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Masons are another group of international scope aiding crippled children. The Nobles of the Imperial Shrine each pay an annual contribution of $2.00, which is being devoted to the erection of children's orthopedic hospitals throughout the United States. A Board of Trustees is now operating five institutions: the Shreveport, La.; Twin Cities (Minneapolis - St. Paul, Minnesota) ; San Francisco, California; Portland, Oregon; and St. Louis, Missouri, Shriners' Hospitals. In addition, there is the Mobile Unit, which holds clinics in the various Hawaiian Islands and sends the children to Honolulu hospitals, or gives them home treatment. Hospitals are under construction at Springfield, Mass., and Montreal, Canada. Sites have been chosen in Chicago, Illinois, and Philadelphia, Pennsylvania.

On May 1, 1924, in addition to 243 children which had been treated and dismissed by the Mobile Unit, 700 children had been received as patients in the various hospitals, and 500 had been dismissed, restored to normal condition or greatly improved.-2-

-2- Report of the Board of Trustees of the Shriners' Hospitals for Crippled Children, 1924.

In addition to the institutions operated by the central committee, the Nobles of the Hella Temple, Dallas, Texas, maintain an orthopedic hospital for children, the Korsair Temple, at Louisville, Kentucky, plans to open a convalescent home, the Al Chymia Temple in Memphis, Tennessee, has erected an addition to the Children's Hospital School, operated by the King's Daughters Circle; and the Scottish Rite Masons of Atlanta, Georgia, operate the Scottish Rite Hospital for Crippled Children. This was the first Masonic institution for crippled children in existence, opened in 1915, a new building having been erected two years later. The Masonic hospitals, all of which have waiting lists, are open to patients of any creed or race, and have become a very important factor in the treatment of crippled children throughout the country.

National organizations whose programs include aiding crippled children to various degrees, are the Russell Sage Foundation, the Rockefeller Foundation, the American Red Cross, local chapters of which are frequently doing active clinical work, the Salvation Army, the American Child Health Association, the American Orthopedic Association, the American Medical Association, the American Hospital Association, the National Education Association, the National Welfare Association, the Department of Health, Washington, D. C., the National Tuberculosis Association, the Boy Scouts of America, and the Rockefeller Institute of New York City.

The actual operative machinery which supports the care, cure, and education of crippled children is, in most states, in the hands of State Departments. The authority for their work will be studied in greater detail in the next chapter, but some account of their function is necessary in a discussion of social agencies.

In Ohio, the work of State Departments is probably better developed and wider in scope than anywhere else in this country. When a Rotary Club or other agency wishes to hold a clinic, a public health nurse is generally furnished by the State Department of Health to proceed with follow-up work, and sometimes to assist at the clinic. One of the interested parties submits the child to the judiciary in the person of a judge of the Juvenile Court, who in turn may commit the child into the temporary custody of the State Department of Welfare. If the latter accepts the child, arrangements are made for care and treatment, the cost of which is paid from a rotating fund, and charged back to the county from which the child was received. As soon as the child is in the convalescent stage, the State Department of Education provides instruction, either at the bedside or at home.

In other states, these departments function in this movement to varying degrees. State Boards of Control are frequently responsible for special institutions for crippled children. The judiciary is almost invariably responsible for commitment. Some states, less active in work to aid crippled children, merely make appropriations to Departments of Health, or Public Welfare, a portion of which is to be devoted to the care of indigent handicapped children of all types.

The Federal and State Rehabilitation Bureaus undertake the problem of placing cripples in suitable vocations at the end of their academic training. In Ohio, the Civilian Rehabilitation Service frequently receives direct co-operation from the teachers in the schools for crippled children, who ascertain to which vocation the pupils seem best fitted and make a report to the Director of the Service. The child is then frequently placed immediately upon graduation. -1-

-1- Under authority of an Act of Congress, H. B. 4438, and of State Legislation, April 29, 1921, in House Bill 218.

Local interested agencies vary in activity from providing complete clinical, educational, transportation, and convalescent facilities as does the Association for the Aid of Crippled Children, in New York City, to finding vocational opportunities. The Association in New York City, an organization with over three hundred members and many more contributors, on January 1, 1924, had 3,024 cases under observation. A special bus, owned by the Society, brings the children to schools, hospitals, or clinics. Sixteen home nurses, employed by the Association, during the year 1923 made 44,509 home, hospital, and dispensary visits. A number of children are sent annually to the summer convalescent home at Tarrytown, New York.