Evening star., 1942-04-22
DR.. 0verhoIser
Hits Plan for
Aged Insane
Sees Likelihood of
Substondord Gore in
Suggested Proposal

by a program recently advanced by
the Commissioners was criticized
today by Supt. Winifred Overholser
of st. Elizabeth's Hospital as likely
to result in substancard care for
the aged insane.
DR.. Overholser said the ely heads
had not consulted him on the pro-
posed changes Of procedure but said
he had supplied some information
to representative of Budget Officer
Walter Fowler who recommended
the program to the Commissioners.
He Is equally convinced, however.
that economies can be made with
out violence TO professional stand
ards and Is willing to give his pro-
fessional opinion to the Commis-
sioners or Congress when and II
they ask 1t.
Home Care Proposed.
In brief, the Commissioners have
advanced these economy proposals:
l. Legislation for home care" of
old-age cases.
2. Establishment of a new unit in
the tax collectors Office to collect
expenses from the estate of a
patient or relatives.
3. Erection of a rest home for
aged insane as an adjunct to Gal
hnger Hospital.
4. More effective means of deport-
ing nonresident insane
They are seeking to alleviate the
situation by which the city now
pays some 100000 a year for the
care of 4,200 patients at st. Eliza
beth's. The rate is now $50 a
day per capita, having been recently
raised from $1.80.
To the home care" proposal DR..
Overholser is in hearty accord, pro-
vided placements are made through
the hospital and not the District
Board of Public Welfare, and pro-
vided all age groups-not just the
senile patients-are included.
Urges Flexibility.
Several hundred probably could
be handled in this way" he said,
"and possibly SIS a week saved per
patient"
Such setup-pioneered in this
country in Observation-Disclosures.
however. be elastic, he said. 1t
should be easy to withdraw a pa
tient from home care If it clearly
proves unsatisfactory and substitute
another patient.
Placement should be under the
hospital, he added, because the in
stitution knows the condition of the
patient and the type of home care,
if any, he should have.
The other States which use home
care do it through the hospitals, he
declared
Would Require Inspections.
A good home care plan would re-
quire additional personnel as in
spectors, but would probably result
in net saving, DR.. Overholser con-
tinued. A patient could be boarded
for about Sc a week, he felt, and
about 81 week would cover the cost
of the additional personnel. Ger
tainly it would reduce the need for
capital expenditure.
The superintendent thinks the
Commissioners are overlooking a
good bet in the matter of collections,
but is firmly convinced that the
place to do 1t is not through the
tax collector. His remedy is a
strengthening of the District law
regarding commitments and having
the investigation done by the Board
of Public Welfare, which is already
doing the investigation where it can.
Favors Massachusetts, System.
A tax collector, he feels, can dis
cover the sources of person. S
income but does not explore the
social conditions of the family. The
Massachusetts, system, he said, is
the best and he would be glad to
describe it to city officials.
Meantime, the District law on
lunacy, he said, should be amended
to empower investigators to obtain
information at banks and other such
institutions that might prove val
liable sources on the financial status
of patients, their inheritance of
money, the obligations of the
family, etc
The proposal to add to Gallinger
rest home for aged insane is
particularly opposed by DR. Over
holser. In the first place, there
would be priority problems for
materials. In the second place.
Gallinger is under the Health De-
partment, while the Welfare Board
handles the dealings with the in
sane, thus making for scrambled
Jurisdiction. In the third place,
certain changes in the lunacy law
would have to be made because
St. Elizabeth's is the only hospital
for mental patients recognized in
District law. In the fourth place,
there is nothing in the law which
would even authorize, much less
compel, DR.. Overholser to transfer
any patients there from st. Eliza
beth's- In the fifth place, the cost
per patient per day is about So,
and with the capital outlay of a new
building it would be difficult to
go much below that in a new wing
unless substandard care is provided.
AS far as deporting nonresident
insane to home States is concerned,
DR. Overholser said that is now be-
ing done as far as money appro-
priated will allow, and while some
savings might be made in this field.
they would probably be less than the
SOS 900 estimate of the Commits
Sioners.
The superintendent said his OBJ
jections are not based on a fear of
losing patients because. as a matter
| of fact, he feels a tremendous de-
mand for the limited facilities of the
hospital will result from the war.
Sums Up Situation.
But to him the present situation
is something like this:
St. Elizabeth's Hospital, q S12 900. :
900 plant, is at the disposal of Dis
! trict patients for the cost of mainte-
nance-no contribution to capital
outlay being exacted. II the Dis
trict were to pay interest at per
cent on capital investment, it would
add II cents a day, or 500, ,0oC
year, TO the District expense
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