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Imagine the case of a vocational adviser who has entered the service of the Federal board with a desire to do everything in his power to help disabled soldiers. Conceive that he has been working hard on a particular case, that after careful study he has worked out a plan which he is sure will be successful. He has aroused the soldier's ambitious and brought him into the right frame of mind to undertake a course of training.
But the adviser has no authority to do a thing. He makes a recommendation, which goes to Washington and does not return for some time. Meanwhile his enthused soldier friend drops in to see when he can start. The adviser is embarrassed that he can not tell him. Finally the recommendation is returned disallowed, with a notation by some one who has never seen the soldier giving . a reason which the adviser knows is silly.
We can imagine what a damper will be put on the enthusiasm of the soldier and the spirit of his friend and adviser. With what energy can we picture the adviser following up and putting through the alternative course of training? And as the character aspect is so much more vital than the technical we can conceive it better that the two individuals were left to work out the plan they created and for which they were responsible.
If local representatives were given authority to act, it is clear they should report their action in every case to the Washington office for record, for criticism, for possible review. But meantime something would be under way. And if the central office was snowed under and become months late in review of the cases no grievous injury would be done the disabled soldiers. · With delegation of authority should go grant of funds. Each local office should aave a fund to meet immediate requirements, making expenditures (governed, of course, by the regulations) obtaining vouchers, and forwarding these to Washington with a complete accounting, so that the local fund could be reimbursed.
Such district organization makes it necessary for the director to train and imbue with correct principles for the work the 14 regional chiefs alone. These men would each deal with their representatives in the cities within their distriets. These latter would break in their assistants, and so on likewise down the line.
Consider the organization of Red Cross home service, which must be considered one of the greatest achievements of the American people during the war. Literally hundreds of thousands of cases of American soldiers and their families were handled with dispatch, wisdom, and satisfaction. Yet never a single case was decided in Washington. The central office determined the principles of the work, laid down restrictions, audited accounts. Had the cases been referred to Washington, there is no building large enough to house the force of clerks that would have been required.
When the soldier's relative came for assistance the case was studied, the decision reached, and action taken the same day. Mistakes? Possibly some. But there certainly was service prompt enough to be of some use. And it was not hit or miss. The worker making the decision had been trained by instructors from headquarters; he or she was constantly guided by advice or rulings from the same source.
When a home-service worker was crowded with work, two assistants were broken in. Later, these assistants trained others. With such a system a thouSand cases or a million cases could be cared for with equal ease. And the Washington headquarters were never unduly rushed. The officials there always had time to consider the larger aspects of the work and to strive for further improvement.
3. The most vital factor of all is the caliber of personnel. In this any Government bureau is hampered by limitation of salary scale and civil service formalities. But as we look back to the beginning of the Federal Board's work we recall the generosity with which service and facilities were offered it in the interest of the disabled soldier. The best men in the country would have given a share of their time to serve on boards or committees. Many would have given full-time service either at Washington or in the cities where they lived. No such willingness was availed of. So instead of having the “biggest men in the communities throughout the country identified with its work the board was limited to men whom it could hire for salaries ranging from $2,000 to $4,000.
in only one instance was any volunteer advice or assistance accepted, namely, in the appointment at the suggestion of the National Tuberculosis Association. of an advisory committee on tuberculosis cases. This committee worked faithfully but the Federal Board paid very little attention to its recommendations.
Volunteer work used to be regarded with disfavor but during the war it was demonstrated that it could be made efficient. In the best organizations volunteer workers were “ hired " and discharged" on the same basis as paid employees. There was no subject in which'such intense interest was demonstrated as the future of the disabled soldier, and the Federal Board could have built up a splendid corps.
Leaving the consideration of volunteer service out of the question, however, there are two ways in which men may be employed. The one is to get a good man, give him his instructions, and then give him a free hand to do his work. Every good executive follows this method, checking the results very carefully, of course, and discharging the man if he fails, but not annoying him constantly with petty interference. The remuneration to a good man under such circumstances is part in salary, but part in the creative satisfaction which he takes in his work. The second way is to use a man as a clerk and give him no authority and no responsibility. No really worth while man will keep such a job at any salary, and those who can be obtained are such as work for salary alone, Yet it is the second policy which was adopted by the Federal Board and a number of competent men have resigned by reason of it. Members of a rehabilitation staff should be selected from varied lines. Particularly should those with experience in social work-which is only another name for character and personal problem work—be sought. The Federal Board has restricted its recruiting too largely to teachers.
Another requirement is that district representatives be themselves residents of and familiar with the territories they are to cover. The average New Yorker, would, for example, feel lost in the Northwest, and a Yankee is certainly not the one to send to New Orleans to deal there with both whites and negroes. The local stafis can best be locally recruited.
The failure to use women in the contact work with soldiers was a great mistake. Leaving out of consideration the principle involved, it is a fact that for a given salary there can be employed a higher type of woman than man. And women are peculiarly apt for a human job of this kind.
Inasmuch as the task of the Federal board is to meet a character problem much more than a vocational problem, the question of personnel is of the most vital importance.
4. The next consideration is method of work. The most important factor is that the attitude toward the disabled soldier should be active rather than passive. Representatives of the board should seek out soldiers and an adviser should act in the capacity of attorney for an individual man to see that he gets the benefits that Congress intended him to have. Instead of taking the attitude of an insurance examiner who puts the burden of proof on the claimant there should rather be the spirit of the family lawyer who seeks diligently for the missing nephew in order to convey to him the estate bequeathed to him by an uncle.
The work should all be done through personal contact. Letter writing is beyond many men who could very clearly tell their story verbally. And as half the job conferred upon the Federal board was selling the proposition of rehabilitation, contact work in the field should have been regarded as a primary essential. The up-to-date business house knows its prospective customers can be landed more surely by the personal call of a salesman than by mailing of printed matter. If the disabled soldier does not answer a notice he should be called on at his home, followed up if his address was changed, and brought into the fold.
5. The next question concerns the place and manner of training, the principal difference of opinion being as to whether the disabled soldier should be sent to some regular trade school or to a special school for disabled men in general or for disabled soldiers. All the experience of our allies pointed to the necessity for special schools. The difficulties of depending upon existing educational facilities were: (a) There are practically no trade schools for full-grown men; (1) an adult feels embarrassed attending an industrial school or business college with young boys and girls; (c) the teachers in regular schools are not familiar with the special educational difficulties involved with cases of physical handicap; (d) what the teachers do learn from mistakes and experience is not cumulative for the benefit of other disabled men, because the soldier pupils are too scattered; and (e) in a standard institution doing its regular work the individual attention and constant mental bolstering and encouragement that an injured man requires can not be provided. In a special school the subjects of
instruction, the staff, the methods, the hours, and régime are all planned for the special type of pupil.
Although Canada, Great Britain, France, Belgium, and Italy had all found special schools for disabled soldiers to be necessary to successful work, the Federal board, in its wisdom, determined upon a course diametrically opposite.
6. Mechanism of rehabilitation calls next for consideration; so far as the soldier is concerned this comprises three stages: (a) Field work by sleuths' who run down the disabled men to put them in touch with their opportunities ; (b) personal advice regarding plans for the future, choice of training, etc., and (c) follow up during and after the course of training to see if the plan is working out as expected, to smooth over difficulties, and so far as possible to assure ultimate success in the return to civilian life.
Promptness of action is of particular importance. A man can very quickly drift into habits of idleness or become discouraged and enter a blind-alley occupation. At the beginning of rehabilitation work in the country, the point most emphasized by advisors from abroad was that there should not be a week's delay in starting the disabled soldier on his way. Of course, the only way to attain speed is to decentralize authority, putting it in the hands of high-grade men.
7. Yet overdoing the matter is to be avoided. The indiscriminate award of long courses where they are not required, the loose distribution of Government money in maintenance allowances, may be prejudicial to the real interests of the disabled men. It is a great mistake, for example, to have men take easy courses a couple of years in length, for they become lazy and get into the habit of depending on the Government for their support. In Canada, for example, they have taken great pains to prevent pauperization of the men.
When the Federal board has come under fire, its reaction has been to put cases through by the hundreds and to grant courses by the wholesale. What the disabled soldiers needed instead was more personal attention. If highgrade effort were put on every case, the solution in many instances would be found without necessity for a long and expensive training course.
8. An essential in any successful system of rehabilitation is a strong and effective program of public education relative to the real needs of the disabled soldier, the right attitude toward him on the part of the public, the employer, his family, etc. With the generous cooperation offered by the newspapers, the magazine press, the moving-picture producers, etc., a splendid campaign would have been possible. But the Federal board has accomplished almost nothing in this line.
This memorandum has endeavored to set forth some of the features of a rehabilitation system which are of positive importance. What has been the success in other countries with the same work?
It is true that all the countries have encountered difficulties, but many of them were due to the necessity for sailing an uncharted sea, with no previous experience to observe and follow. There is space for consideration of but one system, and that from the aspect of the disabled soldier.
The injured British soldier is discharged from military hospital and goes at once to his own home. Before he gets his discharge he receives a card advising him to call on the local war pensions committee in his own town; that this body will look out for his needs. When he gets home he goes to the office of the committee on a Tuesday, let us say, and meets the executive secretary, a paid officer placed in the job by the national pensions ministry. He is asked to come back Wednesday afternoon when the members of the committee will be meeting so that he can talk over with them his own situation. Meantime he may be asked to see the medical advisor of the committee so that there shall be ready a report on his physical condition.
The committee is made up of some of the most useful members of the community, serving without pay. It comprises possibly a couple of manufacturers, one educator, a minister, a labor representative, and surely a few women. The soldier talks over his case with the committee or with a delegated number of members. These members know the community, the industrial possibilities, the employers in the various lines. Doubtless one or more of them knows the soldier or his family. So they advise him and, at once, if possible, determine upon the plan he is to pursue. Flis degree of disability under the regulations given them is decided, and the executive secretary is in a position that day to start paying him a pension. They award what is called an “interim pension, which is reported to London, and which is subject to revision if headquarters objects. But meanwhile the man is not left penniless.
If training is determined upon as wise, the soldier can start the next day and, again, the local officer can start paying his tuition and the maintenance allowance for himself and dependents. The course decided upon, its lengtn, and probable cost is reported to Londoil, and, of course, the choice is guiden by certain regulations issued to the local committees from time to time. As with the pension, London may, but seldom does, cut down the length of the course. But meantime the man has made a start.
Individual members of the committee make themselves responsible for keeping in touch with a certain number of the soldiers, visiting their families, etc. This provides follow up of the best type.
The payments mentioned are made from an “imprest" fund, reimbursed from London as expenditure vouchers are sent in.
In large cities there are subcommittees covering different sections of the community.
It is all very simple and direct ; and though the working is not perfect, at least the soldier gets action, and is not put off, put off again, and finally disheartened.
The point again to be emphasized in conclusion is that the problem of dealing with disabled soldiers is a human problem. It involves the establishment of confidence between two individuals, and the acquaintance with record, personality, and temperament upon which can be based helpful advice for the future. The data of human problems can never be standardized or reduced to forms to be read over and judged by distant officials. Some person must make a decision, and that person must be the one in actual touch with the soldier himself.
Supplementing this statement I have a few remarks to make. In the first place I would suggest, Mr. Chairman, if it is in order, the names of several additional witnesses who could give you information.
The CHAIRMAN. Can you give the names to the stenographer?
Mrs. Magee, department of civilian relief, Pennsylvania division, American Red Cross, Philadelphia, Pa.
Dr. James Bordley, 810 Cathedral Street, Baltimore, Md.
Mr. Howard R. Hevdon, secretary of the New Jersey State Chamber of Commerce, Clinton Building, Newark, N. J.
Dr. John Culbert Faries, 101 East Twenty-third Street, New York City.
Nr. Henry Braxton, 609 West One hundred and twenty-seventh Street, New York City.
Mr. Dunlevy Milbank, 42 Wall Street, New York City.
Mr. McMURTRIE. The other suggestion concerns the development of further data and sound judgment on the work that has been actually accomplished by the Federal board, and it will give you some idea of a constructive plan for the improvement for future development. It seems to me and has doubtless occurred to you that it is very difficult to bring out any true facts regarding the situation such as now exist in a congressional hearing of the usual type. For example, much of the best and most reliable information regarding the workings of the Federal board can be gotten from its own employees, and it is hardly within reason that these employees should appear before your committee to make complaints. They might be, however, approached by somebody who is in a position to talk to them confidentially and give a great deal of most valuable information. The same thing has been true regarding the value of the Red Cross Home Service. They did lots, in my judgment, in the workings of the Federal board, and know of hardships in individual cases, but their mouths are sealed with their official connection with some official agency in their relation to particular duties, and could give information, but they are the only body of people in the United States who can tell you surely and most expertly about the situation.
The CHAIRMAN. Suppose they are subpænaed, would they not answer your questions?
Mr. McMURTRIE. I think, perhaps, they would if it were pointed out to them that you were speaking from higher authority than the board and your interest was in doing the best thing for disabled soldiers. It was my original idea and the idea of a number of people who would not appear in Washington and put themselves on record but could be easily obtained by a commission of three absolutely unbiased persons who had some expertness in this work, and it might be possible for them to look into the questions and report to you upon their findings. That would give you an expert report that I think would be extremely helpful and I can not think myself of any other means of really sympathetically eliciting the true situation and finding out, unless some people can be selected on a more or less confidential basis in that way.
The CHAIRMAN. We would be glad to have the names of any persons that have information that would be of value to the committee. I could not say that this information would be gotten through confidential sources.
Mr. McMURTRIE. I see. I might submit now the names of such persons as I think can.
Mr. TOWNER. Let me further state that the difficulty in obtaining information through a committee, volunteer or otherwise, is that that testimony is mere hearsay to base judgment on, as the action of the committee, if it was in part even made upon hearsay testimony it would discredit the action of the committee, and it would make its report a point of attack by those who would say they were influenced by hearsay testimony. It is very unfortunate that that condition exists, and I think you appreciate the condition does exist.
Mr. McMURTRIE. Yes.
Mr. TowNER. Mr. McMurtrie, you gave us a statement regarding the method of getting directly into personal touch with the soldier that was adopted in Great Britain which absolutely legalizes the work of rehabilitation in so far as its inception.
presume that would be, at least, I would like to have jour judgment as to whether that would be possible in the United States, considering the vast number of our cities and towns and the widespread extent of our territory and the distribution of our population over such territory.
Mr. McMURTRIE. Yes; at any rate, I think it would be practicable. The population of Great Britain is a little less than the population of the United States. It would mean we would have to have more committees, and, geographically, ours would be larger. I mean to say this, and it is interesting to Mr. Lamkin, to distribute into about 40 subcommittees, with 20 or 30 branches. It is intimately connected with the character of the work, and the population there would come into very first-hand contact with the men.
Mr. TOWNER. Of course, I can very well understand the desirability of it, but I understood you to give your approval to the division