Library Collections: Document: Full Text

The Ohio plan, embodied in Senate Bill 174 and House Bill 200, is the most successful and efficient system of legislation now in operation. It provides for the co-operation of individual philanthropists, official state departments, and professional social workers. Under Senate Bill 174, applications to the local juvenile court for the care, treatment, and education of a crippled child may be made by parents, guardians, or other interested persons. The judge shall determine the degree to which parents are unable to pay for such treatment, and then make a report of his findings to the Department of Welfare. The latter may accept the child for temporary custody, and ascertain that the child is treated at the nearest of the ten Ohio orthopedic centers. Expenses incurred at the hospital are paid by the State Department from a rotating fund and charged back to the county in which the child resides. The latter charges the parents according to the findings of the juvenile court.

Under House Bill 200, the state superintendent of public instruction may grant permission to any local board of education, which maintains special classes for cripples, to pay the board of a crippled child, who, in the judgment of the Board and the superintendent, cannot be daily transported to his home. This bill further provides that such Boards of Education shall pay for transportation of the crippled children in case they are unable to walk to the school building. Finally, House Bill 200 states that upon petition of parents or guardians of crippled children in any school district, the Board of Education shall apply to the superintendent of public instruction for permission to establish a special class for these pupils. At the close of each school year the Boards of Education are to be refunded by the state the excess operating cost for such pupils, not to exceed $300.00 for the instruction of each, and $250.00 additional for those children boarded at the expense of the local school authorities.

These laws avoid pauperization by charging parents for care and treatment to the degree in which they are able to pay. They avoid overcentralization by leaving the question of where the child should be treated to the discretion of the Department of Public Welfare and by providing for district classes. They avoid unfair apportionment of expenses by charging the cost of care and treatment back to the counties in which the children reside. By the latter plan they avoid the pressure of political influence. There is ample encouragement for private philanthropy in the need for orthopedic wards in local general hospitals. The state is not burdened with the expense of constructing large orthopedic or general institutions.

There are four types of state legislation to provide operative, remedial, and convalescent facilities. There is first the Ohio, distributed and decentralized plan, described above. This type has recently been adopted in Pennsylvania -1- and in North Dakota.-2- Closely akin to the Ohio method is that of Michigan, Oregon, Kansas, and West Virginia, where patients are committed in a like manner to one or more specified hospitals. The fault in these states lies in the attempt to include elements of the older system in the new plan. The purpose of supplying privately operated institutions with patients avoids the expense of constructing state hospitals; but, in these states, fails from insufficient decentralization to reach all of the cases. Following the original Minnesota plan of central state institutions are Wisconsin, Indiana, (original construction cost furnished by public subscription), Massachusetts, New York, Iowa, Minnesota, Nebraska, and North Carolina. Illinois, under the statutes of l917, will use the new Illinois Surgical Institute as a state center for this purpose.

-1- Commitment in Pennsylvania is direct to institutional and educational facilities. The Department of Welfare is notified in all cases that such decrees have been put into operation.

-2- Pennsylvania General Assembly Act. No. 276, approved June 7, 1923, and North Dakota Senate Bill No. 176, approved 1924.

In Michigan, crippled children, whose parents or guardians are unable to provide treatment, are submitted to the probate court for investigation, and subsequently sent to the University of Michigan Hospital. The state bears the entire expense of treatment and care. The expense of returning children to their homes is paid by the hospital and charged to the state in the event that the superintendent is satisfied that parents or guardians are unable to assume this charge.-3- A similar law provides that Oregon children should be committed for treatment to the University of Oregon Medical College.-4- In Kansas such treatment is given at the Medical Department of the University of Kansas.-5- Commitments to the latter institutions are made by the county commissions or officials, and expenses are charged back to county or city authorities.