1 15 2 https://omeka.wilkes.edu/omeka/files/original/0364753e95d86af68ade00dcde893789.pdf f91634da0cadcb46646761b1f89c64ef PDF Text Text rp ! n MMM ffiPMT I rC ' r i r JS1543 1552 1971 WILKES COLLEGE r b WILKES-BARRE, PENNA. �ANNUAL REPORT I (to L p --------------------------------- -| I- 197 1 EUGENE SHEDDEN FARLEY LIBRARY ' | L 1933 F WILKES COLLEGE, WILKES-BARRE- PA. 1 [n In li h ■ I I I c t I Is ' INSTITUTE OF REGIONAL AFFAIRS WILKES COLLEGE WILKES-BARRE, PENNSYLVANIA �ARCHIVES �6 r‘ I - ', tl 3 J I $ li li ■ i 1 3 3 i il I I ;i fl •J * d 1 �FOREWORD I The Institute of Regional Affairs, first organized in 1951 as the Institute of Municipal Government, has just entered its twentieth year of 8 •J service to the College and to the Community. At the close of each year ending on the thirtieth of June an Annual Report has been submitted by its Director to the President and the Board of Trustees to review and summarize its performance. Its content and form have undoubtedly changed as the Institute matured with experience, but its primary purpose remains the same 0 ' fa a 3 8 1 I 8 1 8 I - to provide the custodians of the College's destiny with tangible criteria to evaluate attainment of declared objectives and to reiterate or establish policies designed to the philosophy of the College. Responsibility for the compilation of the report has been the Director's. The preface or foreword of previous reports reaffirmed "the credence that the Institute supports the processes of change in Northeastern Penn­ sylvania which have become the basic concerns of the leaders of the region". The content of each evidenced the Institute's contribution to the College's overall participation in support of productive change throughout the area of its influence. This Nineteenth Annual Report, covering the period July 1, 1970 to June 30, 1971, repeats the affirmation and adheres to the traditional criteria for selection of content. Beyond this point, this Annual Report differs in many respects from its predecessors, but particularly in the lesser comprehensiveness of the i 'i -iii- �B treatment of the Institute's total performance. i The sudden and tragic death of Dr. Mailey, late Founder and Director of the Institute, who alone knew every large and small detail of IRA's operations, placed upon the individual staff members responsibility for completion of projects known to have been IJ 110 initiated by him. This has been, and continues to be done. search of notes and files, as well as comparisons of personal recollections by members of the professional and clerical staff, the latter have grave J doubts about the completeness of the Report content. 3 occur, the staff accepts full responsibility. .B Despite careful Should any omissions content in the conviction that the contents of the Report on this year's activity under Dr. Mailey's brief leadership and direction are more than sufficient to warrant pride and satisfaction. Whatever accomplishments of the Institute were achieved prior to the Director's passing are attributable mainly to his personal dedication, 3 initiative, and competence. Work completed thereafter would have been even more taxing than it was without the sympathetic understanding and personal cooperation of President Michelini and Dr. David Leach, Chairman 1 S of the Division of Social Sciences, who gave the leader less professional staff direction with freedom. The College should not overlook the contribution of the many individuals and agencies outside of the College family who assisted with various programs throughout past and present year. I -iv- Special mention is �1 1 warranted for the Department of Community Affairs, the Public Service Institute of the Department of Education, county and local directors of Civil Defense and others who bore such a large share of the instructional load in the highly successful In-Service Training Program. Above all, perhaps, most appreciation belongs to those hundreds of individuals who I have become friends cf Wilkes as voluntary participants in IRA activities. I Walter H. Niehoff ■J Philip R. Tuhy A Associate Directors J 1 7J I 0 J 1 1 II 1 l>\ 4 �I I I table of contents page dedication 'Ji n FOREWORD iii 1 PART I: EDUCATION A. i JR 111 B. ■I In-Service Training 3 Short-Course Program 1970-71 4 Growth of Short-Course Program 5 Community Service Program 12 Title 1 Program 13 Mental Retardation Seminar 15 Tenth Annual Community Growth Conference 17 Reading Excellence Attainment Development 19 Non-Graded Instruction 20 Annual Awards Dinner 22 171 14 Li J J 7?: J I PART II: INFORMATION A. ,ri 1 1 24 IRA Newsletter 25 Newsletter Distribution 26 B. LIBRARY 28 C. HORIZONS-The Pennsylvania Magazine 29 30 PART III: CONSULTATION Representative Consulting Service 36 PART IV: RESEARCH .7 7 Published Research Projects 1970-71 1 11 I il 32 - VI - 38 �1 43 45 47 LIST OF TABLES J INCOME AND EXPENDITURES 1962-70 48 II. FINANCIAL SUMMARY 1970-71 49 III. INSTITUTE BUDGETS 1970-71 and 1971-72 50 IV. TITLE I PROJECTS 1966-72 51 a i -vii - �11 Hi i I « I I iy f'l I I PART I 3 EDUCATION 1 I i �1 1 i I ill _ dill I J J ■ I., EDUCATION The quality of local government can be no better than the quality of its elected and appointed officials and its employees. The Jacksonian view that the work of government is so simple that practically anyone is capable of doing it has completely lost any validity it may ever have had. The demands on local government have grown in number and complexity with the urbanization of the nation and simple "handy-man" methods are no longer adequate to solve the J pressing problems of municipalities-large or small. '1J limitations relating to elected and appointed officials have become too extensive i Statutory requirements and and complicated to be known and understood without deliberate and guided study. The modern demands for high quality of multiplying municipal services calls for more sophisticated work methods. Thus, in the final analysis, the quality of local government depends upon appropriate knowledge of duties and responsibilities and 3 1 I I technical competence. Unfortunately., officials and job holders are still left largely to their own devices to gain the knowledge and develop the technical competence required. There are, of course, no training schools as such for public officials and municipal employees in Northeastern Pennsylvania. Few local units provide even a modicum of formalized and organized training for employees. The Institute of Regional Affairs, therefore, seeks to fill this crucial need for education and training by providing a broad range of short courses, seminars, and conferences pertaining to urban problems. These are all intended to broaden and improve the -2- �Hil [iil I awareness and understanding of urban problems and thereby to assist in the develop­ ment of enlightened leadership in the region. The Institute assists both lay and govern- mental leaders and employees to discharge their responsibilities and master complex problems under academic auspices. Technical training is becoming increasingly important in many technical, semi- .1 'I 1 •I technical, and para-professional positions. The Institute provides such training tp- portunities through its growing short course program offered in cooperation — Public Service Institute of the Pennsylvania Department of Education. part, instructional compensation for these courses is paid by the -ublic Service In­ stitute. Other courses deemed of value by IRA, but which do net fall in the state" = program, are financed with funds made available tv-rv-g- me College. Seminars and conferences on a wide range of topics region are held throughout the year, utilizing the special talents cf members cf the faculty and individuals outside of the college having spe. activities extend the range of the educational program beyond government general public. A. In-Service Training Goals The In-Service, or short course, Program of the Institute is based upon the assumption that training is not only directly beneficial to the individual, but as well to the municipality which he serves. -3- Its objectives are: �To develop the special skills required for effective and efficient performance of job duties; To update knowledge of changing needs and methods in specific job areas; To stimulate an awareness of the contribution of the individual's job to the total effort of the department and government as a whole; and, To prepare the individual for other duties (his next job), and when appropriate, develop his capacity for a different job of higher grade and responsibilities. Short-Course Program 1970-71 Course completions in the 1970-71 term reached a new high. Certificates of Attainment, awarded by the Public Service Institute, were earned by 689 local officials and employees. . Seventeen instructors, drawn from the College and the community, taught the following 18 courses which ran from one to 15 two-hour sessions: Course Completion 1970-71 □ V n U ny Number Completions Course Instructors Advanced Assessors Thomas Garrity Advanced Communications Albert Spunar Advanced Secretaries Walter H. Niehoff Ambulance Attendant Anthony Broody 131 Auxiliary Police Walter E. Wint 36 16 9 13 Hi ■ p ■ 1 ' �Course Completion 1970-71 CONTINUED a J Civil Defense Operations Nicholas H. Souchik 14 Collective Bargaining Atty. David Koff 20 Fire Apparatus Maintenance Raymond McGarry 19 Fire Ground Strategy B. J. Gross Light Duty Rescue (Hazelton) Thomas Bast 25 Light Duty Rescue (Wilkes-Barre) B. J. Gross 24 Medical Self Help Anthony Broody 63 Principles of Urban Renewal and Housing Philip R. Tuhy Edward Heiselberg 35 Public, Works Equipment Management Robert Betzler Leo Corbett Radiological Monitoring John Sulcoski 89 Small Arms John W. Lowe 7 Township and Borough Auditors E. Cleaver Geist 139 7 27 689 "1 -J n ■ | Growth of Short-Course Program The Short-Course Program was initiated in 1951 by the. Institute of Municipal Government. A course for Borough Councilmen was the only offering, and 29 individuals received certificates of completion. In the ensuing years, the number of offerings, number of participants» and the geographic'area served, have all '• 1 I ,I lj II �grown consistently. Initially, the participants were virtually all from the im- mediate Wilkes-Barre area. Today, most enrollees are residents of Luzerne and Lackawanna counties, but each year an increasing number enroll from other counties in the Northeastern Region, and a few from counties beyond. In the nineteen years in which the Institute has conducted this program, 4,429 officials and employees have completed short courses, and have thus received significant training of value to themselves and their municipalities not otherwise available. This growth is indicated by the following graph: H ifl 1 0 1 0'J 0-6- ��In the nineteen years of the Institute's In-Service Training Program, 160 courses were conducted. The list below indicates that of this total, 97 were primarily in the area of public safety, and 63 were designed for various public officials. Course Completions 1951-71 'Ll mi H B i !n Year Total 1951 1952 1953 1954 1955 1956 29 42 37 27 36 52 1957 37 1958 39 1959 89 1960 90 1961 157 C our s e Certificates Awarded Borough Councilmen Magistrates Basic Police Township Commissioners Borough Councilmen Health Officers Township Commisioners Magistrates Borough Secretaries Advanced Police Councilmen Magistrates Township Supervisors School Directors Basic Police Councilmen Basic Police School Directors Planning and Zoning Police Chief Magistrates Advanced Police Small Arms Basic Police Assessors Borough Secretaries -8- 29 42 37 27 36 11 9 32 13 24 17 22 35 30 24 10 26 29 25 12 26 38 23 20 26 12 �Course Completions 1951-71 1962 231 1963 119 1964 189 1965 184 1966 415 F1 (2) CONTINUED 31 11 8 15 12 20 19 11 35 15 33 21 25 15 18 10 13 17 21 59 12 23 18 15 38 28 37 18 78 6 12 23 15 20 25 5 11 28 31 23 17 5 Magistrates School Educational Secretaries Small Arms Township Supervisors Traffic Management Z oning Highway Maintenence Eire Administration Penal Code Planning School Directors Intoxication and Law Enforcement Assessors Basic Police Report Writing Fire Fighter Instructors Personnel Supervision Municipal Fire Administration Small Arms Magistrates Youth Control Rural Assessment School Directors Small Arms Township Supervisors Arson Detection Criminal Investigation Fundamentals of Fire Fighting Magistrates Fundamentals of Fighting School Law Assessors Magistrates Small Arms Hydraulics Zoning Community Planning Penal Code Basic Police Principles of Inspection Magistrates Assessors Shelter Managers -9- �Course Completions ffl 1967 440 1968 555 i rcr rr- II ]? 1951-71 (3) CONTINUED Civil Defense Adult Education 7 18 Basic Rescue 20 Civil Defense for Local Government Civil Defense for Local Directors 16 Light Duty Rescue 20 44 Radiological Monitoring Auxiliary Police 83 Fundamentals of Fire Fighting 92 22 Radiology 10 Radiology Monitoring Criminal Law 56 Councilmen &: Commissioners 9 Civil Defense for Local Government 37 Auxiliary Police 43 Control Center Operations 28 Fundamentals of Purchasing 5 Light Duty Rescue 49 Shelter Management 9 Small Arms 9 Medical Self-Help 57 Rural Assessment 6 Basic Police Procedure 14 Fire Ground Attack 21 Fundamentals of Fire Fighting 43 Civil Defense Management for Local Directors 22 Advanced Police Course 38 Minor Court Procedure 36 56 Auxiliary Police 26 Civil Defense for Local Government 53 Basic Communications 30 Basic Police Procedure Fundamentals of Fire Fighting 69 15 Hydraulics 18 Light Duty Rescue 5 Police Administration 12 Principles of Assessing 136 Medical Self-Help 26 Radiology 7 Report Writing 28 Small Arms 'IP I1 -10m �B T" i U Course Completion 1951-71I (4) CONTINUED 1969 496 Advanced Communications 21 Arson Detection 45 Auxiliary Police 45 Basic Communications 17 Civil Law 21 Community Planning 3 Control Center Operations 13 Fundamentals of Fire Fighting 115 Hydraulics 16 Medical Self-Help 56 Light Duty Rescue 27 Principles of Purchasing 11 Radiological Monitoring 29 Rural Assessment 35 Small Arms 12 Street & Highway Maintenence 8 1970 476 Appraisal Techniques I-IAAO 12 Auxiliary Police 24 Basic Communications 27 Borough Councilmen 11 Fire Inspection and Prevention 38 Light Duty Rescue 19 Fundamentals of Fire Fighting (Laflin) 44 Radiological Monitoring 24 Medical Self Help 17 Radiological Refresher 46 Principles of Industrial Assessing 16 Small Arms (Public Service Institute) 10 Small Arms (National Rifle Association) 15 Traffic Accident Investigation 22 Wastewater Treatment Operation 31 Zoning Law 62 Fundamentals of Fire Fighting (Lehman Twp.) 15 1971 Total 689 r, 4429 1 -11- �B. Community Service Program All energies of the Institute are oriented toward service to the community. Some activities provide this service indirectly to the community at-ifcarge by training and informing local government officials and employees. 1 I Other activities serve the community directly by providing local leaders and interested citizens with learning opportunities through personal participation. The title of this sec- tion of the Report deals with the latter type, and includes conferences, seminars, ■ I M special ddministfratiire studiesrand guidance, and special instructional programs provided by various College departments. The College, of course, has made varying financial commitments over the 0 years in all of these activities . self-supporting. In general, however, they are wholly or partially Income is derived from admission fees, revenue producing con­ ■ tracts, and various types of federal and state grants, such as Title l of the Higher Education Act. Though Wilkes is a small college, it has received considerable support from this latter source, largely through the personal efforts of Dr. Mailey. The future potential of this program for financial support of the Institute's projects is encouraging . However, the Act places limitations on the types of projects eligible, which means that many of the projects must be financed wholly or in part by the College. For this reason, the general provisions of the Title I pro­ gram should be reiterated. -12- �The Title I Program is designed to bring the resources of the colleges a and universities to bear on significant community problems on a state-by-state basis. It provides federal matching funds to colleges and universities for com­ munity service programs to assist in solving such problems. a Federal funds must be supplemented by funds, either actual cash or inkind services, provided by the institutions. The program is administered by the Department of Education of the Commonwealth, which is the designated Title I Agency, and project grants I T1 are recommended by an Advisory Council ( on which Wilkes is represented by Thomas Kelly) and must receive final approval of the Department. In terms of the Act, community service programs means any educational program, activity or service, including a research program, or a university extension or continuing education offering, which is designed to assist in the solu­ tion of community problems in rural, urban, or suburban areas, with particular emphasis on urban and suburban problems. ! Title I emphasizes the use of higher education to solve community problems, 8 is flexible, in that it permits each state to define its community problems and how resources are best to be utilized, and is broad since it permits programs for both private and public sectors. As has been customary, the following summary of past Title I programs conducted by the Institute is submitted to present an overall and continuing picture of the extent of this activity: �I J il'i Title I: Title 1966 Regional Policy and Goals Principles of Purchasing Community Leadership Joint Communications System Community Leadership Dynamics of Regional Affairs Community Leadership Transportation of Low Income (on-going) Middle Management Seminar I 'T 1 ‘ I 1967 1968 I TO 1969 8 - I ® il Type of Participants Year Number of Participants Public Officials 17 Public Officials 15 Community Leaders 24 Public Officials 75 Community Leaders Social Science Teachers 22 30 Community Leaders Public Officials and general citizenry Industry 28 20 46 It should be noted that the number of programs approved and conducted has varied from year to year. During the year 1970-71, the only Title I program was a Seminar for Parents of Retardates, which is described below. I 'T Three programs have been approved for the year 1971-72, and are now in preparation. Approved Title I Projects I 1971-72 Title I Regional Approach to Local Governmental Problems Federal Funds $ 5,010 s I -14- H ■ Matching Funds Total Cost $ 2,505 $ 7,515 �8 a S (J ci Title Federal Funds Matching Funds Total Cost Training Program for Parents of Retardates and Young Volunteers (Cooperative with Marywood College) $12,788 $6,394 $19,182 5, 980 2, 990 8, 97 0 J Physical Rehabilitation for Nurses (Cooperative with East Stroudsburg State College) The extensile narrative above on Title I projects and their financing should not be interpreted to suggest that these projects rank highest in the In­ H 8 stitute's other community service programs. Far more is done in programs sponsored and administered directly by the College without governmental financial support as the descriptions below will indicate. Following, then, is a summary of the major community service programs conducted by the Institute during the year 1970-71: L 1. Mental Retardation Seminar �The seminar consisted of ten monthly sessions which were held in lb 1 J Stark Hall. Formal remarks: of sp’eaker s are in prbce&S of publication. Attendance reached as high as 125, but Certificates of Attainment were presented to 36 parents and volunteers who met the required standards of participation. ? The program follows: J Date Topic Speaker Sept. 23,1970 Causes of Mental Handicap Dr. Kurt Hirschorn Oct. 14, 1970 Diagnosis & Assessment Joeseph Kanner Nov. 11, 1970 Parents of the Retarded Child Dr. Milford Barnes Dec. 9, 1970 Role of the Physician Dr. John Bartram Jan. 13, 1970 Institutional Care for for the Retardate- Dr. Donald Jolly Feb. 10,1971 Home Training for the Mentally Retarded Franciska Maljovec Mar. 10,1971 Role of the School Dr. Ignacy Goldberg Apr. 14, 1971 Ministry and Mental Retardation Panel: Rev. E. L. Shelling Rev. M. N. Raymond Rabbi A. Sheingold nlb May 12, 1971 Legal Concerns of Retardation Atty. Dennis Haggerty 10 June 9, 1971 What the Future Holds? Dr. Gunnar Dybwad 1 13 I I E i id T? i: -16- �I n The rationale was that new concepts must be tried to replace as far as possible the emphasis on custodial care for retardates, and that the sum total of environmental conditions mupt be considered in order to help there-' tardate learn to function semi-autonomously by way of contacts with the larger social system. The objective was to teach parents, as well as non-related vol­ unteers, how to help the retardate in the home and community environment. 2. Tenth Annual Community Growth Conference The theme of the Tenth Annual Community Growth Conference held on tl September 30, 1970 was " Goals for Human Needs. " I nil 0 The program follows: ■J GOALS FOR HUMAN NEEDS "Goals for Human Needs Henry Walkowiak NEW CONCEPTS IN HEALTH AND SOCIAL WELFARE "A New Approach to Health & Welfare Priorities "Planning at the County Level....................................... "Social Welfare at the Community Level.................. 0 NEW CONCEPTS IN HOUSING "New Concepts in Housing "New Concepts in Modular Housing, "Non-Profit Housing Corporations. -U ■ B Francis E. Moravitz Jack W. Croes , Raymond Condo LUNCHEON H. Gordon Council, Jr. "Operation Breakthrough, i '' . . Robert C. MacGregor , . Harold Sherman . . James E. Reynolds -17- �n LI DISCUSSION GROUP SEMINARS R U I ,1 !i m J J Ph.1 i J I 8 ! B Address Tom Bigler, News Director WBRE-TV The success of the Conference is evidenced by the attendenc e of the 180 participants. SPONSORS David Walker Associates Easter Seal Society of Hazelton Area and Carbon County Economic Development Council of Northeastern Pennsylvania Family Service Association of Wyoming Valley First Federal Savings and Loan Association Franklin Federal Savings and Loan Association Greater Hazleton Chamber of Commerce Greater Nanticoke Chamber of Commerce Greater Scranton Chamber of Commerce Greater Wilkes-Barre Chamber of Commerce Hanover National Bank Junior League of Wilkes-Barre Luzerne County Housing Authority I Luzerne County Redevelopment Authority i!f] National Association of Social Workers -n Northeastern National Bank Northeastern Pennsylvania Heart Association, Inc. Redevelopment Authority of the City of Scranton Redevelopment Authority of the City of Wilkes-Barre ?n u Wilkes-Barre Housing Authority WNEP-TV -18- �3. Reading Excellence Attainment Development R. E. A. D., or Reading Excellence Attainment Development, initiated in October, 1970, and continuing into July 1971, is a reading clinic designed to improve the reading skills and related and supportive language arts of elem­ entary and secondary school children. The academic year program, started in October and completed in May, consisted ofthiirty Saturday morning meetings held at the College. The summer program, begun after the close: of school and ending in July, covered five weeks with morning sessions Monday through Friday. Tuition was $125.00 per session. Individualized instruction and guidance for each child is the core of the general program. Each phase of the course is designed to attempt to correct known deficiencies and/or generally strengthen the child's ability to read well. The instruction ranged from basic auditory and visual discrimination to sophisticated levels of analysis, critical application, and advanced study skills. All activities were developed and applied by staff instructors under supervision of J. George Siles, Assistant Professor of Elementary Education, Reading, and other Language Arts. Each instructor was limited 1 to only one to three children during the academic year and to only two children during the summer session. The child's individual program was determined on the basis of testing for capacity, personal adjustment, and reading level. -19- �Ifil I j ■ Hi . - ill 4. ;l i n I n~' • j Hl This community service program is in the form of a contract between the Institute of Regional Affairs and the Pittston Area School District to . initiate a long-range program to replace the traditional grade system of instruction with non­ graded instruction which will permit each pupil to 11 advance according to his own ability. The District proposes to move in the i direction of eliminating the ineffective mass movement which holds back u n Non-Graded Instruction- Pittston Area School District the able pupil and deprives the less able of needed individual instruction and instituting individual progress without regard for school grading. 'j 3 The contract calls for 15 in-service instructional sessions for the school's professional staff as a preliminary to the institution of the nongraded program in selected levels in September of 1971. The Institute is also obligated to provide continuing consultation and instruction of the professional and paraprofessional staff, provide student teachers properly I LJ instructed on the model, explain the components of the program to parents of 0 selected children, and to test pupils at the close of the first year to determine results of the program. The Education Department of Wilkes College is responsible for I n (J total conduct of this contract. The instructional staff is composed of experienced master Elementary Schoolteachers who hold Pennsylvania Certification and who are specifically trained in clinical techniques and applications in the Masters Degree Program of the College. -20 — �3 - Staff-parent relation throughout the program was maintained. The formal relationship was attained by submitting to the parents of each child - three comprehensive reports. The first indicated the child's level at the H U : ■ 1 n 1 a start of the program, and the second and third reports discussed the child's progress during the year's instruction. In.addition to Professor Siles, the staff was composed of experienced master Elementary School teachers who hold Pennsylvania Certification and are trained specifically in clinical techniques and applications in the Masters Degree Program at Wilkes College. Associated with Professor Siles were: 1 1 I I D J Dr. Joseph T. Bellucci Assistant Professional Educational Psychology Instructor of Testing Devices and Proceedures Graduate Division of Education, Wilkes College Lb p n I □ Mr. Lynn Johnson Instructor in Non-Graded Elementary School Intermediate Team Leader and Chairman of Intermediate Language Arts Wyoming Valley West School District Mrs. Mary Poremba Instructor in Non-f^aded Elementary School Primary Team Member and Chairman of Primary Language Arts Wyoming Valley West School District This project will be featured in pictures and story in the Sunday Independent and several Scr.aiiton newspapers. ■I I .21- �n . 1 u 1 rj Professor Ji'George Siles, Graduate Division of Education at the College, and Associate Director of Educational Planning, Institute of I 11 .) 71 ' nrn S Regional Affairs, is in charge of the project. 0 a P] A documentary on the Non-Graded School Project produced by WBRE-TV has been selected as a finalist for a national television award by the Alfred I. DuPont Columbia University Survey of Television Programs. 5. Annual Awards Dinner It has not been diistomary to include an account of the Annual IRA - Awards Dinner in the Report to the President and the Board :of Trustees. 1 I Perusal of the Programs of previous dinners makes it quite clear that, in addition to its public relations value, this annual affair plays an important educational role in the total Institute Program. This year's dinner, held in the College Dining Hall on May 25, was I 1 J the ntaeteenth'. Although attendance did not reach the record high of the previous year, the more than three hundred guests represented a wider geographic area. Arranged under the direction of Philip R.Tuhy, the dinner, as usual, featured the award of Certificates of Attainment from the Public Service Institute of the Pennsylvania Department of Education for IRA courses completed during the year, and the award of Certificates of Distinguished Service to fifty public officials and employees who had served their communitites over a long period of years. -22- �t [3 l J •TT' I L.1' m - The Special Public Service Award this year was presented to Mr. Thomas Garrity, Chief Assessor of Luzerne County, for outstanding r= I i r J local, state, and national accomplishments in the assessment field. Mrs. Hugo Mailey was the guest of honor and was presented with a silver tray inscribed "He practiced in the community what he taught in the classroom". The presentation was made by Mr..Robert Barker, Public Relations Director, Greater Wilkes-Barre Chamber of Commerce on behalf of the Professional Public Relations Association. The tray will be T' □ i I a 1 I placed ina.Hugo V. Mailey Memorial Room to be established by the College. The principal speaker was Mr. A. L. Hydeman, Jr. , Executive Deputy Secretary, Pennsylvania Department of Community Affairs. His address reviewed the community services available to municipalities, and gave special emphasis to the Neighborhood Assistance Program which is designed, through tax credits, to encourage corporate participation in community improvement. I 1 -23- �I 1 PART II INFORMATION I 1 I i �i i II.. INFORMATION It might be said that every activity of the Institute involves in one 111 way or another the dissemination of information. Conferences, seminars, a a public addresses, and special research projects are techniques of 1ll transmitting information, but they all involve more or less selected and specialized audiences. Information, as one of the four major purposes of the Institute, is concerned specifically with a broad and general audience. The Institute attempts by use of the printed word to keep Lj informed as many public officals, local civic leaders, and interested ■ citizens as it can with the resources at hand. To do so, it publishes a U r L J i monthly Newsletter, maintains a special library replete with periodicals, j brochures, books, and documents which are useful in its own research J as well as useful 'to' the public^ -Contributes on aitalteting basis to the 1 written by staff members to local, state, and national publications. Horizons section of the Pennsylvanian magazine, and submits articles A. The IRA Newsletter p Li A newsletter was first published by the Institute in 1951 under the title I I ,1 fl Luzerne County Newsletter", which title suggests that the publication was oriented to this particular county. The current IRA Newsletter differs in many important ways from its limited predecessor. Its format and type have increased the amount of material in the same I IS amount of space by nearly three times. Originally, all articles and materials were prepared by the Institute's Director, but since the change in title . I- -25- �I I a r?1 1 i i i 3 in 1969, all members of the staff, as well as other faculty members contribute original articles, book reviews, and resumes of larger significant articles and books. The Newsletter also expanded the range of its subject matter, currently including information in the fields of economics, psychology, government, sociology, and any other field which involves urban affairs. The publication is mailed monthly to a carefully compiled list of public F officials, civic leaders, civic organizations, and to private citizens 1a J I I who have requested it. The circulation has increased to approximately 2,600. The following breakdown of the mailing list, shows the type and number of recipients and the geographic areas reached, thus demonstrating the publication's range of influence. IRA NEWSLETTER DISTRIBUTION AS OF JUNE 28, 1971 I Category 1 I ■I ,1 a 'il No. of People 1. Real Estate Board 40 2. Bankers-W. B. Clearing 22 . House . 3. Borough Sec. -Cities & 41 First Class Twps. 4. 8t 15. 114 Supervisors & Commissioners 5.Sec't, Second Class Twps. 32 6. Newspapers & Radio Stations 63 7. Luzerne County Cong. & Leg. Rep't. 8. Conf, of Univ. Bureaus of Gov't. Research Counties Luzerne Luzerne, Lackawanna Luzerne, Lackawanna Luzerne, Lackawanna, Columbia 11 Luzerne, Lackawanna Luzerne, Lackawanna, Berks, Pike, Carbon, Lycoming, Columbia, Phil. , Schuylkill, Lancaster, Lehigh Luzerne 79 All over the U. S. -26- �IRA NEWSLETTER CONTINUED(2) DISTRIBUTION AS OF JUNE 28, 1971 Category "I 9. 10. 11. 12. 13. 16. ■I 17. 18. 1920. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. No.of People 12 Savings fa Loans Assoc. Redevelopment fa Housing Ass. 50 Hospital Administrator s 7 172 Magazines in IRA Library & 1.4 Councilmen in Luzerne Co. Boros. & Cites 257 Luzerne Co. Chief Admin, fa Principals 39 Home Builders 92 Assessors 34 Civil Defense Dept. 75 Police Chief 60 fa 36 Firemen Luzerne County, Fire Chiefs, Co. fa Officers 66 Wilke's College Board of Trustees 27 Community Ambulance Assoc. 45 Wyoming Valley Sanitary Board 17 Solicitors-Luzerne 49 Planning Commission fa Zoning Board 294 Mayors-Boroughs 34 Friends of Wilkes College 145 American Ins. of Archtects 28 HELP 46 Sec. '3f School Boards 19 County Commissioners 31 33. Luzerne County Libraries 34. Region-M-Outside Luzerne Co. 35. Luzerne Co. Guidance Ass. 36. See #21 37. School Boards, Luz. Co. 38. Luzerne County Auditors & City Controllers Counties Luzerne, Lackawanna Luzerne Luzerne All over the U. S. Luzerne Luzerne Luzerne All Counties in Pa. Luzerne Luzerne Luzerne Luzerne, (N. Y. , Delaware) Luzerne Luzerne Luzerne 70 98 Luzerne Luzerne Luzerne, Lackawanna Luzerne, Lackawanna Luzerne Luzerne Luzerne, Lackawanna, Carbon, Pike, Columbia, Schuylkill, Monroe, Wayne, Sullivan, Susquehanna, Wyoming Luzerne Lackawanna. Susquehanna, Wayne, Wyoming Luzerne 33 Luzerne 125 Luzerne 9 -27- �The "new look" of the Newsletter has resulted in a significant increase in the number of individuals and organizations requesting to be placed on the mailing list. Gratifying testimony to the quality of the articles in the Newsletter is the number of requests from state agencies, municipal organizations, and university research bureaus, for copies, reprints,or to reprint articles written by staff members in recent months. Particular interest was shown in Newsletter articles on "Regionalism", "Constitutional Limitations on Altering Salaries of Local Officials", and the "Merger of the Kingston-Dallas Township Police Departments". Requests were received from as diverse sources as the Department of Community Affairs, The Pennsylvania Police Journal, Northwestern University, and the Governor's Office of the Commonwealth. B. Library The Institute's library of carefully selected materials, including books, pamphlets, special reports, surveys, studies, and documentary data, has grown to more than 4,000 items. While a small proportion of the library has been fihanced from IRA appropriations, the vast majority of the items have been received by the Institute on an exchange basis with similar organizations on other college and university campuses, and with many state and local governmental agencies. It is undoubtedly the most useful as well as the largest, collection of its type in the region. The collection deals with most of the important aspects of urban affairs:government, land use, transportation, management, social welfare, edu=>-- cation, public health, recreation, public finance, intergovernmental relations, and others. In effect,the library is a clearing house of information useful —28— �I in the Institute's research, but, also useful to officials of the area seeking a sources of information needed in their decision-making. In addition to its use by interested officials and community leaders, the ■i 1 library is being used to an increasing extent by undergraduate students who may have their first contact with community problems by using the library materials in the urban fields for term papers and research projects. Much of the increase in the use of the library by students results from the new Social Science Urban Affairs degr ee program, and the addition of an I advanced course in Municipal Management by the Political Science department. Officials and the public are kept informed of significant publications 3 I J j I J available via the Newsletter. C. Horizons-The Pennsylvanian Magazine The Pennsylvanian Magazine is the official monthly publication of a number of municipal organizations in the state, and has a circulation of well over 15,000. A four page section, titled "’Horizon", is reserved for special guest articles on subjects of current concern or interest. The Institute is now the only college which is a regular contributor, alternating with individuals from all walks of life who have special competence in a particular field. The Institute has used its opportunities to submit articles to disseminate statewide among local officials those ideas and programs highest on the list of priority of its purposes and objectives. ■ s I -29- ■ ..... �I 11 i ’’I I I 1I I part III CONSULTATION I ' 1 I I rf; 2 J -30- �HI. CONSULTATION The consulting service offered by the Institute of Regional Affairs is, per­ haps, the least spectacular but at the same time the most intimate and productive of the activities. The consultation work of the staff is less spectacular and less glamorous than the other more identifiable and publicized services, since, as a rule, it involves unpublicized contacts with one or a few individuals who have a spe­ cific problem. The small number of participants involved in a particular consulta­ tion and the specificity of the problem produces an intimate man-to-man relation­ ship, which, in turn, enables those seeking help to identify with the College through the members of the IRA staff. This service is very productive because the individuals equesting advice and guidance are more likely to take positive action since their request was prompted by a known and felt problem. The services of the staff are available at all times to governmental officials as well as interested citizens and non-governmental groups or organizations. Con­ sulting activities include such widely disparate services as oral or brief written re­ sponses to telephone inquiries or letters involving single specific questions, direct personal contacts with an individual or group in or outside of the IRA office, lec­ tures by staff members, participating in conferences as panelists, and formal membership and involvement of staff members in the decision-making of governmental and civic agencies. The range of activities extends from a single individual or small municipality to various departments of the Commonwealth of Pennsylvania. -31- �The Institute's consulting service continues to enjoy a wide and unquestioned reputation as the region's leading source of advice, information, and guidance on I i i I urban affairs. Despite its small professional staff, three members now reduced to two, it is uniquely fitted for the consulting function because of the training and experience of its members in general and special areas of governmental and civic concern. The dual role of members of the staff as such as well as active teachers in the Department of Political Science provides those who seek the service the ad vantages of both academic and practical capabilities. Most of the consultations, like the ice berg, are of such a nature that they I are unobservable, and difficult to report. For this reason, as in the past, only the most identifiable services performed during the past year are presented below to I I I Representative Consulting Service 1970-71 Wilkes-Barre Model Cities Agency- Continuing consultation with staff members of the J □ illustrate the wide range and broad types of consulting services. I Wilkes-Barre Model Cities Agency from October to July under terms of con- tract resulting in a formal report on Health and Welfare Services in the Model Cities Neighborhood and including a projected Social Service Center. Wyoming Valley Sanitary Committee- The Director served as a member of the Finance Committee of the Wyoming Valley Sanitary Authority. Economic Development Council of Northeastern Pennsylvania- The staff participated in meetings and conferences sponsored by this organization and provided continuing information and advice. ."'■I -32- �1 I Civil Service Testing- Associate Director, in cooperation with the College Test­ ing Center, conducted civil service tests for police officers and firemen I in Kingston and Wilkes-Barre. Penn State Seminar- Director participated as a principle panelist in Harrisburg, 5, li i Altoona, Washington, and York. His contribution on "Regionalism" has attracted wide acclaim. Mid-Eastern Association of Boroughs— Director served as principal speaker at annual conference in Allentown. I I I I I Welfare Planning Council- Director served as active member. PPS and PAA- Director served as officer of the Pennsylvania Political Science and Public Administration Association. CAAC- Director served as member of the Advisory Council of the Department of Community Affairs. His successor is Thomas Kelly, Director of the Evening School. Back Mountain Police Merger- Director and Associate Director provided continu­ ing consultation to the governing bodies of Dallas and Kingston townships P I and drew the formal agreement which merged the Police Departments of the two jurisdictions. Title I Review Committee- Director continued to serve as a member of the Project Review Committee of the Title I Agency, Pennsylvania Department of n Education. b II WNEP-TV- Director acted as special guest fl s P -33- �Mass Transit Committee- Director was active as a member of the Mass Transit Committee, Greater Wilkes-Barre Chamber of Commerce. Township Supervisors Association- Director addressed the Annual Conference of Pennsylvania Township Supervisors at Camp Hill. Penn State Redevelopment Authority- Director provided consulting service. Department of Community Affairs- Director and Associate Director cooperated with the Department of Community Affairs in providing special information or counsel. I I Luzerne County Communications System- Director served as a coordinator in the establishment and development of the Luzerne County Communications System. Local Government Conference- Director served as reporting Secretary for a dis­ cussion group at the Annual Pennsylvania Local Government Conference at Harrisburg. Educational Television- Associate Director acted as guest panelist on a special Public Educational Television program at Marywood College on the sub- ject of " The Five Proposed Amendments to the Constitution of Pennsylvania" p “ prior to the Primary Election. I AIP- Associate Director continues to serve as President of the Northeastern Section of the Philadelphia Chapter of AIP and First Vice-President of the Luzerne County Association for Retarded Children. n J Y.' O. U. T. H. P. A. R. C. - Associate Director serves as Advisor to the Luzerne County Chapter of Youth Organized and United to Help the Pennsylvania Association for Retarded Children. . I -34- �Luzerne County Association of Boroughs- Director continued to serve as executive Director of the Luzerne County Association of Boroughs. Municipal Management Association- Associate Director continues activities in the Pennsylvania Municipal Managers Association and its Eastern Regional As sociation. -I i West Pittston Borough- Associate Director serves as a continuing advisor and con­ suitant to committees of the West Pittston Borough Council in its effort to improve organization and administration of the Borough's affairs. I I I 1 Environmental Health Task Force- Director continued to serve as a member of the Task Force in the Pennsylvania Department of Health. Luzerne-Lackawanna Committee on Clean Air- Director served as member of Citizens Committee for Clean Air. Bureau of Research, Department of Community Affairs- Director served as con- sultant to the Bureau on Area Government Study by Better Government I Associates. County Extension Service- Associate Director conducted a planning meeting with Township officials under the sponsership of the Luzerne Agricultural County Agent. I Kingston Borough Council- Associate Director conducted a meeting with Court appointed Board to discuss the Awards versus the At Large System in the Borough of Kingston. ( abolition of Awards) 3 fl -35- �! ! I - 3 - B PART; IV RESEARCH ! 1 I 'I I “ 1 3 HS i .y -36- �TV. RESEARCH Because of its relation to both the College and the community, the Institute is uniquely fitted to conduct a continuous research program closely associated and connected with the educational aims of the College. Research is the "bread and butter " of the staff's daily routine. Problems arising during consultations frequently involve extensive research, and the content of the monthly Newsletter is the milled "flour from the grains of wheat". Frequently, research is conducted on a matter of concern to some part of the College itself. Much of the published research, however, is done on request of an individual municipality or, perhaps, a group of municipalities. Projects requiring special costs, such as travel, are usually done for a nominal fee, but most of this type of work is done as a public service by the College. In summarizing research work done during the year, three observations should be made. First, a considerable amount of staff'time is expended in research on problems which result in information without publication, and, consequently, in the past, no record system has been established. Second, the size of the research staff and the time available requires limitation of the number of projects involving publication. Third, the magnitude of the contract project done for the Wilkes-Barre Model Cities, extending from October 1970 to July 1971, precluded a number of Other I lesser projects planned previously. i -37 �Published Research Projects 1970-1971 1. I Employee's Handbook, University Area Joint Authority Under a $600 contract with the University Area Joint Authority, State College, an Employee's Handbook was prepared during last I '■I summer and early fall. It includes rules, regulations, policies, and a position classification and pay plan. The Institute was recommended ) -'ll for this project by the Pennsylvania Municipal Authorities Association. •J J 2. Back Mountain Police Merger Agreement This project developed as a result of a study done the previous year, titled "Joint Police Service for the Back Mountain", which was a J 3 i feasibility study to improve the police services in Kingston and Dallas townships. This study recommended a. merger of the department^, also including Dallas Borough, into a single police force under centralized control and direction. Such police merger, which would have to be I accomplished under the Pennsylvania Municipal Cooperation Act, had never been accomplished before in this state because of constitutional ffl !l and statutory limitations on the delegation of the powers of local governing bodies. Considerable historical and legal research revealed a loophole which showed promise of overcoming the above limitations. The governing bodies of the two townships, agreed to effect a merger under ■I this novel procedure as a test of both the idea of merger and a test I 11 -38- �T; of the legality. I The IRA staff drew the legal agreement which was approved by the respective township solicitors and which had the informal approval of the then state Attorney General. The merger went into effect last fall. I i Lj This study and the final agreement received nationwide publicity in newspapers and professional publications. The Office of Governor Shapp 125 ■|i requested copies, and the Department of Community Affairs has given wide publicity to the concept. Another result has been that several I townships in the Mountain Top Area have indicated interest in a similar i -Lj merger. In June, the governing body of Kingston Township announced that i the community was withdrawing from the merger in six months. I Preliminary investigation by the IRA staff indicates that both governing la in bodies, the police officers, and the general public have been well- satisified with the progress made under the merger, and that the with­ draw! resulted because of excessive salary demands made by the police officers, and not because of any defects in the organization or its ■ 1 functioning. The staff plans to follow through on developments. 3. Limitations on Salaries of Local Officials Because of considerable confusion which has existed for several ■ ® decades, a number of local officials from this region have, from time to >11 4 / I 1 -39- �time, requested information on the powers of governing bodies to raise or diminish salaries of elected and appointed officials in Pennsylvania municipalities. The problem arose betraussof a constitutional provision that the salary of an elected or appointed officials may not be raised or diminished during the term for which he was elected. A short but thorough research paper by a member of the staff quite clearly indicated • that this provision did not apply to all municipal classifications. The Department of Community Affairs, again, gave wide publicity to this paper, and the result has been a serious revival of study and discussion on this delicate matter, and, it is expected, that clarifying legislation will be enacted to eliminate the problem. Mode 1 Cities Contract Under contract with the City of Wilkes-Barre, dated October 6,1970, the Institute conducted a research project for the Wilkes-Barre Model Cities Agency which was culminated in a 200 page report titled, "Health and Welfare Service in the Model Cities Neighborhood". The contract price was $41,000. The purpose of the study was to provide necessary and specific information of present social services in the neighborhood, and to develop courses of action, including a Social Service Center. The project outline included the following major phases: (1) Preparation of a service profile of all agencies ■ta I -40- �and institutions providing social services; I* a (2) Analysis and classification of these services in terms of the problems they each seek to solve; a I (3)Identification of the degree of adequacy and effectiveness of these services in meeting community needs; I (4) Determination of the amount and types of services provided to the Model Cities Area; I (5) Analysis of any gaps or lack in the present service systems, including services nonexistent, but needed; 'I (6) Description and analysis of the preseit relationships between services; . I (7)Analysis and evaluation of the effectiveness of existing services in solving the problems they purport to solve through surveys and interviews with consumers in the area; 1 a (8) Development of a complete social service record system which would provide a current and future index of existing conditions; physical, social, and personal; and, I (9) Exploration and recommendations of facilities needed for services and their geographical location. Dr. Mailey was Project Director to the time of his death, and the project was completed by Walter H. Niehoff as acting project director. The principal professional researchers were: Prof. Philip R. Tuhy, Institute of Regional Affairs Prof. Jaroslav G. Moravec, Department of Sociology Prof. Raymond Weinstein, Department of Sociology -41 �■ Mr. James Reynolds, Peat, Marwick & Mitchell Co. I I (i I 9 Mr. Alfred Groh, Wilkes College was Editorial Consultant, and Mrs. Margaret McDermott, formerly with Model Cities, was special consultant. All work of publication was performed by the fulltime and student staff of the Institute. a I a i 13 F i ( ;l ’ , -1 ■ ■ • 1 ll H 0 .i . I -42- �I is . ,p 8 1'1 18 ia PART V T FINANCES ■ 1 n ! I '1 U" I I I �V FINANCES 1970-1971 Financial Commitment to Public Service Wilkes College has been committed to public service since its inception. Virtually every department and agency of the College is involved at one time or another in community affairs in the region. The Institute of Regional Affairs plays an especially significant role in the public service program by virtue of the variety of its activities, the interdisciplinary use of personnel, and its formal recognition by the College and community as an identifiable agency pur­ suing service on a fulltime continuing basis. Its unique public visibility is an important contributing factor in attaining and developing general recognition and appreceation of the College's vital public service role. Previous sections of this Annual Report described the wide functional scope of the College's commitment. - I U1D I IL J | i I This section demonstrates the depth and sincerity of the commitment by the tangible evidence of financial support of the Institute's service activities. The College has generously subsidized the In- stitute in the interest of Community service since it's inception. was the Institute self-supporting. In no year In fact, despite growing annual income for services rendered, College subsidization also increased. -44- (Table I) �1 I J 01 n A Financial Summary 1970-71 The financial report for the fiscal year July 1, 1970 to June 30, 1971, prepared by the College Finance Office, reflects an even greater deficit operation than in previous years. (Table II) The report shows that cash in­ come during the fiscal period was $32, 677. 31, or $32, 642. 69 below the estimated $56, 320. 00. At the same time, the report indicates that actual expen- ditures of $85, 920. 79 exceeded budget estimates of $13, 600. 00 by $72, 320. 79- This would indicate a deficit operation during the fiscal period of $53, 243.48. Consideration of a number of factors, however, will reveal that the actual deficit to be subsidized by the college will be, in fact, appreciably lower than UJ .. I, i ' the report indicates. I program schedules. These include the form and content of the Institute's annual budget, the college's system of accounting and reporting, and conse- quences of the difference between the college fiscal year and the Institute's Comparison of the budget items shown on the Financial Summary (Table II) (J I and the items on the approved budgets for 1970-71 and 1971-72 reveals that 1 only eight or nine expenditure catagories are budgeted and several recurring 1 I items of expenditures, amounting to considerable sums, are not. Thus, since no funds are shown for salaries and miscellaneous salaries on the estimate side, the annual Financial Summary shows a budget deficit of $23, 910. 03 and $3, 372. 11 for these two items alone. I ■ I I ■ From the same report (Table II) it can be seen that in some instances bud- I -45- �geted income items were not offset by expenditure estimates. For example, $41, 320. 00 was budgeted as income under the Model Cities contract, but there is no budget estimate of expenditures required to conduct the study. The budget itself projects a profit of $41, 320. 00, or 100 per cent. However, the actual expendi­ ture for this project indicates a deficiency of $28, 513. 15, on the budget side. In the case of the Non-Graded Instruction and READ projects, neither estimates of income or expenditures are shown. The College's accounting and reporting system is a second factor which results in a misleading picture of the Institute's financial operation in relation to the year's work program. ! accrual basis. ■ The Institute accounts are on a cash, rather than an Consequently, while contract projects were completed during the fiscal year, payments were not, in some instances. Table II shows that $17, 483. 00 liT) I of the Model Cities contract total of $41, 320. 00 was received within the fiscal year. The expenditure report also shows expenditures of $28, 513. 15 prior to June 30, in­ F n I i I dicating an expenditure excess of $11, 030. 15 over actual cash received. after the close of the fiscal year the $23, 837. 00 balance due on the $41, 320. 00 contract was received. I Thus, in fact, the project income exceeded project expen- ditures by $12,806. 85. f rq I ! However, For the same reason, while expenditures for the READ project are shown to exceed income, in actual fact when due income is received, the project will I III I show a surplus. Frequently, projects, such as the training program for Parents of Retardates under Title I are conducted on a schedule that overlaps the fiscal year. Consequently, at most a percentage of total income is received and reported 1 -46- �for the fiscal year. Title I Projects Title I projects are not only an opportunity to provide public services not otherwise available, but they also provide additional income for the Institute. □ D On the other hand, past experience indicates that the one-third matching funds obligated by the College plus project expenses reduces considerably any net finan­ cial gain. The number of Title I projects has varied from year to year with three projects for 1971—1972 now being organized. Table IV shows the projects approv­ ed and conducted from 1966 to the 1971-72 fiscal year and the method of funding. j ' Si! The College is preparing proposals for projects for fiscal 1972-73 which are due by November 1,1971. I -47- �Table I INCOME AND EXPENDITURES 1962-1970 INCOME ITEM 1964-1965 1966-1967 1968-1969 1969-1970 931.90 887.00 2,280.00 34. 40 121.10 625.00 $1,148.75 300.00 5, 360. 58 495.50 1,067.50 1, 540. 70 $1, 475. 70 7, 224. 01 6, 055.46 49. 25 873.39 $1,661.50 4, 684.00 6, 647.08 $1,156.75 12, 880. 00 8, 984. 26 2,284.59 733.04 200.00 10, 083. 00 1.04 $4, 879.40 $9,913.03 $17, 687. 81 $15,277.17 $34, 038.09 $28,484.09 10, 083. 00 1,100.92 4, 595. 05 6, 583. 30 1962-1963 Dinners & Conferences Grants & Gifts Sale of Services Instructional Material State Reimbursements Survey & Studies College Work Study Miscellaneous TOTAL $; EXPENDITURES Salaries College Work Study Student Help Meetings & Conferences Supplies Special Services Publications Newsletter Equipment Library Travel TOTAL $10, 920. 18 $11,490.88 $9,047.43 $8, 376. 39 1, 767. 82 2,212.38 990.00 965.00 824.70 587.00 990.00 811.30 195. 83 1, 952. 33 2, 007. 63 1,696.50 1,020.01 4,686.58 9,756.00 2, 613.71 4, 522.32 7, 530.91 341.33 510.00 836.09 992.30 613.31 324.50 794.19 703.00 510.00 1,519.20 854.47 1,278.59 971.55 1, 730.48 2,170.35 118.00 540.00 857.62 $19,274.21 $18,936.48 $28, 890. 88 $27,121.86 $56,262.81 oo �TABLE II FINANCIAL SUMMARY JULY 1, 1970-JUNE 30, 1971 INCOME Estimated Dinners and Conferences Grants and Gifts Title I Services Slate Reimbursement PSI Surveys and Studies Publications Instructional Material Model Cities Program Non-Graded Instruction READ TOTAL $ 1,500.00 6,COO.00 5,000.00 2,000.00 500.00 41,320.00 $56, 320.00 Actual Receivable $ 2,285.00 3,291-76 737.15 2,730.00 140.00 52.40 135.00 17,483.00 $ 785.00 2,708.24 4,262.85 730.00 730.00 52. 40 135.00 23,837. 00 5,823.00 5,823.00 $32 677.31 $23,642. 69 EXPENDITURES Budget I I I n Salaries Miscellaneous Student Help Supplies Publications Meetings Newsletter LibraryTravel Equipment Model Cities Program Non-Graded Instruction READ TOTAL Expenditure s $. $23.910.03 3,372.03 2,536.03 9,134.01 1.303.07 3,423.88 1,737.10 639.27 537.80 388.00 28,513.15 3, 000. 00 4,300.00 1,000.CO 2,500.00 1, 300.00 1,000.00 500.00 1 0, 426. 34 $85,920. 79 $13, 600,00 49 ( t or - ) + + + $23,910. 03 372.11 463.97 4,834.01 303.07 923.88 437.10 360.73 37. 80 388.00 28,513. 15 + 10,426. 34 + + + + $ 72,320. 79 �TABLE III INSTITUTE BUDGET 1970-71 BUDGET 1970-71 BUDGET 1971-72 $ 3, 200.00 $ 3,000.00 6, 000.00 6,000.00 0 Student Help-College 3 Student Help-Work Study Supplies ' J| !■ s 100.00 Equipment 600.00 600.00 Publications 1,200.00 1, 000. 00 Meetings 2,500.00 2,000.00 Newsletters 2,000.00 2,500.00 Library 1,500.00 1,000.00 $17,000.00 $16,200.00 Travel Films Lj I 1 ■ 7 I LU I Li I £■ J I .U I u g J II■ J U 1 I -50- �■ TABLE IV TITLE I PROJECTS 1966-71 F ederal $1,275 1,350 3,750 2,902 Matching $ 425 450 1,250 967 1967-68 Community Leadership Seminar 4,625 1,820 6,445 1968-69 Transportation of Low Income People Dynamics of Metropolitan Government Community Leadership Seminar 3,240 5,100 4,325 3,240 5,100 4,365 6,480 10,200 8,690 1969-70 Middle Mamagement Seminar 5,125 5,340 10,465 1970-71 7,376 3,684 11,060 5,010 2,505 7,515 12,788 6,394 19,182 5,980 2,990 8,970 $38,530 $101,376 1966-67 Ibgional Policy and Program Goals Principles of Purchasing Community Leadership Seminar Joint Communication System for Luzerne County Training for Parents of Retardates Total $1,700 1,800 5,000 3,869 Proposed and Approved in 1971-72 u ir wI Regional Approach to Local Government Problems Training Program for Parents Of Retardates and Youth Volunteers (Coop.-WilkesMarywood) Physical Rehabilitation for Nurses (Coop.-Wilkes-E. Stroudsburg) TOTAL $62,846 □ £ 1307^1 1 1 9A ' L -• i- ��iiiiiiiniiin 10002503D0 WILKES UNIVERSITY LIBRARY i- j j! II I; 1 II mi ;* ■ ■ i 0 ,‘71 3 I \ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Series VI of the Hugo Mailey papers: The Institute of Municipal Government and Institute for Regional Affairs publications, 1958-1980 Description An account of the resource Series VI: The Institute of Municipal Government and the Institute for Regional Affairs publications, 1958-1980, is arranged chronologically by publication date and contains annual reports, surveys, conference meetings, proceedings, inventories, and statistics on Wyoming Valley municipalities, institutions, and companies such as the Wyoming Valley Sanitary Authority and the Copley-Whitehall Sewer Company. Creator An entity primarily responsible for making the resource Institute of Municipal Government and Institute for Regional Affairs Date A point or period of time associated with an event in the lifecycle of the resource 1958-1980 Rights Information about rights held in and over the resource Wilkes University retains copyright of these publications. Format The file format, physical medium, or dimensions of the resource PDF Type The nature or genre of the resource Publications Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Annual Report for the Institute for Regional Affairs, 1971 Creator An entity primarily responsible for making the resource Institute for Regional Affairs Date A point or period of time associated with an event in the lifecycle of the resource 1971 Format The file format, physical medium, or dimensions of the resource PDF Type The nature or genre of the resource Publication Rights Information about rights held in and over the resource Wilkes University retains copyright of this publication. https://omeka.wilkes.edu/omeka/files/original/20a351a754154b2fb1d72ced13ec414a.pdf dcc3cf11cc051c3c45256b572fe31059 PDF Text Text 1 HEALTH AHD WELFARE SECWOCE IN i ™ PuWm CfflB MOBOffiOW Ld Mv I I I ^CHs / Q INSTITUTE OF REGIONAL AFFAIRS WILKES COLLEGE WILKES-BARRE, PENNSYLVANIA vJ HV^/1 W6S2- ����S e PAGE c F. GEOGRAPHICAL ANALYSIS OF FINDINGS 79 G. SUMMARY OF FINDINGS 81 PART III; STRATEGIES IN SOCIAL WELFARE-OLD AND NEW B D A. THE PAST IN REVIEW 85 B. GUIDELINES AND PRIORITIES 94 C. GOALS 98 PART IV: RECOMMENDATIONS A. INTRODUCTION 103 B. HUMAN SERVICES DELIVERY SYSTEM 1. A Model Medical Care System . . . 2. A Model Welfare Care System . . . 105 105 108 C. CONSUMER PARTICIPATION 112 D. 1 HUMAN RESOURCES SERVICE CENTER 1. Consumer Protection Service .... 115 117 E. COMMUNITY HEALTH CENTER 123 L F. THE OUT-REACH SYSTEM 126 G. SOCIAL SERVICE CENTER RECORD SYSTEM.................... 130 130 A. Records and Rights.................................................. B. Conceptual Basis of Record System................................... 133 C. Primary Elements of Proposed Record System . . . 134 1. Data Bank.................................................................................... 134 2. Referral Services....................................................................135 3. Follow-up................................................................................... 135 4. Service Evaluation................................................................. 136 D. Components of Proposed Record System........................136 1. Alphabetical List of Major Service Categories . . 137 2. Agencies, Services and Eligibility Requirements.. 138 3. General Service Category Agencies............................. 139 4. Alphabetical List of Service Clue Words.................... 140 5. Clue Word Agency Locator............................................... 142 6. Individual Case Record....................................................... 142 c tr. i. ■ g g uq ,/jfi 1 ■7j\ J 1 I R �1 A PAGE I ' 7. 8. 9. 10. I '• E. : E? r >iz 1 0 •r § p Service Tickler File........................ Appointment Confirmation Form Daily Service Log............................ Monthly Service Report................ SUMMARY 144 144 146 146 147 �LIST OF TABLES I. AGENCIES by source of funding 2. HEALTH SERVICES SERVING MODEL NEIGHBORHOOD AREA-BUDGET, SOURCE OF FUNDING NUMBER OF CLIENTS, COST PER CLIENT 3. WELFARE SERVICES SERVING MODEL NEIGHBORHOOD AREA-BUDGET, I SOURCE OF FUNDING, NUMBER OF CLIENTS, COST PER CLIENT Its 4. HEALTH SERVICES SERVING MODEL NEIGHBORHOOD AREA-NUMBER OF EMPLOYEES, CLIENTS, AND CASE LOAD U 1 5. WELFARE SERVICES SERVING MODEL NEIGHBORHOOD AREA-NUMBER OF EMPLOYEES, CLIENTS, AND CASE LOAD 6. CORE AND PERIPHERAL SERVICES- HEALTH SERVICES 7. CORE AND PERIPHERAL SERVICES -WELFARE SERVICES 8. TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES 9. TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA­ WELFARE SERVICES 7 i f I 10. INTERAGENCY RELATIONSHIPS- HEALTH SERVICES 11. INTERAGENCY RELATIONSHIPS- WELFARE SERVICES 12. MARITAL AND FAMILY CHARACTERISTICS OF RESPONDENTS IN MODEL NEIGHBORHOOD AREA 13. type of housing respondent occupant in model neighborhood AREA 14. EDUCATION AND EMPLOYMENT ATTRIBUTES OF RESPONDENTS IN MODEL NEIGHBORHOOD AREA 15. RATIO RESPONSE DISTRIBUTION OF ADDICTION 16. RESPONSES TO HOUSING- PERCENT OF RESPONDENTS % 17. RESPONSE TO HEALTH - PERCENT OF RESPONDENTS �'___ S' b Ft Q ) 2 [} 1 18. RESPONSES TO JOBS - PERCENT OF RESPONDENTS 19. RESPONSES 20. RESPONSES TO CONSUMER - PERCENT OF RESPONDENTS 21. RESPONSES TO LEGAL - PERCENT OF RESPONDENTS 22. RESPONSES TO PUBLIC SERVICES - PERCENT OF RESPONDENTS 23. PERCENTAGE DISTRIBUTION OF RESPONDENTS TO BASIC SERVICE FOR THE AGED 24. RESPONSES TO CHILDREN - PERCENT OF RESPONDENTS 25. RESPONSES TO EDUCATION - PERCENT OF RESPONDENTS to training 25a. RESPONSES TO RECREATION - PERCENT OF RESPONDENTS 26. RESPONSES TO WELFARE - PERCENT OF RESPONDENTS 27. COMMUNITY PERCEPTION OF "WORSE" RESPONSES BY SELECTED CATEGORIES AND NEIGHBORHOODS 28. PERSONAL PERCEPTION OF "WORSE" responses CATEGORIES AND NEIGHBORHOODS - J 0 ) I I Jli LIST OF TABLES (CON'T) by selected �■I appendix ■'ll •J n -■ 'U a APPENDIX a - SOCIAL SERVICE AGENCY PROFILE appendix b - consumer profile ADDICTION aged CHILDREN consumers education health housing JOBS legal matters PUBLIC SERVICES recreation training welfare a APPENDIX C - MATCHING AGENCY TO SERVICE/PROBLEM CATEGORY fl appendix e APPENDIX D - DEMOGRAPHIC PROFILE - tabulations of perceptions of community SITUATIONS APPENDIX F - TABULATIONS OF PERCEPTIONS OF PERSONAL SITUATION '■ I t I f v; R' fl: _ ■ APPENDIX G - SOCIAL SERVICE AGENCIES SERVING MODEL CITIES neighborhood area APPEND EX H - CLUE WORDS �PREFACE During the initial years of planning for the Model Cities Neighborhood 0 0 n ■ in Wilkes-Barre much research was conducted. However, many problems revolving around integration, coordination, and duplication of services still existed. It seemed apparent to those working on the Model Cities problems that what had already been developed during the initial planning year should be carried just one step further, that is specifically identifying where the problems occur (each agency), and more importantly the cause and recommended course Q of action, which hopefully would lead to both better coordination and integration of services. Heretofore, studies were conducted and reports issued that examined 3 the effectiveness of the social service delivery system from the standpoint of the agency provider. L Missing as an important component of such studies was infor- mation on how the consumers of the social services see these basic services in the light of their needs. This obviously could only mean a beginning based on tangible, visible, permanent, sincere examples of respect and concern for the •- s people of the Model Cities Area, for it has become crystal clear that the hopes ffl first-hand knowledge and experience of a self-determining Model’.Cities community. embraced in the Model Cities concept could not possibly be fulfilled without the Because the Wilkes-Barre Model Cities Agency is determined to avoid misunderstanding that would inevitably result from ignoring the residents of the Model Cities neighborhood, it undertook an evaluation of the social services in -i- �n-. the Model Cities community. Clearly then, this study was not only undertaken to add knowledge on what -residents of the area view as the most pressing social ■ 0 D service problems, but also to obtain data which could assist the Model Cities Agency to plan and coordinate the resources to effectively meet the needs of the people and to contribute to an improved social service delivery system. 3Q nu 0c ■ n n a Q In order to accomplish this result, it was felt that a more objective research project could be implemented by utilizing an independent community resource which could supply research and evaluation without being unduly in­ fluenced by existing or proposed relationships of the already established social service institutions. Wilkes College, its academic resources already an integ- ral part of the total community, was selected to undertake an evaluation of the social services in the Model Cities Neighborhood. Therefore, a contract was entered into between the Model Cities Agency and the Institute of Regional Affairs, a multi-purpose College organization that coordinates all activities in the social science field. The Institute undertook a nine-point program in its evaluative effort of the social service delivery system in the area. 1 i ■ 1 $ Because of the enormous task confronting the Institute of Regional Affairs within a limited time constraint, the study was divided into components that could be more easily performed. In order to provide necessary and specific information of present social services in the Greater Wilkes-Barre area, particularly as they relate to the Model Cities Neighborhood, the Institute utilized the services of two members 3 Pi ■ _____ -ii- �I ■ °f the Department of Sociology. Professors Jaroslav G. Moravec and 0 0 Raymond M. Weinstein were invited to perform the following services: . Prepare a service profile of all agencies and institutions providing social services. . Analyze and classify these services in terms of the problem they seek to solve. r,U' U n 0 ■. s . Describe and analyze the present relationships between services. Under a contract with the Institute of Regional Affairs, Peat, Marwick, Mitchell & Company (PMM) was engaged to evaluate the social services presently provided to the residents of the Model Cities Neighborhood Area. James Reynolds, Consultant of the Philadelphia office of Peat, Marwick, Mitchell & Company, concerned himself with the following services relating to the per­ ceptions of the residents of the area toward the social service problems: . Identify the degree of adequacy and effectiveness of social services in meeting community needs. ■ ts I . Analyze any gaps or deficiencies in present social service systems including services not offered but needed. . Report the amount and type of services provided to the Model Neighborhood Area. Walter Niehoff, Associate Di rector of the Institute whose specialty is urban management, assumed the responsibility to: . Develop a complete social service record-keeping system which would provide a current index of existing conditions: physical, social, and personal. -iii- J �Philip R. Tuhy, Associate Director of the Institute in planning and development, undertook to: fl . Explore and recommend facilities needed for services and their geographic location. Everyone involved in the project pooled their talents and energies to: 0 r - Because the recommendations coming out of the project were intended to be a basis for the application to the third action year and because this pro- d ■ . Analyze and evaluate the effectiveness of existing services in solving the problems they purport to solve through surveys and interviews with consumers. D 6 0 a0 ject was approved near the end of the second action year, a very tight schedule was set up in order to accomplish the objectives. It soon became apparent that a comprehensive research evaluation as originally contemplated would require more than three months. Nevertheless, although a much more extensive analysis of major data would have been desired, enough information was compiled and sorted out on the social service agencies and the attitudes of the MNA residents"toward their social service needs that recommendations could validly be made on the adequacy and effectiveness of the social service de- livery system in the Model Neighborhood Area. It should be noted that just as the study got underway, a Compre- fl hensive Human Service Center was established in the Model Cities Area. By the middle of January, 1971, it already housed the Eyeglass and Hearing Aid Bank, The Consumer Protection Office, and The Revolving Loan Bank. Within another month representatives of the State Department of Public Assistance, is jl __________ - - iv - �fl ■W l—J the Family Service Association, and the Catholic Social Services expect to be 0I located in the Center to make additional human social services available to I! 0 residents of the Model Cities Neighborhood. Note should be made too that a $250, 000 medical clinic for the Neighborhood Area is expected to be operative sometime during the summer. The land has been purchased and preliminary drawings made. This privately owned clinic is expected to conform to a growing nation-wide trend of placing i under one roof every possible medical service so that consumer patients in the Area can avoid costly admission to hospitals. In making this study, the Institute of Regional Affairs accumulated a P store of debts, some of which can now be happily acknowledged. Cities Agency helped in many ways. The Model William A. Schutter, Model Cities Director, gave much clear and useful advice when the initial design of the investigation was 0 I y c in the discussion stage and throughout the study. Source of the heaviest demands for assistance fell on Mrs.Margaret N. McDermott, formerly Human Resources Coordinator, who was unfailingly agreeable and helpful at all times. Likewise, the Institute received the fullest cooperation from all the Id v: social service agencies, institutions and boards whose help was needed in the preparation of this report. In particular, Charles J. Reynolds, Jr. and Harold Sherman, Director of Research and Planning and Executive Director respectively of the Welfare Planning Council read and helped to improve the instrument used to garner data from the social service agencies and institutions. y 0 « - v - �I 1 It was not originally anticipated that residents of the MNA would be 9 engaged on this undertaking, but that the residents would become deeply involved in reviewing the results of the project, so that they could provide in-put into what they felt needed to be accomplished in making available services more responsive to the needs of the residents. It was subsequently determined that the participation of the residents could be utilized in the interviewing process. • • - Although there were some misgivings over engaging their services, everyone -u associated with the study concluded that the MNA resident interviewers performed in a most competent manner. The Institute also gratefully acknowledges the work of the Wilkes ■’ 2 1 College interviewers, some of whom gave up holiday recesses in order to secure pi the data from the social service agencies and institutions. 1 Alfred S. Groh of the Wilkes College faculty and editorial consultant u to the Institute worked over the manuscript during the various stages of writing. The bulk of the credit, as always, should be given those individuals i who performed the actual work of researching the problem, assembling, analyzing and evaluating the mass of data, and preparing the manuscripts of the various sections of this project report. This project was in every sense of the word a team effort, requiring the closest coordination and cooperation. Therefore our greatest appreciation must be extended to team members Mr. James Reynolds, Consultant, Peat, Marwick, Mitchell and Company, Professors Jaroslav G. Moravec and Raymond M. Weinstein of the Wilkes College Department of Sociology, - vi - �1 and Professors Philip R. Tuhy and Walter H. Niehoff of the Department of Political Science and Associate Directors of the Institute of Regional Affairs at Wilkes College. Their combined contribution should provide a firm base for the establishment and expansion of a productive social service program within the framework of the Wilkes-Barre Model Cities Project Area. ■ Significant contributions were made by unnamed individuals whose identity cannot be revealed. Finally, it must necessarily be stated that the findings and recommend­ ations in the study are strictly of the Institute, and therefore the Institute of Regional Affairs assumes full responsibility for securing the data, its analysis, and the recommendations that are the product of that analysis. n Hugo V. Mailey Director Institute of Regional Affairs fi - vii - �? 1,. INTRODUCTION I "Model Cities is a new approach. commitment;. It relies on local initiative and local It places the onus on the Federal government to position itself to respond to city defined strategies and programs. I c The program reflects a candid admission that categorical assistance programs, whether emanating from Federal Departments in D. C. or the Region, have, despite some real accomplish- ments, not measurably affected the quality of urban life. it The above statement is by Floyd H. Hyde, Assistant Secretary, Model J D Cities and Governmental Relations, U. S. Department of Housing & Urban Development, in the Preface to Model Cities Program by Marshall Kaplan, Gaus, and Kahn--a study conducted for HUD (Praeger Publishers, 1970). The Model Cities concept, in general terms, is a beautiful and timely projection. What poor man could be against its multifaceted community services? What poor man could reject the idea of a concentrated attack on poverty, inferior education, unemployment, and slum housing? Who would oppose more legal aid for the defenseless, better health services for the poor--just to mention a few B ingredients of the Model Cities idea. No one is against such a program in principle. The present Model Cities concept is not the first noble idea supposedly to help the disadvantaged. i'f The history of modern society is replete with the failures of ideas of equal worth and urgency. Some of these failures repre- sented the best thinking of prominent names, and experts in their particular -1- �s fields; some represented great wealth; some represented immense political skill and influence; while others were well-known for their sympathy for the I 0 g0 30 poor and the powerless. But most of them had one thing in common: they thought that they, and only they, were capable of working out the solutions to the needs of the poor. That is why in spite of the sincerity of many fine people, the Model Cities program in many cities is looked upon with suspicion by thoughtful poor people. A"Delivery System" to the poor meant that they were to sit quietly by while "they", with alternatingly warm and stern paternalism, delivered the poor what "they" thought the poor needed. To "them, " the advice and consent of the j poor was not needed; and, when volunteered; it was not heeded. 0 0 The prime purpose of a Model Cities program is to take a wide range of federal, state, and local programs--anti-poverty programs, urban renewal, job training, educational assistance, welfare, and so forth--and pull them to­ gether into a concentrated attack on all the problems of a small area. 0 This, it was hoped, would lead to a breakthrough that would point the way to solving the broader urban malaise. In the bureaucratic argot, it was to be post holing (a concentrated effort on a few people) rather than leaf raking (a scattered effort that hits a lot of people, but doesn't do much for any of them). This kind of notion goes to the heart of the Model Cities concept: the need to coordinate the various programs so as to achieve maximum impact ■ Somebody who lives in a slum is likely, at any given time, to be in poor health, -2- .. ............... . .... . �s C have a bad job or no job at all, live in a miserable house, be poorly educated, and so on. But the agencies that administer programs designed to alleviate these conditions have tended to end up fighting one another rather than cooperating. ■ IP The Office of Economic Opportunity runs job training, education and welfare ■ programs; the Labor Department also runs its programs. And all of these often involve the same poor "clients'1 in the model neighborhoods. ni w 0 Multiply this many tunes over and the lack of coordination becomes utterly clear. Not surprisingly, each of these agencies thinks it knows best how to run its type of program. P'l Moreover, each agency wants to spend its available money according to its own philosophy and priorities. ■ 0 do 1 d The result in many cases is that the Model Cities legislation turned out to be not a newly forged instrument for urban rehabilitation but a smorgasbord. While Model Cities has resulted in new and productive relationships with residents, much more needs to be done to find better and more effective ways to solve the problems of a community or area. The governmental agencies must convincingly show that they are concerned with the community people rather than with politics. And by the same token, the powerful social service institutions must convincingly demonstrate that they, too, are primarly concerned with the people who are their neighbors as well as with achieving the long range goals of the institutions. It has now become imperative that our concern be with the applica- fl i ! I « tion of the programs: how and by whom these programs are going to be admin- -3- �1 13 I *' 8 isteted; and who will have the determining, ultimate voice in the structuring [ and in the crucial decision-making processes involved.. Social welfare delivery systems are the programs by which necessary I I services—health care, welfare, education, legal aid, housing, employment opportunities, etc. --are channeled to the people who need them. It is increas ingly and alarmingly clear that many, if not all, existing delivery systems are outmoded and incapable of making substantial headway against massive urban problems, including poverty, illness, inadequate education, and substandard housing, to name a few. There is a question as to whether new programs involving new methods and approaches are needed to respond more effectively to presentday problems. Perhaps what is needed is a fresh start, and not new cliches and new rhetoric about maximum feasible public participation, etc., etc, etc. Facts are a prerequisite at every stage for: 1. The conceptualization of a problem 2. The planning of a program to alleviate the problem 3. The implementation and evaluation of the programs estab­ lished to solve the problem. Unfortunately, facts have not always been used to best advantage. Rather than informing, facts have been used to misinform, often with suspicious consequences. Incorrect facts have often been the basis on which Model Cities programs were built. Study must be the first step in removing the burden of suspicions I -4- �I I ■ placed on the shoulders of governmental social agencies and the major private social institutions. Study must be the first step in preventing a sound concept from becoming just another failure in a long chain of failures. The singular object of study must be to let the Model Cities community play a meaningful and determining role in the definition of "success" in a program for the people 0 1 of the Model Cities community. J •0 iI I? fl -5- 11 �«■ 1 FART SOCIAL SERVICES OF AGENCIES AND INSTITUTIONS A. INTRODUCTION I . To provide specific information of the present human services now pro- J vided in the Greater Wilkes-Barre area, -particularly as they relate to the Model Cities Neighborhood, the researchers began by compiling a complete list of the agencies and institutions. The initial source utilized was the Model Cities application originally submitted to the U. S. Department of Housing and Urban 1 1 b'j c 0 Development. The list extracted from various parts of the application was added to by perusing the 1968 Diagnostic Survey conducted by the Welfare Planning Council for the Model Cities Agency. Both of the sources were then cross-checked against two other sources- the 1970 Luzerne County Yearbook, the annual Handbook of the Sunday Independent [ and HELP, a directory of the Welfare Planning Council. The Sunday Independent publication lists all Federal, state, county, and city offices located in Luzerne County. a public and voluntary in Luzerne County. fll '1 18 g j'l T; HELP is the directory prepared by the Council, a voluntary citizens organization financed by the Wyoming Valley United Fund. 1 In addition, the Handbook contains a listing of all welfare agencies - The Council, composed of both individuals and organizations interested in cooperative community planning, studies health, welfare and recreation needs of the community and initiates planning leading toward the development of more effective and more adequate social services. -6- �«■ 10 6 arrived at after deliberation on the inclusion of several doubtful agencies. I ' fi o t 0 ! $ B A final listing of 69 social service agencies and institutions was finally »r n After the survey was completed and a final review was made, it was found that five rather important social service agencies had been omitted. In all, 74 agencies and institutions were included as providing social services to the general citizenry in Wilkes-Barre and the Model Cities area. This part of the project was carried out in four stages: 1. Construction of an interview schedule 2. Collection of data 3. Analysis of data 4. Preparation of final report B. THE INSTRUMENT As is true in other parts of the report, decisions must always be made at the beginning of any research that are regretted in the analysis and writing. This'is the very nature of research. Decisions used to be made on the evaluation of the data on the social service agencies, the type and amount of services by H’ l the agencies, the constraints under which the agencies operate, the clientele of the agencies, the interrelationships of the social service agencies, and the service gaps that exist resulting either in a lack of services or ineffective delivery of social services. Again, it must be stated that judgments were made not with a view of being critical of the agencies, but rather in a constructive spirit with a view to helping those in need of the services. I? -7- !- ■ �The interview schedule was first discussed with representatives of the Welfare Planning Council and the Wilkes-Barre General Hospital. A first draft was constructed containing 34 questions aimed at obtaining data on the number and LJ source of clients, the objectives of a service as stated in law or charter, the i eligibility requirements for client service, the budget, personnel, and the relation­ r ships withjother social service agencies. Although the number of questions remained at 34, in the second draft, certain of the questions were refined for specificity. The final and third draft of the interview schedule contained 35 questions as a result of further consultation and refinement. The questions were grouped in topical sequence to provide information on: a 1. Purpose and goals 2. Kinds of services 3. Orientation of service objectives 4. Target 5. Eligibility requiremEnts of clients 6. Personnel and budget 7. Relationships with other agencies population and geographical area Interviewers were instructed on the use of the instrument both during the testing stage and prior to the use of the instrument but in the field,. Con­ sultation with the interviewers was continuous throughout'a 20-xlay period while the interviewers met with the representatives of the social service agencies. A total of 69 interviews were conducted in the field work. Data were �II n kJ collected from an additional 5 agencies because these agencies had been omitted during the 20-day period which began November 1, 1970. After careful analysis, 3 of the agency profiles were discarded on the basis of lack of relevancy to the E r Model Cities area, insufficiency of data, and/or out-of-town orientation. The final analysis of data and classification involved 72 social service agencies, 26 C of these agencies in the health field and 46 in the welfare field. £ C. THE INTERVIEWERS . All interviewers who worked on the social service agency profile were u Wilkes College students majoring in Sociology or Psychology. was assigned a minimum of five agency questionnaires. Each interviewer The professional agency director was forwarded an introductory letter stating that the IRA was undertaking a study of the agencies in the Model Cities Neighborhood and 0 nLy also setting forth the purpose of the study. informed by this letter of October 30j 1970, that within two weeks, an inter­ viewer would call to make arrangements to visit to secure the data on the que stionnair e. 1 The agency professional was In nd instance-were the interviewees, refused information,' ’ As a matter of fact, many agency people called the researchers or the IRA to express feelings of cooperation. i? -9- �D. CLASSIFICATION OF SOCIAL SERVICE AGENCIES A classification of social service organizations based on a single dimension is not only futile but risky. Certainly to classify on a single basis has the advantage Of Simplicity; yet, this advantage is also its weakness since every social service organization is multifunctional even though a single activity may dominate. Unless it can be shown that the selected service activity accounts for a substantial portion of the funds, clients, and energies of a social service organization, the utility of r unidimensional classification is severely limited. single dimension typologies have led to on more than one variable. profiles or patterns. The recognized drawbacks of efforts to construct classifications based An approach in this direction has been to develop Profiles are valuable since they provide a graphic method of locating salient attributes of various social service organizations vis-a-vis Q 0 '('I each other. Of course, there are many ways of classifying social service organizations. But classification, despite the way it is sometimes treated, is not an end in itself; it is a means of enlarging our understanding about the complex subject of social ■ service agencies. Little is gained; for example, by categorizing them by budgets unless this information enables us to predict performance. fl It may be interesting to know how many organizations provide supportive income maintenance, but this kind of knowledge without further application has little relevancy to effectiveness or adequacy of service. One way of classifying social service organizations is to treat them :as * -10- �R J I i 8 governmental and non-governmental. This has a special relevancy as between public and voluntary agencies, especially as concerned with the source of funding. Mutual aid, the church, organized private benevolence, and the state have been t I 0. I and still are the fundamental resources for the care of the poor. order of importance is in reverse. Today, the Moreover, in this current era, the distinctions 'bfetween governmental and non-governmental have become increasingly obscure L P especially with the development of the private, non-profit-making corporation IL as the instrument of social change and with the major funding source actually being the federal government. - . Resultantly, the term of quasiLpublic organization has come into vogue. Using another base for differentiation, organizations that provide social s 0 ■ services may be classified into four main groups: (1) agencies designed primarily d': to give social service to clients, either as individuals or in groups (i. e. , social i (2) organizations which offer social services as well as other services (i. e. I ■! welfare departments, family and children's societies, YWCA, Boy Scouts); American Red Cross, Salvation Army); (3) organizations which are basically designed to offer other services, but which maintain an auxiliary department of social work (i. e. hospitals, clinics, juvenile courts, vocational rehabilitation services); and (4) organizations that are not rendering direct services to individuals or groups but are set up to assist other social agencies (i. e. Welfare 1 Planning Councils). n -u- �r, n ■■ W D - 'J n In modern society, whenever the breadwinner is unable to work, cannot obtain work, or is taken by death, outside help is necessary to provide that economic security. The basic idea is to provide money where there is none or when the individual and/or his family become dependent. Direct income main- tenance can be provided by one of three approaches—public assistance, social I insurance, or a pension system. n then activities that lead in this direction should be emphasized- restoring his •J If the individual can produce his own income, health, improving his state of mind, providing him with skills, etc. These are poverty related activities in that it is difficult to break the poverty cycle. I The problem is an entirely different one if the individual is not rehabitable n and a likely candidate for self support. In that case, the objective is to secure for each human being, rehabitable or not, a decent standard of health, proper living conditions, and the highest degree of self respect. Social Service organizations developed out of the felt needs of a I “ 1 I HI community. These organizations are the expression of felt needs by particular communities of interest. [J Consequently, there are in every city a considerable number of organizations dedicating their efforts in a general or specific health and welfare area and focusing their available resources on that particular interest. In some instances, the functions and operations of these agencies are I clearly defined, while in others the scope of their operations is so broad that it is not always possible to identify what specific services are provided. How- ever, the values which underlie these agencies are quite clear--health of the -12- �r r D u C state of well-being and the value work ethic or income . Since the Institute of Regional Affairs analysis indicated that virtually all needs of the residents of the MNA involve some type of health factors or economic considerations, the broadest classification of service organizations r H fl has been made into health services and welfare services. The former is concerned primarily with matters relating to the physical, mental, and emotional health of the individual and families, while the latter includes those organizations dedicated to assuring emotional well-being and to assisting in restoring or providing income to persons in need, or to assisting them in finding the means to attain a level of income necessary for their general health and well-being. The basic interdependency of these two types of services must, of course, be recognized, since the problem of an individual or family may be essentially one of health, but insufficiency of income may be the cause or contributory of the health problem and vice versa. In each of the foregoing broad categories, the specific agencies differ considerably in the nature of services rendered. Consequently, a further sub-classification is required to facilitate identification of the agency most appropriate to the problem on hand. Health and welfare services are direct or indirect, depending on the client relationship. these fields are of the special interest type. Some agencies in both of Additionally, because of the special nature and magnitude of their functions, certain services should be classified as institutional, to distinguish them from those which are provided on an at-home basis. -13- ���WELFARE SERVICES ECONOMIC SECURITY SERVICES A. Income Maintenance 1. Social Security Administration 2. Veterans' Administration 3. Luzerne County Board of Assistance Jobs and Training 1. Bureau of Employment Security 2. Concentrated Employment Program , FAMILY, CHILDRENS', AND CUSTODIAL CARE SERVICES Family Social Services 1. Family Service Association of Wyoming Valley 2. Wyoming Valley Council of Churches -- Meals on Wheels 3. Catholic Social Services 4. Planned Parenthood Association 5. Jewish Welfare Agency 6. Luzerne County Bureau for the Aging 7. Adult Welfare Services and Project Reach Out for Life (Luzerne County) 8. Visiting Nurses Association of Wyoming Valley Homemakers Service of Luzerne County 9. 10. Commission on Economic Opportunity Children's Welfare and Educational Services 1. Luzerne County Child Welfare Services 2. St. Michaels Home for Boys 3. St. Stanislaus 4. Headstart Institutions 1. Home for Homeless Women 2. Sutton Home DIRECT REHABILITATION SERVICES A. General 1. United Rehabilitation Service 2. Wayside Mission 3. Salvation Army 4. Bureau of Vocational Rehabilitation �WELFARE SERVICES, CONTINUED Special Group Crippled Children's Association 1. Bureau of Visually and Physically Handicapped 2. United Cerebral Palsy 3. Alcoholics Anonymous 4. Pennsylvania Association for the Blind 5. DIRECT LEGAL AND CORRECTIVE SERVICES A. Governmental Adult Probation, Luzerne County 1. Juvenile Court, Luzerne County 2. Domestic Relations Court, Luzerne County 3. Consumer 1. Legal Services Association 2. Legal Aid Society COMMUNITY CHARACTER BUILDING GROUP SERVICES A. National Affiliation Boy Scouts of America 1. Girl Scouts of America 2. 3. YMCA 4. YWCA Local Affiliation 1. Catholic Youth Center 2. Georgetown Settlement 3. Jewish Community Center SPECIAL INTEREST SERVICES A. Pennsylvania Veterans Commission B. F’ F] VII. Federation for the Blind INDIRECT WELFARE SERVICES A. Pennsylvania Department of Public Welfare, Region II, Scranton B. Commission on Economic Opportunity �OEO CAP Agency- Creation of variety of poverty programs for the sake of activity Title N-A- Day care- Creation of large variety of day care programs Hospitals Blue Cross payment-----for hospitalized patients In-patient care It is obvious from Table 1 that mor er.agencies and institutions are engaged in welfare services than in health services. y 1 It should also be noted that many agencies and institutions have more than one source of income - sometimes all governmental, sometimes all voluntary, and more times than not a combination of both. For instance, hospitals have a variety of sources including Federa^(Medicare), state (Medicaid), Blue Cross payments, payments by patients, and private insurance. TABLE 1 AGENCIES BY SOURCE OF FUNDING Source of Funding Federal State-Federal County-State-Federal County-Federal County- State County City Voluntary Voluntary-Federal-State Voluntary-Federal-StateGounty Voluntary-State Voluntary-City TOTAL No. of Agencies 3 6 11 2 1 2 1 37 Health Welfare 1 2 3 3 0 0 0 3 3 3 2 2 8 1 1 2 0 25 2 0 2 1 72 1 0 26 1 0 46 1 12 -15- �One is immediately struck by the high number of social service organizations that receive funds from some level of government, reiterating the earlier statement that a change from voluntary to governmental funding of social service is going on. A significant phenomena is the development of new agencies that use governmental funding: the quasi-public organization. One should also mote the high number of social service agencies;,- especially in welfare, that continue to rely on voluntary sources of funding. The "voir. . '. untary" source of funds needs some clarification, for it is quite varied even though the predominant source is the United Fund’ from which 27 health and welfare agencies receive money. monies only. No agency receives United Fund For instance, Homemakers Service receives United Fund monies combined with county funds and client fees. The "voluntary" sources are drives, dues, endowments, special events, voluntary contributions, fees, investments, church collections, and private insurance payments. One can only speculate on the effect funding availability has on current or proposed programs, and how, in many instances, planning is designed to use that funding availability. ’ F. THE FINDINGS--SOCIAL AGENCIES 1. Introduction Presentation and analysis of the data provided by the health and welfare agencies serving the Model Neighborhood Area reveals several partially valid, though nonetheless useful,, evaluative criteria. -16- Among these are the �£ cost per client, the number of clients per employee, the nature of the core and peripheral services, and the eligibility requirements of each agency. 1 Admittedly, comparison of agencies on these bases has vital drawbacks. Perhaps the most obvious is the lack of uniformity in the method of reporting expenditures and services rendered by health and welfare organizations. For instance, one agency may':treat an individual client as a service unit, while 3 3 0 I I I 1 I another agency may treat a family.compfisirig several individuals, all of whom receive service, as a service unit. Moreover, there are some agencies who treat an individual coming to them for service as individual units-of service each time that individual appears and utilizes the service. Comparison of agencies on the basis of expenditures per service unit, regardless of the definition of the term, is equally useful, but also limited. This basis certainly opens up vast areas and questions for the community and the professionals in the field to do more research. Returning to the point, assuming that two or more agencies provide exactly the same quality of service, comparison of the expenditures per service unit would have considerable validity. However, since the quality of services of all the agencies has not been, and cannot currently be, g determined and compared, such comparison is little more than spec- ulation. The greatest dollar expenditures per client or family do not necessarily mean either the best or the worst quality of service. Lowest cost per client does not indicate poor service, although there may be a Pi ;.i7- �I directi correlation between low cost and low quality of service. Low cost per service unit may indicate that the organization is attempting to do too much in too many different directions, or it may indicate that the organization relies heavily on volunteers to operate. Case-load per employee is another criteria which should be applied with similar caution. It is reasonable to conclude that the number of clients which a given employee can service well depends upon a number of factors, including the number and variety of services which the employee is expected to render, the work time required by the nature of the service, the ability and dedication of the employee, or the characteristics of the individual or family involved. Consideration of the core and peripheral services of an agency likewise supplies a useful criteria for comparison, provided experience is used to buttress the formal statements of services reported by the agencies. It appears perfectly valid to expect that a given agency may rate high in the quality, or services may be "extra-curricular" offshoots of the core onqs,: and therefore, performed perfunctorily and low in quality. g: Again, one agency which treats a given service as a peripheral service may provide a higher quality than one which treats.it as'its principal function. All agencies have eligibility requirements which determine whether not an individual or family should receive assistance. It is sometimes assumed, and often erroneously, that the agency providing the easiest -18- �5K . requirements will be the most readily available and of most effective service to the client. This may or may not be true, but only experience will provide the answer in any given instance. I 5 3 I a s 9 1 other measures are sometimes employed. However, because of the nature of personal and family problems, and the characteristics of many Model Neighborhood Area residents, a knowledge and comparison of the eligibility requirements of similar agencies does provide another useful criteria for selecting the appropriate agency by a. particular client. The tables which follow summarize the data assembled in the many varying forms by the health and welfare agencies in this community. on a study of the community. The application of a more thorough and analytic process to this body of data could very well question and perhaps dispel some of the myths that have been accepted for years. IB 2. Cost per Client a. Health Services Available data, summarized in Table 2, indicate a wide variation in the cost per client for health services by agencies serving the City. 'N 3 Dividing the agency's current operating budget by the number of clients served during the past year shows a spread ranging from a low of $5. 39 to a high of $7928.58 per client. I I A comprehensive view of the whole body of data does show a great impact i 8 To prevent intake flooding, This variation may be misleading because the cost per client obviously depends upon many factors, including the nature and quality of the -19- �fi service performed. 3 Retreat State Hospital has the highest cost per client and the Tuberculosis Society the lowest, but the wide spread is due to the fact that the Hospital provides complete custodial care for s li ; a 3 a some 700 patients while the TB Society's costs involve expenditures for 6,488 chest x rays only. Costs per client are also influenced by whether the services are direct, indirect, or special interest. Hospitals and clinics perform direct services, and the table shows that the Kirby Health Center with an annual budget of $129, 000 provides direct clinical service at a per client cost of $6. 79. The hospitals also provide direct services for which per client costs range from a low of $107. 14 at the Wilkes Barre General Hospital to a high of $351. 76 at Luzerne County's Valley Crest. This-wide difference is undoubtedly due primarily to the difference in institutional functions, the former dealing with customary hospital functions while the latter is mainly custodial, and only partially medical in nature. The special interest services also vary considerably in per client I costs, ranging from $5. 39 for x-rays by the Tuberculosis Society to $600. 00 per client served by the Multiple Sclerosis Foundation whose services to each client are much more comprehensive and extensive. .J Direct services by hospitals providing only medical treatment also vary considerably in per client costs. Mercy Hospital, operating under an annual budget of $6, 000, 000. 00, and serving about 8, 524 n -20- �3 patients, has a per client cost of $703. 89, while the larger Wilkes Barre General Hospital, also operating under a $6,000,000.00 s annual budget, serviced 11, 000 in-patients and 45, 000 out-patients as a per client cost of $107. 14. In this case, the data do not indicate whether the difference in cost is because Mercy may not have included out-patient costs, or for other reasons. The above data, although it presents a general picture of cost per 3 1 y 2 has been created to identify and assist in meeting regional and local TO health needs. £ client illustrates the point that more analytical study is required to deter­ mine what is included in the cost of a case - medication, nursing care, administration, food, maintenance, etc. Nor does the data reveal how much utilization each institution makes of expensive equipment. The Office of Comprehensive Health Planning of Northeastern Pennsylvania The Office has encouraged and promoted the establishment of a Wyoming Valley Hospital Council to consider approaches to group » purchasing hopefully resulting in considerable savings to the area hospi­ tals and therefore to the MNA residents. Perhaps the Council will be the mechanism for assessing the health services expenditures and other fac- u 1 tors, such as equipment, etc. , and analyzing where monies could be better spent. One additional comment needs to be made on the foregoing fund 1 data. There are many agencies - governmental and voluntary and both health and welfare - which engage in some aspect of prevention; and yet n I? -21- �there is no way to know for certain how much - great or little - is actually spent for prevention and what agencies do the spending in Luzerne County, Wyoming Valley, Wilkes-Barre, or the Model Cities Neighborhood. ] 1 3 Bi 1 5 O I j ! ■s G, C ('• p t* r �there is no way to know for certain how much - great or little - is actually spent for prevention and what agencies do the spending TABLE 2 HEALTH SERVICES SERVING MODEL NEIGHBORHOOD AREA BUDGET, SOURCE OF FUNDING, NUMBER OF CLIENTS, COST PER CLIENT HEALTH SERVICES BUDGET I. NO. OF CLIENTS COST PER CLIENT DIRECT MEDICAL SERVICES A. Hospitals 1. Wilkes-Barre General Hospital 2. 3. 4. 5. Mercy Hospital Nesbitt Memorial Hospital Wyoming Valley Hospital Veterans' Administration Hospital Valley Crest 6. B. II. SOURCE OF FUNDING * Clinic Services 1. Kirby Health Center 2. Public Health Center DIRECT MENTAL HEALTH AND/OR RETARDATION SERVICES A. Hospitals 1. Retreat State Hospital 2. B. C. Clinics 1. Luzerne/Wyoming Counties' Mental Health Center 2. Children's Service Center of Wyoming Valley Information and Referral 1. Luzerne/Wyoming Counties' Mental Health/ INDIRECT HEALTH SERVICES Pennsylvania Dept, of Health Regional Office, Regi°K II ] A. B. V. F. S. 6,000,000.00 3,700,000.00 1,612,296.00 9,700,000.00 1„ 525, 881.00 V.F.S. S. F. V. F. S. F. Co. S. F. ,129, 000. 00 V. S. F. 3,700,000.00 ( 8-month ) S. F. 11,00 in patients $ 107.14 45, 000 out-patients 8, 524 703.89 7, 000 528.57 3, 745 430.52 4, 370 2,219.68 500 3, 051.76 19,000 approx. 700 6.79 7, 928.58 White Haven Hospital * * Mental Retardation Program III. $ 6,000,000.00 Wilkes-Barre Department of Health 1,200, 000.00 340,000.00 Co. S. F. V.F.S. Co. 1, 600 700 families 1,500,000.00 Co. S. F. 2, 246 1, 514, 885.00 75, 000. 00 S. F. N/A V. 7, 560 750.00 485.. 71 9.92 �there is no way to know for certain how much - great or little - is actually spent for prevention and what agencies do the spending iirilVo c rr e. or the Model TABLE 2 CONTINUED HEALTH SERVICES ______ SERVING MODEL NEIGHBORHOOD AREA BUDGET, SOURCE OF FUNDING, NUMBER OF CLIENTS, COST PER CLIENT HEALTH SERVICES IV. Luzerne County Association for Retarded Children American Red Cross * KEY-- C Co. F. S V * * Questionnaire ife- SOURCE OF FUNDING * NO. OF CLIENTS COST PER CLIENT ADVOCACY SPECIAL INTEREST SERVICES A American Cancer Society B. Arthritis Foundation C. Cystic Fibrosis Foundation D. Luzerne County Mental Health Association E. Multiple Sclerosis Foundation F. Muscular Dystrophy Association G. National Foundation -- March of Dimes H. Tuberculosis Society I. Northeastern Pennsylvania Heart Association J. K. BUDGET City County Federal State Voluntary not returned at time of publication. i n $ 29,010.00 1,450.00 19, 000.00 12, 000.00 10, 000.00 10, 000.00 35, 000. 00 48, 000. 00 23, 700. 00 190,000.00 . , V. . V. S. F. V. V. V. V. V. V. V. V. 153 248 65 N/A 20 300 43 6, 488 x-rays 300 none directly 1, 544 veterans servicemen and their families. 189.60 22. 31 600.00 33. 33 232.56 5. 39 160.00 123.06 �II there is no way to know for certain how much - great or little - is actually spent for prevention and what agencies do the spending in Luzerne County, Wyoming Valley, Wilkes-Barre, or the Model Cities Neighborhood. These questions are raised because the data are not in themselves conclusive but do suggest other questions for study. As the data now stand, the MNA residents can only view, with some justification, the great disparity in costs per client as beyond their reach. b. Welfare Services Having advised extreme caution in evaluating health service agen­ cies on the basis of their cost per client ratio because of the great variations in the nature and extent of their services, an even stronger word 1 of caution is necessary in the evaluation of welfare services on that basis. Even a cursory examination of Table 3 on welfare services shows such a range of variables among welfare services, that to compare on 1 the basis of cost per client would be like comparing completely unrelated items. The only justifiable conclusion warranted by the data is that Welfare service costs per client range from a low of $. 63 for char- $ acter building activities at the Georgetown Settlement to more than $1,500. 00 per client for direct rehabilitation services at the Bureau of Vocational Rehabilitation. Obviously, there is no basis for comparison but this wide range certainly does make a good argument for preventive activities. The Commission on Economic Opportunity expended $583. 33 to -22- u �provide each of 1,200 clients one of an undesignated number of family social services. In the same fiscal period, the Planned Parenthood Association ex­ pended $33. 86 for each client. It is not valid to compare the former which performs a large variety of services with the latter whose functions are restricted to a single purpose. Even though their services may be quite similar in character, it would be invalid to compare the $30. 34 per client expended by the Legal Aid Society with the $108. 33 spent for each client by the Legal Services Associ­ ation, simply because their approach, clientele, and method of operation differ in so many respects. It would be more valid to make a comparison when each reaches the same target population. But this will not be possible because the Legal Aid Society may be "phased out" because of lack of United Fund support. In spite of the reservations above, certain observations are clearly obvious. Exclusive of the CEO, there is at least $709, 070 expended in the community for family type social services, ranging all the way from $13.33 per client to $318. 58 per client (exclusive of Council of Churches). If only Family Service, Catholic Social Services, Jewish Welfare Agency, Homemaker Service, and Visiting Nurse Association are considered (all of which are United Fund Agencies), the per client cost goes from $33. 86 to $318. 58. <7 All of these agencies are predominately involved in removing family tensions due to lack of finances, poor health, personal disagreements, loss of income, etc. A -23- I �B .. □ rp nnsidered. the cost oer client TABLE 3 WELFARE SERVICES SERVING MODEL NEIGHBORHOOD AREA BUDGET, SOURCE OF FUNDING, NUMBER OF CLIENTS, COST PER CLIENT welfare services budget L ECONOMIC SECURITY SERVICES A. Income Maintenance 1. Social Security Administration 2. veterans1. Administration 3. Luzerne County Board of Assistance $ 18, 000, 000.00 B. Jobs and Training 1. Bureau of Employment Security 2. Concentrated Employment Program 1,200, 000.00 II. FAMILY,CHILDREN'S,AND SUPPORTIVE CARE SERVICES A. Family Social Services 1. Family Service Association of Wyoming Valley 2. Wyoming Valley Council of Churches--Meals on Wheels 3. Catholic Social Services 4. Planned Parenthood Association 5. Jewish Welfare Agency 6. Luzerne County Bureau for the Aging 7 . Adult Welfare Services and Project Reach Out for Life (Luzerne County) g _ Visiting Nurses Association of Wyoming Valley 9. Homemakers Service of Luzerne County 10. Commission ---------- 1 on Economic Opportunity B. Children s Welfare and Educational Services . Luzerne County Child Welfare Services Michaels Home for Boys * * 3. St. Stanislaus Institute 4. Project Headstart * * ST J3 WUI SOURCE OF FUNDING * E. F. F. S. C F. S. F. S. C. NO. OF CLIENTS COST PER CLIENT 77,000 $ - - 16, 328 $ 1,102.40 15,000 1, 200 1, 000.00 95,018. 00 34,000.00 102,056.00 8, 000.00 21,181.00 100,000.00 97, 044.00 V. V. V. V. V. F. S. C. F. S. C. 880 families 100 churches 3, 014 600 160 1,600 1, 500 107.98 340.00 33. 86 13..33 132..38 62.50 64.70 179,771.00 72,000.00 700,000. 00 V. V. F. S. C. 1, 311 226 families 1,200 137.13 318.58 583.33 1, 049,992.00 F. S. C. V. V. F. 1, 500 95 64.70 •d �L k' If direct rehabilitation services are considered, the cost per client ranges from $8. 33 to $2, 000. Of course, again the rehabilitation service of TABLE 3 CONTINUED P? WELFARE SERVICES SERVING MODEL NHGHBORROOD AREA BUDGET, SOURCE OF FUNDING, NUMBER OF CLIENTS, COST PER CLIENT WELFARE SERVICES C. Institutions 1. Home for Homeless Women 2. Sutton Home IH. DIRECT REHABILITATION SERVICES A. General 1. United Rehabilitation Service 2. Wayside Mission 3. Salvation Army 4. Bureau of Vocational Rehabilitation B. Special Group ■ 1. Crippled Children's Association 2. Bureau of Visually and Physically Handicapped 3. United Cerebral Palsy 4. Alcoholics Anonymous 5. Pennsylvania Association for the Blind IV. DIRECT LEGAL AND CORRECTIVE SERVICES A. Governmental •. 1. Adult Probation, Luzerne County 2. Juvenile Court, Luzerne County 3. Dojnestic Relations Court, Luzerne County B. Consumer 1. Legal Services Association 2. Legal Aid Society BUDGET $ approx^ $* 1, 000, 000, 00 100,000.00 3,500,000.00 113, 000.00 .900, 000. 00 41,000. 00 27,000.00 350,000.00 - 400.p00.00 86,590. 00 65, 000.00 23,000.00 SOURCE OF FUNDING* Nd OF CLIENTS V. V. 40 21 F.S. C.V. V. AL F.S. : COST PER CLIENT $ 500 1,000 12,000 2,300 2,000.00 S.V. F.S. S. V. V. V. 781 8, 000 150 144.69 112.50 273.33 362 74.59 s.c. F.S.C. C. 500-600 600 10,000 625.00 11.55 F.S.C. V. 600 768 108.33 30.34 8.33 1,521.74 ��L If direct rehabilitation services are considered, the cost per client & ranges from $8. 33 to $2, 000. £ u 1 I § i Of course, again the rehabilitation service of the Wayside Mission is far different than that of the United Rehabilitation Service. Initial costs may show larger expenditures in certain programs than in others because certain ones are. deliberately initiated on low cost projections (mostly using volunteers) to demonstrate viability before the larger community decides to take on a greater responsibility for the support. 3. Case Load A word of caution must be given to the reader so that he can judiciously COM i. N; 1. 2. 3. use the data that follows. 3 4. L< 1. 2. 3. i INI A. B. each employee in a health service agency is frequently used to determine efficiency and quality of such service. However, it is erroneous to assume that the smaller the ca.se load of an employee the higher the quality of service, or, conversely, the larger the case load the lower the quality. The wide range of case loads per employee in the health service agencies in the City SPE A. B. 3 1 The case load, or the number of clients served by 2 I should be evaluated in relation to many factors, including the nature of the ■I service rendered as well as the professional or voluntary status of the em- s ployee. >4 . a. Health Services The 9 employees of the Kirby Health Center, which operate as a KE' clinical staff, served 19, 000 clients or 2, 111. 1 clients per employee. GSo. F. S. V. Qu i This is doubtless due to the fact that less time is required for each client by the -24- �I nature of the service rendered. In the same sense, the 2 employees of the Luzerne/Wyoming Counties Mental Health/Mental Retardation Program u p served 2,246 clients, or, 1, 123. 0 per employee, primarily because this service is informational and referral in nature. Valley Crest, administered by the County, has the lowest client-employee ! ratio of 2. 5 among the direct service by hospitals. This ratio should not be compared with the other hospitals because the nature of their services differs completely. On the surface, the direct medical service case load of employees at the Wilkes-Barre General Hospital (108. 5) appears to be out of line with the other hospitals cited in the table. However, in addition to caring for 11,000 in-patients with varying periods of stay, the General Hospital ser­ 1 vices 45,000 out-patients requiring short visits. The other hospitals listed do not indicate the number of out-patients, and it may therefore be the reason 1 ■J why the case load per employee for long-stay in-patients is considerably lower than shown. Data were not sought, nor were they offered, as to which activities were handled on an out-patient and in-patient basis. 1 Excluding the Wilkes-Barre General Hospital, the Mercy Hospital has the highest case load per employee with 292 employees handling 8, 524 patients, or 29.2 per employee. At Nesbitt Memorial, 413 employees care for 7, 000 patients, resulting in a case load of 17. 0 per employee. e Wyoming Valley Hospital with approximately one-half the number of employees and patients as Nesbitt, has a case load of 19.7 patients per employee. - 25 - �To return to a point made in a previous section,there is no clear definition °f a case or service with either medical or mental health service. Nor can TABLE 4 HEALTH SERVICES SERVING MODEL NEIGHBORHOOD AREA NUMBER OF EMPLOYEES, CLIENTS^, AND CASE LOAD health services I. DIRECT medical SERVICES A. Hospitals 1. Wilkes-Barre General Hospital 2. Mercy Hospital 3. Nesbitt Memorial Hospital 4. Wyoming Valley Hospital 5. Veterans' Administration Hospital 6. Valley Crest i i I II. f u 292 413 190 340 200 108. 5 29. 2 17.. 0 19.7 12.. 9 2. 5 19,ooo 2,111. 1 DIRECT MENTAL HEALTH AND/OR RETARDATION SERVICES A. Hospitals 1. Retreat State Hospital 2. White Haven State School Hospital* 207 . 700 3.4 Clinics 1. Luzerne/Wyoming Counties' Mental Health Center 2. Children's Service Center of Wyoming Valley Information and Referral 1. Luzerne/Wyoming Counties'1 Mental Health/Mental Retardation Program INDIRECT HEALTH SERVICES A. Pennsylvania Department of Health Regional Office, Region H B. f ' 11, 000 in patients 45, 000 out patients 8, 524 7, 000 3, 745 4, 370 500 516 CLIENTS PER EMPLOYEE 9 22 C. III. NO. OF CLIENTS B. Clinic Services 1. Kirby Health Center 2. Public Health Center B. / NO. OF EMPLOYEES Wilkes-Barre City Department of Weal th 40 28 2 122 8 1, 600 700 families 2, 246 40. 0 25. 0 1,123,'0 not applicable 7, 560 945.0 �u 11 'Ji section, there is no clear definition To return to a point made in a previous Nor can or mental health service. of a case or service with either medical J -clearly spell out what U «•- c .. n w TABLE 4 HEALTH SERVICES SERVING MODEL NEIGHBORHOOD AREA NUMBER OF EMPLOYEES, CLIENTS, AND CASE LOAD n 1/ D HEALTH SER.VICES ADVOCACY SPECIAL INTEREST SERVICES A. American Cancer Society B. Arthritis Foundation C. Cystic Fibrosis Foundation D. Luzerne County Mental Health Association E. Multiple Sclerosis Foundation F. Muscular Dystrophy Association G. National Foundation -- March of Dimes H. Tuberculosis Society Northeastern Pennsylvania Heart Association I. Luzerne County Association for Retarded Children J. K. American Red Cross RE E 1. D I u < 'I U n c r fR U f1 u I ♦ U NO. OF CLIENTS CLIENTS PER EMPLOYEE IV. r\ 1 NO. OF EMPLOYEES CONTINUED •X. Questionnaire not returned at time of publication. 2 1 not applicable 2 1 1 1 1 3 1 30 153 248 76.5 248. 0 65 not applicable 20. 0 20 300 300. 0 43. 0 43 6488 x-rays 6,488. 0 300 100..0 none directly 1,544 servicemen, 51.5 veterans and their families �To return to a point made in a previous section,there is no clear definition of a case or service with either medical or mental health service. Nor can any person or group--professional or otherwise--clearly spell out what activities belong to a "provision of a service?; There is no specificity as to what must occur before a case is closed. Length of time could be a part of the definition, and yet no professional would agree to the use of this 3 single criterion. If the above is so true of "normal” service, an "emergency” hospital service is just as vague and indeterminate if not more so. To illustrate, a patient may need a family doctor to certify admission. If no family doctor can be procured, admission is rejected, as so often happens to the MNA <1 r N L A 3 1 i residents. What then? Is this (no family physician certification) an emer- gency? The comments made in the foregoing are as applicable to mental health organizations as to hospitals. Among the special interest health services, most have indicated only one employee, indicating that much of the work is done by non-listed voluntary personnel. The American Red Cross shows 30 employees hand­ ling the needs of 1,544 servicemen, veterans, and their families, with each st employee serving 51.5 clients. The si.ngle employee of the Muscular Dystrophy Association, serving 300 clients, has a case load of 300 per employee. From the Table 4 it appears that the case load handled by the single -26- �jj employee of the Tuberculosis Society is 6,488, which is the highest case load, shown. This figure represents only the x-ray service which is performed by special personnel, while the one regular Society employee provides an 1 ■ unspecified number of other services for clients. If certain clinics are in the process of phasing out, one could assume that the problems previously handled by them no longer exist. V 3 However, if the problems still plague the community, especially the poor and/or welfare client, there is no way of knowing what agency or agencies now service those clients. lb The data present the number of clients served and not the refusals or rejections. Subsequent data in Part II of this study would indicate that the ,tt rejections are in sufficient numbers to warrant the feeling among the MNA resident that the health problem is "worsening. " The reasons for these could be due to a number of reasons that require a further.in-depth study. b. Welfare Services Evaluation of welfare agencies is not justified on the basis of the number <T> of clients served by each employee but on the nature of the service rather s than on the attributes of the client. Although some of the agencies listed in the following table perform some functions which are somewhat similar, each has its own distinctive type of client, kind of service activity, and 1 I u> lr i’ each differs in the amount of time required by the nature of the service for each client. The case load for family social services ranges from 7. 8 for Homemakers -27- �Service of Luzerne County which has 29 employees serving 226 families to 300. 0 clients for each of the two employees servicing 600 families for the 11 Wj TABLE 5 1 ti WELFARE SERVICES SERVING MODEL NEIGHBORHOOD AREA NUMBER OF EMPLOYEES, CLIENTS, AND CASE LOAD n L.< n ♦. WELFARE SERVICES I. r\ ECONOMIC SECURITY SERVICES A. Income Maintenance 1. Social Security Administration 2. Veterans' Administration 3. Luzerne County Board of Assistance B. r u r: 1 n c 4 P U II. NO. OF EMPLOYEES Jobs and Training 1. Bureau of Employment Security 2. Concentrated Employment Program FAMILY, CHILDREN'S, AND SUPPORTIVE CARE SERVICES A. Family Social Services 1. Family Service Association of Wyoming Valley 2. Wyoming Valley Council of Churches -- Meals on Wheels 3. Catholic Social Services 4. Planned Parenthood Association 5. Jewish Welfare Agency 6. Luzerne County Bureau for the Aging 7. Adult Welfare Services and Project Reach Out for Life (Luzerne Co. ) 8. Visiting Nurses Association of Wyoming Valley 9- Homemakers Service of Luzerne County 10. Commission on Economic Opportunity B. Children's Welfare and Educational Services 1. Luzerne County Child Welfare Services 2. St. Michaels Home for Boys * 3. St. Stanislaus Institute 4. Project Headstart * NO. OF CLIENTS CLIENTS PER EMPLOYEE 340 104 77,000 4, 370 16,328 2, 0R1. 1 12. 9 157. 0 50 25 15,000 1, 200 300. 0 37 48. 0 110. 0 12. 5 8 8 9 2 2 10 7 15 29 23 880 families 100 churches 3, 014 600 160 1, 600 1, 500 1, 311 226 families 1, 200 300. 0 80. 0 160. 0 214. 3 87.4 7. 8 52.. 2 22 12,000 545. 5 24 95 4. 0 33. 5 �Service of Luzerne County which has 29 employees serving 226 families to 300. 0 clients for each of the two employees servicing 600 families for the Doubtless, this is a wide spread in work U n TABLE 5 WELFARE SERVICES SERVING MODEL NEIGHBORHOOD AREA *’ NUMBER OF EMPLOYEES, CLIENTS, AND CASE LOAD Fi u n c n n WELFARE SERVICES C. III. * 1 ■ - B. u ! o LJ < IV. L_J < Special Group 1. Crippled Children's Association 2. Bureau of Visually and Physically Handicapped 3. United Cerebral Palsy 4. Alcoholics Anonymous 5. Pennsylvania Association for the Blind DIRECT LEGAL AND CORRECTIVE SERVICES A. Governmental 1. Adult Probation, Luzerne County 2. Juvenile Court, Luzerne County 3. Domestic Relations Court, Luzerne County B. n Institutions 1. Home for Homeless Women 2. Sutton Home DIRECT REHABILITATION SERVICES A. General 1. United Rehabilitation Service 2. Wayside Mission 3. Salvation Army4. Bur eau of Vocational Rehabilitation o r CONTINUED (2) Consumer 1. Legal Services Association 2. Legal Aid Society NO. OF EMPLOYEES NO. OF CLIENTS CLIENTS PER EMPLOYEE 6 40 21 6. 7 30 5 500 1, 000 12,000 2, 300 16. 7 200. 0 3,000.0 41. 8 7 7 10 N/A 2 781 8, 000 150 111.6 470. 6 15. 0 362 181.0 4 18 500-600 600 6 10,000 137. 5 33. 3 1,250. 0 3 600 1 768 4 55 200. 0 768. 0 �c § 8 Service of Luzerne County which has 29 employees serving 226 families to 300. 0 clients for each of the two employees servicing 600 families for the _ i. u ow TABLE 5 CONTINUED (3) WELFARE SERVICES SERVING MODEL NEIGHBORHOOD AREA NUMBER OF EMPLOYEES, CLIENTS, AND CASE LOAD WELFARE SERVICES n u n V / o kJ [n; V. COMMUNITY CHARACTER BUILDING GROUP SERVICES A. National Affiliation 1. Boy Scouts of America 2. Girl Scouts of America 3. YMCA 4. o B. 'F 60 YWCA * CLIENTS PER EMPLOYEE 10,000 1,428.6 11,310 706. 9 2, 900 paying, 90, 000 non- 1,550. 0 paying 40 VI. SPECIAL INTEREST SERVICES A. Pennsylvania Veterans Commission 2 4, 500 2, 250. 0 1 1, 200 1, 200. 0 23 1,200 52. 2 U u r 7 NO. OF CLIENTS Local Affiliation 1. Catholic Youth Center 2. Georgetown Settlement 3. Jewish Community Center i' ' 3c NO. OF EMPLOYEES B. Federation for the Blind 6 5 6, 209 16,000 approx.l, 600 families 1,034.8 3, 200. 0 40. 0 VII. INDIRECT WELFARE SERVICES A. Pennsylvania Department of Public Welfare, Region II, Scranton* u B. Commission on Economic Opportunity r< * Questionnaire not returned at time of publication. U n �r, Service of Luzerne County which has 29 employees serving 226 families to 300. 0 clients for each of the two employees servicing 600 families for the Planned Parenthood Association. i i 1 Doubtless, this is a wide spread in work load, but perfectly valid and understandable in view of the difference in the type of services rendered. If just the "family type" agencies are considered, the range begins at 33.5 for Catholic Social Services to 110 for the Family Service Association. The rehabilitation work of the United Cerebral Palsy (15. 0 clients per 3 employee) is far different than that of the Salvation Army (3, 000 clients per employee). hx In spite of the fact that the case load per employee in itself is no 3 1 B I 9 indication of the relative efficiency of effectiveness of even the most similar agencies, the data does offer a point from which the ordinary MNA resident makes comparisons and arrives at conclusions sometimes justifiable and sometimes not. 4. Core and Peripheral Services a. Health Services As indicated in the following summary table, 25 surveyed agencies provide a wide range of health services within the City. In In most instances, the type of core services provided can be readily identified by the name of the agency. 1 Peripheral services are usually directly related to or flow from the core services, and, in fact, may justifiably be included as core in some instances. I lb ! -28- �■i 3 The major services currently provided include comprehensive acute rnedical and surgical care for in-patients and out-patients, diagnostic and ■3 nursing service for communicable and chronic diseases, and maternal and child health, immunization, mental health, and varying kinds of assistance in a u □ specialized diseases. Except for the hospitals, a significant number of health agencies devote considerable effort to professional and public education in their respective fields, although it is difficult to tell for whom it is intended. Nearly all of the core services identified by this study relate to those CT ft for acute illness or handicap. a a ■'H Therefore the foci of health services systems are the negative of health. Six agencies provide general acute medical and surgical service, while Valley Crest provides medical, but not surgical service. Only the Public Health Center of Luzerne County provides diagnostic and nursing service for communicable and chronic diseases and maternal and child health. [I Two hospitals, Wilkes-Barre General and Retreat provide psychiatric care. Three other agencies provide such treatment on an out-patient basis, either directly or by referral. There appears to be little or no overlapping of ■ services among the specialized health agencies. It is noteworthy that only ■ a '.U the Kirby Health Center provides a dental service for children. Fourteen of the 25 agencies included in the tabulation provide pro­ fessional and/or public education in their respective fields. ■ Surprisingly, the table indicates very little duplication of services, Q[ m J F- .1 ( . except, °f course in the case of hospitals and agencies dealing in mental health -29- �Problems. But this can be expected since health service is an admitted mis­ nomer , though it makes for a clean administrative definition. Clients (or Patients) are readily lost in this kind of vertical arrangement. Note should be made that fund raising, an integral part of administrative a operation of any organization, is included as a service. if such an activity can be labelled a health service. It is highly doubtful To compound the difficulty in interpreting the data, some agencies placed fund raising as core and others 3 as peripheral. Certainly where funds are expended is a much more significant yardstick of commitment to a health service. It would appear that many agency respondents had difficulty in distinguishing between core and peripheral service. Several other points can be deduced from the data that may help to clarify the data submitted. Emergency care, as listed by several institution?,, could mean only for those who have a family doctor admit them. It could also conceivably mean first aid treatment to a street or home accident. The peripheral services provided by an institution such as Retreat State Hospital are for patients a only, and therefore very limited. A service like cardiology is ordinarily util­ ized only to ascertain the ability of a patient to withstand shock treatment. Finally, it should be stated that it was not the province of the interviewer to question data submitted, although in the analysis and evaluation of data many questions concerning the accuracy and pertinence of data arose. - 30 < I 1 �TABLE 6 CORE AND PERIPHERAL SERVICES HEALTH SERVICES NAME OF AGENCY CORE SERVICES PERIPHERAL SERVICES HOSPITALS id Wilkes-Barre General Hospital Comprehensive medical and diagnostic care for acute illness Emergency care Psychiatric care Mercy Hospital Comprehensive medical care for an acute illne s s Special services such as: inhalation therapy phy s ic al - the r apy cardiology Education for nurses Nesbitt Memorial Hospital Acute medical and surgical care Obstetrical care Emergency care Ancillary medical services Wyoming Valley Hospital Medical care for patients Surgical services Obstetrical and related services Emergency care Veterans 'Administration Hospital C ompr ehens ive physical and mental in-patient care Out-patient medical service Emergency service Social work service Valley Crest County Home Complete medical service except surgery Physical therapy Occupational therapy Diagnostic service Intensive care­ coronary disease �J a TABLE 6 CONTINUED (2) CORE AND PERIPHERAL SERVICES HEALTH SERVICES name of agency 3 CORE SERVICES HEALTH CLINICS Immunization against communicable diseases Controlling food and water quality Public Health Center of Luzerne County Diagnostic and nursing services in communicable diseases, chronic diseases, and in maternal and child health 3 3 3 3 3 3 1 MENTAL HOSPITALS Retreat State Hospital 0 Providing psychiatric services Providing general medical services for patients only Providing special service in surgery Providing special occular care Providing consultation­ in cardiology MENTAL CLINICS Luzerne/Wyoming Counties' Mental Health/Mental Retardation Program Diagnosis & treatment of mental disorders both in out-patient care and in short term in­ patient hospitalization Emergency care and after care Education and consultation Children's Service Center of Wyoming Valley Out-patient psychotherapy Partial hospitalization Diagnosis & treatment of psychological, some neurological and psychiatric malfunctions and dysfunctions Consultation to schools and juvenile court Training of psychiatric social workers and training of clinical psychologists and child psychiatrists 11 3 Dental clinic for children under 13 years of age Chest x-rays testing Kirby Health Center 3 3 PERIPHERAL SERVICES �TABLE 6 CONTINUED (3) CORE AND PERIPHERAL SERVICES HEALTH SERVICES NAME OF AGENCY CORE SERVICES PERIPHERAL SERVICES INFORMATION. AND REFERRAL Luzerne/Wyoming Mental Health and Retardation Program Planning and development of programs concerning mental health and retardation Referral services INDIRECT HEALTH SERVICES Pennsylvania Department of Health, Region II Preventive medical services Environmental control (sewage, etc. ) Enforcement of laws protecting the e nvir o nm e nt Individual r ehabilitation Education Wilkes-Barre City Department of Health Bacteriological and chemical analysis of food and water Checking sewage systems Immunization 3 ||| Li n I ADVOCACY SPECIAL INTEREST ORGANIZATIONS American Cancer Society Informational service concerning the danger of cancer Multiple services such as transportation, medication, dressings Reach to recovery program for mastectomy Arthritis FoundationEastern Pa. Chapter Raising funds for research Education Orthopedic help to patients Weekly clinics n 0 11 3 �TABLE 6 CONTINUED (4) CORE AND PERIPHERAL SERVICES HEALTH SERVICES n II 1 1JI . I 3 1 III il NAME OF AGENCY CORE SERVICES PERIPHERAL SERVICES Cystic Fibrosis Foundation Anthracite Branch Physical and medical assistance to those afflicted Financial support to parents Raising funds for research Education Luzerne County Mental Health Association Educational programs for specialized groups Organizing volunteer program at Retreat State Hospital Multiple Sclerosis Foundation Necessary equipment for afflicted persons Fund raising for research Hope Club for individuals afflicted by multiple sclerosis Muscular Dystrophy Association of N. E. Penna. Medical equipment for persons afflicted by muscular dystrophy Psychological and attitudinal support Raising funds for research National FoundationMarch of Dimes Wyoming Valley Chapter Fund raising campaign for research Medical services for those having birth defects Post-polio care Scholarships to graduate students Education Tuberculosis Society Wyoming Valley TB tests in schools Mobile x-ray units Research on respiratory ailments Christmas Seal Campaign Education �I § 8 TABLE 6 I ‘i CORE AND PERIPHERAL SERVICES HEALTH SERVICES NAME of agency CORE SERVICES PERIPHERAL SERVICES Northeastern Pennsylvania Heart Association Professional and public education concerning the disease of heart and circulatory system Special funds in emergencies to persons suffering from heart conditions Diagnosis of rheumatic fever Luzerne County Association for Retarded Children Education concerning the needs of retarded children Information bureau and referral Seminars on mental retardation Education American Red Cross Organizing blood drives and collecting and dispensing blood Help to armed forces' families Services during disasters Educational program in first aid and swimming Nursing program for nursing aides Program for Red Cross volunteers a a i ffl 1 (I s .1 !1 '8 CONTINUED (5) �NAME of agency CORE SERVICES PERIP HERALSER VICES INCOME MAINTENANCE Social Security Administration ’ Informing public about Processing claims and eligibility, benefits, etc. providing payments Unemployment, medical, and general assistance ' Help in emergencies Processing applications for Viet Nam bonus Securing educational benefits Veterans' Administration Information, screening and referral service for veterans and their survivor s Luzerne County Board of Assistance Counselling Financial assistance to eligible clients General assistance in meeting medical needs Administration of Federal Food Stamp program JOBS AND TRAINING 1 Bureau of Employment Security a Unemployment compen­ sation Placement for job ready applicants Counselling for those not job ready Work training and job placement Job orientation program Day care for children of working mothers Mutual referral with the Bureau of Vocational Rehab. FAMILY SOCIAL SERVICES 1 Family Service Assoc. of Wyoming Valley Family as a group and individual counselling Training of social workers Participating in community planning of the effective welfare delivery system �TABLE 7 CONTINUED (2) CORE AND PERIPHERAL SERVICES WELFARE SERVICES 5 8 NAME OF AGENCY CORE SERVICES PERIPHERAL SERVICES Wyoming Valley Council of Churches Providing chaplain services for hospitals and nursing homes Organizing7 and: executing.' meals oiiwheels Catholic Social Services of Wyoming Valley Family counselling or individual counselling Monitoring community problems and influencing legislation concerning social welfare Planned Parenthood Association Education regarding family planning and birth control Providing birth control devices and pills PAP smear test, pelvic and breast examination Referral Jewish Welfare Agency Consultation and help in various family and individual problems Luzerne County Bureau for the Aging Operating two Senior Citizen centers Counselling and referral Organizing foster care for elderly Organizing and coordinating programs for elderly Adult Welfare Services and Project Reach Out for Life (Luzerne County) Processing applica­ tions for admission to Valley Crest Placement of infirm in nursing homes Processing admissions of alcoholics to the alcoholic unit in Danville Supplying transportation and clothing to TB patients Paying burial services Visiting Nurses Assoc, of Wyoming Valley Professional nursing and related services to patients in homes Counselling and health education to families / 1 ! 1 �CORE AND PERIPHERAL SERVICES WELFARE SERVICES name of agency CORE SERVICES Homemakers Service of Luzerne County Help to families in times of stress such as illness, convales­ cence, or other cases of emergency Commission on Economic Opportunity of Luzerne Reaching the poor Organizing the poor Tutoring, consumer education, manpower, housing, legal County PERIPHERAL SERVICES Information and education CHILDREN'S WELFARE AND EDUCATIONAL SERVICES Luzerne County Child Welfare Services Protective services to children neglected or abused Foster family care Institutional care Adoption services Service to unmarried parents Day care service St- Michael's Home for Boys Institutional care for dependent or neglected children Medical and dental service Social work service with children and their families St. Stanislaus Institute Institutional care for dependent or neglected children Remedial scholastic program for educationally deprived child Providing work-study experience Medical and dental service Social work services with children and their parents Project Headstart Part-day program for Medical and dental services pre-school age child!Social work services with ren who are economicallyr family and child deprived �0 CONTINUED (4) TABLE 7 3 CORE AND PERIPHERAL SERVICES WELFARE SERVICES NAME of AGENCY i 3 CORE SERVICES PERIPHERAL SERVICES INSTITUTIONS Home for Homeless Women Sutton Home for Aged and Infirm Men Residential care for women 70 years of age and over Residential care for the aged and infirm Infirmary for sick Work placement outside the agency Medical care Recreation GENERAL REHABILITATION 1 1 United Rehabilitation Service s Rehabilitation of handi­ capped Sheltered employment Day care Half-way house Wayside Mission Rehabilitation of ale oho lies Assistance to the people in need Rehabilitation through work Salvation Army of Wyoming Valley Recreation and activities not provided by the community Emergency relief Assistance in the form of food, clothing, toys Home for unwed mothers Bureau of Vocational Rehabilitation Medical and vocational Miscellaneous services to diagnosis handicapped persons Counselling and physical rehabilitation Training and job placement 11 1 1 II 1 3 SPECIAL GROUP-REHABILITATTON Crippled Children's Association Diagnosis and treatment Diagnosis and treatment of orthopedic conditions of speech disorders of crippled children Diagnosis and treatment Operation of kindergarten of cerebral palsy and nursery school �CONTINUED (5) TABLE 7 3 I s 2 I 1 CORE AND PERIPHERAL SERVICES WELFARE SERVICES name of agenc y CORE SERVICES Bureau of Visually and Physically Handicapped Vocational rehabilitation Remedial eye care-eye pathology and job placement Services to blind persons Home teaching for adult blind persons United Cerebral Palsy Physical, emotional, and vocational support to persons afflicted by CP Alcoholics Anonymous Rehabilitation Group therapy on fellowship level Pennsylvania Assoc. for the Blind Glasses to those who are not covered by Bureau of Visually and Physically Handicapped 1 1 , JJ Operation of day care center for CP Vision screening and public education to prevent blindness CORRECTIVE GOVERNMENTAL J I PERIPHERAL SER VIC ES Adult Probation, Luzerne County Supervision of parole and probation Pre-sentence inves­ tigation Juvenile Court, Luzerne County Court hearings for children in trouble with the law and pre-sentence investigating Court-commitment of children to institutions Probation services for children Adjudication reissues about children: dependent, neglected or delinquent Work and training placement �6 0 9 i'i 1 0 1 1 CORE AND PERIPHERAL SERVICES WELFARE SERVICES name of agency CORE SERVICES PERIPHERAL SER VIC ES Domestic Relations Court, Luzerne County Entry and enforcement of financial support Hearings to reconcile married couples Enforcement of visitation of father Referrals of cases for counselling, psychiatric help, etc. LEGAL CONSUMER Legal Services Association Legal help to indigent clients in civil matters Legal Aid Society _Legal aid to clients involving mainly land­ lord-tenant relationships Boy Scouts of America Program for boys to Organization of comm­ unity's groups to sponsor insure physical fitness, character scouting units Training adults for assum­ Year round camping ing roles in the program program Girl Scouts of America Penn's Woods Council Organize Girl Scout troops Organize camping program Training adults and girls in leadership Community services by Girl Scouts Young Men's Christian Association Recreation and physical fitness building Helping in educational process Spiritual guidance 1 3 ■3 - a p General concern with injustice and inequity Information concerning legal matters of economically deprived CHARACTER BUILDING GROUPS S s CONTINUED (6) TABLE 7 Young Women's Christian Association* �u I D 3 CORE AND PERIPHERAL SERVICES WELFARE SERVICES name of agency CORE SERVICES Catholic Youth Center Recreation services mainly for group activity Georgetown Settlement Association Meeting place and recreation center for local organi­ zations Nursery school Jewish Community Center of Wyoming Valley Providing recre-x ational opportun­ ities General educational programs Organizing social events a S CONTINUED (7) TABLE 7 PERIPHERAL SERVICES SPECIAL INTEREST SERVICES Pennsylvania Veterans Commission Burial services Providing all veterans Assisting veterans in need with flags & grave markers Federation for the Blind Information and re­ ferral services for the blind Maintenance of advocacy interests for blind Socialization INDIRECT WELFARE SERVICES 0 a Penna. Dept, of Public Welfare, Region II, Scranton* Commission on Economic Opportunity 3 g'SS a * Questionnaire not returned at time of publication �r ! 3 b. Welfare Services Forty-three separate agencies provide a wide range of welfare services ! to residents of the city. • The types of service range from single- purpose public a and private organizations to public and private multi-purpose groups. The following table lists these organizations and indicates that while each has a core function or functions, each also provides a multitude of different services a J which are peripheral to the primary general service by which the agency is best known. Five agencies are concerned solely with provision of economic security, including income maintenance, jobs, and training. 2 I 3s I 0 S I 3 public and private, concentrate their effort on family, children's welfare and educational services, and institutional care. I The core services of four agencies involve direct general rehabilitation, and five devote their total effort to specialized areas of rehabilitation. Direct legal and corrective services are the sole function of three county governmental services, and two private agencies. Character building activities are the basic function of seven agencies, while four agencies provide special interest or indirect welfare services. This table appears to warrant the conclusion that the city has available what seems to be adequate coverage of the broad categories of welfare services. Examination of the tabulation will indicate that, together with the related peripheral services, some of which are duplicated, the number and variety of services available appears adequate. ri Sixteen agencies, both Of course, the significant question -31- �s in so far as the MNA residents are concerned, is the availability of these services when needed. Examination of the table suggests a major concern with families and children and sixteen agencies provide this kind.of service. Clearly many groups in the community carry the same values but this raises the question, why s these groups do not come together to form a more unified delivery system of services. The same comment can be made with the character building activities, rehabilitation, and legal services. 2 The immediate conclusion from the table of services may be a sense of satisfaction. / The community does have quite a number of organizations providing a wide range of services. E We are not as certain that we can deduce from the data the scope of these services, whether the response is a satisfactory one, the broadness of the coverage, and the people actually reached by the service. The core services of the organizations demonstrate the immediate I 8 concerns of the organization. The table suggests preoccupation with services that offer "help" and "advice" to people who need it or who ask for it. It may be that the organizations included in the table are attacking only symptoms of problems by providing services. 'LI 5. Type of Service b I a. Health Services The data that follow identify the specific core and peripheral health -32- 1 •• �TABLE 8 a type of services offered to model neighborhood area HEALTH SERVICES SERVICES AGENCIES ELIGIBILITY REQUIREMENTS MEDICAL TREATMENT--HOSPITALS General medical care a. Wyoming Valley Hospital a. Need for hospital care other than for chronic illness b. Retreat State Hospital b. Nesbitt Memorial Hospital 2 d. a Mercy Hospital d. Need for medical care Valley Crest County Hospital e. Need for skilled nursing care, 20 yearsof age, and indigent f. Veteran's Administra­ tion Hospital f. a. Wyoming Valley Hospital a. Need for hospital care other than for chronic illnesses- b. Nesbitt Memorial Hospital b. Need for medical care c. Veteran's Administra­ tion Hospital c. Need for medical care, and veteran d. Wilkes-Barre General Hospital d. Need for medical care a. Wyoming Valley Hospital a. Need for hospital care other than for chronic illness s g Need for medical care e. 27 Emergency treatment Mentally ill, 16 years of age, and Pennsyl­ vania residency Need for medical care, and veteran I- i Obstetrical treat­ P ment �i TABLE 8 CONTINUED (2) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES SERVICES AGENCIES ELIGIBILITY REQUIREMENTS MEDICAL TREATMENT-HOSPITALS Surgical treat­ ment 0 0 b. Nesbitt Memorial Hospital b. Need, for medical care a. Wyoming Valley Hospital a. Need for hospital care other than for chronic illnesses b. Retreat State Hospital b. Mentally ill, 16 years of age, and Pennsyl­ vania residency Nesbitt Memorial Hospital c. Need for medical care s g Occular treat­ ment a. Retreat State Hospital a. Mentally ill, 16 years of age, and Pennsyl­ vania residency Intensive care-cardiology a. Nesbitt Memorial Hospital a. Need for medical care b. Valley Crest County Home b. Need for skilled nursing care, 20 years of age, and indigent c. Mercy Hospital a. Valley Crest County Home a. Need for skilled nursing care, 20 years— of age, and indigent b. Mercy Hospital b. Need for medical care E E g J Physical therapy Need for medical care I I ____ J �CONTINUED (3) TABLE 8 type of services offered to model neighborhood area HEALTH SERVICES 8 SERVICES AGENCIES ELIGIBILITY REQUIREMENTS MEDICAL--DIAGNOSTIC AND PREVENTIVE 0 Rheumatic fever a. Heart Associatibn a. Heart or circulatory disease PAP smear test a. Planned Parenthood Association a. Age 18 or over, other­ wise accompanied by adult Immunization a. Kirby Health Center a. None b. Wilkes-Barre Dept, of Health b. None a. Bureau of Visually and Physically Handicapped a. Need for services and 30% of visual functioning b. Pennsylvania Associa­ tion for the Blind b. 10% vision or les-s Pennsylvania Associa­ tion for the Blind a. 10% vision or less a. Crippled Children's Association a. Physician's certification b. United Cerebral Palsy Association b. Cerebral palsy Chest X-ray a. b. Kirby Health Center Tuberculosis Society a. b. None Need for X-rays or respiratory help Orthopedic disorders a. Crippled Children's Association a. Physician's certification b. Arthritis Foundation b. Physicians' recommend­ ation. a. Crippled Children's As sociation a. Physicians' certification Remedial eye care S' A g Vision screening Cerebral palsy p I ■ ‘I I Speech disorders __ �TABLE 8 CONTINUED (4) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES services AGENCIES ELIGIBILITY REQUIREMENTS MEDICAL ADVOCACY GROUPS 0 § Medical equipment for persons with muscu­ lar dystrophy a. Muscular Dystrophy Association a. Muscular dystrophy Medical equipment a. Multiple Sclerosis Society a. Multiple sclerosis and indigent Dental clinic for children under 1 3 a. Kirby Health Center a. None Birth defects a. March of Dimes a. Polio, birth defects, and in financial need of help Orthopedic disorders a. Crippled Children's Association a. Physician's certification March of Dimes a. Polio, birth defects and in financial need of help Polio (infantile paralysis) R Speech disorders a. Crippled Children's Association a. Physician's certificate Cerebral palsy a. Crippled Children's Association a. Physician's certificate Hospitalization for alcoholics a. Alcoholics Anonymous a. Desire to stop drinking Cystic Fibrosis a. Anthracite Branch of Cystic Fibrosis Child with cystic fibrosis HEALTH RELATED SERVICES Birth control devices and pills r r a. Planned Parenthood Association a. Age 18 or over, otherwise accom­ panied by adult �r (J n I f' iu fi s s 8 a g TABLE 8 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES SERVICES I r AGENCIES Fund raising for medical research Infirmary for the sick ELIGIBILITY REQUIREMENTS Muscular Dystrophy Association Muscular dystrophy b. Anthracite Branch of Cystic Fibrosis b. Child with cystic fibrosis c. Multiple Sclerosis Society c. Multiple sclerosis and indigent d. Arthritis Foundation d. Physician's recommendation e. March of Dimes e. Polio, birth defects, and in financial need of help f. Tuberculosis Society f. Nursing care for elderly Lutheran Bureau a. Children* s Need for X-rays, or respiratory help Lutheran background preferable but not absolutely necessary Home for Homeless Women a. Age 70 or over, admission fee of $4000. , and relin­ quishment of assets Visiting Nurse Associations a. Under care of physician and need for nursing care (for patients not totally dependent) a. American Cancer Society a. Physician's approval b. Public Health Center b. Need for help c* Luzerne County Board of As si stance c. Need for public assis­ tance according to current regulations Nursing and Medical services to home patients General assistance for medical needs i CONTINUED (5) �TABLE 8 CONTINUED (6) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES services Environmental control i 1 a AGENCIES ELIGIBILITY REQUIREMENTS a. Pennsylvania Department of Health, Region II a. None b. Kirby Health Center b. Mandatory c. Wilkes-Barre Depart­ ment of Health c. Mandatory Consultation for cardiology a. Retreat State Hospital a. Mentally ill, 16 years of age, and Pennsyl­ vania residency Blood drives and dispensary a. American Red Cross a. Immediate need for blood Research on respira­ tion ailments a. Tuberculosis Society a. Need for X-rays or respiratory help MENTAL HEALTH SERVICES Diagnosis for psycho­ logical or psychia­ tric disorder I s a. Children's Service Center a. Under 21 years of age with psychological problems b. Mental Health Center #1 b. Need for mental health services and local residency Psychotherapeutic assistance a. Childrens Service Center a. Under 21 years of age with psychological problems Psychiatric consul­ tation to schools and juvenile court a. Children's Service Center a. Under 21 years of age with psycological problems Group therapy for alcoholics a. Alcoholics Anonymous Desire to stop drinking �1 n s 1 n TABLE 8 CONTINUED (7) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES SER VICES Psychological and emotional support to handicapped persons and their families AGENCIES eligibility requirements a. Muscular Dystrophy Association a. Muscular dystrophy b. United Cerebral Palsy Association b. Cerebral palsy a. Children's Service Center a. Under 21 years of age with psychological problems b. Mental Health Clinic #1 b. Need for mental health services and local residency a. Retreat State Hospital a. Mentally ill, 16 years of age, and Pennsyl­ vania residency 2 b. Veteran's Administration Hospital b. Need for medical care, and veteran 8 c. Wilkes-Barre General Hospital c. Need for medical care g I g d. Children's Service Center d. Under 21 years of age with psychological problems e. Mental Health Center #1 e. Need for mental health services and local residency a. Children's Service Center a. Under 21 years of age with psychological problems 0 0 Out-patient treatment for mental disorders a 3 s 2’ I (K Hospitalization for mental disorders Care or treatment for mentally retarded children �2 a 3 1 TABLE 8 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES SERVICES agencies Planning and develop ing a. mental health and retardation programs Luzerne-Wyoming Mental Health and Retardation Program a. Mental disability Mental Health Associa­ tion of Luzerne County b. None b. 2 1 8 'iJ/ Health education a. Heart Association of N. E. Pennsylvania a. Heart or circulatory disease b. Visiting Nurse Associations b. Under care of physician and need for nursing care (for patients not totally dependent) c. Anthracite Branch of Cystic Fibrosis c. Child with cystic fibrosis d. Mental Health Center #1 d. Need for mental health services and local residency e. American Red Cross e. None f. Mental Health Associa­ tion of Luzerne County f. g- Tuberculosis Society g- Need for X-rays or respiratory help Mental Health education a. Luzerne County Associa­ tion for Retarded Children a. Mentally retarded (IO 80 or less) public education for the prevention of blindness a. Pennsylvania Association for the Blind a. None g g f I fl I 1 ELIGIBILITY REQUIREMENTS HEALTH EDUCATION AND INFORMATION 2 E 3 CONTINUED (8) None �a G TABLE 8 CONTINUED (9) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA HEALTH SERVICES SERVICES AGENCIES ELIGIBILITY REQUIREMENTS Professional education a. Heart Association of N. E. Pennsylvania a. Heart or circulatory disease Health information a. American Cancer Society a. None b. Arthritis Foundation b. Physician's recommen­ dation c. Pennsylvania Depart­ ment of Health, Region II c. None d. March of Dimes d. Polio, birth defects, and in financial need of help e. Tuberculosis Society e. Need for X-rays or respiratory help I s a 'P Mental Health information a. Luzerne County Associa­ tion for Mentally Retarded a. Mentally retarded (IQ 80 or less) I Youth education a. American Red Cross a. None e General Public educational programs a. Heart Association of N. E. Pennsylvania a. Heart or circulatory disease g p p �n i 3 s ■ [ services provided by agencies serving within the city and the bases for client eligibility. The types of service are: Medical services--treatment--hospitals Medical services--diagnostic--and preventive Medical service--advocacy groups Health related activities Mental health services Health education and information 9 3 I 1. Medical Services--Treatment--Hospitals Medical treatment may be both long term and short term, or out-patient in nature. It is clear from analysis of data that the health services systems are focused on provision of care for acute illnesses rather than on preventive measures. The crux of this situation will be to create change from treatment to prevention. g I p 2. Medical Service--Diagnostic and Preventive In many senses these services may still be in embryo. be made with no place for the patient to obtain treatment. Diagnosis may Preventive medicine IO may still have a long way to go if certain environmental elements are cared 3 for, but attention is not paid to additional elements. I 3. Medical Service—Advocacy Groups Many of the organizations in the next table provide a small amount of direct services and concentrate on research functions which do not go on I - 33 - �i locally. Their value to the community is that they call attention to those 8 a 8 causes which may well be the battle cry of tomorrow. 4. Health Related Activities The health related activities listed below are offered by organizations which support diagnostic and treatment plans for individuals and families who might otherwise not receive such treatment and diagnostic service. However, there can be no complacency abort these health related services; they may 1 a J offer what looks clearly as adminstrative or program responsibilities but there is little actual overlap in their activities. Many clients in need may well be lost because of this lack of overlap. 5. Mental Health Services These activities are those which begin with the cry for help and follow 8 through with out-patient or hospitalization of the patient if necessary. The scope of these activities can be total for some patients while for others it can be B partial. Many of these are new services in many ways and there is the need to expand these activities without sacrificing the quality of the service, a real challenge to an organization. 6. Health Education and Information Services Health education and information services are those provided by all agencies to some extent. However, some of these organizations focus more upon reaching the general public with their particular interest than do others. Many of these activites are carried by advocate groups who justify I 34- �their existence in the community by these public information campaigns. b. Welfare Services The data presented in this section show the specific services rendered by welfare agencies and indicate the requirements for client eligibility. The types of service are: Economic security and income maintenance Vocational training, referral, and placement Counseling, placement and referral, family children and institutional Rehabilitation Legal and corrective a Recreational and community P!teJ 1. a Welfare education and information Economic Security and Income Maintenance The two main kinds of economic security programs providing cash income when earned income stops are: 1. social insurances 2. public assistance payments The overall goal for each is income provision to individuals or families when earned income is not available. between the two. I There are a number of basic differences Social insurance is prepaid. To apply, a person need only file a claim to benefits toward which he contributed. of resources. There is no investigation With public assistance payments, a person makes application -35- �■Ml & 'J i 1 s receiving benefits based on need, which carries with it its own peculiar kind of stigma. The person receives payments toward which he does not contribute. Included in this section are direct payments other than those already mentioned ranging all the way from Christmas assistance to a one-time cash § 8 13 0 bonus to Vietnam veterans. Cystic Fibrosis patients receive payments in the form of treatments and equipment. Home for unwed mothers provided by the Salvation Army is not provided locally but out of town, and is a service perhaps beyond the reach of most MNA residents. 2. Vocational Training, Referral, and Placement These services endeavor to help individuals get job training and prepare them for jobs in the open market. The needs for vocational training are usually identified by school systems but training is closely connected with certain requirements for welfare services. CEP is probably best geared for hard core unemployed who are poor IS but those who are not poor are not so fortunate! I s There is a great need for close relationships among all agencies offering vocational training to link up with other organizations providing payment. 3. Counseling, Placement Referral Family, Children, and Institutional Serivces These services include the full gamut of those services expected to be provided by social welfare service organizations. Besides the emphasis on working with individuals and their families, there is considerable effort in working with these individuals and their families in groups. -36- r These services �c a 0 a differ from those providing income maintenance and social insurance and vocational training in that they do not endeavor to directly obtain employment or income for these individuals but do facilitate in every way possible the provision of such services as are necessary. These organizations attempt to strengthen families in their relationships internally by relieving family tensions. There is more internal focus on the dynamics of emotions in these services 3 a since emphasis is placed on optimum functioning in relationships. Of course, it goes without saying that the individual must be ready to adapt himself or herself to various situations, especially those where the 9 person is no longer maintained in his or her own home. 4. Rehabilitation These programs focus more on what agencies can do or achieve for s f certain clients accepted into the agency systems. services, the individual either must be born with a handicap (congenital) or the handicap must have been acquired. I To become eligible for A great deal of funding is available today for such services. Some rehabilitation services have a tendency only to accept those in­ dividuals who show potential to use most fruitfully the resources of the agency. This may not create a client centered service because the intake require­ ments are adjusted to suit what the agency can do rather than what the indi- vidual may be able to do. This is economic use of resources, but it goes without saying that many potential clients are lost because of focus on those who will respond more readily to resources. -37- r i �a & a n 5. Legal and Corrective These services have not fully developed in the community and are not likely to grow beyond their present level unless the state or federal govern- ments change orientation. Legal services in the advocate role are new to the local scene but the activity and social change being generated by the Legal Services for the Poor group will have far-reaching effects for all those s a 0 8 0 concerned. Legal services in its advocate role cannot be extended to cover a broader base of people than the defined poor. However, this base may well expand in time to include those whose income levels are slightly more than pres ait requirements. Corrective services are not particularly wanted by those who recieve them and it isn't likely that many people will want to recieve them. In view of situations as they now stand with drug problems in the community and especially the concern in the MNA, there will be expanded need for professional B personnel to work with those offenders who are involved. 6. Recreational and Community Services s These services are the ounce of prevention so necessary to develop positive attitudes in youth and adults. Such services can encompass activities for Senior Citizens, young Adults, married couples, besides the youth everyone immediately pictures. Actually all community people can benefit from some form of recreational services. The "not so well to do" do not always have recreation services and community services. finding a room for activities in local public facilities. - 38 - They have trouble �TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES services AGENCIES ELIGIBILITY REQUIREMENTS ECONOMIC SECURITY AND INCOME MAINTENANCE 1 tJ 1 a. Veteran's Affairs Bureau a. Veteran of armed forces b. American Red Cross b. Member of armed forces c. Pennsylvania Vet­ eran Commission c. Need for help and vet­ eran with honorable discharge a. Social Securi ty Administration a. Insured under the law and retired, disabled, or deceased b. Wayside Mission b. Need for available services Categorical cash payments to individuals showing need a. Luzerne County Board of Assistance a. Need for public assis­ tance according to current regulations Financial and other assistance for Christ mas a. Salvation Army a. None b. Family Service Association b. Residency in Luzerne County and need for family counseling help c. Catholic Social Services c. None Financial assistance to persons with heart conditions a. a. Heart Association of N. E. Pennsylvania Financial assistance to blind persons a. Federation for the blind Financial and other assistance to vet­ erans or their fanlilies fl s Financial assistance to insured persons fl s I a. Heart or circulatory disease 10% vision or less �L' TABLE 3 CONTINUED (2) 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES AGENCIES SERVICES ELIGIBILITY REQUIREMENTS ECONOMIC SECURITY AND INCOME MAINTENANCE 1 0 g Financial assistance to Cystic Fibrosis patients a. Anthracite Branch of Cystic Fibrosis a. Child with Cystic Fibrosis Unemployment compensation a. Bureau of Employ­ ment Security a. Unemployed, under­ employed, poor, or in need of better job Burial expenses and services a. Veteran's Affairs Bureau a. Veteran of armed forces b. Adult Welfare Services b. Age 18 or over, infirm or indigent Social Security payments a. Social Security Administration a. Insured under the law and retired, disabled, or deceased Food for the Needy (Meals on Wheels) a. Wyoming Valley Council of Churches a. Protestant’ church in need of help with programming and small yearly contribution Food Stamp Program a. Luzerne County Board of Assistance a. Need for public assistance according to current regulations Processing applica­ tions for Vietnam Bonus a. Pennsylvania Veteran Commission a. Need for help and veteran with honorable discharge Scholarships to graduate students a. March of Dimes a. Polio, birth defects, and in financial need of help Transportation and clothing for tuber­ culosis patients a. Adult Welfare Services a. Age 18 or over, infirm or indigent 8 qis �a CONTINUED ( 3) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SER VI CES SERVICES AGENCIES ELIGIBILITY REQUIREMENTS ECONOMIC SECURITY AND INCOME MAINTENANCE 6 Shelter or residen­ tial care ior aged or infirm Aged, small admis­ sions fee, and not totally dependent Sutton Home for Aged and Infirm Men Home for Home­ less Women b. Age 70 or over, admission fee of $4000 , and relin­ quishment of assets a. Luzerne County Bureau for the Aging a. Residency in Luzerne County and age 50 or over b. United Rehabil­ itation Services b. Limited abilities c. Luzerne County c. Child Welfare District Need for services for child d. Concentrated Employment Program d. Income less than $1800 a year ($500 extra for each de­ pendent) and living in target area, plus employabilitie s Nursery School a. Georgetown Settle­ ment Association a. None Home for unwed mcfthers a. Salvation Army a. None Disaster or emer­ gency services a. American Red Cross a. Immediate need of blood b. Pennsylvania Vet­ eran Commission b. Need for help and veteran with honorable discharge . •; b. B 3 G a. Day care services 1 0 a �CONTINUED (4) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES B services AGENCIES c. Salvation Army ELIGIBILITY REQUIREMENTS c. None VOCATIONAL TRAINING, REFERRAL, AND PLACEMENT SERVICES a. Bureau of Employ­ ment Security a. Unemployed, under­ employed, poor, or in need of better job b. Concentrated Em­ ployment Program b. Income less than $1800 a year ($500 extra for each dependent) and living in target area Training of social workers a. Family Service A s sociation a. Residency in Luzerne County and need for family counselling help Training of psychia­ tric social workers a. Children's Service Center a. Under 21 years of age with psycholog­ ical problems Training of nurses a. Mercy Hospital a. Need for medical care b. American Red Cross b. Immediate need of blood a. Girl Scouts, Penn's Wood Council a. Ages 7 to 17 and female b. Boy Scouts of America b. Ages 8 to 17 and male a. Saint Stanislaus Institute a. Child that is de­ pendent, neglected, or orphaned Vocational training in general I 2 2 a g Training of adults as scout leaders g £1 g Work-study pro­ grams �3 table 9 CONTINUED (5) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES s agencies SERVICES eligibility requirements VOCATIONAL TRAINING, REFERRAL, AND PLACEMENT SERVICES Vocational counselling Bureau of Employ­ ment Security a. Unemployed, under­ employed, poor, or in need of better job Federation for the Blind a. 10% of vision or less b. Concentrated Em­ ployment Program b. Income less than $1800 a year ($500 extra for each dependent) and living in target area a. Bureau of Employ­ ment Security a. Unemployed, under­ employed, poor, or in need of better job b. Home for Home­ less Women b. I Age 70 or over, admis­ sion fee of $4000, and relinquishment of assets c. c. a Adult Probation Division Age 18 or over and criminal offender d. Concentrated Em­ ployment Program d. Income less than $1800 a year ($500 extra for each dependent) and living in target area e. Bureau of Visually and e. Physically Handicapped Need for services and 30% of visual functioning f. Pennsylvania Associa- f. tion for the Blind 10% vision or less a. Referrals for employ- ... a... ment or vocational training a a i I 3 Vocational placement. �TABLE s 9 CONTINUED (6) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES AGENCIES SERVICES eligibility requirements COUNSELLING, REFERRAL AND PLACEMENT SERVICES FAMILY AND CHILDREN I 0 a. Lutheran Children's Bureau a. Lutheran background preferable but not absolutely necessary b. Luzerne County Child Welfare District b. Need for services a. Domestic Relations Division a. Need for help in the area of domestic relations b. Luzerne County Association for Re­ tarded Children b. Mentally retarded (IQ 80 or less) c. Luzerne-Wyoming Mental Health and Retardation Program c. Mental disability Referral service for veterans a. Pennsylvania Veteran Commission a. Need for help and for veterans with honorable discharge Referrals for health or welfare a. Luzerne County Bureau for the Aging a. Residence in Luzerne County and age 50 or over b. Planned Parenthood A ssociation b. Age 18 or over, other­ wise accompanied by adult a. Adult Welfare Services a. Age 18 or over, infirm or indigent Adoption services S 0 a Referrals for coun­ selling or psychiatric help 0 E f E cr r a n Placement for hospitals or nursing homes �1 0 CONTINUED (7) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES c AGENCIES SERVICES ELIGIBILITY REQUIREMENTS COUNSELLING, REFERRAL AND PLACEMENT SFRVICEff FAMILY AND CHILDREN 0 a. Lutheran Children's Bureau a. Lutheran background preferable but not absolutely necessary b. Juvenile Court b, Neglected or delinquent child under age 18 c. Luzerne County Child Welfare District c. Need for services Placement of elderly in foster homes a. Luzerne County Bureau for the Aging a. Residency in Luzerne County and age 50 or over Processing applica­ tions for hospital admis sion a. Adult Welfare Services a. Age 18 or over, infirm or indigent Placement of child­ ren in foster homes £ s a s COUNSELLING SERVICES f Counselling to un­ wed mothers a. Lutheran Children's Bureau a. Lutheran background preferable but not absolutely necessary b. Saint Stanislaus Institute b. Child that is depen­ dent, neglected, or orphaned a. Luzerne County Child Welfare District a. Need for services b. Saint Stanislaus Institute b. Child that is depen­ dent, neglected, or orphaned a § s S' n a Counselling to ne­ glected and orphaned children �TABLE 9 CONTINUED (8) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES agencies SERVICES ELIGIBILITY REQUIREMENTS COUNSELLING SERVICES Catholic Social Services a. None b. Jewish Welfare Agency b. Local residency c. Family Service Association c. Residency in Luzerne County and need for family counselling help d. Veteran's Administion Hospital d. Need for medical care and veteran e. Visiting Nurse Associations e. Under care of physician and need for nursing care (for patients not totally dependent) f. Homemaker's Service of Luzerne County f. Disability, illness, elderly without relatives, or family stressful sit­ uation g- Pennsylvania Vet­ eran Commission g- Need for help and vet­ eran with honorable discharge a. Wyoming Valley Council of Churches a. Protestant church in need of help with pro­ gramming and small yearly contribution b. YMCA b. Membership in organ­ ization, age 7 or over and male Counselling for fam­ ily or individual problems a a a a s Religious or spiri­ tual guidance �CONTINUED (9) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES i COUNSELLING SERVICES Health and welfare counselling i fl S § fl fl 0 I Jewish Welfare Agency a. Local residency b. Luzerne County Bureau for the Aging b. Residency in Luzerne County and age 50 or over c. Luzerne County Board of Assistance c. Need for public assis­ tance according to current regularities a. Salvation Army Men's Social Service Center a. Treatable handicaps b. Alcoholics Anonymous b. Desire to stop drinking c. Wayside Mission c. Need for available services Sheltered employ­ ment a. United Rehabilitation Service a. Handicapped position Half-way house a. United Rehabilitation Service a. Handicapped position Hope Club for per­ sons with multiple sclerosis a. Multiple Sclerosis Society a. Multiple Sclerosis and indigent Vocational rehab­ ilitation for visually handicapped a. Federation for the Blind a. 10% vision or less I1 a a. REHABILITATION SERVICES Rehabilitation ser­ vices for alcoholics fl ELIGIBILITY REQUIREMENTS AGENCIES SERVICES �TABLE ? 3 g 3 E n s TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA welfare services services services b. Bureau of Visually and Physically Hand­ icapped b. Need for services and 30% of visual functioning c. Pennsylvania Associa­ tion of the Blind c. 10% vision or less United Cerebral Palsy Association a. Cerebral Palsy a. United Rehabilitation Services a. Handicapped position b. Bureau of Vocational Rehabilitation b. Employable and hand­ icapped c. Bureau of Visually and Physically Handicapped c. Need for services and 30% of visual functioning a. General rehabilita­ tion services for cerebral palsy patients Rehabilitation ser­ vices for handicapped persons in general ELIGIBILITY REQUIREMENTS AGENCIES REHABILITATION C i Home teaching for blind adults a. Bureau of Visually and Physically Handicapped a. Need for services and 30% ov visual functioning S' General rehabilita­ tion a. Salvation Army Men's Social Service Center a. Treatable handicaps b. Pennsylvania Dept, of Health, Region II b. None Remedial education a. Saint Stanislaus Institute a. Child that is dependent, neglected, or orphaned Occupational therapy or vocational rehabilitation a. Valley Crest County Home a. Need for skilled nursing care, 20 years of age, and indigent b. Wayside Mission b. Need for available services c. Bureau of Vocational Rehabilitation c. Employable and handi­ capped S E s 3 Pi CONTINUED (10) �f CONTINUED (11) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES 5 SERVICES AGENCIES ELIGIBILITY REQUIREMENTS legal and corrective services E E s S' 9 Legal protection or aid Legal Aid Society of Luzerne County b. Federation for the Blind b. 10% vision or less a. Juvenile Court a. Neglected or delinquent child under age 18 b. Adult Probation Division b. Age 18 or over and criminal offender Pre-sentence inves­ tigations a. Adult Probation Division a. Age 18 or over and criminal offender Marital hearings a. Domestic Relations Division a. Need for help in the area of domestic relations Enforcement of visi­ tation rights and financial support a. Domestic Relations Division a. Need for help in the area of domestic relations Legal protection of neglected children a. Juvenile Court a. Neglected or delinquent child under age 18 b. Luzerne County Child Welfare District b. Need for services a. Juvenile Court Parole and proba­ tion supervision I s Individual determina­ tion based on financial status a. Court hearings for juvenile delinquents Neglected or delinquent child under age 18 P 0 ’i ____ �CONTINUED (12) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES AGENCIES SERVICES ELIGIBILITY REQUIREMENTS LEGAL AND CORRECTIVE SERVICES Legal assistance to indigent persons a. Legal Service Association General legal concern with injustice and inequality a. Legal Service Association Enforcement of environmental laws a. Pennsylvania Depart­ ment of Health, Region II a. Residency in Luzerne County, limited income, and case of civil nature Residency in Luzerne County, limited income, and case of civil nature a. None CHARACTER BUILDING GROUP a. Federation for the Blind a. 10% vision or less b. United Cerebral Palsy Association b. Cerebral palsy c. Pennsylvania Associa­ tion of the Blind c. 10% vision or less a. Girl Scouts, Penn's Wood Council a. Ages 7 to 17 and female b. Boy Scouts of America b. Ages 8 to 17 and male physical fitness programs a. Boy Scouts of America a. Ages 8 to 17 and male General recreational services a. YMCA a. Membership in organization, age 7 or over and male Recreational services for handicapped persons a a Camping programs g p g g 0 �V CONTINUED (13) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES 0 SERVICES AGENCIES ELIGIBILITY REQUIREMENTS CHARACTER BUILDING GROUP b. Catholic Youth Center b. Age 8 and over c. Georgetown Settle­ ment Association c. None d. St. Stanislaus Institute d. Child that is dependent, neglected, or orphaned e. Jewish CommunityCenter e. Membership in center f. Salvation Army f. None Meeting place for organizations a. Georgetown Settle­ ment Association a. None Organization of social activities a. Luzerne County Bureau for the Aging a. Residency in Luzerne County and age 50 or over b. Jewish Community Center b. Membership in center a. Girl Scouts, Penn's Wood Council a. Ages 7 to 17 and female b. Boy Scouts of America b. Ages 8 to 17 and male a. Catholic Social Services a. Age 8 and over b. Family Service Association b. Residency in Luzerne County and need for family counselling help I 0 13 Q g 0 Organization of community groups for scouting g a c g fi ?3 Community planning for effective welfare delivery systems �CONTINUED (14) TABLE 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES AGENCIES SERVICES ELIGIBILITY REQUIREMENTS CHARACTER BUILDING GROUP 0 g 0 Community services by scouts a. Girl Scouts, Penn's Wood. Council a. Ages 7 to 17 and female Senior Citizens Centers a. Luzerne County Bureau for the Aging a. Residency in Luzerne County and age 50 or over Community programs for the poor a. Commission on Economic Oppor­ tunity a. Need for services, in­ come limitations, and participation in long range goals Community services to youth a. Luzerne County Association for Retarded Children a. Mentally retarded (IQ 80 or less) WELFARE, EDUCATION AND INFORMATION SERVICES q L_-i General public educational programs s s Information concern­ ing legal matters a. YMCA a. Membership in organisa­ tion, age 7 or over and male b. Family Service Association b. Residency in Luzerne County and need for family counselling help c. Commission on Economic Opportunity c. d. Jewish Community Center d. Need for services, income limitations, and participation in long range goals Membership in center a. Legal Aid Society a. Individual determination based on financial status �! a 5 TABLE 0 CONTINUED (15) 9 TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES services AGENCIES ELIGIBILITY REQUIREMENTS WELFARE, EDUCATION AND INFORMATION SERVICES b. Commission on Ec­ onomic Opportunity b. Need for services, in­ come limitations, and participation in long range goals c. Legal Service Association c. Residency in Luzerne County, limited income, and case of civil nature Luzerne County Agri­ cultural & Home Ec­ onomics Association a. Client need for services and agency's availabil­ ity of resources 0 0 p A! I 0 a a § Agricultural education Home economics education a. Luzerne County Agri­ cultural & Home Ec­ onomics Association a. Client need for services and agency's availabil­ ity of resources Youth education a. Luzerne County Agri­ cultural & Home Ec­ onomics Association a. Client need for services and agency's availabil­ ity of resources Educational assis­ tance to rural governments a. Luzerne County Agri­ cultural & Home Ec­ onomics Association a. Client need for services and agency's availabil­ ity of resources Job orientation programs a. Concentrated Employ­ ment Program a. Income less than $1800 a year ($500 extra for each dependent) and living in target area Family planning and birth control infor­ mation a. Planned Parenthood Association a. Age 18 or over, other­ wise accompanied by adult I g 8 ' fl �TABLE 9 CONTINUED (16) TYPE OF SERVICES OFFERED TO MODEL NEIGHBORHOOD AREA WELFARE SERVICES SERVICES 1 1 5 1 1 I I 1 I F3 agencies ELIGIBILITY REQUIREMENTS WELFARE, EDUCATION AND INFORMATION SERVICES Social Security information a. Social Security Ad­ ministration Vocational information a. Bureau of Employ­ ment Security Insured under the law and retired, disabled, or deceased a. Unemployed, under­ employed, poor, or in need of better job �Welfare Education and Information These services really are geared to the possibility and the probability that someone somewhere within the community may need to use a service connected with the information and hopefully will be steered to that service by the public education route. These services should be functions of every agency which provides service in the community. Without this kind of dissemination, little may ever be communicated about programs. If the programs are not known, nobody will find it out as is mentioned in another part ’of this study . 6. Eligibility Requirements a. Health Services In order to understand the narrative on eligibility requirements that 0 follows, the reader is asked to turn to Table 8. Despite the wide range of health services rendered by the 25 agencies, a the availability of a particular service to a client or patient depends primarily upon the type of eligibility requirements established by each agency. I J The accompanying summary table, in most instances designates the special re­ quirements of given agencies, but it should be understood that there may also be some general requirements common to all or most of the agencies which have not been included in the response to survey. Residence within the service area is required in all instances, except that Retreat Hospital extends its services to any resident of Pennsylvania. There is some feeling in the minds of many that the facility is for local residents only. R I I ■' 'I -39- �Other requirements vary considerably. Hospitals normally charge for service, although without exception all perform gratis services in special cases, although;"special" case is not defined. This may have a very specific meaning for the disadvantaged and Model Neighborhood Area residents. Two agencies specifically indicate they have no financial requirements. 8 The two agencies serving veterans or members of the Armed Forces also have no financial criteria, Hospitals indicate that they provide service for acute, but not chronic illness, while only the Public Health Center of Luzerne 0 County specifies assistance in chronic cases, and even this might well be limited. Indigency is necessary for care at Valley Crest, but at least three agencies require financial responsibility according to ability to pay. B s a B Finan­ cial requirements are often a hidden requirement, the equivalency of patient liability. Property and other assets may well be fair game, especially at public institutions, not just a diagnosis of a disability that requires hospital­ ization. A few services are available only upon recommendation of a physician, which as has already been pointed out earlier, could and does have adverse consequences for the poor. Age limits are established by a few agencies, one serving only those 16 years or over, one under 20 years, and one over 20. All in all, it may seem that eligibility requirements are specific when they really are not so, especially when requirements are hidden and veiled. - 40 - �Often times, the eligibility criteria are vague (illness), or it is doubtful that what an agency stated as an eligibility requirement is truly one (anyone who requests). b. Welfare-Services Table 9 is the source for the discussion on eligibility requirements in the Welfare Services that follows in the next several pages. The number and variety of welfare agencies is immaterial unless the residents of Model Neighborhood Area are eligible to receive them, and as Table 9 indicates, this eligibility depends upon a variety of criteria established 3 by each agency. Initial examination of welfare services eligibility requirements shows that two criteria are nearly universal requirements: age and income. These qualifications form the bases of the means test that either permits entry s S G into a particular agency system or prohibits entry. The table shows that some eligibility requirements are common to most agencies. For example, residence in the community area is virtually universal, and in many instances there are age groups restrictions. Thus the Boy and Girl Scouts limit membership between the ages of 7 or 8 to 17 years, and custodial care agencies specify definite minimum age requirements, such as 50 or over, or use the general term "aged". Of special importance to Model Neighborhood Area residents requiring welfare services is the economic status or income requirement. Agencies providing only or mainly counselling services generally have no such limitations, or charge a nominal fee. The Salvation Army is especially notable for providing 7 - 41 - �its numerous services "in case of need" but fixes absolutely no income minima, nor does it charge fees. or fees. Many of the character building groups charge dues and/ Governmental agencies, such as Social Security and the Concentrated Employment Program, restrict eligibility to those earning not more than $1, 800, I with perhaps additional allowance for dependent'.children. § financial status, while the Legal Services Association of Luzerne County requires 3 5 5 The Legal Aid Society, assisting mainly in family or landlord -tenant cases, bases eligibility upon indigency, and provide services only in cases not involving those which may generate fees. The Sutton Home for the Aged and Infirm Men required " a small entrance fee", while the Home for Homeless Women require an admission fee of $4, 000 and an agreement that all assets become the property of the agency upon the death of the client. Of late, the means test has fallen into some disrepute because of the £ g way the test was administered. Many efforts have been made to eliminate a means test as a way of determining who could or should enter into agency services. Eligibility factors also center on certain groups which at times have created a great deal of pressure.for satisfaction of their demands, hence the proliferation of organizations serving veterans. 7. r1 Interagency Relationships In order to identify relationships between services, the following criteria were utilized: R (1) Source of Referrals (2) Relationships with Similar Agencies (3) Relationships with Governmental Agencies -42- �The tables on the pages that follow depict the cross-tabular relationships of agencies and the three focal concerns listed above. The ensuing discussion will concentrate primarily on the dominant patterns that have emerged from the data analysis. Again it must be strongly reiterated that the tables on the aspects of E interagency relationships must be viewed with extreme caution. It must be remembered that since time was of the essence, it was impossible to request and examine the substance of a "purchase agreement. " It just was not possible to analyze a hidden pattern of competition between and among agencies and institutions. ii Often times, these patterns exist in a very passive way and are really dominant patterns. Referral sources indicate flow of clients into a system of sources but it does not necessarily identify the actual relationships among agencies. s How else can you explain the "shopping around" that clients do to get help from agencies that have similar functions. The data on referrals and relationships, if taken alone, is a beginning point. If this data were combined in a meaningful manner, with the information on funding sources relationships, cooperative and otherwise services can better be understood. a. Health Services For hospitals, coordinated services exist between all but one institution, while relationships with state and federal governmental agencies are uniformly presented with all institutions, probably as a result of Medicare and Medicaid, though the relationship is not precisely spelled out. - 43 - The use of purchase �li 1 £3 J33 j -Ej_i LETS j 'SB .. i 133 Es 3 TABLE C:4 10 INTERAGENCY RELATIONSHIPS HEALTH SERVICES Source of Referrals Relationships with Similar Agencies Relationships with Governmental Agencies :_____ w TJ (D 4-i w O UH (D Social Service Agencies w W 0) a§ o O <q O TO 5 S) <D o o nJ tn g ro CD U > o 5 u cn .5 2 8 rP (D O 2 W) Oh <q >2 4-> W 0) •»-< o O £ O rt <D O HOSPITALS Wilkes-Barre General Hospital Mercy Hospital Nesbitt Memorial Hospital Wyoming Valley Hospital Veterans' Administration Hospital Valley Crest County Home HEALTH CLINICS Kirby Health Center Public Health Center X X X X X X X X X X X X X X X X X MENTAL HOSPITALS Retreat State Hospital White Haven State School Hospital* X X X X X �I i I L_jl -E> 3 ■J TABLE 10 CONTINUED (2) INTERAGENCY RELATIONSHIPS HEALTH SERVICES Source of Referrals u o w (D s -< Social Service Agencies cq 0) •H <D £ M O< o S 3 rg O o CQ Relationships with Governmental Agencies Relationships with Similar Agencies .S g o i> Oro .1 4-» W 0} £ O O <D 38 35 0 OO ?■! PbD O S 8 (D J ss X X 4-> MENTAL CLINICS Luzerne/Wyoming Counties Mental Health Center #1 Children's Service Center of Wyoming Valley X X X X X X X X X INFORMATION AND REFERRAL Luzerne/Wyoming Counties' Mental X Health/Menial Retardation Program X X X X X X X X X X INDIRECT HEALTH SERVICES Pennsylvania Department of Health Regional Offiqe, Region II Wilkes-Barre City Department of Health X X X X X X X X X �Arthritis Foundation Cystic Fibrosis Foundation Luzerne County Mental Health Association Multiple Sclerosis Foundation Muscular Dystrophy Foundation National Foundation-March of Dimes y Tuberculosis Society Northeastern Pennsylvania. Heart Association Luzerne County Association for Retarded Children American Red Cross X X N/A X N/A X X N/A X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X r �( s Fl agreements appears rather limited among hospitals as is true with cooperative relationships. Among hospitals, the referrals from other agencies appears minimal. £ Health clinics, because of the nature of the service, show a trend toward cooperative relationships and coordinated services, though purchase agree- 1 ments are conspicuously absent. The largest class of health service agencies, listed as advocacy L special interest organizations, presents a very interesting picture concerning I 3 relationships with similar social service agencies. rely on a variety of sources for referrals. Although some manifest not a single one of the coordinated and cooperative services, advocacy special interest organizations utilize purchase agreements. I These agencies seem to Relationships with local, state, and Federal governmental agencies seem to abound among these advocacy groups. It should be pointed that the essence of the relationship re-coordinated services, cooperative services, and governmental agencies is not precisely revealed. The cardinal point to bear in mind is that the relationships with !_L; governmental agencies at the various levels of activity are meaningless unless money streams are significantly attached to such relationships. b. Welfare Services The data on the economic security agencies reveal multi sources of referrals, maximum coordinated and cooperative relationships with similar agencies and with Federal, state, and local governments. There is no indi­ cation of the use of purchase agreements with these agencies. ■ [ I < -44- �[ I. I The interagency relationships among the family and children's organizations are of particular significance in this study because of the impact of their activities on the Model Neighborhood Area residents. The data does indicate little coordinated services and few purchase agreements among these organizations. Relationships with other agencies really exist only superficially since these i * agencies theoretically could exist without the others except Project Headstart and CEO. These systems do not rely on each other for support and what they do with each other at their parameters does not require a great deal of activity unless, of course, one system threatens another. § These groups are given lifeblood by a certain community of interests among the citizenry and each group of citizens desires to maintain its own identity. 3 The family and children organizations include a wide variety of voluntary organizations which provide total care service as well as partial care, referral service, etc. referrals. n These social services seem to utilize many sources of However, purchase agreements and coordinated services with similar agencies is very minimal. Almost all of these organizations have a working relationship at all levels of government. in i The rehabilitation organizations are in quixotic position in that their goals and objectives can easily be subsumed into health organizations. (Tr Many services of these organizations are medical in nature but the foci is to generate individuals who tend to be self supporting despite handicaps, mental or physical. Referral sources of these groups are open to all categories. Competition, rather than coordination and cooperation, seems to be the keynote among the -45- ft J �rehabilitation agencies, even though many of them depend on the same source of funding - the United Fund. Rehabilitation organizations seem to relate poorly to each other, as in other services, because the first priority is given to their own organizational perservation and protection. As one local worker put it, "Each organization here will try to expand its range of services to preserve its own turf." The legal and corrective agencies are most likely to be isolated services 0 from the others, since few people choose to use these services, but have them thrust upon them. Consequently little is done to have an impact on these organi- zations at a local level. The court related agencies do show some inclination toward coordination and cooperation, indicating that other similar agencies may be performing some of their tasks. in the data. Yet, purchase agreements are not signified It is significant that the Legal Services Association has what appears to be a negative relationship with similar agencies, not only because it is new on the local scene, but because of its role as "advocate of the poor. tl Basically the community character building services are preventive in nature, accentuating positive values in development. These agencies show an interest in cooperative relationships with other social service agencies, While in their relationships with governmental agencies, they focus on local and state government. They evidence a wide source of referrals. G. SUMMARY OF. FINDINGS There is a wide variation in the cost per client for health services by agencies serving the city, including the hospitals, the clinics, and the special -46- �TABLE 11 INTERAGENCY RELATIONSHIPS WELFARE SERVICES Source of Referrals TJ 0) w 2 CH Social Service Agency <D £ § 5 S> o s w (D □ 2 o ___ O r£ Relationships with Governmental Agencies Relationships with Similar Agencies .s CD > 34 cn <D TJ a o W O . CD CD § S 6CD a o 3 m <D -&-5L CD rg o 6 d o o JD 4-> CD HZ (D h INCOME MAINTENANCE Social Security Administration Veterans' Administration Luzerne County Board of Assistance X X X X X X X X X X X X X X X X X X X X X X X X X JOBS AND TRAINING Bureau of Employment Security Concentrated Employment Program X X X X X X X X X X X X FAMILY SOCIAL~SERVICES Family Service Association of Wyoming Valley Wyoming Valley Council of Churches-Meals on Wheels Catholic Social Services Planned Parenthood Association Jewish Welfare Agency Luzerne County Bureau for the Aging X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X �L f EE3 I III? 7^3 TABLE 11 CONTINUED (2) INTERAGENCY RELATIONSHIPS WELFARE SERVICES Source of Referrals TJ 0) CD M-4 0) Social Service Agency w Adult Welfare Services Visiting Nurse Association Homemakers Service of Luzerne County Commission on Economic Opportunity X X X a§ 5 2) o < X co (D O rS 3 4-> O O uy .s TJ CD o o £ > a O & O X X X X X X X X d ° 2" £5 4_> S 8 41 4) 03 o V 3 bo O ft < X (1) CO O o 0) O X X X X X X X X X X INSTITUTIONS Home for Homeless Women Sutton Home for Aged & Infirm Men X X X GENERAL REHABILITATION United Rehabilitation Service Wayside Mission Salvation Army Bureau of Vocational Rehab- X X X X X X X X X X 6 X X X CHILDREN AND INSTITUTIONAL Luzerne County Child Welfare St. Michael's Home forBoys St- Stanislaus Institute Project Headstart Relationships with Governmental Agencies Relationships with Similar Agencies X �! ikLJ TABLE 11 CONTINUED (3) INTERAGENCY RELATIONSHIPS WELFARE SERVICES Source of Referrals TJ <D cn <D O <p Social Service Agency 0) CO a 0) b-0 O < w <v o a> ■g T5 h tf rtf O -L> O w Relationships with Governmental Agencies Relationships with Similar Agencies O U1 <u o .5 S fi 44 <U o &. Q w o ft C £ aJ tf h O 1) T-4 O O 0) O £<u O SPECIAL GROUP-REHABILITATION Crippled Children's Association Bureau of Visually and Physically Handicapped United Cerebral Palsy Alcoholics Anonymous Pennsylvania Assoc, for the Blind X X X X X X X X X X X X X X X X X X X X CORRECTIVE GOVERNMENTAL Adult Probation Division, Luzerne County Juvenile Court, Luzerne County Domestic Relations Court, Luzerne County X X X X X X X X X X X LEGAL CONSUMER X Legal Services Association Legal Aid Society X X X CHARACTER BUILDING GROUP Boy Scouts of America X X X X X �TABLE INTERAGENCY RELATIONSHIPS WELFARE SERVICES Source of Referrals T3 O -JJ cn CD U-l tn nJ fl S fl o o TJ o <; __O_co o O P O £ 2) Social Service Agency 0) CO. Girl Scouts of America YMCA YWCA* Catholic Youth Center Georgetown Settlement Jewish Community Center X X X X X X X X X X Relationships with Governmental Agencies Relationships with Similar Agencies tn 4> O £ > o a « •H <D cn C nJ *■< CD CD O _ X X X Sb £ -S4 £4-> cn nJ 1-4 Pi O Q) •>-< O O. < CD £ 6 X X X X X o <D >3 <D X X X X W X X X X X X 0) X X X X X X X X X X X X X SPECIAL INTEREST SERVICES Pennsylvania Veterans Commission Federation for the Blind X X X X X X X INDIRECT WELFARE SERVICES Pennsylvania Department of Public Welfare, Region II, Scranton* Commission on Economic Opportunity X X *Questionnaire not returned at time of publication X X X X �interest organizations. case. The data do not reveal what is included in the cost of a The wide variance in costs, justifiable or not, could be a cause of great concern with many Model Neighborhood Area residents. The wide range in cost per client found in health services exists in the welfare services, except that the consumer may not be as aware of this fact with the welfare services as with the health services. There is a wide range of case load per employee in the health and welfare agencies. There is the possibility that the refusals or rejections in both delivery systems could be attributable to a high case load per employee depending on the service or agbncy; but this requires thorough study. The proliferation of health and welfare services among a considerable number of autonomous agencies active within the Model Neighborhood Area poses a number of problems, one of which is the selection of the most appropriate health 1 agency to which the Model Neighborhood Area resident should be referred. Some agencies perform a single specific type of service not performed by others. J such instances, there will be no difficulty in referral simply because there is a only one agency available. In But, in most instances, agencies perform a number of services, some of which are core services covering a wide range, while they also provide peripheral services incident to the core services. In a number of agencies, the core and peripheral services are the same or quite similar. Both long term and short term hospital treatment are provided locally. Diagnostic and particularly preventive medical activities may still be in an in- fancy stage. The data do appear to indicate that health related activities do have -47- �some overlap. Most of the health education and information services are carried by the special health advocacy group. Economic security programs exist in abundance. Vocational training, referral, and placement services appear to be linked up with organizations pro­ viding payment. Social welfare organizations that attempt to strengthen family relationships are found in the city. ' The rehabilitation agencies are client centered because of the intake requirements. At present, the legal services available to the poor are being expanded so that the Model Neighborhood Area residents can make more use of them. 0 Recreational and character building agencies do offer a variety of programs for special interest clientele. Many agencies do make strong efforts to publicize their programs, although the infor­ mation may not always reach those in need. Residence, age, and income appear to be the most often used eligibility requirements for health services, sometimes specifically stated and sometimes veiled. The means test is a much more restricted eligibility requirement in the welfare field than in the health field. ■'i Referral sources indicate a flow of clients into both the health and welfare services, however, this data should not be taken alone but in combination with y a other data to understand the true relationship between and among agencies. The use of purchase agreements appears to be rather limited in Luzerne County. Health clinics do manifest some inclination toward cooperative relationships and coordinate services. A special interest advocacy health organization relies on many sources of referrals, but many do not report any coordinating or cooperative - 48 - �sources with other agencies. There, is little or no use made of purchase agreements among the welfare services. Only further study can reveal whether the coordinated and cooperative relationships among voluntary welfare organizations are superficial. The charac­ ter building agencies do show some inclination toward a wide source of referrals. It has become so common as to be trite to end summaries of data with hard comments on what the data does not reveal, or perhaps to raise the hard questions and implications that stem from the data. It should be noted that these are not brought to the fore simply for the scholarly purpose of knowing something that we do not know, but for the practical necessity of finding ways to meet public responsibility for providing sorely needed social services with the greatest effective efficiency. n From the study data it is not possible to obtain accurate dollar expend­ itures for individual clients or families. 0 fl a great deal of speculation. The information collected lends itself to The greatest dollar expenditures per client or family do not necessarily mean the best possible care for the dollars expended. On the other hand low dollar expenditures per client or family raise the question of scope and adequacy of service in addition to raising other issues such as an organization trying to do too much in too many different directions, or whether the organization relies heavily on volunteer services for agency operation. Perhaps what is needed is not only more adequate support for both the health and welfare delivery systems, but more efficient administration of the resources now expended. crucial than the general public realizes. =49- This may be more �It would appear that an individual must be sick to become healthy. I One need only look at the low cost of preventive programs (though not always easily discerned from the data) versus the high unit cost of some kind of institutional placement. There seems to be such a strong intent on spending literally thousands of dollars per year for an individual for institutionalization and yet pinch pennies to shore up a family situation wherein the original problems were generated. Though the availability of money can make a difference in life style, how it is spent is just as significant. Preventive dollars seem to be at a minimum. The data would seem to carry with it the challenge to change the foci of the health and 0 welfare systems to more positive systems of prevention. Relating this more realistically to the data at hand, the systems will have to change their duties of operation from what is now a core service to what is now a peripheral service, 9 since at present prevention is either non-existent or hidden as a peripheral function. The computer and statistics have taken control of much of our lives, § fi fl but there may be times when the statistics are made to say what we want them to say, All agencies are more concerned with the year-end total of the number of clients served, even if a telephone call must be counted as a service performed and/or client served. But the orientation in a rehabilitation agency is a slight variation of client count. Most rehabilitation agencies tend to be as agency centered as the income maintenance services. E Most of these organizations may be careful not to accept for service anyone they believe they cannot succeed with. E r -50- ______ �Consequently, a premium must be placed on a client showing determination to overcome handicaps. Is there a restrictive intake process over and above the stated eligibility requirements? if the agency can't anticipate success that will show statistically, do they forget about the prospective client? If so, what agency gets to service this "left-over? !1 The volume of organizations concerned with somewhat the same problems should cause considerable concern about the utilization of resources. How wise is it to use the small percentage of the total income in the city devotedt'o welfare in the way that it is used? There may be a justification for the maintenance of separate organizations for similar services if there is a clear probability that the interests of the special group would be lost or disregarded, but this philosophy must be carefully examined in its application. As matters stand now, it is futile for agencies providing similar functions to purchase services from each other. It is in the best interest of an agency to expand staff and services rather than spend resources to get same services from another agency. Self-preservation and self-interest require this. Most of the character building agencies are developments of the settle­ g ment house concept which is now being recycled into use in many parts of the country as neighborhood centers with a trained staff, not only to give help when A needed, but also to provide appropriate social experiences for those who use the facility and its programs. IB -51- �Seven agencies listed in the study concern themselves with prevention since they concentrate on character building activities. these that justifies the existence of all seven? What is so different among Are the differences irreconcilable? Or do these organizations continue to provide these services because a generation I or so ago, there was a genuine need that no longer exists? How responsive are I these agencies to today's children? i Have these agencies made their programs really available to those they are trying to reach? Are they aiming at the deprived, or are they directed toward middle class values and services only? ) If these character building agencies are not related to poor people, why are they ) not identified to the community as middle class oriented? Most startling of all the data collected and collated is the absence of a single place where an individual or a family with a problem or problems can call to find out where to go for help with the problem. Many of the health and welfare organizations are aware of the dimension of the problems and needs for services, but it is literally an impossible task for everyone to be aware of everyone else's n programs. The truth of the matter is that the poor and the disadvantaged are compelled to "shop around" until the frustration overwhelms them. More often than not, the subculture of the disadvantaged is characterized by resignation to living with a problem rather than "shop around" in vain. No effort has been made to coordinate these services and programs from the delivery level to the middle fl management (supervisory) level, and to the administrative level, in the local community. -52- r �The purchase agreement is not a social welfare phenomenon in Luzerne County perhaps because of the development of large, strong voluntary services, possibly because of the religious factor and the availability of religious institutions to take on the more obvious needs. they were public services. When services really got going, Whether or not purchase agreements could be a use- ful tool to provide better service, except for individual case situations, may never be known. I 5 Whether an effective health and welfare delivery system can be constructed with the utilization of purchase agreements as a first step is open to debate, as is the question of whether the purchase agreement is the final end product of a well organized health and welfare delivery system. One of the chief reasons for any means test at all has not been perversity, but the fear that general availability of a service, particularly income maintenance, J would consume all the resources of our social and economic system. Whenever monies were to be saved in the past in the public assistance system, restrictive requirements were added which reduced the general availability of public in & assistance resources. Significantly, in this time when individual rights have gained increasing recognition, and as welfare rights groups press for more acceptable administration and grant levels, restrictive requirements are not n being added but the entire welfare system is breaking apart from the pressures of finding resources to meet the needs. i This is not to be interpreted as endorse­ ment of restrictive requirements, but metely to elucidate what occurs when a system relies too heavily on "keeping people out" to keep operating. I J -53- �Fixing of public responsibility for certain kinds of services has had the effect of creating public agencies to provide the services as well as the result of separating out many needs from other needs, and separating people from their family systems in a sense. Again, this has been an effect of eligibility requirements that many agencies are now taking steps to counter. In some instances the separation of certain family members from the rest of the family has been used to gain recognition of genuine needs of such individuals and to create a kind of lobby for them. Children have been identified separately from their parents to draw attention to the specialized needs of childhood and youth. Restrictive requirements have been the source of such an underlying fear that most services do not really move toward the social utility concept. Perhaps the one single summary comment from all the data presented in Part I should be the question: DO THE DATA INDICATE THAT WE ARE WILLING TO FINANCE, WITH EFFICIENCY, THE OPERATION OF A VALUE SYSTEM THAT WE ENDORSE? j II f L 111 '1 -54- �PART II PERCEPTION OF SOCIAL SERVICE PROBLEMS AND NEEDS A. ASSUMPTIONS AND METHODOLOGY Two assumptions framed the analysis by model neighborhood area resi- dents of the MNA residents' perception of social service needs. First, it was assumed by the PMM researchers that the social structure of a person influences his perception of needs. Therefore, the perception of social service needs by that individual is a consequence, at least in part, of how he perceives either his personal or community situations. perceive of a need for health For example, individuals are more likely to care if they have had persistent health problems. On the other hand, a person who has not experienced a need for social services, may regard them as necessary, depending upon his definition of social problems. The second assumption concerns the utilization of social services, i. e. a priori, that the utilization of available services by MNA residents was a function of one's perception. In evaluating the consumer end of social services, for in­ stance, it is not enough merely to know about the availability of services and the numbers who complete various programs. More importantly, if the MNA residents do not perceive of any benefits derived from using services, as experi- enced at the personal or community levels, they may not avail themselves of services being offered. The first step then in defining the goals of the survey was to formulate an exploratory hypothesis on the attitudes and/or perceptions of the respondents -55- �from the standpoint of either their personal or community situations. Thirteen areas of basic services were considered in the study: . . . . . . . Housing . Jobs . Legal . Public .Recreation and Training . Welfare Addiction Aged Children Consumer Education Health B. THE INSTRUMENT The interview schedule utilized in the Model Neighborhood Area Survey consisted of 137 questions - including both demographic and perceptual questions. It was arranged in the following order: 1. Instruction sheet 2. Demographic and informational questions 3. Questions concerned with perception of service problem areas individually classified by thirteen separate sheets The interview schedule consisted of both open - and closed -end type questions in order to elicit from the respondents three things: 1. Perception of the thirteen service categories as related to either personal or community problems Indication of whether the problems are getting "better,’’ "worse,•' or remaining the "same" Comments of interviewee concerning services they were utilizing The findings were systematically treated in the following steps: Classified data according to perception of community and personal levels 2. Tabulated responses by service area in terms of "better,1.1 "worse, " and the "same" -56- �Compared responses of six neighborhood areas to service category Interpreted findings by grouping the consensus of both perceptions of community and personal problems according to "worse,".' "better,1;1 "no consensus!and the "same" Analyzed content of comments of the respondents based on an opti­ mistic-pessimistic continuum The most delicate chore of a researcher is to interpret the results of his survey so that the validity of his interpretations is beyond questionable dispute. Arbitrary decisions are made in the classification of the data, but such decisions are always well-intentioned and made with a view to credibility and acceptance. If the "worse" responses exceeded 50% of the total number of responses within a social service category it was classified as "worse". The one exception to this general rule is the housing category, wherein the "worse" responses, as a perceptual problem at the personal level, rated 48%. A 2% variance can- not be considered too significant when 60% of the respondents perceive of housing as a problem at the community level. The " no consensus" designation was applied to those service categories where a clear picture could not be discerned because of the unusual combination of responses at the community and personal levels. Certainly the "worse" responses do not exceed 50%, and yet when the "worse" and "same" responses are combined, either at the community and/or at the personal level, the responses exceed 50%. When the highest number of responses in a social service category g -57- �fell into the "same" designation even though it was less than 50% of the responses, the service category was placed in the "same" class. If the responses were highest in the "better" grouping, even though less than 50%, then the social service category was classified as "better. " C. THE INTERVIEWERS Interviewers were paired together, with at least one interviewer a resident of the neighborhood. The rationale for this approach was that more interesting answers would be elicited to informational and attitudinal questions once the respondent felt comfortable with the interviewer. In addition, it was presumed that indigenous residents would be unlikely to offend respondents with personal questions. The interview schedule was pre-tested in twelve hours of training sessions conducted for the interviewers by the professional staff of PMM. During these sessions, the interviewers were oriented to the techniques of interviewing. Just as importantly, through role-playing activities, credibility of the interview schedule was briefly pretested. Where it was believed that answers could not be anticipated adequately, available space for the interviewers to insert written responses was provided. Answers to questions requiring expressions of the respondents' perceptions of problem service categories, based on either their community or personal situations, were arranged on a "BETTER," "WORSE, " or "THE SAME" classification scheme. -58- �D. SOCIO-ECONOMIC CONSIDERATIONS In looking at MNA, the researchers sought to ascertain the attributes of the residents by seeking answers to questions such as the following: 1. Is the area suburban, small-townish, or rural? 2. What kind of people live in the area? 3. What employment opportunities are there? 4. What kind of housing is available? 5. What is the educational background of the residents? By disaggregating the MNA into six areas, it was found to be a medium sized city with both good and poor residential areas. s 0 ■ In addition to residential areas, the land uses consisted of commercial, industrial and institutional mixes. Land use patterns also were characterized by a number of vacant buildings, particularly in the Iron Triangle, Southeast, and Central areas. However, along Market Street, the lineal extension from the central business district of WilkesBarre, there was a mix of occupied and vacant commercial establishments. Many of the respondents lived in the rear of or above these commercial buildings. This neighborhood profile corresponds closely to many of the Model Cities target areas.in medium sized cities where the population density is not excessive. 1. Marital Status, Sex and Proggncy The characteristics of the 536 respondents tend to take on a domestic pattern. married. For example, 86% of the respondents were female, of which 68% were Of the households, 54% had a family size no larger than two children. -59- �The exact areas of the Model Neighborhood Areas in which the inter­ viewing was to be conducted were then delineated. The selection of six areas, although essentially an arbitrary decision, was based on consideration of the following factors: 1. The Model Neighborhood Area had already been divided into six neighborhood associations to maximize citizen participation in the Model Cities Program and 2. The concentration of low income residents was dispersed almost equally among the six areas. The random selection of streets within each Area was then performed. In order to do this, an equal number of streets to each Area was arbitrarily assigned. Nine streets from each of the Areas were then selected. Using the city street index, the addresses on each street per area were tallied. Finally, through simple random sampling, the lottery method was utilized by selecting every alternate address for the survey sample. s Active interviewing began on November 23, 1970, and was completed by December 11, 1970. J The interviewers wer.e required to report at 9:00 A. M. every day for the first week at the Model Cities Agency. During the first week, this reporting procedure was adhered to so that interview schedules could be checked daily and any questions raised by the interviewers could be answered. In total, 564 interviews were conducted. That figure, of course, was reduced to 536 because 28 interview schedules were considered to be unsatisfactory. After careful evaluation and analysis,and some additional surveying, it was determined to completely discard them without affecting the final results. -60- �Such a profile points out that the households of the MNA tend to have the predominant pattern of the conjugal, nuclear family structure. While there are low income residents in the MNA, a large segment of the population consists of work­ ing class and middle class types. These characteristics were reflected in the demographic profile of the MNA. TABLE 12 MARITIAL AND FAMILY CHARACTERISTICS OF RESPONDENTS IN MODEL NEIGHBORHOOD AREA Maritial Status Married Single Divorced Widowed Total L; 3 y Number ~367 34 23 112 536 Percent 68 6 5 21 100 Sex of Respondents Male Female Total 78 458 536 14 86 100 Number of Children One Two More than two Total 70 81 131 282 25 29 46 100 It should be noted that the 21% widowed category reside in the interstice between the Iron Triangle and central areas where the O'Karma Public Housing Project is located. 0 I '1 family. This again points out the pattern of isolation of the conjugal Moreover, it suggests a trend toward the isolation of the aged from the rest of the MNA residents. d o J -61- �2. Population Density and Home Ownership As mentioned previously, there does not seem to be a density problem with respect to the residential use of land in the MNA. The overriding pattern seems to be competition for residential space in terms of the physical desirabil­ ity of the Area. This pattern stands in strong relief when comparing home own- ership to rental properties. The data indicate that home ownership is highest in the most desirable area (Northeast) of the MNA, and lowest in the least desirable area (Central). In the MNA as a whole, 43% of the respondents owned their homes and 57% rented. The following table reflects a breakdown of owners and renters in the six neighborhood areas. TABLE 13 TYPE OF HOUSING RESPONDENT OCCUPANT IN MODEL neighborhood area s 0 3 a Number in Sample . . NE SE SW C Total Number Type Type NW Own 36 67 1 45 20 64 233 43 Rent 22 54 80 31 62 54 303 57 3. IT Education and Employment To understand how the MNA residents perceived their social service needs, it was important to obtain the education and employment profile of the respondents. This is important precisely because lack of education tends to keep the consumer of social services from knowing what service is available, as well -62- �as how to avail himself of that service. Furthermore, unemployment or under­ employment determines differential accessibility to social services in terms of need. High unemployment, for instance, may indicate a greater need for basic social services. The education and employment characteristics of the respondents suggest that these social indexes are mutually supportive;i. e., 60% of the respondents have a high school education, and 43% are employed with the bulk of them engaged in industrial work. However, the significant fact in the employment index was that 57% of the respondents are receiving some form of public assistance. This finding appears to have some correlation with the percentage of those respon- dents who are aged, rent, and need basic services. Moreover, the public assis­ tance recipient would assumingly have a broader need for varied social services. TABLE 14 EDUCATION AND EMPLOYMENT ATTRIBUTES OF RESPONDENTS IN MODEL NEIGHBORHOOD AREA / / a g EDUCATION Number College High School Grade School Total 23 325 188 536 Percent 4 61 35 100 EMPLOYMENT 0 Public Assistance Industrial Commercial Institutional Total 306 101 58 71 536 i ■■ -63- 57 19 11 13 100 �E. THE FINDINGS - RESPONDENT PERCEPTIONS From the data garnered by the use of random sampling selection techniques, the social service categories are catalogued in the following groupings: Worse No Consensus Same Better . Addiction . Housing . Health .Jobs . Training . Consumer . Legal . Public . . . . . 1. Aged Children Education Recreation Welfare "Worse" Responses The two catagories that were perceived by the respondents as social ser­ vice problems getting "worse" both in terms of their community and personal situations were; . addiction . housing a. Responses to Addiction Category Of the 536 respondents in the total sample, an exceedingly high number, or 82%, perceived of addiction as worsening at the community level. J I E The 82% represents 274 responses to the question: "Do you see addiction as a community problem in which more service is needed?" At the personal level, 62% of the resident respondents viewed this problem as getting worse, as reflected in the ■'f ted 101 responses given to the same question. - -64- �TABLE 15 RATIO RESPONSE DISTRIBUTION ON ADDICTION C ommunity 3 Better Worse Same 82 15 Personal 4 62 34 The comments of the respondents regarding addiction generally focused on it as a problem affecting the community. However, there was little specificity concerning what agencies could do to reduce the problem. were mainly impressionistic. Rather the opinions For example, among the comments mentioned most frequently were; . "Very disgusting that the kids of today are taking such a destructive thing,?1 . "The law can do more than they are doing to rid our community of this menace. " . "There is a definite need for a drug clinic in our community. " ."Our neighborhood is being used for the sale of drugs." b. Q B Responses to Housing Category The next table reflects a definite concern about housing as a problem which is getting worse, particularly as a community problem. -65f' ■ �TABLE 16 RESPONSES TO HOUSING PERCENT OF RESPONDENTS C ommunity 20% 60% 20% Better Worse Same Personal 18% 48% 34% A concern about the housing conditions in the MNA was expressed by 60% of the respondents. The object of such concern was largely the unfavorable treatment tenants received from the Public Housing Authority. Of particular interest was the fact that the terms of the Authority did not express such a feeling as much as the non-tenants. Among the tenants, there seemed to be pervasive­ ness of indifference and/or an attitude of not speaking too negatively about their X, situation. s 1 nr ; iS An analysis of pertinent comments ranged from "nothing being done by the Housing Authority" to "need more housing unity in the MNA. " The following is a sampling of the respondents' remarks: I . "O'Karma housing director is a tyrant and the rents are too high." . "Too many homes are unfit to live in. " l=j ."A greater need for more housing for low income families." . "Too many dilapidated houses along Market Street. " S T! Q . "The aged fear the Housing Authority. " . "Living in O'Karma is like living in a concentration camp. " B -66- �2. ”No Consensus" Responses Those service categories, which were perceived as getting worse at both the community and personal levels but do not exceed 50%, were classified "no consensus." These services consisted of: . Health . Jobs . Training a. Responses to Health Needs Category With respect to health as a service and/or problem area, more than 60% of the 536 respondents responded to it at the community level, and 43% of the total sample responded in terms of personal perceptions. TABLE 17 RESPONSES TO HEALTH PERCENT OF RESPONDENTS a Better Worse Same Community 30% 43% 27% Personal 34% 27% 39% While the data do not suggest any clear-cut pattern regarding the poor­ 0 ness of health services, many respondents'^ comments indicate the need for qualitative improvement in the delivery of such services. The common observation focused on the relationship between perceptual immediacy of health needs and the responsiveness of health care delivery systems. Second, there was a general tendency in the responses to criticize the increasing health care 0 costs at hospitals and clinics. The following excerpts reflect the latter two -67- �orientations: ."For the money you have to pay, you would think the services would be much better. " i 4 . "It's a shame how long you have to wait in hospital emergency rooms. " f ■ G . "Something must be done soon about how long the elderly and children have to wait for treatment. " ."Poor sanitary conditions and the 'indifferent1 attitude of the doctors at hospitals. " ■ ."Everything about health care services is bad." i ■ ."Local doctors will not even handle emergency cases for public assistance clients." . "Nursing services are terrible." b. Responses to Job Category It should be noted that there may be more than just a casual relationship ri ; ■ between the jobs and training service areas. The data indicate, based on 28% of the total sample responding, that either the majority of the respondents were employed and under-employed or had received training and were later employed. Z*; i The next table generally reflects the perceptions of two types of respondents: (1) those who are employed, whether full-time or marginally, and (2) those who are temporarily employed and receiving some kind of employee compensation. w A L tt -68:J f 1 �I TABLE 18 RESPONSES TO JOBS percent OF respondents Personal 32% 26% 42% Community 36% 35% 29% Better Worse Same The survey profile of perceptions of both jobs and training tends to reflect good, bad, and ambivalent feelings. tion for this ambivalence. The researchers offer a plausible explana­ If a person needed a job and was placed, the Employ­ ment Service was obviously satisfactory. would be the urgency of employment. a Certainly, a key intervening variable On the other hand, if a person had market­ able skills and sought employment help, but experienced undue lag-time in being placed on a job, the Service was perceived as being poor. The following interview comments demonstrate the ambivalence mentioned .‘ KTL if ■' / fl J I ® earlier: . "We need more jobs for people on relief to get them off welfare. " . "The attitude of the employment service agencies is rotten and they are of no help. " . "There are plenty of jobs available, if people wanted to work. " 1 c. Responses to Training Category The next table clearly implies that training is not perceived as a serious problem at either the community or personal levels, as manifested by the 32% I - of the respondents. If perhaps suggests that those persons receiving training may have employment or they are at least satisfied with the training experience. H J II n -69- �TABLE 19 RESPONSES TO TRAINING C ommunity 62 Better Worse Same Personal 43 6 6 32 51 Illustrating the jointed comments of the respondents are the following: ."There is no job after completion of the training period." ."CEP (Concentrated Employment Program) is so desperate for candidates that they should be investigated." 3. Same Responses Of the 536 respondents reacting to community and personal problems 1 and/or service areas, approximately 42% perceived of these situations as being substantially "the same." This bloc of respondents assigned "the same" to the following classification service categories: . Consumer . Legal . Public ■ 0 The data indicate that the respondents viewed the above social service categories as remaining substantially "the same" regardless of whether they were better or worse. To that end, if the categories were "better" in the past, this optimistic attitude was reflected in many of their observations. On the other hand, if the services were "bad" in the past, the observations of the 3 respondents indicate that there has not been any significant improvement in the quality of these services in the present. r’ -70- �consumer and legal services, however, an analysis of the data suggests that the This attitude quite possibly could be respondents were ostensibly indifferent. attributed to the respondents not perceiving such areas as exigent concerns regarding their community and personal situations. a. Responses to Consumer Category Despite the fact that consumer problems regarding the purchase of goods tend to be a concern in large urban areas, the most prevalent tendency in the MNA was relevant to people on public assistance. This, moreover, was peculiar to the Department of Public Welfare's Food Stamp Program. The respondents believed the program was still generally unresponsive to the welfare recipients, since the stamps are not redeemable for non-edible consumer items such as soap, toilet items, cigarettes, etc. TABLE 20 0 ■ ’ RESPONSES TO CONSUMER PERCENT OF RESPONDENTS Community 34 25 41 Better Worse Same b. Personal 21 28 51 Response to Legal Service Category The survey profile on legal matters represented, ranged from advice to requesting action on such matters as insurance claims, divorce, and consumer -71- �problems. Most of the service was sought from the Legal Services Program. Common perceptions held, usually pertaining to personal matters, were evenly distributed between satisfaction and dissatisfaction. In regard to the latter re- sponse, the feeling was that the agent offering the legal help was incompetent. The conclusion, therefore, was that private legal counselling can render a more effective service. TABLE 21 RESPONSES TO LEGAL PERCENT OF RESPONDENTS Better Worse Same 0 - Community Personal 43 11 46 34 8 58 Respondents' remarks had more of a tenor of dissatisfaction rather than satisfaction. Some of the comments, for instance, were as follows: • "Some people need legal help from the Legal Services Program, but cannot receive it because they are not low income persons. " G • "Legal Services is doing a terrible job. " 0 . "We need help with workmen's compensation to collect what is rightfully ours. " . "The courts and police can provide better assistance. " . "There are not that many people, who have legal problems, for whom assistance is not available. " -72- �Responses to Public Service Category The data on this set of responses revealed that more than 55% of the respondents were highly opinionated about this category. Even though they may have viewed the level of services, both community and personal, as being about "the same, " the tenor of their responses indicated general dissatisfaction. Therefore, what may appear to be an almost even division on the community level of services - 31%, 31%, and 38% - could be misleading without an under­ a standing of the undertone and intensity of the responses. TABLE 22 a RESPONSES TO PUBLIC SERVICES PERCENT OF RESPONDENTS Community 0 a Better Worse Same 31 31 38 Personal 33 25 42 "City Hall, " the agency provider of public services, was seen as either being incompetent or lacking sufficient resources to meet the needs of the MNA respondents on many respondents. The three functions of Wilkes-Barre City that raised the most negative responses were in public works, (streets and g 0 sanitation) and public safety (police). In response to the public services category, the prevailing negativism manifested itself in such comments as: ■ "The police are slow to respond to calls from O'Karma housing. " . "Garbage and refuse are not picked up frequently enough. " -73- I �L . "Snow removal is terrible. " . "There are too many roaming dogs in the area. " . "They never clean streets nor tow away vandalized cars. " . "The police are good but their hands are tied. " 4. "Better" Responses This section of the survey findings presents the perceptions in which the respondents perceived that either their personal, community, or both, situat tions were getting better with respect to the problem and/or service category. Those categories in which the 536 respondents perceived of conditions and services as getting "Better" consisted of the following: 3 a 0 s . . . . . Aged Children Education Recreation Welfare a. Responses to Aged Category Although the survey profile indicates that the aged person was not overrepresented in the survey, there was considerable response to an awareness of problems of the senior citizen as evidenced by a 59% response to the question, "Is this a problem in the community?" n -74- 1 �TABLE 23 PERCENTAGE DISTRIBUTION OF RESPONDENTS TO BASIC SERVICE FOR THE AGED Personal 46 16 38 Community 47 19 34 Better Worse Same Despite this sensitivity to the problems that exist for older people (as regards community problems or personal problems respectively), 47% s flJ a 0 (community) and 46% (personal) of the respondents indicated that the situation for the aged is getting better. Only 19% and 16% (using the same community and personal perceptions as above) stated that the situation of older people was getting worse. In their comments on this category, respondents generally did not identify the problems with a specific agency, although the Social Security offices were mentioned several times. Among the comments mentioned more than once were: . "More dollars needed than is provided by Social Security. " . "Tax rebates should be given to older persons owning homes. " 0 . "Daytime recreation programs would be useful. " 0 . "Older persons' pride must be handled before help can be accepted." 8 . "Transportation (even to and from shopping areas) is a problem for them. " a. Responses to Children Reflecting on the demographic characteristics of the respondents, one -75- �■ - is compelled to note that about 75% of the survey sample had children in their homes, indicating a familiarity with the subject matter being surveyed in this area. This area (together with the area of education) received most favorable comments of all thirteen social service subject areas. There were a number or specific recommendations and problems, but about 60% of the respondents felt that the situations both community and personal, involving children, were a a ■> f 6 Q 0 getting better, as indicated in the table below: TABLE 24 RESPONSES TO CHILDREN PERCENT OF RESPONDENTS Better Worse Same C ommunity 65 8 27 Personal 56 6 38 The fact that less than 10% of the respondents felt that situations revolving around children were worsening (rather than remaining "the same") confirms the attitude of optimism about the community's services for children. J fl The specific comments about children's problem situations seemed to focus on teenagers ("they need sport facilities, like basketball and football"; "drinking is a major problem for teenagers") who are also the focus of the problem areas dealing with drug addiction. 1 With regard to child-serving agencies, several respondents complained A about the "red tape" and the persistence of overlapping agency jurisdictions, p i -76- r �citing a major need for consolidation of child services and increasing commu­ nications between education, counseling, recreation, and police services. The word "respect" appeared quite often in the respondents comments ■J about children, reflecting the feeling that "this younger generation doesn't learn the proper respect for established ways and procedures... 0 c. It Responses to Education Category This subject area received the highest, most positive rating from the survey population. Less than 10% felt that educational services were worsening at either the community or personal levels. The detailed tabulation reveals the following: fl TABLE 25 RESPONSES TO EDUCATION PERCENT OF RESIDENTS Better Worse Same Community 71 7 22 Personal 60 9 31 This very positive attitude towards formal education systems was reinforced by many of the volunteered comments, although specific examples of further 0 improvements were also given: . "Retire older teachers and hire more younger ones" . "Overcrowded classrooms" 0 . "More supervision is required during school playtimes" In addition, several of the respondents commented upon the existence of supplemental educational programs which were more designed to spend money that was available than to accomplish needed objectives. -77- Several respondents �suggested that investigation was required of various "grants" that had been given to community educational facilities. These suggestions, however, must be weighed in the light of the excellent "report card" being given to the area's educational facilities by the surveyed population. d. Responses to Recreation Category The data indicate that slightly more persons surveyed felt positively about recreational services than felt negatively. The volume and type of critical unmet need was much less than would be anticipated, reflecting a high degree of satis­ faction with existing recreational programs and services. Since this subject area comes in for early, if only surface criticism in ■ ■ y nearly every community survey, the findings, shown on the table that follows, must be considered quite positive: TABLE 11 RESPONSES TO RECREATION PERCENT OF RESPONDENTS - 0 u Community Better Worse Same Personal 42% 30 28 40% 23 37 Supervision, to prevent vandalism and to relieve working parents, was noted as an unmet need by many respondents. fi fl Focus was upon the teenager in this area, seconding the point made with regard to children, that this age group was the greatest perceived source of problems. Specific criticisms of the Recreation Department and the Cub Scouts centered about the geographic narrowness of the services of these agencies. -77a- Specific criticism was also voiced �at the absence of park-like areas for recreation and the use of certain recreation facilities near areas of danger (the railroad tracks near Lehigh and Hill Streets). e. Responses to Welfa're Category To be particularly noted with reference to the responses on the wel­ fare social service need is the fact that more than half of the respondents (57%) were receiving some type of public assistance. <p This social service area is classified as one of the five in which'the positive attitudes of the survey population exceeded the negative comments or a attitudes. Yet in this inclusion in this select group with education, child­ ren, the aged, and recreation is but a matter of only a few percentage points. TABLE 26 RESPONSES TO WELFARE PERCENT OF RESPONDENTS Community •T~- 0 a I Better Worse Same 46 24 30 Personal 41 21 38 What is unusual, also, is that the minority (24% and 21%, respective- ly) who felt that the welfare system was worsening was very vocal and citbd many -78- �different types of shortcomings. There seemed to be fundamental political and personal negative feelings about welfare recipients, which is voiced by this minority. 3 0 3 Among the major problems citied were: 1. That there were many persons receiving welfare who did not deserve it and.conversely, 2. That people in true need were not on the rolls. Additional criticism of the basic system assumptions was widespread, including such allegations as: "Investigators are lax in their work and too nosey" . "Requirements that welfare recipients be compelled to work" . "Payments should not exceed what a man could earn at $2. 00 per hour" . "Need day care centers so that mothers on welfare can work" . "Need consumer education to help recipients spend money wisely. " The failings, such as were noted by the respondents, are more structural and basic to the welfare system, than mere service reforms of improvement suggestions as is the case in other subject areas covered by- B the survey. F. GEOGRAPHICAL ANALYSIS OF FINDINGS An examination of the data by neighborhood area denotes some inter­ esting patterns about social service needs. The most negative view of services at both the community and personal levels appears to have the highest -79- I �- incidence in the Iron Triangle, Southeast and Central neighborhoods of the MNA. The ranking of those services, by area, which were viewed as getting "worse" appears on the two tables that follow: 0di a TABLE 27 COMMUNITY PERCEPTION OF "WORSE" RESPONSES BY SELECTED CATEGORIES AND NEIGHBORHOODS fl Iron Triangle Southeast Northwest Southwest Central HOUSING HEALTH ADDICTION 62 49 46 29 23 Southeast Iron Triangle Northwest Central Southwest 43 30 26 15 13 Iron Triangle 58 Southeast 47 Central 33 Northwest 27 17 Southwest JOBS Iron Triangle 34 23 Southeast Northwest 15 Central 12 Southwest 8 TABLE 28 PERSONAL PERCEPTION OF "WORSE" RESPONSES BY SELECTED CATEGORIES AND NEIGHBORHOODS ADDICTION 0 Iron Triangle Central Southwest Southeast Northwest HEALTH 16 15 11 4 1 Iron Triangle Central Southwest Southeast Northwest HOUSING 18 9 8 7 4 JOBS Iron Triangle 41 Iron Triangle Central 22 Southwest 7 Southeast Southwest 6 Central Southeast Northwest 3 Northwest If income data could have been obtained from the respondents, a more discriminating profile could have been obtained on those persons who viewed fl 0 fl fl services as getting "better" or as remaining the "same The basic services, such as recreation, children, and education, could have been considered either -80- 17 8 7 7 1 �these services directly increase the consumption by individuals. In that case, however, they are not a means to the attainment of other resources; rather, 0 are themselves an important component of the level and quality of living. On the other hand, as investments, they are the bases for improving the capacity of individuals to gain access to resources through the private market. To illustrate, better education services or improved transportation to jobs increase n the earning capacity of the individual or of the family. Therefore, if some kind of measure could be constructed that would discern whether these services were-amenities or investments, a more accurate determination could be made as to whether or not people actually see these services as getting "better ii or as remaining the "same. y 0 0 B 0 G. SUMMARY OF FINDINGS Substantial numbers of respondents in the Model Cities Neighborhood commented that services were better in the service categories dealing with children (child, recreation, and education) and/or the aged. The latter group has improved its services, and yet a third of the respondents see their situations merely as. the same. Although the welfare service was placed in the "better" Category, it could well have been placed in another category. Only a few percentage points would have dropped it into the "No Consensus" rating. Of significance is the fact that a quarter of the respondents not only rated it "worse" but expressed very strong feelings about the shortcomings of the welfare system. -81- �The only summary comment that can be made concerning services rated. the "same" is that the respondents exhibited either indifference as in the case of consumer and legal services or dissatisfaction as in the case of public services. If the findings are considered from the community level alone, then the conclusion could be deduced that the major pessimistic comments indicate a general decline in the quality of life. The evidence for such a negative view is found in the fact that addiction, housing, and health are rated "worse" at the 0 9 community level. Addiction and housing are rated "worse" at the personal level as well. A word should be said about those services which were given the "same" rating, either at the community or personal level (or both for that matter). These services would include health (personal), jobs (personal), training (personal), consumer (community and personal), legal ( community and per­ sonal), and public ( community and personal). If life generally improves for everyone in the society, but a- respondent views conditions as remaining the "same" at the community and/or the personal level, it doesn't necessarily 0 mean that his lot is now or will be a happy one. Viewing life as the "same" is not to equate it with improvement, for what may be the "same" today may be ''worse" tomorrow. The negative view of services at the community level appears to have the highest incidence in the Iron Triangle and Southeast Sections of the MNA. In evaluating the perception of the consumers of basic social services, r> 8 -82- �were gaps consequence of: 1. the presentation of the service by the agency provider and 2. the consumers' experience of that service. For example, the data reflected an increasing concern about addiction, Undoubtedly much of this concern has been generated by the news media. 9 a J How­ ever, it also appears bbvious that the residents have not been made aware of any agency that provides addiction rehabilitation services so as to allay their apprehensions. For the consumer to understand and interpret addiction as a problem or service need presented in the news media implies that the listener is not being made aware of what is available services exist at this 1 0 y point in time. The pessimistic comments of the respondents concerning the unresponsiveness of service agencies to this problem hint at the un­ availability of service resourses to focus on the problem. There are two: aspects that affect a consumer's perception of social services based on his experience with the agency provider. happens to the consumers who apply for a service? ! 0 And, second, how does the agency treat them? The data findings on the "worse" responses to health serve as a good sounding board to these questions. The MNA respondents expressed concern about the unresponsiveness of health delivery systems. p s First, what This perception was ostensibly a consequence of their experience in seeking health care. -83- 1 �Their comments imply that health agencies (hospitals and clinics) vary in their understanding of and openness to various modes of individual behavior. It is a known fact that low income people of all ages consult doctors, dentists, and medical specialists less frequently than do the non-poor. Therefore, given emergency conditions, the responsiveness of the provider tends’-to be a function of the consumer’s past utilization rate which is contingent upon social class position. In most cases, according to the findings, the poor consumer was either excluded or spent long periods of time waiting. Another point frequently mentioned regarding the responsiveness to the appeal for health services was that some doctors will not take public assistance clients. of inadequate health. These persons are usually the ones who have a history Hence, a more’in-depth analysis of the - availability of health services to this group in the MNA might reveal the inequality in the distribution of health services and physicians among the six neighborhoods within the MNA. -84- �1 ■ I ! f P PART HI f” STRATEGIES IN SOCIAL WELFARE OLD AND NEW Change is the lifeblood of any political, social, or economic system. Health and welfare programs as major components of our social life have under­ a 5 gone change too. Traditionally, our social welfare programs have rested on the concept of charity rather than on the concept of special rights. The value has been on voluntarism rather than on public (governmental) responsibility. a It is not that poverty, the poor, or the disadvantaged have been rediscovered in f Wyoming Valley, particularly in the Model Cities Area. I r i \ It is just that subtle changes have finally caught up with the general citizenry hereabouts. The response locally is to be found in the change in thinking about the United Fund and its constituent agencies, and particularly in the Welfare Planning Council. A. THE PAST IN REVIEW The structure of welfare organizations differs in those agencies estab­ lished under public auspices from those which are of voluntary or private nature. u Public agencies are established by individuals or philanthropic, religious, frater- nal, or humanitarian groups; their management is the responsibility of a board of directors, and they are supported mainly by contributions, donations, endowments, trust funds, and often by participation in the distributions of a United Fund. In Wyoming Valley, the foundation of private social agencies and the continuation of their activities in the past has been based upon the recognition of I the need for a service in the local community. -85- n Originally, philanthropists, a ��United Fund soon developed into the one single fund-raising agency in behalf of many health and welfare agencies. It was a result of taking on this support function as one of its main tasks of making allocations to the member agencies 1 a that eventually led the United Fund to study the role of the various agencies in the Wyoming Valley Area. The Fund did develop over the years what seemed to a logical set of standards and objectives for the allocation of the United Fund dollars. However, often times informal reasons or criteria frustrated the more formal, stated criteria. Factors such as professionalism, previous budget, administration, budget d consideration, and clients served, were always considered in an informal way, 0 along with the presentations made by community and influential people who spoke D for a social agency. The prestige of the agency, historic or current, and the plain human sympathies of those on the allocation panel were a factor. have participated in or used the services of an agency. They may The representative of an agency might have been more skillful in presenting its needs. Also, it was always easier to enlist support for a direct, personal service. Perhaps more importantly, the past history of allocations became an immutable pattern, difficult to change radically, reduce, or eliminate. iu rn The desire for orderly change would become a typical defense mechanism of social agencies. The truth of the matter is that informal reasons may have been used because neither priorities nor guidelines had been adequately developed, adopted, or implemented with any muscle. -87- �tit for tat" rationale concerning fund raising that could more charitably be labeled a "philosophy of flexible concern" meaning no more than "I’ll work to raise funds for your agency if you will work to raise funds for me. " Although there may not have been constraints in reference to ethnicity, religious beliefs, degree of professionalism, the number of clients served, etc. , there certainly were "understandings." In the allocation process, these did operate, but not always to keep an agency out of the Fund, although it should be emphatically stated that this community, and the Fund, have a minimum of bias. Probably the two most serious constraints have been professionalism and the number of clients served. The lack of professional qualifications (Jewish Welfare) has posed a problem. 0 And yet, the Agency may have done a good job in the past in dealing with people problems. There has always been a feeling at allocations time that the Salvation Army was really operating a religious enterprise and with a bookkeeping system that "left much to be desired. " 0 But many felt that it performed a social as well as a religious service. In spite of a recognition of the fact that the United Fund was supporting a religious operation, cognizance had to be taken of the fact that many community leaders 0 0 were very much interested in the success of the "Army. " Planned Parenthood has never been a United Fund agency and may never be, by choice, as well as by opposition from the Catholic Church. People on the allocations panels have been influenced by their ancestry - 88 - �and r eligion. Regard for professional operation has run the gamut from cold calculation to warm, undiscerning emotionalism. This has delayed the consolid­ ation of some agencies with related functions. The agency' s spokesman may state that the constraints do not relate to agency goals, objectives, or functions, and may have regarded these constraints as inconsequential. The fact of the matter is that they do relate to the goals and functions. Even if Catholic Social Services did not consider family counseling for Catholics its own perogative, Catholics would feel more comfortable with the Ilf agency. An Orthodox Jewish person would tend to go to the Jewish Welfare Agency. The goals and functions must, of necessity, be geared to the type of people they serve - based either on ethnics, age, religion, particular problem, etc. Agencies have not in the past always shown an awareness of goals and and often confused objectives as goals, compounding this difficulty by being un­ able to clearly define the parameters of the responsibilities. it, "Rehabilitation is rehabilitation. As one person put What difference does it make who does it? II Agencies have had grandiose goals and kidded themselves on their actual impact. 0 J Both the Red Cross and the Salvation Army do disaster work. If it is the province of one or the other, is there any justification for spending the Fund dollar twice? There would not be if goals were clear to all agencies. The problems as to goals are posed by changing goals in a changing society. fl 0 Should the Community continue to put money into an activity such as Council House when such activity is now government financed? -89- It has been the �habit of many agencies to stay in a comfortable rut and not discard outmoded programs that do not anymore fit the goals of today. Many of the problems of the voluntary agencies are caused by legislative procedures about which they can do nothing. Public health and welfare programs have influenced the activities of the voluntary organizations profoundly. Many of the old activities of the voluntary organizations have been taken over by the public agencies, and therefore the voluntary agencies must constantly readjust their sights. q a Therefore, their function may change from actually supplying the service to playing "watch dog" when the service becomes public. The public health and welfare system is influential in respect to United Fund agencies in a number of ways. Firstly, it takes on the burden of the welfare cases, and leaves other areas of income and need to the community agencies. To the extent that public funding meets needs, the rest of the community needs become the province of the United Fund Agencies. In many instances, public funding is used to purchase services from United Fund agencies. This in turn frees volunteer dollars for more extended use to those not covered by public funding standards. Public funding can change the direction of the volunteer dollar and does s force voluntary agencies to reexamine their goals in the light of availability and the nature of public funding. The United Fund agencies' influence has been substantial if not at times H overwhelming. The United Fund and the Welfare Planning Council have been able to get health and welfare agencies to change procedures and legislation in -90- > �in order to offer services that people need. Very often voluntary organizations lead the way to changes in restrictive requirements later adopted by public agencies. For example, Family Service Association provides services to all families who ask or need these services, regardless of ability to pay. The public welfare system also appears to be moving in that direction toward the creation of a public family services agency. Jj 3 T 'J I United Fund agencies have voiced needs and started services. An ex- ample is Homemaker Service which came first by the Junior League out of a private agency and now has been adopted and is used by public welfare. United Fund has been a strong constructive critic of many Federal and state programs and has mobilized a substantial bloc of public opinion on occasion. What is has not done, hampered perhaps by limited funds and some lack of vision within itself, has been to volunteer and be in the forefront of new approaches. There may have been a time (coal companies, bankers, leading citizens) ■I were capable of exerting influence through allocations procedure. But no particular group could be considered powerful today, although there are some individuals who may be. .I 3 J If the Family Service Association receives a high allocation it may not necessarily be because certain individuals have not only been the presidents of the association, but also chairmen of the United Fund drives and presidents of 0 the Welfare Planning Council. Rather the high allocations are due to the fact that the agency has been considered by many people in the community as doing a very effective job of counciling. Coincidentally,, these same individuals who -91- J �have headed the United Fund and the Welfare Planning Council have also been instrumental in raising the level of the agency. On the other hand, no single influential person or group could save the Legal Aid Society allocation. Allocations to the Jewish Welfare Agency have not been due to any single person, but rather due to the United Fund Allocation J Committee feeling sympathy toward its director for past performance. The same is true with the Salvation Army. As a matter of fact, there have been instances of counter reactions to 3 influence. A group of 59 community-minded people and individuals who serve on the Allocations Committee is too diversified a group to influence let alone control. There may be a feeling that neither the Welfare Planning Council nor the United Fund approached the Model Cities Agency to offer assistance. This is true, but the law and the concept written into it not only prevented the agencies going to the MNA,but neither could the MNA initiate communication with the agencies. It is the feeling of the voluntary agencies that when Model Cities was first conceived, the basic assumption was that the old institutions of whatever category -- economic, political, social, etc. -- had failed to meet the human problems. Therefore, out of this concept developed the idea that innovative plans, policies, and programshad to be the road to meet problems. New agen­ cies, institutions, and programs had to be developed. Therefore, the corollary assumption was that "restructuring" the old institutions would not be enough to accomplish the objective. Consequently, there was no communication -92- �between the social service agencies and Model Cities Agency. Research and consultants were given priority in the early days of Model Cities Agency. After the consultants advised MNA that some of the old agencies, if restructured, could serve a useful purpose, communication began, i. e. Human Resources Center was as a recommendation of just such a recommendation. At the same time that communications between the United Fund agencies and the Model Cities Agency began, the United Fund and the Welfare Planning Commission began an intensive study on goals, objectives, priorities, and allocations of the member agencies. It was the feeling of many that a reap- praisal should be made of both the agency goals and the requests for money. This two pronged attack - one on a restudy of the old traditional social service agencies and the other predicated on innovation and new concepts, have brought the two groups together for what perhaps can be the development of a more effective and humane health and welfare delivery system for the residents of 3 the MNA. The feeling was also extant among many board and staff members of the Welfare Planning Council, the United Fund, and social service agencies that J J the Model Cities Organization is essentially an administrative body and not an operating body. In other words many agency people have felt that as such i a body, the Model Cities Area purchased services. Aware of this fact and also realizing that some agencies would have allocations difficulties and that others may want to enlarge their programs, the United Fund has recently encouraged its agencies to seek Model Cities funds in those areas where the program objectives coincide with the program objectives of Model Cities. -93- �B. GUIDELINES AND PRIORITIES If the United Fund and the voluntary field is to survive, it became clear to its Board and that of the Welfare Planning Council that it would have to exhibit an aggressive and dynamic leadership role in solving community health and social problems. This means a more dynamic mission than merely raising funds for a group of agencies, or supplementing public programs, or reducing the number of campaigns, all of which may be commendable in themselves. Steps in this direction were taken when, in 1967, the United Fund reached a decision that it needed a priorities plan to help in allocating funds D n ! raised in its annual campaigns. It was decided that no one from the outside could really tell a community what its priorities should be. of those working with the Fund that these are decisions It was the conviction each community must inake for itself in terms of its own problems, assets, and aspirations. In attempting to develop a priorities plan, it took the work of many 0 dedicated people over two years to prepare a priorities plan. There were twelve persons primarily involved, six from the United Fund and six from the Welfare Planning Council. a This committee drafted a Position Paper which was shared with the agencies before it was presented to the Board of the Fund for its approval. Each agency was asked to review the paper. It searched for material from other areas and from other United Funds, but none was to be found. They had hoped to find something they could use "right now" but there was none. -94- �The United Fund was faced with answering the following questions when determining allocations through a priorities plan: 3 1. What services do we want or should we provide to meet our community needs ? 2. What are the most important services which the Fund should be supporting ? 3. Are Fund dollars being used to support services which could and should be supported by public funds ? 4. Are funds now being appropriated to services in relation to their importance ? 5. By what criteria should agencies and the services they provide be evaluated? I di 9 The "Position Paper " declared that: U n A priorities system should be part of the community planning process, for priority planning is actually a refinement of community planning. Priority planning is never completed; it is a continuing process. Know­ ledge of needs, agency programs and service standards is fundamental. It is important that agencies understand and accept the criteria and procedures employed. Agencies have autonomy and can directly influence the success or failure of any priorities plan. The system must be flexible, and adapted continuously to changing conditions and increased knowledge. Changes in needs, in service methods, and in community values will change priorities. Increased knowledge will provide a basis for a better evaluation of needs and services. J Iff I'J /H) I’ Implementation of a priorities plan will place additional requirements on member agencies and the organization developing the plan. The Fund and Council are committed to invest the staff time to its develop­ ment and maintenance. A priorities system is concerned with services -- not agencies. Since many agencies offer more than one service (some of which may rank high, some low), it is necessary to be able to separate the cost of these services. -95'U I iRl F �A priorities plan-- starts with an analysis of community needs and problems and services designed to solve, whether currently existing or not. ranks the needs with respect to their importance. evaluates the adequacy and effectiveness, both quantively and qualitatively, of existing services. assesses the gap between need and present levels, both with respect to existing services and services which should be developed. determines how services should be administered and financed, whether by voluntary or tax dollars. makes recommendations as to which services should be initiated, which expanded, which modified, and which curtailed or eliminated. Guidelines were then prepared containing seven components, a summary of which is presented below: I Hi ■J 1. Objectives for Agency Services: Stress was placed on relevant community social ills, approaches, prevention of family and/or individual breakdowns and services in building character. Priority was to be given to those services which serve the low income and disadvantaged. 2. Responsibility for Voluntary Support: Emphasis was placed on client self-support if possible. More important perhaps was the point made that agencies should not seek funds for state mandated services, but should complement those ser­ vices. A total community approach --public and voluntary-to community needs was underscored. 3. Effectiveness of Agency: Agencies were asked to continously evaluate the effectiveness of their programs and identify gaps in both services and areas served. 4. Efficiency of Operation: Management efficiency, consolidation of services, employment of consumers of services, and the develop­ ment of multi-purpose service centers were given a marked accent. n .y I - 96 - ‘U I �5. Board and Membership: Consumer participation on governing boards and effective citizen involvement were given a high priority. Note should be made of these guidelines in the light of later sections I of this study. The "Guidelines" were then converted into a rating sheet form. I Agencies were not asked to fill out the rating form, but to answer the questions that would enable a reviewer to make an evaluation of the agency relative to the . I s areas defined. The narrative form of the response was expected to include service statistics if they were considered pertinent to an understanding of a program, other pertinent data, and especially the purpose of the agency as stated in the bylaws of the agency. The agency was expected to clearly state its activities as related to the objectives of the agency and its responsibility to the community for community support. J 1 This was an attempt to look at the profile of the agency and the community service being rendered. After the rating material was received by the Central Allocations Committee, the responses were reviewed by a number of individual panelists who were knowledgable people in the community not connected with any United Fund agency. I These evaluations were compiled and submitted for use by the Central Allocations Committee and Conference Groups. 0 The results, in and of themselves, were not to be the determining factors for allocations. How- ever, they were important in developing the priorities which all agencies have- agheed must guide the United Fund ixl allocating limited voluntary dollars for the future. T -97- U L- �to pre-established community goals. The Fund is making an effort to base decisions on a relationship to those community goals. Hopefully this would provide the information and tools necessary to allocate community resources. C. GOALS Consistent with the guidelines and priorities , a number of goals were reviewed and adopted by the United Fund-Welfare Planning Council which will have a very significant impact on the delivery of social services in n 1 i - Wyoming Valley and particularly in the Model Neighborhood Area. Some of ihese goals are set for the current 1971 United Fund year while others are more long distant. The number one goal for 1971 is the merger of the Visiting Nurse n i J j Association and Wyoming Valley Homemakers Service, Inc. into the Home Health Services of Luzerne County. The goal is (a) to finalize formation of the new agency and admit it as a member agency, and (b) to market this organization to include the Visiting Nurse Association of Pittston as capabil­ ities grow in 1971. The purpose of the new organization is to provide a more comprehensive home health care program. In this manner, it is hoped to take better advantage of maximum public and1 pri vate fi nancial support; e. g. Social Securities Benefits "Home Health Aides" and Blue Cross coverage, and eligibility medicare services. The improved relationship between Home and Health Services and hospital care is expected to develop from the merger. The 1971 allocations were made for only six months, with March 17, 1971 set �as the activation date for the new organization. A second goal of major import is the deactivation of Council House and its program of out-patient hospitalization merged with Luzerne/Wyoming County Mental Health Center since the resocialization program will be merged with United Rehabilitation Services resocialization program. The United Rehabilitation Services resocialization'program now handles many, of the Council House clients. Thie major ^objective i's tb'. develop United Rehabilitation Service into the single rehabilitative service in Luzerne County. . 'j ■1 Ji Of course, the merger is contingent on the United Rehabilitation Service's program capability to absorb additional services and Council House's willingness to join its resocialization program into a new program. A one year timetable is set for the coordinated program. 3 Goal number three involved transferring the United Cerebral Palsy Day Care Program to United Rehabilitation Services in order to provide additional medical and physical orientation to the Day Care Program. 3 3 The United Rehabilitation Service staff and program capabilities are expected to handle clients in wheel chairs, etc. Again, a time limit of one year has been set for the transfer. Consolidation of the Luzerne County Association for Retarded Children and the Luzerne County Mental Health Association has been set as Fund priority four. m The direct service programs, such as the Clergy, Clinic and Day care are expected to be turned over to the Luzerne/Wyoming County Mental Health Center and/or the United Rehabilitation Service. -99- The purpose of this �OH action, no doubt meeting state and National Board opposition of both organi- zations, is intended to provide organizational strength and leadership. c It is expected that the new organization will be better able to devote more time to its primary function in monitoring public funding. 3 111 United Fund priority number six will also be of significance to the Model Neighborhood Area residents, for this objective contemplates that all '7! Family Service Agencies (office oriented agencies) will be housed in one build­ ing. The agencies eventually contemplated for consolidation are Family Service Association, Catholic Social Services, and Jewish Welfare Agency. All three of these agencies have a long community history of separate operation. It is expected that this single family service agency can make better use of voluntary dollars in office administration so that more dollars can be used for client services. It is expected that a joint answering service and office equip- ment can result in initial savings. The joint approach will make it possible to obtain benefits of public and private funding for total community services. The separate agencies have all experienced a fact of life that government sources hesitate to individually purchase service on separate contracts. Although no time table has been set up for this merger, a continuing review through 1971 can remove any obstacles that may arise. It is the hope of many associated with the joint planning, that the merger can come to fruition by 1975. Other priorities include the establishment of allocations to all Character - u 3 Building Agencies on the basis of need, the consolidation of Red Cross Chapters, identification of Salvation Army funding as community service. 3 u ■ '"d -100- Allocations to �recreation and character building agencies will be combined in the "ability- to-pay" support. A system of analysis is expected to be developed for those who need assistance to participate in the activities of these agencies. i. b 1 I L In the case of the Salvation Army, the social program will be separated from the primarily religious activities. One of the purposes of this review is to better coordinate its activities and community services with those already established, and thus make better use of United Fund dollars. Another recent decision of the United Fund-Welfare Planning Council ul a n relates to the Legal Aid Society, sponsored by the Bar Association and a long time member agency of the United Fund. It was primarily funded by the United Fund up until 1966 when the Office of Economic Opportunity began to provide funding. g 1 During the past two years, the Commission on Economic Opportunity claimed that the Legal Aid Society was not conforming to essential guidelines necessary to continue Federal funding, culminating in the withdrawal of Commission on Economic Opportunity funding in March of ■■ 1970. LJ 3 The United Fund was then faced with two Legal Service Agencies: the newly proposed Legal Services Association sponsored by the Commission on Economic Opportunity and the Legal Aid Society. Although the handling of divorce cases was a bone of disagreement, of greater concern to the Commission on Economic Opportunity was the fact that the Legal Aid Society did not commit itself to the reform of laws that worked a disadvantage to the poor, and the Society did not have anyone defined 3 n a; as poor by the Commission on Economic Opportunity on'the Board of the -101 - 123374 �Legal Aid Society. The Luzerne County Commissioners, after discussion with repre­ sentatives of both organizations concluded to continue support for the Society for the year. Since the action of the Commissioners of funding the Society left the Commission on Economic Opportunity program with no local share to provide the 20% necessary to receive Federal funds, the United Fund allocated funds to the Legal Services Association taking them from the Legal g di Aid Society. During the discussion on the issue, reference was made to the Guide- lines in respect to the use of voluntary dollars as they duplicate or as public (1 11 If I a fl 9 This is a classic example where service had been provided through voluntary giving for twenty years and finally became such an obvious need that the public sector assumed responsibility for providing the service. It is typical of a situation where a governmentally funded service supplants a locally-sponsored activity in the interest of community betterment. It was the feeling of Board members that maintenance of two duplicative service groups wastes local and public money through the costs ID 8 I I dollars become available. of duplicate staff and administrative expense. -102- �L PART IV I recommendations A. INTRODUCTION Daniel p. Moynihan, counsellor to the President on Urban Affairs, writing I? jy in the May,23, 1970 issue of Saturday Review stated, "This nation is moving from a services strategy to an income strategy. L_. A services strategy, in rough terms, is one that seeks to make up presumed deficits in the behavior of one set of persons J by providing them the counsel, advice, and example of another set of persons with presumed surpluses of such behavior. ■ The terms of trade are, in essence, advice in return for deference. " He goes on to state that the services strategy is characterized by the fact 'I that out of selfless beginnings evolved vested interests. Therefore, the purveyors of services acquire an interest in the maintenance of demand. I I n ■ The point that he makes is that services should be for everyone, not just the poor. His blunt point is that segregated services deteriorate. And that is really the focus of these final words. Social services should be community services, not poor people's services, available to everyone. '■ u n difficult to construct the components of a model social services system delivering health and welfare benefits because of the primitive nature of our knowledge and understanding relating to the social services. Given this stage of development, perhaps a statement of problems helps point the way. u - 103- I 3 ‘ [ |L It is �1 First, we cannot seem to agree on the scope or definition of social services; what they are or who they are for. Are services only to make up for individual deficiencies and, therefore, to aim at rehabilitation, or are they also to include services which enhance normal growth and development? preventive, rehabilitative? Should they be remedial, Or, should they be developmental? This latter concept, which conceives of social services as social utilities, opens the way for consid­ a eration of a large spectrum of community-sponsored facilities and activities, such as day care, supervised play lets, home helps, and many more.. Our second problem is our inability to rationalize in any way the current organization of social services. Services programs have grown up historically, accidentally, publicly sponsored or privately endowed, geographically deter­ mined, professionally controlled, and often heavily regulated from above or outside. Third, we cannot measure adequately the effectiveness or know precisely the ■ results of social services. We are very largely at the mercy of the professionals' imprecise and impressionistic evaluation cf their own services. This is an adequate base from which to determine future policy, particularly when community resources are scarce and alternatives must be defined and analyzed. According to the 1968 Report of the Steering Committee of the Arden House (I Conference on Public Welfare stated, that "The vast majority of the welfare a population is either too young, too old, too sick, or too disabled to be selfsupportive." If a hard analysis of the MNA populations even tends to be described as above, as unpleasant and unpalatable as that fact may be, then a reappraisal of the health and welfare systems is a must. I -104- II i fl /i • M �B. HUMAN SERVICES DELIVERY SYSTEM 1. A Model Medical Care System The preceding discussion leads to the formulation of a model medical care system. This system should emphasize decentralization outreach, multiple services readily available, and the use of the indigenous non-professional as the prime human resource of the delivery system. Access to health is important and a major determinant of use is accessi- 3 bility. The reverse may not be true. Creating access does not necessarily ■ elicit use. 3' Technology may lead to better care, but the truth of the matter is that the great majority of ailments can be managed in a simple rather than in a complex setting. In the past, provision of health care was grounded on a system of care by the private practitioner and free choice of physician by the patient. Private care will no doubt continue to exist along with a social health delivery system. The legislation to influence a change to the latter system is already on the books: . Amendments to Social Security Act Medicare and Medicaid Health care for pre- school and school age children Health care for crippled children Maternal health care . Regional Medical Program . Comprehensive Health Planning Program -105- I �i L . Child Health Act Maternal child health program for low income services for ( retarded children . Economic Opportunity Act Neighborhood health centers in low income areas This latter Act has direct applicability to the Model Neighborhood Area. d L The centers can provide complete and accessible medical care, with emphasis on preventive medicine and family planning services. This type of primary health service delivery at the neighborhood level appears to be the wave of the I r futur e. Public, voluntary, trade union, profit and non-profit group arrangements in neighborhoods are increasing as is group practice by physicians. A breakthrough has already been made in the field of mental health with the Mental Retardation and Mental Health Act of 1963, which provides for < prevention, treatment, and rehabilitation services for the mentally ill. Lacking, however, is a clear relationship between the new mental health model and social and health services in a community. n The mental health facility must be easily accessible, convenient, familiar and accessible to neighborhood residents. It should not only be a treatment center but perhaps a coordinating center for ;—t r many health and welfare services. The foregoing pieces of legislation, and many others, have the beginnings of a health system revolving around preventive medicine. r If preventive medicine is to be more than a myth, it must be organized at the three levels of service. The first level, the outreach system, would -106- L p �— 1 include shared health and welfare services. system. l The staff would support the outreach The central health facility would be a comprehensive neighborhood health center operated under contract by local practitioners, a local community hospital, or some combination of these. The neighborhood health center would provide appropriate diagnostic and therapeutic services, and would educate I whatever necessary. The third level of service would be in a local hospital with or without a close clinical service, staff, and educational tie to the ■ program. All of these services must be closely related physically, functionally, I 1 u and psychologically to other human services. The basic thrust of a model health model should permit the disadvantaged access to the mainstream of health services and to utilize more fully all 3 existing health services. Within this dual framework, the model must revolve around several key programs: 1. A community health center. 2. Development of a group health practice whether in a facility owned and administered by a non-profit health group or profession owned. 3. e illnesses in the Model Neighborhood. 0 4. r~\ ! A i 1 Use of trained resident aides to prevent and reduce the impact of Development of a prepaid medical, mental, and dental care program. The success of preventive medicine revolves around the health center which is easily distinguishable from the present health delivery system: 1. "Walk-in" versus appointment usage of services. 2. Demand for services versus supply. 3. Continuing comprehensive care versus acute episodic care. -107- �pi'. Examples of health functions which might be carried out in a decentralized system in the neighborhood center include school health program, inoculations , routine well-baby and early childhood care, mental health services, medical and n J 3 3 dental screening services, pre- and post-natal services, family planning and counseling involving health problems, and simple emergency services. The citizenry who in a community health center neighborhood signed up would be covered by a capitation system paid in advance either through public sources, through a combination of self-payment and public support, or entirely through self-payment. The World Health Organization's definition of health is a "state of complete physical, mental, and social well-being and not merely the absence of disease." If the WHO definition is to be more than mere words only a system of preventive medicine can provide the complete medical, dental, and y community outreach service that the MNA residents deserve. It is within the context of this model medical care system that a medical services system should be established for the MNA residents. I Ijhi An integral part of this model health program should be a pre-paid comprehensive health insurance plan for the residents. 2. A Model Welfare Care System Welfare today is caught in a confusion of objectives-objectives which 5 /' ■ ■ are as vague and contradictory as are personal and societal attitudes toward the poor. Some people think it is wrong to be poor, so they demand a welfare program which is harsh and punitive. Others think we should do something -108- fl? �_ I for the poor-but not too much. They advocate a welfare program which provides just enough food, just enough clothing and just enough shelter to get Still others see the poor primarily as potentially productive citizens. along. For them, a rehabilitation program geared to helping the poor make up their deficiencies is the proper course to fellow. m In a model welfare delivery system, efforts should be directed toward the original and still the basic function which is to supply money where there nd. is none. First things must come first, and for a MN’A resident, many of whom are on welfare, money is first, the rest follows. I Therefore, the ■ financial assistance and the social service functions of a welfare care program f g g must be separated. Each’ is made to stand on its own; two separate functions with two separate objectives. Public aid then becomes an independent financial transaction, conducted in a simple, direct manner with the goal of providing sufficient inccme where it is needed. 5u. Social services are offered independent of the public aid on a community-wide basis to everyone. Eligibility for services thus becomes desire for service, and not label of ■ income. This means that the services must be available to the rehabilitable as well as the non-rehabilitable - to the poor as well as the non-poor. Based upon this conviction, the rest follows. If everyone, not just those living below the financial aid eligibility level, can and should benefit from day care centers, family counseling, homemaker services, skill training p services and the like, then efforts should be directed toward making the important welfare services more susceptible to economies of scale, elimination -109- 'T �of duplication, wastage of human energies, and overlapping administrative procedures. The rigidities of present welfare resource allocation schemes must be reviewed with a view to reducing socially disruptive activities in a whole neighborhood. The essentials of a model welfare component will be distinguished fl eL fl by the following characteristics: 1. Human services will be oriented to client rather than professional need. 2. Combinations of diverse welfare services will be available at a single site. 3. The system maximizes local citizen responsibility. 4. The two vertical level welfare service organization includes an outreach system and close collaboration with those agencies not located in a neighborhood. 5. Maximum use can be made of newly trained indigenous non­ professionals in.delivery service and in facilitating the clients movement in the system. 6. Greater emphasis can be placed on prevention in all services at both levels. J A fl- Only through a comprehensive center in the social service area can emphasis be placed on the need to improve the range, quantity and quality of traditional welfare services. fl" /•fl!' Only through such a consolidation of welfare services in the center - both public and voluntary - can: 1. consideration and review be given to revising eligibility requirements associated with many services in order to increase their use to the MNA residents. -110- 'T �n 2. increased awareness of the array of welfare programs be developed. 3. both the Federal and State governments be encouraged and influenced to decentralize select functions and activities. An early detection system through out-reach can inform the center when certain life stresses occur. These life stresses are frequent precedents or precipitants for maladaptation. Examined across the life span, such an early 3 '• crisis detection system might include birth, early socialization experiences, entry into school, pre-puberiy, adolescence, leaving school and/or entering the work force, marriage, children, the involutional period, aging, and death. 1 Each of these life events would activate the staff of the center to invite the involved person to participate or to make home visits to reach out and offer service. Voluntarism in welfare is still a uniquely strong tradition, although many far-reaching patterns of public - private relationships have developed. Welfare agencies will continue to and accept government funds for support for new programs and for innovative approaches to old problems. The model welfare care system will therefore include both the voluntary agencies and the public agencies. The new approaches will be characterized by: 1. Decentralization into neighborhoods. 2. Involvement of more non-professionals. 3. Role of advocates. -111- �Q! a The public funds already make it possible for the voluntary agencies to serve new populations with new or restructured programs. Not only have : these voluntary agencies broadened their programs, they have broadened their boards and councils as well. 0 a The thrust of the new public funds has compelled these agencies to engage in aggressive case finding. maximum decentralization are key points in the new welfare strategy. It is expected that the more planned approach in combating social problems will relate to complete social development. n Citizen participation and Continuum of core and comprehensive services will be designed more and more. Therefore preven- tive and therapeutic services will be effectively combined. R The key objective in future welfare strategy will be for all-poor and u non-poor. In this kind of a setting, social services will increasingly be considered public social utilities. Only if the needed welfare services in the Model Neighborhood Area are provided within the framework o'f this model welfare delivery system can the residents hope to achieve a better life. .. C. CONSUMER PARTICIPATION Consumer participation is a vital concern today because it involves almost every major issue now before the American public. In its simplest terms, it means citizen power - the strategies of redistributing the social control of institutions among all the people of a community. It implies the "open door" approach to everyone's inclusion in the opportunities to determine how information is shared, goals and policies set, resources I u? -112- �a allocated, programs and services operated, and benefits parceled out. Consumer participation is not new because it has long been found that consumer - provider relationships have political, psychological, and ! educational dimensions. a There's ample evidence from the experience around the nation that such a wholesome relationship can remove the mutual distrust and lack of understanding that often times exists between consumer and provider. Because consumers are no longer willing to passively allow providers to control their destinies, health and welfare programs as human service programs must seek the valuable input of the poorest, richest, and the worst frustrated clients at the policy, planning, and operational levels for one reason only - to retain or maintain solid neighborhood area support. Therefore, the organization and method of providing the needed u - services must be consumer, rather than professionally, or bur eaucratic ally- oriented. Community services must be dictated by the needs of the citizens in the community, and not by the prior presence of a particular agency, nor by the imperialism of a certain profession. There must be a strong element of community control in the planning, organizing, and providing of services. The toughest, but perhaps most indispensable aspect of that control involves the development of a constructive partnership between the purveyors and the consumers of social service. There remains, however, a great deal of reluctance by professionals to accept this principle, and consumers may even be slow to insist on its (J adoption. The problem of c onsumer participation is further compounded <?\ -113 — �because it may be unclear just "who" properly represents the consumer's point of view. Perhaps the most serious difficulties lie in finding ways to "open up" the responsible roles in both the decision and delivery processes. The two vital areas that call for more rapid breakthroughs are: 1. In neighborhood and community representation of the advisory boards that determine policies, programs, and services, part­ icularly at the neighborhood levels. 2. In the development of additional and new community service workers trained for effective participation in decision-making situations and qualified to help relieve the shortages in manpower, especially in the health field. With citizen participation, neighborhood-based services have had promising payoffs because of their value as important outpost terminals that can link entire health and welfare systems to gaps in full community coverage. The input of the consumer would require his perception of the amount of benefit which he believes he is receiving or will receive from a service program. (0. Such utilization is inextricably tied to the mode of presentation used by the agency and the actual benefits it confers on the user and on others who have utilized the service programs. More individuals are likely to continue with service program if the reason for particular treatment is made understand­ able to them. For agencies to plan around a prospective client seriously limits and handicaps the effectiveness of the service being provided. But once residents have participated actively in the planning approaches, and understands from thb inside the benefits that he will derive from a human services delivery system, he becomes citizen "advocate" and becomes part -114- �of a vital new force in his neighborhood community. A mere cursory glance at the data on the attitudes of respondents in the Model Neighborhood Area toward all human services suggests that one of the major reasons for gaps and deficiencies with the present delivery systems is the lack of the input of the consumer/user for whom those □ □ services are and intended in the first place. The consumer of social services in the Model Neighborhood Area should be the proper judges of what kinds of services they want, how they want them delivered, what form they should take, and in what setting they should be provided. Consumer participation in the MNA will mean that the residents should plan and direct the activities of both the community health center, which should be pre­ a 0 ventive medicine oriented, and of the Human Services Resources Center, which should be client oriented. Of course, if either or both of these proposed centers become mere referral offices, then the possibilities of consumer participation will unfortunately be limited. D. HUMAN RESOURCES SERVICE CENTER 1 The earlier Diagnostic Survey illustrated the obvious lack of coordination existing among social service agencies and consequently the under utilization of the services of the agencies by the Model Cities residents. As a result of the Survey results, the goal- was set up of making these social services more relevant, responsive, accessible, and available to the persons they were designed to help. In addition to the Diagnostic Survey, social service agencies were -115- �requested to provide information on services to the MNA residents. The response from the agencies did not indicate any high degree of cooperation with the Model Cities Agency. Most of the welfare agencies that did co- operate stated that the MNA,residents showed greater utilization of the social services than the Diagnostic Survey results revealed. The reasons for the variance in the two sets of data are speculative and inconclusive. The group meetings that followed the Survey seemed to have a better vehicle in discovering unmet social service needs in the Area. Most of the complaints dealt with inadequacies of present services; delays in getting service; problems in getting to services located outside the neighborhood; a lack of sensitivity to people and a failure to treat persons !' seeking help with dignity and respect. Many of the latter are reflected in the minutes of the Health and Welfare Committee and resident meetings. One of the problems uncovered was that many people in the MNA were not aware of all of the programs available to them. It was too much to expect that people will make a conscious effort to become familiar with all of the many fragmented programs and services available ; [ to people who need help until such time as a problem or a crisis develops. Even professional workers in agencies may not know the details of eligibility requirements and services of all other agencies. It was found that although many agencies provide information and referral services, there is no one single central information and referral -116- �where people can obtain guidance or help with their total problems. As a follow-up of the survey and meetings, the Agency developed both five--■year and one-year objectives listed below: Five Year Objectives 1. Complete administrative integration of all public welfare services in the Model Cities Neighborhood. 2. Establishment of effective consumer participation in the develop­ ment and operation of services. 3. Improve services to a point where consumer complaints are negligible. 4. Increase individual capacity to solve their own problems and to control their own lives. One Year Objectives I. ’ Initiate program to consolidate various service agencies arid de-partments. 2. Begin establishing the necessary functions and selecting alternate site locations for a Comprehensive Human Service Center. 3. Develop central intake and eligibility determination for all services coming under jurisdiction of the Department of Public Welfare at the State level. r, 4. Establish a Consumer Protection Service, including the develop­ ment of a system for investigating, analyzing and reporting complaints. l The methods to accomplish these objectives were two in number: 1. o Consumer Protection Service To develop within the community a service which would coordinate the various consumer protection measures presently in existence and to encourage agencies to initiate programs for which they have the capacity. This service -117C n r I �I I tt w°uld be responsible for making known to the residents all of the various social services which are available and how the residents can take advantage of them. 2. tx tr a U Comprehensive Human Service Center To develop, within the target neighborhood, a model of a comprehensive, family-centered, human service program under one administration so that families could, receive the whole range of services needed and available in solving their problem or problems in an integrated manner. The intent is to provide a location where a person could start the process of getting help with any problem. Not all services needed would necessarily be located in the neigh­ borhood nor Under the control of the center staff, but the first responsibility of the staff would be to see that people get service. The staff was to become more the advocate of the consumer than has been the traditional practice in most agencies. A work program was prepared id demonstrate on a pilot basis that: I 1. a full range of social services could be provided to families on a neighborhood basis, 2. existing agencies could be brought together on a coordinated basis to efficiently deliver these services, and 3. an aggressive approach to delivery services directly to the neighborhood could be effective. o & Consistent with this program, a Human Resource Program was to be IO established within the existing site office by purchasing the staff services of the "Human Service Task Force. " These personnel were to provide a neighborhood delivery system for the following service agendies; i 1 2 3 r 4 5 6 Welfare Planning Council Catholic Social Services Family Service Association Luzerne County Child Welfare Services Wyoming Valley Visiting Nurse Association Luzerne County Board of Assistance The staffing was to consist of six senior supervisors, operating on a -118- ' I u 1 JL - �8 hour day, 1 day per week basis with the aide of two caseworkers from the agencies. However, the exact number of these ancillary personnel would have to be finally determined by the case load volume of each participating agency. Upon receipt of supplemental grant funds, the CDA would purchase the contract services of the Human Service Task Force. J —■ The five-year objectives table toward the complete administrative integration of all public welfare services in the Model Neighborhood was set j up as follows: INITIAL CONDITIONS 1/68-12/68 YEAR"! 7/69-6/70 YEAR II 7/70-6/71 year iii-v Efforts of service agencies lacking co-ordination in M. N. Establish human services pro­ gram and process 250 M. N. resi­ dents in system Evaluate pro­ cessing of 250 M. N. resi­ dents and im­ prove where necessary Utilize prior year experience in formulating proven tech­ niques and methods ip u 7/71-6/74 Although somewhat behind schedule, a Human Services Center was opened in December, 1970 on South Hancock Street in the Model Cities Area, h? r operating on a $45, 000 budget, staffed with two personnel. Other Model Cities components were located in the same quarters: The Revolving Loan Fund operated by the Family Service Association and a r 0 - the Eyeglass and Hearing Aid Bank operated by the Pennsylvania Association for the. Blind. The Revolving Loan Fund is a very limited activity which is aimed at providing emergency funds for moving expenses for persons moving M r into public housing. The Eyeglass and Hearing Aid Bank, administered by -119- r. r �the CDA Human Research Officer, provides preschool and school age children with service in audiology and opthmology. A citizen's advisory committee of 18 residents from the Area was established to offer the consumer view to the Human Resources Program. The Human Resources Service Center is a rather modest beginning toward the model welfare care system out-lined in a previous section of this study. A successful Human Resources Service Center must be constructed by the Model Cities organization if it is to accept the human responsibility to help those who need help in order to achieve and maintain their potential for a fulfilling life. The ideal obviously would be to include in such a Center branches of all the agencies listed under the Health and Welfare classification. Not only is the ideal never attained, some of the agencies are on the way to being merged or phased out. a I Moreover, some of the agencies are advocacy organizations which do not deliver an actual service beyond referral or education. It would appear that the minimum that such a Human Resources Service Center should embrace would be all those agencies categorized as family and children oriented. The proposed Home Health Services and the proposed con- 2 solidation of all family service agencies, both presently being undertaken by the United Fund and the Welfare Planning Council are steps along the way to • 3 such a Center, even though limited to family and children's problems. It should be pointed out that the MNA residents should not be made to wait an unduly" long time before the "family" agencies are brought into the Human -120- �Resources Services Center. The proposed mergers of some of these agencies may encounter seemingly insurmountable barriers at the beginning stages of discussion. The inter-relation of the "family" parts of the Center can only be fostered by an administrative structure which contained all of them. The savings and the possibility of government funds should be a strong incentive in encouraging the structural expansion of the Center. Perhaps an added incentive to the agencies might be that many of the services that can be offered in such a Center need not be gi ven in the context of a caseload delivery systems, although casework itself has a significant role to play as one method in the delivery of social services. Only in such a Human Services Center can greater emphasis be placed on group and community organisation methods. As a beginning toward an enlarged and fully developed Human Resources 11 Services Center, a Community Referral Office should be created with a specific u program of information and referral. Such an office can be instituted even before the "family oriented" agencies have fully established residency in the Center. A complete record system providing accurate and reliable information, discussed in a later section of this study, would be maintained by this office. fl The experience of this office with all health and welfare agencies over a significant period of time will reveal which agencies are most readily avail- in 11:- able and which provide the best service to clients of the MNA. Such experience should provide both subjective and objective evaluation as the Center expands. A great deal of variation could be reduced for the local community �While the tasks carried on by the Office may be those which could be carried by volunteers, the need for accuracy and reliability of information would suggest the utilization of personnel on a paid basis, in a setting tending to provide a unification of health and welfare services. Just as importantly, the whole Out-Reach system, also discussed in a later section, could be easily operated out of the Referral Office and even­ tually out of Human Resources Services Center. It goes without saying and emphasizing the ridiculous that a $45,000 is wholly inadequate for the kind of structure proposed above. Some of the gaps in the social welfare delivery system that a Referral Office and Human Resources Services Center could more clearly identify and n possibly assist in filling, or at least calling attention to them, are; Lack of communication as to what facilities are available, where they are, and how they can be used Inadequate adjustment services for the physically handicapped who have been institutionalized Insufficient supplies for vocational training of blind persons Inadequate supervision of interim housing and foster homes for physically handicapped persons Lack of half-way house for those leaving prison Lack of general day care program Lack of knowledge of availability of services of Planned Parent­ hood -122- �Insufficient facilities for the day care of the youth in the community Insufficient care for alcoholics and drug users Inadequate care for aged persons Expansion of programs such as "Meals on Wheels" for elderly Lack of nutritional information Lack of transportation for those needing welfare services E.' COMMUNITY HEALTH CENTER The Model Cities organization has had long range plans for a Community Health Center as part of an eight-part health component. Although the Neigh- borhood Health Center concept has been successfully initiated in other parts of the country, it represents a new and innovative idea for this area. The long range plan for such a center must still be given first priority. It is a recognizable fact that the physical construction of such a Health Center in the MNA is not in itself a cure for future needs. nu 0 physicians and dentists is a very acute problem. The lack of Staffing of the facility with capable medical personnel will also be a major contributory factor in determining the success of this project. Therefore training of ancillary assistants to relieve doctors and dentists of many routine tasks has been considered of Q equal importance. The establishment of the health center, the training of paraprofessionals and additional research and planning are not expected to produce visible results overnight. ; In -123- �u71 I It has been the feeling of the Board of the Model Cities organization that a medical directory, insurance study, mobile dental unit, and emergency health service (ambulance) would be of more immediate benefit to the residents. Both the Diagnostic Survey results and the records of at least 18 I neighborhood health meetings attest to the fact that health is a serious concern of the residents. The evidence for such a facility outlined in an early pro- posal by the MC Agency is based on the following factors: i r~> 1. the availability of physician time 2. the physical location of physician service 3. the number of citizens going outside the area for treatment (40%) 4. the existing neighborhood physician rate 5. the lack of emergency service It was suggested in an early proposal that the Health Center should operate basically as a satellite of a major area hospital. n It was also hoped that the MH/MR program could probably be used to establish an information and referral service, although the primary focus of the information and referral service under the program should be to direct people with mental disabilities to 2 n appropriate types of help. The regulations promulgated in connection with the legislation describe the purpose of the service as "acquaint inquiring persons u with the care-giving resources available in the community. n given in applying to appropriate resources, and referrals are made to the Base Assistance is ■ Service Unit where indicated. " The regulations further state the "Referral and I. * i •y -124- t �Information Services given under the County program augment, but do not supplement services traditionally provided by every agency in the health and welfare field. " By no stretch of logic can a referral service be construed to be a community health center, however. Just recently, an announcement has been made that a group practice medical clinic will be constructed in the MNA. It is not intended that such a facility will focus on preventive medicine, nor is such a private facility expected to operate in conjunction with an Out-Reach program. its location in the target area. This is not to demean The Kirby Health Center, privately endowed, does immunizations, chest X-rays, and conducts a dental clinic. In the first place, it is not likely that any of these activities can be relocated in the target area. Secondly, the Kirby Center services are available "on demand" not on an Out -Reach program. .Thirdly, the Kirby Center engages in a number of peripheral activities over a large area--probably Northeastern Pennsylvania. The Public Health Center located in the MNA does provide diagnostic and nursing services, but it is a State agency covering the whole county. The facility is not intended to offer even the minimum of treatment services. □r The Mental Health Center #1, outside the Model Cities Neighborhood,’is just what the name impli es. • Located where it is, :and covtering two counties, it can hardly be labelled a community center. A Gommuriity tfealth Center, with its focus on preventive medicine, must still be given a very high priority for the residents. The PMM consumer perceptions underscore the necessity for a center that conforms to the model -125- �discussed earlier if life is to have any fulfillment at all for the target people. The gaps and problems in the medical service delivery system that a Community Health Center and a Referral Office could help to identify and help to solve are; Lack of communication and cooperation between professional, voluntary agencies, and general public concerning availability of services of the Pennsylvania Department of Health, Region'll Lack of physicians and non-existence of intern program Lack of facilities for maternal and infant well-baby clinics Lack preventive dental care for low income families including adults and children Lack of prenatal care for low income familites Lack of information for lower income groups concerning the availability of medical services THE OUT-REACH SYSTEM The Out-Reach recommendation flows from all that has been said thus far and is therefore an integral part of the service delivery system--both health and welfare. A model social services delivery system must not be process-oriented, because process-oriented programs serve agency and professional traditions and produce statistics descriptive of what an agency does, not how the client is helped. A goal orientation is particularly necessary for an efficient organisation of services and for an effective evaluation of that organization and its achievements. The only practical and feasible way to reorient any human service delivery system frqm agency to goal is through an out-reach system. -126- �Neighborhood agents of an out-reach system can contact residents to inform them of‘available services, to discover problems, and perhaps to actually de­ liver needed services. /The "out-reach" would have fohr primary functions: a. stimulating community organization b. providing easy access to facilities; services, and institutions doing prevention and early treatment work d. giving early diagnosis of all sorts of problems In the early stages of experience, the "out-reach" will be expected to focus its attention on access. In time and with increased skill, prevention and even early treatment will be emphasized and may become the central responsibility. The out-reach system can work best when manned by staffs of non­ professionals who are residents in the immediate neighborhood, and are known by their neighbors. They should be intensively trained by all of the participating professions in the basic knowledge an<4' skills necessary to provide elementary services to citizens. These "community agents" will know all the forms , offices, procedures, etc. necessary to move any medical or welfare service agency into action. The success of the O. E. O. family -planning out-reach worker is ample evidence that Out-Reach can play an important role in the expective delivery of both medical and health services. Variations of the concept are being tried locally with varying degrees of -127- �organization operating through the facilities of Radio Station WILK. The purpose of the group is to aid local citizens with such problems as hospital care, poor Complaints received by the housing, crime, narcotics, sanitation, etc. volunteer on duty Monday through Friday from 11 A. M. to 1 P. M., will be referred to the appropriate agency for action. as such a program is, it has many limits. As commendable and successful The program is limited to referrals; there is no follow up; It is demand oriented. Although the station must be lauded for opening up its facility, there is a time limitation. The out-reach concept works best when it is associated with a referral office which is part of the administrative structure of either a Human Resources Services Center or a Community Health Center, or preferably both. A "Mr. Fix-It" can not conceivably be an "Out-Reach Worker. Almost identical comments can be made about other such referral activities. The community-wide Information and Referral Service of Wyoming Valley established under the MH/MR Program did have some possibilities in that it was at least associated within the context of the law, it had a broad base within which to roam--the wholfe medical and welfare field. Personality involvements aside, such an office and the out-reach worker operated out of either type of centers previously menti oned. At the risk of too much emphasis, the out-reach concept is predicated not on demand, but on need. An Out-Reach idea is an integral part of a successful, effective, and -128- I iPiS J �efficient human services delivery system in both the medical and welfare fields, along with a Community Health Center and a Human Resources Services Center, if the Model Cities residents are to be freed from the tyranny of their own biology and their own environment. -129- �G. SOCIAL SERVICE CENTER RECORD SYSTEM A. RECORDS AND RIGHTS One of the specific missions undertaken by'the Institute of Regional Affairs as part of this report was to develop and propose ft.'a complete social service record-keeping system which would provide a current index of existing conditions-physical, social, and personal. 11 This phraseology projects a rather narrow view of the ultimate purpose and function of a record system, leaving the inference that its end product is m>erely to "provide a current index of existing conditions" in the Model Cities Area. Moreover, the simple phrase­ ology belies the broader, if not more important, question of confidentiality of the records when a "human" information record system has been established with the noble aim of bringing the clieilt closer to the service. The term "Social Service Center" has a variety of meanings. Not all of these meanings raise the spectre of traffic in ill-gotten information. It is most commonly used by an individual social service agency in a physical sense to identify the place where its specialized services may be obtained. Confidentiality---- the implicit or explicit agreement between a professional and his client to maintain the private nature of their communi­ cations -- as the basic component of the client-professional relationship would not be altered in the least. Any disclosures made within the relationship -130- �would continue to be used constructively in behalf of the client or as u required by law. Social workers and health professionals in this conception of a "Center" could still jealously guard information obtained from G relation- ships with clients. Less commonly, it is used also in the physical sense to denote the place where a number of specialized service agencies have joined in providing a common building where a prospective client may secure a number of services, r yet each agency may retain its separate identity. In this second type of "Center, " old and comfortable organizational boundaries within which social workers in the past exercised control over information can still be maintained although the physical proximity to one (another of the social service agencies creates many temptations even for the professionals,, to follow the old rules safeguarding privacy and confidentiality. n It may be that greater care will have to be exercised by the professional in this kind of "Center" situation than that, in the old atmosphere when agencies were isolated from each other. The third meaning of a "Social Service Center" denotes a conveniently located "referral" office, which may or may not itself provide actual social services, to which a person in need of assistance may turn for guidance in locating a specialized social agency equipped to assist in his particular problem. This latter concept of a "Social Service Center" has been followed in suggesting a record system in the section of the Project Report. -131 - The Model Cities Agency I �i may now or in the future provide physical facilities for bringing as many as possible individual service agencies under one roof for the convenience of neighborhood residents. In addition, a Model Cities Project may itself offer and perform specific services to residents on a direct basis. Regardless of these possibilities, the essential characteristic of such a Model Cities Social I Service Center is that of referral, and this fact demands that there must be I a central office, including specialized service agencies or not, manned by Model Cities or contracted staff, full or part-time and either professional, a or part professional and part non-professional. The primary function of this staff is to provide a single and certain means through which residents of the area can secure assistance in finding solutions to their problems. p J n The cen- tral requirement is that all Model Cities social service activities flow into and out of the Social Service Center centralized staff. It is precisely because the "referral" office could develop into a dossier type data bank that a word of p L? 1.. caution is raised as a prefatory warning signal even before the record system is presented. Anonymous statistical information records do not usually threaten privFTT) d 0 I Il acy or confidentiality. They contain data on individuals either in the aggre- gate or as individual records identified by numbering systems that are unique to each agency or organizational unit supplying them. systems, because they contain data (such as names, social security numbers, and home addresses, etc.) that directly identify individuals or families, Lw present greater risks all around. Too often, the good intention of achieving -132- n m Dossier information jI i ,h �laudable -goal - a social service rec ord-keeping system for Model Cities - causes the high-minded to lose sight of the fact that in the process it may deny the dignity of the individual, a sense of fair play, or the right of the citizen in a free society to the privacy of his thoughts and activities. In view of the vulner- ability to abuse in the "referral" office, proper safeguards and guidelines will have to be established in order to protect the client-professional relationship. B. CONCEPTUAL BASIS OF RECORD SYSTEM A productive record system should, indeed, provide information which identifies the physical, social, and personal problems in the Model Cities Area, and should also provide a means of evaluating the progress made in resolving these problems. The dominant factor, however, in planning a record system must be the conceptual framework of the Service Center itself. What records and how they are to be managed should be established on the basis of such primary questions as the general purpose and specific functions of the Service Center, the clientele to be served, the mode of service, functional and operational participation of service agencies in the community, and the type of evaluation conducive to program progress. Since the Service Center will be a de novo operation, subject to changes based upon future experience, the initial record system must of necessity be fashioned for an assumed Service Center concept. The following general concept may be safely assumed from conclusions of other sections of this project report: -133- ----- _ �1. An unacceptable variety and number of physical, social, and personal problems exist among the residents of the Model Cities Area. 2. Manyof these problems of residents, or the general Model Cities community, retnain unresolved or are worsening, either because of unawareness of their existence or intensity, or because residents are incapable of solving them without outside assistance. 3. Varying kinds and degrees of assistance are currently available to residents from governmental, communitysupported, or private institutions or organizations operating in the Wyoming Valley area. 4. The crux of the problem, it is believed, is that the residents of the Model Cities Area, as well as other residents of the city, have difficulty in definitely identifying their problems and, additionally, are unaware that assistance is available, or do not know where to turn for a specific kind of assistance. In certain problem areas, there is nowhere to go for help: e.g. health services and housing - because of the nature of local conditions. U P C. PRIMARY ELEMENTS OF PROPOSED RECORD SYSTEM The primary elements of the proposed social service record system are four in number. 1. Data Bank The Service Center should collect and properly store all the necessary data identifying all possible sources of information and every service and program available to Model Cities residents. This data bank should include comprehensive information about agencies and their programs and services, TJ 'J I categorized into broad general service areas such as medical and dental, education, housing, employment, etc. , and further subclassified for rapid location purposes into specific needs such as clothing, transportation, glasses, -134- �- ■mM temporary housing, job training, job placement, and the like. n The basic infor- mation includes the name of the agency, location, telephone number, personnel 1 contacts, hours, nature of related services, limits of service area, eligibility This data should be under constant requirements, and financial responsibility. i 1 review and updating by personnel qualified to collect, store, retrieve, and maintain information. 2. Referral Services The primary function of the Social Service Center should be that of a 1 referral service through which residents can be assisted in securing necessary and appropriate aid from governmental, community-supported, or private B v institutions or organizations whose services are available in the area. "Referral" is not to be narrowly interpreted to mean merely informing the resident where he may receive assistance. I It extends to identification and definition of the specific problem, choice of the agency most likely to be of greatest and most prompt assistance, transmission of problem data to selected agency, and upon confirmation that service is available, arranging appointments n for resident clients and facilitating the subsequent remedial process. h 3. 1 Follow-up 1 Workable routine procedures should be established for timely and prompt t follow-up at each stage of a case activity to assure that both resident clients and participating agencies perform as planned, and ultimately to record at the Service Center and participating agency the conclusion and results of the case process. I -135- I I I I L£ �____ □ I 4. I- Service Evaluation Procedures, including appropriately simple forms, should be installed to facilitate recording of all information involving a case activity at every stage, including a summary of daily actions. This basic daily log should be designed tj to facilitate ease of compiling weekly, monthly, or demand reports, showing progress made on programs and a basis for evaluating the effectiveness of r> if r i- the service on conditions existing in the Model Cities Area. Lj D. COMPONENTS OF PROPOSED RECORD SYSTEM The basic framework of the proposed Social Service Center record r 'h system includes the ten components, all of which serve a specific function 1 n d • > essential to effective service to the Model Service residents. I ■ s of the ten components, complete with accompanying figure and justifying pur­ pose is presented after a summary listing:1. Alphabetical list of major service categories 2. Service agency cards filed according to major service category 3. Alphabetical file of service agencies showing a summary statement of their major services and eligibility requirements T hl. I 8 I ’ / "> u q A description 4. Alphabetical list of service clue words 5. Clue word agency locator 6. Individual Case Record 7. Service tickler file 8. Appointment confirmation form -136- �Daily service log 9. Weekly and/or monthly service report 10. 1. Alphabetical List of Major Service Categories The overall program of the Social Service Center can be clearly indicated by preparation and maintenance of an Alphabetical List of Major Service Cate- gones in which the Social Service Center is capable of providing service either directly, or through referrals to cooperating agencies (see Figure 1). The analysis and interpretation of data showing the variety of social services ren- dered by existing local agencies (see section 6) provides the basic elements of such a list. Other categories, not currently covered by local agencies, but which are deemed desirable under the Model Cities Concept, should be added. The list should be mechanically produced in a form suitable for distri­ I bution to Model Cities administrators, Social Service personnel, local indepen­ dent service agencies, participating or non-participating, city civic and service J P V organizations, appropriate public officials, Model Cities neighborhood leaders, and other interested individuals or groups. 3 T I The List of Major Service Categories serves the following purposes: i. Places in proper perspective the Social Service Center program in relation to the general mission and policies of overall Model Cities program. 2. Delineates the bounds of Social Service Center activities and provides a basis for determination of priorities as action demands require. 3. Aids independent local agencies or organizations engaged in restricted specialized services to direct clients to the Social Service Center for assistance in matters outside of their specialization. -137- �ALPHABETICAL 1 LIST OF MAJOR general service category I ■ FORM NUMBER J1 fill Figure I SERVICE CATEGORIES �Promotes among the residents of the Model Cities neighborhoods and the general city public a well-defined picture of the Service Center functions. Provides a basic outline for public relations programs. Agencies, Services and Eligibility Requirements A master file should be maintained showing at all times the names of agencies, organizations, or individuals, local or otherwise, which are poten­ tial sources of assistance to Model Cities residents. (A previous section of the Project Report contains a listing of agencies or organizations generally known to the public. ) This list provides an excellent starting point for such a master file, since they doubtlessly provide services required by Model T s Cities residents to a greater or lesser degree. However, as residents be- come accustomed to calling on the Social Service Center for assistance, significant problems may be presented which are not covered by the city-wide or popularly recognized agencies. It is, therefore, important that every effort be made to identify and file the name of all possible sources of c assistance active in the city or elsewhere to fill existing gaps. I- Some of these can be ascertained immediately, while others will be revealed through operating experience at the Social Service Center. The primary purpose of this record file is to provide a data bank on the nature of the operations of service agencies or organizations. The form should 1 be printed, or otherwise produced, on standard stock paper of good quality, preferably 8 1/2 x 11", and filed alphabetically according to agency name in ! I -138- �manila folders appropriately separated by alphabetical guides (see Figure 2). As shown in Figure 2, the form provides information to facilitate classi­ fication of agencies on the basis of services provided, identification of General Service Category, a detailed listing of specific detailed assistance available, eligibility requirements for services, contact names for referrals, and time of service availability. 1 '1 This record is especially useful in identifying a source of assistance by reference to the file of General Service Category Agencies (see Figure 3). 3. General Service Category Agencies This record is useful for immediate identification of all agencies pro­ I viding services listed in the Alphabetical List of General Service Category (see Figure 1). The form should be printed, or otherwise mechanically reproduced, on 3" x 5" index cards, showing the information indicated by Figure 3. One card should be filed for each general service provided by each agency listed in the file of Agencies, Services and Eligibility Requirements (Figure 2), according to the classification of services determined by the Complete List of Services Provided. Thus, an agency which provides more than one of the general ser- vices is filed an appropriate number of times under the various service classi­ fications. Cards for each general service category shall be filed, in separate-sections, each section plainly marked by a separating guide showing the title of the cate- gory, and the separators are arranged alphabetically. 4? -139- Within each category �■) i I T7^ AGENCIES, SERVICES AND ELIGIBILITY REQUIREMENTS Agency Name Address General Service Category City State Zip Phone Sponsor Contact # 1 Address Phone Contact # 2 Address Phone Contact # 3 Address Phone COMPLETE LISTING OF SERVICES PROVIDED (Underscore Clue Words for Service Category) FORM NUMBER Figure 2 �d I J ( CONDITIONS FOR SERVICE Eligibility requirements Financial Requirements — Time Open — Free F lat fee Sliding fee M to M (Days) Waiting Period For Service — Transportation Provided to Place of Service Figure 2 (cont.) �- •> co C) I I 1 r*') o O r ■ 0 ') L j .r;) ' ‘ad nd rd '-•d n,d GENERAL SERVICE CATEGORY AGENCIES I I I General Service Category Name of Agency Providing Service FORM NUMBER Address Phone Contact # I Phone Contact tl 2 Phone Contact # 3 Phone Figure 3 II 1 �section, the cards are arranged alphabetically according to the name of the agency providing the specific category of general service. The usefulness of this record file may be illustrated by a hypothetical case. A resident contacts the Social Service Center, in person or by telephone, for assistance on a problem that cannot be identified more specifically than that it is medical. The Center personnel checks the General Service Category Agency file under "Medical" to identify the various agencies providing such general service. The Center personnel can then take one of two courses of action; (1) Should the Center personnel's experience suggest a particular agency among the cards lifted which could most likely assist the resident, the contacts noted on the file card could be reached by phone for consideration of the problem;; or,, (2) should T the personnel be unable to make a choice from experience, reference to services provided could be made by consulting the Record of Agencies, Services and Eligibility Requirements (see figure 2). 4. I I B Alphabetical List of Service Clue Words Having established a records system to identify an appropriate service agency to aid a resident in cases when the exact nature of the problem I has not been determined (Figures 2 & 3), a system of clue words is recommended to facilitate a quick and exact identification of the specific nature of the assis­ tance required. Clue words are those spoken by a resident during an interview which give more specific and accurate indication of the exact problem and assistance 3 -140- �■ �SERVICE SERVICE CLUE WORD Q I a a 3 3 R FORM NUMBER Figure 4 CLUE WORDS ��FORM NUMBER Figure 5 �r productive course o£ action. It aids in the selection of the most appropriate assis­ ting agency, and through a system of reminders, facilitates follow-ups leading to satisfactory solution of the problem. Finally, it provides in summary form the basic information needed by the Center and Model Cities administration to identify, classify, and evaluate the prevalent nature of problems in the various neighborhoods as well as the effectiveness of programs and procedures. In short, all other records and procedures suggested in this report are but subsidiary aids to the Individual Case Record. The Individual Case Record form (Figure 6) should be printed, or otherwise mechanically reproduced on good quality white paper, size 8 1/2 " x 11", and should be stored in metal locked cabinets. From the moment a particular problem case is initiated, the form should be placed in an "active" file consisting of manila folders and arranged alphabetically according to the name of the resi- dent, properly separated by letter guides. A separate form should be used for each problem presented by a given resident. Once a problem has been resolved, the Individual Case Record form should be so marked and placed in a second 5 B I r r cabinet marked "Case Solved. " If, after all remedial resources have been exhausted and no solution attained, such form should be similarly filed in a separate cabinet marked "Cases Unsolved. " TJ - It is suggested that all information be recorded in pencil. Both sides of this form should be utilized. Ti ■I. n Li -143- The front contains information �Client Last Name First Initial Intermediary (Person or Agency) Address Phone Service or Information Category Address Phone Relationship to Client Date and time of Request M N A Area PROBLEM AND DISPOSITION PROBLEM: (Underscore clue word for service category) REFERAL: REMARKS Agency Referred To Address Phone Contact Person Date Appt. Date Time (REMINDER TO CLIENT THREE DAYS PRIOR) REMARKS Agency Referred To Address Phone Contact Person Date Appt. Date Time (REMINDER TO CLIENT THREE DAYS PRIOR) Date Completed PROBLEM SOLUTION: (Reason if problem is not solved) (Check) - Solved or unsolved Cost to Client $ Signature of Service Personnel Date Recorded on Service Summary Form FORM NUMBER Figure 6 �Type of Contact With Whom Made Purpose Results (Walkin, Phone, Letter) SUMMARY OF SERVICE RECORD Service Category Date filed in Soled File Type Service Rendered Date filed in Unresolved File Date Problem Solved Date filed on Monthly Report Reason Problem Unresolved REMARKS Name Service Personnel �required to define the problem, agency to which the case is referred, the action by which the problem was solved, or reason for failure to solve it, and, desirably, a tab or notation at the top right corner of the form to indicate the MNA area in which the case was located. The rear of the form should be used to record each reminder, follow-up, other steps taken throughout the pursuit of a solution, and finally a Summary of Service record for reporting purposes. 7. Service Tickler File To ensure that action agreed upon and entered on the individual Case Record form is taken at the proper time, including making or confirming appoint­ ments, follow-ups, etc., a tickler file using 3" x 5" index cards should be utilized. The arrangement should consist of a series of twelve guides or folders with the names of the months printed on their tabs, and 31 guides or folders whose tabs are printed with 1 through 31 for the days of the month. The tickler card should be printed, or otherwise mechanically re- 13 produced,to include the information indicated in Figure 7 in order to insure I tl some degree of uniformity. 5 Action to be taken at some future date should be filed according to that date which allows sufficient time to make preparations for, or to take the appropriate action on time. Reference to the tickler file should be the first order of business of Center personnel each day. 8. Appointment Confirmation Form As a part of the follow-up procedure which is so important to an effective assistance program, it is suggested that a routine method be established 'T; 11" r -144- �4 k FORM NUMBER Figure 7 �to assure that any appointments made by or through the Social Service Center be adhered to by both residents and agencies. For this purpose the form shown in Figure 8 is suggested. The form should be printed on 3" x 5" light paper stock in alternate ■:- . colors of white, green, and yellow which are self-carboning, with a convenient number of sets bound into manageable pads. The form should be completed at the time an appointment is made for the client. The white form should be retained by the Social Service agency, the green copy and the yellow copy made available respectively to the client and the agency either at that time, or at a reasonable period before the date of the appointment. The resident can be notified in person or by telephone or mail. In the case of the agency with which the resident has the appointment, the confirmation may be telephoned at the appropriate time, or mailed. In both instances, if the confirmation is given in person or by tele­ phone, the Social Service Center should retain all three copies with an appro­ priate notation that contact had been made, and the action recorded on the follow-up form on the rear of the Individual Case Record form (Figure 6). The Social Service Center copy should be placed temporarily in the tickler file, and a follow-up contact made with the resident and the agency at the u appropriate time to be assured that the appointment was kept, and to be informed of the results. -145. �FORM NUMBER Figure 8 �9. Daily Service Log The purpose of the Daily Service Log is to keep a day to day record of every service action taken by personnel, individually, so that a weekly, monthly, or on demand, inventory of actions can be summarized for administrative purposes. The summarized information will indicate the types of problems and their prevalence in each MNA area, and the Model Cities neighborhood as well, the types of actions taken, and the results in solved or unsolved cases. Each Center personnel handling an aspect of a case on any particular day should make appropriate entries on his individual log form, which are then filed for future consolidation for report purposes. When engaged in a case by personal interview or walk-in, conference with a client or agency, or by telephone, letter, or other means, the Center personnel should enter on the day's log form the general service category involved in the transaction, and the subsequent columns simply indicate the nature of the activity by placing a stroke or check. Before the close of each day's -business,'. each individual adds the action iri each column to show daily totals. 10. Monthly Service Report This record consists of a form based on the classifications of the Daily Service Log, and provides a summary of activities for administrative purposes (Figure 10). -146- �i DAILY SERVICE LOG Name of Service Personnel General Service Category Date Case Initiated Case Referred Appts. Made Followup Case Solved i 'S 1 ,fe> TOTAL 7' FORM NUMBER Figure 9 Case Closed �MONTHLY SERVICE REPORT MONTH OF General Service Category Case Initiated 19 Case Referred Appts. Made Followup Cases Solved g rform number Figure 10 TOTAL Cases Closed �E. SUMMARY The general mission of the Model Cities Social Service Center is to improve the quality of living in designated neighborhoods by assisting residents who need help in resolving problems beyond their individual capacities. Surveys conducted to compile the Project Report indicate that these needs are quantitively and qualitively extensive, a.nd, doubtlessly, will become more so as the operation of the Center proceeds in time. While it i'h certain that Center services will eventually be quite comprehensive, the initial and ultimate scope of activities will be limited by such factors as future changes in the mission of the Model Cities Program, available financial resources, fluctuation in the kinds and number of service needs, and the existence of outside local service agencies willing and able to cooperate with the Social Service Center. It is, therefore, essential that the nature of services to be rendered by the Center be broadly, but clearly, defined, subject to future revision based upon accumulated experience. -147- �APPENDIX A SOCIAL SERVICE AGENCY PROFILE 1. Name of agency 2. Address and Telephone 3. Director or Chief Administrator 4. Person interviewed and Title (if different from # 3) 5. What is the main purpose of your agency as stated in your by-laws ? 6. What kinds of services does your agency render ? Can you list these services in their order of importance or priority? a. I b. c. d, e. ■ tl n; 7. What goals or accomplishments do you seek for each of the previously mentioned services? a. b. £ c. d. e. ■ J £ �Considering the nature of the clients' problems; are these services mainly meeting the: (1) immediate needs (2) ilong range needs, or (3) intermediate range needs of your clients? List separately for each service given in question 6. a. b c. L1 d. - e. jr 9. Does your agency provide services which are not part of the goals stated in your by-laws? If yes, what are these services? ! ? G B [J nu n n j', 10. In general, what is the main orientation of your service objectives? Does it seek: a. prevention b. maintenance c. rehabilitation d. education e. other goals fl H -ii- �How do you measure the effectiveness of your agency in achieving your goals ? Do you receive any information regarding effects of services provided to your clients? If yes, is this information coming from:(check more than one if applicable) .. 13. ei a. staff meeting b. board meeting c. clientele d. other sources In terms of the completion of services rendered to your clients, is your program mainly oriented toward: temporary service permanent repetitive other 14. What is the "target population" that you seek to provide services for? □ n n -iii- �F 15. What is the geographic area served by your agency? ' 1 I r ! 16. What are the clients' "eligibility requirements" in order for services to be provided by your agency? 17. During the past calendar year, approximately how many clients have you provided services for ? T 4' F I How many of these were new clients ? S' $ b. 18. K 19i. jj -' 0 I How many were returnees or previous clients ? What did you do with your "ineligible" clients ? a. Were they referred to another agency? b. Were they referred elsewhere? c. given information d. other How do you inform the community of your agency's services? a. paid advertising b. talks c. spot announcements d. newspaper's articles e. outreach-neighborhood workers f. other -iv- n U �Where are your services given? main office building home neighborhood d. clinic or hospital e. other How many people are employed in this agency? Of these people, how many work directly with clients ? How many work in other capacities ? L’ In terms of occupation and work performed, how do you distinguish your professional workers from your para-professional workers? With this in mind, how many of your personnel are: professional paid employees para-professional paid employees professional voluntary workers para-professional voluntary workers -v- �> i •J n 24. d c.l/ £_■ 25. How many of your professional employees work: a. f ull time b. part time In providing services, does your staff work as: a. individuals b. teams both For each of the services rendered (as previously listed in question #6), approximately what proportion of your manpower is expended on the different kinds of services? Explain if need be. L’ a. b. c. d. e. rT' i ] 27. What is your current annual operating budget? r 7 r -vi- �I 1 1*' ;r 28. Xl P>. 29. How much of this is obtained from the following sources ? a. sectarian b. United Fund c. county d. state e. federal f. client fees g- other Where do your referrals come from? <1 I I a. self referrals b. from other agencies c. from other sources (specify)_ i ; n a in 30. I I fl 1 i l.i < f 31. What kind of relationships do you have with other agencies providing similar services? a. coordinated services b. purchase agreement c. cooperative relationship d. other Who makes policy decisions for your agency? 1 A '0, ■ < I r 1 -vii- �J r 3 tr 32. What kind of relationships do you have with governmental agencies ? a. local b. state c. federal t-u’ e 33. What do you see as the main problem (or unresolved social service) of the community? r. & 34. a. How severe is it? b. Does it deserve a priority in dealing with it? Are you aware of any gaps in services or areas of neglected needs in the community? r -viii- La �Would your delivery system function better if you had more: financial help u personnel other Name of Interviewer Date of Interview -ix- �APPENDIX B CONSUMER PROFILE You are to ask the interviewee if he has any problems or if he knows of any problems in the community. category and check. If he spontaneously responds, find the appropriate On any question to which the ‘interviewee responds, ask him if he thinks the problem is getting "better", or "worse", or remaining the same", and mark the appropriate box. For any questions not spontaneously answered, ask him, "Do any of these present personal problems for you?" In some cases, questions may need a short explanation, e. g. what is the health services project as proposed by the Welfare Planning Council. ASSURE THE INTERVIEWEE THAT ALL INFORMATION VOLUNTEERED WILL BE HELD IN STRICTEST CONFIDENCE. Immediately after leaving interviewee's home, write on the back of this questionnaire any comments of. the interviewee which are revelant to community social services but not specifically brought out in the questionnaire, e. g. , the physical condition of home, does respondent seriously want to become involved in Model Cities programs, number of people living home. .. ? of special services, and what kind, etc. Is respondent in need Make these comments short and to the point. CODE: Sp = Spontaneous B = Better W = Worse S = Same �I I Date Interviewer t 1. Name of Interviewee Address 2. J 3. Marital Status M P 4. Number of Children 5. House d n E - 6. 7. , a a a. Own b. Rent c. Mortgage d. Land Contract S College b. High School c. Grade School Employment a. Place b. Position 8. Religious Background 9. Nationality ft -xi- i I ' r W Ages Educational Background a. D �1 Personal Community w s Sp B Have.you ever sought an agency for an addiction problem? Yes Sp B W s ADDICTION ( Narcotics) No What agency? How did they assist you? c. What did you like most about their services? d. What did you dislike most about their services ? When did you last talk to this agency? For what reason? Were they helpful? Yes No -xii- J �■TT u t r Personal Community Sp V B w s Sp B aged pa,' L’ I pi a 1. Are you receiving any service at the present? a. What agency? b. How did they assist you? c. What did you like most about their services? d. What did you dislike most about their services? e. When did you last talk to this agency? f. For what reason? g- Were they helpful? Yes I I « Y es -xiii- No No w s �Personal Community w Sp B Are you receiving services of an agency at the present? Yes S W S ■5 pchildren 1. a. What agency? b. How did they assist you? What did you like most about their services? d. What did you dislike most about their services? e. When did you last talk to this agency? f. For what reason? g- Were they helpful? Yes CP -xivfJ'- I No No �Personal What did you like most about their services? What did you dislike most about their services,? When did you last talk to this agency? For what reason? Were they helpful? Yes -xv- No �Community Personal EDUCATION 1. Yes Are you receiving a service at the present? What agency? How did they assist you? What did you like most about their services? What did you dislike most about their services? When did you last talk to this agency? For what reason? Were they helpful? Yes ft. -xvi - No No �C ommunity Personal W S HEALTH . Sickness or Ill Health, Finding Doctors, Clinics or Hospitals Has there been a need for you or members of your family to seek health services? Yes No Was it a hospital, doctor, clinic or program? Name What kind of service did you seek? What did you like most about the service? What did you dislike most about the service? Did you seek their services again when necessary? For what reason? Briefly tell me if they were helpful or not. •rn i il U I -xvii- �Personal C ommunity B Sp w S Sp B W HOUSING Having a Decent Place to Live Did you seek the services of any local agency to find a place to live? Yes No What agency assisted you? Who referred you? What services did they provide? What did you like most about their services? What did you dislike most about their services? When did you last talk to this agency ? g. For what reason? Briefly tell me if they were helpful or not. -xviiii1 ' /- S �Personal C ommunity B Sp W S Sp B W S JOBS Finding Decent Jobs 1. Have you ever sought the help of agency to find a job? a. What agency? b. How did they assist you? What did you like most about their services? d. What did you dislike most about their services? When did you last talk to this agency? f. For what reason? g. Were they helpful? Yes -xix- - No Yes No �Personal Legal Matters, Courts, and Finding Lawyers Have you ever sought this agency for legal matters? a. What agency? b. How did they assist you? What did you like most about their services? d. What did you dislike most about their services? When did you last talk to this agency? For what reason? Were they helpful? Yes ■ -XX- No Yes No �Personal Community PUBLIC services Are you receiving any service at the present? Yes What agency? How did they assist you? What did you like most about their services? What did you dislike most about their services? When did you last talk to this agency? For what reason? Were they helpful? Yes 0 Ig -xxi - i fl) No No �— Personal Community Sp B W S Sp B W recreation Parks, Playgrounds; Programs for Children fc Teenagers 1. r Have you ever sought any agency for a specific program? Yes a. What agency? b. How did they assist you? What did you like most about their services? d. What did you dislike most about their services? When did you last talk to this agency? .7 /!' f. For what reason? g- Were they helpful? Yes < IZ a 8 -xxii- I flU *1 j No No S �Personal Community B W s Sp B TRAINING Getting Training for Better Jobs Have you ever received job training to improve your job skills? No Yes :: a. What agency provided the training? b. What kind of training was this ? Did this training help you to find better employment? £ Yes No d. What did you like most about their service? e. What did you dislike most about their services? f. Has there been a need to contact this agency? g- For what reason? h. Briefly tell me if they were helpful or not . -xxiii- W S �I * Community Sp B W s Personal Sp B W S WELFARE Social Workers and Investigators not Giving Needed Help Are you receiving this kind of service at present? Yes What agency ? What kind of service(s) are they providing? What do you like most about their services? What do you dislike most about their services? When did you last talk to this agency? For what reason? Briefly tell me if they were helpful or not. -xxiv- No �■■ APPENDIX d demographic profile ATW ApPENDix ne sw SE c IT Total % ,aa ^7 68 C L^ATCHING ' ACENCYTo sbrvicb/problem TO Addiction Aged Vets. Pen. Social Sec. R. R. Pen. Model Cities Children Catholic Youth Charity Education Food Smith School Stamps CEO Child Welfare Blind Assoc. United Rehab. Asthma Assoc. Girl Scouts Head Start Model Cities CYC -1 Category Consumer d.p.a. Head Start Kings College Health Gen. Hosp. Clinic Housing Redev. Auth. Jobs B-E.P. C.E.P. Legal SjbHc_Service Recreation Legal Aid Ambulance Carbage Mercy Hosp. Model Cities Priv. Counsel Streets Medi­ care Family Police Service WilkesBarre Public Schools Blue Cross Sanitation Public Defend. S.P.C.A. Smith School Kirby Health Center Tutor ial Family Doctor YMCA Model Cit. Elk Club Slattery Lounge Jewish Center Wyoming Valley Hosp. Nesbit Hosp. Blind Assoc. -xxv- Welfar Mary- Dept, wood of Coll. Public Asst. WIN. Wik RCA Voc. YWCA Wilkes Coll. Boy Set. ECPI 4-H Prog. T£ng. Public Health Nurse ��I APPENDIX G appendix E tabulations of pERn ■ ■c'XTr'TTr.q ErceptiONs 0-F commumty s1Tuations. B IT E NW T SE T C E SW R NE Total % 1 0 4 2 0 4 11 3% 1 0 3 4 7 29 44 25% 4 3 5 2 4 3 21 7% 30 26 43 15 13 14 141 43% 10 11 8 4 15 21 69 27% 7 0 11 4 16 34 72 41% 12 9 11 4 14 14 64 22% 14 20 16 7 7 24 88 27%> s IT NW 8 4 16 4 6 10 48 15% 21 24 NE Total % Total of 536 333 62% 20 1 3 5 6 2 3 20 8% 12 16 10 7 6 9 60 19% E SW 39 19 55 24 10 64 211 71% Health 9 40 15 10 56 166 65% 62 46 49 23 29 65 274 82% “c 36 8 0 13 14 9 15 59 34% Educ. 34 1 33 22 6 53 149 47% WIT o NW RSE S C ESW NE Total % A SE Cons. Child Addict 16 9 15 22 107 34% 316 59% 255 48% 175 33% 326 296 61% 55% J 3 13 7 11 43 97 30% fl I l/fl Housini 9 9 13 11 4 25 71 20% ... J obs Legal Pub.Serv. Recreat. 20 13 22 10 3 42 110 36% 24 0 17 7 8 36 92 43% 33 3 26 11 5 34 112 31% 58 27 47 33 17 38 220 60% 34 15 23 12 8 14 106 35% 7 0 7 3 2 4 23 11% 14 8 13 4 10 22 71 20% 12 8 20 12 8 26 86 28% 362 68% .. -XXV11- Training Welfare Total 27 9 38 9 8 41 132 42% 43 18 41 17 4 38 161 62% 28 2 28 16 7 45 126 46% 322 86 343 165 85 496 1,497 19 24 22 15 9 24 113 31% 24 7 20 19 12 13 95 30% 5 1 3 5 2 1 17 6% 9 11 8 9 12 16 65 24% 266 179 245 153 123 233 1, 199 8 10 18 6 13 42 97 46% 31 22 26 9 18 30 136 38% 10 16 13 11 10 30 90 28% 7 9 14 5 15 33 83 32% 13 17 21 6 9 15 81 30% 167 158 203 85 156 323 1, 092 361 261 272 212 317 302 67% 59% 49% 51% 56% 40% i J ) �APPENDIX G APPENDIX f TaBULations OF perceptions OF PERSONAL situation Addict B IT E NW T SE T C E SW R NE Total % 3_ 7 4% IT W O NW R SE S C SW E NE Total % 16 1 4 15 11 54 101 62% IT s NW A SE C M E SW NE Total % Resp. Total % of 536 1 1 2 9 29 5 2 10 55 34% 163 30% Aged 26 1 Child 99 24 1 5 9 5 54 98 46% 56% 5 3 2 3 12 2 55 8 34 16% 16 33 7 8 20 84 39% 217 40% 5 2 7 2 13 29 21% 1 6% 2 3 4 28 38 28% 5 5 7 5 6 Cons. 3 2 3 10 27 3 10 21 19 4 8 33 __ 66 69 38% 51% 174 32% 136 25% Educ. Health Housing 25 1 10 14 15 6 4 8 4 43 115 75 60% 34% 5 2 2 2 3 17 9% 18 4 7 9 8 13 59 27% 10 1 31 5 8 __14__ 14 4 36 7 3 22_ 69^ 31% 201 37% Legal Pub. Serv. Recreat. 86 39% 220 4-1% 6 5 2 22 42 18% 41 16 32 15 21 5 5 1 2. 4 8 8 1 15 6 2 9 33% 4 42 82 40% 40 75 43% 12 2 40 73 41% 16 1 7 10 4 9 47 23% 1 1 2 135 22 1 56 2 5 13 8% 8 2 9 11 3 26. 59 25% 10 1 27 27 1 26 39 63 32% 22 7 32 111 48% 17 1 7 7 8 12 52 26% 6 6 3 6 1 34 5 6 24 76 33% 229 43%> 1 33 11 5 27 83 42% 198 _ 37% -xxxii- 3 29 54 34% 4 1 1 5 8 42 93 58% 160 30% 30 79 6 11 29 100 42% 238 44% 9 23 8 6 29 75 37% 204 38% -XXVT.il- r< Training Welfare Total 13 1 60 3 6 Jobs ’ 3 3 4 1 10 6% 7 1 37 4 9 32 90 51% 16 3 3 5 8 18___ 37 21% • 10 32 3 7 16 68 38% 175 178 33% 33% 213 5 70 100 33 470 891 36% 97 66 212 588 24? 134 10 387 73 91 319 1,014 41% 2,403 �■ APPENDIX G SOCIAL SERVICE AGENCIES SERVING MODEL CITIES NEIGHBORHOOD AREA Alcoholics Anonymous American Cancer Society American Red Cross Wyoming Valley Chapter Arthritis Foundation Eastern Penna. Chapter, Luzerne County Unit Boy Scouts of America Penn Mountains Council Bureau of Employment Security Commonwealth of Pennsylvania Bureau of the Visually and Physically Handicapped Commonwealth of Pennsylvania Bureau of Vocational Rehabilitation Commonwealth of Pennsylvania Catholic Social Services of Wyoming Valley Catholic Youth Center of Wyoming Valley Children's Service Center of Wyoming Valley Commission on Economic Opportunity of Luzerne County Concentrated Employment Program Council House Crippled Children's Association of Wyoming Valley National Cystic Fibrosis Research Foundation Anthracite Chapter i -xxviii- —- --- r �Family Service Association of Wyoming Valley National Foundation - March of Dimes Wyoming Valley Chapter Georgetown Settlement Association Girl Scouts Penn's Woods Council Project Headstart Heart Association of Northeastern Pennsylvania Home for Homeless Women Homemakers Service of Luzerne County Jewish Community Center of Wyoming Valley Jewish Welfare Agency Kirby Memorial Health Center Legal Aid Society of Luzerne County Legal Services Association of Luzerne County Lutheran Children's Bureau Luzerne County Agricultural & Home Economics Extension Association fl I Luzerne County Association for Retarded Children Board of Assistance Commonwealth of Pennsylvania Luzerne County Federation for the Blind Public Health Center Commonwealth of Pennsylvania Bureau for the Aging Luzerne County -xxix- ■ J I "I �Adult Welfare Services Luzerne County Institution District Child Welfare Services Luzerne County Juvenile Court Luzerne Coucty Probation Office, Adult Division Luzerne County Domestic Relations Division Luzerne County Veterans Affairs Bureau Luzerne County Mental Retardation Program Mercy Hospital Multiple Sclerosis Society Muscular Dystrophy Association National Polio Foundation Wyoming Valley Chapter Nesbitt Memorial Hospital Pennsylvania Association of the Blind Wilkes-Barre Branch Pennsylvania Department of Health, Region II Pennsylvania Veterans Commission 0 Planned Parenthood Association of Luzerne County Regional Office Department of Welfare Retreat State Hospital -xxx- �Sutton Home for Aged and Infirm Men Tuberculosis Society Wyoming Valley United Cerebral Palsy Association of Wyoming Valley United Rehabilitation Services, Inc. Valley Crest County Home Veterans Administration Veterans Administration Hospital Visiting Nurses Association Wyoming Valley Wayside Mission White Haven State School Wilkes-Barre General Hospital Wyoming Valley Council of Churches Wyoming Valley Hospital Young Men's Christian Association Wilkes-Barre Young Women's Christian Association -xx.xi- �1 ' ■! i �CLUE WORDS (CONTINUED) M handicapped persons health health education health information heart home economics education homeless women home patients home teaching’ hospital admission hospitals mental disorders mental health mental health education mutiple sclerosis muscular distrophy N needy neglected and orphaned children nursery school nurses nursing care elderly nursing homes I immunization income maintenance indigent persons individual infirm injustice O obstetrical treatment occular treatment occupational therapy orthopedic J P job orientation programs jobs juvenile juvenile delinquents Pap smear test parenthood parole physical fitness physically handicapped physical therapy polio (infantile paralysis) poor prevention of blindness preventive medical services probation professional education programs psychiatric consultation to schools psychiatric help L legal legal services M marital hearings medical diagnosis medical equipment meeting place ..xxxiv'r- �CLUE WORDS P (CONTINUED) U psychiatric social workers psychological psychological psychiatric disorder p sychother apeutic public education unemployment compensation unwed mothers V R recreational Red Cross rehabilitation religious remedial education to deprived children retardation programs retarded children rheumatic fever rural government S scholarships scouts senior citizens services sheltered employment social activities social security social security payments social workers speech disorders spiritual surgical treatment veterans Vietnam bonus visually handicapped vocational counselling vocational information vocational placement vocational rehabilitation vocational training - general W welfare welfare delivery systems work-study programs Y youth youth education T training transportation tuberculosis -XXXV — �10001515ge I I I I I I I J. j 4:‘>-. < ♦ . i/ □ n ! f r hr, J r 1 �1 n ! 0 1 I 3 ! 1 i - ■? i*s‘ L-L J I � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Series VI of the Hugo Mailey papers: The Institute of Municipal Government and Institute for Regional Affairs publications, 1958-1980 Description An account of the resource Series VI: The Institute of Municipal Government and the Institute for Regional Affairs publications, 1958-1980, is arranged chronologically by publication date and contains annual reports, surveys, conference meetings, proceedings, inventories, and statistics on Wyoming Valley municipalities, institutions, and companies such as the Wyoming Valley Sanitary Authority and the Copley-Whitehall Sewer Company. Creator An entity primarily responsible for making the resource Institute of Municipal Government and Institute for Regional Affairs Date A point or period of time associated with an event in the lifecycle of the resource 1958-1980 Rights Information about rights held in and over the resource Wilkes University retains copyright of these publications. Format The file format, physical medium, or dimensions of the resource PDF Type The nature or genre of the resource Publications Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Health and Welfare in the Model Cities Neighborhood, 1971 Creator An entity primarily responsible for making the resource Institute for Regional Affairs Date A point or period of time associated with an event in the lifecycle of the resource 1971 Format The file format, physical medium, or dimensions of the resource PDF Type The nature or genre of the resource Publication Rights Information about rights held in and over the resource Wilkes University retains copyright of this publication.