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then treating wards of the District free. They thought they would always have to do it because we were not able to do it.

Dr. FAZEKAS. They never encouraged us in that.


Mr. STOCKMAN. A little while ago you explained how this was going to pay for itself. Like Mr. Furcolo, I did not get the point. Would you mind going through that again?

Dr. FAZEKAS. We estimate that we will be able to take care of 60,000 to 75,000 people at $1.50 a visit. Sixty times $1.50 is $90,000. That $90,000 will be the amount that the District is going to have to pay to provide care for these indigent patients. The cost for a 9-months' period is approximately $70,000.

Let us say that we take care of 70,000 patients. Two times $70,000 is $140,000.

Mr. STOCKMAN. What figure are you going to use?

Dr. FAZEKAS. Sixty thousand or 75,000. Sixty thousand would be $120,000; $70,000 from $120,000 is $50,000, the amount which we would be able to save by providing out-patient care at Gallinger Hospital.

Mr. YATES. What is your cost per indigent patient compared with those at the private hospitals?

Dr. Fazekas. $1.50 as compared to $2.


Mr. STOCKMAN. How important do you rate this project over what the hospital is doing for the people? How important would this department be over existing departments that you have now?

Dr. FAZEKAS. I think out-patient care is much more important than in-patient care. When a patient gets into the hospital he is really in the last stages of his disease. He gets into the hospital because there is nobody taking care of him on the outside. Here again, you are practicing preventive medicine, you are keeping that patient from the hospital just as long as you can.

Mr. STOCKMAN. Then you would say that this proposed new department-and that is what it is, is it not?


Mr. STOCKMAN. Would be more important than any other one feature you are offering to the public today?

Dr. FAZEKAS. Yes, sir. The out-patient department is one of the most important departments in the whole hospital set-up, and we do not have one.

Mr. STOCKMAN. On that basis just suppose that the committee felt that the over-all budget of the hospital is higher than it should be on the basis of today's income, then what department would you say could be dropped that is of lesser importance, to put in this most important department?

Dr. FAZEKAS. Gallinger has never had a budget that has been adequate as far as I know. There certainly is no department that could be dropped. In fact, there are departments that still must be built up in order for it to be a first-rate hospital. For example, we have to

have a rehabilitation service. We cannot begin to think of dropping a department. We have to build up a good hospital at Gallinger Hospital, a well integrated hospital.

Mr. STOCKMAN. You still have not answered my question. I asked, if we did not think that we could furnish you any more money, would there be any one department that you would suggest that could be dropped if this is more important than anything you are doing now?

Dr. FAZEKAS. I feel, as I stated before, that the hospital still needs a great deal of improvement so that I could not drop anything in the hospital. What could I drop? I could not drop the X-ray service. I could not drop the laboratory. I could not drop the surgical division. I could not drop the medical division. I could not drop the rehabilitation service because we do not have one. We would not have any hospital if I dropped out anything:

Mr. Bates. What if you finally dropped out the treatment of indigents in private hospitals?

Dr. FAZEKAS. That is right. I want the indigent patient to be cared for by the community hospital. This should have been done many years ago.

Dr: SECKINGER. Ambulatory patients who come to the hospital would be treated on an out-patient basis when possible. They would not be admitted in the hospital as in-patients at a cost of $11.25 a day. Now a lot of them would simply stop after they got to the out-patient service. In other words, they would not have to go into the hospital and occupy beds, which is very costly. They could be treated and sent back home.

Even if they were admitted to the hospital because of some acute illness, when they were discharged they might be discharged earlier than otherwise would be possible, because they could be told to come back to the out-patient clinic and get their treatment and medicine as they need it. So you would stop them both ways, stop them from getting in the hospital with its high cost, and also get them out of the hospital earlier. Is that not true, Doctor?

Dr. FAZEKAS. Very true.





Mr. BATEs. Now, Mr. Shea, will you give the committee information on the requirements for the Day Care Centers as a result of legislation now pending in Congress.

Mr. Shea. I have here, sir, some of the information in outline form which gives you a comparison of the 1950 budget of $139,240 as compared with the 1951 budget estimate of $125,348 which I would like to submit for the record. It indicates the increases and decreases and breaks down the total budget into various subobjects. The total recommendations show a decrease of $13,892. I would like to submit that for the record.

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Personal services, departmental:

GS-9. Range $4,600-$5,350 (superintendent).
GS-7. Range $3,825-$4,575 (nutritionist).
GS-6. Range $3,450-$4,200 (counselor).-
GS-5. Range $3,100-$3,850 (1 social worker, 4 coun-

GS-4. Range $2,875-$3,355 (counselors, 2 clerks)
CPC-3. Range $2,252-$2,732 (3 laborer-custodians,

6 cooks). CPC-2. Range $2,120-$2,540 (kitchen helpers).

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Total permanent, departmental.
Deduct lapses.

Net permanent, departmental.
Temporary employment, departmental: Part-time em-

ployment (4 public school custodians 20/40; 6 laborer-
books 30/40; 5 laborer-kitchen helpers 30/40; 1 counselor
GS-5, 20/40)

132, 181

-32, 300

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44. 75

125, 348


139, 240

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Mr. SHEA. In addition to that, sir, I have a breakdown of the enrollment in centers, the location, and the income to the District of Columbia for 1950, teachers' lunches, money in the trust fund, and the total of expenses, without terminal leave.

(The statement referred to follows:)

Enrollment as of July 7, 1950
Centers giving service to white children:

314 D Street SE..
Ludlow Public School, Sixth and G Streets NE-

Truesdell Public School, Ninth and Ingraham Streets NW-
Centers giving service to Negro children:

Mott Public School, Fourth and W Streets NW.
Parkside, 3785 Grant Street NE.
Harrison Public School, Thirteenth and V Streets NW

64 39 38

39 64 43

Current enrollment..


Income for 1950

Fees collected
Teachers' lunches.-

$42, 395. 50

1, 634. 00

44, 029. 50

73. 00

Accounts receivable (we will probably not collect $50 of the $73)--

Expenditures for 1950 as of June 30, 1950
Personal services, Federal appropriation.
Trust fund__

$106, 595

17, 845

Total 01 02-09 Trust fund...

124, 440 23, 966

Total all expenses (without terminal leave)

148, 406 Mr. SHEA. The third item includes a further breakdown of the child day-care centers including the average enrollment cost per child per week and the cost in comparison with other cities in this country. I would like to submit that for the record.

(The statement referred to follows:)

The costs of day care per child have been reduced in spite of the fact that there has been a civil service increase of salary during the year, i. e., Classification Act of 1949.

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The most recent figures we have concerning costs for similar programs in other cities were supplied by the Children's Bureau in November 1949. The figures per child per week follow: California: Actual 1947-48..

nursery-- $13. 90 Estimated 1948–49.

-doc-nd 14. 00 State of Washington, 1949

10. 00 Detroit, Mich., 1949-.

do--- 22. 00 New York City-


15. 52

Analysis of occupations, parents child day-care centers, as of Mar. 24, 1950

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1 These 203 families have 381 children, of which 275 attend child day-care centers.


EXAMPLES OF DOUBLE-INCOME FAMILIES NOTE.-In counting double-income families we have included those families where the father is in the home, is incapacitated and is receiving a pension. Examples of all types of double-income families follow:

Family A: Father is waiting for a bed at Glendale for tuberculosis. He expects to receive $60 per month from Veterans' Administration. Mother works small store as an elevator operator at $25.50 per week. One child in the day-care center.

Family B: Father is going to medical school under GI bill. Mother working as an office

worker making $45 per week. One child in the day-care center. Family C: Father makes $150 per month or $1,800 per year. One child is living with and supported by grandparents leaving three children in the home. Mother is making $18 per week ($936 per year) as a maid for an elderly lady. Two children in the day-care center.

Mr. BATEs. Thank you very much, Mr. Shea. I think that is sufficient.





Mr. FOWLER. At the committee's request I have sent for Inspector Lutz. He will be here but while we are waiting, Lieutenant Cox is in a position to go ahead.

Mr. Bates. All right. Lieutenant, will you give the committee information on additional requirements of the Police Department which will be necessitated by the pending legislation authorizing a 5-day workweek in the Department?

Lieutenant Cox. Mr. Chairman, it seems almost a certainty now that the Department will be authorized to go on a 5-day week, since this legislation has progressed to the point where it is almost a surety.

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