The full text on this page is automatically extracted from the file linked above and may contain errors and inconsistencies.
UNITED STATES DEPARTMENT OF LABOR Frances P erkins, Secretary CHILDREN’S BUREAU— Katharine F. Lenroot, Chirf Proceedings of the Conference on State Child-Welfare Services Social Security A ct, A ugust 14, 1935 T itle V , P art 3 W ashington, D . G. A p ril 4 -6 , 1938 Maternal and Child-Welfare Bulletin No. 3 United States Government Printing Office Washington : 1938 For sale by the Superintendent of Documents, Washington ,D .C. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Price 20 cents https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Contents Page V II Letter of transmittal________________________ MONDAY, APRIL 4— MORNING SESSION Greetings, by the Secretary of Labor___________________ Philosophy and development of Federal-State'relationships, by Katharine F. Lenroot, Chief, Children’s Bureau_________ _ ■ What chiid-weifare services have meant from the point of view of the “J Cecilia Carey, director, child-welfare services, Nevada_____ What child-welfare services have meant from the point of view of countv development, by Winifred Lockard, county children’s worker, Burnett County, Wis______________________ _ What child-welfare services have meant from the point o7view_of"services for special groups, by Mrs. Phyllis O’Kelly, county children’s worker, 1 4 10 17 23 MONDAY, APRIL 4—AFTERNOON SESSION RELATION OF CHILD-WELFARE SERVICES TO AID TO DEPENDENT CHILDREN Objectives in aid to dependent children, by Jane M. Hoey, director Bu reau of Public Assistance, Social Security Board______________-__ Fa^ K ^ COnteilt of the program of aid t0 dependent children, by Mrs Elizabeth Thompson, supervisor, aid to dependent children, Tennessee Discussion: By Ruth FitzSimons, assistant director, State Department of Social Security, Washington____________________ __ B3L Liml n Muhlbacb- acting supervisor, Division of Child Welfare State Department of Public Assistance, West Virginia___ w Ui!fr’ director of child welfare, Arkansas Department of Public Welfare______________________________________ By Chariotte Leeper, case-work supervisor, New Hampshire State Board o f Welfare and Relief_____________________ General discussion______________ __________ 29 40 46 48 49 51 53 MONDAY, APRIL 4—EVENING SESSION Some aspects of child-welfare services, by Hon. David C. Adie, commissioner, New York State Department of Social Welfare___ _______ Positive programs of child welfare, by James S. Plant, M. D~ director Essex County, N. J., Juvenile Clinic___ .______________________ _’ 58 63 TUESDAY, APRIL 5— MORNING SESSION MENTAL-HYGIENE PROBLEMS AND SERVICES IN RURAL COMMUNITIES Method of providing psychiatric services, by Howard B. Mettel M D HealthBU_reaU ° f Maternal and Child Health, Indiana State Board of Content of a mental-hygiene program, by George H. Preston, M. D. com missioner of mental hygiene, Maryland State Board o f Mental Hygienem https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis .74 79 CONTENTS IY Page Contribution of the social worker to a mental-hygiene program, by Mrs. Robbie Patterson, supervisor, child-welfare services, Child-Welfare Divi sion, Nebraska State Board of Control-----------------------------------------------Discussion : By C. F. Ramsay, superintendent, Michigan Children’s Institute, State Welfare Department----------------------------------------------------------- --------By Lena Parrott, consultant, child-welfare services, Bureau of Social Welfare, Maine Department of Health and Welfare—— ----- -—— By Evelyn Ehman, psychologist, Division of Child Welfare, Illinois Department of Public Welfare------------------------------------------------------ . 84 87 89 91 TUESDAY, APRIL 5—AFTERNOON SESSION RELATION OF CHILD-WELFARE SERVICES TO FOSTER CARE Statement of the problem by the chairman, Jacob Kepecs, executive direc tor, Jewish Children’s Bureau o f Chicago------------------------— ------- 7— Developing community resources, by Mrs. Ann Botsford Bridge, socialwork consultant, child welfare, Maryland Board of State Aid and Charities--------------------------------------------------- ---------------------------------------Cooperation with private agencies, by Grace M. Houghton, director of child care, Bureau of Child Welfare, Connecticut State Public-Welfare Council___________________________________________________ _—- — -----Initiating foster care in a local community, by Alice R. Haines, super visor, child-welfare services, Department of Child Welfare, Florida State Welfare Board----------------------------------------------------------------- —7- The problem of foster care by juvenile courts, by Mrs. Helen C. Swift, supervisor, Division for Children, State Department of Social Security, Washington------------------------------------------------------------------------------ -—- - The broader scope o f child-welfare services, by the Rev. Bryan J. McEntegart, director, Division of Children, Catholic Charities of the Arch diocese of New York---------------------- -l-------------------------------------------------- 95 *90 192 196 199 m WEDNESDAY, APRIL 6—MORNING SESSION I. DEVELOPMENT OF LOCAL RESOURCES FOR CARE AND PROTECTION OF CHILDREN Discussion : By Mary Lois Pyles, director, Division of Child Welfare, Missouri Social-Security Commission..----------------------------------- -j-------------- -----By Mrs. Doris M. Affleck, case-worker supervisor, Delaware State Board of Charities---------------------------------------------------------------------General discussion------------------------------------------- ----------------------------- \----- H8 121 123 II. CASE RECORDING IN LOCAL PUBLIC AGENCIES Discussion: By Bessie E. Trout, welfare-training assistant, Bureau of Child Wel fare, New York State Department of Social Welfare----- ----------By Frances Steele, director, Division of Child Welfare, Georgia State Department of Public Welfare-------------------------------------------------- — By Mrs. Norma Rankin, director, child-welfare services, Division of Child Welfare, State Board of Control, Texas— -------------------------By Florence M. Mason, assistant director, Catholic Charities Bureau, Diocese of Cleveland----------------------------------------- -— ———-------------- 133 General discussion--------------------------------------------------------------------------------- 134 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 129 132 133 CONTENTS V WEDNESDAY, APRIL 6—LUNCHEON SESSION DEVELOPMENT OF SERVICES FOR RURAL CHILDREN WITHIN A STATE CHILD-WELFARE DIVISION Aspects o f State child-welfare services, by Norris E. Class, supervisor, child-welfare services, Oregon State Relief Committee____ Development of services for rural children, by Paula Frank, director Bureau of Child Welfare, Louisiana Department of Public WelfareSupervisory functions of the State child-welfare division, by Anna Sundo^ P u W i?W elfa re11 ° f Chlld"Welfare Services, Utah State Department Relating the special child-welfare services to the regular State childwelfare program, by Grace A. Reeder, director, Bureau of Child Wel fare, New York State Department of Social W elfare^<1ferenceePreSen^a^ VeS https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Page 339 142 145 148 we^ are departments attending the con152 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Letter of Transmittal U nited S tates D e p ar tm en t of L abor , C h il d r e n ’ s B u r e a u , Washing ton, August 1,1938. M a d a m : There is transmitted herewith a report o f the conference on State child-welfare services under the Social Security Act, which met at Washington, D. C., from April 4 to April 6, 1938. The pro ceedings o f the conference have been prepared for publication by the staff o f the Child Welfare Division o f the Children’s Bureau. Respectfully submitted. K a t h a r in e F . L enroot , Chief. Hon. F rances P e r k in s , Secretary o f Labor. VII https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Proceedings of the Conference on State ChildWelfare Services (Social Security Act, August 14, 1935, Title V, Part 3), Washington, D. C., April 4-6, 1938 Monday, April 4— Morning Session H. Ida Curry, Chairman, United^ States Children’ s Bureau Advisory Committee on Community Child-Welfare Services, Presiding The C h a ir m a n . I am sure you are all quite as thrilled as I am that we are getting together once more to review what has been done in child-welfare work in rural areas. I do not believe that any of you realize the significance o f this meeting as Mr. Carstens and I do. Our minds run back 20 years to a time when there was practically no rural social work under any auspices, except in a very few spots in the United States. What has occurred in these last 2 years has been due largely to the leadership o f the Children’s Bureau. It is a great pleasure to have at the head of that Children’s Bureau as understanding a woman as the one who presides over it, and I am very much pleased to present to you Miss Katharine F. Lenroot. Miss L enroot . S o many of our contacts have to be made through correspondence and verbal reports from our field staff. We could not go on at the Children’s Bureau, those o f us who have to be at desks most o f the time, if we did not have occasional opportunities to work with you in person, sometimes out in the field, when it is a rare privilege o f mine to see you in your own habitats, and more often in the conferences here. We are very happy in the privilege o f having the Secretary of Labor with us. We should never forget that the social-security program of which you are a part grew out o f the work o f the Cabinet Committee on Economic Security, o f which Miss Perkins was chairman. Her realization o f the breadth o f a social-security program and o f the necessity o f making work for children the heart of the program, led to the opportunities that you have for service. The S ecretary op L abor . I cannot tell you how glad I am to be here and how welcome you are in Washington under the roof o f the Department o f Labor for this conference. It is a great pleasure also to know that we are going to have, for a few days at least, conferences with people who have reality always before them when they speak; for we who are here in Washington 1 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2 CONFERENCE ON STATE CHILD-WELFARE SERVICES are without the stimulus of the people who face the problem realisti cally in the field. We are apt to grow theoretical. We are bound to do that if we sit and read reports. We are bound to compare one report with another and then come to some kind of logical conclusion as to what they all mean. The thing that I have learned as I have gone through life has been that logic is a wonderful thing. It is a great invention of mankind. It is a system that man invented to help him think with the use o f these cumbersome tools that we call words. I f we had not had to use words to help our thinking process we probably should never have gone far with thought. Having invented words we had to invent logic to help us think with words. But though people have learned to think logically they do not always act logi cally, and it is in action that the really important part o f life lies. It is what people do and not how they are able to think that matters. People who sit and read reports are likely to follow a logical process o f thought and come to a logical conclusion if it is not corrected by the people who work in the field with human beings, who see them day after day, not acting and reacting logically but acting and re acting according to some inner needs and pressures—some God-given aspiration, some power o f self-discipline that logically they ought not to have, some hopefulness that logically they could not possibly have. I f one has not seen them doing that sort of thing one is likely to come to a false program. That is why it is so reviving to us to have direct contact with you who are in the field, who are seeing people, who know intimately those who are faced with the very problems for which we are today making meager but honest pro vision. It is this meager and honest provision which we Americans should take to our hearts, not so much regretting that it is meager as rejoicing that it is at least an honest and honorable attempt, in which all of us are involved, to make life worth living and to make life as good as possible for the people who happen to be living upon this part of the continent at this particular time in the history of civilization. The keynote of this whole conference appears to be that we are coming to realize that a program that is suitable and possible in one community with one set o f problems and one set o f capabilities on the part o f its people—a program that can be utilized success fully in that community—is not necessarily the same program that can be utilized successfully in another community. The very key to our understanding of what we ought to do is an honest but per sonal approach to the problems of community activity, recognizing that we must be and our program must be adaptable above every thing else, and that it is after all the sincerity and honesty of heart and purpose with which the workers approach their particular prob lems that make them likely to have success. So I hope the time will never come when we here in Washington write a ticket, so to speak, and send it to you through the mails and require you to act exactly along the lines laid down in the specifications. It is the essence of honest work for people and with people that they themselves—the people who are the victims or the subjects or the beneficiaries o f the activity, whatever you want to call them—should be able to take part in it and contribute to it https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 3 as well as those who are doing the work. I was delighted to hear this note and to realize, from what Miss Lenroot has told me o f what is going on, that this is really the refreshing and reviving point o f view which you are bringing to this whole program, which is based upon the idea that the Federal Government and the States and the local citizens everywhere can participate in working out programs following the same general principles but utilizing in every community the things that are best known and best adapted to the people o f that community. Thank you so much for letting me come in for even a little while. I shall hope to see more of you while you are here in Washington. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Philosophy and Development of Federal-State Relationships By K a t h a r in e F. L enroot, Chief, Children’s Bureau, United States Department of Labor This conference o f State directors and supervisors o f child-welfare services gives all o f us a real thrill, as we realize what has been done in a period o f 2 years in translating into reality the purposes which were in the minds o f all those who had some share in the develop ment o f title Y , part 3, o f the Social Security Act. It was not 2 years ago that the first conference o f State super visors o f child-welfare services was held in Washington, in June 1936 immediately following the National Conference o f Social Work in Atlantic City. A t that time an appropriation had been avail able for only 4 months and plans were just in the process of development. I know that people in the States as well as the people in the Children’s Bureau sometimes got a little jittery wondering just how, with the relatively small amounts o f money provided in the act, the very general purposes o f the appropriation expressed in the act could be carried out. ,, , In those first months, in conference with staff and with the people in the States, it was emphasized that the objective o f Federal-aid programs, as administered through the years in various forms of service and as conceived by those responsible for all the titles ox the Social Security Act, was to help to meet needs o f people m every State and in every community and to stimulate the develop ment o f certain Nation-wide standards. These standards are based on recognition of the fact that the needs of children and families and communities everywhere are really the same but that the way they are met must vary from State to State and from community to community, in accordance with, particular conditions ^and with the general framework of the economic, social, and political organiza tion within which the people of the community and the State live. So in the Children’s Bureau we approached, on a case-work basis, the problem of joint planning with the States, as the act requires. I think I can perhaps brag a little, for I feel that we are very fortunate in having in the Child Welfare Division, as director, assistant director, and field representatives, people who are thor oughly steeped in the philosophy of the case-work approach and of not trying to develop a priori theories from Washington to be ap plied regardless o f local situations or methods o f organization but o f working out the problems as you work out a case-work problem with a family or an individual. In the development o f the social-security program it was recog nized, o f course, that we were just at the threshold of enlarging our concepts of what constitutes a broad welfare program on a State-wide https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 5 basis that will serve the needs of rural as well as urban communi ties. For a generation or more, perhaps two generations, the leaders in the development o f urban social work had recognized the fact that people need help for a variety of reasons—economic, medical, and other reasons—and that resources should be available to meet all these types o f needs. That concept was basic in the charity-organiza tion movement and the family-welfare movement, but on the whole it had not gotten into our State services nor into the services avail able outside the large cities. Moreover, the emphasis that had to be given during the period o f depression to the vast and overwhelming economic needs o f the people, the needs for relief and assistance, had more or less overshadowed other needs for social-welfare service. Provision o f funds for child-welfare services, very limited in amount, only a drop in the bucket in comparison to social needs, was, nevertheless, a recognition o f this other type of problem, o f this other approach on the basis o f consideration o f individual needs that might arise from a variety o f reasons only partly economic, although the very important factor of the economic situation is in almost every type o f need. Therefore, child-welfare funds were made available on a broad basis and were directed particularly toward strengthening local services, because it was realized that this broader concept o f a wel fare program must be developed in the local community where needs emerge and where they may be dealt with at very early stages of development. The aid, o f course, was not intended to represent, nor was it in such amounts that it could represent, a real participation o f the Federal Government in a completely rounded State program o f welfare. In the first place we had to specify, on recommendation o f our advisory committee, although it was not in the law, that funds could not be used for the maintenance o f children in foster homes or institutions, because the fund would not stretch that far. Also, it was obvious that funds could not be used for such important programs o f State service as the care o f delinquent children, the care o f feeble-minded children, and the care o f children with physical handicaps, except to the extent that the use of a small amount o f money for study or demonstration o f the relationship between these large State programs and the program of community services might help to bring into closer relationship all the aspects of a complete welfare program. Many States at the beginning o f the social-security program did not have anything approaching a developed State child-welfare program or even a State program o f public welfare, so that, as the reports for the 6 months ending December 31, 1937, show in no in considerable number o f instances, the programs being carried on with child-welfare money, and perhaps in major part with Federal funds, do represent practically all the services, apart from institutional care, that are being developed on a State-wide basis to meet the needs of dependent, neglected, and delinquent children and children in danger o f becoming delinquent. The fact that the legislature will be meeting in the next year in practically every State and that the programs have been in operation now for nearly 2 years means that all of you, in preparing for next year’s activities, will want to analyze very carefully the whole broad https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 6 CONFERENCE ON STATE CHILD-WELFARE SERVICES range o f welfare services for families and for children; to consider the extent to which the State is meeting its responsibilities for children, the extent to which it may be possible in the near future to strengthen its services, extend them, and put into the program increasing proportions o f State funds. All o i us who have had ex perience in the rural programs know that we cannot make effective throughout the States the minimum essentials of service unless State funds as well as local funds are utilized. It may be that as the program develops there will emerge in this field, as in other fields, the need for threefold sharing—Federal, State, and local—to equalize opportunities and help support services as well as to demonstrate methods in newer fields. The child-welfare-services program essentially is one o f demonstration. None of us knows what future developments will bring, but we do know that the next step in many States is to consider very seriously the broad outlines o f a State welfare program and the extent to which the State may contribute more effectively in terms not only o f money but also of leadership. I am deeply gratified by the evidences of real achievement that we have in the progress reports and in the accounts that come to us of the work that you are doing and the pioneer spirit with which you and your staffs are attacking these problems. I do want to mention some allied considerations that you will wish to keep in mind to fill in the outlines o f the picture that you may get in your brief visit to Washington. We hope it is not going to be al together a period o f work and that you will take time to see some thing of the beauties of Washington. But I want you to see Wash ington in terms of the various ways in which people here are trying to think through some of the problems of economic and social life. As you know, we have in the Children’s Bureau, to begin here at home, research activities going on, and services in the fields of maternal and child health and work for crippled children that are intimately related to your own child-welfare-services programs. To begin with the field o f social service, the Social Service Divi sion, o f which Miss Hanna is director, has been paying special atten tion during the past year to problems of adoption and illegitimacy, problems that I know come up again and again in your own work and in your consultation service to local communities. The Delinquency Division, of which Miss Castendyck is director, is making studies o f institutional care o f delinquent children and has an advisory committee which had an all-day meeting Friday. Mr. McLaughlin, the chairman, is with us this morning. On this advisory committee some o f the superintendents o f boys’ and girls’ schools, associated with representatives o f two or three other fields o f activity, are giving very serious consideration to the problems of the training schools and the ways in which they may make their services more effective and more closely related to the com munity activities which the child-welfare services are fostering. In a number of States we have had collaboration in the programs o f service for delinquent children and the child-welfare services, through intake and population studies and through assistance, on a demonstration basis, in developing case-work services in institutions. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 7 Then we have in a small area in St. Paul a demonstration of methods o f preventing and dealing with delinquency before the stage when it must have judicial or correctional-school treatment. We are just now trying to get into that program some skilled groupwork service that will approach problems o f children from the combined point o f view o f the case worker and the group worker, applying some o f the things that have been developed in a pioneer way in Chicago, Cleveland, and other places. The child-welfareservices programs in rural areas include work which is similar to the activities in this urban demonstration, and I hope that in the months to come there can be perhaps some work in one or two rural areas that will directly relate to the things that we are trying to accomplish in the city area. In maternal and child-health work under the Social Security Act all the States, Alaska, Hawaii, and the District of Columbia are cooperating with us. We have been giving special considera tion to the gaps in the program—the things which must be attacked next if we are really to save maternal life and the lives of newborn babies in this country. I am sure you know that at the January conference nearly 500 representatives o f 86 national organizations met here in Washington for 2 days to consider in a very broad way the whole program o f maternal mortality and maternal care and the care o f newborn babies. The direct relation of this program to your program is indicated by the fact that each year about 35,000 children are left motherless because of the deaths of their mothers from causes associated with pregnancy and childbirth. The crippled children’s program is in operation in every State but one. I have been very much pleased to see in the progress reports for State after State evidence that you and those in charge o f crippled children’s programs are really getting together to make available to the crippled child in a concrete way the assistance that his needs require. The program o f aid to dependent children is being carried on by the Social Security Board and must be thought of in the very closest relationship to this program. I know that when we raise problems o f how far a program of service to dependent children, neglected children, and delinquent children should be extended, we cannot escape consideration of the relative stage o f development o f aid to dependent children and the great needs in that field for carrying the program forward on a basis of increasing adequacy. The problems of relief, o f course, and the ways in which the State and local communities are meeting these problems, are uppermost in all our minds. This year the problems o f medical care loom large in all your work, I know, and I am sure you will be interested, if you do not already know about it, in the report of the Interdepartmental Com mittee to Coordinate Health and Welfare Activities, which has just been issued, on the need for a national health program. A techni cal committee, representing the Children’s Bureau, the Public Health Service, and the Social Security Board, worked for about 8 months in exploring the problem and was responsible for the prepa ration and submission o f this report to the full interdepartmental https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 8 CONFERENCE ON STATE CHILD-WELFARE SERVICES committee, which accepted it and transmitted it to the President. The Committee considered the needs of children for medical care, as well as the needs o f mothers and newborn infants, and pointed out the absolute necessity of developing services on a State-wide and a Nation-wide basis to meet the needs o f children who cannot otherwise receive the medical care and health supervision necessary to keep them in a condition o f full health and vitality. The educational program, o f course, is also closely related to the child-welfare-services program, and again and again I have been pleased to see, in the progress reports, appreciation o f this fact and evidences o f cooperation with the schools. I want to call your atten tion to a report of the Advisory Committee on Education, which has just been transmitted to the President and to Congress, reviewing the general problems of education and the relation o f the Federal Gov ernment to general elementary and secondary education and special problems o f education such as vocational education. These are some o f the things that I should like to have you keep in mind and be thinking o f as you go back to your own States, because this program is going to fail unless it continues to perform the serv ice which I know has been performed so well during the past 2 years, namely, bringing to light hitherto unknown and neglected needs of children and helping communities to view them in relation to the total community picture and to develop more adequate ways of meet ing them. The remark that Miss Lathrop made years ago that thejuvenile court helped to make the child visible is applicable to the child-welfare-services program. I am so happy that we can have with us in these deliberations and that we are to hear at dinner tonight from Dr. Plant, whose book, “ Personality and the Cultural Pattern,” has so much o f stimulus suggestion, and challenge for all social workers. All o f us, I am sure, are realizing more and more, as we sense more keenly the problems o f the world around us, that personality is the supremely important thing and that i f American civilization is to mean anything to the world that meaning must lie in the extent to which we cherish and nurture and cultivate the personality o f our people. The C h a ir m a n . We have been fortunate to have so dynamic a per son as a leader in the development of this rural work; one also who by reason o f her past experience had already a wide knowledge of the conditions in different States o f the Union, and we are glad now to hear from Miss Mary Irene Atkinson, Director o f the Child Wel fare Division o f the Children’s Bureau. Miss A t k in s o n . Miss Lenroot has referred to the differences that exist in the child-welfare-services programs developed jointly by the Children’s Bureau and the State welfare agencies. I do not know who wrote title V, part 3, o f the Social Security Act, but whoever is responsible for the wording certainly injected into that part o f the act a great deal o f flexibility, which has made it possible to work with the States on a case-work basis. In planning the program for this meeting we have deliberately chosen to place the accent on content. Each o f you may have some questions about administrative procedure and legislation. We shall be very glad to discuss these questions with you individually, but we should like to carry through these 3 days of conference on the basis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 9 o f a very definite underscoring o f what this program is about in terms o f its effect upon children. We have asked the people from the States rather than the staff of the Child Welfare-Division to participate in this program. After this morning those o f us on the staff o f the Children’s Bureau are, we hope, going to be seen and not heard. It is your conference and wè want it to be as informal as possible. We could not ask all the States to participate in the formal pres entation o f material. We tried to choose from sections o f the country that would be fairly representative, and I am sure that the contribu tions o f the various States will vary greatly. The C h a ir m a n . And now we are going to find out what child-wel fare services have meant in some o f the States. One o f the States that until recently could not be called upon to discuss what was going on in the social-welfare field is going to be represented this morning by a speaker who will tell us what Nevada is accomplishing. I am delighted to introduce Miss Cecilia Carey, who is director o f the service in Nevada. 78986*—31 -2 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis What Child-Welfare Services Have Meant From the Point of View of the State By Cecilia Caret , Director, Child-Welfare Services, Nevada Nevada, probably more than any other State in the Union, can really tell what child-welfare services have meant, and the reason is that they have meant everything from the point of view o f welfare to the State as a whole. At the present time we can say very hon estly that without the stimulus that was given by child-welfare serv ices provided through the Social Security Act, we probably would not be so far along today in Nevada as we are. This was due to the fact that at the inception o f our program there was no State-wide social-work agency in existence. There was no State welfare depart ment at all. All the problems o f people who were in need were handled either through a Federal work-relief program or through counties. By the time Nevada got around to creating a welfare de partment, a child-welfare-services program had already been in ex istence for 9 months.„ We had grown from a staff o f three trained workers to a staff o f six trained workers. We had demonstrated not only that was there a need for social work in a State that had not pre viously thought there was, but that a staff o f trained social workers could really handle the job and do it successfully. Perhaps the latter achievement is the greater one. Our emphasis on high personnel standards and a staff-training program has made itself, felt in the State welfare department that has now been created. In addition to providing the nucleus for the new department, the child-welfare-services program has provided the beginnings o f sound social work involving children ana taking care o f children’s needs and has made considerable headway in bringing to light the weak nesses of the State and in making plans for and leading the way toward overcoming these weaknesses. Our influence has been felt as strongly as it has been during the past 2 years partly because Nevada was really a virgin field so far as social work was concerned. In order to know some o f the things we encountered in developing our program it would be, perhaps, a good thing for you to picture this State, which is certainly different from any other State in the Union. Nevada has an area of 110,000 square miles, only 540 square miles o f which are under cultivation. The rest o f it consists o f vast desert wastes and grazing lands; not rolling hills, but mountainous, bushcovered grazing lands that are very little different from the desert wastes except that there is some contribution in them. The total population o f the State is only 110,000. Reno, the largest city in the State, has 20,000 people. The population o f the oSier 12 or 15 urban communities ranges from 10,000 down to a very few hundred. In many places people live 100 miles from the nearest 10 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 11 doctor or neighbor, and not along good highways either. It lias been nothing to us in the State to travel 100 or 150 miles in going from one place to another without seeing another person or passing another traveler. In the absence of a State welfare agency the child-welfare-services program was attached to the State board of relief, work, planning, and pension control created in 1935 to receive Federal grantS-in-aid. This board was given very broad powers. It handled the work-reliefprogram funds and did planning throughout the State, and its powers were general enough so that it was thought justifiable to allow it to administer the child-welfare-services program. The only working organization o f the board at the time we began was the Works Progress Administration. The child-welfare-services agency began its life in a little office that was donated to it by the W. P. A., and everything that we had in services, office equipment, and the other things we needed came to us through that agency. A survey o f re sources made it clear that Nevada was a very “ have not” State from the point o f view o f child welfare and general welfare. We learned early that if we were going to have development that was very real and very pertinent we would have to be an independent organization. ^ Among the immediately evident resources was the Nevada State Orphanage, governed by an ex officio board o f three members and operated under the direction of a superintendent. Intake was limited to children received on court commitment, and the institution was in a deplorable state. You might like to hear how bad it was, and then I will tell you how much better it became. The building was in a run-down condition so far as physical equipment goes. One boys’ dormitory had been closed because the heating plant was so inefficient that the rooms could not be heated at all. One o f the toilet rooms for the boys was locked because the plumbing was very bad. The youngsters ate from tin dishes in a cheerless dining room. The boys were on one side and the girls on the other side. They were lined up to march in. No conversation was permitted. Staff members, who had their own meals in a separate dining room, were stationed around the walls o f the room to enforce silence and discipline. The superintendent placed children for adoption at his discretion. No records or investigations were known and very little was known about the children themselves, even their birth dates being sometimes lack ing. The compiling o f information o f that sort was initiated after we began to do some work there. ^Besides the State orphanage we had the Nevada Industrial School, which cared for boys committed by the courts as juvenile delinquents' Girls committed to that institution were transferred to training schools outside the State. This institution was under much better management than the orphanage, but it was still true that boys and girls were released from there with no plans for aftercare. In the absence o f a State welfare organization, general relief and aid to mothers in the State were handled by each o f the 20 counties Three counties employed workers; not trained workers but for the most part persons who seemed to need a job and who handled all the relief problems o f the county. The other 17 counties did all their https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 12 CONFERENCE ON STATE CHILD-WELFARE SERVICES work through their county commissioners. There were two full-time probation officers in the State and one half-time probation officer. None o f the three had any special equipment for the work. Because of the neighborly condition the State was still in, we could secure for a child anything that was needed if we could find a worthy ancestor anywhere in the child’s background; any plan could be financed if there was “ worthiness.” But the problem of money was a very real one. We began to be afraid that it might do us very little good to know that foster-home care was indicated, or that a mother’s relief grant should be increased, or that a child needed special training, if it meant always that we had to go to the county commissioners as the only source o f funds. In addition to having to go to counties for money every time we needed any, there was also the problem of taxes in the State. The sources from which funds may be derived in our State are quite limited. Our boast, you know, is “ One Sound State” ; no sales tax, no income tax, and no inheritance tax. The railroads and public utilities furnish about 55 percent of the revenue that is collected. The rest comes from taxes on bullion, property taxes, gasoline tax, and revenue from the sale of liquor. There is, in addition, a constitutional tax limitation o f $5 per hundred dollars valuation in the State. In many places we have already reached that $5 limitation, and almost every other place in the State is very close to it. Within a short time we became conscious of another problem, that o f juvenile-court procedure. We saw many cases handled by juvenile-court judges, who were the regular district-court judges, m which all people who were interested were sworn in as witnesses and were made to testify for or against, in the presence of all par ties concerned. We still see that in some places, but in other places we have done much better and that sort of thing does not go on any longer. Another problem that faced us very early in our history was the lack o f facilities for giving health care or care for specific groups. That is, we had no State provision for the care of tuberculosis and none for the care of feeble-minded children. Feeble-minded children were a charge on the county, if they were provided for at all, and there was no local provision for the care o f tuberculosis. Public-health nurses in the State went into the field under the maternal and child-health program at about the same time we did, and while the two services have now built up much better resources through cooperative efforts, in the early stages each of' us had very little to contribute to the other. The school situation was another hurdle for us. Recalling the description I have given of the State, you will not be surprised to know that in many places it is not possible to have a high school or to have one available for all children who are interested in going to one. Our laws require that we provide every child with an eighthgrade education, but the existence o f high schools themselves is left to the individual school district; if the high-school population is sufficient, high schools can be had, if there is money for them. Overshadowing all these physical handicaps was the complete ig norance throughout the State o f what social work means and what a child-welfare program could mean and was going to mean. The https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 13 general attitude in our completely rural State was “well, that is all right for your city slums, you need that sort of thing there, but we haven’t those problems and we take very good care o f our people without all that fuss,” and social workers themselves were not any too well thought o f in the State. So it is not surprising that after surveying our field and looking at what we did not have, we con cluded that an educational program was going to be our major ob jective, certainly the first thing we would try to do and the thing on which we would spend a great deal of time and effort. Three localities in the State were selected as offering potentiali ties for successful work, and to each one a representative o f the pro gram went, always conferring with county commissioners, judges, district attorneys, church and school officials, and various club and civic leaders. The purpose and possibilities o f the program were explained and met with whole-hearted acceptance. The only ques tion raised was by county commissioners, who asked what it would cost. In some cases they agreed to participate to a certain amount. The commissioners in one county said, for example, “ Well, that sounds pretty good, and if you don’t ask us for more than $25 a month it will be all right.” Office space was arranged for in each of these three localities, either with the W. P; A. office if there was one, or in a county building. It depended a little upon what was avail able and what seemed in the county to be the place where we could cooperate best without having any “ foreign entanglements.” A point was made o f becoming acquainted with the members of our legislature and of showing them as early as we could some of the things that we did not have that could be remedied by legisla tion. We were promised by them everything that could be done. In fact, the slogan was “ Anything for children.” We are singularly fortunate in that thi plan drawn up by the State and approved by the Children’s Eureau set the standards for workers high. That is, they were high in the sense that there was nothing in the State and no personnel standard that we had to shoot at, and certainly high in comparison with the equipment o f some of the local workers and o f work that was being done around us. It specified, for example, that each worker should have a minimum of 6 months’ training in a recognized school o f social work, plus some experience. Three workers were available in the State at the time that we began. These three were immediately absorbed into the program. They were young and enthusiastic about pioneering in social work and were thoroughly imbued with the principle that patience and understanding must prevail and that any seeming progress was not real progress unless the entire community under stood and accepted what was being done. We encouraged very active community participation in making plans and in carrying them out. Practically every service club in the various communities in the State has at some time in our history contributed financially toward carrying out plans for a child. Their natural interest in the welfare of children has been fostered by making them quite active participants in what was being done. We have, for example, service clubs contributing toward the care of tubercular children in a sanitarium outside the State; toward foster home or convalescent care for children; toward supplying special https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 14 CONFERENCE ON STATE CHILD-WELFARE SERVICES medical needs and obtaining training in a school outside the State for two boys whose behavior was tending toward delinquency. Within a few months after the child-welfare-services program be gan we secured a small State fund of $2,000 to be used for child-care purposes. This money seemed a lot to us, and we tried in every case to use it to match local funds or to care for a child temporarily when we hoped and thought that some person or service club in the com munity or county would later take over the care o f the child. That is, we tried not to start financing out o f $2,000 anything that might continue over a very long period. In the first year this fund paved the way for a total expenditure o f $12,000. Practically all of it was collected from counties and service clubs and all o f it was spent on types o f cases that had previously received no care or attention whatever. The public interest gained through this little “bait fund” has been centered, I think, on getting money for us, and surely we will have more money after another session of the legislature.The work that we did at the orphanage has been a great source o f pride to us. The chairman of the board was an excellent person. He was the State superintendent o f education and he had a fine philosophy o f what children needed and what children should have. Working with him we made plans for removing unfit members of the staff, outlined changes in the institution itself, and arranged to place a social worker there. There was a legislative investigation o f the institution at the time we were interested in making changes, and this helped in accomplishing some o f our ends by arousing in terest in providing a better staff, so that at the present time the social worker who is out there is working in a very different'place. The rigidity of rules and discipline has been dispensed with. A much better superintendent is there. Some of the poorest staff members have been removed, and the children themselves are in a much hap pier frame o f mind. Some o f the children who were definitely feeble minded have been removed from the orphanage. One girl who presented a very serious behavior problem has been removed, and the attitude o f the children toward one another is being helped a great deal. Similarly, we have introduced social-service work for the boys at the Nevada Industrial School. Plans for the release of the boys are made now in consultation with the local child-welfare worker and the workers in whose areas the boys will be placed. It is hard for us, now that we have so much more at our com mand and are able to do so much more than in the beginning, to realize that it was only 2 years ago that we had so little. We feel that we have accomplished a great deal in that time. It seems, for example, longer than 2 years ago that we were in the dark basement room in the W. P. A. office, being constantly cautioned about what we should or should not do in the State. We have now the beginning o f a State welfare department that will provide quarters for the child-welfare-services workers. We have State participation in administrative costs. We have six childwelfare workers in the State, including the one at the orphanage. We provide social service for boys at the industrial school. We have an increased relief fund, and the prospect for future develop ments o f our program are very bright indeed. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4— MORNING SESSION 15 In March 1937, a constitutional amendment was adopted which made it possible for the State to participate in relief programs. It was possible then for the State to enact a welfare law providing for a welfare department and to provide an administrative appro priation. The law gives very general authority. It is very broad and it gives the child-welfare-services program legal status which it did not have before. A portion of the appropriation accompany ing the welfare law has been set aside for our use and we are assured of State participation in administration. In a State as small as Nevada, small from the point o f view of population, the direction o f the growth o f our program will depend very largely, we believe, on the growth o f the welfare department as a whole. Besides our division there is only one other operating in the State at the present time and that is the division o f old-age assistance. We hope in the future to include aid to dependent chil dren, aid to the blind, and supervision o f general relief. The two existing divisions are very closely related. Some people are em ployed as half-time workers on each program, and at various times we have lent workers for 3 or 6 months on a part-time basis to the other division. Our aim is to consider our workers as employees o f the department rather than o f their particular division. The educa tional qualifications of our workers are higher than those set forth for workers in old-age assistance, and our emphasis on high training and qualifications has been felt very decidedly by the workers in old-age assistance. We have maintained throughout our existence a training program to enable one or two workers a year to have educational leave for 6 or 9 months. Three o f the workers in old-age assistance have asked for an op portunity to participate in our training program and to work parttime with us when they return. We have already given this op portunity to one o f the workers. Another is going to have some training later in the year. Another encouraging sign that we think is going to build up a better personnel in the State is that three mem bers o f this year’s graduating class in the university are going to enter schools o f social work and finance their own training. We are strongly inclined in Nevada to hold out for workers from our own State. As we did not have enough trained people when old-age assistance went into effect to provide qualified persons for all positions available, we took the best ones available in the State. One by one, through a process of infiltration and training under the programs that we are offering, these people are being added to the list o f trained employees. It is a great source of pride to the State board that better personnel are being acquired. The whole heartedness of the State board in doing the best possible work is evidenced in its recent request to the supervisor o f the old-age-assist ance and the child-welfare-services programs to make recommenda tions for a closer consolidation o f the two existing divisions, looking forward eventually to a staff able to function in any division of the department. We hope that it will not be very long before we are able to assign our workers on a county or a district basis and have each one capable o f handling all the social work in that area. Child-welfare workers are now supervising, in almost every county, all the grants to mothers https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 16 CONFERENCE ON STATE CHILD-WELFARE SERVICES under the county law, and in many cases they are supervising general relief cases also. One county has already asked the State depart ment to send a qualified person who can do all the work that needs to be done, because there is no one in the county really able to do it. The place of the child-welfare-services program has been a very significant one in the development of the State welfare department and in making social work acceptable in the State to those who thought it was not needed. Individual cases have brought to the attention o f the public the need for State provision for the care of the tubercular and feeble-minded children who are now charges on the county and who therefore are being given little care in most counties. Widespread interest has been aroused in remedying de fects through legislation. Improved legislation relating to adoption, juvenile-court procedure, and general welfare work can be enacted probably at the next session of the legislature. Many groups in the State are coming into our office to say “ Well, what can this organiza tion do?” , or “How can we help you accomplish the ends that you have in mind?” Thus, reviewing the developments, slight though they have been, and the anticipated developments, and remembering the former general apathy in the State toward social work or any kind of welfare work, we are sincere in saying that the State childwelfare-services program in Nevada really has meant everything. The C h a i r m a n . Y ou have heard the very interesting story of what has been happening in the State of Nevada and how they began from scratch, as it were, in the building up of welfare work. We are now going to hear from a State that had gone quite a long way along the road o f public welfare when the Social Security Act came into being. I am glad to introduce Miss Winifred Lockard, one of the county children’s workers in Wisconsin. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis What Child-Welfare Services Have Meant From the Point of View of County Development By W iniered L ockard, County Children's Worker, Burnett County, Wis. Before I can begin to tell you exactly what child-welfare services have meant in Wisconsin, I should like to describe briefly what kind of county I am speaking of. Burnett County is one of the so-called rural counties of northern Wisconsin. It has a total area of about 566,000 acres. One-quarter of that area is zoned for recreational purposes, which in itself sounds rather ideal from the point of view of the child. Unfortunately, the area so zoned is not developed. In August 1936, 26.6 percent of all tax levies on real estate was de linquent. In December 1937, according to a survey made by the public-welfare department, 23.4 percent of our total county popula tion was receiving some form of public assistance, through the Works Progress Administration, old-age assistance, aid to dependent chil dren, or some other type of relief. Naturally all of this has had an effect on the child-welfare program and on the resources that we could expect to develop within the county. At the inception of the program in June 1936, Burnett County was given a part-time worker who devoted 10 days a month to childwelfare work in the county. After approximately 1 year of this type of arrangement we were given a half-time worker, and since September 1937, we have had a worker who spends her entire time in the county. F ifty percent of her time is devoted to cases in the public-welfare department, cases in which there are children’s prob lems. The other 50 percent of her time is devoted to cases assigned by the juvenile court, the county children’s board, or interested per sons in the county. This has had obvious advantages. It has shown the community that the family is the basis for treatment. These services were not so emphasized before and the community has not seen the tie-up and neither have the workers. Another advantage of relating child-welfare work to family prob lems, which is probably the one which the community appreciates more than any other at this point in our program, is the financial advantage. There is less duplication o f time and effort. The only disadvantage is that whereas the activities are integrated at the county level, the State still differentiates between the two fields. One State department deals with child welfare and another depart ment deals with public welfare. There is also a State pension de partment, which is a misnomer since it handles old-age assistance and aid to dependent children. We do have many cases referred to us which we cannot handle, but we work with the area investigator and we confer with her on cases in which the children are in families receiving aid to dependent children. 17 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 18 CONFERENCE ON STATE CHILD-WELFARE SERVICES Now I should like to discuss briefly the specific problems we have encountered in our work. Probably the first is that of selling our selves to the community as individuals. A rural worker has to have more than the usual amount of imagination, I think, and a special ability to adapt herself to community standards. Those of you who come from a rural community will agree with me that standards of conduct are rigid. A rural worker has to learn the standards and abide by them, regardless of the different standards which may have prevailed in the community from which she has come. After you have sold yourself as an individual you must sell yourself with relation to your program. I sometimes hesitate to use the term “ personality” as a desirable attribute o f any worker, but I think that if we consider it as William Allen White did when he said that “ personality is the individual’s social stimulus value” perhaps we may have the future o f our child-welfare program depend upon the per sonality o f the persons chosen to carry it out. After we have sold ourselves, if we do succeed in that, we must go ahead and deal with the county in a practical way. First we have to decide what shall be our point of concentration. I f we choose interpretation as a major part o f our program, are we to go around talking to community groups, acting as gadflies, stimulating the community to approach the preventive aspect of the problem, and are we not also to act as integrators o f the various resources which we find in the community? Although we do not have an advisory committee in our community, many o f the counties o f the State have chosen an advisory committee which meets with the children’s board. Other counties which do not have a children’s board have only an advisory committee made up largely of lay people, sometimes with some professional people, if they are available in the community, and these persons help in interpreting the programs to the groups which they represent. Another problem which we have found to impede our progress is a lack of recreational facilities. We do have a State-wide recrea tional program which has a branch in our county. Unfortunately, however, there are such things as quota restrictions o f the W. P. A. These quota restrictions do not permit the employment of noncertified persons on the program. Consequently the program must have as its leader someone from a certified group, which all too often, in our rural communities, does not include persons who have any special leadership ability or any special knowledge of recreational programs or the types o f things that can be worked out. Incidentally, the areas of our county in which there are no villages, and we have only four, the largest o f which has a population of less than 800, are not touched by the W. P. A. program at all, because, unfortunately, the leaders are nor furnished mileage and cannot afford to go into other areas at their own expense. That throws us back upon the schools for our recrea tional facilities, but if you go into most of our rural schools you will be fortunate if you find a swing in the playground. I wonder why they call them “ playgrounds” because they are not. Usually it is just a bare space adjoining the school, and the children, if they have anything to play with, have it because they brought it from home. This is due not only to the fact that funds are lacking but also to the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 19 fact that the school-board members never had those things when they went to school, so they do not understand why children need them now. Another problem in connection with the schools is that o f the superior and the retarded child. We have all talked a great deal in the past few years, nationally and in our States and local communi ties, about the conservation of natural resources. We have said much too little about the conservation of human resources, and I am think ing particularly of the superior child in the rural school. He is many paces ahead o f most of his fellow classmates and has a teacher who perhaps is not quite in pace with him and who has no concep tion of how to guide him and no understanding of his interests. I f the child has no one to guide him, his energies are going to be turned into destructive channels. Neither does the retarded child receive the treatment or a course o f work adapted to his ability and needs, and it is hard to see what chance either of these groups of children has. . • . The housing problem is an acute one in the county. Many people live in poorly constructed tar-paper shacks. They do have the advan tage o f being well-ventilated, but in winter weather that is not an asset. Manv o f them have one or two rooms. Sometimes they have three rooms,“but that is rare. Families of 8 and 10 and 12 live in those tar-paper shacks throughout the year. That situation has a tremen dous effect on moral standards. How can we go in and say, “Well, look at the effect this will have on Johnny, all living here together like this. Why don’t you move out?” Where would we move them to? There are no houses for them to move into. I f there were, how could they pay the rent? We can’t say, “ You will get the rent paid by the relief office.” Tied up with the housing situation is the inade quacy o f relief. Relief is administered by the local units of govern ment, which receive a small grant each month from the State. This takes’ care o f about 50 percent o f their needs, and their conception o f their relief needs is just about 50 percent of that of the State relief office. As the situation exists now, the people are fortunate, indeed, if they get food, much less shelter. It is hard for us to try to raise standards o f living. In fact, we question whether we should even suggest it. The standards of living are not satisfactory, but we know very well we cannot get an increase o f relief funds by talking with the county chairman. We have a small Indian population in the northernmost section o f our county. There were, according to the last census, 224 of them, and they create their own special problem. Their cultural background is different from that o f the white population. Their physical history is different. The greater percentage o f our tubercular people is found amongst the Indians in this county. In a recent meeting which we held relative to Indian problems, I was interested to hear the educa tional field agent of our Great Lakes Indian agencies, who is himself an Indian, express the viewpoint that basically most of our Indians have a deep feeling of inferiority, which affects their reserve, their apparent inability to understand, and their lack of ability to adapt themselves to the standards o f the communities in which they live. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 20 CONFERENCE ON STATE CHILD-WELFARE SERVICES We also have wondered about the younger generation of Indians who apparently have assimilated some o f the standards o f the community in which they live, yet are using the cultural patterns o f their tribe as an excuse for their actions or deviation from the standards set up by white Americans. I have cited a great many problems, and it sounds perhaps as if we are not getting anywhere except in contemplating the problems and that we are throwing up our hands, but I should like to tell you what our accomplishments are. Thus far in Burnett County we have done something in the way of publicity. We grant it is not nearly enough. We have had some newspaper articles; we have talked to various organizations and clubs » we have done a great deal of talking to our local officials. At the time of the last county board meeting m November the secretary of the children’s board presented the report of the children’s worker and the children’s worker also cited illustra tions of actual case work so that the board members might understand what our aims are and what type o f work we are trying to do. Mimeographed copies of this report were given to all the board members so that they might peruse it at their leisure. Copies were furnished the rural-school teachers, the principals of the four high schools in the county, the presidents o f the women’s clubs, the Ameri can Legion auxiliary, the editors of the newspapers, and various other groups. We had a mental and health clinic at which over 200 children were examined. They were given dental examinations, their eyes were examined, and about 30 o f them were given mental tests by a psychol ogist from a State department. We were not able to do as much follow-up work as we should have liked to do, as far as the physical examinations were concerned. In the first place, we could not dp so much with the children who were from families not on relief because the communities’ attitude was that they were not going to pay for medical expenditures unless they were absolutely desperate cases, but the welfare departments did all the follow-up work recommended for the children from relief families. The mental tests were o f great help to us because many of them were given to persons with whom we had been working for some time. Since then we have had brought to our attention other children who were tested, and on the basis of mental tests we do have a little better idea o f the type o f children we must cope with. One o f our little villages with a population o f about 500 has in it a high school which draws its students from neighborhood towns. The young people come into town and board at the various private homes in this village, but they are without supervision except that provided by the families with whom they live. As a result, these children were walking the streets and spending their time in taverns, and some of them clubbed together and stayed in one house by themselves and did their own cooking. The situation became, rather acute, and the social worker and the children’s board met to discuss it and called in various persons from this village. The school board took the initiative and appointed teachers to make regular visits to these children in the homes in which they were living to discuss the problems o f the pupils with the families and to see that they were not spending their time https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 21 on the streets and becoming involved in difficulties. A curfew was also established. This method has really worked out very satisfac torily, and we have heard frequently from this community expres sions of gratitude for the interest the children’s board took at the time it was needed. One project in which we are particularly interested is a council which we have organized in the northern section of the county, in the community adjoining the place where the Indians live. Practically every problem conceivable presented itself in that community. We decided that something should be done, so we called in the various people o f the community who we knew were interested—the town treasurer, the county health officer, the county chairman, the county treasurer, a storekeeper, a scout master, a member o f a scout com mittee, and other persons. We also called in the high-school principal and teachers and other persons from the county who did not live in the community but had connection with it. We called in the county judge, the county pension investigator, the county nurse, the nurse for the Indian agency, and the Indian educational field agent. We had quite a meeting. Each person presented the problems which he encountered in the community, his place in the community, what he had been doing and what he could do, and any suggestions he might have. We met from 8 until about 12:30 one evening and these members from the community seemed quite appreciative and took our suggestions to heart, not only listening but actually writing them down. As a consequence, a curfew was established in this village. They appointed a truant officer. It was decided that a library should be established and the next question was where to locate this library. It was suggested that the barber shop seemed to be the only place in town with sufficient extra space to house the books; the barber gave his consent and the library was established. All o f tnat came out of one meeting. I have been in that community several times since then, and every time I set foot on the street these people crowd around and tell me what they are doing and ask what I think of it. I think that is just one example o f the type of thing we can do if we want to. Too often we don’t realize that we can do it. We have established an unofficial advisory committee in our county. We don’t call it that because the children’s board was not enthusi astic about it, so we did not say anything about it. We just kept inviting other people to the meeting and the board accepts them and think it is a fine thing. These people consist principally of pension investigators, the county judge, the county supervisor, teachers, and county nurses. When we have a specific problem we invite other people who can throw light on the problem. Another evidence of what we like to think is our progress is the fact that the problems presented to us mainly are problems in which preventive work is possible. I could tell you o f a lot of little aims that we have worked out for various sections o f the county, but I won’t take your time to do that. I should like to mention that I think we are realizing more and more that our program depends upon our conceiving the ideal situation in our localities and then adapting it to the real situation. We must not forget that we must aid the individual to develop to the maximum o f his ability so that https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 22 CONFERENCE ON STATE CHILD-WELFARE SERVICES he may be o f most value to himself and to the community. But we must not forget that we tap the county’s resources and develop them so that they may be o f the greatest help to the individual. The C h a ir m a n . A dozen years or so ago it was my pleasure to visit a State which was then outstanding for its development o f a county welfare program. I am very glad to see selected as a speaker on the program this morning a representative from North Carolina, who will speak from the point o f view of services for special groups. Mrs. Phyllis O’Kelly. . https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis What Child-Welfare Services Have Meant From the Point of View of Services for Special Groups By Mrs. P hyllis O’K elly, County Children's Worker, North Carolina \) I want to present to you some o f the particular things that the Negro social worker, under the child-welfare-services program, has been doing for the Negro child. Child-welfare services have meant for the Negro child in North Carolina extending the present program and placing special emphasis on case work, and I think mat this has meant a great deal to the Negro child. When we think of child welfare there immediately comes to our minds that phase o f activity that has to do with the well-being of the child. Specifically, it may mean recreational or group work with children and care for the physically handicapped, the mentally deficient, the delinquent or predelinquent, and the neglected and dependent. Child-welfare services under the Social Security Act have permeated to some extent all of these areas of child welfare and have made such services available to children in need o f special ized care. The worker under this program has been expected by the local community to fill adequately the role o f one equipped to deal with all of the above-mentioned aspects of child welfare. More than that she has had the job of interpreting her role to the com munity. Gradually there has been aroused in the communities where the workers have been placed a consciousness o f that community’s problem in meeting the need o f the child. The child-welfare-services worker has demonstrated the existence o f such a need by her han dling o f the problems with the limited facilities available for carry ing out a plan o f treatment in a particular situation. I f facilities have been limited in general for meeting the child’s needs in the community, this.limitation has been felt to greater extent in childwelfare services to special groups. Here we have in mind particu larly the Negro child, who has had very few resources, local, State, or national, that could be used to serve his need efficiently. Childwelfare services have entered into the field o f Negro child welfare, and since their recent beginning they have made an inestimable con tribution to whatever programs were in existence for understanding and meeting the needs o f the Negro dependent, delinquent, or neglected child. Reviewing briefly the situation o f child welfare in North Carolina before the tune o f child-welfare services, we find that there were eight institutions caring for Negro children: One for delinquent Negro boys, public ; one for delinquent Negro girls, privately operated and subsidized by public funds; two Negro orphanages; a ward of the State Orthopedic Hospital for the care o f crippled children ; a ward for the treatment o f the feeble-minded and epileptic Negro child at 23 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 24 CONFERENCE ON STATE CHILD-WELFARE SERVICES the State Hospital for the Negro Insane; and an institution for the blind and the deaf. The institution for delinquent boys had few facili ties for adequate case-work treatment; that is, there was no social worker at the institution to study the needs o f the child and to bring together the interest o f the community from which he came and the interest o f the institution to which he was sent. Nor did the insti tution have available the services o f a psychologist who might help in determining the needs of the child. The institution for delinquent girls represents a noble effort, inadequate though it may be, on the part o f the Federation o f Negro Women’s Clubs of North Carolina to meet the needs o f the maladjusted girl. The provision made for the feeble-minded Negro child by no means met the problem. Never theless, we can say that in spite o f these inadequacies there was, to some extent, a program for Negro child welfare well on the way in North Carolina when the present specialized services became available. From such a beginning let us review for a few minutes some of the outstanding contributions of this program to the Negro child. Child-welfare services have meant, first, an opportunity for the understanding of the child in his local community. Negro childwelfare-services workers were placed in sections of North Carolina thickly populated by Negroes, one county worker in the northeastern section, another in the southwestern section, and a third in the cen tral area serving the children in a three-county unit. These workers are not only giving individualized treatment to the maladjusted Negro child and arranging care for the dependent or neglected child, but are also making the community itself more aware of the need for such service. The following summary of a case was received from one o f the Negro child-welfare assistants. Mr. J., serving a 20-year sentence, requested assistance for his family and the opportunity for his children to attend school. His wife and five children were living with Mr. J.’s father, who was un able to support them. The child-welfare-services worker gave Mrs. J. the opportunity of expressing her ideas about her financial, physi cal, and social needs, and her feeling toward the persons and o f ficials who, she felt, might have defended her husband when he got into trouble 8 months before. The next step was to learn the atti tudes o f the community toward the J. family and to interpret the family’s needs and attitudes to the community. Twice the family had been denied public and local assistance by board authorities be cause influential citizens felt the family’s deprivation was a part of Mr. J.’s punishment. To them the family were carriers of venereal disease and “no good.” Through the efforts o f the child-welfare worker a grant was made available and medical service was given. The children are now attending school. Secondly, child-welf are services have meant increasing the facili ties already available for the study and treatment o f the delinquent Negro child in the institution and in the community. There is now a case worker on the staff o f the State institution for delinquent Negro boys, and a psychologist visits the institution and the local county unit to aid in the better understanding o f the cause of be havior difficulty. The social worker at the institution began im- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—MORNING SESSION 25 mediately to make the local community from which the committed child came plan in his behalf. I f the child was found to be unsuited for the type o f care that such an institution could give, plans were immediately made for his return to that community or to an environment more suited to fill his need. There is now more careful study o f the children and the communities’ facilities before com mitment, so that mentally deficient, dependent, or neglected children are not so frequently sent to the institution because the communities have no other place for them. The county children’s worker has found the cooperation o f the case worker at the institution an ines timable asset to her in making plans for the child who is being dis missed or paroled from the institution. Thirdly, child-welfare services have meant the bringing together o f all available resources to provide adequate care for the family as child 6 an<* *ntens*ve case' WOI>k service for the individual problem , Finally, child-welfare services have placed a new emphasis upon the need of the child to grow up in a normal home environment his own home if possible. The following case illustrates what has been done through the children’s worker in returning a child to her home after 3 years in foster care. A girl o f 5, reported neglected, was taken into the custody o f the welfare department m 1933 and was sent to the Orthopedic Hospital for treatment o f a crippled foot. When released she was placed in one free home and then another. Nothing was done in the meantime to relieve the poverty-stricken condition o f the family o f six, who were sleeping in two beds, the remaining furniture consisting of a cook stove, a table, a bench, and a kitchen cabinet. The services of the child-welfare worker were requested when it was reported that the foster parents were abusing the child. The parents, who had heard nothing o f the child in some months, were eager to participate m any way they could to improve their home condition so that their daughter might return to them. In a few months’ time the family was given additional furniture. In exchange for labor the landlord r?Pa,lr®d home and gave them the use o f the entire house. The child herself was eager to return to her family. Although her own home is not so well equipped physically as the foster home, the child nas made an adequate readjustment to her family. Even i f child-welfare services meant no more than making avail able the above-mentioned services for Negro children, their contri bution could not be overestimated. But together with meeting some of the problems facing special groups of children, these services have deepened the realization o f our inadequate facilities for a wellrounded development o f the Negro child. We need boarding homes to give either permanent or temporary care to the Negro child homes which can meet the State’s requirement. We feel th f need for those S ri iuat canA f P m our treatment o f the maladjusted Negro g 1 and the mentally deficient child. We are more conscious than o f , tJie n?eA f o r a sch° o1 curriculum that is made to meet the needs o f the child and not to make the child fill the need of the cur riculum. In short, child-welfare services have given us a perspective 78986° - 3 8 ------3 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis r 20 CONFERENCE ON STATE CHILD-WELFARE SERVICES o f the needs of Negro child welfare, have increased our-resources for specialized treatment, have developed an awareness of the need for a better understanding of the Negro child, and finally have brought us face to face with the limitations of our present facilities for a wellrounded program o f child welfare. The C h a ir m a n . Well, we have dipped into three States just as samples. I am sure this gives us a background for the further dis cussion which is to take place this afternoon. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Monday, April 4—Afternoon Session RELATION OF CHILD-WELFARE SERVICES TO AID TO DEPENDENT CHILDREN Miss Anita J. Faatz, Director, Social-Work Department, Maryland Board o f State Aid and Charities, Presiding Wi are V6ry glad this afternoon that we can have fh* y Wlth US’ ^ecaif e want to sPend a little time considr h n f i p i r pr0grai^ ° f aid t0 dePendent children in its relation to cniia-weiiare services. i at the people who are doing child-welfare services are not alwaj s the workers having responsibility for administering aid tw T Chw re? d° ef not mean that there is not an interest in W bh? wgramA haV6 bf n sa? mg in this country, since the first White House Conference, that children should not be removed from their own homes for poverty alone. The passage o f the Social Security Act, which broadened the old mothers’ aid laws so that they inciutle a much more flexible program of aid to dependent children, is regarded as a great step forward in this thing which we call child welfare in its broadest sense. There has been a tendency in some parts o f the country to think that with enactment o f legislation the job was ended and we would have adequate protection for children m their own homes. We know that there are still many hurdles to be taken. We know tor example,, that there has been a much more vocal constituency for the old-age group than has been true for the children’s group. We believe that the purposes o f the act which created the Children’s Bureau, namely, that the Bureau should be concerned with conditions attecting children, make it a fit and proper procedure for us to give this afternoon to a consideration o f the relationship between these two programs. I am very glad that Miss Hoey, who has as great concern about services to children as any o f the children’s workers m y“ ® States or m the Children’s Bureau, is here to express to you the point o f view o f the Social Security Board and the objectives and the possibilities that the Board sees in the administration o f aid to dependent children. Miss Faatz, who is director o f the social-work department o f the Maryland Board of State Aid and Charities, wiM be the chairman this afternoon. I shall now turn the meeting over to Miss Faatz. The C h a ir m a n I listened to Miss Curry open the meeting this morning and felt deeply grateful to her for reminding us that things are really happening, because, as a matter o f fact, the old phrase o f not being able to see the woods for the trees is all too true o f those who are m State and local jobs. It is also a bit like looking at the 27 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 2g CONFERENCE ON STATE CHILD-WELFARE SERVICES hour hand on the clock, which you cannot see move but which is in a different place at a different time if you have the opportunity to stop long enough to look at it. I was interested to hear Miss Atkinson say, for purposes o f the record, that all parts o f the pro gram are one. While I don’t have the historical perspective o f the public-welfare program that Miss Curry has, I do feel, as I am sure a good many of you here do, a little battle-scarred by the emergencyrelief program, as though if we have not been at it quite so long we nevertheless have lived very fast in the last few years, in a much too quick and too hectic existence at particular times. As I sat in the audience this morning listening to the comment that the juvenile court had made the child visible, I could not help think ing o f the pounds and pounds o f surplus commodities, C. C. C. en rollments, W. P. A. certifications, and so on, under the weight of which we sometimes lose sight o f the individual. We do lose sight o f the child all too often in our general work with families. I am particularly interested, and also particularly grateful, that the purpose o f the meeting is to discuss content rather than admin istration, and I also am gratified to be part of the program to dis cuss the family program from the standpoint o f aid to dependent children and the child-welfare programs. With these comments, I will introduce Miss Hoey, who is well known to all o f you. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Objectives in Aid to Dependent Ghildren By J ane M. H oey, Director, Bureau of Public Assistance, Social Security Board To those, who do not look beneath the surface, my topic may seem like one o f those unnecessary questions that answer themselves. It is easy to say that the objectives o f aid to dependent children are selfexplanatory. And it is easy to give legal definitions as set forth in the Social Security Act and in the laws of the several States. That is all right as far as it goes; but it is only a very small part of the answer. Beyond this, what does this Nation-wide program imply? Have we thought through, step by step, what our immediate objec tives and our long-term objectives should be—on the Federal level, in the States, and in local communities? In analyzing objectives, we must begin by restating the basic re lationship, as conceived in the Social Security Act, among these three units o f our American Government. The relationship o f the Federal Government is with the States, and the purpose o f the Federal pro gram is to strengthen the State programs. To this end the act pro mulgates certain Nation-wide standards designed to assure minimum essentials, provides for Federal grants to States with plans approved as meeting these standards, and authorizes the Social Security Board to cooperate with the States in developing their programs. The State has a two-fold relationship—with the Federal Government on the one hand and with its own local communities on the other. It is responsible to the Federal Government for the administration of its program in accordance with basic national requirements in all parts o f the State. But this is only the beginning. The Social Security Act reserves to the States a large measure of discretion in setting up and administering their own programs. Building on the founda tion afforded by the Social Security Act, the State therefore has a major obligation to help all its local communities in continuously improving their services to dependent children. These local agencies are the most important link in the chain; and this is equally true whether the program is directly administered by the State agency through its own district offices or whether it is locally administered by county agencies under State supervision. For the local commu nity is the only point at which the “ plan” and the people meet. In the last analysis, everything we do at the Federal level and at the State level has this one purpose—to promote effective and construc tive local services to individual children and families in each com munity. In all that we do we must keep this fact clearly in mind. But at the same time we must be equally clear as to the area of responsibility within which each level of government must operate i f it is to make its proper contribution to this program. The Social Security Board has interpreted its relationship with the States as one of genuine cooperation. It has not been content 29 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 30 CONFERENCE ON STATE CHILD-WELFARE SERVICES merely to see that States receiving public-assistance grants conform to the letter o f the law. This is, indeed, an essential part of its obli gation to the country as a whole. Beyond this, however, the Board believes that it also nas an obligation to give the States all possible help in developing their own programs. But true cooperation is a two-way process, and the Board realizes that the experience gained by the States in administering aid to dependent children is the major source o f increasing knowledge and understanding in the field. In line with this liberal conception o f Federal-State cooperation, the Board considers service to State agencies to be one of its most important immediate objectives. Through its Bureau o f .Public As sistance it acts as a clearing house for State experience and is en deavoring to make more services, based on this experience, available as rapidly as possible. These services are carried on in part in the field through the Board’s 12 regional offices, and in part through its staff in Washington. The Board, as you know, reviews all State plans as they are sub mitted. These plans are developed by State officials. But members of the Board’s field staff are available for consultation, if the State wishes, even in these preliminary steps; and most o f the States have called upon them for extended consultation during the development o f their plans. After evaluating the plan and studying the field reports o f regional representatives, the Board may suggest to the State changes that seem advisable either in its legislation or m its proposed organization. After the plan is approved, regular contacts between the field staff and the State agency are continuously main tained, and reports are made both to the State and to the Board. To supplement this regular service, and for the use o f both the State agencies and its own representatives, the Board’s Bureau of Public Assistance has been developing a body o f written materials, based on the past 2 years’ experience in the States. These suggestions are being sent to the State agencies for adaptation in line with their own procedures and policies. _ . . In addition to this regular service in the field and from Washing ton the Board makes a variety of special'services available. Con sultants on the staff of its Bureau of Public Assistance offer the States advisory services on matters o f personnel, family budgeting, tech nical training, and other special fields. Such services are of value not only in dealing with particular problems but also in promoting a well-balanced development throughout the State program. This is true also of the administrative studies made by a division set up for this purpose in the Bureau o f Public Assistance. It often happens that a State agency is interested in surveying the actual operation of its public-assistance plans but lacks facilities for this kind of detailed study. I f so, the Division of Administrative Studies will cooperate with it in making a survey. This is simply an exten sion of the Board’s regular field service. Sending m this specially equipped staff helps the State to see what is happening within its own boundaries. . , V, . . . , ’ , In accordance with the Social Security Act, the Board, as you probably know, has held two hearings with regard to improper ad ministration o f State public-assistance plans. Though administra tive studies preceded both these hearings, this does not mean in the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 31 least that every study leads to a hearing. Most o f the studies made have had no such outcome. Their major purpose is simply to fur nish an objective, impartial view of how a particular program is working out. The Social Security Board offers the State agencies other special services in addition to those o f its public-assistance staff. For ex ample, in cooperation with the Bureau o f Public Assistance, the Board’s Bureau o f Research and Statistics and its Informational Service assist the States whenever they want advice in their respective fields. In the same way the Board’s legal staff has given consulta tive services to some States. When public-assistance cases have been taken to court, regional attorneys have, upon request, occasionally advised with the State’s attorneys in the preparation of their briefs. The General Counsel’s office and the Bureau of Public Assistance have also been working with the States in clarifying the relation ship between the State attorney general’s office and the State publicwelfare department. The suggestions, which have grown out of the experience of various States, seem to offer a satisfactory working basis, and should be o f interest to all those concerned with this aspect o f public welfare. Questions have also been raised with regard to fiscal procedures and relationships—between the State and its local communities and between the State department of public welfare and State fiscal agencies, such as the offices o f the State auditor and the State treasurer. Here again the Social Security Board, through its Bureau o f Accounts and Audits and other consultants on its staff, is prepared to assist the States in developing sound and effective practices. These services have been of material help in clarifying some of the States’ financial problems. But a still more important financial problem has to do with the basis on which Federal grants for aid to dependent children are made. Under the present terms of the Social Security Act the Federal Government matches State expendi tures for aid to the aged and the blind on a dollar-for-dollar basis, while for aid to dependent children it gives $1 of Federal money for every $2 o f State and local money. It seems probable that this d if ferential is at least one of the reasons why old-age assistance with 50 participating States and territories, has progressed more rapidly than aid to dependent children, in which only 40 States are taking part. For the past 2 years the Social Security Board has therefore been recommending that the grants for all three programs should be put upon a uniform equal-matching basis. It would seem desirable also to make a change with regard to Federal grants for public-assistance administration. The Federal Government now pays one-third o f the total cost, including adminis tration as well as assistance, for aid to dependent children; but for the other two programs it adds to its assistance grant a supple mentary 5 percent which the State may use for assistance, adminis tration, or both. It would be logical to expect that it would be to the best interests of effective administration if this 5-percent provision were eliminated and the act amended so that the Federal Government could pay half the total cost for both administration and assistance under all three programs. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 32 CONFERENCE ON STATE CHILD-WELFARE SERVICES Bills are now pending in Congress for another important amend ment to the act to liberalize Federal financial participation in aid to dependent children. Under the existing provisions o f the act, Federal grants are determined on the basis o f a maximum of $18 for the first child and $12 for each additional child in the same home. This, of course, does not limit the State, which may pay more or less than this amount; but if it pays more it must make up the additional amount from State and local funds. The present limitation on Federal grants might well be removed so that the Federal Government could con tribute its proportionate share of whatever allowance was called for on the basis of individual needs. I f this is not feasible, the upper limit might at least be raised to $18 for all children aided. So far these changes are no more than hopes, but many people, both in the Federal Government and in the States, are aware of the need for some such modification. It is not unreasonable to hope that these long-term Federal objectives will be realized in the not too distant future. It seems clear that one o f the immediate objectives of the States should be complete coverage of all children who are “ dependent” within the definition of the Social Security Act and for whose care Federal grants are available. Approximately 554,000 dependent chil dren in over 222,000 families are now receiving allowances from Fed eral, State, and local funds under this program. Compared with the 122,000 families who received mothers’ aid in 39 States in January 1936, the last month before Federal funds became available, the pres ent coverage represents an increase of about 82 percent. But 10 States are still taking no part in this program, though they may, o f course, still be operating under State mothers’ aid provisions. Even in States that are participating, the extent o f coverage varies greatly. The number of children receiving assistance, as compared with the total population under 16, ranges from 41 per 1,000 in some States to less than 10 per 1,000 in others. Taking all the participating States to gether, the average stands at about 19 out o f 1,000, though the best estimates available indicate that this is lower than the number who might conceivably be eligible for aid if all the States adopted the definition o f dependency in the Federal act. One immediate objective is, then, to extend State participation until this Federal-State program is Nation-wide. Another is to extend aid to dependent children within each State until it reaches all children who are in need o f and should be eligible for this kind o f assistance and service. In a number o f States this second objective has obviously not been reached. In some the definition of a dependent child in the State law is less liberal than that in the Federal act. In others the legal definition is sufficiently liberal, but its application is hampered by opinion and attitude. Children may, for example, be excluded from this program because their parents’ behavior does not conform to a certain pattern. The transfer from general relief to aid to depend ent children in some States thus seems to be made on a basis of “ pro moting the nice families.” This is hardly a sound method o f selection, and it is certainly not in accordance with the intent of the Federal law. Moreover, since most of the families so excluded are in need and re quire some kind o f public care in any case, denying them aid to de pendent children is particularly short-sighted. It simply means that https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 33 they are thrown back on general relief or some other program. This not only increases the local financial burden but also prevents the Federal Government from helping the State and community take more adequate care o f children who need the best help available. Families with dependent children should at the very least have the opportunity to receive assistance according to the objective standards established by Federal and State law. This is a basic essential if the interests of the children for whom this program was set up are to be safeguarded. Another point at which the States need to safeguard the children’s interest, is in the matter of family budgeting. This problem is par ticularly urgent in the many States where general relief is either very inadequate or nonexistent. Under such circumstances the Fed eral-State allowance for dependent children is sometimes expected to carry the budget for the whole family. This may mean that even though the maximum allowance is being granted the child himself gets very little. The family’s total budget deficiency must, of course, be given consideration in determining the needs of any of its mem bers. Though the Federal provisions for aid to dependent children do not include an allowance for the mother, general overhead ex penses—rent, light, heat, and so on—may thus properly be charged to the aid given the children, as far as the State’s available funds will permit. This is warranted by the fact that otherwise no home could be maintained for the children. But where such emergency expedi ents are necessary, great care must be exercised to protect the welfare of the children for whom the law is intended to provide. Differences in budgeting practices, whether based on family needs or individual needs, undoubtedly account in some measure for the wide variation in the State averages o f payments made to families with dependent children. For February 1938 the range was from $10.41 to $60.39 per family, with the average for all participating States $32.02. For old-age assistance and aid to the blind, which pre sumably are on an individual rather than a family basis, February payments averaged, respectively, $19.34 and $25.49. As has already been pointed out, the existing Federal provisions for financing aid to dependent children present serious problems, but there can be no question that one o f the major goals o f both the Federal Government and the States should be to make the aid offered to dependent chil dren at least as adequate as that available for the aged and the blind. Increasing coverage and increasing adequacy of assistance are, then, two o f our most important objectives; but there is a third which is o f at least equal importance—effective administrative organization. Everyone experienced in the public-welfare field would, I believe, agree that the most effective system o f State organization is that in which a public-welfare department administers not only the FederalState public-assistance and child-welfare programs but also general relief and possibly other State services. The establishment o f a single State agency does not mean that all these activities are, as it were, to be dumped indiscriminately into a single hopper. Func tions and areas o f responsibility must be clearly defined, if confusion is not to result—as some States have learned from experience. Sound organization recognizes both “horizontal” and “vertical” lines o f relationship and facilitates coordination in both directions. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 34 CONFERENCE ON STATE CHILD-WELFARE SERVICES The horizontal lines are those that relate the various programs and services administered by the department. For example, from the point o f view o f administration the child-welfare service and the public-assistance division are separate and correlative units, though both may operate within the same agency. But the director and staff o f the child-welfare program should act as consultants and advisers to the public-assistance division, in relation to aid to dependent chil dren. Division o f responsibility, plus cooperation in related fields, is a measure o f really effective organization. These horizontal lines are, on the whole, less likely to get tangled than the vertical lines which serve to integrate “ overhead” adminis trative functions. Definition within this area should, if the agency is headed by a board, begin with the board-staff relationship. Oth erwise the board may become involved in administrative details, even though its duties are clearly described in the State law as advisory. The board and the staff each has important responsibilities, but neither can fulfill them effectively unless it knows what they are. Within the administrative staff, three major functions must also be clearly distinguished and provided for—business management, includ ing fiscal control; research and statistics; and social service. State public-welfare programs involve large sums o f public money and demand as much business efficiency as private enterprises of like financial proportions. It should be clear to everyone that this money is intended for the single purpose o f providing necessary assistance and services for which government has made itself responsible. The social-service function of the public-welfare department is therefore the core and center o f the entire organization, and it should be clearly understood that the social-service staff is responsible for all parts o f the program that actually touch people’s lives. Special consultants also form a functional part of an adequate social-service staff. A home economist, for example, serves in an essential advisory capacity; and there are a number o f other special aspects o f the program for which the State agency will bring in con sultants to work with its field staff, and, through it, with the local agencies. In addition, as in the relationship between child welfare and aid to dependent children mentioned above, the staff of one divi sion may frequently be called into consultation by another division. One o f the major responsibilities o f the State social-service staff is the supervision o f local agencies. Failure to distinguish between these State supervisory and consultative functions on the one hand and local administrative functions on the other has caused much needless confusion in some States. Sometimes, for instance, a State staff undertakes to duplicate the investigations made by local workers or to check on the eligibility requirements as set forth in each indi vidual case record. Neither o f these practices seems satisfactory in terms o f real supervision. The job o f the State supervisory staff is, rather, to strengthen the local agencies, to supplement their efforts, and to help train their workers for their own everyday duties. The State agency must know what is happening in the communities, and it will make detailed spot checks upon occasion. But it should not attempt to do the job for the local agency, just as a Federal agency does not attempt to do the job for the State. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 35 Another source o f State and local confusion in some States is the lack o f clear definition and information in matters of policy and pro cedure. In some cases State policies have not been put in written form and distributed to local agencies. In others, they have been sent out in occasional bulletins? which are too easily lost or misplaced. Or again, the content o f bulletins may be superseded, without making certain that the local agencies are informed o f the change. The State agency should maintain a comprehensive, up-to-date manual of which all local agencies have copies. These manuals, which might well be bound in loose-leaf form to facilitate changes and additions, should include all statements of policy, instructions, working plans and procedures, and suggestions for local agencies. These are, o f course, only a few o f the problems of administration which the States are encountering, but they serve to suggest needs and trends in development. Increasingly efficient organization is important not only in the internal operation of the State welfare department but also in its external-relationships—its contacts with the public. In view o f current criticisms, it is worth while to make it abundantly clear that the department fully recognizes and is fully equipped to meet all its responsibilities, in business management, social service, and all along the line. Before this can be made clear it must be true. Sound organization speaks for itself. I f the public sees that the business end of public welfare is well man aged it will be better prepared to accept the need for social service administered by a staff specially trained in this field. We hear a great deal of talk about the need for businessmen in public-welfare administration. But what are the particular func tions they are equipped by training and experience to fill ? I f people can be persuaded to ask that, to inquire into the actual nature o f the work to be performed, there will be less misunderstanding o f per sonnel problems than there is at present. As one businessman is quoted as saying, after he had his first view o f public welfare from the inside: “ I ’m going to make a speech to my chamber o f commerce. Those fellows think a department like this just spends money. I ’ll tell them this is important. It takes skilled people.” When people reach that point they will be ready to accept the idea that appointments should be made in accordance with the requirements o f a particular job and that the social-service aspects of public wel fare require trained social workers, as competent in their own field as an efficient businessman is in his. But in matters o f personnel some o f our objectives are not yet fully understood, much less at tained, in many States. This issue has been most discussed in relation to the social-service aspects o f the program, no doubt because the need for adequate stand ards in this field has been most urgent and least recognized. We hope, however, that the selection o f all State and local personnel—including clerical and administrative staffs and even “businessmen”—will be placed on a merit basis. I use the term “merit” advisedly, because it seems to me that civil service may or may not be on a merit basis. Regardless of terminology, we believe that the State agency should set up minimum objective standards o f education, training, and expe- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 36 CONFERENCE ON STATE CHILD-WELFARE SERVICES rience, not only for the State staff but also for the local staffs. Stand ards for local positions should, of course, be worked out with the co operation o f the local agencies. But simply setting up standards is not enough. Some States have tried to put through merit procedures with very good standards only to see the entire system overturned and devastated. The people of the State have not understood the issues involved, and without their support the agency has been unable to withstand the pressures placed upon it. A great deal of public education is still necessary before the public will be willing to accept and to stand solidly behind really ade quate personnel standards. Though we have a long way to go to reach this objective, we shall be deceiving ourselves if we assume that public acceptance is the only hurdle we still have to cross. We believe in adequate personnel stand ards and selection on the basis of merit; we are advocating them and working for them. But what beyond that? By what process of judging—by examinations or otherwise—are we most likely to dis cover what skills people really have and whether they are fitted for particular positions ? We all know it is the “plus” that counts. But by what yardstick can we measure it? On what basis, too, can we best judge the quality o f performance ? Now that this program has been in operation for 2 years, is it not time that Federal and State au thorities began to work out methods for evaluating performance on the job, both of individuals and of the staff as a whole—clerical, statistical, and administrative, as well as social service ? We have made a beginning at solving these problems, but only a beginning. A special unit o f the Social Security Board’s staff is co operating with its Bureau o f Public Assistance in helping the States to develop personnel standards on an objective merit basis. But in this area there is still too little detailed knowledge. The issues we aye facing are analogous to those that already exist in other profes sions like engineering, medicine, and law. Surely we can learn some thing from their experience. In addition to exploring the questions as fully as we can ourselves, we must also stimulate research agencies, universities, schools of social work, and other groups to help us work them out. This discussion of organization and o f personnel has naturally car ried over from the State to the local field; for all our objectives, not only at the State level but also at the Federal level, are directed toward the service given locally to those who are in need of help. Without the support and guidance provided by the State and Federal organi zations, local agencies would, presumably, be less prepared to give dependent children and their families constructive care. But un less directed toward the development of effective local service, all the efforts o f the State and Federal governments would be futile. What we are all working for is adequate and appropriate assist ance and service for each individual in accordance with his particu lar needs. During the period of expansion through which we have so far been going this objective has not always been realized. Too often the help offered has stopped short with meeting—more or less adequately—-the money needs o f families with dependent children. This limitation, this failure to consider the equally important service needs o f such families, has not by any means always been due to https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4— AFTERNOON SESSION 37 deliberate intention. Often the pressure o f work and the heavy case loads carried by local workers have made it impossible for them to do more. We all hope that in the next few years these handicaps will be overcome. When local agencies are more ade quately staffed—both as to the number o f workers appointed and as to the standards by which they are selected—they will be better prepared to give assistance plus service and not merely cash assist ance, necessary as it is, without its equally necessary complement. Another thing that seems perhaps even more important on the local level than elsewhere is the question of attitude—of the point of view o f the worker. On all levels we must, o f course, be objec tive. We cannot base decisions on emotion or prejudice, or anything but facts— and facts about a particular situation that have been carefully weighed with all o f the knowledge and experience at our command. This may seem too obvious for further emphasis until we look at what is happening in some places. Allowances are some times, as it were, conditional. Parents whose behavior is not con sidered acceptable may be told, in effect, that unless they mend their ways their children will not get an allowance next month. Failure to fit a particular mold is assumed to be their own fault and to relieve the public agency o f responsibility. That is most cer tainly not the intent o f the Social Security Act nor of any welltrained social worker. But without facilities for good case work and with many workers who have had little or no social-service experience all sorts of short cuts are set up, and these inevitably preclude the possibility o f giving families any real service in meet ing their problems. We must help all the workers in this program to develop an attitude o f respect for the individual and for his right to his own point o f view. And along with this we must help the local agencies to develop both the concept of genuine service and the capacity to give it in the light o f particular needs. Wherever possible we must set up yardsticks by which we can measure the effectiveness o f service. This is another important area in which little guidance is available. There is little in writing; and though a good many people have been thinking along these lines, we still have almost nothing to put into the hands o f local workers— or o f State and Federal workers, for that matter—to help them judge the effectiveness of a service program. We can do certain things. We can see that payments are sent out regularly and we can check on other routine procedures. But if anybody has found a yardstick for measuring how effective a service program is or should be, I, for one, should like to hear about it. Here again we need to do a great deal of exploration. I hope that in the next few years we can all work together to find constructive answers to our own questions. But when all is said and done, the basic issue is aiding dependent children— and by this we understand not only cash assistance but also such services as will enable the family to maintain a relatively normal home and bring up its own children. In accepting this we accept also the premise that it is a good thing, wherever possible, to keep the child in his own home or with his relatives; or, if neither o f these is possible, in some other family group. A ll our past ex perience and such insight as we have into children’s emotional and https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 38 CONFERENCE ON STATE CHILD-WELFARE SERVICES social needs point in this direction. To the best o f our knowledge this is the best we can do for the child. But it is best only if we recognize—and if we help the family to recognize—that the family and society together have a responsibility not only for the child’s present but also for his future. He has a right to all the care we can give him, but that care should be directed toward helping him when he grows up to help himself. The final goal in aid to depend ent children is the prevention o f future dependency. And the final test o f the care we give children today comes years hence when they go out to find jobs and make a place for themselves in the world. There is no question that the public is behind the beginning and the end o f this program. They believe in taking care of.dependent children now, and they realize the importance o f taking care of them in such a way that they will grow toward normal adult independ ence. It is the steps between that require interpretation. Such a program demands the highest type o f service and this kind o f service is expensive. We need to make it clear to the public that the money expended in such service is a sound investment. We need to explain our reasons for believing that “ a good heart” is not enough and that experience and skill are essential. We need to make it self-evident that the program is organized and administered in the interests of maximum efliciency and effectiveness. We need to convince people that the public interest and the child’s interest are identical and that we are working to safeguard both. In some parts o f the country these things are beginning to be understood, but in many places they have not yet been accepted. No doubt we, ourselves, are at least partly responsible for this lack of public understanding in that we have not interpreted our job so that the man in the street can see what we are driving at and why. Perhaps we have failed to understand the need for interpretation. Perhaps we have been so harassed and weighed down with the size o f the job that we have forgotten it can go on only if it has com munity support. Whatever the reason for our past neglect, we must from now on devote time and effort to seeing that the community does understand and stand back o f our methods as well as our ob jectives. Public-welfare agencies must themselves take the-initiative in this.broad program of public education. State and local boards that are really representative o f all groups in the community—and we should all help to make them so— will be their most helpful sup porters and interpreters in such a program. This process of interpretation and education must extend not only to the community as a whole, but also to the children and the families who are receiving help. But before we can do either o f these things we must undertake the still more important job o f educating our selves continuously and progressively. “Know thyself”—understand your own program, your own objectives, your own attitudes, and be sure that they are as sound as intelligence and experience can make them—that is the fundamental challenge to every one of us who has a part in this Nation-wide program o f aid to dependent children. The C h a ir m a n . Thank you, Miss Hoey. I should like to start right in discussing methods of evaluating what we are doing and problems of deciding what we do that is o f value, and so on. How- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 39 ever, we are going on for the rest of the program now. I f this were a local meeting and if we stopped for just a minute here, a hundred to one somebody in some corner o f the room would rise to his feet and say, “Miss Hoey, what is a suitable home?” That may still come out. The next part o f the program is a discussion o f factors in the con tent o f the program o f aid to dependent children, and this time we go to Tennessee, with Mrs. Elizabeth Thompson, supervisor o f aid to dependent children in Tennessee. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Factors in the Content of the Program of Aid to Dependent Children By Mrs. E lizabeth T hompson , Supervisor, Aid to Dependent Children, Tennessee There is in the Bank o f England a delicate machine, a monument to the ingenuity o f its inventor. The purpose o f the instrument is to measure, within the smallest fraction, the weight and size o f the coins o f the Empire as they come from the" mint and go into the economic blood stream of the nation. The coins are placed on a long slide and as each token reaches the top it pauses for a moment and is then cast either to the right, a perfect specimen committed to the service of mankind, or to the left, an imperfect and valueless object which must be remolded and reworked before it can possess any usefulness. Nor is it a far cry from a machine for measuring coins in the Bank of England to the program o f aid to dependent children in the United States. There are those who see in the various State statutes setting forth the conditions o f eligibility for this form o f assistance, just such an automatic measure for determining who shall and who shall not be so benefited. It is peculiarly fitting, therefore, that we, as a pro fessional group first, and then as citizens interested in the common weal, give thoughtful consideration not only to the administration of the public-assistance program for children but to what is included in that program, the content of the legislative enactments and their interpretation, the plans that we are putting into effect for the con servation of child life in the Nation. Much has been said—Miss Hoey has gone into some detail— on the subject o f the philosophy o f the program of aid to dependent children as it has been set up, first by the Federal Government and then more recently by the several States. As in any good edifice the foundation was laid first, in this case many years before the structure was com pleted ; and while the span of time between the White House Confer ence of 1909 and the Social Security Act o f 1935 is a long one, it is solidly constructed. It is, of course, impossible to be aware o f the fundamentals o f social organization and doubt that “home life is the highest and finest product of civilization,” that “ it is the great mold ing force of mind and of character,” and that “ children should not be deprived o f it except for urgent and compelling reasons.” The 1909 conference report, so rich in historical significance, then goes on to lay down the primary principle that “ except in unusual circumstances, the home should not be broken up for reasons o f poverty, but only for the considerations o f inefficiency and immorality” and, continuing, “ such aid should be given as may be necessary to maintain suitable homes for the rearing o f children.” The impetus thus given to the principle of aid for children in their own homes soon set in motion the establishment o f public as well as private provision for such care. The mothers’ aid laws o f Missouri 40 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 41 and Illinois, passed in 1911, were the beginning o f a movement so popular that by 1934, 46 States, the District of Columbia, Alaska, Hawaii, and Puerto Rico had enacted such legislation in one form or another. But as is so often true o f purely statistical pictures, the fatherless children and their mothers in this country did not benefit so much as might be expected. What was the actual situation? Many of the mothers’ aid laws were permissive in character. Many more depended for their financial provision on tax units? that were too small, too unsound economically, or too limited by statutory provisions to carry the burden. The result? Many laws were not fully operative. In one State, for example, only about 5 out o f the 95 counties ever put the permissive State-wide mothers’ aid law into effect, and in 3 o f these counties the assistance was in reality poor relief to widows, the quarterly grant of $10 to $15 merely being glorified by the name mothers aid. Thus in many localities the assistance, while - being given to parents o f “worthy character” as usually required by law, was totally inadequate “to maintain suitable homes for the rearing o f children,” as outlined in the White House Conference report. The relationship between insufficient income and inefficient living, and, indeed, even immoral conduct, has long been known by students and observers o f social welfare, and yet it was our experience with mothers’ aid that assistance was often denied to applicants because they were considered unsuitable individuals or were maintaining an unfit home and that the very aid provided was often insufficient for the maintenance o f suitable and efficient homes. In addition to the factors in the administration o f the various mothers’ aid programs already mentioned, one other has unusual significance for us in this discussion. The number o f recipients of mothers’ aid, even in States that were granting aid on a State-wide basis, was often relatively small compared with the number o f applicants apparently eligible for the assistance by any test. Long waiting lists were the rule in such localities or awards of necessity were spread thin to allow for a more extensive distribution. Aid to dependent children, an extension o f mothers’ aid, to be sure, has come into a troubled world disturbed by the failure of society to accept and deal with its responsibility in the past. And aid to dependent children is often, too often, held up as the panacea for all problems of the dependent child and criticized if it does not solve within a short space of months those maladjustments that have been developing over decades. It is interesting but disheartening to read case record after case record and observe the disintegration of the family following the death o f the wage earner. Should we not as citizens feel a pro found sense o f social guilt when we see a family, deprived o f its source o f income by death, forced to turn to begging or stealing for its livelihood? And what has been the reaction o f the community to such a situation? We can find it in many o f the State laws governing the granting o f aid to dependent children in which will be found words like these: “The child or children must be residing in a suitable family home, with an adult who is fit”—yes, the word “fit” is often used—ccto raise that child.” What are we saying in 78986°—38- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 42 CONFERENCE ON STATE CHILD-WELFARE SERVICES these laws? Are we not saying, in localities where we have made little or no provision in the past for the maintenance o f the health and decency o f dependent children, and often their equally dependent parent or parents, that even though their needs may have been longlived—may have developed not this year or the preceding year but perhaps 5 or 10 years before—that family must somehow have main tained efficient and moral standards? Does not a consideration o f the mothers’ aid laws therefore have something more than historical significance for us in explaining how we have come in 1938 to an almost universal acceptance o f the social-security program in the United States? Does it not also indi cate that if aid to dependent children is to make any lasting and perma nent improvement in the condition o f child life in the country, it must devote itself and its resources not only to preventing and ameliorat ing economic want and human maladjustment, but also to rehabili tating family life, which has come to be accepted as the highest and finest product o f civilization? Social workers are traditionally vocal when they are on the old familiar ground o f case material, and the family situations that have been brought to light by aid to depend ent children, illustrative o f this point, are legion. In a State, a day’s journey from our meeting place, resides a family of a mother and four children. Unfortunately for this family the application for aid to dependent children was made before the local staff, learning on the job, had come to understand and accept the philosophy o f the program they were so conscien tiously trying to administer. The investigation brought to light the fact that a notorious bootlegger o f the community was making this home his headquarters, and a frank interview was the result o f the mother’s demand to know the reason for the rejection o f her applica tion. The details o f that interview would perhaps as well be left untold, but the summary statement by the worker was, “ and so, Mrs. T., your home is not suitable and therefore we cannot grant aid for your dependent children.” It was not until some months later that this case was accepted for assistance when the child-welfare-services case consultant pointed out that there were strong ties o f human affection between this mother and her children and that in spite o f the small and irregular pay checks coming into the home since the death of the husband, the home showed, not signs o f neglect, but care and attention. It was consoling to realize that while the aid to dependent children law stated that the home must be suitable, that phrase could be interpreted to mean “ in the future.” Thus the question, “Is this a suitable family home?” has come to have a companion question, “ Can the conditions in the home be made more suitable with aid for the children?” Certainly we, as a group of social workers, are interested in seeing that every child has the advantage o f a suitable family home under the care and guidance of a fit parent or adult, but we are learning, sometimes painfully and sometimes slowly, that the way to accom plish that end is not by rejecting at intake or after an investiga tion an applicant for aid whose home life in the past may have left much to be desired. Rather are we learning that the solution rests either in working out some substitute form o f care if rehabilitation https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 43 o f the home is impossible or in giving to that home, along with adequate assistance, intelligent case-work service adapted to the requirements o f the family. What constitutes a suitable home and what o f the factors that make for unsuitability ? A relative term, it has been observed that it is not uncommon to find a chronic physical condition constituting the difference. Can we absolve ourselves from all responsibility to the mother deemed unfit in a home called unsuitable until we have de termined not only the causative factors for this 6ondition but until we have exhausted every available resource to help correct such a situation? In short, are we not saying that it is the responsibility of those charged with the administration o f the various programs o f aid to dependent children in our States to take the rigid frame work o f the statutes governing those programs and so interweave that framework with broad policy and interpretation that the laws be come the flexible vehicles that sound social-work philosophy de mands in any program o f social welfare? In the light o f this con cept, how arbitrary may we be in saying that we will not grant as sistance if there is an income in a particular family from an older son or daughter ? What- right have we to say that that child shall not marry until the next child in the family is able to take his place as a breadwinner? To be sure, the program of aid to dependent children must have limitations—limitations o f law and limitations o f policy—but is it not sound thinking to say that these limitations should be as few as possible in the service o f the dependent child, for whose needs the Federal and the State laws were passed? True, the aid to dependent children law has been heralded as a progressive step toward a more inclusive program o f child care. It is encouraging that children are now able to establish their own place o f legal residence and are not being bound to the wanderings o f their parents. It is possible now to grant assistance to fathers of children deprived o f the care of their mother so that a housekeeper may be employed to provide at least for the physical needs o f the youngsters in the family; for whether the State is a partner o f the father or o f the mother, the needs o f the families are not unlike. Again, it is possible in many States to supplement the earnings o f the physically handicapped father when, because o f his disability, he cannot hope to care for all o f the needs o f his family. In many cases it is not necessary for that father to absent himself forever from his family in order that they may be assisted. While our aid to dependent children laws almost without exception hold that the child must be living with a relative, it has been possible in many States to extend the term relative to include any degree of relation ship. Similarly, it is possible to grant aid to children in many States regardless o f the length o f the absence from the home of the de serting father or mother, or without placing too much significance on whether the disabling condition will be likely to endure for 6 months or 6 years. I f 2 therefore, the law is to prove the progressive step toward this more inclusive program, it will mean that we, as the administrative agents, will have to clear away the entangling under brush o f strict, legalistic impediments by broadening our interpreta- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 44 CONFERENCE ON STATE CHILD-WELFARE SERVICES tion to include all groups o f children so as to accomplish the farreaching purposes o f the Social Security Act. Recently one o f our workers asked us to make a rule o f supplemen tation. We wanted to be obliging, so we sat down to make the rule; but the more we thought the more we realized that a rule was im possible at that particular point. We have already mentioned two types o f situation in which we are able to grant supplementation: In case the wages o f an older son or daughter are insufficient or the father is physically handicapped and therefore not able to earn a sufficient amount. I think that worker had in mind the question whether we should give aid to dependent children in case the mother is at work, and I imagine that is a question that has come up in some other States. The answer that we were able to give was that we were not interested, o f course, in supplementing unsound industries, and the relationship between unsound industries and an insufficient wage sometimes is a little bit hard to define. But it was possible to say that in some cases the fact that some part-time work, when the mother is able to relieve herself of some o f the responsibilities of her home and secure adequate care for her children, may represent the difference to that mother between a complete long-time and unwant ed dependency and the feeling that she is in truth making her contribu tion as an active partner o f the State. What o f the other factors making up the total content o f the pro gram of aid to dependent children? We have touched on the im portance o f adequate assistance and o f the relationship between inefficient living and inadequate income. To be more specific, we are constantly confronted with the results of inadequate income even in the wage-earning group; and, indeed, the offspring of poverty run the whole gamut of social ills from delinquency to a high disease rate. While inadequate income is thus a serious problem in itself, how much more serious may it become when combined with one or more signs of the family’s breakdown. The limitations of the program o f aid to dependent children have prevented the granting o f adequate assistance to many families. Whether the limitation on the amount o f the award is set by law or whether it is determined by a too-low appropriation, the results in general are the same. In an analysis made by the Social Security Board just a year ago, 12 of the 28 States having approved plans for the administration o f aid to dependent children had no law limiting the amount of the award, and 9 had laws in which the amount set by the Federal Social Security Act was specified. Two States, however, set an award as low as $12 for the first child and $8 for each additional child, and at least one State has joined this group since that time. The legal maximums, while greatly limiting the amount o f the awards, are probably not the greatest deterrent factor in giving adequate assistance, since in some States allowed by law to make sufficient awards, appropriations have proved totally insuf ficient to meet the needs. Although it is not always a loud voice, it is a rather constant voice that comes from the tax-paying citizens to spread the assistance thin and extend the aid over a wider area. Applications for aid to dependent children cannot be put in a pending file to await the removal o f some more fortunate family from the assistance rolls. Accidents to the breadwinner will con- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 45 tinue to occur and permanent disabling conditions will continue to manifest themselves. I f the public purse is exhausted the family as well as society is sure to suffer. As the Governor o f a Southern State said recently in speaking o f the penal institutions in his State, “ The State pays for child welfare whether it gets it or not, and it is much wiser and cheaper to see that it gets it.” I f the parent or adult receiving aid for dependent children is in truth entering into a partnership with the State, certainly the State’s obligation, which is the financial resource making possible this partnership, must be sufficient or the partnership cannot succeed in its stated aim. The distinction has been made often between those receiving oldage assistance and those receiving aid to dependent children that the former are quite vocal while the latter are a silent group need ing a champion. What better champion could the dependent chil dren o f this country have than those who are constantly in touch with their problems and who speak with the voice o f interpretation o f the need for sufficient awards? Large returns for small invest ments are what Mr. and Mrs. Taxpayer want, and where can we find better illustrative material than m our own field ? The battle for adequate funds will be a constant one, because it has been wisely said that for every new service there develops a new need; but both legislative and administrative changes are sure to come from a sane interpretation o f the very serious economic and social results of inadequate assistance. On the other hand, it can be said that it is the legal limitations on aid to dependent children that are placing such a heavy responsi bility upon private and other public forms o f child welfare at the present time—limitations that cannot be removed by any action other than legislative. Since the Federal act limits the degrees o f rela tionship that may exist between the child and the individuals re ceiving the assistance, there are no funds available for foster-family care either on a temporary or on a more permanent basis. No assist ance may be offered to the physically or mentally handicapped child unless he is able to qualify for assistance on the same basis as other children. It is a very interesting mental exercise to try to explain to the mother o f a 17-year-old son with a mental age o f 4 or 5 why he is not a dependent child. In short, the program of aid to dependent children in its content is not the all-inclusive form o f assistance that had been anticipated by many individuals nor can even the broadest interpretation always make it so. The redefinitions o f other programs o f child welfare and their readjustments to the needs of- excluded groups are of necessity causing a lag in our war on social maladjustments, and child-welfape services are playing a momentous part in this read-, justment. But whether we are working through aid to dependent children, provisions for a broad, adequate, and socially progressive assistance program available for all children coming within the purpose of the law, or whether we are working through childwelfare services to demonstrate what can be accomplished with sound case work and in helping to point up the still unmet needs of children, the challenge presented by the return of the investment that is sure to come makes any amount o f effort required seem well worth making in terms o f the creation o f a better society. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 46 CONFERENCE ON STATE CHILD-WELFARE SERVICES DISCUSSION The C h a ik m a n . Certainly w e have plenty to discuss now. Mrs. Thompson quite courteously did not name the States she was refer ring to, particularly the one where the unfit mother was told that her home was not suitable. It urges me to tell of a choice nugget that I took out o f a case record in a State within 50 miles of Wash ington. The worker told Mrs. So-and-So that she would not grant aid to dependent children for her illegitimate child because she was afraid that if she did so it would encourage illegitimacy. This is what the worker said: “ The mother then said to me very scornfully that there always had been illegitimate children in the world and there always would be, whether anybody looked after them or not.” I considered that quite a piece o f interpretation on the part of the client to the worker. We now have discussion of the two topics that have been presented by Miss Hoey and Mrs. Thompson. We will go on to a discussion by Miss Ruth FitzSimons, assistant director, State Department of Social Security, Washington, and member of the Advisory Commit tee on Community Child-Welfare Services. Miss F i t z S im o n s . I think Miss Hoey has voiced the oft-felt hope and wish o f all o f us that in the next year or two we shall come around to a concentration on service rather than on assistance. I think that we have been appalled in these first 2 years o f our publicassistance programs by the methods of determining eligibility and by the mere machinery of making grants. I believe social workers as a group are optimists, and I think it is well that we are, because it is always just next year or the next year or two that we are going to be able to shift emphasis. I think that in the States where all o f the assistance and service programs have been combined in one department we have had some very interesting opportunities to watch the reactions among members o f the staff. In Washington our child-welfare-services program has been favored in that we have made a very definite effort to keep case loads low and to select better-equipped personnel for the child-w^elfareservices program. We have been able to protect the children’s pro gram better than other divisions such as old age and general assistance. Somewhere in the middle, I think the programs o f aid to dependent children have come along with somewhat limited loads, in contrast to the general assistance part of the program. I think that in the aid to dependent children program there has been a real reflection of the more careful, more painstaking piece of work that has been possible by a worker at an adjoining desk who is carrying out a distinct service program. The very fact that in many of the counties, for the first time, the child-welfare-services program is the one which has no eligibility re quirements, that a child in a rather well-to-do family is brought to the attention of the service program through school or even through the court has been a stimulus and a recognition of service entirely apart from assistance needs. We hope in the next year or two, Miss Hoey, to carry over even into our program o f aid to dependent children some o f the finer service work, some o f the careful analysis and in- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4— AFTERNOON SESSION 47 terpretation to parent, child, and community o f what we are doing as a demonstration in the service program. Even though we go only a short way with it, I think that we are seeing definite gains all the way around. But perhaps we are seeing more tangible things that are troubling us just as much—things that perhaps are not dependent upon the quality and skill o f the personnel but upon community resources. I find myself constantly challenged by the very tangible service needed in our families, all o f our families, in terms o f health care. I pre sume that the State o f Washington is typical of perhaps half the States, and when we went into the broad program 2 years ago only 1 county out o f 39 had clinic service; and we still have just 1 county that has anything that could rightfully be recognized as offer ing general varied clinic care, so that we have tackled that type o f service throughout the State as one of the objective things that perhaps we should try to get under way early. We have had everything from the small rural county with a part-time county doctor to a good many counties, perhaps half the State, with free choice of physicians, and in none o f them have we had anything like satisfactory service. I think perhaps a good deal has been gained from the fact that at least five or six types o f service were being experimented with. I think our greatest gain has been a recognition o f the fact that we just did not know what the health needs of our children were. We wondered whether those receiving aid to dependent children were typi cal o f all o f the children in the community and whether their health was any worse; our workers had a sense of responsibility about them. Perhaps we were not thinking about all o f the children in the com munity, and just recently we have attempted, with the State depart ment o f health, to make a complete study of the whole group o f chil dren receiving aid to dependent children and those in the child-wel-. fare-services program in two or three counties. In order not to single a group out and make it conspicuous, and also in order to have a control group, the department o f health through the school nurses and health officers was bringing in about 300 children selected through the schools. In the first county about 300 children were receiving aid to dependent children, so that there will be a group o f 600 who this week or next week are being examined. We hope that this piece of re search, which at least m our State represents a decided advance in fact finding, will inform us whether the group we are dealing with is a representative cross section o f youngsters, over the State, whether they do have particular health needs that are being overlooked, and, if so, how serious they are. I wish that we could outline research projects in the field not only of health but o f recreation and special educational needs. It seems to me that until we do, any case-work service for which we may be building up a staff is not going to be able to produce the results that would be possible had we not only a knowledge of our needs for community services but cooperation by our counties, through their welfare councils and otherwise, in attacking the problem o f the child that we are interested in from the point o f view of all other children in the community who are being handicapped by the same conditions or the same lack o f services. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 48 CONFERENCE ON STATE CHILD-WELFARE SERVICES The C h a ir m a n . Our next discussant is from West Virginia, Miss Lillian Muhlbach, acting supervisor o f the Division o f Child Welfare, State Department o f Public Assistance. Miss M u h l b a c h . There are two problems that are concerning us that are somewhat related to aid to dependent children, but perhaps more related to the integrated public-welfare program that we have in West Virginia. The county departments o f public assistance in West Virginia combine the assistance program and most o f the other wel fare activities in the counties. That is, in addition to aid to dependent children and blind and old-age assistance, these departments are re sponsible for the supervision o f children who are released from the industrial schools on parole, and they are also responsible for foster home care in the county, and participate to some degree in the crippled-children program, as well as in the adult-rehabilitation pro gram. In other words, it is the pivot on which public assistance is administered. Therefore it is necessary to define the functions o f the children’s worker in this broad program. Each children’s worker is placed on the staff o f the county depart ment o f public assistance. We have thought o f the children’s workers’ responsibility as being primarily the care and supervision o f children who must be placed away from their own homes. That is our basic case load. Most o f the children who are receiving aid to dependent children or general relief do have poor home conditions, and it is rather difficult to distinguish between the general responsibility o f the regular visitor on the staff of the department o f public assistance and the responsi bility o f the children’s worker. It is in the area o f the children’s workers’ job that we are finding it necessary now to define relation ships a little more strictly than we did at the beginning of the pro gram. The supervision o f the children who are returning from the in dustrial schools to be supervised in their own homes or in foster homes comes also into this area. Under the new welfare law the director of public assistance in the county is the probation officer, and he may delegate that responsibility to any member o f his staff. In some counties that responsibility is delegated to the children’s worker; in other counties there are probation officers. In thinking o f the children’s worker’s responsibility in relation to children who return from the industrial schools and need placement in foster homes we have considered that the children’s worker should be the one to select the foster home and to supervise the children who are placed there. It is more difficult, however, to determine whose respon sibility it should be and who might best be able to serve paroled children who are to remain in their own homes receiving aid to dependent children or general relief. There is another problem that is very much with us. It is rather difficult to have the local county council think in terms other than of a relief grant, even when a child must be placed in a home that is not his own or in an institution. It is possible to supplement a grant of aid to dependent children for a child in his own home, so that we are hoping that with the philosophy o f making the financial assistance in a home more commensurate with the child’s needs the foster-home pro gram may also be defined by the child’s need away from his home and not in terms o f an assistance grant. We are one o f the States, I am https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 49 sorry to say, that have a grant limit o f $8 to $12. We hope in time that with an increase o f this grant there will be also a change in the attitude toward payments for children who must be cared for away from their own homes. The child-welfare-services program, through the division of child welfare, is operating in 22 counties of West Virginia through the county children’s workers. In the counties without children’s workers case consultants offer consultation services. It is hoped that through the stimulus o f the division o f child welfare there will be a county children’s worker on the staff of every local county department and that the consultation services will take the form of pnore intensive supervision of those children’s workers. The integrated welfare program in the State means that a county department is the only agency in any county to administer social serv ice or to perform anything approaching a case-work service, whether those they serve are recipients o f assistance or whether they are chil dren from families who are not recipients c f relief. It also means that the children’s services are utilized beyond the relief area, and problems from schools and from families who in no other way touch a public program are referred to the children’s worker. Consequently the serviced o f the children’s worker to those receiving aid to de pendent children must be somewhat restricted. This, againj brings us back to the necessity o f defining the children’s worker’s job m terms of services to children away from their own homes and also to those children who present behavior problems or in some instances health problems. The C h a ir m a n . I wish that we had time this afternoon to talk some more about the adequacy o f grants. Some o f the discussants have mentioned increasing the maximum grants of $18 for one child and $12 for each additional child. I have been puzzled, and I know that many of you must have been also, about what happens in a situation in which a smaller grant is given by reason o f the past standards of living of the family. What happens when the local wage rate and the standard o f living of the independent families are exceeded ? I always like to hear in a discussion the whole background o f the problem of the family budgeting, of home management, o f better expenditure of funds, along with the question o f adequacy, which is so essential in a program of aid to dependent children. Our next discussant is Miss Beth Muller, director of child welfare, Arkansas Department o f Public Welfare. Miss M uller . In asking me to discuss this phase of aid to dependent children, it was suggested that I deal with it in relationship to our experiences in Arkansas. Arkansas has to plead guilty, according to a report from the Social Security Board of last December, to paying the lowest aid to dependent children grant of any State making these grants. It reminds me a bit o f a trip that I made out into the hills o f Arkansas one day. I met an old woman and asked her how to get to a certain place and she said, “ Well, lady, you just keep on going and going, and finally when you can’t go any more you know that you are getting there.” That is what we are doing in Arkansas; we are going and going, and we hope that we will get nearer our goal, but we are rather nearer the beginning o f the going. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 50 CONFERENCE ON STATE CHILD-WELFARE SERVICES There are some circumstances that have put us in this unenviable position. You are talking about the maximum grants of $18 and $12 for which reimbursement from Federal funds is possible under the Social Security Act. We have to look up to see that amount, and we cannot help but envy the States a bit that do have those amounts as a minimum or even as a maximum. According to reports, our aver age family grant was a little more than $10 a month. Now you know, and we know in Arkansas, that we cannot pretend to tell a mother that we are justifying the giving o f that amount for the care of her children. What are spme o f the reasons for this? Well, Arkansas is a lowincome State and our revenues for the last 4 months have fallen off tremendously, so that even our average of $10 may go down. We are in a position o f saying that we cannot pay more than $12 to any one family in the State. The range is from $6 to $12. At the same time, our average for the old-age group has been around $9, so that again you see that those in the older group have an advantage over the mother with young children. Because o f this condition we are faced with some other difficulties. For instance, a group has started very actively agitating in the State to follow the example o f Colorado and to have an old-age pension system of $50 for every person over 60 years of age in the State. That sounds like a pipe dream, but it is not so far from reality.. Things like that can happen, you know, and that has been one of the results of the great interest that has been created in the pensions for the aged in the State. Another thing that is happening is that we do have a very large general-assistance group in the State, cared for from State funds. We know that in that group are many of the most serious problems for children. The family that is not yet ready for aid to dependent chil dren, the family that has had sudden catastrophe, the family with temporary illness, the family whose resources are gone for the time being—their needs are met from our State funds. That means that funds that might be used for Federal matching have to be used for that purpose, so that again our children are penalized. Those are some o f the conditions that we are meeting now, and we talk about a service level. We are just as interested in a service level of care in Arkansas as you are anywhere else. Personnel has been one o f our serious problems, closely related to these other problems, and you may have been noticing that Arkansas has had its ups and downs in that matter. There was a civil-service law which was operated successfully, and persons had passed the examination for county positions. Then the question was raised whether they were county or State employees, and that went into a long controversy and discussion and finally came up to a friendly suit in the courts of the State. It was decided that these people are State employees and therefore come under the provisions of the civil-service commission. The question has gone to the Supreme Court, and the opinion will be handed down within the next few days. That has held up progress in Arkansas for months, because nobody knew the status o f these positions and nothing could be done to be sure whether people were going to stay on in them; yet those in the positions are the ones who are administering aid to dependent children and who https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 51 are the representatives of the State department o f public welfare in the counties. Those situations have held back some of the progress that we might have liked to make. Now conditions are clearing considerably. A civil-service examina tion has been given for the workers in the State Child-Welfare Divi sion, and within a short time we will be having our field consultants in child welfare. That sounds as though we were only starting. Let us go back a bit. There are good things in Arkansas as well as prob lems. In the first place, we do have an excellent law setting up the State Department of Public Welfare, a flexible law, a law that does not make rigid provisions within the act. The assistance groups—old-age assistance, aid to the blind, aid to dependent children, and general relief—are all under an assistance division in the department of public welfare, which is closely in tegrated, physically and in organization. Even though Arkansas is at the foot o f the list so far as the financial side goes, we are aware that we are at the foot of the list, and we are hoping that something can be done about it. We realize that our children’s program is being penalized for the other programs. Be cause of the 50-percent reimbursement for old-age assistance and for aid to the blind, and because of the 50-percent reimbursement on the administration cost, people are still agitating for giving more attention to these categories than to the children’s end of the program. But in spite of all this, there is a splendid awareness in the State, a splendid eagerness for progress in child welfare, and a splendid oppor tunity for going on, so that we are hoping that we can keep on going and going until we get nearer to the place where we cannot go anv further. The C h a ir m a n . The last discussant on the program this afternoon is Miss Charlotte Leeper, case-work supervisor of the New Hampshire State Board of Welfare and Relief. Miss L eeper . I want to discuss for a few minutes one of the ques tions raised by Miss Hoey, the problem of transition of emphasis from what a man who wrote me recently called a “ widows’ rights program” to aid to dependent children. In New Hampshire where we have had a widows’ rights program or aid to dependent mothers since 1915 and now have aid to dependent children, the change of emphasis is a very real problem, and it is hard to know how fast we should go or how to measure community progress in the change o f thinking, be cause it does seem almost revolutionary to communities that have accepted since 1915 widows’ rights, and the worthy family, and the fact that there is a particular prestige in being a family receiving mothers’ aid as compared with general relief. The mothers’ aid law was administered by the Department o f Edu cation until 1928, and since that time it has been administered by the State Department of Public Welfare by means of an appropria tion made by the legislature to the State. Two workers from the Concord office took care o f the aid and service throughout the State. We have now a maximum load o f 360 families with 1,000 children, so that you see it has always been a fairly small case load, but the two workers have had too large a case load to give adequate service considering the number of cases and the amount of territory which they must cover. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 52 CONFERENCE ON STATE CHILD-WELFARE SERVICES The child-welfare program of the State prior to the time o f the Social Security Act was carried out by four workers who worked out from the State capital to the various sections o f the State, pro viding protective, preventive, and corrective services as well as foster home care. So with the beginning o f the child-welfare services, set up in four rural areas with trained workers who had a fairly small case load, we were able to give to that work and to those areas more adequate child-welfare service than it was possible to obtain in the mothers’ aid program. The mothers’ aid worker could call on the child-welfare worker who was going to be fairly near one o f her families to help her out on special needs and special problems of the children. Next in pro viding aid for motherless children, for example, the law says that a housekeeper must be employed at the time the grant is made. The homes were so often on a subsistence or under-subsistence level that it was very difficult to find a housekeeper in those remote rural areas, and it was most difficult to try to find one who would agree to live under those trying conditions. So if the family could not qualify at the time the application was made, we had, under the law, to say that they were ineligible, and that was the last that we heard of them. Now they can be referred to the child-welfare workers, and while it is still one o f our problems to solve this question of ade quate housekeeping service in motherless families, we have made progress and feel that we have a beginning, at least a point o f de parture, for expanding our program in that field. The next problem, which we feel child-welfare services are helping us with, is the community acceptance of our continuing to assist families that to the community no longer appear to be worthy. We had to begin with a change of emphasis on the part of workers on our own staff. Workers who have been administering a program find it difficult to change their thinking, but we have tried to use material that we found in our case records. I quote from one entry made in 1931 by a worker who said: “I recommend that we try this family with $18. I don’t believe that it is going to be a worthy family, because she is extravagant with her money, and has been on relief, and therefore a pauper.” In January 1938, this entry was made in the record, by the same visitor, incidentally, who made the original one: “I feel this woman has managed better than any case I ever have known. I admire her capacity for stretching pennies.” Then we have the other type o f case record, which is more tragic in its significance, and that is an application made in the same year by a family that had been on relief. The worker recommended at that time: “ This family can get along on relief comfortably, and we will not consider it for mothers’ aid.” Reapplication was made in 1937 and 1938. Investigation showed deterioration of the family and the death of a child because o f medical neglect. There is rather startling case material in our own office, which we have used first of all with our own staff in clarifying our thinking and in following through on our new program. We have asked the child-welfare worker in one area to administer the mothers’ aid program. In this area we have an added problem in the fact that our appropriation is limited, and in considering con tinuing cases o f mothers whose behavior is somewhat out o f the pat- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 53 tern o f the community life, or taking on new cases when we have inadequate funds, the community sentiment is “ W hy let this one wait while you are helping another one that the community feels is unworthy?” We hope that by transferring the mothers’ aid cases to this worker who has established herself in a community where cases o f neglect and poverty and o f delinquency are referred to her, we can build up in the community an identification between the pro gram o f aid to dependent children and the needs o f children. On July 1, 1938, our department will start a new program, under new legislation, to administer public assistance together with childwelfare work, and we hope at that time to have workers carry on the preventive and protective work as well as the assistance program. It has been very interesting today to hear o f the integration of child welfare with the assistance program. Certainly I feel that in New Hampshire we will bring a richer service to our children if we can correlate the two. The C h a ir m a n . Well, there you have before you the panorama of problems. I am struck, perhaps because I am so identified with it, with the similarity o f the problems with which we are all faced and with the experimental attitude and the gropings for better methods. The comments are now yours. We have about 20 minutes left for general discussion. I want to ask Mr. Carstens, executive director o f the Child Welfare League o f America, to comment on some of the discussion this afternoon. Mr. C arsten s . One question has arisen in my mind that I wish we could have an answer to from the various States: What effect has the $18-$12 rule in the Social Security Act had upon those States that had previously had no limitations or that now in their statutes have no financial limitations for grants? Has it led to the reduction o f grants in the States where there was no limitation previously or where there is no limitation whatsoever at the present time ? And then I would like to make a very brief statement. Together with certain others here, I date back to the period when aid to de pendent children, then called mothers’ aid and various other things, began. It was very interesting that the movement did not begin among social workers. Some of the finest types o f social worker at that time resisted the mothers’ aid movement very strongly ; and that, it seems to me, has a lesson for some o f us and ought to have a lesson for all o f us. Now, I do feel that there may be certain things that are being done nowadays, in child welfare or in certain other lines, by people whom we are inclined to look askance at, and who may after all contribute something that we ought also to be willing to listen to. The C h a ir m a n . W ill some o f the States that have no limit on aid to dependent children grants comment on Mr. Carstens’ statement? Mr. Adie, commissioner o f social welfare, New York State. Mr. A d ie . We think o f the categories in terms of long-range grants; and we think in terms o f home relief, as we call it, in terms o f meet ing the situations as they arise out o f this social order. Now, in New York State we are doing a better family budgetary job on the general relief than we are in the categories. I have become convinced (and I say this not with any pride or with any assertiveness) that we https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 54 CONFERENCE ON STATE CHILD-WELFARE SERVICES have gone too far in the insistence on categories, and what we need to do is to make John Citizen realize that assistance, on a broad foundation o f general assistance, will build a better structure for our client. Furthermore, it will give us a stronger service than i f we keep insisting on aid to dependent children, old-age assistance, and the others. You have justification for all that you are saying here, but there is another side to it. It is our responsibility to see that the care of all becomes the concern o f all in a very fundamental way, and not by placing people into pigeonholes and categories. You can talk all of your life about content, but, in my judgment, not until you have the conviction of the philosophy o f the matter will we get the service that our clients deserve and must have. Somebody said today, and I like this, that on the State level they had been ambitious and had gone outside for leaders, but she said, “ On the local level we are sticking to local people.” I believe that principle to be so fundamental for the future that I would rather wait 10 years for my standards than get them tomorrow by impor tation; because a fundamental job in social care is to grow our social servants, not to have them always come from outside the social life of the community. In New York State, with all o f the mistakes that we are making and all o f the inhibitions that we have, we have no illusions as to what is meant when our public-welfare law says “the care o f per sons.” That means what the local man will interpret it to mean— and if he wants to do a big job he can, and if he wants to do a small job he can. But we have placed the emphasis on general assistance, and we shall continue to do it in our State because we believe with all o f the categories, and there are many, the important thing is the integration o f the service in terms o f peed. Fundamentally, in society the broad general-assistance program is the only program that will in the long run prevent us from destroying the family pool. Remember that England showed it to us, and a great many other countries showed it to us. Each time that you emphasize a social service pub licly, in terms o f a particularization, you have to offset that by a real emphasis o f the family pool. The important element is the family and the integrity o f the family in terms o f a unit o f living cooperating together. It is much more interesting to me than this other question. That is why I feel very definitely that the social worker’s future is not on the categories but is one projected in terms o f service first and assistance in line with the social mores o f that community. The C h a ir m a n . I am sure that there must be some challengers o f Commissioner Adie’s statements or some vigorous backers o f his state ments, because certainly there is no more controversial subject in the whole field than the points which he has so hastily hit. Mr. C arsten s . I should like to make one additional suggestion to the commissioner, and that is that while a great many o f us believe in the general-assistance program, we have seen certain evidences to show that where mothers’ aid has been in effect it has aroused the sentiment and the general assistance o f the community. Now I am thoroughly in accord with what Mr. Adie said, but I wonder whether in the States where aid averages $10 and upward— after all, we have to recognize that in New York it is in the $40’s—something might https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—AFTERNOON SESSION 55 happen to lift the general assistance when we specialize for a time on the mothers’ aid program. When I was in Massachusetts, and some o f these Massachusetts people can tell about it a great deal better than I can, we rewrote the statute that a. commission had presented and asked that mothers’ aid be administered by the selectmen or the officers of the poor, so as to get it integrated with the general-relief program, but none the less, setting a standard which emphasized mothers’ aid. The result, if I am not very badly mistaken, was that it lifted the whole generalrelief standard. Now, in New York you had a special board set apart to do that work, and I think that in Massachusetts we had a mixture of the two forms of aid that was really o f value to both sides. I wonder, therefore, i f there is not some value for a time in working in the direction o f specialization of a category. Mr. A d ie . May I just make myself clear? I hope no one will think that I am asking for the abandonment o f categorical services now. I tried to say that that cannot be done in all the States at the same time. Whatever our position on the categories is now, we must bear in mind that our goal is family service. Miss G ordon (Rhode Island). I should hate to say what our rating is on general family relief. It is pathetically low, terribly low, and now that we have the more liberal aid to dependent children law, which lets in certain beneficiaries carefully excluded under mothers’ aid, we are in a position where we are going to have a toboggan slide unless we are very careful, because we have now a group of families that have been in this low category, who are eligible under aid to dependent children, and we cannot get an appropriation to meet their needs. The C h a ir m a n . Are there other States that can comment on this question o f the relation o f the general public-assistance appropriations and their effect on categorical assistance ? Miss P arrott (Maine). I think that in Maine there has been a tendency to think of the Social Security limit as the yardstick to be used in setting grants in the State, and that we are having lower grants than perhaps we did a year ago. Mr. C arsten s . May I ask Miss Parrott whether that is because there was a limit set? Miss P arrott . It is, because they are going through their list of grants to see how many o f them are over the amount, the maximum amount of the Social Security Act, and up until that time they were not conscious of a maximum amount, because the law did not fix it. Mr. J am es (Virginia). I represent a State that has just begun to receive the benefits of aid to dependent children under the Social Security Act, and I might say that we are very much concerned about the effect o f the new public-assistance features on the limited but now -15-year-old mothers’ aid program. We have had a State fund of $1,000,000 for subsidy to the counties and cities for general relief, which we have by bookkeeping kept categorically, but nevertheless it was a general-relief subsidy. During the last few years we have done that. Now both with the use o f the small State mothers’ aid appro priations and the use o f the much larger proportion o f the general public-assistance fund, in the mothers’ aid cases, we have a State https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 56 CONFERENCE ON STATE CHILD-WELFARE SERVICES average o f $45 for the city cases and $25 for the country cases, or an average o f $30 in the mothers’ aid cases, or what we might now call the aid to dependent children’s cases. We have no idea in the world that under the new program we are going to be able to keep the stand ard up to that level, although we shall have an opportunity of supple menting those cases out o f the general-relief fund, which goes into the new bill at approximately $1,000,000 or whatever it is now. Now, our brain trust down there is addressing itself to the problem that we are going to have, o f preserving the status quo, or even improving it under the new program, and it is hopeful that we shall. Miss A t k in s o n . I think that there is one more thing that might be said, before we close this meeting, on the discussion of the relation ship between aid to dependent children and child-welfare services. I think that you all should know that on June 30, 193T, there re mained in the aid to dependent children fund that had been allocated to the Social Security Board, $14,800,000, which had not been dis tributed to the States, because the States did not have matching funds and therefore did not present demands for the allocation of that money. | Mr. Bane told me the day before yesterday that the estimate for this year is that on June 30, 1938, there will be a $25,000,000 unex pended balance o f Federal funds for aid to dependent children. It seems to me that these two figures are very significant. They show us the way that we must go in trying to rally support in the States for more adequate aid to dependent children programs and also that we have some responsibility for doing the thing that Miss Hoey said, namely, letting Congress know that we think it is time that the National Government stopped discriminating against children and at least became willing to reimburse the States on a 50-50 basis as is done for the other two categories. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Monday, April 4—Evening Session Katharine F. Lenroot, Chief, Children’s Bureau, United States Department of Labor, Presiding Miss L enroot . In planning this program Miss Atkinson was, I think, very wise in saying that she wanted the emphasis this year to be placed not upon the mechanism of organization, not even upon problems of training and selection of personnel, which are so vital to the work, but upon a consideration of what the program may mean to individual children back in the communities to whose workers you are giving counsel and guidance and for whose services you are planning. The children who are in neglected homes—in homes where the inadequate relief or the absence of relief may mean real hunger, suffer ing, and deprivation—the children who are in trouble in school, who come in conflict with the law, who are bewildered and frustrated by the fact that they don’t seem to keep up with the other children— they are the children who have the countless difficulties which bring them to the attention of the workers in the communities. And so we have asked two persons to contribute to this evening’s program who are unusually able to bring to us a message o f signifi cance as to what we are trying to accomplish in human terms. I have very great pleasure in presenting to you as our first speaker the Honorable David C. Adie, commissioner of welfare of the State o f New York. 57 78986“— 38- -5 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Some Aspects of Child-Welfare Services By Hon. David C. A die, Commissioner, New York State Department of Social Welfare Somebody was good enough to suggest a general line o f approach for me tonight in asking me to discuss some very obvious aspects of child-welfare service. I am glad to do that because we certainly do need to begin at a very early date to think outside o f the relief pro gram ; not that we might get away from the relief program but that we might add to it. Let no one think that, in any remarks I have to make tonight, there is any less insistence upon standards of work. In the insistence on it I believe, but I also believe, as I think everyone else does, that the key to the whole situation administratively is personnel. With a good personnel we can accomplish much, and with a poor personnel we can have all kinds of difficulties. Like most people I have been impressed with the fact that we have been for many years very definitely under the tyranny o f relief itself; We have concentrated on the mere gathering up o f great numbers of people who had to be rapidly succored, who had to be thought of in terms of needs in the first place, and to whose needs there had to be added other services. These facts have colored our thinking. They have been compelling in their nature, and as a result I think we have not stopped long enough to ask ourselves what may be implied in some of the other aspects of the problem. Tonight, therefore, I am going to direct my thinking to some very obvious things, nothing new, and try to restate, to reemphasize, as it were, some of the things for which this conference particularly stands tonight. I do that because I am becoming more and more convinced that fundamental to this whole national program is not so much the ques tion o f raising tax monies to care for people as the need for finding a means of getting an additional method of redistributing the national income; that what we are engaged upon today is not merely the care of millions of people in a work program, a relief program, or any o f the other programs, but the more adequate spreading out o f the surplus that society has. This is done not solely for the care o f the client but for the underpinnings of the whole economic order and the structure in which we live. I have come at this question, as most o f us do, from a general case work basis. I take it that the family case worker is still in that relationship to a family; that consultative and definitely advisory relationship which, however arduous it may be in its nature, nevertheless is a general continuing policy. The crises that we meet in the family field are never so real as they appear to be. When you move over, however, into the children’s field, 58 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4— EVENING SESSION 59 it seems to me that you are in a very different relationship, in that the worker in the child-welfare field has a more authoritative relationship to the child. It is because of that fact that I, among others, have been stressing the need m our communities o f raising standards o f work manship among the child-caring agencies higher even than we are trymg to get into our public-assistance program. I do not mean by that to cast any disparagement upon any o f us engaged in the publicassistance work, but I am trying to sav that you can condition a person more easily to the one than you can to the other. The child-welfare worker, as I see it, must have that relationship by which he skillfully adapts himself to the task o f establishing environments, o f creating definite associations, of modifying a culture in which the child has to develop. That definite relationship not only is sharp and defined but sets him apart with a need for developing new skills and for developing more definitely specialized skills than some o f the rest o f us are called upon to develop in our jobs. Both approaches have the same type of objectives. Both are strug gling for the conservation and development o f personality; and both are struggling for the preservation and the reconditioning, and necessanly the reconstruction, o f the family life, all the while accepting the family unit as a basis o f the operation. While we have this common objective, I want to emphasize some other facts, lhere is a need, it seems to me, to realize in the very first instance that mere knowledge about a child does not lead to an under standing o f the child. We can develop all kinds of systems for ac quiring knowledge—statistical knowledge and data on the several fields, which might be far-flung and very exhaustive in its n a tu rebut that by no means enables us to come to the job o f understanding a child. 13 It is comparatively easy, it seems to me, to secure that type o f infor mation. What is difficult is to get our service to such a point that we can see the child’s experience through the eyes o f the child and that we become intensely sensitive to what life has done to the child—to try to catch that experience in childlike terms. I have a feeling that a child is the hardest thing in the world to see. I f you do not believe that, all you need to do is look at the average educational structure and see how few people educated in the peda gogical methodology, with all o f the advantages o f the modern edu cational system, have the faculty o f seeing the child in relation to the development o f personality. We social workers must not make that mistake. We must be able to see children, and we must be able to get away from that other attitude which is so characteristic of the adult. One o f the great things that we have to learn, although it seems to be a very obvious thing, is that gathering this type of infor mation about children ought not to enable us to side-step the task of attempting to understand them. We have to develop our programs in terms of reality and not in t^ . ° f ideology. We must get away from thinking that we must establish the environment m which children shall grow, that we know what a suitable home is, that we know what family life should be and that by going through a school o f social work or from experience we have acquired some skills in social-work practices by means o f https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis A0 CONFERENCE ON STATE CHILD-WELFARE SERVICES which, we can determine the validity o f the home. That, it seems to me, is one of the most unrealistic approaches that we can develop— purely an approach o f expediency. It was an old Jesuit who once said that at 20 a man was governed by his desires, at 30 by expediency, and at 40 by reason. Somehow or other we soeial workers must project ourselves to 40 as quickly as we can and apply ourselves to the work with reason. We are too much concerned, it seems to me, with material factors, with homes conditioned in terms o f measurement. I f there is a sun parlor, some cushions in the living room, something in the kitchen, and this, that, and the other thing around the place, we consider that makes a desirable substitute home. Well, does it? You and I know that in all too many cases the child m a so-called perfect material substitute home cannot retain the contact with his parents because o f the fact that psychologically the parents and the foster parents cannot meet on the same ground by the very virtue of the material advantages that now surround the child in the substitute home. We must realize that if we are going to have perfect substi tute homes for our children we must haye those things in them which relate themselves to the background in which the child finds his experience. . The whole child program, it seems to me, has to be viewed m that way, and I am simply indicating some o f these things to you tonight. I think the first responsibility o f every child-caring institution follows at that point—the preservation o f the family in itself. I think we must realize that we have gone around a circle, and we might well say to ourselves, “ Let’s call it a day.” | . When we first began, we grouped the children with the blind and the poor and the others. That, o f course, did not work. Then we built institutions which have not been satisfactory to everyone. Now we have been worshiping too long at the shrine o f foster homes. We must move back to the realistic thing, the child’s own home. We must begin to realize that, just as the real-estate people have sold, us this system of “ own your own home,” we have to start philosophically to say to the child, “ Go back to your home.” We have to have a sort of “ own your own home” development. In New York State we had a judge who was breaking up a trio o f children and placing them in foster homes because the children should not be brought up in the manner in which they had been living. What we forgot, o f course, was that 3 years before we had done ex actly the same thing with two other children in that same family because the mother was fond o f dancing every Saturday night and the-father of the children had some rough companions and occasion ally got drunk. So this judge proceeded to make possible the con tinuation o f a futile policy. What has society done to that mother? To that father with his desire for rough company? I am beginning to feel that it is over looking the fact that our clients have rights—and very real rights. Sometimes they exercise some o f those rights that we do not like, but that is not the point. They are their rights. Society can use police measures on some o f these; but we have to realize that that is the atmosphere in which we are going to operate whether we like it or not. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—EVENING SESSION 61 thai .is t0 °°me must7 then>be based on an attempt to e very realistic. It is not a question o f the institution versus the er ome*. ^ is a Question o f mobilizing all o f the resources in the community, based on an understanding o f the child, and the shill with which we can use the means at our disposal. the, c^ild must bend; the foster home—not U , f h w T S bnn d i ?n j the soc11.al worker—not the child—must bend. We have all got to do our adjusting to the child a SM J a strange process We have all been so busy making children ad]|ust themselves to the adult; whereas, although the adults riiatlire 5nd intelligent, very little o f this adjust ment responsibility is placed on them. I think, too, very little o f it o W ? e'fn TeS )-eCit^(l as ^P^fession. To be perfectly frank about it, I think that we have suffered from an undue appreciation of t0 ch\ldren- Now> we are never going to see the child m this category unless, as I say, we are realistic about it. f admg- t0night m^seif and for you to realize that our ijfk 1S just opening up and that, with all o f the skills that come to us rom the advances in child care, these are merely tools in the last analysis. It is your job and my job to realize that we have been set ? w t l £ r 5 let/ aS f0?1 fePders and tool users; and, if we do not have that attitude to our job in realism and in terms o f the ideal at the same time, with all our training we are not going to be very effective You cannot begin to say that the job is to deal with personalities and to allow personalities to be as free as possible until you begin to translate that wish o f ours, that concept o f ourselves in terms of the spiritual or the spiritualization o f our own job. ■a V ? seeing it in terms o f numbers and in terms o f material needs, but seeing it in terms o f that which is so sacred to us that it has been termed the possessing of a reverence for life. It is seeing that our programs, whatever they are, are motivated not by the a£ °U nt ? f m?n®y’ ^ot by the number o f institutions, and not by the number o f free homes or other kinds o f homes that are at our disposal, but by the workers dedicating themselves to the task of becoming responsible for holding themselves sufficiently in check to al ow that personality that we claim to believe in to have a chance to take wings unto itself and fly. cnance to js 01? ntbat basis tbat it seems to me our programs should develon We should be motivated by the philosophy, hy the compulsion, and by T f w o T i t ^ hlch We have f ^ is sacred thing we call a personality7 i L if L? i hat’ WefCan g° and take that back to our communities and SfJLy n ternis o f more money to the legislatures and more money f L»r. P kut will pn?1f ' n0t aiWays easy but ^ Plant will h be interested to1Siknow that not so ’long asois IPossible7 went to the legislature to try to get a psychiatrist for one of our institutions The committee went down the budget line by line very slowly and suddenly stopped at that word. y y a An official said to me, “ What is that?” ‘ Oh,” I said, “that is a psychiatrist.” Well,” he said, “ what is that?” I tried to put into plain English what that was. He iust listened to me very patiently and then said, “ Oh, well, out with that” d https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 62 CONFERENCE ON STATE CHILD-WELFARE SERVICES Now, that was because I had not convinced that man that there was a real need and real validity in the application of intelligence and affection to the reconditioning o f delinquent children. The fault did not lie with the legislator, the fault lay with the interpreter. So I plead with you, and I plead with myself, tonight, to think this job through, not in terms o f processes but in terms of real concern for people who are in unadjusted positions and under adverse conditions, who, unless they become dependent upon our seeing the matter fairly and squarely and in a related manner, have really no hope of gaining a growth or development under any governmental plan or govern mental system. Miss L enroot . Mr. Adie has brought us back to reality in a very vivid way, back to the question o f a child’s own home and the possi bilities for the development of the child’s personality within that home. I know that we are thinking tonight of the conditions confronting so many homes in this land of ours, of the shadows which poverty, and unemployment, and sickness bring, and the thwarting o f per sonalities which result from those shadows, and the tragedies into which they often materialize. It gives me more pleasure, I think, to introduce the next speaker, than to introduce any speaker that I know in this country. I had the great privilege of working with him, at the time of the White House Conference on Child Health and Protection, when we were formulat ing that report on the delinquent child, and he used to say that I ran a thermometer over every line o f the manuscript, and when it registered about seventy I cut it out. I think that he felt great freedom in working on the book which he published this year because he did not have to have it subjected to any such process. But we are tremendously privileged to have Dr. Plant associated with us in this movement. He always responds whenever he possi bly can. He has gone out into the Middle West to give counsel and advice in the development o f one o f the programs there. He is always a great tower of strength to all who know him and have the privilege of hearing him. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Positive Programs of Child Welfare B y J a m e s S. P l a n t , M . D., Director, Essex County, N. J., Juvenile Clinic Dividing our entire project into three parts, let us see whether we can define for ourselves certain objectivés for the child with whom we work, for ourselves, the workers, and for the program in which we are working. In attempting to define certain objectives for the lives of these children, 1 could say nothing more to you than Commissioner Adie has already said, except to try to fill in this picture o f what we are after and what we are striving for. This does not mean in any sense that you are to accept the particular points that I am going ^ a t y ?u are to try to build an approach yourselves which is one o f setting up a picture o f this personality we would develop or these rights o f the child. One has to do that, because in our work you and I have dealt too much with negatives. We must not go on simply trying to get a child out of such and such a situation. This is not true in the field o f physical health, is it? Health is not just the absence o f disease. There is something more positive about it. In this whole field of the social development of the child and m the development o f his personality we must think about the things that we want to develop rather than the things that we want to get rid of. " There are five things, I think, that should be the right o f each child, as he awakes tomorrow morning, to have as possibilities during the day. I hat is, just as you know that tomorrow, from a physical point o f view, he needs a certain amount of sunshine and a certain amount o f vitamins, is it not possible that there are similarlv five things m the mental field which the child needs? And if there are these things, then these must be our goals, the things that we must never forget and the things that we must think o f providing for each child as he comes to us. Always, o f course, we have to 5lfal S ^ t h e negative things, and always, o f course, we have to get the child out o f one or another scrape* but we must work toward this more positive goal. I think that when the child wakes up tomorrow morning, or indeed when any one o f us wakes up tomorrow morning, perhaps, first of all, he will look for a thing which I will call “ security.^’ I am fon ifh t° USe the t6rm “ security ” if 1 may> in a rather special sense To illustrate, let us go back to the Covenant o f the Old Testament, in which God said to Abraham that in return for certain things every person who is bom a Jew would be a chosen person. God did not say that that person needed to be tall or handsome, and He did not even say that he needed to have a high I. Q., or that he needed to have any special social or intellectual or emotional qualifications, but rather that each person bom in a certain family by that fact 63 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 04 CONFERENCE ON STATE CHILD-WELFARE SERVICES would have a certain, place. Nor did God say to Abraham that it was only those people who were at that time alive. A person 200 or 2,000 or 20,000 years from that time born in a certain family would be a chosen person. That is a position which a person gets because o f who he is. I am glad that you have had Commissioner Adie’s statement earlier as to the need o f getting back to the own family o f the child. X am quite sure that it is within the child s own family and within that family alone that the child gets this security—because o f who he is. To put it another way: Any one o f you might talk to me about your mother; you might say that you know more beautiful women than your mother; you might say that you know more intelligent women than your mother; you might say that you know better cooks than your mother; but then each o f you would say, “ But she is my mother.” You see, she has a place because o f who she is. Many o f you have heard me tell a story that I cannot forget. I have to tell it again because it stays with me through all of my work. It is the story o f a little 12-year-old girl who had been adopted into a family that had everything that a family could give to a c h i l d wealth, affection, and all that sort o f thing. O f course, the neigh bors and relatives had told her all about what poor parents her own were and how they had run away from her. When we were talking about the adopting parents she said that she cared more for them than she did for her own parents and that she accepted them as her own. She never thought about her own parents. We went on talk ing about some other things and later on she said that she did not always go to sleep immediately when she went to bed. “What do you think about then?” She said, “ I wonder always what they used to call me.” You see—here is the deep need o f the child to know who she really is. The place a person has because of belonging to a certain family, an unassailable place that a person has because o f who he is, is o f vital importance. From a practical point of view, from the point o f view o f our programs, we must go on with our institutions. And, as has been said to you, we must go on with foster-home care because we have to. But we must fight every minute for the preservation o f family life because there is something in family life which is given to the child that nothing else can give to it—this unassailable place because of who the chfld is. We get the same thing, I am very sure, a great many o f us, in our religious life, in which you notice that again we use this family pattern. God is the Father and we are His children. Here again, God does not ask us where we live or how much money we have or how we are getting along in school. The mere fact that we are His people gives us a place, this belongingness that we have because o f who we are. I could say to you, I think, that the devel opment o f a rich religious life for each child is again a deep neces sity. I do not say it, because, o f course, here is something that comes up from within the child, something over which we have so little external control. The second thing that I would look for tomorrow morning for each one o f these children is what I would call a certain degree of extro version. Without trying to be too scientific about it or going into all o f the minute intricacies, you, I am sure, know the difference be- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—EVENING SESSION 65 tween the extrovert and the introvert—the bouncy, expressive sort o f person and the one who has all the drives the extrovert has but who is working them out within himself. In our group we feel that a mild degree o f extroversion is far more healthy and normal than is introversion. It is better that one live in the world that is than in the one he wishes existed. But the extrovert has a hard time o f it. For instance, if you go into your nearest schoolroom and ask the teacher to name her three worst problems, the three most difficult children in the room, she will name three extroverts. They are too bouncy—too sudden-about-thehouse— for the kind o f civilization in which we live where everybody is huddled together. You see this problem very nicely in marriage, of course. When two introverts marry, the marriage often will not go along well, because there is not in the. shut-in personalities of these individuals the freedom of give and take that is so necessary in that sort of venture. The introvert and extrovert in marrying get along fairly comfortably. When you have two extroverts marrying, well, you do not call that a family—that is a zoo. We are inclined to let these things pass by rather rapidly but you must not do so. Give plenty o f thought to the fact that the extro vert is constantly being punished in the culture in which we live. He is in trouble in the family, he is the one who gets into court, he is the one who makes trouble in school. Everywhere he dramatizes and does something about the problems that are around him—he is the one who gets into difficulties. I have the feeling that not only must we provide for children the opportunity to be extroverts but that we have a tremendous task in interpreting that sort o f expression to society so that society under stands instead o f merely punishing these individuals. Could I give this illustration: I was asked a month or so ago to see a boy in the seventh grade o f school. He was a pest, an awful nuisance, just the sore thumb of the group. I did as I very often like to do in these situations—went to sit in the back o f the room for a while just to watch the situation. The teacher was going over some thing about the surrender o f Cornwallis, and I thought that she was doing it correctly. This teacher, from the point of view of an intellectual task, was doing a good job and apparently a correct job; but she was also doing something that I could liken, I think, to nothing more aptly than a person going around a field with an elec tric flashlight. First, she worked with two children here and then with three over there, and then with two here, with no ability to bring this whole room together and make this whole room operate as a total group. I had not been there 10 minutes before I saw six individuals who, to my way o f thing, were far worse problems than the boy I had been asked to see. They were just lumps o f dough— sitting there doing nothing. My “ patient”was merrily and busily calling attention to the fact that the teacher was doing a poor job. You may be interested to know that already there has been a very marked change in this teacher’s mode o f teaching. Why ? Because o f this extrovert. You see, if it had not been for him, if he had been a lump o f dough like the rest o f them, she would still be doing a poor job with that whole room full of kids. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 66 CONFERENCE ON STATE CHILD-WELFARE SERVICES From a practical point of view, this means for our children (and I talk very much more to city workers now than to rural workers) the constant opportunity to handle or touch reality, and it means, in the building up o f the child’s play life, the development in the earlier years o f opportunities to face the world as it really is. Let us not go to the limits that we went earlier in my own pro fession, when we said that any sort o f introversion and any sort of daydreaming represented something that was definitely abnormal. We have to daydream. Certainly there is no one in this room who does not have to go to the world that we wish existed, the world that we can dream about, as some kind o f surcease from the things that happen to us during the day and from the things that happen to our group during the day, the things that we just simply cannot afford to believe will go on always. We have to go, and our children have to go, to these daydreams, but for the most part we must foster for the children (and this is a job that demands a great deal o f community interpretation) a program that means that they are living in the world as it is rather than just the world that they wish existed. You are up against two troubles here. One o f them, as I said, is that society does not like extroverts, and the other is that for the individual introversion represents, o f course, a much more pleasant sort o f world than does extroversion. You remember the daydream you used to have when you went out on the back porch and thought about dying—how sorry the family would be, and what a long funeral there would b e ! There was nobody who said, “ Well, thank the Lord, she is gone.” We always in our daydreams have a happy ending; we conquer and win and have things come out just as they should. So you have here a dual problem. The first is that o f interpreting to society, to the school, and to the people with whom you are working this need o f the child to express himself, the fact that the extrovert is trying in some way to solve a certain problem, and that that is the more healthy adjustment than quietly accepting the problem and not trying to escape. The second is that introversion offers so much to the child that you cannot kid him out o f it, you cannot drive him out o f it, but you have to coax him into the world of extroversion through making reality, at least for a time, a pleasant experience. I think, in the third place, that we would look for something to morrow that is what one might call a healthy adjustment to the group. I cannot explain this in any better way, perhaps, than by askmg each o f you to think o f yourselves somewhat dramatically in the following situation: Suppose that you wake up tomorrow morn ing with a pain in your abdomen. You will feel disturbed about this pam, partly because it hurts, but also because you do not know what is the matter. You will go to the doctor and he will tell you, after appropriate prodding ancT questions, that you have appendicitis. It is interesting that you will immediately feel considerably relieved. You will have found that you have something that everybody else has, something that is quite socially acceptable, something that is known, something that makes you belong in a large group. The doctor has made you like everybody else. Then if the doctor is properly persuasive and you ^go to the hospital to have your appendix out and convalesce, it is similarly interesting that before you o-0 home you will want the doctor to tell you that your appendix was the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—EVENING SESSION 67 longest one he ever saw, or the shortest, or the hardest to get out, or the reddest. You do not care what the factor is as long as he has made you different from anybody else. That is what I call the paradox of life—the need that each o f us has to be lost in a group, to be like other people, to be regimented—not to be different— and at the same time to be individual, to be odd and different. You never see these two drives teased out and separated. They appear often in the same sentence. You see the same thing beautifully in that most wonderful o f psychiatric ventures—the buying o f a hat. This particular event is preceded by some weeks of watching the papers and magazines and people to see “ what they are wearing.” But the matter is not settled then because when you go into the store you find that you must not buy a hat “that you are going to see on six people the minute you step out of the door.” I could give many examples o f this sort of thing. Two come to mind. One is the disturbance of the social worker in these days of budgets and relief over the families’ spending money for some un necessary or foolish thing. We so often forget that in the tremendous regimentation that is going on today we are failing co meet the need of people to be different—to spend some money foolishly—not because it is a foolish expenditure but because it is a different expenditure. Then also you see the same problem on its opposite side, in the mat ter o f the schools. The older school was too regimented, but I think that many of the modern schools have gone too far in the other direction. They are failing to realize that most of us have to be lost in a group, to be regimented, to get strength precisely from this mat ter o f being lost in the group. In our planning for the child in his games and in his life, we must provide largely those situations in which he has the same experiences as others, in which he is the follower, in which he is a part o f the group. And we must equally provide for each child some little corner of his life in which he is the leader, in which he is different from anyone else. You see, I am not talking about anything other than the need o f a hobby. The fourth thing that we would look for tomorrow morning would be what I would call “ integration.” You can use this term in a num ber of different ways. This evening I am thinking of it in the sense of a certain wholeness. Perhaps I could explain this in the following way. We understand the problem o f weaning in the physical field. We recognize that when a child is born he is absolutely dependent upon the mother and that then by 5 or 6 he must get to the place where he can eat almost anything. We similarly know something about the problem o f emotional weaning. We note that here again the child is dependent upon the parents to begin with, whereas at 18 or 19 or 20 he must still love his parents but must not be dependent upon them. This whole matter of emotional maturity has been very much talked about in the last few years. What I think very few people under stand is that parents have to be emotionally weaned from their chil dren quite as much as children have to be weaned from their parents. Parents, as I see them, seem to resent this fact that weaning must go on all over again after one has grown up. What I mean by integra- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 0g CONFERENCE ON STATE CHILD-WELFARE SERVICES tion here is this sort of wholeness of one’s life that means that he is not dependent upon the others around him. I am not talking about being a hermit. I am trying to say that for the child, and indeed for yourself or myself, it is. much better that one’s house be built in the midst o f other houses, because this means a richer and more complete sort of life; but that this house must be built so that i f the other houses tumble down it still will stand. In the area in which I work we have provided so much for the children and have scheduled their lives so much and have given them so much of external resources, that we have not built up these in ternal strengths that I am trying to cover under the term “ integration.” We do not have children who, when put on their own, know how to live with themselves, and I am sure that this is a fundamental necessity. Finally, I think that tomorrow morning we will hope that the day will provide for us or for the child a certain amount o f success. I am not sure that you will agree with my definition of success. It is the only one that seems to me to fit what I actually see at the clinic. I am sure that successful people are not necessarily people with money, nor those with possessions, nor those who are growing or de veloping as I would have thought that successful people should^ I am quite sure that success comes to a person when he is in a situation where “nobody else will do.” This is the only way that I can explain why Mrs. Macaroni, with 10 or 12 children, no money, nothing at all but hard work day in and day out, trudging alone through life, shows some sort of release from the problem o f happiness that I do not see in Mrs. Astorbilt, who lives in a very large house and has all sorts of servants about. I am quite sure that Mrs. Macaroni often has an experience that the other woman is striving desperately for— the experience o f being needed by other people, the experience once a day or 20 times a day of being turned to because “ nobody else will do.” So far as the child is concerned, I think that this means for us, again, very much less scheduling and planning than we are doing in this country. It means very much more a chance for the child to have responsibility, to be turned to for real jobs, to have experiences in which he can take hold of life himself. Some o f you have seen this in the problem of the runaway child. There are many times when the child, at least in my area, goes on this sort of venture because here he has responsibility. When you are a runaway you have to find your own food and your own place to sleep. There are many tragic things that happen to runaways, and I am not trying to present this as a good pattern for children to follow. I use it only as an example of the need on the part of many children to experience this thing that I have called success. It should point to us the need in our programs for giving to the child a real place that is his own. a real job that is his own, situations in which “nobody else will do.” Just to recapitulate: In what we plan for the child, let us think of those things we want him to have instead of those things we want him to be rid of. Here first of all would be our joy in his having security in his own family. This will raise havoc with your work. It will mean that https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—EVENING SESSION 69 often when you know just what Johnny needs and just what should be done with him, the parents’ only response to you will be, “But he is Johnny.” It seems to me that we must foster just that sort of attitude, regardless of how much trouble it makes for us, because it means that the boy has an assured place in his relationships with other people. Then we must work for those things that will constantly lead to ward the development or the preservation of a certain degree of extroversion in children. This is difficult because every advancing civilization represents an introverting process. All young civiliza tions are extroverted. The Greeks in the early part of their civiliza tion captured the woman they loved, carried her off, went and killed people because of her. Then when they came to their golden age, to a higher and higher civilization, they made marble heroes instead of flesh-and-blood heroes. Each civilization as it advances similarly replaces reality with symbols. Finally it comes to its golden age and then you notice that it decays. I f we are to preserve the strength of our group, we must be forever interpreting to the community the strength that is represented in the extroverted child. We must try to develop for the child a pattern of life in which for the large part he is lost in the group, and yet one in which he has a corner in which he is the leader or is different. It is only then that the child who is behind in his school work, who is not making a good social adjustment, who is lost in every other part of his life, says, “Well, wait till they come to checkers.” That is the place that is his own, that makes him an individual, that gives him leadership, that allows him to meet every sort of buffeting with sweetness and a sense of adequacy. And then we must plan to develop for the child, as best we can, the ability to live by himself, the ability to find within himself resources o f richness and happiness in life. And finally we must develop for the child those opportunities to have experience which I have called “ successful” experiences.. I am not going to talk very long about your own objectives, but I should like to say just two things about them. The first o f these is an objective that has a good deal to do with that cynical, beaten, bitter attitude that we see expressed in so many adults, of “ Oh, well, what’s the use?” You all know this sort of hardened picture of defeat. To me it represents the most subtle enemy o f the social worker. I am very sure that this attitude most frequently develops from having set goals and objectives that are too high. It is dangerous to talk about having goals that are not too high, and yet I am sure that the matter o f plodding along with an eye to a goal that is attainable gives us those experiences in triumph that are absolutely necessary. It is when you build stand ards for yourself that are impossible that your spirit breaks. I often feel in my own work—and this again is perhaps a dangerous thing to say—that the first approach that it is wise to make to a problem is not in terms o f measuring those things that we can do for the child but in first separating out those things that we cannot do for him. It seems to me that it is so often necessary for us to find first those stone walls that will only break our spirits. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 70 CONFERENCE ON STATE CHILD-WELFARE SERVICES And the second thing, in the matter of your own objectives, has to do with the way of measuring your work. I should like to see social workers more and more measuring their work in terms of themselves—how much they have grown, how much more life means to them than it did last year. I say this because I am quite sure that the children with whom you work do not grow any more than you do. Oh, yes, you can set out at the end o f the year a very hand some statistical table o f the calls that you have made, the number o f children you have had in your care, the clothes that you have provided for them, the job placements you have made. But I am sure that if life is not richer for you, if you do not have stronger faith in those things in which you had faith, if you do not know now better than you did a year ago what you are after in life, those things that you are striving for—then I am sure that your clients have not done much real developing. In every other human rela tionship, in every friendship, we know that both people grow. We must see that this holds for the social worker-client relationship. And then could I say to you just two little things about the pro gram. First, you must use this program to teach your communities. It is your delinquents that have built your playgrounds. It is your truants that have changed your school curriculum. Go anywhere you want to, and you will see that it is the rebel who dramatizes life. I f you go back to your communities just to work with the rebel you are doing only half the job. You must constantly be interpreting to the community what that boy or what that girl is trying to do. When you do that you will become real teachers. It is the only way that I can see of escaping the present plight of most social workers, that o f being glorified street sweepers, forever just sweeping up the debris o f life. I like to think here of one of the oldest prophecies that man has had: “ The stone that the builders reject will be made the headstone o f the corner.” O f course, a great many people feel that this proph ecy was fulfilled some 2,000 years ago. But we can fulfill it today just as truly as when it was first made. In fact, that seems to me to be the great challenge of our work—that we interpret to society its weaknesses, its stresses and tensions, through what the delinquent, the truant, the breakdown tell us. When once you start to use this child—this problem child—to teach your community what it is doing to all o f these people, to teach your community the problems o f the child, then indeed do you make the stone that we reject the headstone o f a new social philosophy. These children pay a terrible price, but you can make that sacrifice worth while if you teach your community what it is doing to all of its children. There comes in this way out of your program the basis of teaching our society a new sort of justice for all children and for all people. Lots o f times I wonder, when I am sitting alone with a youngster in the office, what is the use o f doing this work with John and Mary and Helen when there seem to be so many large and engulfing issues sweeping over the whole world. Why keep at this picayune sort o f individual business when fear and hatred and war are about to engulf us all? I suppose that many times the same question occurs to you. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 4—EVENING SESSION 71 My own answer—perhaps it is not a very good one—is that per haps we are one o f the few groups that remain truly democratic, in that we are still pinning our faith on the development of single individuals. So I ask you to preserve this faith, to preserve this vestige o f democratic philosophy in a world that would seem to sweep it all aside in great mass movements. That is all that I have to say. It has been hard to put into words what I feel about your relationships to the program. I could not do any better here than to quote a bit o f Chinese poetry. The poet Wang-Wei was asked what he liked best in life. He answered: I am old, Nothing interests me now. Moreover, I am not very intelligent And my ideas Have never traveled further than my feet. I know only my forest, To which I always come back. You ask me What is the supreme happiness here below? It is listening to the song of a little girl As she goes on down the road, After having asked me the way. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Tuesday, April 5— Morning Session MENTAL-HYGIENE PROBLEMS AND SERVICES IN RURAL COMMUNITIES Cheney C. Jones, Superintendent, The New England Home for Little Wanderers, Boston, and Member of the Advisory Committee on Community Child-Welfare Services, Presiding The C h a ir m a n . A s I left my office Saturday I picked up a book left on my desk and on the train I fell to reading it. I think it would be a good idea for all o f us to look at it. The book is “A Pediatrician in Search o f Mental Hygiene,” by Dr. Bronson Crothers, assistant professor o f pediatrics at the Harvard Medical School and visiting physician to the Children’s Hospital in Boston. It is published by the Commonwealth Fund. I have not read the entire book, but became much interested as I browsed in it. The title is intriguing. In ap proaching this meeting this morning one might think of a book entitled “A Farmer in Search of Mental Hygiene.” Any one o f us might consider himself as searching for this thing called mental hygiene and then might say, “What is it we are searching for?” I have come to this meeting with anticipation because I hope that here I may find the answer to the question. I am certain that many other ordinary persons and I. will never find out what we mean by mental hygiene from these tremendously thick books that are piled up on our desks. We take them up, but most of us bog down after about 25 pages and never get further. The more I read about it and the more I hear people talk about it, the more I am confused as to what we really mean by a program for mental hygiene. Sometimes I get the suggestion that mental hygiene consists of an assortment o f mental pills that come in a variety o f bottles labeled with a variety of names. There is a new label every year. I have heard these words so many times that I have found myself using them, not being very certain about what I meant when I spoke them. I reached the stage one year where I told my secretary that if one particular so-called psychiatric social worker appeared again and said to me, “It is a marvelous case of identification,” I feared she would not be identified for some time to come. Sometimes it seems that these labels are part and parcel of a very large language that would bother a rural man a great deal more than it would help. There was a young person in my office one morning who was very able and exceedingly attractive. She was presenting to us a case situation. She said, “ This client is having difficulty in the health area.” The farmer-physician and I sitting by were as much in the dark as ever after this remark, and so I replied with the question, “What do you mean? Has she the itch, or what?” Language ought to be used to convey meaning. 72 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 73 At other times mental hygiene practically seems to consist o f trying to break the patients out in a sort of mental smallpox, and by such breaking out it seems to be supposed that they will be immune from all sorts of mental difficulty ever after. I believe this is sometimes called “ analysis.” Sometimes hygiene seems to be mixed up with sanitation, but I suppose there are times when a mental bath is help ful. I have sat through some so-called clinics after which I was glad o f an opportunity to go outdoors and get a breath o f fresh air or to get a copy o f Sidney Lanier and take a mental bath myself. This is the picture o f how the meaning of mental hygiene is apt to be confused in the mind o f the average man. There is one thing certain, and that is that those o f us who were fortunate enough to be at the dinner at the Willard Hotel last evening got a good course in mental hygiene from our good friend, Dr. Plant. There is another thing about which I am certain, and that is that the average country boy knows that basically there is a need for the kind of service we visualize. There are very definite mental hazards that a boy in the country feels just as though he lived in any other part of the world, and as I hear psychiatrists in the city describe certain emotional difficulties they are recognizable to me as something that I as a country boy faced. I went to school in a sod schoolhouse—something that many o f you have never seen. It was very inadequate, and the books and the teacher were inadequate. By accident I came upon a book that told of beautiful schools in another part o f the world. In that sod schoolhouse I was as resentful as anyone could be about the inadequacy of •my opportunity, and doubtless there are things in my personality now that are the direct result o f that experience. I like the title Miss Atkinson has given us for this meeting this morning, “ Mental-Hygiene Problems and Services in Rural Commu nities.” We are facing these problems and not starting out with the assumption that we have the program all set up and ready to carry out. I was glad to see that we had not been brought here to discuss the application of dynamic therapy, or o f deep-level therapy, or o f some other psychoanalytic technique to farmer boys and girls, even though their needs may be very deep-seated. I doubt whether we are ready for any such finesse in our wide-open spaces. Facing these rural problems thoughtfully until we understand them may lead us to provide the sort o f service that will give rural children more than meat and drink, for they, too, “ shall not live by bread alone.” We are to hear first something about a method o f providing psychi atric services, and I am very happy to present Dr. Howard B. Mettel, chief o f the Bureau o f Maternal and Child Health, Indiana State Board o f Health. 78986*—88-----6 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Method of Providing Psychiatric Services By H oward B. M ettel , M. D., Chief, Bureau of Maternal and Child Health, Indiana State Board of Health Mr. Jones has broken the ice for me because I likewise am not a psychiatrist. I am a pediatrician in search of mental hygiene, as Dr. Crothers’ book has set it up. However, my father taught me a long time ago that if you did not know something about something and did not have time to dig it out for yourself, perhaps you could organize a group about you that could teach you something. That is the purpose o i my paper this morning—not to take up any methods of treatment or diagnosis of the problems o f mental hygiene but to show that Indiana is as primitive as some of our other States in its backwardness in establishing mental-hygiene services, and how we are struggling and beginning to provide a mental-hygiene service, a psychiatric service for children in rural communities in Indiana. The trend of child psychiatry today is toward the integration of the biologic and social sciences. It includes not only the art of the care of the abnormal child but also the important field of prevention. The needs for setting up a mental-hygiene program for the children o f Indiana were evident, but financial resources for promoting an adequate program were not available from any one public-health or welfare agency in the State. The primary objectives in setting up such a program by the de partment o f health were— 1. To further the activities o f the Bureau of Maternal and Child Health of the Indiana State Board of Health in carrying out a pre ventive public-health program. 2. To cooperate with the State Department o f Public Instruction and the Indiana State Department o f Public Welfare by giving as sistance to schools, and to dependent children who need psychiatric consultation services. 3. To provide better psychiatric training to undergraduate and graduate physicians, educators, and welfare workers, and to teach the importance of the basic psychiatric approach to some of the behavior problems that appear early in childhood but are not often recognized and dealt with until later years. In August 1937 a mental-hygiene program for children was in augurated in Indiana. This demonstration was made possible by the approval of the Children’s Bureau of the United States Department o f Labor. The program in Indiana is under the joint auspices of the Bureau o f Maternal and Child Health of the Indiana State Board o f Health, and the Children’s Division o f the State Department of Public Welfare. These two organizations have pooled their facilities to establish and foster a well-organized child-guidance service. It is to be noted here that the annual budget o f either of these two 74 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 75 State departments singly did not provide sufficient financial assist ance for such a demonstration, and that only by pooling avail able funds from both agencies was it possible to administer such a program. Since both of these groups were engaged in giving com munity service in their own particular fields, it was felt that in a mental-health program lay the opportunity for a liaison which would allow for a more unified program. In this manner the services given by each of these groups might contribute more completely to a wellrounded community service and their functions dove-tail efficiently and harmoniously. The ground work for the child-guidance service was laid sub stantially by the director o f the bureau o f maternal and child health and the director of the children’s division o f the State welfare de partment. The former interested and obtained the approval of the Indiana State Medical Association, so that medical cooperation be came a forceful part o f the mental-hygiene program for children. This official approval was also followed by more direct contact with the local medical societies in those areas where the program was to be established first. This type of medical cooperation is always essen tial in setting up any program which involves medical care or con sultation. Other facilities were enlisted by way o f uniting more closely the various parts o f community service. These included the official State public-health-nursing program, the county public-health nurses of the demonstration areas, and the State department of pub lic instruction, including local school superintendents and principals in the selected areas. The director of the children’s division of the State welfare depart ment and the supervisor o f the child-welfare services of the State met with the officials of the specified departments of county welfare and with the directors of the local boards to arrange for a childwelfare worker in each of the several chosen counties. The purpose of these conferences was to outline methods of local functioning and to define the duties of the local worker in each area. As a result the local welfare worker functions closely with the county welfare de partment, is a member of the official county welfare staff, and works closely with the schools and with various other public and private agencies that deal with the welfare of the children. The welfare worker is an integral member o f the community and is in close touch with all aspects of a well-rounded child-welfare program. The di rector o f the children’s welfare services assumes the responsibility for the supervision o f these child-welfare workers. It is around the activities of the child-welfare worker that the childrpsychiatric services are based, because the child-welfare worker remains the local representative of the service and carries out therapy as planned by the psychiatric personnel. The psychiatric staff is composed o f a team that includes a psychiatrist (director), psycholo gists, and psychiatric social workers. In order to carry out this program it was necessary to obtain the services o f a psychiatrist to act as director o f this division. In making this selection a physician was chosen who had had training and experi ence in child and adult psychiatry and mental-hygiene problems. This provided an adequate foundation for the study of the mental prob- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 76 CONFERENCE ON STATE CHILD-WELFARE SERVICES lems o f children as evidenced by their behavior. In order to evaluate human behavior properly a psychiatrist dealing with children must be a person who is a medical graduate. This demands an under standing of the individual as regards his physical status, his intel lectual endowment, and his emotional make-up. S t u d y of the intellectual endowments and special abilities and disabilities of the patient is a particular contribution of the psychologist. Study of the environmental factors is the offering of the social worker. With these at hand the psychiatrist draws together all available data, including physical status, his own study o f the individual and family, and then evaluates, diagnoses, and advises or treats on the basis of the instruc tive data with which he has to work. A t the beginning of the child-mental-health program in Indiana, with only a single unit of the psychiatric team available, the areas in which the unit could function necessarily had to be limited if satis factory work was to be performed. Three counties in the State were chosen for the child-psychiatry demonstration. These counties were selected on the basis of the generalized health program already estab lished and the need for such additional services to help round out the health and welfare services. This established program included a child-welfare worker, county public-health nurses, and other cooper ating persons, such as the local medical group and the school authori ties. Sullivan, Morgan, and Jay Counties were then chosen to receive the psychiatric and psychologic services. The Indiana home for soldiers’ and sailors’ orphans also receives this service, because the administrators felt a special need for it and because there is already a social-service and medical program established in that institution. The need for a program of child psychiatry in Indiana is shown by the fact that, with the exception of Fort Wayne, South Bend, and Indianapolis, there have been no places for referring or examining these types o f cases in Indiana. In most o f these cities this type of work is conducted as a part of the school or educational program and is often conducted by nonmedically trained persons. There existed no provision in the curriculum of the Indiana Uni versity School of Medicine for teaching students the problems of child psychiatry. Therefore this most important branch of pediatrics is little understood or practiced by the majority o f the medical pro fession of the State of Indiana. In the children’s clinic of the Riley Hospital for Children there existed no medically trained person who was qualified to deal with the problems o f child psychiatry. Thus far no funds have been available for the establishment o f a department of child psychiatry. Throughout the State of Indiana the Indiana State Welfare De partment has under its care a number of dependent and homeless children. Many of these children present mental-hygiene problems for which the State Welfare Department is unable to have diagnosis made and treatment outlined. This problem has especially presented itself to the State Welfare Department in dealing with the placement o f dependent and homeless children who heretofore have been housed in orphanages and like institutions. With the exception o f those in the larger cities mentioned before, teachers have no access to guidance in problems o f child mental hygiene. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 77 The psychiatric services were actually started in these demonstra tion areas in September 1937. Preliminary meetings were held with the boards and the children’s committees o f the local county welfare department. The director of the children’s division o f the State welfare department, the supervisor, the psychiatrist, and the psy chologist, along with the child-welfare worker, attended all o f these conferences. Shortly after the services were started the director of the bureau o f maternal and child health and the psychiatrist met with the county medical societies, where the program was described, dis cussed, and approved. Rules and regulations in regard to the eli gibility and admission o f children to these services were drawn up and approved. Among these was the regulation that each child before being admitted to the service must have a routine physical examination, including a Wassermann test and a urine test. For this routine examination the referring physician or clinic was required to fill out a physical-examination form supplied by the State welfare department, and the referring physician was reimbursed by the county welfare department when the patient was unable to pay. For his private patients he made his own charges. All psychiatric services are free, regardless of the financial status of the child’s parents, family, or guardian. After the medical, social, and psychiatric work is completed, the psychiatrist confers with the referring physician who carries out the recommended medical program if any further medical treatment or observation in the hospital is indicated. Conferences concerning the program are also held with the school principals as well as with individual teachers. All members o f the staff participate in these conferences at various times. Psychiatric services to the State home for soldiers’ and sailors’ orpharis were started in October. After preliminary conferences with the governing boards and administrative officers of these institutions, the services began. The children were given psychological examina tions in order to obtain a broader knowledge o f school adjustment or vocational guidance. The greatest number of children referred to the service are those needing school adjustment and those having emo tional difficulties. Another important group referred were those who were planning to leave the institutions shortly and who wanted to discuss plans for their vocations, living arrangements, home place ment, or to proceed to advanced schools o f education. Special services have also been given to orphanages which have asked for help in the understanding o f some o f their children, and to certain individuals in other counties where acute situations have arisen and where the worker or teacher felt that psychiatric and psychological examination would help in more adequate handling of the given case. The psychiatrist spends 2 days of each week at the Riley Hospital for Children, which is a part o f the Indiana University Medical Cen ter and School o f Medicine. Here psychological service is given by the psychology department, which is under the direction of the department of psychology o f Indiana University. Although no spe cially trained children’s psychiatric social worker is available at the moment, expansion in this direction is a definitely indicated need. In this area the psychiatrist gives lectures to senior medical stu dents on the pediatric service; makes ward rounds with the intern https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 78 CONFERENCE ON STATE CHILD-WELFARE SERVICES and resident staff; is consultant for ward cases; and conducts an out-patient clinic for return patients and for those who have not been in-patients but who have been referred from the out-patient pediatric clinic after physical examination has been made. Many children and their parents have been seen by the psychiatrist; some have had a series o f subsequent interviews. Recommendations and contacts are made with referring and interested persons or agencies, the parents, the county departments, the juvenile courts, the family physician, or the schools, as indicated. In addition to actual clinical service rendered by a child-guidance unit, perhaps especially when the service is new, there is the important function o f proper interpretation—giving communities and socially minded groups correct information and stimulating local interest. This function leads not only to more substantial backing for the already existing unit but it is hoped that it will create an interest and demand for further expansion of child-welfare services. To this end the psychiatrist has given lectures throughout the State before these socially minded groups, which include State welfare conferences, parent-teacher-association conferences, federated women’s clubs, and similar organizations. It is hoped that the demonstration will stimulate interest through out the State for an extension of needed services, and that local feel ings and interests will be so developed and stimulated that the com munity or county will ultimately take over the financial and adminis trative responsibility for the establishment o f its own psychiatric unit. The C h a ir m a n . In line with the general theme of this whole con ference, that is, looking at the content o f our undertakings, we are now to hear more about the content of a mental-hygiene program, and we are certainly fortunate in having with us Dr. George H. Preston, com missioner of mental hygiene o f the Maryland State Board of Mental Hygiene, who will address us on that subject. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Content of a Mental-Hygiene Program By G eobge H. P reston, M. D., Commissioner of Mental Hygiene, Maryland State Board of Mental Hygiene I was asked to talk about the “ content o f a mental-hygiene pro gram.” I am going to start by saying that I don’t believe there should be a mental-hygiene program. Mental hygiene to be effective must be content o f a general welfare program and not a program by itself. It is like a religion. You can nave a beautiful church and a good minister and you can even have services two or three times on Sunday and once during the week, but if what is preached is not part o f the community content, then it is nothing but a nice ornament to show visitors. It does not accomplish anything so far as the community is concerned. I feel very much that way about mental hygiene. I f it is a program, it is not anything; but if it is content o f a child-welfare program, then it probably will mean something concrete to a community. I believe I can talk from that basis about the content of a mentalhygiene program, and in deference to our chairman I am going to try to oe specific. He said something about the generalities o f mental hygiene, and I am going to begin backwards by talking about what the mental-hygiene content o f a child-welfare program is not. Cer tainly it is not just picking out the feeble-minded. You see a cer tain number o f mental-hygiene programs that are concerned only with that problem, but that is not mental hygiene. Nor is a mental-hygiene program only the recognition o f psychotic parents, difficult as they may be in a case-work job. Again it is not—and I am very particular about this—the establishment of a special dump for all difficult cases. There is a tendency in the direction of setting up psychiatric service, mental-hygiene service, and then taking everything that nobody else can handle and dumping it on the psychiatric service and expectmg miracles. The failure to work miracles serves to segregate mental hygiene and to keep mental hygiene from becoming content o f the general program. Furthermore, psychiatric service is not vocabulary, although it occasionally tends to be. These are some o f the things that mentalhygiene programs are not. They are all essentials and I do not mean at all to belittle them. To my mind those things are like the dishes and the forks and the garbage can in the kitchen. They are essentials to meals, but by themselves they do not constitute a diet. You need to have them to feed people; you have got to have certain services to do a mentalhygiene job, but they are not the job any more than the garbage can is the dinner table. They are essential pieces o f machinery but the really important factor lies outside o f the tools. 79 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 80 CONFERENCE ON STATE CHILD-WELFARE SERVICES What is important is that the use of any mental-hygiene equip ment within a community depends entirely upon the attitude of everybody working in the program. Unless there is a common point of view in regard to mental hygiene that is part of the common equipment of everybody working, these tools are not enough. I am not at all convinced of the value of a few psychiatric specialists working at a specialty within a case-working organization. The value of a specialized psychiatric group within an agency is doubt ful because every social-work situation has its mental-hygiene implications. I read a very interesting article not so very long ago by Professor Jansen, of Duke University, which is in the January 1937 number of Mental Hygiene, and I think it is entitled “ The Place of Mental Hygiene in Social Work.” It is thoroughly well done. Doctor Jan sen brings out the point that in every situation in which you meet social-work problems you find a mental-hygiene layer somewhere, and he quotes one case that struck me as very pertinent. He talks about a professional man and his wife and daughter who reached the stage at which this man could not keep himself going by the fees he was collecting from his clients or patients and landed in a relief situation, with a daughter who was an honor student in high school and with the immediate questions being presented: Do we put this family on relief and try to carry it through? Do we take the girl out of high school and help her get a job to keep the family going? Do we allow the man to continue doing what he can professionally and find a job for his wife? Aside from whether you could find jobs for these people you had at once the psychiatric questions: Are you going to damage this girl’s self-respect more by pulling her out of high school or more by putting her mother to work to support her in high school ? What are you going to do to this man if you make it obvious to the community that he cannot support himself and'that his wife has to go to work for him to keep things going? It seems to me that questions of that sort, which are very simple, common to all o f you, have to be decided on the basis of a knowledge of the attitude and the feelings of the people involved. You must know what this man thinks and feels, you must know what his wife thinks and feels, and you must know what the daughter thinks and feels, and no solving of such situations by rule is going to work. There are family attitudes and children’s attitudes which must be considered before you make a decision as to which one of the various facilities a community offers may be used. The same factors apply to all the problems that arise in a community, for example to the simple problem of telling a family that somebody has tuberculosis. That requires an understanding o f people, and in one particular case I know o f I think the way in which the situation was explained made the difference between a man who would have gone to a hos pital and literally fretted himself to death and a man who could go to a hospital with some assurance and some ability to rest and get well. The difference in the technique was the simple kind o f mental hygiene I am talking about. I f that is going to be done, then this thing that we are talking about as mental hygiene must be the common knowledge of all the people dealing with people. That does not mean just social workers. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 81 It certainly means physicians. It means ministers and lawyers and everybody in the community if it is to be effective, but primarily it means the social-worker group at the present moment. There is a beautiful outline of institutional mental-hygiene content in an article by Sybil Foster in the January 1938 Mental Hygiene. It is beauti fully done, worth anybody’s looking at, whether he is doing institu tional work or not, because you can take it right out of the institution and use it in any dealings with children. I still have not been specific. I have talked about what things were not. The first concrete item in this common knowledge of mental hygiene is some understanding of what human behavior actu ally means when you see it going on in front of you. At the risk of being very elementary in my talking, I am going to talk about two or three situations. t I remember a small boy o f 6 who was being brought into my office. I happened to see him walk down the street outside my windows and stop and pick up a cigarette butt off the sidewalk and light, it and walk the rest of the block smoking the cigarette. That was a per fectly beautiful label, “ I want to be grown up and I am not having a chance.” And you did not need a lot more than that. By the time the boy got in you knew what you were dealing with. A similar sort of case was that of a boy who came to me and said, “Dr. Preston, did you ever see a hippopotamus?” I said that I had. He said, “Well, you know I saw one out in the lot in back o f the house the other day and I did not do a thing but go up and twist his tail off.” You do not want people to give you much more than that kind of story, do you? They have just hung out signs for you. I knew two boys who were about 15, and on the same Sunday one of them slipped away from home and joined the Presbyterian church and the other one slipped away from home and broke into a grocery store. They had exactly the same motivation—no difference in the type of behavior from my point of view at all. Both of them wanted to show the world they had grown up. What they did depended upon the pattern of the home in which they had grown up. Those are the simple sorts of things that mean mental-hygiene content. Somebody said once that there was a group of social work ers still in existence that believed it was not worth while to listen to a story o f distress unless you could do something about it. That just does not make sense from the mental-hygiene point of view, because, of course, the actual telling of a story of distress to some body who will be decent enough to listen is good therapy. Patience, tact,, and frankness and not throwing the person out of the office is good psychiatric therapy by itself—good mental hygiene in the sense about which I am talking. Understanding o f the meaning o f human behavior is one o f the essential mental-hygiene components. The second is much more diffi cult to attain. It is the need for every worker in the children’s field or in the social-work field to be able to face without prejudices any type o f behavior that happens to be presented. The doctor is in exactly that situation. I f he approaches a patient with the feeling that the patient or the patient’s condition is nasty or dirty, he cannot treat the patient. The social worker who approaches a situation and says, “ I can’t stand liars,” or says, “ I can put up with anybody except a client https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 82 CONFERENCE ON STATE CHILD-WELFARE SERVICES who is cheating on me,” is not mental-hygiene conscious. That is per sonal prejudice. That is emotional astigmatism. And it is one of the things that give you an improper point o f view in dealing with people. You cannot approach a client as a drunken bum and do social work with him. And unless you can approach him with a question, “ Why is this man doing the kind o f thing he is?” you cannot do social work with him. You cannot walk into a woman’s house and discover that the beds have not been made for a week and the dishes have not been washed since last Sunday, and approach her as a filthy, dirty, lowdown housekeeper. You have got to approach that sort of thing with the feeling, “What is this all about—why is this person doing the kind o f thing that she is doing?” There is the need for not letting personal prejudices get in the way o f your social-work technique. You may say that these things are ordinary common sense. I grant that they are for a few people who have had a great deal o f experience, who have met many people in many places, and who are themselves relatively well mentally. These things are matters o f character that you may acquire in the course of 70 years of living. They are also things that can be acquired by technical training. It is possible to acquire an understanding of what human behavior means, and it is also possible to compensate for personal prejudices by careful technical training. The essential content o f a welfare program is mental hygiene, and by that content I mean that every worker should know what the human behavior that she sees means. She should be able to face any type of human behavior, recognizing her own prejudices, and making allow ance for them so that it can be approached unemotionally with the question, “What is this person doing—what does this thing mean?” rather than saying, “This is something I cannot stand.” With that sort of content a program ought to develop in two direc tions. First, it should be developed so that the work can be carried on without too much damage to the client. I say “ too much” advisedly. I believe it is a rare individual that handles a social-work case or a medical case without doing some damage to the personality o f the client. I am going to mention just one phase o f that because I think it is the most important thing we are facing in this country at the present moment. The mental-hygiene content o f a welfare program should be such that it would be possible to handle clients on relief without dam aging their self-respect. That is the only hope that we have of not producing a few million chronic dependents and professional beggars, and that is the responsibility that rests upon the mental-hygiene, train ing o f a social-work group. I f you put a person on relief in a way that destroys his self-respect, that person is not coming back. I believe the mental-hygiene content should be developed in the direction of protecting the client from damage, particularly in relation to his self-respect. The other direction in which this content should be developed is to make it possible for the worker to foresee trouble before she gets into it up to her neck. A knowledge of the attitude o f people and what things mean to them will make it possible for her to see that certain things cannot be done with certain people, that other things can be done, and will prevent her from getting into a situation in which she https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 83 and the client are both helpless and which neither has stability enough to retreat from. You see it takes a lot o f stability to admit you are wrong and to walk out o f a situation and start over again, and it takes a lot for the client to admit that he has made a mistake, so that push ing him into a place where he has got to admit he is a fool is just a mistake. A mental-hygiene content ought to make it helpful to foresee danger before you land in the middle o f it. When we begin to talk about the way this sort o f content ought to be developed in a program, let us assume that we have the base o f a child-welfare program in a community and that the training o f the people doing the job is average, so that the ordinary technique o f child-welfare work is done automatically. The first requirement in developing a concrete mental-hygiene content in a child-welfare pro gram is please get healthy workers. That is a very difficult job, but essential. I mean by that people who do not have too many preju dices. They are people who are not too narrow-minded, people who are not too personally peculiar, and people who are able to change. One o f the characteristics of mentally ill persons is rigidity. They develop one method o f meeting difficulties and they go right along with that method regardless of the difficulty. We talk about dead people as “ stiffs,” and you do not want that kind of person on a socialwork staff. They are of no use. You want people who are flexible and who are not too sick mentally. The next step is to have a supervisor or somebody, whatever you call them in the organization, who knows mental hygiene. That person should not carry cases, because the min ute she begins to carry cases everything difficult in the organization gets dumped on her. That person needs to be a consultant, a person who can be approached, who should approach everybody doing a case work job that involves problems, and who can teach mental-hygiene attitudes to workers. And one more thing. That person should have an opportunity to carry mental-hygiene content to every other agency that deals with children in the community—the juvenile court, ministers, doctors, school teachers. I f mental hygiene does not exist widespread through your community it does not do any particular good. I f you build up a nice mental-hygiene job with a child in a family and put him in a school that does not know what you are talking about you may have the whole thing undone, very promptly, by something like the follow ing : I walked into a classroom on one occasion and the teacher said, “ Oh, children, here is Dr. Preston, you know what Dr. Preston does, he takes care o f all the foolish children. Johnny, I wish you would come up here and let Dr. Preston look at you. He has such a funny head, Doctor.” I think that is the story. This thing is a matter not o f program but o f content o f existing programs. It is like the salt in the soup. The salt by itself is of no use, but without the salt the soup is not fit to eat, and that is my point o f view in regard to the content o f a mental-hygiene program. The C h a ir m a n . Our next scheduled speaker, Mrs. Robbie Patter son, supervisor o f child-welfare services on Nebraska, is unable to be present today, but we have her paper and it will be read by Mr. Harry Becker, director of the Child-Welfare Division in the Nebraska State Board o f Control. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Contribution of the Social Worker to a Mental-Hygiene Program By Mrs. R obbie P atterson, Supervisor, Child-Welfare Services, Child-Welfare Division, Nebraska State Board of Control In a mental-hygiene program we think of the psychiatrist, the psy chologist, and the social worker, because each has an essential and specialized contribution to make. In considering the place of the social worker in a mental-hygiene program, we are presupposing that the worker has at her command an adequate working knowledge of and a belief in mental hygiene— a knowledge that understands human relationships and human reac tions to environment. The social worker is a person who has ac quired distinctive knowledge and experience and has added definite personality developments to this knowledge and experience. Social workers in mental-hygiene programs should be persons who have reached maturity and have found in their own achievement a basis o f security with respect to themselves and to their professional obliga tions. They should be free from prejudices and preconceptions, realizing that prejudices and preconceived ideas are likely to dominate the handling o f situations. On the other hand, social workers should be able to let reasoned conviction based upon a study o f facts take the place of dogma in regard to human behavior. Workers also must realize the danger of an exaggerated sense of authority on their part in assisting clients to develop a capacity to make their own adjust ments o f life. The social worker in a mental-hygiene program is in a strategic position to do an important piece o f educational work in the com munity. Through her relationship with the psychiatrist, the worker’s knowledge is increased, and she is able to interpret to the com munity what the functions of a mental-hygiene program are. Social agencies are subject to the demands made upon them by the communi ties. As the social worker in the agency deals with the problems involved in the demands, wTe become increasingly aware o f new aspects of the problems, o f the need for new understanding on the part o f the general public or the strategic groups within the comnninity, and frequently the need for the development of new forms of effort in order to meet adequately the problems o f the socially mal adjusted individual. The social worker is invaluable in her personal contacts with the doctor, the teacher, and the judge, in bringing about a better understanding o f problems involved in the treatment o f dependency, delinquency, and other social maladjustments. , I r mi educational program it is important that social workers keep m mind that mental hygiene is primarily concerned with the normal and not the abnormal. They then make a positive rather than a 84 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 85 negative approach. We should remember that the positive educa tional aspects o f mental hygiene are relatively simple, understand able, and susceptible of being developed into principles o f living. A great deal that mental hygiene has to offer in a positive educa tional way does not call for mental-hygiene clinics. It is recognized that if the principles of mental hygiene are to be applied on a sufficiently extensive scale to be effective upon the mental habits of people generally, these principles, for the most part, will have to be applied by persons who are not specialists or experts. Such princi ples are applied by the social worker not with the familiarity of the intricacies o f psychiatry, but with an understanding of the simpler but highly significant fundamentals of positive mental hygiene, which is reflected and practiced in the contacts with others. The position in the community and the relationship with the public afford opportun ity for interpreting the services o f the psychiatrist and advising ex pert services where needed. One of the social worker’s greatest contributions to mental hygiene is aid in removing many of the ancient superstitutions and prejudices that, in the past, surrounded mental illness. The social worker has played a great part in the concerted effort to bring about a realiza tion that mental diseases, like physical diseases, are subject to cure and improvement, as well as prevention. With the psychologist and psychiatrist, the social worker is aiding the public to see that there should be no hesitation about seeking early and expert treatment for mental illness. The social worker has to assume a large responsibility in guiding the educative process to meet the needs o f the individual. Whether these educative experiences are o f a social, intellectual, physical, or emotional nature, or a combination o f all four, it is necessary that the interpretation o f the growth process be related to the limitations and capacities of the defectives and the subnormal as well as the superior intellectual group. The social worker in the community frequently finds herself in contact with the beginning and occasionally with well-developed problems of mental disease and deficiency. Early recognition of the possibilities of training, with emphasis on the specific needs o f the defective child, makes it possible to promote better-organized educa tional and social opportunities for these groups. Because o f her position, the social worker has an opportunity to bring to the attention o f the psychiatrist many individuals who need care in the early stages o f mental break-down before deterioration begins. This may increase commitments, but it makes for better prognosis. As the social worker is an important factor in the early treatment o f mental diseases, so she is an important factor in the pre ventive aspects o f mental hygiene, some o f which are the direction and guidance o f parents in the handling o f their children and making contacts with school authorities, through which helpful guidance may be given in meeting the needs o f individual children This leads us to think o f the social worker in relation to the schools. Children, as the result o f physical disability or deep emotional dis turbance or for some other reason, often cannot conform to school standards. A competent case worker brings her skills to the aid of the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 86 CONFERENCE ON STATE CHILD-WELFARE SERVICES teachers and parents, often building a guidance program in the school, but more often giving a better understanding of the child. The social worker makes a contribution by providing leadership in relationship to the client and to the community. In discussing the leadership o f the social worker in their book, Mental Hygiene and Social Work, Lee and Ken worthy point out that the relationship with the client is the keystone to successful treatment. To this relation ship the worker brings the combination of working knowledge, point o f view, and adjusted personality, added to the ability to handle one self in such a relationship so as to make social case work an art. It is this relationship that enables one to conduct oneself in all contacts with the client so as to enable him willingly to accept the suggestions which the worker’s knowledge of mental hygiene and social work enables her to make. When a mental-hygiene program is new, the social worker is the leader in interpreting the services o f the psychia trist to the client. It is she who can help a mother understand that because she has talked over the behavior of her 12-year-old son with the psychiatrist she will not be regarded as “ queer,” or because the son makes weekly visits to the psychiatrist’s office he is not mentally de ficient and ready to be committed to an institution. The social worker also must assume responsibility for explaining that a “ magic spell” will not be worked in a day by the psychiatrist and the child or his parents be made anew. As a leader in the community, the social worker is called upon to develop attitudes that will lead to the acceptance of mental hygiene. In a rural community there is so much neighborliness that what the worker does is more or less shared by the whole group. Everyone knows that the Joneses are finding it hard to understand their adoles cent daughter, that the Browns are receiving relief, that the Smiths’ daughter has a child born out of wedlock. This responsibility of interpretation may seem anything but an asset, but there are defi nite values in this function. There is an opportunity, in talking with the lay public, to develop a better understanding of the respon sibilities to the unmarried mother or to interpret the needs o f the child rather than o f the adults in the foster family in the placement of dependent children. The worker in the community, then, has an important function in the modification of the attitudes o f parents, teachers, judges, and lay groups toward people whose self-expression may conflict with the gen erally accepted practices o f the community. It often becomes difficult to maintain a non judgmental attitude, but this is necessary if the worker is to become an integral part o f the community and be its leader in developing harmonious community life. The social worker should share in the successes o f the progress of the mental-hygiene program. A good many o f the cases come to her attention first, and she is responsible for collecting the social data and social study. She is keeping ever before her the control of clientworker relationship so that the client will reveal how the history func tions in the present situation in determining the attitudes and in conditioning the reaction. The worker further will be objective and attain the social workers’ goal o f social adjustment without invading the psychiatric field o f dealing directly with the personality difficul ties. The worker brings to her aid general interest, penetrating under https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5— MORNING SESSION 87 standing, sincere good will, quick responsiveness to the client’s groping efforts. In advising psychiatric care, she evaluates the social data, keeping in mind the treatableness, the limitation o f the situation, such as time element, funds for boarding care, and accessibility to the psy chiatrist. It is the social worker who is always in constant touch with the reality and practicality o f the situation. We are finding a change in public attitude all over the country. Social workers are being accepted in counties and areas untouched before. The recognition by local public officials of the need for case work services is hopeful. Public officials are coming tq see that the lack o f economic security, poor housing, inadequate health, and poor edu cational facilities are social ills. Situations presenting a wide range o f problems are being referred to the social worker by the county official, the layman, the neighbor, the client himself. Many o f these situations; ignored before, are now being faced, and we find county boards willing to pay for medical services and for boarding care. Also, we find lay persons serving on advisory committees, organizing clinics, and volunteering their services in community efforts to solve environmental problems affecting the well-being o f the individual. DISCUSSION The C h a ir m a n . We are now to have some discussion o f these matters. Those who have been selected for discussion will be given first opportunity. First I shall call upon Mr. C. F. Ramsay, super intendent o f the Michigan Children’s Institute of the State Welfare Department. I understand that the discussants may discuss matter in any o f the papers, so you have a free hand, Mr. Ramsay. Mr. R a m s a y . I do not think I should have the audacity to presume that I could properly discuss the papers that have been presented. I happen to be just a social worker on the firing line who sees some children that are sent to us and for whom we have to make some future plans. We did not have the privilege o f knowing what the papers were going to contain today, and therefore could not pre pare in advance a discussion of them. I was probably chosen to bring to you the experiences we have had in Michigan in this work. I think that we can agree with Dr. Preston, o f course, that mental hygiene is just one part and should be integrated with the entire* program. There are some fundamental truths that it seems to me are very common to mental-hygiene programs and as social workers we are not fully cognizant of them. One o f these truths is the fact that change in social conditions among mankind is a very slow and arduous process and that very little effect comes from external forces. That is, most o f it has to come from inside the individuals themselves, and any kind of mental-hygiene program must accept this slow process o f inner forces acting on the individuals who are responsible for any program that pertains to the welfare o f children. In order to alleviate distress it is fundamental that social workers should approach the problem with sympathy and good will but without the attitude o f coddling or coercion. The social worker may also find himself in between pressures of the community that asks that something be done with a.family or with children and the rights of https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 88 CONFERENCE ON STATE CHILD-WELFARE SERVICES individuals to resist that contact o f society with their prejudices and with their resistance to change. In our experience in Michigan I cannot help but think we have had the beginning o f some chance to change these attitudes and prejudices on the part o f the community with our child-welfare services. We have not placed in each rural community a full-time child-welfare worker but have exposed the community to some o f the newer processes and techniques o f social case work, and as we have gone from county to county we have appealed to the pro bate judge, because he decides what happens to children that are brought to the attention o f public authorities. He has the power under the law to take them away from their parents, to assign them to institutions or agencies or to commit them to suitable institutions, and he is the key person as far as the public child-welfare program in the counties is concerned. Through our child-welfare services we have brought to him the supervisor who discusses the problems of the families o f children that come to his attention and offers the services o f trained social, workers and psychologists to advise with him. When the social worker and the psychologist have gathered all social material and completed the mental examination of the child to see what the potentialities are, a conference is called of the representatives o f all the interested agencies in the county— the health people, the school people, and the relief administrator, the county welfare agents, and the probate judge. The socialworker presents her case on the basis of facts found and without any pre conceived ideas o f her own. Out of this group conference comes some suggestion of group thinking and “ What have we in our county that can help this particular family or help this particular child?” We cannot help but think that such an approach may bear some fruit in changing the attitude toward the disposition o f children that come before the probate judges, because in many instances this is the first time in the county that any o f these people have ever got together and talked about the whole child. And we cannot help but feel just a little bit of pride, as it has been only 2 years now since that service has been inaugurated. We feel that we are be ginning to get some sign that maybe the result o f the investigations by the social worker and the summary the worker has sent back are bearing fruit, because the thing that we are aiming at, which we did not propose at the beginning, is the fact that we would like to have the judges refer problems to the agency before any dis position is made. Under the law we do not have that privilege, but in the county where we first started to work in April 1936 the probate judge is now beginning to write letters saying, “I have a family in which the children have been called to our attention and I would like to know what we are to do about it. Have you some one you can send out to study the situation and see whether there are any suggestions that you can make?” There may be a mother who is going down to the university hospital. “W ill you have some worker interview her to see what are the best plans to be made for her child ?” I think that is what Dr. Preston was trying to impress on us—-that the changing o f the attitude is a slow, long-drawn-out process. But I think the social worker who has the training and the experience https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 89 and probably not so much the knowledge o f what to do as the knowl edge o f what not to do is needed in inaugurating a mental-hygiene program for children in the rural counties. I think that he has brought out for us in his remarks that psychiatry is the tool o f a social worker; that the social worker should draw on all the resources of health, education, and psychia try, and everything else that we need to understand problems of children that are presented to us. With all the advancement we have made so far we are still far removed from knowing all the answers to the problems that children present, and if we can inte grate these other services I think we have the beginning of a mentalhygiene program. In conclusion, I want to say this: I could not help but be impressed with Commissioner Adie’s remarks last eve ning, and also the remarks of Dr. Plant, indicating that those in administrative positions in the public-welfare departments o f the States could start with the individual and work up, thus having some realization of what is being done for the individual that the administrative agency is trying to serve. Those o f us in the childwelfare field would welcome the day we could leave out the name of child-welfare service and call it by the broader name o f social welfare. The C h a i r m a n . N ow we move from Michigan to Maine, and Miss Lena Parrott, consultant on child-welfare services of the Bureau of Social Welfare, State Department o f Health and Welfare, will con tinue the discussion. Miss P arrott . When I noticed that I was on the program I w o n dered a little, because we feel that while we have made progress in Maine along many lines we have not done very much in mental hygiene. But after I heard Dr. Preston’s remarks I began to feel that we have done a little bit o f what he thinks is the right thing and a little bit o f what he thinks is the wrong thing. So I am glad to tell you what we have done, whether it is right or wrong. I think the wrong thing we have done is to take down to Boston to the Home for Little Wanderers our most serious problems—the ones we could do nothing with. We sent them down to Mr. Jones and I must say that he, in a good many cases, did a very good piece o f work. Sometimes he sent them back and told us that he wished we would not send any more cases like that. So we are beginning to learn to work together a little better and get more service, but we do appreciate what the Home for Little Wanderers has been able to do to help us with special child problems. In developing the child-welfare program in Maine there seems to be an overwhelming need to set standards for case work, and we put most o f our emphasis on providing supervisors who would have general supervision o f the workers caring for some 5,000 children who are under the care o f the bureau. About 2,500 o f them were committed children and 2,500 children receiving aid to dependent children. We were very anxious to find, and we did succeed in find ing, supervisors who had had good case-work training and experi ence, with a generous amount of mental-hygiene training and ex perience thrown in. And it has been, in the 2 years we have been operating, most gratifying to see the change o f attitude toward children and their needs and the place o f the child in his own home 78986°— 38-----7 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 90 CONFERENCE ON STATE CHILD-WELFARE SERVICES and his feeling for his parents. In the past I think the State—and if there are any Maine persons here, I will stand corrected—has been very kind to its children. It had a very paternalistic feeling toward children, but that very feeling o f protecting the child has in the past led it to do what seem to me to be terrible things to chil dren. The State seemed to feel itself so much more adequate to care for the child than were his parents that children were often uprooted and grew up with no knowledge o f their parents. I think workers in the past felt that when a child was removed from his own home a curtain was drawn between that child and his family and that there never was any need for the child to want to peep behind the curtain to see his parents or to know anything about them, since the State was quite capable of filling their role. So in these 2 years there has been a tremendous change in the attitude toward a child and his own family. There has been a d if ference in the attitude toward the child and his behavior, o f under standing him and his needs, and why he is presenting some o f the difficulties that he does present. So, as I heard Dr. Preston talk, I thought that by the selection o f supervisors with that particular experience we really had gone a little bit farther in our mental-hygiene program than I thought we had when I first came down. We have had one institute for the workers'. It was held by a psychiatric social worker who was in child-guidance work. We hope that we may have more institutes for the workers, plus the everyday help they get from their super visors, so that, Mr. Jones, we will not have to send so many children to you. I think the Children’s Bureau would like me to speak about what we have tried to do to use to the best advantage the available bed space in the one school for the feeble-minded in the State. As in most States it was almost impossible to get a child into the State institution for the feeble-minded. It was crowded and no one thought o f making the effort to find out whether another child could be placed or where there would be an empty bed. Three years ago a building program was started and a new building for mental de fectives was completed. It had a capacity o f about 350 beds, and last year when the legislature was making an appropriation for the maintenance of the new building it was staggering to find that insti tution had 350 beds but a waiting list o f about 425. It was an endless job—no sooner was a building finished than there were more people waiting to get in. It was found that the institution had no field service and no one to examine or study applications. It was also found that the waiting list was an accumulation o f 6 or 7 years, and it was decided by the budget committee o f the legislature that before an appropriation was made the Bureau o f Social Welfare, which is the State agency with a field staff, would make a study of these applications to determine what their status was. This proved to be very interesting. O f the first hundred studied only 60 appli cants were really in need of institutional care. It was discovered that some had died and some had been committed to other institu tions; that in a great many cases the families had found that they could care for the defective persons themselves. In other instances some well-meaning person.had led the family to think that if the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 91 child was sent to the institution he would have a training and an education which would fit him for life. And when they found that the program might not accomplish that a great many o f the appli cations were withdrawn. "W® found also a situation that had made for much misery and unhappiness. It was written in the law that there would be four classifications. First preference was given to a person who was in a State institution or who was being supported from public funds. The next classification included persons who were in public institutions but were being supported partly from private sources. In the third group were persons receiving town relief, and in the remain ing group were persons whose families or relatives were able to pay for their care. What we found was that in the third classification particularly, and the fourth, too, were persons who had been strug gling with children in their own homes; that we were probably admit ting to the institution from the first two classifications children and persons who were not as much a problem either to the community or to the family as the ones in the third and fourth classifications ; that families were just being wrecked by the strain o f this burden. This led to legislation that abolished the classifications and the order of admission, and the institution took the most urgent cases. Another result was that the Bureau o f Social Welfare accepted responsibility for investigating and studying all applications to the institution be fore applicants were admitted. And the result is now that if a person because of behavior or the strain on the family, does need insti tutional care, it is not quite so hopeless to get him in. We are able to get care for our more urgent cases as a result o f this study o f the problem. The C h a ir m a n . We are now going back to the Middle West and will hear from a psychologist, Miss Evelyn Ehman, of the Illinois State Department o f Public Welfare. Miss E h m a n . I think it is interesting, in view of Dr. Prestónos remarks about mental-hygiene programs as such, that the Illinois program for child welfare started out with no special provision for men tal hygiene. Illinois for many years has had a very good childguidance clinic in the Institute for Juvenile Research in Chicago That clinic has mainly served Chicago, but it has developed some traveling-clinic units which serve communities that have been ready for that kind o f service. J . J 0 n?j; believe there was much thought, at the time of establishing child-welfare services for the rural areas, of beginning the child-guidance service m those areas immediately; but out o f one part o f the child-welfare services a program came as a result o f the demand for something similar to this mental-hygiene work. Illinois has made plans for four demonstration areas—that is counties in which child-welfare service will be undertaken extensively • and m two o f these counties the work has been going on for almost a In ? ne o f the counties it was obvious that there were many children about whom we needed to know a good bit more than we could have learned from what the resident social workers could gather t o r instance, it was necessary that we have mental-test data and sometimes the study that a psychiatrist could give, and so it was neces- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 92 CONFERENCE ON STATE CHILD-WELFARE SERVICES sary to develop some sort o f service to take care of that. Also, it was obvious that this program was designed from the point of view of preventing these behavior difficulties from occurring. And so in Illi nois we have taken the track o f providing in these demonstration areas for the individual problems by developing a psychological and psy chiatric service, but also by bringing our program directly to the rural schools. It was possible to proceed to the teachers’ meeting in one little village school. The teachers met every week in the afternoon to dis cuss their problems. They were discussing a book on the mental hygiene o f school children, and it was possible for the school counselor to be present during those discussions and to take advantage o f what ever opportunity came up for interpretation. In'another school we found the principal worried about the fact that many o f his freshmen were poor readers. The grammar school and high school are in one building in that village and we could go back to the elementary grades to the origin o f these reading difficulties in the first, second, and third grades. Eventually we can get the school thinking in terms of individual differences and provide for meeting these differences before they become a serious problem. In the rural schools themselves we had some interesting develop ments. There was one rural-school teacher with 18 students who was very anxious to hear from the school counselor, and she very readily accepted the suggestion o f ordering group tests and achievement tests for all o f her children. The point behind that suggestion was that if this teacher could actually see the individual differences o f this group it might be possible for her to think in terms o f a program for each child. As it happened, she had one child who was seriously mentally defective. She felt that this girl should not be in school, that she should go to an institution. As it happened, the girl was learning as much as she could in that group. The teacher had taught her up to a capacity level and had also made the program as comfortable for her as she could in that schoolroom. The child was giving no special difficulty except that she was different from the other children. It was suggested that it was not so necessary to send this child away just because she was different. It was suggested that this teacher could be working out a relationship with the family that would provide pro tection for this child in the event that she did become more suggestible. Then this teacher had a very bright child who was in the sixth grade at that time and who measured up to eighth-grade level in ability and achievement. In this little rural school it is not possible to give a great variety o f materials and subjects, and it was suggested that the teacher see if the child could complete the seventh and eighth grades in 1 year and let him enter high school a year earlier. She said she did not think that would be a good idea because this youngster might not be able to go to high school very long; that it would be difficult for the family to send him to high school because it would be more expensive. He would have to go out o f the community and would have to have bus fare, and so on. The other side o f that problem was that this child very probably would have to drop school after he was 16, and that if he could enter high school a year earlier he would get far more from the school program than if he kept the regular pace o f a grade a year. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—MORNING SESSION 93 , The aPProach to the rural schools has been optimistic and we cannot talk about any program—m the first place it has not been going very long but we have m one county created a position defined as school counselor and the county superintendent o f schools has announced to w* T Packers that the service o f a school counselor is available. . have talked to school principals and to school teachers and have visited rural schools before the psychologist was available to this unit. ™ i children had been referred whose problem seemed to be mental deficiency, and the case Worker in the unit had arranged for group mental tests to be given by a nearby college. Well, these chil dren had been gathered up from various ends o f the county and had been brought m as one group and had been given a group test, and the material that was obtained from that test was n o t .felt to be i liable. It was felt that it was not safe to give it out in too impersonal a manner, so we made a point o f visiting teachers and discussing child proWems with them. As a result of that discussion we heard o f other fihlldi hr? ? gh the t e a r ’s saying, “Well, this child isn’t known to the child-welfare service but I wish you could tell us about him,” or I wish you would see what you can find out about him.” O f those children who were supposedly mentally defective we found one to be a perfectly normal child, but he had a reading disability and we were able to demonstrate to his teacher the use o f reading diagnostic tests and also to give suggestions for remedial treatment. 9ni S r J M i tl?at lil? i hat, We are W ing t0 develop the understanding and the thinking o f teachers, and I suppose there are two lines of attack we are pursuing. I think we are encouraging the use o f mental tests and achievement teste for what they can show about individual differences m children and, o f course, in the mechanism and behavior ai\d r deri aildm? -? I chddrens P^blems. These might be worked out throughthe child-welfare-services staff or through the teachers’ colleges in the State Thus far the teachers’ colleges have not given much leadership and their bulletins do not show many courses bmTt around that particular problem. So far as the eventual placement o f this service is concerned per haps it should be tied up with the department o f public instructionperhaps it should be m the county superintendent’s office. But for th^ present we are hoping to bring as close to the teachers as possible this H ? u °f “ “ many of the problems and the behavior o f the children that they have in their classrooms. The C h a ir m a n . I regret that we must adjourn earlier today on S d L ^ fc S 6” 10011 program- 1 wish we had anothCT hour w I he conclusion o f the matter, as I got it this morning, is that we wnrSn^ thatr hlldieilhllke a? ults’ are Persons, and that they live m a 1W0Jr¥ em(?^.101 ns 5 and we who call ourselves child-welfare workS n ] lad ketteJ think not so much o f doing things for or to these children as o f doing things m company with them. What we are talking about is not only the content o f a program but the content of life We are trying, oTcourse, to find socfal m a e h i n ^ y X t will facihtate °ur understanding o f the business o f living with our children. We have had suggested the possibilities o f traveling clinics with specialized facilities, which certainly are being found ufeful re sources m many places. There is also the suggestion of a somewhat https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 94 CONFERENCE ON STATE CHILD-WELFARE SERVICES centrally located house “by the side of the road” where children who are not quite “ roadworthy” at the moment may go for a while and be studied by people who are especially qualified to make such explora tion. None of these facilities are real things of real value except as they are enlarged and enriched and quickened by our genuine under standing of the personality o f the child. From Dr. Preston I gather that the thing that will matter most will be what these undertakings do to our thinking and our attitudes. We realize at this moment that there are points that we have not touched this morning and that we would like to discuss. The whole question o f parent and teacher relationship is one in which I have become much interested and about which child-welfare workers may do more thinking. It would be easy this morning to launch a discus sion of the subject of adoption, in which field there are great hazards for children. From hearing Dr. Plant and Dr. Preston talk I get a deep and what seems to me a very important conviction that life can do something for itself and that very often it can do what it needs to do for itself, and that the hazards of transplanting young life too quickly and thoughtlessly are very great. Last night I happened to be reading “ The Last Empress,” the story of a Chinese woman who was a contemporary of Queen Victoria and who kept her hands in the affairs o f China for a long time. It is a very interesting and significant story. Here was a little Chinese girl who was not born to royalty but who arrived there because o f her beauty, wit, and intelligence, along with her drive for power and the force of circumstance, enabled her to become a real ruler. There is a threatening, even terrifying, yet lovely picture of her childhood after the death of her father. The author, who probably has not thought in terms o f child-welfare programs or psychiatric programs, speaking o f the early experience of this little girl, said: The fact of having acquired some personal knowledge-even at so early an age—o f the realities of life as known to her subjects gave to Yehonala in later years a notable advantage over those members of the Imperial family who had been brought up from infancy in the seclusion of the palace. A child’s experience of a modest household, with its little economies and ex pedients to keep up appearances, would not seem of much use as training for one who was destined to rule over a fourth of the human race. Yet it served as a corrective to that ignorance of the world as it is, which has so often been the ruin of an Oriental despotism. Like her subjects, Yehonala knew nothing of the barbarians who lived beyond the Four Seas. But she knew her own people well. And so the very circumstances of life from which we would some times rescue children may be fitting them for the responsibilities that are to come. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Tuesday, April 5—Afternoon Session RELATION OF CHILD-WELFARE SERVICES TO FOSTER CARE Jacob Kepecs, Executive Director o f the Jewish Children’ s Bureau of Chicago and Member of the Advisory Committee on Community Child-Welfare Services, Presiding Statement of the Problem by the Chairman This morning I was stimulated by one o f the talks on mental hygiene in which content rather than program was emphasized. We were told that child welfare should not be segregated or isolated in a seg ment separate from other case-work activities. Child welfare really belongs to social work and should be so con sidered. I think that child welfare and the child-welfare services serve social work in a very useful way. Miss Julia Lathrop has been quoted as saying that the juvenile court helped to make the child visible. Well, I will say that the child-welfare services make social work more visible. And I should add that foster care has made child welfare more visible. For a long time child welfare was synonymous with foster care; when we talked or thought of child welfare we meant foster care, and very naturally so, because foster care is dramatic. There is not much drama or excitement in looking after a child in his own home. Nobody sees it, nobody knows about it unless you “yank” him out of his home and put him in an institution or foster family. That is dramatic and everybody sits up and takes notice. So let me repeat, child welfare makes social work more visible on account of the natural interest o f people in the child. Somebody said yesterday, 1 believe, that in one of the States you can get anything for any child if he comes from a worthy family. I am inclined to believe that you can make almost any child look “ worthy.” Our subject is the relationships of child-welfare service to foster care or the place of foster care in the child-welfare services. It seems to me that foster-care provisions and resources are an essential part of child-welfare services. A complete or comprehensive child-welfareservices program without some provision for foster care is unthinkable The question is how much foster care is needed. Do we need foster care for one child in each thousand or in each 2,000 children in the community? What is the total number of places we need, and how large a program o f foster care is required ? I do not think that figures are available. A guess is possible, a guess based on experience and some familiarity with the field. My guess is that we need foster-care facilities for a minimum of one child to every thousand children in the community. This is a dogmatic statement, I am aware, and I could not substantiate it if you challenged me. Furthermore, it must be qualified in relation to other services and assistance resources in the 95 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 96 CONFERENCE ON STATE CHILD-WELFARE SERVICES community. I am fairly certain that there is something wrong if you have less than one per thousand or more than two per thousand chil dren in foster care. . What kind o f foster care do we need ? Well, I would say that insti tutional care alone or institutional facilities alone will not do, nor will free foster-home facilities alone do. We have to have various types o f foster-home facilities in order to function fairly adequately. What does it cost? Well, that varies, but certainly we cannot have foster-home care free o f charge. Even the selection of free homes and adoption work cost money, and these services are extremely lim ited in a foster-care program. What kind of skill is required ? That is very important, because when you work in rural areas where you cannot possibly have specialists for various phases o f case work it is very difficult to say that you must require experience or training in foster-home work before placing children. It would be unreasonable to require that; certain situations demand placement. But it seems to me that it is not unreasonable to require o f child-welfare-services workers that they should have had some courses and perhaps some experience in foster care. Workers in child-welfare services should have had some contact with or should have been exposed to foster-care work. But if not all the workers have these qualifications, at least some workers in the child-welfare services should. Every good case worker knows, of course, that not all families, no matter how. good they may be in themselves, are suitable foster fami lies. This is very important to remember. Any good case workers should be able to do foster-care work in urgent situations. It should be done very carefully, and the worker should remember a few simple but fundamental principles, such as are to be found in “ABC o f Fos ter-Family Care .for Children,” published by the United States Chil dren’s Bureau, and in “Reconstructing Behavior in Youth.” In the areas in which child-welfare-services demonstrations are carried on it is difficult to find experienced child-placing workers. It is also a problem to get the money necessary for foster care. There are many other problems, as you well know. There is the problem of the relationship between voluntary and Government agencies in the field o f child care. The voluntary agen cies, and in particular the old-line institutions, feel themselves threat ened by the child-welfare services and by aid to dependent children. They are quite worried, because they do not know what is going to happen to them. They feel that the Government services and assist ance provisions are competing with them, and perhaps they are. How is the situation to be met? Unless you can work out some kind of cooperative formula, you will find your program blocked. Those on the defensive fight hard, and the private agencies are on the de fensive and are going to fight for their existence. Unless we can find a way or an acceptable formula, the Government program will be hampered if not blocked. The problem is rather complicated by the prevalence of the subsidy or compensation system. I call it a subsidy, because I believe that private agencies, particularly sectarian child-caring agencies, want to do their work. They are not waiting to be asked to do it. They want to do it under any circumstances if they can afford it. They naturally welcome Government help. It makes it much easier for them to do the job. I call that a subsidy. Others call it https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 97 compensation, because it is the Government’s responsibility that the voluntary agencies cairy, and if the Government depends upon the private agencies to discharge its responsibilities it is only right that the Government should pay the cost o f care and service. In that sense it is compensation. Another problem is to get the voluntary agencies to modify their program. Usually the voluntary agencies, particularly the institu tions, have a rigid program; and unless they modify their program to make it more flexible^ they will be less useful in the scheme of things. The question arises, now can we get the private institutions and agencies to modify their program? Still another problem: Are you going to insist upon minimum standards? I f you are going to compensate or subsidize private agencies, can you insist upon minimum standards o f care, including a minimum 6i case-work service at the point of intake, during care, and at- the point of termination? W ill you require Government supervision? Local public agencies and institutions require super vision and minimum standards as well. Voluntary agencies under the most favorable conditions are limited, and must remain limited in their services. They never have met the whole job and never will. This we must accept. Which part of the job then are voluntary agencies to do, and to what extent is the Government to supplement the services without engaging in competition? Competition is not confined to private agencies or private and public agencies. In many parts o f the coun try, including some of the areas m which child-welfare-services dem onstrations are carried on, competition exists between Government agencies. In some places you have the juvenile court resisting the child-welfare services. It desires to do the whole job, including foster care. Some juvenile courts feel themselves threatened by child-welfare services and by the other social-security measures. How is that to be met? There are also the county homes for children that are threatened by the newer developments, and how can that be met? At what point should you say to the juvenile courts, “ This is not your job, this is not a judicial function” ? At what point can you say to the juvenile courts, “ This is not within your competence” ? After all, judges, too, have limitations. Juvenile-court judges, by and large, are usually limited when it comes to social case work. Another problem is that in some parts of the country you will find voluntary agencies saying, “Now that the Government has come in, let them do all the ‘dirty’ work and we shall confine ourselves to a nice, neat little job, let’s say foster-home care only. Everything else the Government is welcome to. We shall do only the highly tech nical job, the kind of job for which Government is not fitted, some thing that is very fancy.” Such agencies desire to withdraw into isolation. Well, how safe is that? In my humble opinion, such agencies make a great mistake, not only because it is poor social w ork but because you cannot do foster-family care without doing all o f the other things that go with it, namely, work with the child’s own family at every point. It is a great mistake from the point o f view o f the agency as well. I believe that our institutions are in the plight in which they find themselves because of their isolation. And now, if child-placing agencies are going to confine themselves to one small bit o f fancy https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 98 CONFERENCE ON STATE CHILD-WELFARE SERVICES work such as foster-home care, they will soon find themselves in isolation and out of the running. I believe that it is a mistake for any agency to do that. Obstacles that confront everybody in social work are the realities of the situation, certainly the realities o f economics. We say that all of these things need to be done in child-welfare services, but how are we going to get them done? Some people would like to solve their problems by putting all neglected children into adoptive homes or free homes. Social workers know that that is a violation o f very fundamental human rights, namely, the right of kinship ties. It seems to me that we should be able to put across to the public the principle of preserving kinship ties and that we should be able to have it accepted. It is not possible to preserve kinship ties by plac ing children in adoptive homes or in free homes. But the realities of economics are on the side of the people who would like to solve the problem in that way. Then there are people who have very little use for, or very little faith in, professional services in connection with child placing or in connection with the selection of foster families. Some o f these people say time and again: “Well, what else do you want to know other than this is a good Christian family—that this is a religious family with good intentions—and that it is altruistic? Why do you need social workers to make an investigation?” These people are nat urally not conversant with the history o f child placing in America or they would not say that. Those o f us who are conversant with that history know that these things have been tried and that they do not work. We know that child placing cannot be done on faith alone or on the basis o f good motives alone. We know that caring for other people’s children requires more than religion. The religious motive is essential, altruism is essential, but yo.u need more than these in a satisfactory child-placing job. We know that some o f the best families, families that will meet every requirement as a family, will not make satisfactory foster families. We social workers know that, but the average person, the average citizen, does not know i t ; and it is up to us to put that idea across. Plenty of good families will not do as foster families. The protection of other people’s children in homes o f strangers requires professional service and the interest o f governmental authorities. In conclusion let me say that the areas in which child-welfare serv ices are being demonstrated are virgin soil. You are there because there is so little in these areas; and the question arises, What is going to happen after the demonstration is finished, after you have left ? That depends on what you are going to demonstrate. As far as foster care o f children is concerned, the demonstration may be over before the placed child grows up. The demonstrations are most valuable in preparing the ground and in creating an atmosphere favorable to social service. These, it seems to me, are the primary objectives of the demonstrations. But I do not think that is enough. No matter how well you have done your job, no matter how well you have demon strated needs and utility o f social services, and no matter how well you have prepared the ground and the atmosphere, if you withdraw from any o f these areas that belong to the poorest, the likelihood is that in a comparatively short time much o f what has been accom- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 99 plished will be undone. That has been our experience with, relief when the Federal Government withdrew. Many communities dropped standards and wTent back to the conditions that existed prior to Federal assistance. After all, we must not ignore the economic realities in many, if not most, local rural communities. These people are not worse than the people in the large cities or in wealthy counties, but they are poorer. The demonstrations should demonstrate not alone the in equalities between communities and the unequal distribution of wealth, which all social work does; they should not alone demonstrate the unequal opportunities to be found everywhere; but they must show the values of competent social service. It is my belief that permanent services cannot be assured without continuous Federal help. Even if you succeed in “ selling” child-welfare services, the demonstrations will show, I believe, that many communities cannot carry on alone and often they cannot carry on even with the help of the State. To protect the demonstration it will be necessary for the Federal Government to stay in. The C h a ir m a n . The first person on the list for discussing some o f these problems is Mrs. Ann Botsford Bridge, of Maryland. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Developing Community Resources By Mrs. A nn B otsfobd B bidge, Social-Work Consultant, Child Welfare, Maryland Board of State Aid and Charities Initiation o f foster care in our rural counties demands special skill, even though the worker may have had experience in the foster-home field. The most difficult problem that confronts the workers in rural counties is arousing the community to a nonacceptance ox some o the things that have been accepted over a long period of time. I am thinking o f rural counties in which the child-welfare worker attempts to initiate foster-care services and is met by the response from the community that, after all, nothing can be done about the situations that are in the greatest need of having something done about them. After all, they say, that is the way these people have always lived, it is the way they always have been, and there is not much you can do by taking the children out of their homes and plac ing them in foster homes. The complete acceptance of that point of view is, I think, one of the hardest things that the child-welfare worker has to combat. ., noa Mr. Kepecs spoke of the realities o f the economic situation, these realities are very difficult and present a problem m the matter oi continuing the program after a demonstration has been made. We have said a great deal about community participation, and it has become pretty trite to say that we must have community participa tion if the program is to continue. One of the ways m which the child-welfare worker can best help the community is by not under taking to do the things demanded at the beginning, but by helping the community to build up its own resources with the aid o f what the Government agencies can do. . . £. ' , A A situation by which I can illustrate my point is one that happened not long ago in one o f the counties in which we have a child-welfare worker, where a rather isolated and self-satisfied community worked out an interesting development. In that community, which was rather small, and in which homes are somewhat far apart, a number o f old families lived—good, substantial people who were pretty well satisfied with the ways of their community. Into this community there* moved a family consisting o f a father, a mother, and eight children. Things began to happen that brought the people, the re spectable citizens, to the door of the welfare department demanding that something be done. There was some thievery ; there was a great deal of disturbance in school because the children o f this new family did not behave as the other children behaved, and there were a great many things that irritated the old residents. One was that the^tathei of the faimly was alcoholic and did not have a steady ]ob. beveraJ citizens demanded that the family be removed and the children taken away—out o f sight, out o f mind. The child-welfare worker who 100 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 101 went into that situation did not immediately respond to the demands o f the community but began to look at the community itself and to try to get the respectable citizens who had made the complaints to see what perhaps might be wrong for those' children in the com munity itself. To make a long story short, they began to be concerned about their own community, not only for the children who had moved in but for their own children and for themselves, and they did get to gether and discuss what might be done. They managed to establish a very interesting association for which they have quite a long name which ends in “ Civic Association,” and they are now trying to pro vide a richer community life which will give assistance not only to the children in that community but to the community itself. They have succeeded in building a rather fine recreational program which started from the complaints about this one family. There is one other point I should like to make, and that is, if we are not to continue to be what Dr. Plant referred to as “glorified scavengers,” it seems to me that we need to find a really new philoso phy o f both content and method in doing something about the condi tions that produce the breakdowns in family life. I am thinking of the economic environmental factors. One of our child-welfare workers was asked a short time ago what was the greatest need in her child-care program. The first thing on her list was good roads, which seemed to be quite unrelated, perhaps, to the program, but she was pointing out that, after all. even though clinics were ade quate and other resources in communities were adequate, unless there were good means of transportation in the county so that the people could make use o f those resources there was not much use in talking about the building up o f foster care and other facilities. The C h a ir m a n . The next discussant is Miss Grace M. Houghton, o f Connecticut. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Cooperation With Private Agencies By G race M. H oughton, Director of Child Care, Bureau of Child Welfare, Connecticut State Public-Welfare Council I am going to approach this discussion from the standpoint that Mr. Kepecs spoke of, the relationship to the private agencies already in the community. Because of that point of view, the first thing the supervisors who had been appointed to the district work did was to meet with representatives of these private agencies, in order to show them that we were not going to get in on their job but to ask them to get in on ours. We realized at first that we could not possibly do foster-home care, since no funds were provided by the Federal Bureau for the purpose and we were not in a position to provide such funds. We met with the three State-wide child-welfare organizations, and they all offered their cooperation whenever cases came up that needed their care. Then came the question of financial support. Connecticut has peculiar laws, as most o f you people know, but one law which seems peculiar has been o f great help to us in dealing with the private agencies. We may call it subsidizing, or we may call it compensation, but anyway the State is able to pay through the towns for seven-tenths o f the cost of maintaining children who may be placed by private agencies. In that way we have been able to ask the private agencies to give us foster-home care when it has been necessary, and they get full reimbursement—three-tenths from the local town and seven-tenths from the State. Whether this is an ad visable situation or not, it has been helpful. I think it is open to discussion, and I hope very definitely that somebody will challenge it. Connecticut licenses all homes that care for or board children. The State Department of Welfare issues licenses to homes after they have been inspected and approved. These homes are licensed for a specific number o f children and are under constant supervision. Child-welfare services have offered to supervise children placed in these licensed homes in the rural communities where we are organ ized, and in that way we not only have been able to safeguard the placing of some children by parents who are just shunting their re sponsibility but also have been able to get into the history o f the children who have been placed more or less for adoption without sufficient investigation o f their suitability for adoption. And in that respect we have been able to utilize the Yale University Clinic for studying the children who are placed for adoption. This, in general, shows our use of the private agencies for foster-home care. I should like to give you a few instances o f cases in which we have had to use these facilities. I am not going back into the reasons for their coming to us, particularly, or the steps that we took preceding our request for foster-home care, because it would take too long. 102 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 103 But just try to imagine that the child-welfare services have done everything in their power before they asked for foster-home place ment. This is the case o f a boy 9 years o f age, a member o f a family o f four children. The father and mother were separated, and the father and two children lived in Maine. The mother had one boy with her and the boy we are speaking o f had been left in a foster home. The boy had a reading disability. He had gotten beyond control o f the present foster home, and the request came from inter ested people to us to do something about the situation. We took the boy immediately to the State psychiatrist, who said that he had been totally rejected by his own family and now by the foster familv be cause o f his behavior problem. What he needed, if he could not have his own people, was to go back into a foster home where he would have care, affection, and understanding. We were able to locate the father in Maine, and, incidentally, to have the girls, who were im properly placed, placed in proper foster homes in Maine. The father could not assume care o f the boy, so the Connecticut Children’s Aid Society came to our rescue and placed him in a foster home, where we have him under supervision. We had a case o f a widow who was on widows’ aid. She developed tuberculosis and some plan had to be made for her and her four children. She was immediately hospitalized and two of the children, who were diagnosed as tuberculosis contacts, were placed in a foster home. The other two children were placed in Highland Heights, a Catholic institution in the area. By making these foster-care place ments through private agencies it was possible to avoid commitment to the State, which might have resulted in a permanent break in the family relationship, because under our laws children remain State wards until they are 18 years o f age. I f those children had been committed, the mother would have felt definitely that her illness was something besides a physical disability; that it was a reflection on her character. Therefore, we felt that the less permanent foster home placement was much better for the mother’s morale. She has come out o f the institution and is working. Definite plans are under way for this family to be gathered together again as soon as her health permits. The child-welfare-services worker felt elated when the judge asked her what could be done to help a 16-year-old boy who had been brought to his attention with the idea o f having him committed to a correctional school. The boy had been stealing. He was malad justed in his home, which was a broken home, and it seemed that foster-home care would perhaps not be the thing for him, since he had been so long without proper home treatment. He was o f fairly good intelligence and needed something by way of trade training. We have a Junior Republic in Connecticut which does a rather good job of* adjusting our boys and fitting them for trades, but the problem was where to get the $500 needed to keep him at the institution for 2 years. The boy’s stepfather was very much interested. He could raise about half o f the amount, the Junior Republic agreed to raise some o f it, and the town of settlement is paying the rest. In one of our districts our worker is a trained nurse as well as a social worker. She was called in on a case of a girl whose physical condition was poor. The girl was drinking quite heavily, although https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 104 CONFERENCE ON STATE CHILD-WELFARE SERVICES she was under 14 years o f age. She was also suffering from severe headaches. Apparently it never occurred to the local authorities to have a physical examination made o f this girl. Our worker recog nized the need, and as a result a physical examination was performed immediately. She required immediate hospitalization to prevent diabetic complications. Following her discharge from the hospital it was necessary to plan for her because she was out of her own home. A fine foster home was made available by the home-finding depart ment o f the State Child-Welfare Bureau, where the foster mother was able to provide a proper diet and give her insulin treatments. The child-welfare-services worker is supervising the case and the town is paying the full amount for the cost o f her care. The C h a ir m a n . While Miss Houghton was speaking I saw Mr. Bane enter the room. Mr. Frank Bane is executive director o f the Social Security Board, and I believe he came to say something to us. Mr. Bane, would you mind stepping up here and giving us your message ? Mr. B a n e . I deny the allegation. I did not come to say anything to you. I just came to see what you were doing, and I notice from the program I am approximately 24 hours behind time. Yesterday afternoon you were discussing child-welfare services and aid to de pendent children and their relations. However, since I am here I should like to say that we have been operating now for something like 2 years on this general program o f child-welfare services on the one hand and aid to dependent children on the other. We have been operating so closely, as a matter of fact, that I have had great diffi culty upon occasions in telling which was our staff and which was your staff. And I am quite certain that upon occasions Miss Mary Irene Atkinson has had the same trouble out in the field. We have tried to tie together in the States, and tie together here in Washington also, child-welfare services and aid to dependent children. They are two parts o f a more or less coordinated program. We have, as you know, a few problems left in the States. We have every State in the Union now with programs o f aid for the aged. We have only 40 States with aid for dependent children, and we have another interest ing situation. We have, insofar as appropriation is concerned, all o f the money we need and more for aid to dependent children on the Federal level. Last year we had an appropriation o f something like $35,000,000 of Federal funds to be used to match State funds for aid to dependent children. We did not use half o f it. This year we have something like $46,000,000, and we will have a balance o f approximately $25,000,000,1 think, at the end of this fiscal year in that program. Now, that may mean one o f two things. It does mean, of course, that all the States are not as yet participating in this program, and we are very anxious to have all States participating. It may mean, on the other hand, that in many o f the States aid to dependent children is not being administered in as adequate fashion as we would like to have it. There was a clause in the original bill o f the Social Security Act as submitted to Congress which said something about standards. That little phrase did not stay in the bill? and so the problem of adequacy o i care is a problem to be determined by the States. The https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 105 type o f care is largely determined by the States, and the type o f its administration is, to a large extent, also a matter to be determined by the States. So the Social Security Board welcomes, in fact urges, all of the assistance we can get from you who are interested in child welfare in getting all o f the States to cooperate in this general program and in persuading and urging the States to maintain this service on a more adequate and on a more constructive basis. The C h a ir m a n . The limitations placed on Federal funds for aid to dependent children have a great deal to do with the difficulties found in these demonstration areas. They work great hardships on these various areas in which you operate which are the poorest, and I am quite certain that Mr. Bane would like to do away with these limitations, as far as the agencies are concerned. I think we ought to work for a removal o f those very great limitations which are responsible for the accumulation o f all o f these millions in the Federal Treasury. The next discussant is Miss Alice C. Haines, training supervisor o f child-welfare services in Florida. 78986"— 38- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Initiating Foster Care in a Local Community Supervisor, Child-Welfare Services, Department of Child Welfare, Florida State Welfare Board B y A l ic e : R . H a i n e s , Florida, stripped of the glamour of tourist spots, the fragrance of orange blossoms, and the romance o f the South, gets down to the stark reality that children in Florida have needs just as serious and just as pressing as do children on the West Side o f Chicago. Our country slums produce serious problems just as cities do. I think perhaps the circumstances under which a child-welfare unit initiates a foster-care program are not particularly different from the circumstances under which it initiates a child-caring program in a community in which the child-welfare service is completely uni form. That is, it has required first and foremost and all o f the time continual interpretation to the community o f what we plan to do, what we have to do over, and how we can work with the community and through it in accomplishing our aims for children. Hillsboro County, with Tampa as the county seat, was selected at its own request as a demonstration center for the beginning o f a training program o f Florida girls in children’s case work. Hills boro County had really very little conception o f children’s case work. The job that we had to do has resolved itself into four phases: First, interpretation o f the meaning o f a children’s program; second, the actual development o f a children’s agency in order that we might have an opportunity to give training and demonstrate to the community the real need for the continuation o f children’s services after the training center was discontinued; third, the build ing up o f a foster-care program (and by that I mean very largely a boarding-care program), because that was. one o f the points on which our program was sold to the community before we began to function; and fourth, the financing o f our program. The previous, facilities in the community for care o f children who had to be removed from their own homes consisted o f four institu tions and three boarding homes supervised and licensed by the child-welfare department o f the State. These boarding homes were licensed to take care o f a certain number of children. They were visited regularly by child-welfare department workers, but children were placed by any individual or any agency in the community that felt that a child needed to be taken out o f his home and that money could be obtained to pay for his board. There was no attempt to place a child in a home because the child had a particular need or because that home had a particular service to render that child. The task o f interpreting to the community what we meant by real foster care and what a boarding home might have to offer a child was not particularly difficult. We did not feel that the private 106 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 107 agencies, the juvenile court, or the community thought that we were usurping their jobs or threatening their position in the community. They welcomed what we had to offer. We did not have particular difficulty in finding some funds with which to place children, al though they were not sufficient. We had a total o f about $3,000 for boarding care with which we have operated in the 15 months. Finding boarding homes was our difficulty. We had the children, we knew the type of home the child needed, we knew what foster parents should offer the children, we had the money to pay the child’s board, but we could not find the home. It took us weeks to find the type o f home we needed for a particular child. We used every known method in obtaining leads for foster homes. That is, every method short o f publishing the child’s picture and giving his name and telling the pathetic details of his story, which our local newspapers would have been glad to publish. But finally we found one home which we could accept, which we felt had a great deal to offer the child; and from that beginning we have found additional homes. But one o f our difficulties has been the finding o f sufficient homes without the help o f an official home finder to devote a great deal o f time to building up for us a list of acceptable homes. With our 3 trainees we have been able to find 13 homes and we have placed 55 children and possibly we might have placed more children had we had more homes and had we had more funds. But perhaps it has been a healthy thing for us because we have used all our skills and all our resources in developing home ties for the child and in finding family ties for him, whereas if we had had more homes and more money we might have been tempted to give up a little more easily. Mr. Kepecs has made the point, which I think has perhaps been the most difficult for us to face, that our position in the community is one of impermanence. I think we felt a little less .secure, a little less permanent in our community than the other demonstration units. The placement o f children often anticipates a period longer than a year, and in our local problem, particularly in the foster-care program, we have felt a lack o f confidence in the real value we could be to the community. This was particularly true when two private agencies in the community, which were operating institutions for the “ temporary” care of children, which in some instances meant 2 to 4 years, welcomed our presence in the community and wanted to make use o f our help in closing their institutions and in making more acceptable plans for their children. They hesitated very de cidedly, however, before they made the final decision to close the institution, because they did not know how long the training center would be available. However, in our preliminary conferences with the agencies it was possible to work out plans for all but 4 of the 32 children in the 2 institutions. These 4 required foster placements. However, the boards of the 2 agencies had enough confidence in the ground work that had been laid and in the ultimate ability of the community to take over the financial burden, to accept our services and plose the institutions. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 108 CONFERENCE ON STATE CHILD-WELFARE SERVICES The C h a ir m a n . A great deal o f care goes into the selection of homes, and for your encouragement, Miss Haines, and for the en couragement o f others, I should like to say that agencies that have been doing home selection for decades perhaps have just as difficult a time in finding homes as you have in Florida, where you have just started. Mrs. Helen C. Swift, supervisor for the Division for Children in the Washington State Department o f Social Security, is next on the program. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis The Problem of Foster Care by Juvenile Courts By Mrs. H elen C. S w ift , Supervisor, Division for Children, State Department of Social Security, Washington We were told what part we were to discuss and what we were to contribute to the general thinking of our program this afternoon, and I have been asked to tell how we got the results we did in Washing ton. I am really frank to say that I do not know how we have accom plished what we have. It is one o f those intangible things that do happen sometimes when we go about searching for certain things that we want to accomplish. We set our goals and our aims and we are determined that we are going to reach them if it takes from 5 to 25 years, and we do not know just what one thing has contributed to that final result. In attempting to bring to the judges o f our State a knowledge of our ability to do the work we planned, we impressed upon them our sincerity m trying to be helpful and our desire to give them service and to understand what we had to give them. I believe that those things are the intangible things that have contributed definitely to the final result. I f you could have seen our State before 1935 you would have seen a typical old juvenile-court law that is still on our statute books. The first attempt at this sort of thing did not give us much encourage ment. In 1933 we created a division for children in the State Welfare Department, but it did not function then. It did not have enough money; in fact, only $1,500 was appropriated. But in 1935 the State Department of Public Welfare was created with its different divisions carrying on all o f the public-assistance programs, including a division for children; and in 1935 the Federal Social Security Act was passed. That was the beginning o f the planning and the beginning o f an opportunity to really begin to plan. Our juvenile-court law provides for a juvenile-court judge only in counties with populations of 30,000 and over. We are a rural State. We have only one million and a half population, but there were only 12 counties where we could have a juvenile court and actually only 5 counties with special juvenilecourt judges. We have four functions in our State child-welfare division; namely, aid to dependent children, child welfare, crippled children’s services, and licensing o f private agencies and institutions. When we put our program before the judges they asked us to put in writing what we could do. We agreed with the judges on two points—the type of cases that would come into court and the type of cases that we would handle. We agreed that we would take care o f the cases that did not need court action. They conceded that care o f dependent children was not a judicial function, and we agreed to handle all dependency cases, including those of children needing care in their own homes 109 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis X 10 CONFERENCE ON STATE CHILD-WELFARE SERVICES and o f those who must be cared for away from their homes. We agreed that we would ask first the private agencies to care for the children who needed temporary care and would ourselves take .care o f the long-time cases. We agreed with the agencies that if they had the type o f service needed for a particular child we would pay for that child on a per capita basis. Then we said the cases that needed court action would be those that needed change of custody or guar dianship. As a result o f these agreements no child is committed to any agency or any institution for which the county welfare department is ex pected to pay unless the arrangements have previously been made by the court, the private agency, and the county welfare department, because before this the courts had been sending the children to the private children’s agencies, the county paying for them on a flat grant. The C h a ir m a n . I am now going to call upon Father McEntegart, o f the Catholic Charities o f New York. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis The Broader Scope of Child-Welfare Services By the Rev. B byan J. M cE ntegabt, Director, Division of Children, Catholic Charities of the Archdiocese of New York, and Member, General Advisory Committee on Maternal and Child-Welfare Services We should all thank the Children’s Bureau for bringing us together for these few days. As we sit in our own home town and read the papers, we hear much about reorganization of this department and that department. Well, at least two Federal departments are work ing together pretty well—the Weather Bureau and the Children’s Bureau. On the other hand, we might pass a motion condemning the Department of Agriculture for bringing out the cherry blossoms before we got here. That should have been held up for our meeting and we hope it will not happen again. The meeting has been a real success so far, I think, because it was so well planned. The reports given to us were very well done. Speakers from different parts of the country have given us a broad picture o f activities. Time and time again when I came to Washington, I have thought that I was looking over the map of the United States. That is the impression you get when you listen to people from various States. You begin to realize how different are the problems of various sec tions. When you are close to the picture at home, you think the rest of the country is just the same. But when yo\i get out and hear a speaker from Nevada with 110,000 population describe how a social worker has to go from one end of the State to the other over moun tains and deserts, and tell you that the biggest city has a population o f 20,000 and that the others run from 10,000 down, you begin to say to yourself, “ Well, conditions differ greatly in various parts of this country.” Then you realize the need and the wisdom o f that policy which Miss Lenroot announced yesterday morning—the flexibility of the program as administered by the Children’s Bureau with no attempt to rigidly set down one uniform method of doing things. The breadth o f the program was clearly set forth by the speakers. The number o f things that have been done and are being done made me feel that some o f the hopes which child-welfare workers start out with may well be realized even during the span o f one person’s life. In the White House conferences we dreamed many dreams. I want to add the White House conference reports of 1930 to the books that Mr. Kepecs would like all child-welfare workers to read. I f you read the conference report on dependency and neglect, you will find that the committees believed child welfare was something broader than just foster care and that child-welfare workers needed to be more than case workers. They thought o f child welfare as comprising the welfare o f all the children o f the United States. You will find that they at111 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 112 CONFERENCE ON STATE CHILD-WELFARE SERVICES tempted to lay down a children’s charter o f rights for every child, not for one in a thousand, or for two in a thousand, but for all. That report gave a broader vision to our child-welfare workers. When we came to the dependency and neglect part of it, I will never forget how J. Prentice Murphy worked on that. With all his heart he wanted to emphasize the prevention o f dependency and the prevention of neglect. I f you are going to prevent dependency and neglect, something must be done that is beyond the scope o f the case worker. The deeper economic and social causes must be reached. We tried to figure out how many industrial accidents there were in this country and how many automobile accidents and home accidents and how many children those accidents deprived o f their parents, and we asked child-welfare workers to take a vital interest in safety campaigns in industry and outside o f industry and in workmen’s compensation laws. Other causes mentioned were sickness and insanity. I f I remember rightly, 330,000 people were then in insane hospitals. How many of them were parents separated from their children? And how many children are in foster homes because of the insanity o f parents? Another cause was premature deaths o f mothers. The statistics that have been brought out in the last few months by Miss Lenroot prove the great importance o f preventing premature deaths of mothers at the time o f childbirth and later. We touched at that time on unemployment, on low income, and on the racial factors that were causing dependency and neglect. Throughout it all we felt that the social worker who was engaged in child welfare should be interested in the preservation and up building o f family life, not only by case work? but by removing the social and economic causes that tend to disintegrate family life. A good many o f us cpme out o f the White House conference feeling that the biggest job o f a social worker is to prevent the disintegration of families. After that White House conference there was a conference here in 1933 for child-welfare leaders o f the whole country. The first item on the resolutions passed by that conference was the need of proper care for the 7,000,000 children then on the relief rolls. When the advisory committee to the President’s Council on Eco nomic Security began to hand in memoranda for the Social Security Act, these were the things they were thinking o f: The children on relief; the children receiving mothers’ pensions (now we call it aid to dependent children); and the maternal and child-health program. Then, because private agencies and public agencies throughout this country were concentrated mostly in cities and in urban areas, it was felt that child-welfare services were needed to reach out into the rural regions and into areas in special need. Such child-welfare services could help to stimulate in those areas the forces necessary to supply proper facilities for childhood, the opportunities for the satis factory growing up of American children, and the influences required to hold family life together. And so these child-welfare services came into being. The reports given here show that those who have been appointed in the various States have caught the larger vision o f child welfare. They have not confined themselves to foster care. But they have tried to integrate https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 5—AFTERNOON SESSION 113 their work with the work o f the aid to dependent children, with the work of relief, with the children’s courts, with adoption proce dures, with the intake o f institutions and the supervision of the chil dren afterwards, with training programs for those engaged in childwelfare work, and with the arousing of volunteer groups to take an interest in the children o f the State. I also caught a reflection o f something that I consider even more important. Child-welfare services in some places are acting like leaven. They are influencing .people in other fields of work. In the health field we have been told of many instances in which childwelfare services helped to start proper health facilities for the chil dren o f the whole community. They have stimulated proper recrea tional facilities, more adequate mental clinics, and institutional care o f the feeble-minded; proper educational facilities and vocationaleducation facilities. I received the definite impression that the childwelfare-services worker is in fact a community organizer. That is a more important side o f her job than tending to a few cases here and there. Such cases might absorb all her time. But if she can help to organize the State welfare department, if she can stimulate health groups, recreational groups, and educational groups to do a better job for all the community, she is carrying out on a broad scale the function that those who planned this program had in mind. I believe that the flexibility shown in these reports is a real virtue. Nevada will not be like New York for a good many years. You will always need a different kind of program for Nevada. Now, coming down to the matter o f foster care. It is my im pression that you cannot take any one arbitrary figure and say that if any community has foster-care facilities beyond that, it has too much foster care, or if any community has smaller foster-care facil ities, it has too little foster care. You will find 250,000 to 260,000 chil dren receiving foster care among the 130,000,000 of our people. That figures out two to each thousand people for the whole country. Now it is true that in certain sections special factors are present. The economic and social factors mentioned before, and others, may be concentrated in certain places. You will have to vary your index of foster care according to the conditions you find. There is no rule o f thumb by which you can settle the problems of the whole country. Some sections have too great facilities for foster care and others have too little. Let us remember, however, that for the whole country we have foster-care facilities for two children among each thousand people. In sections where there is too little, let us try by cooperative arrangement to plan out who will take up the work. Let us use whatever resources there are in that section and try to upbuild them. Let us not take the position that anybody who does not go along with the public official 100 percent is “blocking the Government program.” After all, the people in this room are for the most part Government officials, These prob lems must be settled in thousands of little communities by people who are bankers, who are tradesmen, who are doctors, who are school teachers. The great bulk o f the American people back in their home communities have to debate these questions and reach their con clusions. They are not “blocking the Government program” if, as members o f a community, they insist on planning out for themselves https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 114 CONFERENCE ON STATE CHILD-WELFARE SERVICES a program that will suit the facilities, the traditions, and the per sonnel o f their own community. And, finally, I believe that where foster care is necessary it ought to be provided through existing facilities, improved arid standard ized if need be. Let us utilize what we have. There is so much to be done for all the children o f this country. I f we take the broader view that family conservation and family upbuilding is the major task o f child welfare, and that the removing o f the social and economic causes producing family breakdown is also a part of our task, we will not lack great opportunities for service even though foster-care facilities may be sufficient in our districts. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Wednesday, April 6— Morning Session /. DEVELOPMENT OF LOCAL RESOURCES FOR CARE AND PROTECTION OF CHILDREN Mildred Arnold, Director, Children’ s Division, State Department of Public Welfare, Indiana, Presiding Miss A t k in s o n . We knew that the meeting yesterday afternoon would have to be cut fairly short, and we thought we ought to plan for a continuation o f this meeting on the question o f development of local resources for care and protection o f children and again touch on the relation o f child-welfare services to foster care. We have asked Miss Mildred Arnold o f Indiana to assume responsi bility for serving as chairman at this meeting. I think there will be an opportunity for a discussion of some questions you had in mind yesterday afternoon but had no opportunity to discuss. We want to divide the time, however, so we can at least begin on a discussion o f case records in a public children’s agency. We know there will not be an opportunity to finish that subject either, but we believe in this morning period we can at least get it opened up. The C h a ir m a n . A s Miss Atkinson has pointed out, we have had two things in mind in arranging for this meeting: To carry on yesterday afternoon’s meeting—and I am sure there were some very interesting questions raised on which we would like to have further discussion—and to have a discussion meeting. This may be the last opportunity you will have to tell us o f your accomplishments, and I think it is a healthy thing to have all opportunity to talk about all the accomplishments sometimes and also to raise certain ques tions you might have in mind. The first topic will be the development of local resources for the care and protection of children, and that goes over to the discussion o f yesterday afternoon, which was on the relation o f child-welfare services to foster care. The second topic is more specific—case re cording in local public agencies. We are all interested, I am sure, in that particular subject. Some very interesting questions were raised by Mr. Kepecs yes terday afternoon and some were discussed in part. One was, “How are we going to get private agencies to modify their program?” I think there is a great necessity for the modification of many pro grams o f private agencies, and the State departments must take a definite part in working with the private agencies and helping the private agencies, in a joint effort to make the program fill in the gaps. Another point raised was in regard to limitations of cooperation with juvenile-court judges. We are very much interested in that in Indiana now. A good part o f our child-welfare program is centered 115 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 116 CONFERENCE ON STATE CHILD-WELFARE SERVICES around the court, and when we realize the number o f judges we work with and the differences in their backgrounds and training— how many have not had an opportunity to have any help in the more modern principles of child care, and how much authority is centered in the court— we must do some serious thinking. And there is the problem o f withdrawing services from demon stration areas. I f any State has done it, I wish they would tell Indiana how to do it. First, we should like to know how to with draw gracefully, and then we should like to be sure that the services that we try to develop will continue. Another thing: What is being done in the local communities to keep the child-service program before the local boards? How can we give the local board a picture o f accomplishments and problems? I wonder, Mr. Kepecs, if you would not like to say a few words, since we are carrying on from the program o f yesterday afternoon before we start out with our discussions? Mr. K epecs . I do not want to take up very much time and would rather coniine myself to a discussion o f some o f the points you think are necessary. The C h a ir m a n . The first thing, the question you brought out yes terday, is how are we going to get private agencies to modify their programs? W ill you give us suggestions on that? Mr. K epecs . It is a very, very difficult problem to tackle. I feel that the institutions in particular have isolated themselves. I feel 1hat if the institutions had not isolated themselves from the rest o f the social-work program, they would be in a better position at the present time to adapt themselves to services required of them. Some institutions have not isolated themselves, and they stand out because they have been able to modify and adapt their program to newer needs. Case-work services in any institutional or child-welfare program should be among the minimum requirements o f State departments. State departments that have licensing and supervisory powers should establish certain minimum requirements for all foster-care work, in regard to physical care, educational opportunities, health supervision, recreation, vocational preparation, and case-work services. These are essentials in the development of child life in foster care. Wherever it can be done with the consent o f the institutions, that should be done, but in any event they should be made to realize the importance o f these standards. When nothing else will help, the State should exercise its power by saying, “ These are the minimum require ments, and if you wish to operate you had better comply.” I do not think it is very difficult to make boards see that they would be more useful to the community as a whole if they modified their programs. The difficulty lies with the people who are attached to institutions— emotionally and economically. I mean the people who work in the institutions. And presidents are not less difficult in some situations. Sectarian agencies are particularly protective o f their work. I have no specific suggestions in regard to the matter. I am trying to clarify the situation. The State departments will have to clarify the situa tion for themselves. They will have to determine how far they can go and how far they want to go. We should have a goal and a https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—MORNING SESSION H 7 method of reaching it. We may progress only inch by inch, but unless we know what we are after it will be doubly difficult. The C h a ir m a n . One thing I should like to ask you. You speak about the State department’s requiring case-work service in children’s institutions. I am thinking about thé institutions that are very small and could never afford a full-time case worker. Do you think it is feasible to tie the case-work service up with the county department that is using that institution, for instance, or do you have any other suggestions for these small institutions— and there are many of them all over the country ? Mr. K epecs . I believe that wherever possible institutions should employ a case worker. Where that is not possible they should make an arrangement with a case-work agency to attend to case work. They might pay for case-work service through a case-work agency. I should prefer if the institutions assumed responsibility for their own case work, but if that is not possible, it should be gotten some how. _ The county welfare department might furnish case-work services. I should do that only as the last thing. Miss M aso n . I should like to second and emphasize the suggestion Mr. Kepecs made with regard to the approach to the institutions. Without a doubt there ought to be steady, friendly pressure brought on them to apply case-work principles'. Too often they have been left out of conferences or have left them selves out. The institutions will probably have to be more specialized in their work, that is, they will have to be more specialized in the type of service they propose to render in the communities and the State. Sometimes the executive of the institution is not very re sponsive, and pressure for cooperation may be brought on certain influential members of the board who may be approached and made to see the point. There should be a steady process of getting these institutions to study themselves and to realize that the good old style has passed out and that the average institutions must adapt themselves to a new day. The C h a ir m a n . I think the suggestion is very interesting that institutions should decide what type of service they want to give and develop a program to meet those needs. I wonder if any o f the States has been able to get the institutions to do that. Miss B artlett (Illinois). We are very much concerned in Illinois about that question. We have been studying it from various angles. The first approach is the compilation of reports by child-caring agencies in the State. When we have analyzed the material that has come in, we hope to have a picture o f child care in the State and also to know the gaps in the program. We are attempting to work particularly with the small rural agencies. Our plan has been to have a consultant go to the small agency and discuss the whole program. We have also attacked the question through regional conferences. A series of conferences in cluding all institutions in the State has just been completed. Board members and executives were invited, and discussion leaders were persons who believed that the institution has some place in child care. I think the institutions have been afraid that the new movement is going to put them out of business entirely. We have in the State https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis H g CONFERENCE ON STATE CHILD-WELFARE SERVICES people who can talk from experience and who can lead the group to see itself from the point of view o f the needs o f the whole State. Our second series o f conferences will be on minimum standards. The C h a ir m a n . Does anyone else have anything to say on this subject? Miss M aso n . From the standpoint of case work in the institutions I think it important that it be an integrated part of the institutions and not something on the outside. I f case work is not really a part o f the institution the situation is the same whether it is an isolated case-work department of the institution or whether case work is furnished by an outside organization, either a family or children’s agency. I think the question of the board’s participation is very important also. I have sat with a number o f boards o f institutions, and I have found that they spend quite a part o f the time talking about finances and that for the most part they know very little of what is going on. I think we as case workers have frequently failed in not knowing the institutions and their problems and exactly where we can fit in. We keep case work as something on the outside rather than help to integrate the whole thing and understand what it really means to run an institution and to live in an institution. The C h a ir m a n . Miss Mary Lois Pyles, director o f the Division of Child Welfare, Missouri Social-Security Commission, will discuss some problems in the development o f local resources for child care and protection. Miss P yles . We might begin with the words o f the Social Security Act itself. It seems to me that the statement o f the child-welfareservices part o f the Social Security Act “ to pay part o f the cost of district or other local child-welfare service in areas predominantly rural” requires development of local units. In Missouri we have 8 local units ranging from 2 to 4 counties in each unit, including 25 counties, in which some real program is being carried out locally for the care and protection of children. We begin with local financial participation ranging from $15 to $30 a month from each county for a share in the expenses o f this service program. It is perfectly true that some of the counties have more money than others and should pay more for this local care than other counties. Two o f the 25 are among the poorest counties in the State and are paying from $15 to $30 per month. This payment is made on the basis of its being a preventive program and a good investment for the future. In our local units we have two counties carrying over unexpended balances-from one year to another, and they could finance their pro gram entirely if they were convinced o f its value. It is our job, at least, to take the leadership in interpreting the program in the coun ties. I f it does not seem worth while to the public, then we are prob ably going too fast, and we will not be able to build a successful and lasting program. Some of these demonstrations have continued for a year or 2 years, and as we go on in developing child-welfare work in local units we should work toward increasingly local financial support. Now, a suggestion as to how demonstration units may become permanent and how we may withdraw demonstration. One county, after having a local unit for a year or a year and a half, felt, when making up its https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—MORNING SESSION 119 local budget in January 1938, that it did not have the funds to continue its small participation in the work and would withdraw. That brought a great howl from the community, from the women’s clubs, men’s service clubs, school, and so forth. Some school officials who felt that the child-welfare-services work was very helpful went to the town officials and the town called a meeting with the county officials, requesting that some way be found to go on. The result was that there is now a combination of local and private funds and public funds from the town and county, along with the State funds, that will continue the work o f that unit. Certainly when the counties have enough money they should take over the expense along with as much local participation as possible. We know that not enough possibility exists in some localities for financing the work, so we need in some places, perhaps, a State appro priation for child-welfare services. Our State legislature meets only every 2 years unless the Governor can be prevailed upon, because o f an emergency, to call a special session. It will not meet again until 1939. One and a half years ago there was some agitation in areas where we had local agencies for a State appropriation to make it possible for every county to have one child-welfare-services worker. That program would not have gone across then. A group in our State connected with the State advisory committee is anxious to see the program go across next year, but we doubt if the program has enough public interest as yet and also whether we would have enough facilities in the way o f an adequately prepared personnel to carry out the program successfully. We want to go slowly enough to succeed in the long run instead o f starting something which may not last. We have not been very definite as to how long a demonstration should last, but after this length of experi ence I wonder whether in the counties where we are well enough integrated into the thinking o f the public and are well enough known and thought of it would not be well to start thinking and talking about how much they might be willing and think it worth while to spend for this sort o f work. Even in the areas where we are doing pioneering work, we do have some tools to use. We do have the kindliness and neighborliness and altruistic interests of rural people to offset the. great unmet and unrec ognized needs. Wherever there is an outstanding case it seems pos sible to get the public officials to respond. We are spending a great deal of time meeting Johnny Brown’s needs, and there are a lot of other children who ought to have the same thing. We should have a general program to meet all the needs. In the very rural sections we often do not have any agencies, either public or private. Where they do exist, it is sometimes very difficult to avoid duplication and to work together efficiently and economically. Often nothing is available but neighborliness and willingness to take care o f individual cases that are more outstanding than others. I think one point we might be interested in discussing might be the combination o f public and private interests and support. I shall read a summary of activities in one community which illustrates this. Mrs. L., leader in a church group, called an informal meeting of two representatives from each o f the churches to discuss the need for community interest and participation in child-welfare activities. At https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 120 CONFERENCE ON STATE CHILD-WELFARE SERVICES this meeting Mrs. L. outlined the work and functions o f the childwelfare worker and stressed some of the local problems presented in carrying on the work. She brought up the lack o f local resources available in. caring for children, such as the H case, in which emer gency temporary care was needed. Mrs. L. first became interested in learning about the child-welfare work in this county because she was interested in the H family, in which the mother was dead and the father in jail, leaving four children at home with no one to take care o f them. She cited other families known to her and asked the childwelfare worker to tell the group o f the problems coming up in her work wherein it would be very helpful for the community to give assistance. Since there was considerable sentiment in the group for the estab lishment of a local children’s home, the worker tried to stress the fact that we did not want to destroy family relationships, and that whereever we found anything hopeful upon which to build it was much better to try to improve the child’s own home where he has the love and affection and the security given by a feeling of belonging which it is difficult to give a child in a foster home. The worker tried to interest the group in doing something for the child in his own home. After that, it was pointed out, a foster home occasionally is needed for a child or family of children almost over night, and some plan must be worked out so that a boarding home or other means o f care may be available when needed. First there was discussion of how we found homes, and it was brought out that those members of the community in the meeting who knew everyone better than the worker who came into the community only a year and a half ago would be a fine source of suggestions for such homes. It would save time, and better homes would be found, if people in the community would be on the alert in finding them. This brought up the question of financing these homes. One woman said children needed a home spelled with a little “ h” rather than a big “H .” They hated the thought of a “ children’s home.” .She is rearing two boys whom she adopted. There seemed to be a difference of opinion about the desirability of boarding homes, and the worker pointed out that we had a State receiving home for children who need permanent foster care. Per haps the question of responsibility for different kinds of child-welfare activities would be a profitable one to discuss. Is finding permanent substitute homes for children really a local responsibility, or should there be facilities for the finding of a home for the child who needs another home, perhaps an adoptive home, because his own family can never take care of him? To have a greater source o f supply of homes than those that can be found in his own county ? It was sug gested that we might use the private and public child-caring agencies to provide permanent foster care, but even in places where we have such facilities temporary foster care might be more desirable for the child, keeping him nearer the family and community ties which we want to preserve and strengthen. Several meetings of the group were held to decide whether the small community should have foster homes and/or an institution, and who would pay for the homes. The women called a meeting of the men’s clubs and officials, and the result was that the group, representing' a https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6— MORNING SESSION 121 large number of voters, intei^sted the county commissioner (or county court, as it is called in Missouri) in paying the board for children found to be in need o f such care. This group, which had learned a great deal about child-welfare needs o f the community and about the child-welfare work which could be carried on with State supervision and backing and resources by a worker who is jointly a State and local worker, became a county child-welfare council. We now see the interest o f the community people in doing something themselves. They had utilized resources for the individual things needed by chil dren to supplement what could be done by the general programs, the State and categorical relief programs, and the county financing of boarding homes. The members of the group wanted to continue friendly services such as raising funds in their own group to supple ment the resources for dental care, providing dues and uniforms for Boy Scouts and Camp Fire Girls, and havmg a committee start a Big Brother and Big Sister activity. They worked out a plan for special education for some children from underprivileged families to provide training that can be given in their own homes. The C h a ir m a n . Miss Pyles has given some interesting material on case work in the community. We will have our next discussant, Mrs. Doris M. Affleck, case-work supervisor o f the Delaware State Board o f Chanties. . Mrs. A ff l e c k . In considering this topic I should like to approach it entirely from a case-work or service point o f view. There has been a great deal o f emphasis upon the community in these discussions, and rightly so, since we are all dependent upon local support. I believe we tend to swing from one extreme to the other in social work. Either one hears only about the individual and his importance quite apart from, or even against, any modifying community influ ence, or else one hears only about environment, standards of relief and need o f public support, and very little about the individual who is in need o f all this. This conflict is inevitable, since both sides are fundamentally important for us all. It is, as Dr. Plant said in his discussion, our need to be like and our need to be different. At one m°ment we see only the individual, even as we tend to be individual and different m ourselves. A t another moment we see only the group as our need for social living and likeness asserts itself again As sociai workers we are required to find a balance here o f accepting both of these real factors, that o f individual needs and that of the community. I should like to develop this further by saying that effective case work is helping people to help themselves, and I want to make more clear that by this I do not mean what is so often heard defined as case work, namely, gathering social data, considering all the factors in Tt6 S1^ua^10n.’ anc* fhen making a plan. Rather I mean respect of another person s own strength and ability to make his own plan if lie is helped to do this by a social worker who helps him to feel his own situation and the problems in it, but who really leaves him free to make a choice, even though this choice is not always perfect. Several people here have touched upon this. Both Mr. Adie and Mr. Ramsay mentioned the rights of clients and the value o f the child’s own f 6- 1 h opew eare tending more toward this sincere belief in the strength of individuals rather than in their weakness. 78986°— 38-----9 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 122 CONFERENCE ON STATE CHILD-WELFARE SERVICES This may seem far afield from our connections with our community, but actually it is vitally related. This same attitude of thinking that we know best and that we must educate or reform leads us into ditfi° i cannot help but question some of our intense efforts to make com munities aware of their problems. This seems to be a first objective of many programs. I am not questioning the need for local support, but I am asking: Does it really occur by this method ? So often we approach our community with ready-made plans ana assumptions that we know best, that we have all the answers. Is this not an intrusion and an insult to the strength and intelligence of a community just as much as ready-made plans for individuals. Gould this not account to a large extent for the resistance and opposition to the professional social worker ? _ , O f first importance in the development of local resources for the care and protection of children is a sincere desire to use our skill m the service of the community rather than in the domination ox it. The problems within it are really not ours but theirs, and any change or solution must come from the citizens; with our help, yes, if by this we mean presenting facts we have found in our daily work, but not if by help we mean asking a community to accept our plans and l(^,m from us. Learning comes only through experiencing, and then S °Now, if we should be able to develop this really helpful profes sional attitude, how can the visitor concretely work with the com munity? I feel that it is only through her actual service job that this can happen. The case worker who has a real concern tor chil dren has to be interested first in the individual child and only sec ondly in the community as it comes into the picture of this child s needs. I f her concern is genuine, then it is around this that the com munity is vitally reached, and here only is the real object in common between the agency and its locals. Otherwise, how can one hope to interest groups in general welfare? We all know it is through the individual case that people are reached, and for that matter without this the worker has no place in the community agency. It is her job that gives her the right to participate. It seems to me that community support is given only when the quality of the agency job is good enough to deserve it and when the conviction o f the importance o f the job is so real to the staff that the community cannot help but feel it. It is not something that is verbal ized nearly so much as something that is felt because of the farreaching effects of the actual service job being done. There is a vitally related question of how we can help or hinder the development o f local resources by the kind of existence we have in rural areas. Again this goes back to the kind of job we are doing. The rural worker probably is asked to do every kind of service. I f she is too obliging, will the community ever develop far on its own or take any active responsibility for the problems of its people? Again I wish to point out that helpfulness comes through finding and holding to our agency and professional limitations. I f we do only what we sincerely believe is within our job capacity, is this not a much more responsible functioning than trying to do many things that are needed but that the community alone can do ? Is it not more https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6— MORNING SESSION 123 sound to recognize our limitations and to believe that the community can and will develop to meet its own needs if we do not interfere with too much interpretation and control ? Along with this must go a measure o f flexibility and a willingness to work with others. In defining our responsibility and not going be yond that, there is a chance for the community to take hold in the spaces we do not and cannot fill. This still leaves us much room for case committees, discussion of problems with interested or related individuals, and opportunities to present the facts. But the im portant thing is our recognition of our own place in the picture as bemg partial only, and this must be sincere. There is only one other thought I should like to put before you. I wish there could have been time for us to hear more about the actual case-work thinking going into these programs, that we might have heard more o f the reasons for developments going one way or another. I hope we are setting up our plans not from the top down but from the client himself up, and that our administration is serving our clients, as far as possible, thoughtfully and sincerely. The problem o f specialization of services has arisen in Delaware as it must have elsewhere, and I am wondering what thought you have had about it. O f course, in large rural sections there probably is no choice as to whether one worker will do all services or whether ^o®y .can, . centered in different workers. For us division is possible thinking it out it raises the question of what actually happens o the worker and the client when, for instance, the same person has to do child placing and supervision o f children in their own homes if you have ever tried this, haven’t you felt a problem in it? t seems to me that the aim o f each is so opposite in principle as to require an almost impossible professional orientation in a worker. l or instance, under child-welfare services the aim is to help preserve the family if possible; whereas in placement it is to help a familyseparation process so that placement can occur without injury to the child. JSow, how can one worker find it humanly possible to orient herself toward preserving family unity and at the same time toward separation of family ties and destruction o f 'this unity « Both unitv and separation are among our most powerful and elemental forces, and to handle either one helpfully is difficult enough. Besides the problem for the worker, in a function o f all-in-one there is also a very real psychological problem for the client. How’ can a mother relate herself to a worker who represents not only assistance m her own home but also removal o f her children from her« I f the worker represents so much, so many functions that are in themselves contradictory, it is too confusing to expect any helpful ness to come of it, I believe. A client can work through a problem situation only when an agency service is sufficiently clear-cut to offer one particular kind o f service which the client can know and then choose to accept and work with or reject. 5 * ag,ain goes b.^ k to tbe c°ncept that a limited agency function is the only responsible one. & j t-hink ° n,? Ter/ . ™ P ? r t a n t question has been that 1 w fa t'f,g u,s a\oertainiy facing us in Indiana, and that is the problem of the distribution of case loads. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 124 CONFERENCE ON STATE CHILD-WELFARE SERVICES Can any o f you contribute anything on that, or is that too big a Question? I think it is a pretty serious one and one about which there is a great variance o f opinion, one person feeling there should be a geographical distribution and another that the .case-load dist bution should be on a categorical basis. . . . ,, , e Miss H o u g h t o n (Connecticut). Connecticut is facing that dennitcly. Serious consideration is being given to the distribution of services on a geographical basis. One worker in a given area would be responsible for all services. The C h a i r m a n . The same person would also do child-welfare serv ices in general? Miss H o u g h t o n . Yes. . . . , Mr K epecs . I f the social worker has the qualifications indicated, she should be able to do almost anything-bring assistance to children in their own homes and at the same time give the mother enough sup port to see that she needs to be separated from her children. An ideal social worker, one who knows and understands human relations, should be able to deal with both. . . -, In regard to intrusion into the lives of people and communities, it seems to me that where communities have not done anything without intrusion and have come to us for assistance, or for that matter if we come to them and offer our assistance, they welcome and look tor some intrusion or leadership. ,•« In regard to specialization, I believe that that depends upon the volume of work, resources, and the number o f worke-rs available. It is governed by expediency, in other words. When the work is large in volume and concentrated in areas, specialization seems desirable, but there may be a conflict between specialization of function and districting of territory. When the choice lies between territorial division of work and specialization, territorial division is to be pre ferred. With a small number of workers m an organization, I would rather have one person cover a territory and attend to various serv ices than to have two or more persons going to the same district and pass the same door for different services. Good case workers should be able to deal with human relations o f all kinds. But where volume of work is concentrated in relatively small areas, it probably pays to have specialists because you can develop certain judgments through concentrated experiences which are helpful m the specialties. Vol ume of work per worker is, o f course, an important consideration. It seems to me that in rural areas there will have to be considerable undifferentiated case work coupled with consultant services for spe cial tasks. A program would not be sound without specialists, it only on a consultant basis. Child placing is a specialty requiring specialized skills, but I would take a chance with a good case worker doing placement work, provided that consultant service in placement work is available. . , There is another reason why I am in favor o f the same worker s doing many jobs—it is enriching and broadening, and the worker has an opportunity of acquiring an understanding o f various phases o f human relations. Confinement to a specialty over a long period o f time is narrowing. In child placing it seems to me that the worker who helps the child in his home should be able to help him accept https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6— MORNING SESSION other forms o f aid. work. 125 I am inclined to favor undifferentiated case The C h a i r m a n . Three important problems have been brought up. One is the volume o f work. For instance, next July, in Indiana, the age at which old-age assistance is granted drops from 70 to 65, and we look forward to forty to fifty thousand applications. I am afraid child-welfare services in Indiana will stop until this is handled. Sec ond, the requirements o f our workers, and third, the requirements of the programs. Miss D u d l e y (Maine). I am one o f the people doing a miscella neous case-work job within the child-welfare-services set-up, doing partly the regular State department job and partly local work, and also, as we have said in a kind o f phonograph record speech—the speech you have to make over and over again to people—lending my hands^ and feet to the selectmen and court and schools in an area with just three or four towns. The whole population is not more than four or five thousand in my area. I expected all kinds o f difficulties, as one who was going from a specialized child-placing job into a miscellaneous job. But I think it has an analogy in the field of other professions. The doctor who has an interest in rural medicine and who comes from a specialized city set-up must deal with emergencies, appendectomies, skin diseases, and everything. It seems to me a question o f whether you fit into the professional pattern o f the community if you are going to be a help to them in the handling of community difficulties. ^ I have found the problem within myself that Mrs. Affleck men tioned. In one case in which it bothered me most, I was the person trying to keep the family together and the person trying to take them apart. I have seen them over a period o f almost 2 years through a father’s court experience and a mother’s desertion, trying to keep the family together through the grandmother’s death and all kinds o f troubles. Finally the father, who was perfectly terrified . y avmg the children taken care of by the State and was going to •jump m the river and never pay a nickel, came to me a few weeks ago and said he would have to ask me where the children could go because he decided I had a good head. , ^'HAIRMA^- What about those who are doing assistance work for the aged and blind and independent child-welfare service 2 The assistance work is so much greater than the child-welfare service. I am concerned as to whether the assistance program will not over shadow the child-welfare work. Miss F r a n k (Louisiana). I should like to hear from some one who is working in that kind o f program. Miss D udley. May I say that in the distribution o f administrative areas in the Maine set-up we have come to feel strongly that it has to be a small enough population area for general welfare services I am not doing work for the aged and blind. My work relates to chil dren and helping with general local relief. The three towns in the iP | e|fc supporting the service to the extent o f $1,150 a year, so they feel that it belongs to them. But in Maine we felt we could not extend our work over an area so broad that one person could not cover it in 9,10, or 12 hours a day. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 126 CONFERENCE ON STATE CHILD-WELFARE SERVICES Miss P y l e s . Even if the ability and skill o f the worker should be taken for granted and if we feel that the worker could do a good gen eral job in all its aspects, her ability to do it would also depend upon the size of the area. The C h a ir m a n . I should be interested in knowing whether all these States are throwing the whole program together and dividing it on a geographical basis. Is any one doing that ? Miss bARABCT, (U. S. Children’s Bureau). Don’t we have to help people define what service is? Some one recently said to me, “ Yes, we carry a number of service cases.” When I questioned further I found that it was not the families receiving grants that were getting service but out-of-town inquiries that they were calling service cases. It seems to me that through our children’s work we have an oppor tunity to define for them something of what service means. Miss F r a n k . I should like to hear more about some differentiated case loads. All I have been able to gather is that an undifferentiated case load is better, but I am not clear why. You think of the W. P. A. certifications and the C. C. C. enrollments, and, as Miss Labaree points out, the service cases are cases that are not relief cases. I should be interested to know what thinking went into it when you say, “ It is better.” The C h a ir m a n . Who can discuss that point? Miss S teele (Georgia). I know the two arguments given in our State. One is that an undifferentiated case load is more economical to the county because mileage is saved, and the second is that it helps develop the worker. I want them to point out why it is better for the children. Miss F r a n k . D o we want the development o f the worker at the expense o f the children, and could we say because an undifferentiated case load saves mileage it is in the long run economical to the State? I wonder if any group has given any consideration to that. Mrs. R a n k i n (Texas). I should like to know why it is better for the worker. ' Miss H e w in s (Vermont). I was trying to make up my mind what our policy is. We have been forced by the exigencies of the situation to have one, two, and three combinations o f this generic case work. I think from the point of view of the ultimate development of the community we can say it has helped us to have this generic case work, and that it specifically helps us in our aid to dependent chil dren program, where within the last year or so the case loads have been reduced from—nobody knows exactly what— 150, 1T5, or per haps 200, to an approximate 90. The exposure to the service angle which has been possible through general welfare services has sold the idea to the department, so that today aid to dependent children is on a service basis. Old-age assist ance is not in the department o f public welfare, and we do not have that to consider, but I think the undifferentiated case work has helped us in aid to dependent children, and I think it is broadening to the worker. Mrs. R a n k i n . Doesn’t this in some cases become a family problem with the unit really the family rather than the child ? I f you think o f it as a family job, it becomes sound to me. It is a family job. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6— MORNING SESSION 127 Mrs. B u c k l e y (Connecticut). O f course, some o f the other argu ments used are that the special agent has about reached the limit and that the town officials are tired o f all the different people coming in and spending a whole day. They are tired of seeing all the different people coming in about the different things, and they cannot under stand why so many should come. Miss S u n d w a l l (Utah). We also do a generalized job in going into the counties. Our workers accept the families in which there are children’s problems. O f course, our case work is limited, but we do the assistance job along with the child-welfare job. We are trying to fit our program to the needs o f the community. Miss D ud le y . I am perhaps being misinterpreted in my statement o f what a miscellaneous job is. A child-welfare worker can give service to children and at the same time take care of other assistance needed by the family, such as enrollment o f a boy in a C. C. C. camp, or assistance o f that sort. We do the job needed in the particular family. Miss L abaree . Could I ask whether these people are supervised by the State, these different people for these different jobs? The C h a ir m a n . That brings up the whole problem o f State super vision. Do you want to have some discussion on State supervision? Mr. P age (New Hampshire). I want to discuss the matter o f State supervision. Beginning July 1, we plan to have the workers carry undifferentiated loads. We have done a lot of planning and have run into a lot o f headaches. The question of supervision comes to me. What is the difference between supervision and consultation service ? Do they overlap when you call your consultants to strengthen your local or field office? I should like to hear a little discussion on that point, because I think if you get that set-up on a district-office basis, when the worker is carrying undifferentiated loads, you are «-oinff to have a little difficulty. The C h a i r m a n . I think Mr. Kepecs brought out the point of consultant service. Mr. K epecs . There are two aspects. One is administrative, and where State funds are made available it is up to the State to see that funds are spent well. The other is consultant service which may be handled in connection with administrative supervision or in connec tion with specialized services. I am not sure which. It is essential to find persons who can do these things. The State has certain ad ministrative responsibilities in connection with maintaining mini mum standards, and it also has the function o f supplying consultant services in connection with specialties in case work such as child placing. Much depends upon the number o f people that the State can afford. The State does not discharge its obligation unless it has someone to supervise and enforce minimum standards. Consult ants and specialists are very desirable. I believe that they are essen tial. But it is a question whether the State can afford and can find such persons. It is not likely that the same person can function in both capacities adequately. Mr. C lass (Oregon). What do you mean by an undifferentiated case load? What are your criteria? https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 128 CONFERENCE ON STATE .CHILD-WELFARE SERVICES Mr. P age . I think o f it, as has been mentioned here, as having the workers carry not only the categorical work—work for the aged and blind and aid to dependent children—but also being responsible for service work in relief families and for child welfare. In New Hampshire relief is going back to our local officials. .W e work on a county and town basis, and I might say here that I think perhaps in New Hampshire we are different, but it seems to me we are having quite a change in thinking on the part o f the general public as it sinks through their heads that no longer should they label relief legislation “ emergency legislation,” as they have done m the past, and as they realize that this will cost a lot of money and be a permanent program. We find taxpayers’ groups being formed an., examination o f the way in which general relief and all other forms of assistance are being administered, and they are wondering it this is the better way o f doing the job. A ll o f this to me is very, very ^T h en , too, as happened recently, here is a little town overseer of the poor, as he is called in New Hampshire, and he has visiting him in 1 day seven people. He says, “What kind of service is this? Ia m a part-time official and I have to work, and I entertain seven o you boys and girls from the State office in 1 day. It doesn t make sense, and he feels it costs a lot of money. They traveled a long way and two went in to visit one family, one to see an aged person and the other a blind one. Money still talks. It is pretty close to the hearts o f these people, and I think we will have to adjust ourselves to a situation which financially is very, very real, as well as recognize the social problems involved. . , Then too, as it becomes a permanent problem and is recognized as such by the people in general, we are having thrown up m New Hampshire fences that say, “ You are not to go out of the state to get your trained workers.” You have all heard that before, and it you are administrators it is a very real problem. . , , What that means is that when you start to take over an entire load, as we are going to do in New Hampshire in July b e c a u s e ot new legislation, we are going to have to take boys and girls out ot the State universities. They have been exposed to sociology for 4 years and they are sincere in their desire to go into public-welfare work, but they are not trained. . So to me the only hope o f doing a fairly decent job eventually is to put into the key positions—on the consulting jobs and supervisory n0bs—persons trained and experienced. I f we can do that, I think there is some hope over a period of months of arriving eventually at a program that will satisfy the general public and will actually be doing something for the social needs o f the people. II. CASE RECORDING IN LOCAL PUBLIC AGENCIES The C hairm an . We must go on to case recording. Public agencies are interested in case recording. We in Indiana have recently checked over all court dockets in search o f lost files and we found 1,500. One judge said, when he was approached, No, you can’t now, but I will let you go through the docket in a couple ot https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—MORNING SESSION 129 months.” We found that every afternoon at 1 o’clock he was shutting himself up in his office and getting the court docket up to date, and for the first time in the history of the county it is up to date. Miss Bessie E. Trout, welfare-training assistant in the Bureau o f Child Welfare, New York State Department of Social Welfare, will open the discussion. Miss T ro ut . Record keeping is one of the factors in our work that is general— at least the problems in it are. I am going to mention just a few o f the outstanding difficulties we face in New York State before mentioning some of the constructive factors in the use of our records. First, there is the heavy case load. In New York State we have usually one children’s worker assigned for all children’s work in the county. The average case load ranges from 90 to 100. I f Mr. Carstens were here, he would probably say it is double the norm for a case load—if we have such a thing. The time element, therefore, is one of the first difficulties we face in social case recording. Recently one of the county children’s workers said that she had four records for me to read because there had been four Sundays since my last visit and she wrote all of her records on Sundays and holidays. Not all o f our records are written on Sundays and holidays, but social case recording, by and large, has become something that does not have the importance o f the rest of the job—something to be done after the day’s work or when one has the least amount o f pressure. An associated factor is that pressure o f work seems to create in the worker a habit o f activity which tends away from the kind o f evaluative, constructive thinking necessary to social case recording. It is easier to jump in a car and “ do the job” than to develop the selfdiscipline necessary to good social case recording. I think we all would agree it is more important to do a job than to record it on any single occasion, but over a period o f time this habit of activity is likely to become a state of mind. Another difficulty (and it is in the working out of this difficulty that we can make one of the most constructive uses of the records) is the fact that we have not gained recognition of social case recording as an integral part o f the responsibility for a child in a child-welfare program. The importance o f statistical and financial recording is fairly clear, but that social case recording is a real part o f the program is not recognized. In the medical field recording is accepted; all doctors, nurses, and hospitals recognize that a record o f the patient’s daily condition may mean the life or death o f that patient. The lay public recognizes its value to the extent that confidence is increased in a physician or hos pital that keeps such records. A dentist over a period o f years will keep a record o f his patient’s condition; and if he does not, we question his ability and perhaps consider a change o f dentists. I wonder how many o f our public officials know that it is necessary in order to give adequate care to a child that we have a record of that child’s experiences and development. We have the task o f defining for our officials what should go into these records. We must Imow what has happened to a child. We need some perspective o f the life experi ences he has had—not only information about him, but what his ex periences have meant to him, what interpretations have been given him, https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 130 CONFERENCE ON STATE CHILD-WELFARE SERVICES and how he understands them, as well as other factors in his life which represent so frequently the basis of his behavior and which we must know before we can understand how to treat him. Probably few of our public officials have any way o f knowing the importance o f having in a record the facts o f the child’s origin so that we may preserve for him the things about his family and about himself. We need also to have made clear to public officials and board mem bers that both the child and the foster parents can suffer a great deal from a change o f workers that results in change o f methods unless we have some record of the way in which the previous worker has treated the situation. Naturally, too, there is great loss of time when records are not kept, because each new worker must accumulate the knowledge already gained by the previous worker. In addition to loss o f time there is annoyance to members of the community and to the foster parents or to the child in going over again the ground someone has already covered. These are some o f the difficulties. We come, then, to the use we can make o f the record. The workers themselves are not wholly clear as to the use o f the social case record. We need to do more work in making clear what should go into the record as well as what uses can be made o f it. A record is a tangible thing. It provides one o f the ways in which we can give the broad interpretation to our program, and we have many opportunities for interpretation presented to us. Recently a county commissioner who was questioning the quality o f work done by his child-welfare worker commented, “I don’t know about her records, but I guess they must be good because there ,are pages and pages and pages o f them.” How could he evaluate his own work? He was reaching out to know what should be in the record. As we interpret what is important to the welfare of a child in the way o f a record, we find we are explaining at least in part a child’s needs and our responsibility in meeting them, as well as defining and clarifying the child-welfare program. In considering another factor o f the use o f records, namely, the value received from rereading and evaluating for treatment, we must again turn to the medical field. A doctor does not see a patient with out first glancing at his chart. All too frequently our children’s work ers file their records as a task completed and do not refer to them before visiting a child for the purpose of understanding what is hap pening to the child—learning what has already been done and how the child has reacted—and determining what the next step in the treatment should be. It has been interesting to me in visiting the different counties to find that where there is poor recording there is generally a poor quality o f work, and where there is the best recording there is usually the best quality o f work. I do not know which comes first, but there is something in the discipline that causes the worker to look at what is happening to the child under her care, that causes her to stop and think (and those who keep the best records must stop and think), that brings a perspective and a stimulation which promote the growth and development o f the worker—a value that we could interpret to our public officials. There are so many ways in which we can use our records for broad interpretation o f what child welfare is. I wish we could get together and work out methods that would be a little clearer to us. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6— MORNING SESSION 131 Workers are all pressed for time—we find it necessary to talk about short cuts and to determine which things in our work we cannot do without. As we define more clearly the necessary content o f our records and clarify our thinking on the broad constructive uses, we may be able to bring about changes, such as the lowering o f heavy case loads, which would make more effective recording possible. The C h a ir m a n . The discussion will be continued by Miss Frances Steele, director of the Division o f Child Welfare, Georgia State De partment o f Public Welfare. Miss S teele . I am thinking in terms o f my own State of Georgia in regard to the problem of records. Our main point is we have no pro tection for our records. The administration has instructed the direc tors that they must have the records open for the grand jury at any time. The newspapers have asked that the records be available in the courthouse and the name, address, and race of the recipient o f aid. Those are the two main problems we have. Building from the pro grams of F. E. R. A. we have in every county folders for relief cases. Sometimes there isn’t anything in the folder except the name and ad dress and race, but the old W. P. A. Form 144 went a little further and actually asked for the occupation. Along comes child-welfare service, and our problem now is, are we going to give way to the temptation to lower our standards because we feel the pressure of lack o f stenographic service and because many of the county directors have not gathered the idea o f child-welfare service ? I f we can get across to our boards and county commissioners the fact that a record does not hold a lot of secret and confidential in formation against a family but is our tool and guide, we will get further away from the idea that case histories have no real value. We have had no test yet o f the child-welfare records, but, as I have said, in one county the newspapers demanded that they be public. When the test .does come as to whether or not the records will be open to the public, we will have to work on the idea that they are not secret or confidential, as well as on the fact that they are the tools with which we work. We feel that in these records it is our job to weigh and evaluate what the board and what the layman can understand, because in that way we can sell our program to the State and increase our funds. It is the only way I see that we can reach the people and our State and county officials. In Georgia the old-age-assistance program has had so much em phasis that we have had to creep along on child-welfare services, and we.have gone pretty slowly at times, but we have managed now to get the eye of the administration fixed on children’s problems. I f any of the rest of you have the problem o f open records for the public we should like to know how you handle it. Miss A t k in s o n . Let me present to the group Miss Josephine Brown, who led us through the struggle in the F. E. R. A. program. Miss B r o w n . I have been much interested in hearing what you had to say and realizing what a fine lot of people there are doing the child-welfare job over the country. I think perhaps I am in a little better position to appreciate that than a good many people who came into the job fairly recently. You may be interested to know we did have a very serious test case on records in the F. E. R. A., and the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 132 CONFERENCE ON STATE CHILD-WELFARE SERVICES Federal Department o f Justice was willing and glad to be called in. The rules o f the courts in one or two cases have been that such records have professional status and they are not subject to revelation to the public in court or anywhere. The C h a ir m a n . We are very glad to have this reassurance about what help we may be able to get in this problem. Mrs. Norma Ran kin, director o f child-welfare services o f the Division o f Child Wel fare, Texas State Board of Control, will discuss the subject. Mrs. R a n k i n . Case recording is an all-important matter and one we have had considerable discussion about recently in our own staff meetings. I might say that as far as Texas is concerned it is o f the open road and wide spaces. As one o f our workers said in a meeting, “ We have nothing and we need everything.” So we must approach it at that point in Texas. Jn thinking o f this question I have analyzed it from several points o f view, and one has been brought out in our set-up—the relation o f public agencies to the State office from the point o f view of record keeping and the effort to assist and facilitate office mechanics in order not to burden the worker with too much in the way o f setting up procedures necessary to get factual data and data we need for rela tionship and research matters. A county judge said, “What are these things you talk about as case records and what do you use them for anyhow? I have always thought the reason we have these records is so that the worker is given something to do in her spare time, so she will have an opportunity to write about what she has done in her spare time.” Then he pointed to the confidential nature o f the records and said, “ You refer to the all-importance o f the matter of your records. Do you permit any one to have the information, and what do you do with it after it is written?” I think we have opened a new area in the use o f records and inter pretation to boards from the point o f view o f community case records, as well as case records o f children. I should like to present very briefly some o f the comments given by members o f our staff who were discussing the question o f case-record writing recently. In addition to the general phases we are all familiar with, our staff members have these remarks to make: The recent influx of out-of-State inquiries and cases of aid to dependent chil dren has been a difficult problem to us in our county. Frequently the informa tion given is vague, misleading, incomplete, and as a result our own reports on each case are necessarily inadequate. There is a lack of understanding of what we might consider the elementary rules for weighing the value or determining the usefulness of the data obtained. Often facts are unknown or information is misleading. I f the principles of record keeping were clear to the social workers recording the i n f o r m a t i o n it would probably enable them to make more reliable inferences. The matter of inadequate case recording has been brought to my attention lately in endeavoring to assist this county in planning for cases of children supported by the county in some one of the children’s institutions. There are no records regarding the parents, no listing of relatives, and no reasons given for declaring the children to be dependent and removing them from their own homes. It is evident that time and expense could have been saved had such information been on file, and certainly the county would have a more sound basis of explanation of the circumstances which warranted the action taken. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—MORNING SESSION 133 I have been impressed constantly with the importance of complete and accurate case recording. In numerous instances "I have been called upon to refer to the records in our office on points of discussion which have arisen with county officials, the county attorney, county judge, health officer, and others. In every instance the information as stated in the record in a clear and concise manner has been accepted as the final issue in the case. Another worker brings out the point: Thinking a little beyond the mechanics of record writing, I believe the case record could be a real factor in the actual development of community resources. What better sources of information regarding interested individuals and com munity groups, sources from which funds may be obtained, and so forth, do we have than the records of contacts with individuals? It can easily be seen that a new worker going into a county in answer to an application or request for service could benefit greatly through first reading and analyzing the results of contacts made and cases recorded. From the standpoint o f the ethics o f recording, the problem of confidential information is an important one. It is well for the worker to inform the client that it is necessary to make a record of facts. The worker may enter information in the record and place the word “ confidential” before it. Often confidential information is given which has no bearing on treatment and therefore, in my opinion, might be omitted from the record. A record is not objective if it includes only the facts that are favor able to the case worker, when possibly there are unfavorable ele ments which are also significant. Regardless o f how the recording is done, we should bear in mind that the primary purpose o f keeping records is to assist us in beneficial treatment o f our client, and the record is most helpful when written in such a manner that it gives a clear picture o f the child involved and his relationship to his environment. I might say in summing up that my own belief in connection with record writing is that the record, in addition to being useful in the handling o f the case with reference to the child, should serve as a competent qualitative measure o f the shortcomings or ability of the worker. The C h a ir m a n . The discussion will be continued by Miss Florence Mason, assistant director of the Catholic Charities Bureau, Diocese o f Cleveland, and member of the Children’s Bureau’s Advisory Com mittee on Community Child-Welfare Services. Miss M aso n . When I think in terms o f the case loads you must carry, I immediately realize what your records must mean to you; but all o f us have the same problem of recording, that is, establishing the importance o f records. Whether you have large case loads or whether you are from a well-regulated agency, you will find the case workers doing the work at night. Case recording has not been established as an important function of the agency. You talk about case loads in relation to your record writing. To sit down and dictate without a plan makes for some very long records that are not thought through. I f you are to write a good record, you have to take time to organize your material. It seems to me that in child-welfare service you have an opportunity o f establishing the importance of records and the sig nificance o f factual material, which no person in child welfare has a right to leave out. I f you are ever placed in a position o f having the children coming back and trying to find out about themselves, or o f https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 134 CONFERENCE ON STATE CHILD-WELFARE SERVICES people trying to find out something about the children they have adopted, you will immediately realize the importance o f that type of material. I often wonder what right we have to get the facts and not have them where they can be used afterwards. Then there is the record o f the child himself. X wonder if some problems could not be solved for a generic case worker if you had a separate record for the child, a record giving the picture o f the child, 15 ? '8 ° f record you think ,of .using as a tool for treatment. You could have your factual material in the general family record, and for each child a separate record giving a picture of the child himself, or what you know about the child, and what is being done for the child— placement that has been made, what that has meant for the child, the things you have done for this child, and the child’s rela tionship to the family. A ll this material would have to be pretty care fully worked out. I was in an institution recently when two little girls, sisters, came in and were waiting for the head o f the institution. The younger one was asking if she could go out and buy some material, a book helpingher to design some things for a party. The older sister said, “Margaret doesnt like to draw as well as I do,” and the younger child said “ Betty only says that because she draws better than I do but she* doesn’t know what is inside of me.” And I think that is the thing we must know in the records—what is inside of the children, something o f the hopes and ambition o f the child. The C h a i r m a n . We have a few minutes left for discussion. Some thing came up in Indiana the other day that was very interesting. It concerned case reporting by a private agency to the State department. We have a new set-up in our State, and the executive director o f one of the private agencies said they had sent in all the cards and all rec ords except one. The case worker refused to send that one because it concerned an illegitimate child, and the paternal grandfather came from a prominent family of the city. She said the records were not kept confidential enough, and we could not guarantee that confidential material would be safeguarded. That is the old feeling that public records are public, and that is the reaction we are getting from some private agencies to those records. It involves two things. Do we have to give an assurance to agencies and people in general that public records are not public ? Have you had such problems in your States ? Miss B r o w n . I think perhaps one thing I worried about more than anything else in the F. E. B. A. days was what was being written in the record. I know a lot of people did not have time to write much of anything, but a great many workers who came from private agencies felt strongly about putting everything they knew on paper. I want to warn you again to ask your county workers to be sure they do not write anything in the records that they cannot verify; that they have not verified—gossip and judgments about people’s moral character. Somebody said something about a child’s coming back and wanting to know something about the family. Just suppose the worker had written something about the mother’s character that she did not know as a fact. The case I spoke of a few minutes ago in which the Depart ment o f Justice came in was a suit against a worker for libel by a client, and I do not know whether the worker had verified the informa- https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6— MORNING SESSION 135 tion she put down. It is possible to get into a jam by making unveri fied statements about people’s mental condition, and their moral character. Mr. J o n es . I should like to say something about records from the standpoint of an executive. I think I know as much as anybody knows about the inadequate-record story, because as the superintend ent o f an old agency I now have a continuing correspondence with people in all parts of the world in an effort to get factual information for many people who as children were sent West years ago. I could speak at length and eloquently about that aspect of the matter. I know the unfortunate results o f not recording information about peo ple. For example, at this very moment it is unfortunate, indeed, that I cannot give a brilliant young university graduate in the Middle West, who is about to marry a brilliant young woman, a few facts about his family background for the simple reason that these facts were not recorded when his father as a boy was shipped to a distant point. But this morning I wish to point out the other extreme—the long and overwordy record. This question o f record is fast becoming a headache to many executives. A young woman in our office the other morning was referring a case. She told the supervisor and me some thing about the matter. The supervisor remarked, “ Perhaps I had better drop in at your office and look at your record.” The young woman said, “Well, there are 40 pages of it.” After she had gone and I showed some concern over her evident idea that service is now being measured by the yard, the supervisor remarked to me, “Why, one of the students in training had to read a record o f 80 pages the other day.” A friend of mine, who is a supervisor in a large city, told me recently that her field visitors were averaging about 1% hours in the field each day, and when I said, “ What are they doing the rest of the time?” she said, “ Why, processing their records, of course.” From the experience I have had in working with a scientist in another field, I have a conviction that we greatly overrate the socialservice records as research material. They are not prepared under the conditions demanded by a scientist, and I do not accept at all the oftrepeated statement that these records are full of rich research material. As I read them, they very often go into long statements about what Miss So-and-So, the social worker back in 1915,1920, or 1925 felt about Mrs. So-and-So as a good housekeeper, or a good mother, or something else of that sort. I read one of these records the other day in which six or eight different people had “ felt” things about one person and another—page after page. I knew none of the people who had written this material, and no one who is at all scientifically minded could place very much value on such talk. Much o f it should never have been recorded at all. I hope that you will not have such an amount of money that you can be reckless with it and go on spreading yourselves over acres of paper. The fact that you may realize that you'may have to account directly to the public for what you spend and for what you say about people should be a challenge to you to get something done about records which has not yet been done in the social-service field. I could tell you o f many executives who are becoming very much dis turbed on this subject. Some of us cannot even hire room in which to store these voluminous records, which we might as well admit no one ever reads. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 136 CONFERENCE ON STATE CHILD-WELFARE SERVICES N°W, please do not go away from this meeting and say that I do not believe in records. I do believe in records o f factual material. I believe that you people who are gathered in this room can do somehing about this matter. You are young, energetic, and open-minded, and you have a broad view, and you are out before the public as public servants. You need not be hindered by the patterns that have set the minds o f some o f us. Can you not take up this record business and in some way see that records are brought into a limited territory and they contain factual information, which everyone admits we need and leave out emotional impressions as to whether Mrs. So-and-So was domestically inclined, whether her mother should have held her in a different arm when she gave her her bottle, or whether she should ^ k ® ? he in the crib ? Let all that lie in the field o f speculation, which tor the time need not be committed to print. You may write arti cles about such matters and publish them m journals and there they may be rather harmless. Let us get away from the idea that civiliza tion has to be saved by the typewriter and the mimeograph. What I have heard you saying here this morning is very important, and its importance could be emphasized almost daily in the offices o f any of the old agencies. Often I am very dependent on a tidbit o f factual information which may change a whole situation in life. A very simple letter o f half a dozen lines, with an address, kept in our records for 20 years, enabled me to bring together a mother and son. This tactual information was very useful in this situation. The business o f how “she felt,” “he felt,” “ I felt,” and “ the worker felt,” did not seem so important after 20 years. Miss T rout . Miss Arnold, I think Mr. Jones has made quite a point. Especially during the last few years there have been differing opinions o f what we should do. I wonder if it is in keeping to suggest that we have a committee to study further what problems we face and how to deal with them, and perhaps make something o f what Mr. Jones suggests as to how we should do it. The C h a ir m a n . What is the feeling o f the group? We have been challenged now. I wonder, Miss Atkinson, if you would be willing to appoint such a committee, and perhaps, if we have a child-welfare conference next year, we can have the committee’s report. A t k in s o n . I f it is the wish o f the group, it seems to me the Children s Dureau could appoint a committee for the purpose o f con tinuing to explore this topic and to get some material together which would be helpful to the various States. J !& ? .t0 re.% to something Dr. Plant said one time to the ettect that, in his opinion, a good many records were not records o f children at all but were merely portraits o f social workers. One time 1, a 1W0rf®?’, 0i1 my staff who always tried to include his entire philosophy o f life in every record he wrote. It was important to know his attitude toward the problems o f children, but it was not exactlv germane to the treatment o f the child to make his pronouncements on social, economic, and moral questions a part o f a child’s record. •f Have on that committee somebody who comes to it rather fresh. Got some one to come in absolutely new who will sav “Whv do you do things this way?” That is the sort o f person whTusuallv makes a contribution to life. usually https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Wednesday, A pril 6—Luncheon Session DEVELOPMENT OF SERVICES FOR RURAL CHILDREN WITHIN A STATE CHILDWELFARE DIVISION C. C. Carstens, Executive Director, Child Welfare League of America, and Member, General Advisory Committee on Maternal and Child-Welfare Services, Presiding Miss A t k in s o n . We have asked Mr. Carstens, executive director o f the Child Welfare League o f America, to carry the responsibility for this meeting this afternoon, and I turn it over to him now. The C h a ir m a n . The first responsibility I have is to present to you two resolutions that were voted by the Advisory Committee on Com munity Child-Welfare Services. These resolutions you will be interested in, but you are not asked to take any action on them, because they have already been approved. The first one reads as follows: Whereas a State or local public-welfare program is complete only as it makes provision for a broad program o f service to children; and Whereas the acceptance of this principle by the various States and by local units is necessary to full development of such child-welfare services; and Whereas title V, part 3, of the Social Security Act, providing for child-welfare services, implies the continuous expansion and strengthening of community services for children: Therefore be it Resolved, That the Children’s Bureau, in cooperating with State public-welfare agencies in establishing, extending, and strengthening, especially in predomi nantly rural areas, public-welfare services for the protection and care of home less, dependent, and neglected children, and children tending to become delin quent, bring to the various States the necessity o f making legal and financial provision for the whole program of child care and protection, so that its benefits may reach all rural and urban areas. The second resolution adopted by the Advisory Committee on Com munity Child-Welfare Services o f the Children’s Bureau reads as follow s: Whereas a complete program of child welfare has for its most important prin ciple the maintenance of the child’s own home whenever possible; and Whereas the limitations incorporated in title IV of the Social Security Act with reference to the amount of the Federal contribution and the amount of aid authorized, for each child have resulted in a less rapid extension of aid to dependent children than has characterized the program of assistance to the aged and have further resulted in many children in receipt of aid having assistance so inadequate in amount as to fail to provide the m in im u m essentials of life : Therefore be it Resolved, That the Advisory Committee on Community Child-Welfare Services request the Children’s Bureau to express to the Social Security Board the com mittee’s deep interest in the extension of the program of aid to dependent children and its opinion that the objectives of the program cannot be fully attained until the Federal Government contributes on as generous a basis as in the case of old-age assistance and assistance to the blind, namely, at least 50 percent of the total costs; The committee believes further that an increase in the Federal Government’s share in the program should be accompanied by requirements which would tend to assure the granting of aid in each case sufficient to maintain home life for children in accordance with minimum standards of health and well-being. 78986* — 38—— 10 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 137 138 CONFERENCE ON STATE CHILD-WELFARE SERVICES That gives me a very satisfactory text for my brief remarks. Our greatest living philosopher said at one time something that 1 think is also a text of value which we ought to keep in mind and which is a second text for me today: “What the wisest and best parent wants for his own child, that must the community want for all its children.” That is a quotation from John Dewey. We have been discussing during these 3 days problems that have related themselves mainly, in some way or other, to the tragedies of human life. I am interested not only m the tragedies but also in the prevention o f tragedies, and therefore I should like during the few minutes that I have with you to point out that instead of having pre vention always being merely the last work o f our speeches, it should, perhaps, come somewhere along early in the game in our interpretation to the communities with which we work. We should aim to have in our community organization provision for good health protection, for good schools, for good recreational pro grams, for good libraries, for artistic surroundings, for music that is elevating, and dance that is an expression o f the joy of life; proper housing, proper protection against demoralizing conditions, a press, motion pictures, and all those things that make for wholesome sur roundings and wholesome family life. This cannot be obtained in a day, in a week, in a year, or perhaps in many years, but I think we are derelict—you and I are derelict—if we do not somewhere in our day’s work or our week’s work or our month’s work emphasize that prevention results from having many wholesome things in our com munity life rather than from any little formula that someone may spring upon the community and for which he takes great credit to himself and to the agencies. Prevention o f dependency, neglect, and delinquency is a long road, but it is a road that each one of us and those who are connected with us must be invited to tra vel. A ll this is implied in good community organization. There are a few things, it seems to me, that are inalienable rights that chil dren have, and I have just selected a few. They may not be inalien able rights at all, but they seem to me to be. First, a good physical start in life ; second, a home—emphasizing the simple mores o f the community; third, a protection o f the kinship ties and the right of a child to know who his kin are; fourth, an opportunity to develop the intellectual powers with which he has been endowed; fifth, help, if necessary, to find the niche for a useful place in the world’s economy. You have heard much about how we ought to deal with dependent, neglected, and delinquent children, but let us remember that we must make our contribution too, through community ^organization toward better things. Yet all the time we are dealing with the physically handicapped, the mentally handicapped, and the socially handicapped, let us also constantly preach the doctrine o f prevention through wholesome community life and community living. .Now, it is a good deal more important that you should hear from those who have something to contribute from the field, and then I hope that Miss Atkinson will give us her words of blessing for another year. . The first speaker comes from Oregon—Mr. Norris E.^ Class, super visor o f child-welfare services o f the State relief committee. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Aspects of State Child-Welfare Services By N orris E. Class , Supervisor, Child-Welfare Services, Oregon State Relief Committee Both from the program as it was printed and from Miss Atkin son’s letter, I interpreted the topic that I might discuss briefly to be the operation o f a division o f child-welfare services at the State level. I believe that such a division can do two or three things at this particular point of our development. First, that division can and should furnish consultation in cer tain areas o f child-welfare service such as we have been discussing during these 2 or 3 days, as for example, substitute parental care, psychiatric problems, and possibly vocational counseling. I do not believe, along with most of you, that this consultation is the same as field supervision. It is different in that it lacks the authoritative basis upon which supervision usually rests,* and it is different in that it assumes, generally speaking, no responsibility beyond an educational level. . . _ . Consultation, as I see it, is the imparting o f information. It is assisting with interpretation, and above everything else it involves dealing with or handling in a constructive manner this thing which is eternally present and which, for the lack of a better term, might be defined as the “ will not to learn,” which seemingly accompanies every situation in which there is a will to. learn. Unless the con sultant has the training and the experience to turn that negative factor or that resistance which arises into something that is construc tive, into a form that may become the basis upon which this newer knowledge or understanding can be predicated, then the value of that consultation will last only as long as perhaps the relationship, the personal relationship, between the consultant and worker lasts and will have little or no professional significance. Secondly, I think perhaps the function of a division of childwelfare services can be the assumption of responsibility for the more formal aspects of community organization and interpretation, in respect to meeting the needs of dependent children. Now, in saying this I do not mean to imply that what the local worker does in the way of informal community organization and interpretation is any the less valuable, but from my own experience, at least, I do believe that the work that the local person does is most effective when it is done on a case basis, that is, when the worker goes to the county official or specific organization and can challenge them with a particular situation. Now if you grant that that is the primary approach in the local unit, I think you also will grant that in some instances the activity will not be geared in a direction that will fit the total picture. 139 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 140 CONFERENCE ON STATE CHILD-WELFARE SERVICES Therefore the broader aspects o f community organization and interpretation must generate, as I see it,, from a State-wide apprecia tion o f all the problems and all the needs. And I might add that in doing this job o f interpretation the State division can possibly depersonalize the service, perhaps more than the local worker can, in order that the community may sense the professional basis upon which the program must eventually rest. The community must sense that it is really more than Miss Jones’ or Miss Black’s personality that puts this particular task across, or i f they do not, they will feel at a loss when Miss Jones or Miss Black leaves the community. I am quite convinced that only when such community interpretation is effectively engaged in by the State divi sions will social work cease eternally starting from scratch. The third function is that o f research. Now, in some manner or other we have got to get away from the conception that everybody can do social research, that it is sort of God’s universal gift to mankind. I often wonder how that idea came about, but what causes me most concern is how we are going to persuade individuals—coax them, or coerce them, or whatever is necessary—to give up that concept. Research must be done if these programs are going to meet the needs of* dependent children completely. Otherwise it will simply be a matter o f shooting in the dark. We may hit the mark, but we most likely will not. For performing social research, skill and technical training are essential if it is going to be done properly. For that reason I think— although I may be wrong about it—that it will have to be done, in the main, by the State division, because the workers in the local units do not have the training and the experience to do it, and even granting that they have, the training and the experience, they do not have the time unless a worker is particularly or specifically appointed to do that task. This does not mean that local workers will not manifest an experi mental attitude o f mind, that they will not continue to engage in a trial-and-error process in meeting the needs of dependent individuals or the requests o f the community, but these things—experimental at titude o f mind, trial and error, critical evaluations of what you are doing—are the attributes o f any professional approach. They consti tute a beginning for social research, but they are certainly not the final requirements. These three functions, the rendering of consultation in certain areas o f service to children, responsibility for the formal aspects o f com munity organization, and engaging in social research in relationship to the needs o f children, I believe might serve at this point o f develop ment as primary activities of the division of child-welfare services. They may not be the only services that a division may render. That division may have a psychologist and an expert in the field o f nutri tion, but I believe that these activities will be temporary in that they will be eventually taken over by the department o f public welfare as a whole or may be delegated to some other branch of the public administration. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—LUNCHEON SESSION 141 These three functions are things which we can do, and if we ac cept the tenets o f several o f our conference speakers that we be realis tic, accepting limitations but at the same time striving for a certain amount o f success, then perhaps we should attempt to do these things because they are seemingly within the realm o f realization. The C h a ir m a n . We will now have further discussion of the de velopment o f services for rural children by Miss Paula Frank, direc tor o f the Bureau o f Child Welfare o f the Louisiana Department of Public Welfare. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Development of Services for Rural Children By P attt.a F r a n k , Director, Bureau of Child Welfare, Louisiana Department of Public Welfare I feel just a little apologetic about having a topic which it seems to me has been practically and thoroughly covered by the speakers who preceded me. It has seemed to us out o f our experience that the basic essential in educating a community is interpretation on a case basis. In our communities a formalistic approach concerning structure or philoso phy would be utterly futile, and we have not attempted it since we have felt that our differences of terminology might in themselves act as barriers, and that the very words we used might block understand ing and raise questions in the minds of those that we wished to serve. And so we started out by placing a worker in a community and prac tically letting nature take its course. We were perhaps fortunate in having the right kind o f cases so that certain dynamics occurred in the relationship of worker to the case, which in itself gave more mo mentum to the program than we could give it. A t that point I think a definite responsibility was placed upon the State office. You cannot continue to let nature take its course or I suppose it would run away just as floods and winds do; and so it was up to us to think as skillfully and objectively and with just as much analysis as was possible with our limited understanding, and to come to some kind of evaluation o f what was happening, why it was hap pening, what we wanted from it, where it should logically and nat urally go, and where it would go in spite of us. We have tried the old method o f arriving at conclusions without calling it social research. Through our supervision we have our finger on the pulse o f the community. We lmow this is limited and does not completely meet the needs, but it does serve two purposes, one o f chan neling to our workers a certain security and a certain content which we think is one of our objectives in the State program, and then re laying back to us in the State office the actual work in the community which shows us whether our activities are in keeping with the needs in the community. The other approach is not so well developed. It attempts to make our workers themselves responsible, willingly and actively responsible, for an evaluation o f their own processes in the community, taking into consideration their relationships to the people, their oneness with the people and yet their differences; enough differences to be able to see what they are to see in their jobs, enough similarity and oneness to feel with the people in the community rather than to feel something about them. From that kind o f objective, if we can attain it, per haps there may come subjective valuations, and I think a certain amount o f subjectiveness is wholesome in that relationship. We may 142 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—LUNCHEON SESSION 143 have an idea o f our own workers’ needs, but we have not yet developed the technique in the State office to meet all those needs adequately; but we are beginning to be conscious of them and from that point we feel that we can go on toward some definite goal. The other condition which I think the workers have come to realize is that they have a responsibility for certain programs in the com munity which must remain the community’s, and that they merely act as the dynamics for leadership. They set in motion the things the community has been wanting to do but did not know how to accom plish because it never before had proper machinery available, and stimulate the use of latent resources which the community actually has for caring for its problems within its own area. When you work in a very rural area, as we do, you must face the fact that you are not going to have very high-powered scientific resources. I f we did have them, it would be only in spots here and there beyond our reach, be cause of the lack of transportation facilities and because o f their costliness. In assuming that responsibility the workers have perhaps done more for the community to make it self-conscious, not about its problems and unhappy about them, but about what it can do that it has been wanting so long to do but has never had any opportunity to do. In the whole experience o f the relief program a certain de featist attitude seems to have arisen in many communities. I f you could not solve the problem with money, then you could not do any thing about it and you were very unhappy about it. I do not believe we have called attention to anything unknown, but I think we have made communities feel that something can be done about the things that they wish they might have struggled with earlier. In that sense it has been a question of giving leadership and devotion to what was already there, and eagerness to get started on developing something that was perhaps started long ago.but was held back because of lack o f leadership. The other thing I think the workers have taken responsibility for out o f our supervision or attempt at supervision from the State office has been developing within themselves a responsibility for their own professional growth. This probably sounds very fantastic to you when you realize they are in rural areas. Because we are so remote from the workers we had to resort to whatever devices we could that would sustain their relationship to professional life without making it artificial. In some instances this has tended to produce an arti ficial area for them. We have tried to make it something very real and very vital which made them happy to go on in spite o f the disap pointing and despairing phases of their jobs. The rural child-welfare workers are sometimes hundreds o f miles from anyone who speaks their kind of language, and it has been a real strain to develop a relationship to the community and yet sustain their relationship to the professional aspect of the job in the State office. . We have done a very limited job in consultant service, because we have no specialists and we haven’t enough people to go around. In thinking of the social-research aspect of the job, it has not been an accumulation of material in the State office. It has been rather a living content which has had a constant flow back and forth from https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 144 CONFERENCE ON STATE CHILD-WELFARE SERVICES the community to the State office, with an interchange o f ideas, re valuation o f the topic as it came up some months ago and as it is today, without thinking of it in terms of statistics, so much money, so many cases o f this kind, so many problems here, and so many re ferrals there. It is what has been the content of thinking in that community, how it has expressed itself, and where we want to go from that point. Mr. C arstens . Something that Miss Frank said reminds me to say just this one word. In rural organizations I think personal develop ment comes harder than it does in city service. It is what you have made o f yourself that is the bridge over which you are going to walk into the lives o f people,, particularly in rural service. Our next con tributor to this discussion is Miss Anna Sundwall, chief o f the Divi sion o f Child-Welfare Services, Utah State Department o f Public Welfare. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Supervisory Functions of the State Child-Welfare Division By A n n a S u n d w a ix , Chief, Division of Child-Welfare Services, Utah State Department of Public Welfare I t is very helpful, I think, to be preceded by two speakers who are in such conformity with my thinking, because it relieves me o f a certain amount o f responsibility. I can say they have covered my points and let it go at that. I thought, when Mr. C t o was talkin^ “He forgot supervision of the case worker; I will make a. p° that ” A h in k I had better summarize what they said and not be calle a contributor, because they certainly have made the contribution. I do think it is necessary in developing services for rural ch dren for the State to provide an adequate system ofsupervision. Miss Lenroot, in our opening speech, set the plan for developi g fdequa?e system of supervision. It must be on a case-work approach to the needs o f the local communities. . _ By supervision I mean seeing the job is done m an effective mamier. We must see that the objectives of the plan we develop with the Children’s Bureau are realized, and I think that that is the job of the State child-welfare division. We must make some pattern or gi some direction to the local program, but we must not permit the loca nroffram to be rigid or to conform too closely to a set pattern. P ifh in k the functions of supervision have been well covered. There is first the responsibility in the State division of helping the local o-roup that is interested in developing child-welfare services to have a workable system. We cannot do a good 3ob for children unless the mechanics the system o f the set-up, is sound. Therefore, our em phasis o n ’this phase of the program has been necessary to do good ^The^State division must also do something about financial super vision We need to raise funds to support child-welfare services. It is true that the money we receive from the Children s Bureau is a ffreat help, but as we move forward with our objectives we find in creasing need for more funds. The State division can help the local worker! by seeing that their program is supported. In addition to raising funds we have the responsibility o f accounting for expendi t u r e s ^ we interpret our program we must account for the money WM r eClass expressed the importance of supervising statistical and reporting procedures. I agree with him that that is an essential func tion o f the State child-welfare division. We must collect information about our program. We must be able to tell people what we are domg not only by use o f a case-by-case method, but on a scientific basis as well. 145 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 146 CONFERENCE ON STATE CHILD-WELFARE SERVICES The fourth function is the supervision o f case-work service, which has been discussed by Miss Frank. It is very important that we help the local workers on methods and techniques o f case work. In our meeting this morning we indicated our need for some assist ance: “ How to write records,” “how to write letters,” “ how to con serve the worker’s time,” “ how to make her work more effective,” “ should she devote her time to community organization or should she limit it to service to children ?” We must see that the work done with individual cases is of a standard which is acceptable to the State division and that there is some uniformity throughout the State in standards o f care and service. In the children’s field we have established standards o f care and service for private child-caring agencies. However, we are not quite so definite in what we expect to do for children in rural areas. Miss Hoey said the other day that we have no very satisfactory measuring stick o f service. We should know each worker well, what she is doing, and what is happening to children. The State division certainly does have the responsibility o f settipg minimum standards o f care and service. In the realm o f case-work supervision lies the function o f pro viding consultation services. To me that is just one small phase o f supervision. There are the special problems, the special cases which the child-welfare workers are encountering with which they need some help. They need the wisdom o f someone who has worked longer and who knows more about a particular problem. I think the medical profession points the way in this matter: I f a general prac titioner has a puzzling case, something he is not equipped to deal with, he calls for the advice o f a specialist. The State division must make available to the local workers these specialists. The methods o f providing this service vary, o f course, from State to State. The local needs determine what specialists are needed. I think there is need for case-work consultants, but there is also need for consultants in the realm o f health, in the realm of speech pathology, and in the realm o f nutrition—I could go on and on into the many very specialized problems that the workers have found and for which they have had to turn to the State for help. In the supervision o f the case-work service lies the responsibility o f training and personnel development, which function has been mentioned. I have been very much interested in seeing what some workers in the Western States have done without close supervision. I think we have freed them from some o f the limitations o f a super visor. They have had to do their own thinking. They have had to use their own initiative in developing the program. I do not know, but I think we are fortunate in having geographical factors which prevent close supervision, this close relationship between worker and supervisor, because some o f the persons have grown tremendously on their job. From their growing we know something is happening to cases, as Dr. Plant said the other night. I think perhaps there will be some modification in our thinking about prin ciples o f supervision after a few years’ demonstration of what a worker can do in an isolated rural community. The last function which is very important in the State division is coordinating the many activities relating to children. Just the https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—LUNCHEON SESSION 147 public programs alone are pretty overwhelming. Within the crippled children’s program, maternal and child health, our workers are constantly inquiring, “Do I do this?” , “Do I do that?’\ “ Is that the nurse’s function?” We must work with them in clarifying our own responsibility. There is also the whole realm o f the private agency, which requires cooperative activity on the part o f the divi sion o f child-welfare services. The State division as well as the local unit should participate in this interchange o f information by getting to know what the other programs are all about, by defining responsibilities, by defining relationships, by seeing the program for children on a State-wide basis. I think that is the only manner by which we can fit in and decide what our program o f child-welfare services should be. Where we are needed can be determined not by taking over a function that belongs to the schools or juvenile court, not by telling them what is wrong with their programs, but only by knowing these groups and working with them. I think we have pointed out the defects in all the other child-caring systems pretty well. We need to recognize the strengths o f those programs and coordinate them so that the needs o f children can be realized and new services for children can be devloped. Mr. C ar sten s . We are very glad to have Miss Grace Reeder to speak to us. Miss Reeder is director of the Bureau of Child Welfare o f the New York State Department o f Social W elfare.. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis Relating the Special Child-Welfare Services to the Regular State Child-Welfare Program By G race A. R eeder, Director, Bureau of Child Welfare, New York State Department of Social Welfare After three able discussants^ you see the only thing left for the fourth discussant is to take issue with something that has been said, and I cannot help commenting on what the last speaker said. I am perfectly willing to let a worker go without supervision if she has a pretty good start in the first place, but in New York State we have seen the results o f some o f these untrained workers in counties where they have had no supervision and no training to start with, and they were very near disastrous. New York State is one o f the old States in child welfare, as in a good, many other things, and we have had for a good many years a provision in our State constitution requiring that all charitable and eleemosynary institutions and agencies must be conducted pursuant fhe rules o f the State Board o f Social Welfare to receive any public funds; and as our whole child-welfare system in New York State is pretty much built on the per capita payments for children to private agencies you can see that that is an important weapon. Besides that we have a legal provision that the State Department ° f Social Welfare has the right to inspect all places that care for children. That resulted early in an active division o f child welfare within the State department, and last year when we combined the work o f the State Department o f Social Welfare with the Temporary Emergency Relief Administration, and had such a large volume of work to do with public assistance and child welfare, we decided to district the State, divide it into seven areas—New York City as one and six other areas—and distribute all o f our work, and have the workers in child welfare as well as other fields in those area offices. We felt that would help in supervising the work in local districts. We were fortunate in the early days o f the 1900’s, thanks to Miss Curry and the State Charities Aid, in the development in New York State o f county units, county agencies for dependent children. They were developed first by the State Charities Aid, and many counties followed suit. You know the kind o f public official who says that no private agency is going to tell him how to do his job and who at the same time is glad to imitate the kind o f child-welfare agency that was set up in other counties that were willing to take the help o f the State Charities Aid. By the time we were ready for the special child-welfare services under the Social Security Act all but four counties had children’s workers. I can hear you saying that this is a very rosy picture, but my answer is that you should see some o f the children’s workers. Be cause you happen to have children’s workers in a rural county you 148 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—LUNCHEON SESSION 149 may not be particularly fortunate, as we found out. There were some o f these that had been without supervision. It was not only that; they had not had training to start with. As we talked over the program with the Children’s Bureau we realized that the thing New York State needed more than anything else was improvement in the quality o f children’s work, not m the quantity, and so we decided to work on that basis. We put a trainmg unit in our child-welfare services. The problem now was to plan a training program and a supervision program that would work together and that would take into account the needs o f an individual county, the way you would the needs o f an individual child. We made surveys o f every county in the State. Then we reviewed the county situation and the quality or tne work in each county with the area office in which the county was situated, which was responsible for the supervision o f that county. We had a case committee that decided what the county needed -whether it needed a special training program (and when I say training I mean case-work training on the job ), whether the county worker needed some very close supervision from the central office, or just what tne C°-Jyey decided that one county needed to have the child-welfare worker go to the New York School of Social Work, and we have been able to put in a substitute worker in that county. In the mean time this county decided that it did not want to give the substitute worker up when its regular worker came back, so an extra worker was put in the budget. We have tried to look at each county, all the coun ties, as we would a case load, and each county individually as we would an individual child, and it seems to me that in a State like New York we need to see that there are not any forgotten counties, that we have each one definitely in our mind as a county that we are going to try to work with to improve the quality o f work. To help us in improving quality, besides the child-welfare-services program, we had a law passed last year which ^provided that the State would reimburse the counties for the salaries of local person nel doing work with the county commissioner o f public welfare to the extent o f 40 percent, provided the workers had the qualifications set up by the State Department o f Social Welfare. I can hear you saying, “ Well, now that looks pretty good too,” but that is not quite as good as it sounds, because we have a good many civil-service counties in the State, where the child-welfare workers have civilservice status; also we have counties where the workers have been tor a good many years and the counties are satisfied with them. They think the workers are very good. We cannot walk mto a county like that and say that the work is no good and we will not reimburse the community for her salary. . In some o f those communities we have said, W e will reimburse for that salary if the person will take training from our childwelfare-services unit.” When the instructor first went mto some of the counties the local worker seemed^ to feel that this was ]ust a bitter pill she was having to swallow in order to have her salary reimbursed by the State, but it has worked out well in several counties. We did set the date o f November 1, after which time the standards we set up were going to be required for reimbursement. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 150 CONFERENCE ON STATE CHILD-WELFARE SERVICES •^ feeling that unless in this program we integrate spe cial child-welfare-services work very closely with the “ rgular” work o± the State department, we are not going to have permanent results rom it. ^We want to integrate it so that if the Federal Government stopsgivmg us funds New York State will not know where the State department begins and the work with Federal funds leaves off. The State legislators will feel that it is all part o f the same thing, and tliey will feel they have to go on with it because it is their program. I was a little bit envious yesterday when I talked with one o f the State representatives who said her State was just starting its childweltare work on a county basis, because I thought, “ Oh, well, she has not any o f these old workers to worry about and inherit, and she has not any o f this feeling that we must have a worker from the county one with county residence.” Incidentally, may I say that some of our counties have been very well brought up by Miss Curry, and they do not^ feel that they have to have someone who has a residence right in their county, but we still have some of that to overcome. I was feelmg envious o f this State, and then I began to think that we have some counties that have an awfully good record of work, and we have our work cut out for us to bring our other counties up to that standard. So I feel that Dr. Plant’s story the other night seems to fit in here that we are all going to have different hats on in this child-welfareservices business. There are going to be special decorations on them in the different States, but they are all going to be built on the same pattern o f interest and concern for the child and his family. Mr. C arstens . And now there remains only this blessing, and I am very glad to turn the meeting back to Miss Atkinson. Miss A t k in s o n . I should like to say just a word about Utah before I say my last word. I should not want anyone to get the wrong im pression about the kind o f job Miss Sundwall is doing out in Utah. I think wh.6n shs t&lks «ifooiit th.6 development o f workers h&ving been stimulated by lack of supervision she is talking about that very con structive process which someone has referred to as supervised neglect. I think one o f the results of this conference o f the people from all over the country who are carrying on this program, and our reason for planning such a meeting, is expressed in the following paragraph from the address which President Koosevelt gave last fall when lie visited Bonneville Dam. He said. The responsibility o f the Federal Government for the welfare o f its citizens will not come from the top in the form of un planned, hit-or-miss appropriations o f money, but will progress to the National Capital from the ground up, from the communities and counties and States which lie within each o f the logical geographical cirGiis# This conference probably should not be adjourned without a word o f warning There is not any question but that for 3 days we have all been thmkmg very well o f ourselves. In view o f the struggles and difficulties that most o f us have gone through in order to get this program going, it is fitting that we have waxed somewhat expansive dunng the meetings. But I think it would be very unfortunate if we left Washington in such a glow that we went back to our respective communities and acted a little bit superior. We should recognize that some o f the dangers in the program and some o f the things that https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis APRIL 6—LUNCHEON SESSION 151 we have to learn are analogous to some o f the dangers in adolescence and the things we have to learn as we grow up. Child-welfare serv ices are in the process of growing up. Some o f us who have been in the field much longer than many of you perhaps realize more clearly just what that means and what is involved. We realize also that we have been in a very advantageous position in the administration of title Y, part 3, o f the Social Security Act. . . Ordinarily we do not think o f a limited amount of money as giving persons or groups a superior advantage, but I think in this program we have been fortunate thus far in the small amount o f money that we have had. Because the sums available have been so insignificant we have escaped some of the pressures that go hand in hand with large appropriations for public work, and we have been able to do some things that might have been impossible if we had had more money with which to initiate child-welfare services. The fact that we have been in an advantageous position places upon us a very great obligation. We know that we cannot go forward with any kind o f public-welfare program except as we go forward together. It may be that we are, once more, acting on the theory that the world moves forward on the feet of little children-—and that we are trying to push forward the whole program of public welfare through services to children. Be that as it may, it is important as we go home to remember our obligation to the whole welfare program and to see it not from the standpoint of one little segment but from the standpoint o f the entire circle which encompasses all types of public service to citizens in need and distress. We started this conference on Monday morning with the statement that we were going to limit the discussions, insofar as we could, to a consideration o f the content o f child-welfare services. We know that we can have no content without mechanism, and in these past 2 years the spotlight has necessarily been on legislation and administrative procedures. We hoped that we now had the kind of mechanism through which services to children would flow and that we could begin to think more in terms of what the program means in terms of the treatment o f individual children and families. It seems to me that these 3 days have indicated interest in content and progress in getting beyond the initial emphasis upon administration. I know of nothing more appropriate for the last word o f this con ference than a paragraph from a recent issue o f the Birmingham News: _ “ The whole truth is simple and plain, it seems to us. It is that we all, all the children of the earth, are lost together for the time being, but still searching, and that if we find a good and secure way of life, we will find it together.” https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis List of Representatives of State Welfare Departments Attending the Conference Adie, David C., commissioner, New York State Department of Social Welfare. Affleck, Mrs. Doris M., case supervisor, Delaware State Board of Charities. Allen, Theodora, director, Children’s Bureau, Public Welfare Board of North Dakota. Alloway, Joseph E., executive director, Board of Children’s Guardians, New Jersey Department o f Institutions and Agencies. Alper, Minnie, supervisor o f child-welfare services, Division of Child Welfare, State Social Security Commission of Missouri. Arnold, Mildred, director, Children’s Division, Indiana State Department of Public Welfare. Auer, Katharine, case worker, Michigan Children’s Institute, State Welfare Department. Baker, Mrs. Mary, assistant commissioner, Mississippi State Department of Public Welfare. Bartlett, Ruth M., supervisor o f child-welfare services, Division of Child Welfare, Illinois Department of Public Welfare. Baughman, Wilhelmina, supervisor of local child-welfare services, Virginia Department of Public Welfare. Becker, Harry, director, Child Welfare Division, Nebraska Department of Assist ance and Child Welfare. Berry, Mrs. Laura, county supervisor, Division of Child Welfare, Kentucky Department of Welfare. Billopp, Katharine R., case supervisor, Division Child Welfare. Board of Public Welfare, District of Columbia. Boan, Fern, director o f training, child-welfare services, Oklahoma Department of Public Welfare. Bonham, Martha A., director, Child Welfare Division, South Carolina State Department of Public Welfare. Bost, Mrs. W. T „ commissioner, North Carolina State Board of Charities and Public Welfare. Bosworth, Mrs. Abigail, case worker, Michigan Children’s Institute, State Welfare Department. Bowen, Ruth, deputy director, Michigan State Welfare Department. Bridge, Mrs. Ann Botsford, social-work consultant, child welfare, Social Work Department, Maryland Board of State Aid and Charities. Buckley, Mrs. Mary, supervisor of child-welfare services, Bureau of Child Welfare, Connecticut State Public Welfare Council. Butterfield, Dr. D. L., chief, Children’s Bureau, West Virginia State Department of Public Assistance. Carey, Cecilia, director, child-welfare services, Nevada State Welfare De partment. Carr, Louise K., technical consultant, child-welfare services, Department of Child Welfare, Florida State Welfare Board. Chambers, Flonnia, district consultant, Division of Child Welfare, Kentucky Department of Welfare. Class, Norris E., supervisor, child-welfare services, State Relief Committee of Oregon. Chappell, Loretto, supervisor, child-welfare services, Division of Child Welfare, Georgia -State Department of Public Welfare. Closson, Eleanor, case supervisor, Division of Child Welfare, Board of Public Welfare, District of Columbia. Coates, Elizabeth, welfare-training assistant, child-welfare services, Bureau of Child Welfare, New York State Department o f Social Welfare. Cook, Gladys, case worker, Michigan Children’s Institute, State Welfare De partment. 152 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis LIST OF REPRESENTATIVES I53 Cooper, Elizabeth, supervisor of child-welfare services, Michigan Children’s Institute, State Welfare Department. Coon, Helen F., social-service worker, Child Welfare Demonstration Unit, Board of Public Welfare, District of Columbia. Cotton, Mrs. Dorothy W., case supervisor, Division of Child Welfare, Board of Public Welfare, District of Columbia. Cuddy, Louise, child-welfare supervisor, Idaho Department of Public Assistance. Dale, Timothy C., commissioner, Vermont Department of Public Welfare. Deets, Mrs. Ruth, director, Division of Child Welfare, South Dakota Department of Social Security. Denton, Virginia, assistant director for child-welfare services, Division of Child Welfare, North Carolina State Board o f Charities and Public Welfare. Dester, Laura, supervisor of child-welfare services, Oklahoma Department of Public Welfare. Dew, Mrs. Eleanor A. R., consultant, Child Welfare Division, South Carolina State Department of Public Welfare. Donahue, A. Madorah, director, Child Welfare Demonstration Unit, Board of Public Welfare, District of Columbia. Drayer, Dr. C. S., director and psychiatrist, Tri-County Child Guidance Center, Harrisburg, Pennsylvania. Dudley, Virginia, social worker, Demonstration Area, Bridgton, Maine. Dunn, Loula, commissioner, Alabama Department of Public Welfare. Ehman, Evelyn, psychologist, Division of Child Welfare, Illinois Department of Public Welfare. Faatz, Anita J., director, Social Work Department, Maryland Board of State Aid and Charities. FitzSimons, Ruth, assistant director, Washington Department of Social Security. Fortune, Gertrude, superintendent, Bureau of Charities, Division of Public Assistance, Ohio Department of Public Welfare. Foss, Lillian F., supervisor of child-welfare district service, Massachusetts Department of Public Welfare. Frank, Paula, director, Bureau of Child Welfare, Louisiana Department of Public Welfare. Garnett, A. W., director, West Virginia State Department of Public Assistance. Golway, Everett A., social-service worker, Child Welfare Demonstration Unit, Board of Public Welfare, District of Columbia. Gordon, Mildred, case supervisor, Division of Social Security, Rhode Island State Department of Public Welfare. Goudy, Elmer R., administrator, State Relief Committee of Oregon. Greenhill, Mrs. Violet S., chief, Division of Child Welfare, Texas State Board o f Control. Gresham, Mrs. Judith Hall, director, Bureau of Child Welfare, Alabama Depart ment of Public Welfare. Griffin, Louise, supervisor of child-welfare services, Children’s Division, Indiana State Department of Public Welfare. Gullixson, Elvira, case consultant, Children’s Bureau, Minnesota State Board of Control. Haines, Alice R., supervisor o f child-welfare services, Department o f Child Welfare, Florida State Welfare Board. Hankins, Mildred, district supervisor, Bureau o f Social Welfare, Maine Depart ment of Health and Welfare. Haynie, Gussie, commissioner, Arkansas Department o f Public Welfare. Hewins, Katherine P., director o f case-work services, Vermont State Department of Public Welfare. Houghton, Grace M., supervisor o f field service, Bureau of Child Welfare, Con necticut State Public Welfare Council. Hubbell, Helen C., supervisor of rural extension unit, Division of Community Work, Pennsylvania Department of Welfare. James, Arthur W., commissioner, Virginia Department o f Public Welfare. Johnson, Jean, supervisor o f child-welfare services, Children’s Bureau, Minne sota State Board of Control. Johnson, Milton G., child-welfare consultant, Division of Child Welfare, Social Security Commission of Missouri. Kelly, Rose Marie, supervisor of special demonstration units, Child Welfare Division, South Carolina State Department of Public Welfare. 78986°—38----- 11 https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis 154 CONFERENCE ON STATE CHILD-WELFARE SERVICES Leeper, Charlotte, case-work supervisor, Division of Welfare, New Hampshire State Board of Welfare and Relief. Lockard, Winifred, county children’s worker, Burnett County, Wisconsin. MacDonald, Norman W., director, Bureau of Social Welfare, Maine Department of Health and Welfare. Marks, Mrs. Mabel B., director, Division of Child Welfare, Kentucky Department of Welfare. McGonagle, Mrs. Ellen, district supervisor, child-welfare services, Children’s Bureau, Virginia Department o f Public Welfare. Mitchell, Lily É., director, Division of Child Welfare, North Carolina State Board of Charities and Public Welfare. Muhlbach, Lillian, acting supervisor, Division of Child Welfare, Children’s Bureau, West Virginia State Department of Public Assistance. Muller, Beth, director of child welfare, Arkansas Department of Public Welfare. Nygard, J. Wallace, acting director, Division of Institutions, North Carolina State Board of Charities and Public Welfare. O’Kelly, Mrs. Phyllis, child-welfare assistant, Anson County, North Carolina. Page, Harry O., director, Division o f Welfare, New Hampshire State Board of Welfare and Relief. Parrott, Lena, consultant, child-welfare services, Bureau of Social Welfare, Maine Department o f Health and Welfare. Perkins, Juanita V., supervisor of child-welfare unit and training center, Jeffer son County, Colorado. Pyles, Mary Lois, director, Division o f Child Welfare, State Social Security Commission of Missouri. Ramsay, C. F., superintendent, Michigan Children’s Institute, State Welfare Department. Rankin, Mrs. Norma, director of child-welfare services, Division of Child Wel fare, Texas State Board of Control. Reeder, Grace A., director, Bureau of Child Welfare, New York State Depart ment of Social Welfare. Reinhold, Rosemary, chief, Division o f Community Work, Pennsylvania Depart ment of Welfare. Richardson, Helen, supervisor o f child-welfare services, Bureau of Charities, Division of Public Assistance, Ohio Department of Public Welfare. Roberts, Mrs. Mary Edwards, director, Child Welfare Division, Tennessee Department of Institutions and Public Welfare. Smith, Marie C., director, Child Welfáre Division, Colorado Department of Public Welfare. Smith, Robert J., deputy commissioner of welfare, Connecticut. Smith, Vallie, supervisor of child-welfare services, Child Welfare Division, Tennessee Department of Institutions and Public Welfare. Stalnaker, Mrs. Frances F., child-welfare consultant, Division of Child Welfare, Children’s Bureau, West Virginia State Department of Public Assistance. Steele, Frances, director, Division of Child Welfare, Georgia State Department of Public Welfare. Stephens, Anne, supervisor, Division o f Relief, New Hampshire State Board of Welfare and Relief. Stoddard, Effie, homeflnder, Crippled Children’s Division, South Carolina State Department of Public Welfare. Stokes, Lavinia, consultant, Child Welfare Division, South Carolina State Department of Public Welfare. Street, Elwood, director, Board of Public Welfare, District of Columbia. Sundwall, Anna, chief, Division o f Child Welfare, Utah State Department of Public Welfare. Swift, Mrs. Helen C., supervisor, Division for Children, Washington Department of Social Security. Sycle, Margaret, field worker, Children’s Bureau, Virginia Department of Public Welfare. Taft, Laura L., director o f child-welfare services, Division of Child Welfare, Iowa State Board of Social Welfare. Thompson, Mrs. Elizabeth, supervisor of aid to dependent children, Tennessee Department of Institutions and Public Welfare. Thornhill, Dora Page, child-welfare consultant, Division of Child Welfare, Children’s Bureau, West Virginia State Department of Public Assistance. https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis LIST OF REPRESENTATIVES V • 155 Trout, Bessie, welfare-training assistant, Child Welfare Services, Bureau of Child Welfare, New York State Department of Social Welfare. Tryon, Anne, Children’s Bureau, West Virginia State Department of Public . Assistance. Tynes, Harriet L., director of child-welfare services, Children’s Bureau, Virginia Department of Public Welfare. Underhill, Bertha S., child-welfare agent, Division of Child Welfare, California Department of Social Welfare. Walcott, F. C., commissioner of welfare, Connecticut. Walton, Frank T., superintendent, Division of Child Welfare, Iowa State Board of Social Welfare. Webb, Frank, secretary, Public Welfare Board o f North Dakota. Webster, Josephine, director of child-welfare services, Bureau o f Child Welfare, New York State Department of Social Welfare. Willson, E. A., executive director, Public Welfare Board of North Dakota. Withers, Elizabeth, consultant, Child Welfare Division, South Carolina State Department of Public Welfare. Wretling, Alma, secretary, Division of Child Welfare, Montana Department of Public Welfare. Yerxa, Elizabeth, director, Juvenile Department, Wisconsin State Board of Control. Zane, C. Rollin, executive director, Delaware State Board o f Charities. Zewadski, Mrs. Irene Dayton, director, Department o f Child Welfare, Florida State Welfare Board. o https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis https://fraser.stlouisfed.org Federal Reserve Bank of St. Louis
@FedFRASER