Evening star., 1942-04-07
DC. Heads Act
ToCufCosts al
ST. Elizabeth S
Hope to Sove $500, 900;
At Home Care Urged
For OId-Age Cases
BY DON S. WARREN.

Unnecessarily high cost of the
care of the Districts insane at st.
Elizabeth's Hospital, the Commis-
sioners moved today to establish
new procedures by. which they hope
to cut the annual cost by nearly
100000.
They approved in principle re-
ports by District Budget Officer
Walter L. Fowler proposing legisla-
ton to permit home care" of old
age cases." persons suffering from
senility or cerebral arteriosclerosis
and establishment of new unit in
the Office of the District tax COL
lector to collect expenses from the
estates of the patient or from his
relatives.
They also considered the possibil-
ity of erecting rest home for the
aged insane" as an adjunct to
Gallinger Municipal Hospital.
Not Attack on Hospital.
The city heads disclosed they have
already proposed minor increase in
staff for the fiscal year beginning
July l to provide better collection
machinery.
The Fowler program and the
Commissioners tentative plan were
not intended as attacks ON st. Eliz-
abeth's Hospital, but municipal Off
cials agreed that past procedures
here were behind modern practices
in other places The District now
is spending nearly S3,000,000 for the
care of something more than 4,200
patients.
The District is to be advanced
S20,000,000 under the Lanham bill,
now awaiting the signature of Presi-
dent Roosevelt, for provision of nee
essary facilities here, in addition
to larger sum earmarked for hous-
ing Commissioner Young said he
hoped that some of this $40 900, 900
found would be made available for a
hospital annex at Gallinger, where
the aged insane could be cared for
at greatly reduced cost.
Twice u. S. Average Cost.
For the last fiscal year the District
paid $2,774,534 for board and care
of District patients at St. Elizabeth's
at a per capita cost of 81 day;
or more than twice the per capita
daily cost-82 cents-for the State
hospitals of the United States in
1899.
St. Elizabeth's has one employe
for each 80 patients. whereas the
national average is one employe per
ST. patients. Also while the mairr-
tenance cost for the country de-
creased from "a cents per day ITO
80 cents per day between 1926 and
1899, the cost here rose from $3.50
TO sl80.
Mr.. Fowler told the Commission
ers Dr. Winfred Overholser, st.
Elizabeth's superintendent, had at
tributed the large percentage of in
sane in the District to three factors:
l. The area of Washington is ur-
ban and deviations in personal con-
duct are not tolerated here to the
extent they are in rural areas.
2. Because the District is the Ma
tons Capital, many persons of un-
sound mind come here to offer their
ideas to the Government, and if
their home residence cannot be de-
termined they remain charges of
the District.
3. People generally have conf
dence in st. Elizabeth's and are
willing to have mentally-ill relatives
sent there for care.
Family Care Increasing.
Mr. Fowler emphasized that II
States have adopted progressive"
methods to reduce the hospital load,
particularly by adopting family
care for mental patients not of the
dangerous type. Massachusetts, was
a pioneer in this procedure, but Mr..
Fowler said it had been used in Bel
gium for six centuries. the plan
gaining momentum in this country
only since 1880.
Mr.. Fowler stressed: "It is neces-
sary to educate the public that all
inmates of hospitals for the men,
tally i'll are not screaming maniacs
and that many are harmless to
themselves and others. This can be
accomplished by careful selection
and judicious placement Of the pa
tient, accompanied by publicity both
direct and Indirect"
Mr.. Fowler said one other advan-
tage would be to release space at st.
EliZabeth's for patients who become
Ill because of war service.
500 Could Be Boarded Out.
He estimated that if 500 District
patients at ST. Elizabeth's-about
half of those classed as "old age"
cases-could be boarded out the
yearly savings to the District would
be S171 600.
The budget officer also estimated
that if 100 other patients were given
places in a rest home at Gallinger,
which would be connected with the
operations of the Home for the Aged
and Inf1rm, there were prospects OF
an additional 100000 savings, and
he estimated some $4,000 could be
saved each year by more effective
means of deporting nonresident in
sane to their home States and an
additional $4,000 saving from i'm
proved methods of collecting pay
ments due from estates of the pa