarding which the State Depart- ment has repeatedly recorded its desire that the activities pres- ently integrated under his headship should be distributed among the other Social Workers. There is obviously therefore, a rather labyrinthine confusion of thought upon the part of the State Department in reference to this area of case work.


Following receipt of the Report, the findings and recom- mendations respecting each Division were typed and distrib- uted to the respective Supervisors and conferences were arranged in each instance, for review of the material with the State Field Representative Mr. John Grady, whose objectivity, cooperative and understanding counsel proved helpful and


176


ANNUAL REPORTS


gratifying. A number of minor recommendations contained in the Report pertaining to ways of improving case recording and the development of card controls, were adopted by the Agency.


The Board of Public Welfare, after the members enjoyed an opportunity to study the Report, devoted the full time of a Special Meeting on October 4 to an analytical examination of the contents. In brief, the Board found little that was new or unanticipated in the Report and was satisfied that its feasible suggestions were being utilized. The Board has long debated the merits of the system of caseloads styled "integrated" be- cause of certain problems peculiar to our local organization, and therefore took the proposal under advisement, as it did also the hypothesis that it would be advantageous to segment- alize the clerical staff as outlined.


Only one paragraph in the Report brought the positive con- demnation of the Board as being ostensibly inaccurate and our sentiments about this unfortunate intrusion into the script were immediately communicated formally to the District Of- fice of the Department.


CONSTRUCTIVE ACTION


It is utterly impossible to encompass within a scant few pages an adequately comprehensive delineation of the virtual infinitude of acts and events which kept the energies of the Department fully mobilized during the memorable year 1955. Every phase of the Department's ample program was subjected to searching reexamination, frontal attacks were made on a score of perennial handicaps and on every level the accent was placed on the positive. In supplementation therefore, of the skeletal outline etched above under the divers captions we would like to catalogue here in compendious fashion, a plethora of progressive innovations which we confidently trust are but harbingers on the horizon of the future.


1. Complete processing of all assistance rosters through local banks in search for hidden assets. This project resulted in the discovery of several unreported ac- counts and in the closure of some cases.


2. Solution of the problem of belatedly dated fiscal war- rants for medical payrolls about which the State Audi- tors had repeatedly complained to the City Treasurer. Problem solved promptly upon being drawn to our at- tention.


177


WELFARE DEPARTMENT


3. Speeded refunding procedure whereby cash receipts are deposited on day of receipt with City Treasurer.


4. Time saving payroll procedure whereby checks (un- signed) for assistance recipients are prepared by our Department and relayed to Treasurer for mailing.


5. New personnel time schedule whereby Social Work Supervisors are held responsible for filing of complete weekly reports with Head Clerk each Friday afternoon.


6. New system of authorization whereby Supervisors are extended decisive power thus speeding activation of cases and increasing amount of Federal financial par- ticipation.


7. Uniform individual authorization procedure by Social Workers in all Divisions whereby payroll composition is greatly expedited.


8. Revision of fee schedule upwards for billing other Cities and Towns for treatments given by our City Physicians to cases "settled" elsewhere. Designed to increase Department's revenue in accordance with real costs.


9. Authorization received from Secretary of State to de- stroy obsolete case records after seven years. Author- ization sought after State Welfare Department notified us no official policy existed. Purpose is to conserve filing cabinet and floor space.


10. Lump-sum Annual Budget appropriation approval re- ceived from Director of Accounts of the Common- wealth whereby local appropriation accounts can be reduced from twelve to three, thus simplifying book- keeping all along the line.


11. Successful tracing and refunding of outstanding checks brought to our attention by State Auditors. We are still attempting as we have for years, to obtain periodic lists of uncashed checks from City Treasurer's Office. However, this is primarily a Treasury matter.


12. New Ordinance requiring automatic sprinkler systems and improved Safety Equipment in Nursing Homes. General Agent helped formulate same in conjunction with five other Department heads.


13. Elimination of extravagant billing for medical supplies by one of the larger Nursing Homes which submitted


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ANNUAL REPORTS


to our ultimatum to cease such practices which in- cluded charging for nutriments and detergents.


14. Successful insistence that a veteran refused Veteran's Benefits be allowed to appeal and favorable decision by State Commissioner of Veterans' Services. This indi- vidual had been on our General Relief rolls for months.


15. Recouping of $2,392.34 in a Disability Assistance case disallowed by the State Welfare Department which after our clarifying communications rescinded the dis- allowance decision and reallocated the money to us.


16. An exchange of letters with the Chief engineer of the Fire Department clarifying areas of cooperative action open to our respective Departments.


17. Rotation of Supervisors during vacation season where- by all Divisions have available supervisory consultation and oversight at all times. A similar system defining the succession of authority in the clerical staff was likewise instituted.


18. Successful implementation (with consequent savings to the agency) of the decision elicited from the State Wel- fare Department in respect to the basic supplies which must be provided by Nursing Homes.


19. Our vigorous protests against two important policies of the State Welfare Department have been sustained in subsequent official pronouncements by the Depart- ment. Early in the year we were informed that our practice of paying Nursing Home rates to incorporated charitable institutions would bring adverse action. We immediately communicated our opinion that "Nursing Homes" are defined by statute, and the term cannot be narrowed by administrative rules. A State Letter later upheld this position and the previous policy was re- scinded.


More recently, we strongly dissented from the of- ficial policy requiring us to pay full hospital rates irrespective of the client's income. State Letter 68K reverses the previous policy in favor of our contention.


20. The printing and binding in booklet form and the wider distribution of our Annual Report has proved a boon to good inter-agency relationships.


21. The centralization of ordering in the hands of the Head Clerk is a much more efficient method than the pre- vious custom of dispersed requisitioning.


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WELFARE DEPARTMENT


22. Insistence on competitive bidding by the approved sup- pliers has also netted some savings.


23. The introduction of systematic, uniform and detailed statistical reporting by all Divisions has greatly abetted the accumulation of factual material about the Depart- ment's operations.


CONCLUDING REMARKS


However desirable such an objective may appear, it is not possible in governmental administration "to start all over" as if from a fresh beginning, no more than it is possible for one generation of the human race to ignore or entirely thrust aside the heritage of both good and evil bequeathed to it by its predecessors, as the foundational point of departure for all of its activities. Despite the modest advances which the Somer- ville Welfare Department has undoubtedly made during 1955, the ideal of a perfectly functioning organization remains re- mote and we are acutely aware of the truth. There are certain. deeply rooted difficulties intertextured in the very fabric of contemporary municipal government which prosper ineffi- ciency and inequities. Our personnel system itself while obviously far better than the old political "spoils system" of decades ago, has nevertheless intrinsic limitations totally alien to modern business management especially in respect to the recruitment, retention and merited advancement of qualified personnel, and correlatively the sloughing off of non-produc- tive employees. Circumscribed selectivity militates against the recruitment of highly competent staff, as do also unrealistically low salary schedules. Inflexibly rigid classification and wage ratings operate against merited adjustments, and the assump -. tion of absolute job security on the part of employees often works at cross purposes with the common good and maximum effectiveness of an agency. No panacea is available and im- provement must necessarily be gradual. The members of the Board of Public Welfare have been an unfailing source of strength and encouragement during the year 1955. To the Board under the gracious and capable Chairmanship of Mrs. J .- Helen Clough we owe in no small part, whatever measure of success we have achieved, and we are deeply grateful for its sustained support.


To the newspapers, especially the SOMERVILLE JOUR- NAL-PRESS, THE BOSTON AMERICAN and the BOSTON SUNDAY HERALD we again offer a word of sincere apprecia-


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ANNUAL REPORTS


tion for assisting us in our work of keeping the community in- formed.


We also acknowledge a debt of gratitude to the civic, fraternal, veterans' and religious organizations which have ex- hibited a solicitous interest in our needy clientele.


JOHN J. GRIFFIN,


General Agent


February 10, 1956


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WELFARE DEPARTMENT


ANNUAL BUDGET - 1955


Miscellaneous Welfare-


Personal Services


$41,522.45


$


$41,522.45


Miscellaneous Welfare-


Ordinary Maintenance


143,812.87


77,000.00


220,812.87


Aid to Dependent Children- Personal Services


46,457.46


........... ....


46,457.46


Aid to Dependent Children Ordinary Maintenance


205,645.21


17,000.00


222,645.21


Old Age Assistance-


Personal Services


98,101.49


.......... ....


98,101.49


Old Age Assistance-


Ordinary Maintenance


995,252.13


50,000.00


1,045,252.13


Disability Assistance-


Personal Services


22,111.97


.........


..


Disability Assistance-


Ordinary Maintenance


158,478.79


16,000.00


174,478.79


$1,711,382.37


*$160,000.00 $1,871,382.37


* Bond Issue


DETAILED BREAKDOWN SHOWING EXPENDITURES, RECEIPTS AND NET COST TO THE CITY - 1955


Table No. 1 OLD AGE ASSISTANCE


Ordinary Maintenance


$1,839,205.70


Personal Services


87,296.60


Equipment


1,104.52


Gross Expenditures


$1,927,606.82


Refunds


11,235.60


Recoveries


39,603.30


Federal Grants (Assistance)


737,623.36


Federal Grants (Administrative)


48,791.93


Revenue from Meal Tax


39,753.07


Cities and Towns


45,141.85


State Reimbursements


751,581.73


Total Reimbursements


1,673,730.84


Net Expenditures


$ 253,875.98


Net Costs equal 13.2% of Gross Expenditures


Table No. 2 AID TO DEPENDENT CHILDREN


Ordinary Maintenance


$480,250.60 46,712.20


Personal Services


Gross Expenditures $526,962.80


Initial Appropriations


Supplementary Appropriations


Total


22,111.97


182


ANNUAL REPORTS


Refunds


24,585.73


Recoveries


1,780.00


Federal Grants (Assistance)


206,307.47


Federal Grants (Administrative)


23,005.80


State Reimbursements


146,366.83


Total Reimbursements


402,045.83


Net Expenditures


$124,916.97


Net Costs equal 23.7% of Gross Expenditures


Table No. 3 DISABILITY ASSISTANCE


Ordinary Maintenance


$284,686.56


Personal Services


22,540.02


Equipment


679.52


Gross Expenditures


$307,906.10


Refunds


2,143.67


Recoveries


1,470.39


Federal Grants (Assistance)


91,192.83


Federal Grants (Administrative)


12,944.23


State Reimbursements (Assistance)


115,884.39


State Reimbursements (Administrative)


6,472.11


Total Reimbursements 230,107.62


Net Expenditures


$77,798.48


Net Costs equal 25.2% of Gross Expenditures


Table No. 4 MISCELLANEOUS WELFARE


Ordinary Maintenance


$202,508.18 45,445.77


Personal Services


Gross Expenditures


$247,953.95


Refunds


2,887.84


Cities and Towns


18,917.33


Commonwealth (Unsettled Cases)


17,832.81


City Home-Cities and Towns


2,548.22


City Home-Commonwealth (Unsettled Cases)


79.65


Total Reimbursements 42,265.85


Net Expenditures


$205,688.10


Net Costs equal 82.9% of Gross Expenditures


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WELFARE DEPARTMENT


Table No. 5 RECAPITULATION


Gross Expenditures


Percentage of Aggregate Costs


Net Expenditures


Percentage of Total Net Costs


O. A. A.


$1,927,606.82


64.0%


$253,875.98


38.3%


A. D. C.


526,962.80


17.5%


124,916.97


18.9%


D. A.


307,906.10


10.2%


77,798.48


11.7%


Misc. Welfare


247,953.95


8.3%


205,688.10


31.1%


$3,010,429.67


100.0%


$662,279.53


100.0%


Net Costs represent 22% of Gross Expenditures


Table No. 6 ADMINISTRATIVE COSTS OF CATEGORICAL DIVISIONS AND ENTIRE WELFARE DEPARTMENT - 1955


Gross Expenditures


Administrative Expenditures


Percentage


O. A. A.


$1,927,606.82


$96,321.40


5.0%


A. D. C.


526,962.80


49,236.81


9.3%


D. A.


307,906.10


24,901.73


8.1%


Misc. Welfare


247,953.95


48,641.50


19.6%


Total - Entire Dept.


$3,010,429.67


$219,101.44


7.3%


Administrative expenses equal 7.3% of Gross Expenditures


Table A FEDERAL MONIES RECEIVED FOR CATEGORICAL ASSISTANCE - 1955


Category


Assistance


Administration


Aggregate


Old Age Assistance


$737,623.36


$48,791.93


$786,415.29


Aid to Dependent Children ...


206,307.47


23,005.80


229,313.27


Disability Assistance


91,192.83


12,944.23


104,137.06


TOTAL


$1,035,123.66


$84,741.96 $1,119,865.62


Table B INCOME FROM THE COMMONWEALTH - 1955


Type of Assistance


Amount


Old Age Assistance


$751,581.72


Aid to Dependent Children


146,366.83


Disability Assistance


122,356.50


Old Age Assistance-Meal Tax


39,753.07


General Relief-(Non-Settled Cases)


17,832.81


City Home-(Non-Settled Cases)


79.65


TOTAL


$1,077,970.59


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ANNUAL REPORTS


Table C REFUNDS IN VARIOUS DIVISIONS - 1955


Type of Assistance


Amount


Old Age Assistance


$11,235.60


Aid to Dependent Children


24,585.73


Disability Assistance


2,143.67


Miscellaneous Welfare


2,887.84


TOTAL


$40,852.84


Table D RECOVERIES IN DIFFERENT ASSISTANCE CATEGORIES - 1955


Type of Assistance


Amount


Old Age Assistance


$39,603.30


Aid to Dependent Children


1,780.00


Disability Assistance


1,470.39


TOTAL


$42,853.69


Table E REIMBURSEMENTS FROM OTHER CITIES AND TOWNS - 1955


Type of Assistance


Amount


Old Age Assistance


$18,917.33


General Relief


45,141.85


City Home


2,548.22


TOTAL


$66,607.40


DEPARTMENT'S AGGREGATE INCOME


$2,348,150.14


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WELFARE DEPARTMENT


YEARLY STATISTICAL REPORT ON MEDICAL CARE - 1955


Item


Totals


O.A.A.


A.D.C.


D.A.


G.R.


TOTAL-Amount $776,442.50


$548,573.32


$40,111.25


$146,356.26


$41,401.67


HOSPITALIZATION:


A. General


a. Units


10634


6607 100,570.66


10,277.81


2141 33,726.72


19,225.34


B. Chronic


a. Units


7425


1612


4252


1561


b. Amount


50,264.38


11,895.39


............


31,849.67


6,519.32


PHYSICIANS:


A. Home Visits


a. Units


13033


10217 39,233.14


1170 2,070.49


1220


426 821.72


B. Office Visits


a. Units


7893


4299


1744


775


1075


b. Amount


18,232.76


11,609.15


3,147.96


1,561.00


1,914.65


NURSING HOME CARE:


a. Recipients


2640


2267


2


365


6


b. Amount


330,657.51


277,702.43


110.00


52,353.76


491.32


DRUGS:


Amount


99,352.52


69,106.32


9,399.58


14,232.41


6,614.21


DENTAL CARE:


a. Recipients


832


179


239


20


394


b. Amount


17,715.00


7,435.50


7,783.00


691.00


1,806.00


OUTPATIENT CARE:


a. Units


3023


1085


726


720


510


b. Amount


6,198.00


2,247.00


1,469.00




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